Rizact

Keith S. Meredith, MD

• Regional Vice President
• Mountain Region
• Pediatrix/Obstetrix Medical Group
• Phoenix, Arizona

In another animal study knee pain laser treatment cheap 10mg rizact amex, no observable signs of mortality or toxicity were shown when the dry leaf decoction (1 g plant matter/mL extract) was given orally to mice (18 breakthrough pain treatment guidelines purchase rizact now. Contraindications: No information is available on the safety of this plant in children and pregnant or lactating women (Germosen-Robineau 2005) treatment pain between shoulder blades buy 5mg rizact with mastercard. Major chemical constituents of this plant include the following: proanthocyanidins (CaballeroGeorge et al pain treatment center franklin tennessee 5 mg rizact. The leaves contain caffeine (Duke & Beckstrom-Sternberg 1998) narcotic pain medication for uti discount rizact 10mg otc, and the bark contains flavonoids: epicatechin and procyanidin derivatives (Hor et al the pain treatment & wellness center hempfield boulevard greensburg pa cheap rizact 5 mg visa. The recommended dosage is a decoction of 12 g crushed leaves in 1 liter (4 cups) of water, boiled for at least 10 minutes in a covered container, strained, cooled and taken orally in the amount of 3-4 cups daily (Carballo 1995B, Caceres 1996, Germosen-Robineau 2005). Biological screening of selected medicinal Panamanian plants by radioligand-binding techniques. Screening of antibacterial activity of medicinal plants from Belize (Central America). Antiviral effect of Guazuma ulmifolia and Stryphnodendron adstringens on Poliovirus and Bovine Herpesvirus. Determinacion de parametros farmacologicos en vegetales utilizados en medicina tradicional en la Cuenca del Caribe. Laboratorio de fitofarmacologia, Departamento de Farmacologia, Facultad de Salud, Universidad del Valle, Cali, Colombia. Inhibition of intestinal chloride secretion by proanthocyanidins from Guazuma ulmifolia. Antibacterial, antiprotozoal and antioxidant activity of five plants used in Izabal for infectious diseases. Traditional Preparation: Typically prepared as a tea by decoction or infusion and often combined with other plants. For infections (in general), contaminated blood (mala sangre) and to cleanse the blood, guajabo leaves are combined with coffee (cafe) leaves and boiled in water to make a decoction that is taken orally as a tea. This remedy may be prepared with golden shower tree (canafistula) bean pods and pineapple (pina) fruit rind. For diarrhea and intestinal parasites, a tea is prepared with guajabo leaves and/or flowers combined with the leaves of coffee (cafe), wild privet senna (sen) and wormseed (apazote). To treat skin disorders (including pano), the leaves are prepared as a decoction and used externally as a wash. Availability: Dried leaves can be purchased from select botanicas (Latino/Afro-Caribbean herb and spiritual shops) in New York City. Leaves are pinnately compound with 5-12 pairs of opposite leaflets which are oblong to oval in shape, thin and papery in texture, fuzzy on the underside and rounded at the tip with a strongly asymmetric base and smooth leaf-edges. Fruits are leguminous seeds pods (10-17 cm long), oblong in shape with a longitudinal wing along the side of the opening and contain wedge-shaped, brown seeds (Acevedo-Rodriguez 1996). Distribution: this plant is most likely native to the South America, particularly the Orinoco and Amazon basins, but is naturalized throughout the tropics, including the Caribbean. It grows in moist, open areas, is somewhat uncommon and is sometimes cultivated in gardens (Acevedo-Rodriguez 1996). These side-effects included abdominal pain, diarrhea, dyspepsia and nausea (Thamlikitkul et al. For topical use, one clinical trial conducted in India reported that no negative side-effects were observed when the aqueous leaf extract was administered as a single application for the treatment of skin fungal infection (Domadaran & Venkataraman 1994). Animal Toxicity Studies: Animal studies have shown that this plant is relatively safe and non-irritating when applied topically and has not shown toxic effects when administered orally. No evident clinical signs of adverse effects were observed in rabbits when an aqueous extract of the fresh leaf (20%; macerated for 1 hour) was applied (0. In mice, no signs of toxicity were observed when the hydroalcoholic leaf extract (10 g dry plant/kg body weight) was administered orally and subcutaneously (Mokkhasmit et al. Results of histopathology studies did not reveal any organic damage, so this extract was determined to be nontoxic in this study (Martinez, Morejon, Lopez et al. Contraindications: Contraindicated in patients with: intestinal obstruction (due to stimulation of peristalsis), gastrointestinal inflammatory disease (due to potential irritation), anal prolapse (due to aggravation of bowels actions), hemorrhoids (due to potential induction of prolapse, stenosis and thrombosis), pregnancy (may cause endometrial stimulation although shown to be safe during pregnancy in human clinical trial), lactation (due to potentially genotoxic and mutagenic constituents), children under age 12 (due to potential dehydration), extended use (due to damage) and abdominal pain or appendicitis of unknown origin (due to the possibility of rupturing by contracting an inflamed organ; Brinker 1998). Drug Interactions: Diuretics (may aggravate potassium loss if co-administered), cardiac glycosides (if herb is over-used or misused, may increase the toxicity of these drugs; Brinker 1998). Leaves and leaf extracts of this plant have demonstrated the following pharmacological effects in laboratory and animal studies: adherence inhibition, anti-inflammatory, antimicrobial, antiplatelet and dermatophilosis improvement (see Laboratory and Preclinical Data table below). Biologically active compounds identified in this plant include: aloe emodin, chrysophanol, emodin and rhein; and in the leaf include: chrysarobin, dihydroxymetholanthraquinone, rhein glycoside and tannin. For skin infections, pimples or bumps (granos) on the skin, chop 50 grams of the leaf (15-20 small leaves) and add them to 1 liter (4 cups) of boiled water; let it sit for 12 hours to infuse; and use this decoction to wash the affected area 2-3 times per day (note: this preparation will not keep for more than 24 hours and should be prepared fresh daily). For skin fungal infections: wash the affected area with soap and water, wash the laves, crush them to make a poultice and apply 1 spoonful 263 (5 grams) of this vegetal matter topically on the affected area; cover with a bandage or clean cloth and change 3-4 times daily (Germosen-Robineau 2005, Giron 1988). Clinical Data: Senna alata Activity/Effect Preparation Design & Model Results Reference Constipation Leaf infusion (120 Multicenter Showed significant Thamlikitkul et treatment mL) administered at randomized laxative effect (P < al. Treatment of bovine dermatophilosis with Senna alata, Lantana camara and Mitracarups scaber leaf extracts. Antiinflammatory activity of heat-treated Cassia alata leaf extract and its flavonoid glycoside. Thamlikitkul V, Bunyapraphatsara N, Dechatiwongse T, Theerapong S, Chantrakul C, Thanaveerasuwan T, Nimitnon S, Boonroj P, Punkrut W, Gingsungneon V et al. Traditional Preparation: Typically the leaves are prepared as a tea by infusion or decoction for a short period of time. Traditional Uses: For the common cold or flu, a tea is prepared using the leaves of guanabana