Abnormal Vaginal Discharge Research Articles

Uterine Cervix Rhabdomyosarcoma : A Case Report

Rhabdomyosarcoma is a malignant tumor that arises from embryonal skeletal muscle cells. It is responsible for 3% of cancer cases among children aged from 0 to 14 and 1% among adolescent and young adult aged from 15 to 19. Embryonal Rhabdomyosarcoma is the most prevalent subtype in the female genital tract and Botryoid sarcomas being a polypoid variant. In young patients, the majority of genital tract rhabdomyosarcomas occur in vagina; however, the most common site being cervix followed by uterine corpus, in adults. We hereby report a case of 24 years lady P2L2 diagnosed as Botryoid Embryonal Rhabdomyosarcoma with evidence of anaplasia without extrauterine metastasis. Embryonal cervical rhabdomyosarcoma is a rare malignant tumor and its typical manifestations are vaginal bleeding and a pelvic mass. However, attention should also be paid to any abnormal vaginal discharge in young unmarried women. Diagnosis of pure rhabdomyosarcoma in uterus involves perfect sampling and histopathological evaluation.

Progesterone-independent endometrial mRNA expression in dairy cows with clinical or subclinical endometritis

Up to 50 % of dairy cows fail to resolve uterine involution and develop chronic clinical (CE) or subclinical endometritis (SE) 21 days after calving. Clinical endometritis is associated with purulent discharge, while SE is not associated with overt clinical signs. Along with numerous knowledge gaps related to its pathogenesis, SE does not allow for a straightforward and effective therapy. Therefore, it is crucial to unravel differences in the expression of genes among healthy, CE, and SE cows. This might contribute to the discovery of new drug candidates and, in consequence, a potentially effective treatment. In the present study, cows between 21 and 28 days postpartum (PP) were examined using vaginoscopy for the presence of vaginal discharge and endometrial cytology for the determination of the endometrial polymorphonuclear cell (PMN) percentage. Next, an endometrial biopsy sample was taken to investigate the expression of 13 selected candidate genes by qPCR. Uterine health status was assigned to healthy (absence of abnormal vaginal discharge and ≤5 % PMN, n = 13), SE (absence of abnormal vaginal discharge and >5 % PMN, n = 30), and CE (mucopurulent or purulent vaginal discharge and >5 % PMN, n = 9). At the same time, a blood sample was collected to assess serum progesterone concentration and to categorize cows as low (≤1 ng/mL) or high (>1 ng/mL) in progesterone. High expression of IL1B, IL6, IL17A, CXCL8, PTGES, PTGS1, PTGS2, and INHBA genes and low expression of FST was noted in the endometrium of CE compared to healthy cows. Increased endometrial INHBA expression was observed in both SE and CE compared to healthy cows. Interestingly, greater expression of PTGES and PRXL2B genes and lower expression of PTGS2 were characteristic of SE versus CE or healthy. Among cows with no overt clinical symptoms of uterine disease (healthy and SE), the endometrial expression of IL1 B, CXCL8, and PTGES was greater in cows with high versus low serum progesterone. Several genes were differentially expressed among healthy, SE, and CE cows indicating different pathways for the development of different uterine diseases. In conclusion, we found progesterone-independent SE markers, which suggests that low endometrial PTGS2 expression may be indicative of an inadequate immune response and thus contribute to the pathogenesis of SE.

