Summaryobjective To demonstrate the importance of surveillance systems in detecting emerging diseases and highlighting the strengths and weaknesses of an existing one.
Sixty five patients with benign ectopy of the uterine cervix were treated by cryosurgery in the departments of genitourinary medicine at St Luke's Hospital, Bradford, and the Airedale General Hospital, West Yorkshire, without analgesia or anaesthesia. A symptomatic cure rate of 98/o was achieved. There were no serious complications. This treatment is considered to be appropriate in genitourinary clinics in the United Kingdom as these have routine screening procedures for various genital infections.
Vaginitis associated with the presence of Gardnerella vaginalis (confirmed by culture) was treated either with metronidazole or with one of the two nitroimidazole derivatives; nimorazole or tinidazole, as a single oral 2 g dose. Eighty-two patients were treated with metronidazole, 100 with nimorazole and 98 with tinidazole. The cure rates were 79%, 88% and 92% with metronidazole, nimorazole and tinidazole respectively. Therefore we recommend a single dose of 2 g of any of these three drugs in the treatment of such infection.
The cost effectiveness of 25% podophyllin resin and 0.5% podophyllotoxin solution in the treatment of genital warts in Genitourinary Medicine Clinic attenders was studied. Although the average treatment cost for a course of podophyllotoxin was more than that for podophyllin resin (20.75 pounds v. 14.95 pounds respectively) the overall cure rate with podophyllotoxin was 66% as opposed to 34.6% with podophyllin. When the costing of secondary treatment options was considered the cost per patient cured of warts with podophyllin resin was 27.15 pounds compared with 25.73 pounds for podophyllotoxin solution (not significant).
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