combined with cinnamon (canela) bark, acerola cherry (cereza) leaves and bitter orange (naranja agria) leaves. Guanabana leaves are used to support recovery from musculoskeletal injury, typically prepared as a tea in combination with lemongrass (limoncillo) leaves, sweet orange (naranja) leaves and lime/lemon (limon) fruit. For menopausal hot flashes, a tea is prepared of the leaves and is considered a relaxant, often combined with the leaves/stalk of lemongrass (limoncillo). To calm down anxiety and nerves (los 266 nervios), a sedative tea is prepared of the leaves along with lemon/lime (limon) or sweet orange (naranja) leaves and taken internally. The fruit is thought to be cold (frio) or cooling (fresco) and is used as a diuretic and to lower fever. Healers consider the leaves of this plant to be potentially toxic if taken in large doses, so caution is advised and only small to moderate amounts of the tea should be taken internally. To avoid extracting too many toxins from this potent plant, herbalists advise that the leaves be boiled only for a very short period of time when preparing a tea/decoction. Herbalists contraindicate eating the fruit during pregnancy or menstruation because it is attributed very cold properties which could cause complications such as menstrual cramps, the accumulation of phlegm and mucha frialdad en la matriz (lots of coldness in the womb). Availability: Fruits are available in season on a limited basis (as they are highly perishable) at ethnic grocery stores, food markets and fruit stands in Latino/Caribbean neighborhoods. Dried leaves can be purchased from botanicas that specialize in selling Caribbean medicinal plants. Leaves are alternate and narrowly oval (6-17 cm long) with a thin, papery texture, shiny surface and smooth leaf edges that curl up slightly. Fruits are fleshy and shaped like a rounded or elongated heart (15-30 cm long) with green skin and covered with small bumps or lumpy spine-like projections. Seeds are numerous, dark brown and surrounded by a tart, white pulp (Acevedo-Rodriguez 1996). Distribution: Native to tropical America, this plant grows in the Caribbean and is often found in disturbed areas (Acevedo-Rodriguez 1996). Potentially neurotoxic compounds have been identified in the leaves and other parts of Annona muricata and other members of the plant family Annonaceae; however, these compounds were not detected in the fruit pulp or seeds. Uptake and accumulation of these benzylisoquinoline derivatives in the brain may be related to the high incidence of atypical levodopa-resistant Parkinsonism and progressive supranuclear palsy in Guadeloupe in the French West Indies (Kotake et al. Animal and Laboratory Toxicity Studies: No mortality was observed in mice given 1-5 g/kg of the aqueous decoction orally (Saravia 1992). The leaves administered orally to rats resulted in fibrosarcomas, and the topical application in hamsters caused skin cancer development (OGara et al. Plants in the family Annonaceae have been shown to contain annonaceous acetogenins which are powerful, lipophilic complex I inhibitors. Annonacin has been shown to be toxic to mesencephalic dopaminergic neurons by impairing energy metabolism (Lannuzel et al. These results suggests that ingestion of Annonaceae plants may play a role in the development of Guadeloupean Parkinsonism (Champy et al. Results suggest that alkaloids from Annona muricata can modulate the function and survival of dopaminergic nerve cells and could conceivably cause neuronal dysfunction and degeneration after repeated consumption (Lannuzel et al. The edible portion of the fruit (the white pulp) is a source of potassium and vitamins B1, B2 and C (U. Laboratory and Preclinical Data: Annona muricata Activity/Effect Preparation Design & Model Results Reference Antioxidant Ethanol extract of In vivo: albino rats Inhibited cold Padma et al. Possible relation of atypical parkinsonism in the French West Indies with consumption of tropical plants: a case-control study. Annonacin, a lipophilic inhibitor of mitochondrial complex I, induces nigral and striatal neurodegeneration in rats: possible relevance for atypical parkinsonism in Guadeloupe. Proliferative lesions in check and esophagus of hamster treated with plants from Curacao. Muricoreacin and murihexocin C, mono-tetrahydrofuran acetogenins, from the leaves of Annona muricata. Kotake Y, Okuda K, Kamizono M, Matsumoto N, Tanahashi T, Hara H, Caparros-Lefebvre D, Ohta S. Detection and determination of reticuline and N-methylcoculaurine in the Annonaceae family using liquid chromatography-tandem mass spectrometry. Journal of Chromatography B: Analytical Technologies in the Biomedical & Life Sciences 806(1):75-8. Toxicity of Annonaceae for dopaminergic neurons: potential role in atypical parkinsonism in Guadeloupe. The mitochondrial complex I inhibitor annonacin is toxic to mesencephalic dopaminergic neurons by impairment of energy metabolism. Effect of alcohol extract of Annona muricata on cold immobilization stress induced tissue lipid peroxidation. Effect of the extract of Annona muricata and Petunia nyctaginiflora on Herpes simplex virus. Five novel mono-tetrahydrofuran ring acetogenins from the seeds of Annona muricata. Recherche de quelques activites pharmacologiques traditionnelles dAnnona muricata et dAnnona reticulate chez lanimal. Traditional Uses: the beans (pigeon peas) of this plant are used for nutrition and nourishment and prepared as a part of Dominican culinary traditions. For arthritis and joint pain, the leaf is applied locally to the affected area to relieve pain and inflammation. To induce abortion, the root of this plant is boiled to make a strong decoction and taken internally as a tea. In the Caribbean, this plant is used to treat toothache and conjunctivitis (Germosen-Robineau 1995). Availability: Dried roots can be purchased from select botanicas in New York City. Beans can be purchased from grocery stores and supermarkets, especially in Latino and Caribbean neighborhoods. On the underside, leaves have yellow spots, resinous dots and are covered with whitish, woolly hairs. Flowers are yellow and red, grow in loose clusters at the 271 tip of the stem and have bracts and sepals covered with short, rust-colored, wooly hairs. Fruits are oblong bean pods covered with short, soft, gland-bearing hairs and are slightly constricted around the seeds which are green, turning light brown as they mature (Acevedo-Rodriguez 1996). Distribution: Thought to be native to Africa, this plant is an important grain legume that is widely cultivated throughout the tropics and primarily produced in India (Acevedo-Rodriguez 1996). No data on the safety of the leaves or root in humans has been identified in the available literature. Animal Toxicity Studies: In rats, the whole plant administered intraperitoneally resulted in toxic effects at 100 mg/kg and at 112. Guandul has shown the following effects in preclinical studies: antimalarial (Yarnell et al. Cajanone, an isoflavone from the seed and root, has demonstrated antimicrobial and antifungal properties (Dhar et al. Phenylalanine is the active constituent responsible for the antisickling effects of the seed extract (Ekeke & Shode 1990). In addition to hypoglycemic properties, the seed has demonstrated activity in restoring erythrocyte morphology in blood samples from individuals with sickle-cell anemia (Iwu et al. Cajanus cajan is recognized by the Pharmacopeia of Oriental Medicine, 1968 edition (Penso 1980). Compounds identified in the plant include: 2hydrozygenistein, cajanone and ferreirin; root: 2 0methylcajanone, alpha-amyrin, cajaflavanone, cajaisoflavone, cajaquinone, geinstein, isogenistein-7-0glucoside, lupeol; and seed: cajanin and concajanin (Duke & Beckstrom-Sternberg 1998). The cooked beans are high in potassium and phosphorus, contain moderate amounts of calcium and magnesium and have a low content of iron, zinc, copper and manganese (Nwokolo 1987). The raw beans also contain significant amounts of vitamins B1, B2, B3, B5 and B6 (U. To validate the efficacy of traditional use, more research is needed on the antiinflammatory and analgesic effects of the leaf (Germosen-Robineau 1995). Laboratory and Preclinical Data: Cajanus cajan Activity/Effect Preparation Design & Model Results Reference Antibacterial & Dry leaf extract; 50 In vitro Active against Bacillus Boily & Van antituberculosis mg/mL dose subtilis, Staphylococcus Puyvele 1986 aureus & Mycobacterium smegmatis Antimicrobial Leaf decoction In vitro Active against strains of Kambu et al. Screening of medicinal plants of Rwanda (Central Africa) for antimicrobial activity.