INCIDENCE OF VULVO VAGINAL CANDIDIASIS IN YOUNG WOMEN; EXPERIENCE FROM A TERTIARY CARE HOSPITAL, KARACHI PAKISTAN

Objective: To study the incidence of Candida species in women of child bearing age presenting with abnormal vaginal discharge with and without symptom of pruritus vulvae. Material and Methods: The descriptive cross sectional study was done from Feb 2022 to Jan 2023, HVS of 300 women were taken who presented with abnormal discharge from vagina and pruritus vulvae. Samples were taken for microbiological culture testing, after thorough assessment of pertinent gynecological and obstetric history. The cultures were followed up and the results recorded. Results: The most frequently identified organism causing abnormal vaginal discharge was Candida albicans (62.27%) with pregnant women experiencing a 59.09% considerably higher prevalence rate. The study found that vaginal candidiasis symptoms were itching, white curdy vaginal discharge, burning, and dyspareunia. Candida albicans was found in 62.2% of cases, while non-albicans were found in 37.7%. Pregnant women accounted for 59.09% of positive cases, with 74 cases of Candida albicans and 56 cases of non-albicans. Non-pregnant women accounted for 40.9% of positive cases, with 63 cases of Candida albicans and 27 cases of non-albicans. Conclusion: Vulvo Vaginal Candidiasis associated with C. albicans as well as non albicans species of Candida is very common in women of reproductive age especially in developing countries. Specific diagnosis of is important as it leads to prompt treatment with antifungal, thus improving patient's health and preventing chronicity associated with disease. Keywords: High vaginal swab, Vaginal candidiasis, Vaginal discharge.

Fluor Albus Characteristics Associated with Sexually Transmitted Infection (STI) in Makassar Pregnant Women

Sexually Transmitted Infection (STI) is a common condition with increased prevalence among pregnant women and can negatively affect the fetus. According to WHO, a total of 374 million new cases of STI are projected to occur in 2020, including gonorrhea (82 million), syphilis (7.1 million), and trichomoniasis (156 million). Therefore, this study aimed to determine the relationship between the characteristics of vaginal discharge (fluor albus) in pregnant women and STI. The descriptive method was used with a cross-sectional design, and the procedures were conducted in May 2023. The sample population comprised all pregnant women with ANC in Makassar during the study period. Vaginal swabs were obtained from 127 pregnant women who were willing to participate and had vaginal discharge. The results showed that 53 participants reported having physiological flour albus, while 74 had pathological symptoms. Itching and odor were reported to be the most common clinical signs associated with patients' abnormal vaginal discharge, followed by itching, pain, and odor. Furthermore, a significantly high prevalence of the condition was observed among pregnant women aged 20-30 years. Based on the results, the predominant symptom of fluor albus was itching and odor when combined with microorganisms that caused STI. Several pregnant women with clinical complaints also had microorganisms apart from those associated with STI. These results indicated the pressing need to develop additional testing in pregnant women with fluor albus, particularly those with concomitant symptoms.
 

Phenotypic characterization and antifungal susceptibility profile of Candida isolates from women with vulvovaginal candidiasis at a community health center linked to a teaching institution in the Sub-Himalayan region of North India.

Vulvovaginal candidiasis (VVC) is considered a common gynecological problem among females of reproductive age group. 70-75% of women report having had candidal vulvovaginitis at some point in their lifetimes and 40-50% suffer recurrent candidal vulvovaginitis. This study aims to identify the Candida species involved in VVC and to determine their antifungal susceptibility pattern. The present study was a cross-sectional study conducted on 257 females (18-55 yr) with complaints of abnormal vaginal discharge. For detection of Candida, the swab samples were subjected to Gram stain, 10% KOH mount, and culture on Sabouraud dextrose agar (SDA). Candida species identification was done by subculturing Candida isolates onto CHROMagar, corn meal agar (Himedia), and further confirmation was done by MALDI-TOF MS. Antifungal testing was done using the disk diffusion method. A total of 257 females with complaints of abnormal discharge were enrolled in this study. Out of 257, C. albicans 37 (58.7%) and 26 (41.3%) isolates were identified as non-albicans Candida. Out of 63 positive cases, a maximum number of study subject belongs to the age group 26-35 years (50.8%). Along with vaginal discharge, itching (65.37%) is the most common complaint. VVC was found to be most predominant in patients with prolonged antibiotic therapy (38.1%), and in pregnant females (15.9%). Understanding the emerging fungal pathogens and their drug susceptibility patterns is essential for the effective management of infections. Drug resistance can lead to treatment failure and highlights the need for alternative treatment options or strategies.

Determinants of prelabor rupture of membrane among pregnant women attending governmental hospitals in Jimma zone, Oromia region, Ethiopia: A multi-center case-control study.

