Abnormal Vaginal Discharge Research Articles

Can Probiotics Play a Major Role as an Adjunctive Therapy in Treatment of Bacterial Vaginosis?

Background: Bacterial Vaginosis is one of the most common causes of abnormal vaginal discharge in women of reproductive age, which can have a major impact on quality of life. Although the treatment course of oral metronidazole for 7 days results in curative rate of 70%–80% at four weeks of treatment, but is associated with high rates of recurrence occurred within twelve months, reaching up to 40%–50%. Methods: A Randomized Prospective Interventional Study was done on 1000 reproductive age group females (pregnant or non-pregnant) diagnosed with bacterial vaginosis from November 2020 to October 2022 at department of Obstetrics & Gynaecology, Kanpur. The study group were divided into two subgroups - Group 1 were given metronidazole 500 mg for 7 days and probiotics for 14 days and group 2 were given metronidazole 500 mg for 7 days and placebo for 14 days. The patients were followed after 3 months to know the recurrence. Results: Majority of patients belonged to rural background (63.1%) with lower socioeconomic (46.6%) and belong to age group 20-35 years. It was observed that there was significant change in Amsel’s criteria and Nugent’s scoring in Group 1 as compared to Group 2. The rate of recurrence at the end of the treatment for Amsel’s criteria in group 1 were 1.03 as compared to group 2 was 1.68 and for Nugent’s scoring, the rate of recurrence at the end of treatment in group 1 was 3.17 as compared to group 2 was 4.78. Conclusion: Probiotics can be considered as one the adjuvant therapy for treating bacterial vaginosis and re-establishing equilibrium in the vaginal microflora thus, preventing the recurrences.

Utility, acceptability and applicability of a nucleic acid amplification test in comparison with a syndromic approach in the management of sexually transmitted diseases at Mulago National Referral Hospital in Uganda (ASTRHA): protocol for an open-label, randomised controlled trial

IntroductionSexually transmitted diseases (STDs) are a major cause of long-term disability. Urethral discharge syndrome (UDS), abnormal vaginal discharge (AVD) and genital ulcer disease (GUD) are very common in low-income and...

Ayurvedic Perspective of Abnormal Vaginal Discharge

In the context of wide prevalence and growing incidence of abnormal vaginal discharge throughout the globe and due to the lack of effective and safe therapy in modern science, there is an increasing focus on alternative systems of medicine. Ayurveda is an age-old life science that offers great potential in treating the symptom. The present study was taken up to review the theoretical foundations and empirical evidence of Ayurvedic drugs for this. Apart from consulting the texts in Ayurveda and modern systems, the study got access to internet sources like AYUSH Portal and PubMed, Google Scholar etc. Out of 90 papers identified, forty research papers were selected for review on various aspects of AVD, such as observational studies, clinical studies, review studies. They are reviewed for theoretical background, research techniques adopted, the drugs and methods employed for treatment and the parameters chosen for evaluation of the effects of these drugs. The results show that Ayurveda has both theoretical foundations and empirical evidence of efficacy of Ayurvedic drugs and shows the promise of evolving a polyherbal formulation to address the symptom holistically.

The Effect of Giving Water Extract Boiled Beluntas Leaves on the Prevention of Vaginal Discharge in S1 Public Health Students at the STRADA Indonesia Institute of Health Sciences

Background: The high rate of vaginal discharge in women is caused by infection of various fungi in the vagina by bacteria Thricmonas vaginalis and candida albicans. Excessive and abnormal vaginal discharge can be an early symptom of cervical cancer that can lead to death in women. Purpose: The purpose of this study was to determine the effect of giving water extract of boiled beluntas leaves on the prevention of vaginal discharge in S1 Public Health students at the STRADA Indonesia Institute of Health Sciences. Methods: This study used a pre-experimental method with a type of research one group pre test post test. The population in this study was all S1 Public Health students at the STRADA Indonesia Institute of Health Sciences and sampling using the simple random sampling method with a total of 84 respondents. Data analysis techniques used to test hypotheses are the Wilcoxon Test and data collection using questionnaires. Results: Data analysis using the Wilcoxon test shows that the significance level is 0.000< α = 0.05 so that H0 is rejected and H1 is accepted which means that there is an effect of giving beluntas leaf boiled water extract on the prevention of leucorrhoea in S1 Public Health students at the STRADA Indonesia Institute of Health Sciences. Conclusion: It is expected that female students who experience vaginal discharge can apply water extract of beluntas leaf decoction as a non-pharmacological drug that can be used if experiencing vaginal discharge.