This food source plays an important role in pig feeding pain treatment center colorado springs co generic 10mg rizact mastercard, especially in free range and small-scale production systems pain medication for dogs after dental surgery order 5mg rizact overnight delivery. Crops and by-products include sweet potato vines pain medication for dogs carprofen order rizact 5 mg, kales tuomey pain treatment center order rizact 5mg otc, cabbages pain treatment herniated disc buy generic rizact 5mg, Napier grass iasp neuropathic pain treatment guidelines cheapest rizact, sugar cane cuttings, sugar cane tops, garden weeds, mangoes, tomatoes, oranges, avocadoes, peelings and market byproducts/waste. The use of feeds such as cereal residues, cassava and potatoes has been shown to save up to 20 percent on feed costs for growing pigs and 50 percent for breeding pigs. Other by-products include brewers waste, rumen contents and slaughter blood from slaughter slabs. Another source of feedstuffs for pigs is swill from schools, hotels and government institutions. Some institutions, especially schools and prisons, feed their own pigs with the available kitchen leftovers. The drawbacks are that the safety, amount and quality of feed is not guaranteed and pigs fed inadequate and unbalanced diets will have low weight gains. In the free range systems common to Nyanza and Western Kenya, pigs are primarily fed on pasture grasses of various types, crop residues, crop by-products, cassava, sugar cane, sweet potato tubers and vines, ugali and kitchen leftovers. Sweet potato tubers and vines are frequently fed to pigs in these areas with the vines providing, if used appropriately, a year round source of pig feed. Farmers are encouraged to plant dual-purpose varieties of sweet potato tubers which are rich in carbohydrates, vitamins and minerals. Uncooked peelings of sweet potatoes, cassava and bananas from household consumption are given to the pigs, as well as whole cassava or sweet potatoes (either raw or cooked), and posho mill waste (fagia) which is cooked and may be mixed with kitchen leftovers and offered to the pigs. Kitchen leftovers contain many of the essential nutrients required for a healthy balanced diet. Their composition has been found to be adequate in protein and energy but low in dry matter content, which affects growth in younger animals and should be addressed by supplementing with other feeds. Blood contains up to 80 percent protein and is another source of easily digestible protein for pigs. The contents of the rumen of slaughtered cattle have also been found to have a good crude protein composition, suitable for pigs. The pigs are either tethered and the feed brought to them, or they are left to roam and feed from various sources. Sometimes the pigs are untethered and taken to surrounding marshy and watering areas for a bath and to feed on earthworms as a source of protein although these excursions are as often a source of infection by ascarids and lungworm. Most farmers feed their pigs no more than three times a day, with the majority feeding the pigs twice a day, morning and evening. In the complete free range/backyard system found in slum areas around major towns and cities, the pigs roam garbage heaps, pits, disposal areas and dump sites where they eat any edible by-products, swill and domestic waste. In some small-scale commercial system common in Central, Eastern, Central and North Rift Valley and parts of Western and Nyanza Provinces, pigs are fed on commercial feeds and supplemented with swill, kitchen leftovers, market by-products/ waste and crop residues. Most farmers provide the pigs with crop residues as feed, bedding and also a source of organic farmyard manure. Piggeries are often established near official institutions owing to the availability of swill. However, there are small-scale commercial farmers in these areas who feed their pigs exclusively on commercial feeds. The pigs are fed twice a day according to their age, production status and type of feed. The weaners, sows, boars, gilts and early fattening stage pig are fed on Sow & Weaners meal while the baconers/finishers are fed on Pig Finisher meal. Most farmers will have a feeding table as shown below from the Department of Livestock Production. Some small-scale farmers have formed cooperatives to manufacture cheaper and higher quality pig feed. In the large-scale commercial pig-keeping systems common in Central Kenya, Nairobi, Central and North Rift Valley, the pigs are fed on commercial feeds according to age and production status. The weaners, sows, boars, gilts and early fattening-stage pigs are fed Sow & Weaner meal while the baconers/ finishers are fed Pig Finisher meal. Most farmers use Sow & Weaner feed across the board, with the recommended amount given over the course of the day, usually morning and evening. The feeding regime generally follows that set out in the recommendations from the Department of Livestock Production, as shown below. In these cases, its field officers monitor and advise on feeding, to produce quality finished pigs. Animals brought to market include cattle, sheep, goats, donkeys and camels but not pigs. The farmer calls the trader, or traders visit the farmers, especially in the traditional free range systems where traders move from village to village looking for pigs. There is hope that it will be revived but for the time being there is no organized or regular sale of stock. In the meantime, there is a drive to organize pig farmers into groups and cooperatives able to organize and manage live pig trade markets. Farmers Choice Limited Kenyas largest abattoir is located at Kamiti, on the outskirts of Nairobi City. This facility combines slaughtering and processing, and is a private company established in 1975 as Kenya Meat Processors Ltd. The original purpose was to supply the Groups hotels with reliable pork products. In the late 1980s, Farmers Choice acquired an export license when it built a slaughter and processing plant licensed for export by the Kenyan Government. It is connected to the Nairobi Water and Sewerage Company main line and has a borehole to supplement the water supply. The factory slaughters 400 pigs per day and processes 350 pig carcasses per day into products such as ham, bacon, sausages and burgers. Products from the factory has a number of outlets in the domestic market: tourist hotels