Sexually transmitted infections in Pakistan

Sexually transmitted infections [STIs] represent a major global health problem leading to morbidity, mortality and stigma. Prior to this study there was no information on the prevalence and knowledge of STIs in Faisalabad, Pakistan. Prospective, cross-sectional study in patients attending STI clinics from July 2006 to September 2009. After obtaining consent, patients completed structured questionnaires used for behavioral surveys. Blood and urethral swabs were collected and tested for syphilis, gonococcus, genital herpes, chlamydia and chancroid. Mean [standard deviation] age of the 1532 participants was 38.9 [9.4] years, including 37.8 [10.2] years for males and 35.5 [6.3] years females. Male gender [n=1276, 83.3%], low socioeconomic class [n=1026, 67.0%] and residence in rural suburbs [n=970, 63.3%] were more common. Most [n=913, 59.6%] were aware of the modes of transmission of STIs and the associated complications, 20% [n=306] were condom users, and 21.2% [n=324] had knowledge of safe sex. Opposite-sex partners were preferred by 972 [63.4%] patients, while 29.9% [n=458] had both homosexual and heterosexual sex partners. Syphilis was present in 29.5% of patients [n=452]; gonorrhea, in 13% [n=200], HSV-2, in 3.2% [n=49], chlamydia, in 4.7% [n=72] and chancroid, in 1.3% [n=20]. This report establishes baseline local prevalence rates for STIs. Syphilis emerged as the most prevalent STI in Faisalabad. Population-based studies are required to study the epidemiology of STIs, along with initiation of national health-education campaign

Genitourinary infections: a leading cause of chronic urticaria in married females

Chronic urticaria [CU] is a common clinical problem in dermatological practice. Characterized by intense itching and fleeting erythematous weals, the condition persists beyond six weeks. It can occur at any age and in both sexes. Many etiological agents may be held responsible, but in a sizeable number of patients it is difficult to reach a definitive cause. It was our clinical impression that CU in married ladies was commonly related to genitourinary tract infections [GUTIs] but no clinical details were available. Therefore we designed this study to work out causes of urticaria in married ladies, and the possible role of GUTIs in this condition. All the married ladies with urticaria of more than 6 weeks were enrolled from outdoor clinics of dermatology, Quaid-e-Azam Medical College, Bahawal Victoria Hospital and Allama Iqbal Medical college, Jinnah Hospital Lahore, over a period of 18 months. They were thoroughly investigated, managed and findings were recorded. Along with recurrent weals, almost half of the patients had additional symptoms. GUTIs lead to CU in 39 ladies, drugs in 13, scabies in 6, helminthiasis in 3, intrauterine contraceptive device [copper T] in 2, dental caries, chronic hepatitis, amoebiasis and chronic sinusitis 1 patient each. In 36 cases no cause was found for CU and were labelled as idiopathic. It is therefore concluded that GUTIs are an important cause of CU and should be looked for while investigating such a case