Prelabor rupture of membrane defined as the rupture of fetal membranes before the beginning of uterine contractions, is a common complication of pregnancy and the leading cause of preterm birth. In Ethiopia, the prevalence of prelabor rupture of membrane varied significantly between settings due to variations in risk factors. Besides, there was no study conducted using primary data, particularly in the Jimma zone, Ethiopia. Therefore, this study aimed to identify determinants of prelabor rupture of membrane among pregnant women attending governmental hospitals in the Jimma zone, Oromia region, Ethiopia. An institutional-based unmatched case-control study design was conducted from October 15 to December 15, 2021, at four governmental hospitals. A consecutive sampling technique was used to select 316 participants (79 cases and 237 controls). Women with prelabor rupture of the membrane were confirmed by history, sterile vaginal examination, and ultrasound as cases, and their counterparts as controls. An interviewer-administered questionnaire was used to collect data on maternal (obstetric, medical, behavioral) and fetal-related characteristics. The data were entered into Epi Data version 4.6 and analyzed using SPSS version 25. Descriptive statistics, bi-variable, and multivariable logistic regression were computed. The odds ratio with a 95% confidence level was used, and the significance level was declared at a p-value < 0.05. A total of 316 participants (79 cases and 237 controls) were included in this study. Pregnancy-induced hypertension (AOR = 3.06, 95% CI: 1.41-6.64), history of abortion (AOR = 3.67, 95% CI: 1.56-8.65), urinary tract infections (AOR = 2.61, 95% CI: 1.13-6.06), abnormal vaginal discharge (AOR = 2.65, 95% CI: 1.21-5.79), maternal khat chewing (AOR = 3.40, 95% CI: 1.70-6.80), mid-upper arm circumference less than 23 cm (AOR = 2.80, 95% CI: 1.51-5.19), and fetal presentation (breech) (AOR = 2.63, 95% CI: 1.10-6.28) were determinants of prelabor rupture of membrane among pregnant women. This study revealed that the aforementioned factors were found to be determinants of prelabor rupture of membrane among pregnant women. Therefore, hospitals should give focus to the early screening, diagnosis, and treatment of pregnancy-induced hypertension, urinary tract infection, and abnormal vaginal discharge to reduce the burden of prelabor rupture of membranes.

A rare case of cervical gastric-type adenocarcinoma mimicking bilateral ovarian malignancy in a genetically confirmed Peutz-Jeghers syndrome without known polyposis

Abstract Introduction/Objective Cervical gastric-type adenocarcinoma (GAS) is rare and accounts for 2-4% of cervical cancer. GAS is usually sporadic but can be associated with Peutz-Jeghers syndrome (PJS), a rare autosomal dominant disorder caused by germline STK11 mutations and characterized by hamartomatous polyposis in the gastrointestinal (GI) tract, mucocutaneous pigmentation, and cancer predisposition. Although cases of GAS may occur in patients with PJS associated with polyposis, our patient with GAS has an unusual and perhaps unique association with the PJS mutation that is unassociated with polyposis. Methods/Case Report A 33-year-old female presented with abdominal pain, abnormal uterine bleeding, vaginal discharge, weight loss, and fatigue for one year. Pigmentations were noted on lips, gum, tongue, and hands. She had a family history of maternal ovarian and pancreatic cancers. Computerized tomography revealed large bilateral multiloculated complex cystic adnexal masses, thickened endometrium extending into the endocervix, and ascites. Tumor markers showed increased CA19-9 and CA125, suggesting either a primary ovarian malignancy or possible metastatic GI tract cancer to both ovaries. Her PAP smear demonstrated atypical glandular cells that favored endocervical origin. HPV was not detected. A cervical biopsy showed bland gastric-type glands without obvious stromal invasion. Given the clinical concern for malignancy, a cervical cone biopsy was performed, demonstrating unequivocal invasion by gastric-appearing glands. The tumor cells were positive for CK7, CEA, and PAX8, and were negative for CK20, CDX2, and p16. The pathologic diagnosis confirmed a primary GAS with a spread to bilateral ovaries. Although the upper GI tract and left colon were free of polyps or masses by endoscopic exam, the genetic evaluation revealed a germline heterozygous STK11 mutation consistent with PJS. Results (if a Case Study enter NA) NA Conclusion To our knowledge, this is the first case of occult PJS (confirmed by genetic analysis) presenting with widely advanced metastatic GAS without known polyposis.

