Vaginismus, sometimes anglicized vaginism is the German name for a condition which affects a woman’s capability to engage in any form of vaginal penetration, including sexual intercourse, attachment of tampons, and the penetration involved in gynecological examinations. This is the result of a reflex of the pubococcygeus muscle, which is sometimes referred to as the “PC muscle”. The reflex causes the muscles in the vagina to tense suddenly, which makes any kind of vaginal penetration painful or impossible.
A woman struggling from vaginismus does not purposely control the spasm. The vaginismic reflex can be compared to the response of the eye shutting when an object comes towards it. The intensity of vaginismus and the pain during penetration, including sexual penetration, differs from woman to woman.
A woman is said to have main vaginismus when she has never been able to have penetrative sex or experience vaginal penetration without pain. It is generally discovered in teenagers and women in their early twenties, as this is when many young women in the Western world attempt to use tampons, have penetrative sex, or undergo a Pap smear. Women with vaginismus may be unaware of the condition until they attempt vaginal penetration. It may be confusing for a woman to discover she has vaginismus. She may believe that vaginal penetration should naturally be easy, or may be unaware of the reasons for her condition.
A few of the main factors which may contribute to primary vaginismus contain:
- a situation called vaginal vestibulair symptoms more or less synonimous to focal vaginitis a so called subclinical inflammation. No pain is perceived, until some form of transmission is tried.
- urinary tract infections or vaginal yeast infections.
- sexual abuse, rape, or attempted lovemaking abuse
- knowledge of (or witnessing) sexual or physical abuse of others, without being personally abused
- domestic violence or discord in the early home environment
- having been taught that sex is immoral, vulgar, or demoralizing
- fear of pain associated with penetration, particularly the popular misconception of ‘breaking’ the hymen upon the first attempt at penetration, or the idea that vaginal penetration will inevitably hurt the first time it occurs
- being sexualized or told about sex in violent or unnecessarily graphic terms before an age at which one is comfortable with such details
- any physically invasive trauma
- generalized anxiety
- stress
Occasionally, primary vaginismus is idiopathic.

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Vaginismus has been categorized by Lamont according to the severity of the condition. He describes four degrees of vaginismus: In first degree vaginismus, the patient has spasm of the pelvic floor which can be relieved with reassurance. In second degree, the spasm is present but maintained throughout the pelvis even with reassurance. In third degree, the patient elevates the buttocks to avoid being examined. In fourth degree vaginismus, the most severe form of vaginismus, the patient elevates the buttocks, retreats and tightly closes the thighs to avoid examination. Pacik expanded the Lamont classification to include a fifth degree in which the patient experiences a visceral reaction such as sweating, hyperventilation, palpitations, trembling, shaking, nausea, vomiting, going unconscious, wanting to jump off the table or attacking the doctor. The Lamont classification continues to be used to the present and allows for a common language among researchers and therapists. However, it does not allow for a language in which a woman might be able to verbalise her concerns, pain or problems. A woman with a lot of trust in the doctor might be classified as 1 but experience severe pain. A woman with less trust or a woman who is or has been exposed to harsh examination, might be classified as four or five .
Though spasm of the pubococcygeus muscle is commonly thought to be the primary muscle required in vaginismus, Pacik recognized 2 additional included spastic muscles in treated patients under sedation. These include the entry muscle (bulbocavernosum) and the mid oral muscle (puborectalis). This accounts for the common complaint that patients often say when trying to have sexual intercourse “It’s like reaching a brick wall”.
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Bronchitis is an contamination of the main airways of the lungs , which leads to them to become inflamed (see box, below left). It is typical in winter and often evolves following a cold, sore throat or flu. The main indicator of bronchitis is a cough, which may bring up yellow-grey mucus. Bronchitis may also cause a sore neck, wheezing and a blocked nose (see Symptoms of respiratory disease for more details). Who is impacted? Anyone can be impacted by bronchitis, although smokers and people who work with substances that can aggravate the lungs, such as grains or fabrics, are more probably to get it. Acute and chronic bronchitis Bronchitis is usually a mild and self-restricting condition. Self-restricting means that it clears up by itself, generally within a couple of weeks. This is known as acute bronchitis as it lasts for only a short period of time.

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However in some cases, the damage caused by the infection of the bronchi can become permanent, causing the condition to be more severe and long lasting. If the infection lasts longer than three months, it is known as chronic bronchitis. Outlook Most instances of respiratory disease can be treated easily at home and do not usually require further medication. However, people with severe or persistent bronchitis, or those with an underpinning condition such as asthma, may need remedy from a GP.