Sertaconazole 300 mg versus clotrimazole 500 mg vaginal suppository for treating pregnant women with acute vaginal candidiasis: a double-blinded, randomized trial

BackgroundVaginal candidiasis (VC) commonly affects pregnant women. Traditionally, clotrimazole vaginal tablets (CLO) have been the cornerstone of management. However, sertaconazole ovules (SER) offer a novel topical antimycotic option. This double-blinded, randomized trial evaluated the efficacy of single-dose SER and CLO in treating acute VC during pregnancy.MethodsFrom June 2020 to May 2021, this trial recruited pregnant women aged ≥ 18 years with VC symptoms (abnormal vaginal discharge and/or vulvar/vaginal itching) confirmed by microscopy. Participants with ≥ 4 VC episodes in the prior year, immunocompromised status, or imidazole contraindications and those who were absent at the 2-week follow-up were excluded. Participants were randomized to receive either 300 mg SER or 500 mg CLO. Evaluations 2 weeks after the initial medication administration included clinical cure (self-reported resolution of all symptoms), microscopic cure (pseudohyphal absence), patient satisfaction, side effects, and time to clinical cure. Participants with persistent VC received weekly SER doses until delivery. Assessments of recurrence and pregnancy outcomes were done.ResultsThe analysis included 96 participants (48 per group, mean age 27.4 ± 7.4 years, gestational age at diagnosis 22.9 ± 6.4 weeks). Without statistical significance, SER achieved a higher clinical cure rate (62.5% vs 50%, p = 0.217; a mean difference of 12.5%, 95%CI: -17.5% to 42.5%; and a rate ratio of 1.25, 95%CI: 0.71 to 2.23) and a lower microscopic cure (47.9% vs. 62.5%, p = 0.151; a mean difference of -14.6%, 95%CI: -44.3% to 15.1%; and a rate ratio of 0.77, 95%CI: 0.43 to 1.37). The two groups had comparable times to clinical cure (SER: 3.1 ± 1.8 days, CLO: 3.4 ± 2.7 days; p = 0.848) and substantial satisfaction rates (SER: 66.7%, CLO: 60.4%; p = 0.753). No side effects were reported. Of 60 participants who gave birth at Siriraj Hospital, there were no significant differences in pregnancy outcomes. Repeated SER dosing eradicated symptoms and enhanced the microscopic cure rate. Recurrence was observed in four SER and two CLO participants within 1–2 months.ConclusionIn the treatment of acute VC during pregnancy, 300 mg SER and 500 mg CLO exhibited comparable efficacy in terms of clinical and microscopic cure rates, satisfaction, side effects, time to clinical cure, recurrence rates, and pregnancy outcomes.Trial registrationTCTR20190308004 (registration date March 8, 2019).

IJCM_74A: Reproductive health problems and its determinants among the tribal women in Wayanad, Kerala; a cross sectional study.