around Nairobi (20%); tourist hotels at the coast (10%); lodges and institutions (5%); major supermarkets (Uchumi, Nakumatt, Tuskys) (15%); other mass markets (kiosks, retail outlets) (50%). The company has its own refrigerated vehicles which transport over 90 percent of the products to various destinations in Kenya and neighbouring countries. Version du 17 novembre 2011 20 Trade, marketing and markets Ndumboini Farm slaughter house this dedicated abattoir, established in 1972, is located in Kiambu County, Kikuyu District on the western outskirts of Nairobi. It is located on a private farm owned by David Kiarie, and receives pigs from Malaba, Bungoma, Kimilili and Busia in Western Province; Kisumu, Homabay and Migori in Nyanza; Nakuru, Kitale, Kajiado, Ngong and Eldoret in the Rift Valley; Thika, Nyeri, Kiambu, Kabete and Muranga in Central; and Ruai, Kibera and Dandora slums in Nairobi. One pig trader transports 40 to 80 pigs here every week from Homabay and Migori districts. These pigs have a variety of skin colours and are seen in the overnight holding pens. There is an effluent treatment plant, the sludge from which is used as manure for the farm crops. This abattoir is the main supplier of pork to most of the butcheries in Nairobi city centre, as well as its estates and outskirts. The meat is transported in well-labelled clean containers by bicycle, motorcycles and four-wheeled vehicles (mainly pickups). Oscar Food Industries, Chefs Choice and Olive Enterprises (Limuru) buy carcasses from Ndumboini Farm slaughter house for processing at their premises into value-added products such as sausages and burgers. It is on the site of a coffee farm and slaughters between six and ten pigs a day from Ruai, Dandora, Mathare and Embakasi in Nairobi; and from Limuru, Ndumberi and Kiambu Town in Kiambu. Blood byproducts go into a disposal tank while ingesta are used as farm manure and intestines are cleaned and sold for human consumption. Outlets for the carcasses include Nairobi City Market butcheries, several hotels, popular entertainment places and supermarkets. Clover Foods and Lemok Enterprises source pork for their products from Lyntano slaughter house. Cattle, sheep and goats are slaughtered in one section while pigs are slaughtered in the other, keeping the two operations separate. The facility is well-constructed and maintained, with separate areas for the clean and dirty operations and an adequate supply of water from a borehole. Operation areas are clean, sludge from the effluent treatment plant goes into farmyard manure, and offal by-products are used for human consumption. The abattoir kills between 18 and 25 pigs per day, limited only by the shortage of pigs for slaughter. Most of the pigs are supplied by small-scale farmers in the district, with a few from Thika, Machakos, Nyeri, Nyahururu and Kirinyaga and Kitale. The main market for the carcasses is Thika Town which is thought to lead Kenya in pork consumption and has many pork butcheries and eateries. One pork outlet, Thika Pork Centre, retails an average of 500 kg per day through four butcheries in the town. These enterprises own butcheries in Nairobi (Kenyatta Market) and Nakuru (Utugi and Ngae) where the pork is sold. Pig-raising areas in major cities, towns and rural districts generally have several slaughter slabs varying in type and hygiene standards. One style is a simple pole structure in the open air where the carcasses are hanged and flayed. Another type is an open concrete structure with a killing floor, while still others are roofed and equipped with a disposal and condemnation pit. Note the advertisements Meat inspection at most of these slaughter slabs is carried out by the Department of Veterinary Services, although it was observed that no inspection was performed in open air slaughter slabs common among the free range traditional systems. Here butchers slaughtered their pigs and sold them, with no license or inspection, at the pork butcheries and eateries dotting the town centres and residential areas. Hoping to stimulate the market for value-added products, the Kenyan Government has been encouraging the private sector and local authorities to establish small abattoirs and meat-processing facilities. Others buy weaned and growing pigs which they keep and fatten for slaughter (weaner-to-finisher). Among small-scale pig farmers in some rural areas, a farmer notifies neighbours before he slaughters a pig, and requests that they book the amounts they wish to buy. If the farmer gets enough booking in terms of weight, the pig is slaughtered, inspected and the booked amounts distributed to the neighbours. In Western Kenya, among the traditional free range systems, a farmer informs neighbours about slaughtering a pig by means of a hilltop drum. The neighbours get the message and come for various amounts of the uninspected meat. The system is well-organized and value is added to every product along the value chain. A proliferation of small firms processing pork at various levels in Kenyas major towns has improved the market situation and is encouraging local communities to eat this meat. Previously, over 80 percent of pork and pork products were consumed by the rich and by tourists but this consumption pattern is now changing. In Western Kenya and Nyanzas free range traditional systems, butchers and pig traders move from homestead to homestead and village to village buying slaughter pigs. Some are slaughtered locally while other are transported to Ndumboini slaughter house near Nairobi. In the small-scale enterprises, the farmers will inform the traders and butchers when their pigs are ready for slaughter. Others will visit Farmers Choice and secure a supply order when the pigs are mature. Live pigs are transported by truck from western Kenya and Nyanza to Kiambu West slaughterhouse. Farmers Choice moves pigs from North Rift Valley, Kiambu and Nairobi to their abattoir in Kamiti. In Central Province, Eastern and Central Rift Valley (Nakuru), trade routes branch out from the abattoirs, with the pork being transported by container by bicycle, motorcycle and vehicles to various market butcheries where consumers buy meat. Farmers Choice and various smaller pork processing companies create a variety of valueadded products from the slaughter house pork. Farmers Choice sell to the export market while the remainder sell their products in the local market. Smaller market outlets include Oscar Foods, Gourmet Bacon, Nairobi Airport Services, Chefs Choice and Kenya Cold Storage. Small butcheries in major towns are beginning to take off, and some enterprising farmers are looking for export markets in the region and beyond. Pork barbeque joints are also becoming common in a number of urban centres such as Thika, Nyeri, Kerugoya, Nakuru, Eldoret Trans Nzoia, Kakamega and Kajiado. Imports are regulated by the Department of Veterinary Services and are allowed from certified countries. Import licenses are issued after a risk assessment of the original source of the imports. Twenty five percent of the total Farmers Choice factory output of processed pork products is exported. These include special cuts of meat, value-added pork products such as ham, bacon and sausages. Farmers Choice products are sent by land, sea and air, from the factory to destinations worldwide. In this tradition, a young boy is expected to visit his uncle who will give him a female piglet as a gift. No preparations are made to house or feed the piglet; it is fed on kitchen leftover and pasture.

