Initial consultation

• First establish why the patient is presenting 'now' for the test.

• Explore the 'hidden component' of the patient's consultation.

• Take a full sexual, medical and drug-taking history. It is recognised that this can be embarrassing for both the doctor and the patient, but those experienced in this process advise the following approach:

o Establish a supportive, non-judgmental atmosphere. Encourage disclosure of history and patterns of partners and sexual practices in a gender-neutral situation. Make no assumptions about sexual preferences; they will be indicated by the patient as the history evolves, provided you allow this to happen; this will take time.

• Non-judgmental matter-of-fact questions such as 'Have you injected yourself with drugs?' and (to a male patient) 'Do you have sex with men?' may permit honest disclosure.

• Stress the importance of disclosure of prior, known infections with STDs. Assess the patient's risk for an STD.

• Assess the patient's coping strategies and social network.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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