Background: India has the largest proportion of tribal population, and there is a growing concern about the maternal and reproductive health of women, particularly those who are marginalized. In Kerala, the maternal and reproductive health indicators of tribal women exhibit notable variations compared to other social groups. Objectives: 1) To estimate the prevalence of reproductive health problems among the tribal women in Wayanad district. 2)To assess the factors associated with reproductive health problems. Methodology: A convenience sampling method was employed to conduct a cross-sectional study involving 300 tribal women aged 15-49 in Kalpatta, Wayanad district. The study gathered information on sociodemographic factors, reproductive health issues, hygienic practices, and anthropometric details through a pretested semi-structured questionnaire. The collected data were entered into MS Excel, and the analysis was carried out using SPSS 21.0. Results: The mean age of the participants is 30.4±10.3 years. The prevalence of reporting any reproductive health issue is 16.3%, with 10.7% reporting two symptoms and 14.7% reporting three or more while 58.3% had no symptoms. The most common symptom is abnormal vaginal discharge with itching (57.1%). Among the participants, 64.5% are currently married, with 41.7% having low BMI, 55% use smokeless tobacco products,93.7% maintain good hygienic practices and 18.7% experienced pregnancy wastage. Occupation status and hygienic practices were found to be significantly associated with reproductive health problems. Conclusion: Adhering to appropriate hygiene practices in daily life, including menstruation, can minimize prevalent reproductive health issues among women in tribal communities.

Knowledge and Practice Regarding Abnormal Vaginal Discharge Among Adolescent Females in Riyadh City: An Observational Study.

Introduction Vaginal discharge (VD) is a common condition that affects women during their childbearing years and often requires medical attention. It results from the physiological secretion of cervical and Bartholin's glands, as well as the shedding of vaginal epithelial cells caused by bacterial action in the vagina, which alters the acidic environment of the vagina.Experiencing vaginal symptoms is a common reason for seeking medical attention, especially among women during their reproductive years. This often leads to a visit to an obstetrician or a gynecologist. Accordingly,addressing such issues becomes even more crucial. The aim of this study is to assess the knowledge and practice regarding abnormal VD (AVD) among adolescent females in Riyadh City, Saudi Arabia. Methods The present study utilized a correlational cross-sectional survey methodology conducted in Riyadh City. The questionnaire was employed as thedata collection instrument from November 2022 to November 2023. Eligibility for inclusion was limited to adolescent femalesand students living in Riyadh City, aged from 14 to 20 years. Electronic consent was obtained from participants aged 18 years and above, while consent from guardians was sought for those below 18 years. This sample size was determined with a minimum requirement of 500 participants, and 824 were involved. The questionnaire encompassed several sections, including demographic characteristics (gender, age, education, and menstruation history), history of AVD, knowledge regarding VD, and students' practices and behaviors related to VD. Cronbach's alpha values for all the sections were more than 0.7. Data analysis was performed using statistical software, employing descriptive analysis, chi-square tests, and t-tests. Results A total of 824 girls were included, and their ages ranged from 14 to 20 years, with a mean age of (16 years ± 5) years old. Exactly 697 (84.6%) were high school students. Most of the study students (85.1%; 701) complained of an AVD at any point in their lives. Only 97 (11.8%) of the study students had a good knowledge level of VD. Higher age, marriage, late menarche, and seeking medical care for complaints of VD were the factors associated with a high knowledge level about VD (P<0.05). Additionally, 44.2% of school-age females sought medical care when experiencing AVD, with reasons including worsening symptoms over time and fear of serious diseases. However, a significant portion of participants opted for self-treatment using herbal remedies, medication from pharmacies, or leaving VD untreated, citing reasons such as perceiving it as a simple condition or fearing examination and disclosure. Conclusion In summary, the current study revealed that adolescent femalesdemonstrate a sub-optimal level of knowledge regarding AVD. These findings are primarily observed among adolescent girls and individuals who exhibit a reluctance to seek appropriate medical intervention when having AVD.