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It is used to treat serious infections due to Gram-positive cocci including meticillin-resistant staphylococcal infections pain treatment center johns hopkins buy rizact visa, brain abscess midwest pain treatment center beloit wi order 5 mg rizact with mastercard, meningitis pain treatment doctors safe 5 mg rizact, and septicaemia and should be used in a hospital setting only treatment pain during intercourse 5 mg rizact amex. Uses: meticillin-resistant staphylococcal pneumonia; septicaemia related to vascular catheter; meningitis; antibiotic-associated colitis; endocarditis prophylaxis (with gentamicin) pain management for osteosarcoma in dogs generic 10mg rizact with amex. Precautions: avoid rapid infusion (risk of anaphylactoid reactions allied pain treatment center buy rizact 10mg line, see Adverse effects); rotate infusion sites; renal impairment (Appendix 4); the elderly; history of deafness (avoid); monitor plasma vancomycin concentration after 3 or 4 doses (earlier in the elderly and in renal impairment), blood counts, urine, and renal function; monitor auditory function in the elderly or in renal impairment; pregnancy (Appendix 2) and breastfeeding (Appendix 3); interactions: Appendix 1. Anti-infective medicines erythema multiforme (Stevens-Johnson syndrome), toxic epidermal necrolysis, and vasculitis; phlebitis; severe hypotension (with shock and cardiac arrest), wheezing, dyspnoea, urticaria, pruritus, flushing of the upper body (red man syndrome), pain, and muscle spasm of the back and chest on rapid infusion. The incubation period between infection and appearance of leprosy is normally between 2 and 10 years, but may be up to 20 years. It is transmitted from person-to-person when bacilli are shed from the nose; most individuals have natural immunity and symptoms are suppressed. The two forms may be distinguished by skin smears, but facilities are not always available to process them and their reliability is often doubtful. Medicines used in the treatment of leprosy should always be used in combination; this is essential to prevent the emergence of resistance. Lepra reactions are episodes of sudden increase in the activity of leprosy and are often accompanied by neuritis; reactions must always be treated promptly to prevent permanent nerve damage and disability. Leprosy multidrug therapy should continue during a lepra reaction without interruption. If there is nerve involvement, corticosteroids such as oral prednisolone (section 3) should be used in addition to analgesics. Therapy for type 2 reactions may include analgesics, such as acetylsalicylic acid or paracetamol, and a corticosteroid, such as oral prednisolone. Severe type 2 lepra reactions should be treated under medical supervision in hospital. If a patient does not respond to lepra reaction treatment within 6 weeks or their condition worsen, the patient must be sent immediately to the nearest specialist centre. It can be successfully treated with a 12-week course of oral prednisolone (section 18. For example, dapsone, 25 mg daily, clofazimine, 50 mg twice a week, and clofazimine, 100 mg and rifampicin, 300 mg once a month. Precautions: pre-existing gastrointestinal symptoms (reduce dose; increase dose interval or discontinue if symptoms develop during treatment); liver and renal impairment; pregnancy (Appendix 2); and breastfeeding (Appendix 3); may discolour soft contact lenses. Adverse effects: reversible discoloration of skin, hair, cornea, conjunctiva, tears, sweat, sputum, faeces, and urine; dose-related gastrointestinal symptoms including pain, nausea, vomiting, diarrhoea, weight loss, and gastrointestinal bleeding; severe mucosal and submucosal oedema, with prolonged treatment with high doses (may be severe enough to cause subacute small-bowel obstruction; see also Precautions); dry skin, acne-like eruptions, rash, pruritus, photosensitivity reactions, decreased sweat production; dry eyes; rarely headache, drowsiness, dizziness, taste disorders, and elevation of blood glucose concentration. On long-term treatment patients and their carers should be told how to recognize blood disorders and advised to seek immediate medical attention if symptoms such as fever, sore throat, rash, mouth ulcers, purpura, bruising, or bleeding develop. Adverse effects: haemolysis and methaemoglobinaemia; allergic dermatitis (rarely including toxic epidermal necrolysis and Stevens-Johnson syndrome); rarely hepatitis and agranulocytosis; dapsone syndrome resembling mononucleosis (a rare hypersensitivity reaction with symptoms including rash, fever, jaundice, and eosinophilia); gastrointestinal irritation; tachycardia, headache, nervousness, insomnia, blurred vision, paraesthesia, reversible peripheral neuropathy, and psychoses reported. Precautions: hepatic impairment (reduce dose; Appendix 5); monitor liver function and blood counts in liver disorders, alcohol dependency, the elderly, and in those on prolonged therapy; renal impairment (if dose above 600 mg daily; Appendix 4); pregnancy (Appendix 2) and breastfeeding (Appendix 3); porphyria; discolours soft contact lenses; important: advise patients on oral contraceptives to use additional means; interactions: Appendix 1. Resumption of rifampicin treatment after a long interval may cause serious immunological reactions, resulting in renal impairment, haemolysis, or thrombocytopenia; discontinue permanently if serious adverse effects occur. Patients or their carers should be told how to recognize signs of liver disorders and advised to discontinue treatment and seek immediate medical attention if symptoms such as persistent nausea, vomiting, malaise, or jaundice develop. Adverse effects: severe gastrointestinal disturbances including anorexia, nausea, vomiting, and diarrhoea (antibiotic-associated colitis reported); headache, drowsiness; rash, fever, influenza-like syndrome and respiratory symptoms, collapse, shock, haemolytic anaemia, acute renal failure, and thrombocytopenic purpura (more frequent with intermittent therapy); alterations of liver function) jaundice, and potentially fatal hepatitis (doserelated; do not exceed maximum daily dose of 600 mg); oedema, muscular weakness and myopathy, exfoliative dermatitis, toxic epidermal necrolysis, pemphigoid reactions, leukopenia, eosinophilia, and menstrual disturbances also reported; urine, tears, saliva, and sputum coloured orange-red. Infection is usually due to inhalation of infected droplet nuclei with the lung generally being the first organ affected. The primary infection is usually asymptomatic, and infection and inflammatory responses resolve with the development of acquired immunity. Surviving bacteria may become dormant, or in susceptible patients, progress to active primary disease; dormant organisms may later produce disease and this often occurs if immune status is altered. Tuberculosis is the most prevalent infectious disease of adults and causes 26% of avoidable adult deaths in the developing world. Simplified drug regimens and intermittent therapy have been introduced to improve compliance. Anti-infective medicines the patient was receiving a 3 times weekly or daily dose regimen. Therefore, there is a greater risk of treatment failure with