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Tetanus, also known as tetanus is a serious disease, but preventable disease that affects muscles and nerves. It is usually due to skin wound contaminated by bacteria called Clostridium tetani, which is often observed in the country.
When bacteria are in the body, they produce a neurotoxin (a protein that acts as a poison for the nervous system of the organism) known as tetanospasmin that causes muscle spasms. Toxin can travel throughout the body via the bloodstream and lymphatic system. As it circulates more widely, the toxin interferes with the normal activity of nerves throughout the body, causing generalized muscle spasms. Without treatment, tetanus can be fatal.
United States, most cases of tetanus follow contaminated cut or deep holes in the injury, as the wound-induced nail step. Sometimes the damage is so small the person does not even see a doctor. Injuries, which the dead skin (such as burns, frostbite, gangrene, or crush) can cause tetanus. Wounds contaminated with soil, saliva or feces – especially if not properly cleaned – and bites from non-sterile needles (such as drug use or a tattoo or piercing self-made) are at increased risk.
Another form of tetanus, neonatal tetanus in newborns occurs delivered in unsanitary conditions, especially if the umbilical cord stump becomes contaminated. Before vaccination, neonatal tetanus was much more widespread in the United States. Now, routine immunizations for tetanus produce antibodies that mothers go to their unborn children. These maternal antibodies and sanitary cord-care techniques have made the newborn tetanus very rare in developed countries.
Self-tetanus is usually rare in the United States and other nations with tetanus vaccination programs – fewer than 50 cases of tetanus are reported each year in the U.S.. However, many developing countries are less effective prevention and immunization programs against tetanus, so the disease is more common there.
Signs and symptoms
Tetanus often begins with muscle spasms in the jaw (called trismus), and may be accompanied by difficulty swallowing and stiffness or pain in the muscles of the neck, shoulders or back. These spasms can spread to the muscles of the abdomen, arms and thighs. Symptoms can occur anywhere from several days to several months after exposure to bacteria.
Prevention
There are two important ways to prevent tetanus:
1-) Vaccinated against tetanus
2-) After the injury, which can cause tetanus, can be a shot (post-exposure tetanus prophylaxis)
For children, tetanus immunization is part of the DTaP (diphtheria, tetanus and acellular pertussis) vaccine. They often receive a series of four doses of DTaP vaccine before 2 years, followed by a booster dose at 4-6 years. After that, a booster (Tdap) is recommended 11 to 12 years, then, tetanus and diphtheria every 10 years through adulthood. Make sure your children do not miss their appointments so that the vaccines are administered on time.
As with all immunization schedules, there are important exceptions and special circumstances. Your doctor will have the most current information.
tetanus post-exposure prophylaxis is also the tetanus, but after an injury. Vaccines given by the number of years since the last reminder of the patient, the total number of vaccines against tetanus, the patient received and the nature of the injury. Your doctor may recommend a booster against tetanus (Td, DTaP, or Tdap, depending on patient age and previous immunizations) and / or an injection of tetanus immunoglobulin (TIG) to neutralize the toxins released by bacteria.
Neonatal tetanus can be prevented by ensuring that all pregnant women had their immunization against tetanus, by delivering babies in sanitary conditions, and by proper umbilical cord care. If you are pregnant, discuss your immunization record with your obstetrician well before your due date.
Any skin wound – especially a deep puncture or wound may be contaminated with feces, soil, or saliva – should be cleaned and covered immediately. While it is important to clean all wounds, remember that cleanliness is not a substitute for vaccination.
Treatment
Doctors play an important role to prevent tetanus, ensuring that children’s vaccinations are up to date and to provide post-exposure prophylaxis, if your child has a wound that is at risk of tetanus.
A child who develops tetanus treated in hospital, usually in the intensive care unit (ICU). There, the child is usually antibiotics kill bacteria and TIG to neutralize the toxins that the bacteria have already published. Kids will also receive medicines that control muscle spasms and may be subject to treatment to support vital bodily functions.
When to Call the Doctor
If you do not know if their children have been vaccinated against tetanus, or if you know they are not fully immunized, call your doctor. If more than 10 years that someone in your family has had a tetanus booster, schedule an office visit for updating immunizations.
If the event is a hole or other deep wound, clean the wound and call your doctor and discuss whether the child should receive post-exposure prevention of tetanus. If a child develops muscle spasms and tetanus – especially when given a wound – seek medical attention immediately.
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