Antimicrobial Properties of Shrevestakadi Yoni Dhoopan for Management of Abnormal Vaginal Discharge

Ayurveda, an ancient system of medicine adopts a holistic approach, focusing on both curing diseases and enhancing the overall well-being of individuals. It emphasizes the importance of maintaining a balance between the individual (body, mind, soul, spirit) and the environment. It includes a range of pharmaceutical preparations and therapeutic techniques. However, in the contemporary era, only a limited number of these procedures are actively employed, leading to the loss of significance and recognition for numerous valuable formulations and techniques, Dhoopan karma being one of them. "Dhoopana" is a procedure involving the use of herbal, herbo-mineral, or animal-origin substances for fumigation. Dhoopan has been actively used as a preventive measure during pre and post-operative care and as a therapeutic procedure due to its antimicrobial, analgesic, anti-inflammatory properties. Yoni Dhoopan is effectively utilized in addressing diverse Yonivyapad conditions. Medicinal properties of Dhoopan drugs includes Kashaya and Tikta in Rasa, Katu in Vipaka, and Laghu and Ruksha in Guna, rendering them to be a potent Kledashoshaka, Shodhaka (detoxifier), and ropaka (wound-healer). Furthermore, it exhibits Yoni doshhara, Kledashoshaka, and Jantughana (anti-microbial) properties.

Risk factors for premature rupture of membranes in pregnant women: a systematic review and meta-analysis

ObjectiveTo identify risk factors for premature rupture of membranes (PROM) in pregnant women.DesignSystematic review and meta-analysis.Data sourcesWeb of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese...

Low uptake of gynecological consultation following domestic or sexual violence: A case-control study during pregnancy follow-up

ObjectiveThe aim of this study was to examine the association between exposure to domestic and sexual violence and low uptake of gynecological consultation. Study designBetween October 2021 and October 2022, a case-control studywas conducted in mother andchild centers and sexual health centers in the Paris, France area. The case group included pregnant women who did not have a scheduled gynecological consultation in the past two years. The control group included pregnant women who had a scheduled gynecological consultation in the past two years. Pregnant women were interviewed using a standardized questionnaire about a history of domestic and sexual violence, the date of their last gynecological consultation and the gynecological health. ResultsA total of 405 pregnant women were included in the case group (n = 129) or in the control group (n = 276). After adjustment for age, couple, social security, supplementary health insurance, dyspareunia, abnormal vaginal discharge, dysmenorrhea, regular pelvic pain, mastodynia, vulvodynia and history of difficult delivery, a history of intimate partner violence was associated with the absence of a gynecological consultation in the past two years (OR 2.13; CI95% 1.21–3.73, p = 0.008). A history of sexual violence, regardless of age, was associated with the absence a gynecological consultation in the past two years (OR 1.92; CI95% 1.05–3.49, p = 0.03). The absence of a gynecological consultation was associated with dyspareunia and domestic or sexual violence (p < 0.0001 and p < 0.0001, respectively). ConclusionsThis study highlighted the association between domestic and sexual violence and the absence of gynecological consultations in the past two years. It underlines the importance of screening for domestic and sexual violence during gynecological consultations and its impacts on mental health, in particular psychotraumatic symptoms, and on gynecological health, in particular dyspareunia.

Point-of-care diagnostics for sexually transmitted infections among migrants in Greece.

Sexually transmitted infections (STIs) can impact individuals of any demographic. The most common pathogens causing STIs are Chlamydia trachomatis, Neisseria gonorrhea and Trichomonas vaginalis; these can be treated with specific antibiotics. To compare the GeneXpert CT/NG test-and-treat algorithm to the syndromic approach algorithm and their impact on antibiotic prescription for gonorrhoea and chlamydia STIs. A retrospective observational study on women aged ≥18 years who accessed the Médecins Sans Frontières Day Care Centre in Athens with complaints related to urogenital infections between January 2021 and March 2022. Women with abnormal vaginal discharge, excluding clinically diagnosed candidiasis, were eligible for Xpert CT/NG testing. Of the 450 women who accessed care, 84 were eligible for Xpert CT/NG testing, and only one was positive for chlamydia, therefore resulting in saving 81 doses of ceftriaxone and azithromycin, and 19 doses of metronidazole. The cost of Xpert CT/NG testing, including treatment was €4,606.37, while full antibiotic treatment would have costed €536.76. The overall cost of the Xpert CT/NG test-and-treat algorithm was higher than the syndromic approach. However, quality of care should be weighed against the potential benefits of testing and syndromic treatment to determine the best option for each patient; we therefore advocate for decreasing the costs.