twice weekly regimens. Fixeddose combination tablets incorporating two or more drugs are used to improve compliance and decrease medication errors; they should be used unless one of the components cannot be given because of resistance or intolerance. The initial phase (2 months) involves the concurrent use of at least 3 drugs to reduce the bacterial population rapidly and prevent drug-resistant bacteria emerging. Direct observation of therapy is considered essential to ensure compliance in the initial phase and is also useful in the continuation phase, especially if patients are receiving rifampicin. Unsupervised and alternative regimens as set out in the following tables may be administered as specified. Chemoprophylaxis with isoniazid can prevent the development of clinically apparent disease in persons in close contact with infectious patients, and also prevent the reactivation of previously dormant disease in other persons at high risk particularly those who are immunodeficient. Anti-infective medicines Diagnosis the tuberculin test has limited diagnostic value. Anti-infective medicines 1 Continuation phase (antibacterials administered daily or 3 times weekly): isoniazid + rifampicin for 4 months (or isoniazid + ethambutol for 6 months but less effective than isoniazid + rifampicin). Contraindications: optic neuritis; children under 5 years (unable to report symptomatic visual disturbances); severe renal impairment. Precautions: ocular examination recommended before and during treatment (see also note below); renal impairment (reduce dose and monitor plasma ethambutol concentration if creatinine clearance is less than 30 ml/minute; Appendix 4); the elderly; pregnancy (Appendix 2); breastfeeding (Appendix 3). Patients should report visual disturbances immediately and discontinue treatment; children who are incapable of reporting symptomatic visual changes accurately should be given alternative therapy, as should, if possible, any patient who cannot understand warnings about visual adverse effects. Adverse effects: optic neuritis including reduced visual acuity and red/green colour blindness (early changes usually reversible; prompt withdrawal may prevent blindness); peripheral neuritis (especially in legs); gout; rarely rash, pruritus, urticaria, and thrombocytopenia. Uses: tuberculosis treatment, in combination with other drugs (see notes and tables above); tuberculosis prophylaxis. Patients or their carers should be told how to recognize signs of liver disorder, and advised to discontinue treatment and seek immediate medical attention if symptoms such as nausea, vomiting, malaise or jaundice develop. Isoniazid should be taken on an empty stomach; if taken with food to reduce gastrointestinal irritation, oral absorption and bioavailability may be impaired. Adverse effects: gastrointestinal disorders including nausea and vomiting, diarrhoea and pain, constipation, and dry mouth; hypersensitivity reactions including fever, rash, joint pain, erythema multiforme, and purpura (usually during the first weeks of treatment); peripheral neuropathy; blood disorders including agranulocytosis, haemolytic anaemia, and aplastic anaemia; optic neuritis, toxic psychoses, and convulsions; hepatitis (especially in those over the age of 35 years and in regular users of alcohol; withdraw treatment); systemic lupus erythematosus-like syndrome, pellagra, hyperreflexia, difficulty with micturition, hyperglycaemia, and gynaecomastia also reported. Contraindications: combined preparation not suitable for use in children; see also under Ethambutol and Isoniazid. Patients or their carers should be told how to recognize signs of liver disorder, and advised to discontinue treatment and seek immediate medical attention if symptoms such as persistent nausea, vomiting, malaise or jaundice develop. Adverse effects: hepatotoxicity including fever, anorexia, hepatomegaly, splenomegaly, jaundice, and liver failure; nausea, vomiting; flushing; dysuria; arthralgia; gout; sideroblastic anaemia; rash, photosensitivity. Precautions: hepatic impairment (reduce dose; Appendix 5); monitor liver function and blood counts in liver disorders, alcohol dependency, the elderly, and in those on prolonged therapy; renal impairment (if dose above 600 mg daily; Appendix 4); pregnancy (Appendix 2) and breastfeeding (Appendix 3); porphyria; discolours soft contact lenses; important: advise patients on hormonal contraceptives to use additional means; interactions: Appendix 1. Take dose at least 30 minutes before a meal, as absorption is reduced when taken with food. Anti-infective medicines Adverse effects: severe gastrointestinal disturbances including anorexia, nausea, vomiting, and diarrhoea (antibiotic-associated colitis reported); headache, drowsiness; rash, fever, influenza-like syndrome and respiratory symptoms, collapse, shock, haemolytic anaemia, acute renal failure, and thrombocytopenic purpura (more frequent with intermittent therapy); alterations of liver function, jaundice, and potentially fatal hepatitis (dose related; do not exceed maximum dose of 600 mg daily); oedema, muscular weakness and myopathy, exfoliative dermatitis, toxic epidermal necrolysis, pemphigoid reactions, leukopenia, eosinophilia, and menstrual disturbances also reported; urine, tears, saliva, and sputum coloured orange-red. Precautions: combined preparation usually not suitable for use in children; see also under Isoniazid and Rifampicin. Precautions: combined preparation usually not suitable for use in children, see also under Isoniazid, Ethambutol, and Rifampicin. Rifampicin + isoniazid + pyrazinamide Tablet: 60 mg + 30 mg + 150 mg; 150 mg + 75 mg + 400 mg. Contraindications: combined preparation not suitable for use in children; see also under Isoniazid, Pyrazinamide, and Rifampicin. Rifampicin + isoniazid + pyrazinamide + ethambutol Tablet: 150 mg + 75 mg + 400 mg + 275 mg. Contraindications: combined preparation not suitable for use in children; see also under Ethambutol, Isoniazid, Pyrazinamide, and Rifampicin. Anti-infective medicines Streptomycin Powder for injection: 1 g (as sulfate) in vial. Uses: tuberculosis, in combination with other drugs; tularaemia; plague; brucellosis (with doxycycline; section 6. Precautions: children (painful injection, avoid use if possible); renal impairment (Appendix 4), infants, and the elderly (adjust dose and monitor renal, auditory, and vestibular function, and plasma streptomycin concentrations); breastfeeding (Appendix 3); interactions: Appendix 1. Adverse effects: vestibular and auditory damage, nephrotoxicity; hypersensitivity reactions (withdraw treatment); paraesthesia of mouth; rarely hypomagnesaemia on prolonged therapy; antibiotic-associated colitis; also, nausea, vomiting, and rash; rarely haemolytic anaemia, aplastic anaemia, agranulocytosis, and thrombocytopenia; pain and abscess at injection site. Superficial infections affect only the skin, hair, nails or mucous membranes, whereas systemic fungal infections affect the body as a whole. Systemic fungal infections are sometimes caused by inhalation, ingestion or inoculation of primary pathogens, and sometimes by opportunistic invasion of commensals in patients with lowered host resistance. Anti-infective medicines Amphotericin B