Bacterial isolates and antibiotic susceptibility among women with abnormal vaginal discharge attending the gynecology clinic at a tertiary hospital in southwestern Uganda: a cross-sectional study

BackgroundAbnormal vaginal discharge is a common complaint among women of reproductive age, affecting about one- third of all women. In resource-limited settings where access to laboratory services is limited, treatment is usually syndromic. This approach may result in ineffective treatment, with high recurrence rates and a potential of developing antibiotic resistance. This study aimed to determine the bacterial isolates and antibiotic susceptibility among women with an abnormal vaginal discharge attending the gynecology clinic at a tertiary hospital in Southwestern Uganda.MethodsWe conducted a hospital based cross-sectional study among 361 women aged 15–49 years, presenting with abnormal vaginal discharge at the gynecology clinic of Mbarara Regional Referral Hospital from December 2020 to June 2021. Demographic characteristics were collected using a structured questionnaire. We collected cervical and vaginal sterile swabs and subjected them to wet preparation and gram stain. The specimens were cultured for bacterial isolates. Susceptibility testing was performed on samples with bacterial isolates using the Kirby-Bauer disc diffusion method, on the commonly prescribed antibiotics in this setting. We summarized and described the bacterial isolates and antibiotic susceptibility patterns as frequencies and percentages.ResultsWe enrolled 361 women with abnormal vaginal discharge. Bacteria were isolated in 29.6% (107/361) of the women, and the commonest isolates included; Staphylococcus aureus 48.6% (52/107), Klebsiella pneumoniae 29.9% (32/107) and Enterococcus faecalis 15% (16/107). Yeast cells were found in 17.7% (64/361) of the women with abnormal vaginal discharge. Cefuroxime (90.7%) and Ciprofloxacin (81.3%) had a high level of sensitivity while high levels of resistance were observed for Doxycycline (86.0%) and Azithromycin (67.0%).ConclusionThe common bacterial isolates were Staphylococcus aureus, Klebsiella pneumoniae and Enterococcus faecalis. The isolated bacteria were most sensitive to Cefuroxime and Ciprofloxacin but resistant to Doxycycline and Azithromycin. There is need for routine culture and susceptibility testing of women with abnormal vaginal discharge so as to guide treatment, minimize inappropriate antibiotic use and consequently reduce antibiotic resistance.

The predisposing factors of personal hygiene behavior of women of childbearing age in preventing leucorrhoea

Abnormal vaginal discharge in women of childbearing age becomes worse if it is not treated immediately because it can cause ectopic pregnancy and infertility. The low level of knowledge on hygiene of the reproductive organs often results in women ignoring it and assuming that vaginal discharge is a common health problem. The aim of the study was to analyze the personal hygiene behavior of women of childbearing age in preventing leucorrhoea in the Muncar coastal area, Banyuwangi Regency. This type of research is a qualitative method using a case study approach (Case Studies). Informants in this study amounted to 30 people. The results showed that most of the main informants had knowledge about the meaning of leucorrhoea, its causes, signs and symptoms, and prevention of leucorrhoea. The main informants get knowledge through social media, health workers, and the people closest to them. A small number of key informants did not know about the meaning of leucorrhoea, its causes, signs and symptoms, and prevention of leucorrhoea due to a lack of health information from health workers, social media and close people. Suggestions for women of childbearing age should improve personal hygiene for themselves. Be more open and communicate well about vaginal discharge with health workers, family and close friends.

Prevalence and Predictors of Chlamydia trachomatis and Neisseria gonorrhoeae Among HIV-Negative Pregnant Women in Kenya.