Prevalence of high-risk human papillomavirus infection and cervical lesions among female migrant head porters (kayayei) in Accra, Ghana: a pilot cross-sectional study

BackgroundLittle attention has been given to the risk of high-risk human papillomavirus (hr-HPV) infection and cervical precancerous lesions among female migrant head porters (kayayei) in Ghana, as a vulnerable group, and to promote cervical screening in these women. This pilot study aimed to determine the prevalence of hr-HPV infection and cervical lesions among kayayei in Accra, the capital of the Greater Accra Region of Ghana and to describe our approach to triaging and treating these women.MethodsThis descriptive cross-sectional cohort study involved the screening of 63 kayayei aged ≥ 18 years at the Tema Station and Agbogbloshie markets in March 2022 and May 2022. Concurrent hr-HPV DNA testing (with the MA-6000 platform) and visual inspection with acetic acid (VIA) was performed. We present prevalence estimates for hr-HPV DNA positivity and VIA ‘positivity’ as rates, together with their 95% confidence intervals (CIs). We performed univariate and multivariable nominal logistic regression to explore factors associated with hr-HPV infection.ResultsGross vulvovaginal inspection revealed vulval warts in 3 (5.0%) and vaginal warts in 2 (3.3%) women. Overall, the rate of hr-HPV positivity was 33.3% (95% CI, 21.7–46.7), whereas the VIA ‘positivity’ rate was 8.3% (95% CI, 2.8–18.4). In the univariate logistic regression analysis, none of the sociodemographic and clinical variables assessed, including age, number of prior pregnancies, parity, past contraceptive use, or the presence of abnormal vaginal discharge showed statistically significant association with hr-HPV positivity. After controlling for age and past contraceptive use, only having fewer than two prior pregnancies (compared to having ≥ 2) was independently associated with reduced odds of hr-HPV infection (adjusted odds ratio, 0.11; 95% CI, 0.02–0.69).ConclusionIn this relatively young cohort with a high hr-HPV positivity rate of 33.3% and 8.3% of women showing cervical lesions on visual inspection, we posit that kayayei may have an increased risk of developing cervical cancer if their accessibility to cervical precancer screening services is not increased.

Vaginal foreign bodies in pediatric population - presentation, diagnostic challenges, and role of vaginoscopy: A case series

Background: Vaginal foreign bodies (VFBs) in the pediatric population pose diagnostic and management challenges. This is due to the usual difficulty in obtaining an appropriate history, difficulty in conducting a vaginal examination, and the fallibility of conventional imaging modalities in picking most of the vaginal foreign bodies. In prepubertal who present with abnormal vaginal discharge or vaginal bleeding, the diagnosis of a vaginal foreign body should be considered, and appropriate care should be provided. Vaginoscopy is an excellent diagnostic and therapeutic modality for these cases. Case series: Between 2018 and 2023, 6 children aged between 3 and 6 years underwent vaginoscopy at our institution, having presented with diverse vaginal symptoms. The mean age was 4.5 years. Three presented with vaginal bleeding, two had recurrent vaginal discharge, and one had a history of trauma to the genitalia. There were no cases suspicious of sexual abuse. All except two had a normal external genital examination, with one having a small excoriation on the labia and the other having superficial perineal injuries due to trauma. All six cases had intact hymens. Vaginoscopy was performed using a 4-mm scope. Vaginal foreign bodies of varying size and consistency were retrieved from three patients. One patient had inflammatory changes on the proximal anterior vaginal wall. Two had normal findings. All 6 children tolerated the procedure well, with an excellent response to treatment. Conclusion: Correct diagnosis and management of pediatric vaginal foreign bodies is challenging compared with the adult population. A high index of suspicion is necessary for any young girl presenting with vaginal bleeding or abnormal vaginal discharge. Vaginoscopy is a safe and efficient diagnostic and therapeutic procedure for vaginal foreign bodies in the pediatric population.

