Tactical approaches to treatment of obesity should be implemented taking into account predisposing factors and the etiology of the disease. First of all it is necessary to eliminate the possibility of predisposing aspects of disease to focus on treatment of accompanying diseases and functional disorders. When hypofunction of the ovaries need to adjust their work aimed at making up for the deficiency of hormones in the body.
The next moment, which must be strictly adhered to in the treatment of obesity, is a complete cessation of sexual life during treatment. It is necessary to survey and indications treatment of sexual partner. Treatment of vaginitis consists of local and General given the nature of the pathogen. Local treatment is to appoint a sedentary warm bath with chamomile extract. When thick purulent or mucous secretions is carried out irrigation of the vagina with a solution of bicarbonate of soda (2 tsp to 1 Cup water), and 20-25 minutes is douching with potassium permanganate.
In purulent fetid secretions douching is carried out with sulfuric acid zinc (2 tsp in 1 l water), copper sulphate (0.5 to 1 tsp. to 1 liter of water). At the termination of purulent discharge vaginal douching carried out with astringent. In resistant cases, apply vaginal baths: after a preliminary douching soda solution through a circular vaginal speculum is introduced 1-2 tbsp 2-3% solution of silver nitrate, 3-10% solution of protargol. After 2-3 minutes the liquid is removed. Vaginal baths are doing 2-3 days.
At the same time apply restorative treatment. When vaginitis is caused by Candida germ, recommended douching with a solution of copper sulfate (1 tablespoon of 2% solution in a glass of boiled water) or 1-3% solution of borax. At the same time, you must enter the vagina by means of tampons of 20% solution of borax in glycerine. In senile vaginitis should do douching with chamomile extract or one of the following solutions: boric acid, lactic acid,0,25% solution of zinc chloride, as well as introduce tampons with fish oil.
In secondary vaginitis need to treat the underlying disease. If there is no effective treatment, tendency to relapses and severe ovarian hypofunction recommended local application of estrogenic hormones in the form of emulsions or in combination with sea buckthorn oil in small doses (0,2-0,5) within 10-15 days (further indication). Antibiotics and sulfa drugs are prescribed after determining the sensitivity of the pathogen to them. They are used topically in the form of solutions and emulsions, and for General treatment.
In the treatment of gonorrheal vaginitis in the case of high sensitivity of gonococci to penicillin and tetracycline, it is recommended to use one of the following schemes. If gonococci are highly sensitive to the tetracyclines, is used amoksicilin oral dose of 3 g and probenecid at a dose of 1 g orally and once. Salt of benzylpenicillin (high sensitivity of gonococci to penicillin) administered once intramuscularly in a dose of 4-8 million IU once and probenecid oral dose of 1 g. the introduction of doxycycline orally 2 times a day in a dose of 100 mg for 2 days or tetracycline hydrochloride at a dose of 500 mg orally 4 two times a day for 7 days. Pregnant women tetracycline should not be assigned.
In areas where gonococci are less antibiotic resistant, kanamycin administered intramuscularly at a dose of 2 mg or thiamphenicol for 2 consecutive days oral 2.5 g of 1 times a day, it is possible to use trimethoprim 80 mg, sulfamethoxazole (400 mg) 10 tablets daily for 3 days. At high stability gonokokkov to antibiotics Ceftriaxone administered intramuscularly at a dose of 250 mg, cephalosporin or 3rd generation, or ciprofloxacin single oral dose of 500 mg, or quinolone, or spectinomycin intramuscularly at a dose of 2 mg.
Infections vaginal Trichomonas, treat the introduction of metronidazole oral 2 g as a single dose. Metronidazole has antimicrobial activity and activates phagocytic and antimicrobial functions of macrophages. Sexual partners of women with trichomoniasis should be treated once metronidazolum in an amount of 2 g. Metronidazole is contraindicated in 1st trimester of pregnancy, but if necessary can be used during 2nd and 3rd trimesters.
Pregnant and lactating women, patients with Trichomonas vaginitis, use alternative regimen: clotrimazole intravaginally at 100 mg every evening during the week. When this occurs the weakening of symptoms, but healing only happens in 1/5 of the patients. Treatment of Trichomonas vaginitis in lactating women spend metronidazole (single oral dose 2 mg), cease breastfeeding for 24 hours.
With candidiasis, prescribe topical application of any one drug from a wide range of imidazolone antifungal agents (miconazole, clotrimazole, econazole, butoconazole, terconazole) or a polyene (nystatin or candicidin). The imidazolov allow the use of a shorter course of treatment. Nystatin is administered 100 000 – 1 000 000 IU intravaginally, daily for 14 days. Miconazole or clotrimazole administered at 100 mg intravaginally daily for 7 days. Perhaps the introduction of miconazole or clotrimazole 200 mg intravaginally, daily for 3 days. Colpitis treat chlamydia taking doxycycline orally 2 times a day in a dose of 100 mg for 7 days. Perhaps the appointment of tetracycline hydrochloride orally 4 times a day in a dose of 500 mg for 7 days.
Alternative regimens for patients who cannot tolerate the drugs of the tetracycline group, are to use oral erythromycin at a dose of 500 mg 4 times daily for 7 days or 250 mg orally 4 times a day for 7 days. Perhaps the appointment of sulfafurazole. Oral dose of 500 mg 4 times a day for 7 days.