Changes since 2011 guideline • First line empirical treatment is now monotherapy with ceftriaxone 1 g intramuscularly • If antimicrobial susceptibility test results from all sites of infection are available prior to treatment and the isolate is sensitive to ciprofloxacin, then this should be used for treatment in preference to ceftriaxone • Inclusion of testing recommendations in people following genital reconstructive surgery • Recommendations for extra-genital testing in those with suspected or confirmed antimicrobial resistance • Epidemiological treatment is recommended only for those presenting within 14 days of exposure. For those presenting after 14 days of exposure we recommend treatment based on the results of testing SCOPE AND PURPOSE This guideline offers recommendations for the diagnostic tests, treatment regimens and health promotion principles needed for the effective management of gonorrhoea in people aged 16 years and older. For individuals under the age of 16 years please see the British Association for Sexual Health and HIV (BASHH) guideline on STI and Related Conditions in Children and Young People. The guidelines are primarily aimed at level 3 sexual health services within the United Kingdom (UK) although the principles of the recommendations could be adopted at all levels. EDITORIAL INDEPENDENCE This guideline was commissioned and edited by the Clinical Effectiveness Group (CEG) of BASHH, which provided funding for the literature search. No other funding was obtained. RIGOUR OF DEVELOPMENT This guideline was produced according to specifications set out in the CEG's 2015 document 'Framework for guideline development and assessment' outlined at https://www.bashh.org/bashh-groups/clinical-effective ness-group/ and has been updated by reviewing the previous gonorrhoea guideline (2011) and medical literature since its publication. A MEDLINE search of published articles in English language for the years 2009-18 was done using the subject headings 'gonorrhoea' OR 'gonorrhea' OR 'Neisseria gonorrhoeae' AND 'therapy' OR 'treatment' OR 'therapeutics' OR 'resistance' OR 'anti-bacterial agents' OR 'antibiotics' OR 'failure' OR 'toxicity'. All entries in the English language or with abstracts in English were viewed because of the paucity of 'clinical trials' or 'reviews'. The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness and Cochrane Controlled Trials Register were reviewed using the textword 'gonorrhoea' and all entries were considered. Abstracts from meetings in the relevant period were hand-searched and considered. Priority was given to randomized controlled trials and

The successful application of data mining in highly visible fields like e-business, marketing and retail has led to its application in other industries and sectors. Among these sectors just discovering is healthcare. The healthcare environment is still "information rich" but "knowledge poor". There is a wealth of data available within the healthcare systems. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. This research paper intends to provide a survey of current techniques of knowledge discovery in databases using data mining techniques that are in use in today"s medical research particularly in Heart Disease Prediction. Number of experiment has been conducted to compare the performance of predictive data mining technique on the same dataset and the outcome reveals that Decision Tree outperforms and some time Bayesian classification is having similar accuracy as of decision tree but other predictive methods like KNN, Neural Networks, Classification based on clustering are not performing well. The second conclusion is that the accuracy of the Decision Tree and Bayesian Classification further improves after applying genetic algorithm to reduce the actual data size to get the optimal subset of attribute sufficient for heart disease prediction.

This is the first British Association for Sexual Health and HIV (BASHH) guideline for the diagnosis and management of Mycoplasma genitalium in people aged 16 years and older. The guideline is primarily aimed at level 3 sexually transmitted infection (STI) management services within the UK, although it could also serve as a reference guide for STI services at other levels.

Rates of MG are much higher in HIV-positive MSM than HIV-negative MSM at both urethral and rectal sites, and MG is more prevalent in HIV-positive MSM than other bacterial STI. Although the subclinical nature of MG in the rectum questions its significance, the high prevalence seen at this site could be a potential source of onward urethral transmission. Future work should assess the need for appropriate screening and treatment of MG infection in MSM, particularly those with HIV infection and high-risk sexual behaviour.

Home assessment of medical abortion outcome with a low-sensitivity urine pregnancy test is non-inferior to clinic follow-up, and could be introduced instead of a clinic follow-up visit in a low-resource setting.

Despite advances in the treatment of patients with human immunodeficiency virus (HIV), HIV-associated neurocognitive disorder occurs in 15-50% of HIV-infected individuals, and may become more apparent as ageing advances. In the present study we investigated regional cerebral blood flow (rCBF) and regional cerebral metabolic rate of glucose uptake (rCMRglc) in medically and psychiatrically stable HIV-1-infected participants in two age-groups. Positron emission tomography (PET) and magnetic resonance imaging (MRI)-based arterial spin labeling (ASL) were used to measure rCMRglc and rCBF, respectively, in 35 HIV-infected participants and 37 HIV-negative matched controls. All participants were currently asymptomatic with undetectable HIV-1 viral loads, without medical or psychiatric comorbidity, alcohol or substance misuse, stable on medication for at least 6 months before enrolment in the study. We found significant age effects on both ASL and PET with reduced rCBF and rCMRglc in related frontal brain regions, and consistent, although small, reductions in rCBF and rCMRglc in the anterior cingulate cortex (ACC) in HIV, a finding of potential clinical significance. There was no significant interaction between HIV status and the ageing process, and no significant HIV-related changes elsewhere in the brain on PET or ASL. This is the first paper to combine evidence from ASL and PET method in HIV participants. These finding provide evidence of crossvalidity between the two techniques, both in ageing and a clinical condition (HIV).

These findings highlight the need for the introduction of similar screening approaches in HIV clinics. Self-collected specimens using sensitive and specific GC and CT nucleic acid amplification tests are a convenient and acceptable way of testing, and it may address some of the barriers to screening in this population.

SUMMARY BackgroundLymphogranuloma venereum (LGV) is a recognized cause of proctitis. Symptoms, endoscopy and histology findings are similar in IBD and LGV proctitis.