Penyuluhan tentang Keputihan pada Remaja Putri di Pondok Pesantren Tahfidz Qur’an Hisbah Al-Fatih Sintang

Adolescence is a developmental phase and transition period from childhood to adulthood that is characterized by accelerated physical, mental, emotional, and social changes. This development begins with growth, change, and the emergence of various opportunities and risks of problems in reproductive health. Adolescents must prepare themselves from the aspect of knowledge and attitudes toward achieving healthy reproduction. One of the reproductive health problems in adolescent girls is vaginal discharge. The impact of abnormal vaginal discharge is the occurrence of infection and can lead to infertility. The purpose of this counseling is to provide health education about vaginal discharge so that the knowledge of young women increases so that they can better understand how to prevent vaginal discharge and maintain the cleanliness of the reproductive organs. The counseling was carried out at the Tahfidz Qur'an Islamic Boarding School Hisbah Al Fatih Sintang with 16 participants. Counseling is done using lecture and question and answer methods, the media used are leaflets and PowerPoint slide shows. The measurement of participants' knowledge was carried out by conducting a pretest and posttest and processed by the Paired Sample Test. The test results show that there is a change in the level of knowledge before and after being given counseling with a Sig value. (2-tailed) of 0.000 &lt; 0.05. The conclusion from the counseling was that there was an increase in participants' knowledge after given counseling. Counseling participants are expected to be able to apply a clean and healthy lifestyle to avoid vaginal discharge.

Using unsupervised machine learning to classify behavioral risk markers of bacterial vaginosis.

This study used an unsupervised machine learning algorithm, sidClustering and random forests, to identify clusters of risk behaviors of Bacterial Vaginosis (BV), the most common cause of abnormal vaginal discharge linked to STI and HIV acquisition. METHODS: Participants were 391 cisgender women in Miami, Florida, with a mean of 30.8 (SD = 7.81) years of age; 41.7% identified as Hispanic; 41.7% as Black and 44.8% as White. Participants completed measures of demographics, risk behaviors [sexual, medical, and reproductive history, substance use, and intravaginal practices (IVP)], and underwent collection of vaginal samples; 135 behavioral variables were analyzed. BV was diagnosed using Nugent criteria. We identified four clusters, and variables were ranked by importance in distinguishing clusters: Cluster 1: nulliparous women who engaged in IVPs to clean themselves and please sexual partners, and used substances frequently [n = 118 (30.2%)]; Cluster 2: primiparous women who engaged in IVPs using vaginal douches to clean themselves (n = 112 (28.6%)]; Cluster 3: primiparous women who did not use IVPs or substances [n = 87 (22.3%)]; and Cluster 4: nulliparous women who did not use IVPs but used substances [n = 74 (18.9%)]. Clusters were related to BV (p < 0.001). Cluster 2, the cluster of women who used vaginal douches as IVPs, had the highest prevalence of BV (52.7%). Machine learning methods may be particularly useful in identifying specific clusters of high-risk behaviors, in developing interventions intended to reduce BV and IVP, and ultimately in reducing the risk of HIV infection among women.

Prevalence, risk factors and genotyping of chlamydia trachomatis from endocervical specimens of infertile women at a tertiary care hospital, Vietnam.