is a lipophilic polyene antibiotic; it is fungistatic against a broad spectrum of pathogenic fungi, including Candida spp. It is used for the empirical treatment of serious fungal infections and is used alone or in conjunction with flucytosine to treat cryptococcal meningitis and systemic candidosis. Amphotericin B has to be administered parenterally as there is little or no absorption from the gastrointestinal tract; amphotericin B can be nephrotoxic. Duration of therapy depends on the initial severity of the infection and the clinical response of the patient. In some infections, a satisfactory response is only obtained after several months of continuous treatment. Clotrimazole is an imidazole antifungal which is effective in short courses for the treatment of vaginal candidosis. Treatment involves insertion of pessaries (vaginal tablets) or cream high into the vagina (including during menstruation). Recurrent infection may be treated with a high-dose pessary every week for 6 months. Fluconazole, an orally active synthetic imidazole derivative, possesses fungistatic activity against dermatophytes, yeasts, and other pathogenic fungi. It is widely used in the treatment of serious gastrointestinal and systemic mycoses, such as ringworm (see also section 13. Fluconazole is also used to prevent fungal infections in immunocompromised patients. Flucytosine is a synthetic fluorinated pyrimidine with a narrow spectrum of antifungal activity, but which is particularly against Cryptococcus and Candida spp. Flucytosine is myelosuppressive and plasma concentrations above 75 micrograms/ml are associated with myelotoxicity. Griseofulvin is a fungistatic antibiotic derived from Penicillium griseofulvum with selective activity against the dermatophytes causing ringworm, Microsporum canis, Trichophyton rubrum, and T. Griseofulvin is deposited selectively in keratin precursor cells of skin, hair, and nails where it disrupts the mitotic apparatus of fungal cells thus preventing fungal invasion of newlyformed cells. Close attention should be given to hygiene and to possible reservoirs of reinfection in clothing, footwear, and bedding. Anti-infective medicines Nystatin, a polyene antifungal antibiotic derived from Streptomyces noursei, is effective against infections caused by a wide range of yeasts and yeast-like fungi. It is poorly absorbed from the gastrointestinal tract and it is not absorbed from the skin or mucous membranes when applied topically. It is used for the treatment of candidosis, but is less effective for prevention or treatment of candidosis in immunocompromised patients. Potassium iodide aqueous oral solution is a clear liquid with a characteristic, strong salty taste. It is effective against sporotrichosis and subcutaneous phycomycosis, which are fungal infections caused by Sporothrix schenckii and Basidiobolus haptosporus, respectively. In subcutaneous sporotrichosis, amphotericin B is often effective in patients unable to tolerate iodides. Uses: life-threatening fungal infections including histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis, aspergillosis, cryptococcosis, mucormycosis, sporotrichosis, and candidosis; leishmaniasis (section 6. Precautions: initial test dose required (see note below); renal impairment (Appendix 4); monitor hepatic and renal function; blood counts, and plasma electrolyte concentrations (including potassium and magnesium concentration); pregnancy (Appendix 2) and breastfeeding (Appendix 3); avoid rapid infusion (risk of arrhythmias); interactions: Appendix 1. Prolonged treatment is usually necessary; if treatment is interrupted for longer than 7 days, it should be recommenced at 250 micrograms/kg daily and increased gradually. Anti-infective medicines Adverse effects: fever, headache, anorexia, weight loss, nausea and vomiting, malaise, diarrhoea, muscle and joint pain, dyspepsia, epigastric pain; renal function disturbances (including hypokalaemia, hypomagnesaemia, and renal toxicity); blood disorders; cardiovascular toxicity (including arrhythmias); neurological disorders (including peripheral neuropathy); abnormal liver function (discontinue treatment); rash; anaphylactoid reactions (see note above); pain and thrombophlebitis at injection site. Precautions: damages latex condoms and diaphragms (advise patients to use alternative contraceptive precautions).

Efcacy of clindamycin vaginal and intermediate fora in pregnancy and efect of oral clindamycin pain medication for dogs in labor buy on line rizact. Prevalence of rectal vent preterm delivery in pregnant women with asymptomatic Trichomonas vaginalis and Mycoplasma genitalium in male patients bacterial vaginosis pain treatment studies purchase generic rizact canada. Prevalence of metronidazolepreterm birth in women with an increased recurrence risk: a ranresistant Trichomonas vaginalis in a gynecology clinic pain treatment center orland park il best buy rizact. Treatment of treatment for bacterial vaginosis: efects on preterm delivery and low Trichomonas in pregnancy and adverse outcomes of pregnancy: a subabirth weight knee pain treatment uk cheap rizact uk. Trichomonas vaginalis history pain evaluation and treatment center tulsa ok rizact 5mg fast delivery, and response to treatment of Trichomonas vaginalis infection infection and human immunodefciency virus acquisition in African among adolescent women pain treatment satisfaction scale generic rizact 10mg with amex. Trichomonas vaginalis is vaginalis organisms on a liquid-based papanicolaou smear. Treatment of vaginitis caused defciency virus 1 infection on microbial origins of pelvic infammatory by Candida glabrata: use of topical boric acid and fucytosine. Infuence of human tibility among Candida species isolates recovered from human immuimmunodefciency virus infection on pelvic infammatory disease. Comparison of acute and subdefciency virus-1 infection on treatment outcome of acute salpingitis. Microbiology profle in women vaginosis-associated microfora and pelvic infammatory disease. Clinical predictors of endometritis the natural history of human papillomavirus infection and cervical in women with symptoms and signs of pelvic infammatory disease. Optimal frequency predict reproductive morbidity after pelvic infammatory disease. Possible mechanisms in the induction of vitiligodisease: results from the Pelvic Infammatory Disease Evaluation and like hypopigmentation by topical imiquimod. Bacterial vaginosis and risk of pelvic tea extract, in the treatment of external anogenital warts: a randomized infammatory disease. Topical Polyphenon E in the treattive outpatient pelvic infammatory disease treatment strategies. Condyloma in pregnancy clindamycin and gentamicin in the treatment of pelvic infammatory is strongly predictive of juvenile-onset recurrent respiratory papillomadisease or endometritis. Incidence and risk factors for mycin as monotherapy or combined with metronidazole compared verrucae in women. Cervical cancer screening among women vovaginal and perianal condylomata acuminata and intraepithelial neowithout a cervix. Two decades after strategies for patients with atypical squamous cells of undetermined vaccine license: hepatitis B immunization and infection among young signifcance: baseline results from a