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in pregnancy contribute to adverse perinatal outcomes. We identified predictors of CT and/or NG infection among pregnant Kenyan women. Women without HIV were enrolled at 2 antenatal clinics in Western Kenya. Both CT and NG were assessed using endocervical samples for nucleic acid amplification tests. Poisson regression models were used to evaluate potential CT/NG risk factors. Classification and regression trees were generated to evaluate the joint effects of predictors. Overall, 1276 women had both CT and NG assessments. Women enrolled at a median of 26 weeks' gestation (interquartile range, 22-31 weeks), median age was 22 years (interquartile range, 19-27 years), and 78% were married. In total, 98 (7.7%) tested positive for CT/NG: 70 (5.5%) for CT and 32 (2.5%) for NG, 4 of whom (0.3%) had coinfections. Two-thirds (66%) of CT/NG cases were asymptomatic and would have been missed with only syndromic management. Risk factors of CT/NG included age <22 years, crowded living conditions, being unmarried, being in partnerships for <1 year, abnormal vaginal discharge, sexually transmitted infection history, and Trichomonas vaginalis diagnosis ( P < 0.1). Classification and regression tree analyses identified unmarried women <22 years in relationships for <1 year as 6.1 times more likely to have CT/NG compared with women without these characteristics (26% vs. 6%, adjusted prevalence ratio = 6.1, 95% confidence interval = 3.55-10.39, P < 0.001). Chlamydia trachomatis / Neisseria gonorrhoeae was frequently asymptomatic and common among young unmarried women in newer partnerships in this cohort. Integrating CT/NG testing into routine antenatal care may be beneficial, especially for young women in Kenya.

Stillbirth rates and their determinants in a national maternity hospital in Phnom Penh, Cambodia in 2017–2020: a cross-sectional assessment with a nested case–control study

BackgroundIn Cambodia, stillbirths and their underlying factors have not been systematically studied. This study aimed to assess the proportion and trends in stillbirths between 2017 and 2020 in a large maternity referral hospital in the country and identify their key determinants to inform future prevention efforts.MethodsThis was a retrospective cross-sectional analysis with a nested case–control study of women giving birth at the National Maternal and Child Health Centre (NMCHC) in Phnom Penh, 2017–2020. We calculated percentages of singleton births at ≥ 22 weeks’ gestation resulting in stillbirth and annual stillbirth rates by timing: intrapartum (fresh) or antepartum (macerated). Multivariable logistic regression was used to explore factors associated with stillbirth, where cases were all women who gave birth to a singleton stillborn baby in the 4-year period. One singleton live birth immediately following each case served as an unmatched control. Multiple imputation was used to handle missing data for gestational age.ResultsBetween 2017 and 2020, 3.2% of singleton births ended in stillbirth (938/29,742). The stillbirth rate increased from 24.8 per 1000 births in 2017 to 38.1 per 1000 births in 2020, largely due to an increase in intrapartum stillbirth rates which rose from 18.8 to 27.4 per 1000 births in the same period. The case–control study included 938 cases (stillbirth) and 938 controls (livebirths). Factors independently associated with stillbirth were maternal age ≥ 35 years compared to < 20 years (aOR: 1.82, 95%CI: 1.39, 2.38), extreme (aOR: 3.29, 95%CI: 2.37, 4.55) or moderate (aOR: 2.45, 95%CI: 1.74, 3.46) prematurity compared with full term, and small-for-gestational age (SGA) (aOR: 2.32, 1.71, 3.14) compared to average size-for-age. Breech/transverse births had nearly four times greater odds of stillbirth (aOR: 3.84, 95%CI: 2.78, 5.29), while caesarean section reduced the odds by half compared with vaginal birth (aOR: 0.50, 95%CI: 0.39, 0.64). A history of abnormal vaginal discharge increased odds of stillbirth (aOR: 1.42, 95%CI: 1.11, 1.81) as did a history of stillbirth (aOR: 3.08, 95%CI: 1.5, 6.5).ConclusionsStillbirth prevention in this maternity referral hospital in Cambodia requires strengthening preterm birth detection and management of SGA, intrapartum care, monitoring women with stillbirth history, management of breech births, and further investigation of high-risk referral cases.

Cervical cancer awareness and risk factors among women residing in an urban slum in Lagos, Southwest Nigeria.

Poor awareness of cervical cancer and high prevalence of its risk factors may be responsible for the large burden of cervical cancer in low-income countries. This study assessed awareness of cervical cancer and prevalence of risk factors among women residing in a slum in Lagos, Nigeria. This was a descriptive cross-sectional study carried out amongst 305 women of reproductive age (15-49 years) in Idi-Araba, a slum in Urban Lagos. Data were collected using interviewer administered questionnaires. Analysis was done with SPSS 20 software. Mean age of respondents was 33.5(9.0) years. Only 12.8% of the respondents had heard of cervical cancer. Ninety-five percent of respondents were sexually active and 56.2% had more than one lifetime sexual partner. Close to half (47.3%) of respondents had their first sexual intercourse before the age of 20. One in five (22.2%) had 5 or more children. Half of the respondents (54.8%) had had abnormal vaginal discharge. Awareness of cervical cancer among the women was poor and prevalence of risk factors of cervical cancer was high. Campaigns aimed at increasing awareness of cervical cancer, and screening should be carried out by governmental and charitable organizations for women residing in slums.