To our knowledge, the prevalence, risk factors and distribution of C. trachomatis genotypes are rarely mentioned in Vietnam. This study aimed to find the prevalence, risk factors and distribution of C. trachomatis genotypes in infertile Vietnamese women. Endocervical swabs were collected from infertile women at the National Hospital of Obstetrics and Gynecology, Vietnam, between January 2020 and December 2021. All samples were analyzed for C. trachomatis presence by Cobas 4800 CT/NG Test. Sequencing methods of ompA gene were used to determine the C. trachomatis genotypes. An approximately 1200 bp ompA fragment was aligned with reference sequences from GenBank to identify the corresponding genotype. The prevalence of endocervical C. trachomatis infection was 15.6% of 761 participants. Factors independently associated with CT infection among infertile women, obtained by multivariate analysis, included abnormal vaginal discharge, cervicitis, lower abdominal pain, a history of ectopic pregnancy, having more than one sex partner, and age at first intercourse. Among the samples, genotype E (25.93%) was most frequently found, followed by genotypes D/Da (22.23%), F (13.58%), G/Ga (12.35%), J (12.35%), H (6.17%), K (3.70%), B/Ba (2.47%), and I/Ia (1.23%), respectively. Genotype F was related to types of infertility, and genotype H was associated with a history of miscarriage. The present study indicated a high prevalence of C. trachomatis in infertile Vietnamese women. The most common genotypes found in this population were E, D, and F. Our findings suggest that routine screening is necessary for early detection and performance of infection control methods.

LITERATURE REVIEW ON SHLESHMALA YONIVYAPAD (VULVOVAGINITIS)

Women are the pioneers of any Nation; they comprise half of the world’s population. They are the key to sustainable development, and the quality of life in families depends on them. Any disorder that hampers women’s general, mental, and reproductive health should be considered and require medical attention. Ayurvedic texts discuss the subject of women’s reproductive organ diseases under the subject of Yonivyapads. All Ayurvedic texts have described twenty Yonivyapads covering almost all gynaecological disorders. Shleshmala Yonivyapad is one of them, occurring due to vitiated Kapha Dosh having signs and symptoms like abnormal vaginal discharge, itching, coldness, and pain. Vulvovaginitis is the inflammation of the vulva and vagina due to several conditions like various infections, improper hygiene and dietary habits, etc. It is a frequently observed condition in gynaecological practice in today’s era. Its symptoms are more or less similar to that of Shleshmala Yonivyapad. Hence, an effort has been made to gather information available in texts on this disease in both aspects i.e. Ayurveda and modern, for better understanding and curing the patients.

Evaluation of Various Diagnostic Strategies for Bacterial Vaginosis, Including a New Approach Based on MALDI-TOF Mass Spectrometry.

Bacterial vaginosis (BV) is a common dysbiosis of unclear etiology but with potential consequences representing a public health problem. The diagnostic strategies vary widely. The Amsel criteria and Nugent score have obvious limitations, while molecular biology techniques are expensive and not yet widespread. We set out to evaluate different diagnostic strategies from vaginal samples using (1) a combination of abnormal vaginal discharge and vaginal pH > 4.5; (2) the Amsel-like criteria (replacing the "whiff test" with "malodorous discharge"); (3) the Nugent score; (4) the molecular quantification of Fannyhessea vaginae and Gardnerella vaginalis (qPCR); (5) and MALDI-TOF mass spectrometry (we also refer to it as "VAGI-TOF"). Overall, 54/129 patients (42%) were diagnosed with BV using the combination of vaginal discharge and pH, 46/118 (39%) using the Amsel-like criteria, 31/130 (24%) using qPCR, 32/130 (25%) using "VAGI-TOF", and 23/84 (27%) using the Nugent score (not including the 26 (31%) with intermediate flora). Of the 84 women for whom the five diagnostic strategies were performed, the diagnosis of BV was considered for 38% using the combination of vaginal discharge and pH, 34.5% using the Amsel-like criteria, 27% using the Nugent score, 25% using qPCR, and 25% using "VAGI-TOF". When qPCR was considered as the reference, the sensitivity rate for BV was 76.2% for the combination of vaginal discharge and pH, 90.5% for the Amsel-like criteria, 95.2% for the Nugent score, and 90.5% for "VAGI-TOF", while the specificity rates were 74.6%, 84.1%, 95.3%, and 95.3%, respectively. When the Nugent score was considered as the reference, the sensitivity for BV was 69.6% for the combination of vaginal discharge and pH, 82.6% for the Amsel-like criteria, 87% for qPCR, and 78.7% for "VAGI-TOF", while the specificity rates were 80%, 94.3%, 100%, and 97.1%, respectively. Overall, the use of qPCR and "VAGI-TOF" provided a consistent diagnosis of BV, followed by the Nugent score. If qPCR seems tedious and for some costly, "VAGI-TOF" could be an inexpensive, practical, and less time-consuming alternative.