randomized trial. Efcacy of commercial confor the management of women with cervical intraepithelial neoplasia doms in the prevention of hepatitis B virus infection. The prevalence of hepatitis a randomized controlled trial comparing human papillomavirus testC virus infection in the United States, 1999 through 2002. Transmission of hepatitis C virus order on Chlamydia trachomatis and Neisseria gonorrhoeae test perforbetween spouses: the important role of exposure duration. Absence of hepatitis C virus transmission in a prospective cohort of heterosexual serodiscordant couples. Am J Obstet Gynecol self declared non-injecting sexual partners of injecting drug users. Hepatitis C virus in the Neisseria gonorrhoeae in children being evaluated for sexual abuse. Guidelines for laboratory testing and result reporting of antibody warts in children: a retrospective analysis. Comparative in vitro pediculicidal efcacy of treatments in a resistant head lice population in the United States. Use of trade names and commercial sources is for identifcation only and does not imply endorsement by the U. Two infections that youcan get from havingsex with another person are calledchlamydia andgonorrhea. Theseinfectionscan move up from your vagina andcervix(opening to the womb) to infect your uterus (womb) andfallopian tubes(tubes that carryyoureggs from yourovaries to your uterus). Chlamydia andgonorrhea can also grow in the rectumand rarely in the mouth, throat, or eyes. Some women haveabnormalvaginaldischarge,burning when theyurinate (pee), or bleedingbetween periods. Many men who have chlamydia or gonorrhea will haveadischarge (fluid that leaks) from their penis or burning when theyurinate. Yourhealth care provider will takeasampleoffluidfrom your cervix with a cotton swab or a urine sampletotest for the bacteria. Youcan get chlamydia or gonorrhea by havingvaginal, oral, or analsex with a person who has the bacteria. Youcan get chlamydia andgonorrhea again ifyou have sex again before your sexualpartner is treated. Youcan alsohaveinfertility, whichis not being abletoget pregnant when you want to become pregnant. When should I see my health care provider to be tested for chlamydia or gonorrhea You maybe given a medicine where all the pills are taken at one time, or you maketake pills for severaldays. Youshould be retestedfor chlamydia 3 months after you are treated to make sure the infection isgone. Ifyou are pregnant, youshould haveanotherchlamydia test 3 weeks after finishing the pills to make sure the chlamydia isgone. You should not have sexuntilboth you andyour sexualpartner havetaken all the medicine you have been given. If you takethepills for 7days, you need to wait to have sexuntilyou are done taking all the pills. Because chlamydia is often found with gonorrhea, you will probably also be given antibioticpills for chlamydia ifyou are treatedfor gonorrhea. Youshould not have sexuntilboth you andyour sexualpartner have been treated andyoudonothaveanysymptoms. Anysexualpartner you havehadsexualcontactwithinthepast 60 days should betested and treatedfor chlamydia andgonorrhea. Ifit hasbeen more than 60 days since you hadsex, your last sexualpartner should betreated. Being treateddecreasesyour chanceofgivingbirth early andgiving the infection to your baby at birth. If you are not treated and the baby is exposed to the bacteria at the time ofbirth,your baby can get an eyeinfection,pneumonia (infection in the lungs), or a veryserious blood infection. Make sure your partners get treated before you have sex with them if they have chlamydia or gonorrhea! Any other reproduction is subject to the Journal ofMidwifery&Womens Healths approval. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specifc information concerning your personal medical condition, the Journal of Midwifery&Womens Health suggests that you consult your health care provider. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb). You can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia. If your sex partner is male you can still get chlamydia even if he does not ejaculate (cum). If youve had chlamydia and were treated in the past, you can still get infected again. Anyone who has sex can get chlamydia through unprotected vaginal, anal, or oral sex. Gay, bisexual, and other men who have sex with men are also at risk since chlamydia can spread through oral and anal sex. If you are a sexually active woman younger than 25 years, you should get a test for chlamydia every year. Gay, bisexual, and other men who have sex with men; as well as pregnant women should also get tested for chlamydia. If you are pregnant and have chlamydia, you can pass the infection to your baby during delivery. If you are pregnant, you should get tested for chlamydia at your first prenatal visit. This happens ContactUs/Form either by having receptive anal sex, or by spread from another infected site (such as the vagina). It is important that you take all 27709-3827 of the medication your doctor prescribes to cure your infection. When taken properly 1-800-783-9877 it will stop the infection and could decrease your chances of having complications later on. You should be tested again about three months after you are treated, even if your sex partner(s) was treated. You should not have sex again until you and your sex partner(s) have completed treatment. If your doctor prescribes a single dose of medication, you should wait seven days after taking the medicine before having sex. If your doctor prescribes a medicine for you to take for seven days, you should wait until you have taken all of the doses before having sex. If you are a woman, untreated chlamydia can spread to your uterus and fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus). Infection sometimes spreads to the tube that carries sperm from the testicles, causing pain and fever. Classification of Immunologically Mediated Drug sensitivity Reactions Annotations for Disease Management of Drug HyperA. Miscellaneous syndromes Parameters, representing the American Academy of Allergy, Asthma and 1. Hypersensitivity vasculitis Immunology; the American College of Allergy, Asthma and Immunology; and the Joint Council of Allergy, Asthma and Immunology. Drug-induced lupus erythematosus have jointly accepted responsibility for establishing Drug Allergy: An 5. The medical environment is a changing environwithout vasculitis ment, and not all recommendations will be appropriate for all patients. Immunologic hepatitis Because this document incorporated the efforts of many participants, no 7. Blistering disorders single individual, including those who served on the Joint Task Force, is a. Reprint requests: Joint Council of Allergy, Asthma & Immunology, 50 specific cephalosporins N. Physical examination the Joint Task Force has made a concerted effort to acknowlC. Immunologic IgE induction of drug tolerance Division of Allergy and Immunology (drug desensitization) the Corvallis Clinic D. Immunologic non-IgE induction of drug tolerance Corvallis, Oregon for nonanaphylactic reactions David A. Pharmacologic induction of drug tolerance (eg, Professor of Medicine aspirin desensitization) Division of Allergy & Immunology F. Undefined induction of drug tolerance University of Texas Southwestern Medical Center G.