Effect of Cymbopogon olivieri-based herbal vaginal product on bacterial vaginosis.

Bacterial vaginosis is the most common vaginal infection in reproductive-age women. If it is not treated, the quality of life will be reduced. In this study, the herbal medicine product Cymbopogon olivieri was used for its treatment. This study was conducted with 90 women. The patients were randomly divided into two groups of 45: Cymbopogon olivieri and metronidazole. The treatment period was 7 days for each group. Improvement status was determined by eliminating at least three out of four of Amsel's criteria. A new variable with two order levels (negative and positive) was constructed. This new variable shows the status of the treatment process. Chi-square and Fisher's exact tests were used to examine the relationship between the new variable and treatment status. The results demonstrate that Cymbopogon olivieri and metronidazole significantly reduced the burning, itching, malodor, abnormal vaginal discharge, pH, clue cell, and positive whiff test (p<0.05). The findings also demonstrate that neither treatment was statistically different from the other for at least three of Amsel's criteria. This study shows that the effect of Cymbopogon olivieri on bacterial vaginosis is similar to that of metronidazole. Hence, Cymbopogon olivieri is a suitable option to treat bacterial vaginosis.

Risk of ovarian cancer in women using ovarian induction protocols for infertility treatment.

Abstract: Cancer is rapidly becoming a major cause of morbidity and mortality worldwide, &amp; Infertility has been found to be an important risk factor for ovarian cancer. However, the association between infertility drugs and ovarian cancer needs to be addressed with consideration of other factors such as age, body mass index, parity, genetic factors (i.e. family history for ovarian cancer), and etiology of the infertility, along with longer followup times Aim of the study:To rule out or to prove that; the ovulation induction in infertility treatments and can cause ovarian cancer . Design: Retrospective randomized study Setting: Data were obtained from the patient records of those who were diagnosed as ovarian problem, which indicate surgical intervention, at lamis hospital for infertility &amp; Gyn. Misurata -libya. From January 1, 2017 to December 31, 2023. (seven years). Our study contained 110 patients operated with ovarian tumors &amp; 3608 patients treated for infertility by ovulation induction drugs &amp; icsi . Results: The age range of patients with ovarian tumors in our study was from 24 to 72 years, and the highest incidence of ovarian tumors was seen between 46 to 60 years. Most of the patients were at postmenopaus. More than half of the patient with ovarian pathology (58.2%) were multiparous; while nulliparous &amp; patients delivered up to three kids were 8.2% &amp; 33.6% consecutively. The main complain that the patient with ovarian pathology presented with abnormal vaginal bleeding (38.2%) ,lower abdominal pain (26.4%), abnormal vaginal discharge (23.6%) &amp; pelvic mass (21.8%), Some patients were with more than one complains. Only two patient out of 110 included at this study , received ovulation induction drugs (1.8%), while 98.2% of patient with ovarian pathology they never use any drugs for ovarian stimulation. Out of (110) patient there 38 patient were their diagnosis confirmed by histopathology as ovarian cancer of different types, tow patients were received ovulation induction drugs. Only one of them with history of icsi &amp; ovum retrieval (1/3608) I.e. 0.027%, she also had family history of breast cancer.(3608 are the number of cases done ovum retrieval for icsi at lamis infertility clinic at the period from January 2017 up to December 2023.) Conclusions: Although ,the question of whether ovarian stimulation increases the incidence of ovarian cancer, as an independent factor remains unanswered , We confirmed that ovulation induction drugs as treatment of infertility &amp; ovum retrieval for icsi are not a risk factors for ovarian cancer, and we observed no increase incidence of ovarian cancer , Further larger studies are recommended to confirm such findings