Modern possibilities of correcting violations of the vaginal biotope in pregnant women at risk in wartime conditions

Research objective: to determine the effectiveness of a complex local preparation with antiseptic action based on octenidine and repair agent dexpanthenol (Prodexyn) in the syndrome of abnormal vaginal discharge (AVD) in pregnant women with obstetric pathology during the gestation and in the sanitation of the birth canal on the eve of childbirth.&#x0D; Materials and methods. 49 pregnant women were examined and divided into 2 groups: group I – 21 women (including 6 pregnant women with the status of internally displaced persons (IDPs)) with AVD in the period of 14–36 weeks of pregnancy; group II – 28 pregnant women (15 of them IDPs) on the eve of childbirth, who needed sanitation of the birth canal in the period of 37-41 weeks. The selection of patients was based on complaints, objective examination in mirrors and determination of vaginal pH. A bacterioscopic and bacteriological study was carried out if the pH deviates from the norm in order to identify pathogens and control the treatment effectiveness. Prodexyn was prescribed to all women in the vaginal suppositories at night for 10 days from the II trimester of pregnancy.&#x0D; Results. Most of women had a complicated obstetric and gynecological history, chronic inflammatory diseases of the pelvic organs, and viral infections. 87.7% of women had obstetric complications during current pregnancy.&#x0D; In the group I the primary average value of vaginal pH was 4.94 ± 0.02, and was the highest in IDPs (5.0-5.3). In the group II the pH before delivery at the initial screening was 5.1 ± 0.03, and in IDPs it was 5.7. Bacterioscopic examination in both groups showed a large number of leukocytes, cocci and fungal flora. Bacteriological examination in both groups showed a total of 11 pathogenic and opportunistic pathogens in various 2–3 component microbial and microbial-fungal associations against the background of a significant decrease in the number of lactobacilli. Single cases of Staphylococcus aureus and Streptococcus agalactiae (in group I) and Streptococcus viridans (in group II) were found.&#x0D; After sanitation the state of the vaginal biotope significantly improved in the majority of pregnant women of both groups. pH in group I was 4.51 ± 0.013, in group II was 4.55 ± 0.03. According to bacterioscopy, the number of leukocytes, coccal, bacillus and fungal flora significantly decreased in both groups. Bacteriological examination showed positive dynamics of the microflora concentration and the amount of its species spectrum. The lactobacilli concentration increased in both groups. Worse indicators of the vaginal biotope restoration were observed in IDPs, especially in the I group in the II–III trimesters, which required an extension of the treatment course for another 5–10 days.&#x0D; Conclusions. The complex local preparation with antiseptic action Prodexyn for AVD in pregnant women with obstetric pathology has shown its effectiveness and safety. As a result of the treatment, the number of pathogenic and conditionally pathogenic flora decreased significantly, with a simultaneous increase in the saprophytic flora and lacISSN 2309-4117tobacilli concentration.

A Clinical Study to Evaluate the Efficacy of Kasisadi Vaginal Pessary and Udumbaradi Tail Pichu in Management of Shweta Pradar (Abnormal Vaginal Discharge): A Double Arm Random Control Study

Shwetapradara, a symptom of many gynaecologic disorders, develop due to vitiation of Kapha predominant Doshas. Laghutriya described Shwetapradar. In Charak Samhita management of Shwetpradar is described under the description of Pandurasrigdara. Chakrapani has explained Pandura-Asrigdara as Shwetapradar in his commentary. Objectives: To draw Ayurvedic management to the disease with effective cure and no or minimal side effects, that can be easily administered and accepted by the patient. Materials &amp; Methods: After obtaining Ethics Committee approval and informed consent, 210 patients were randomized into two groups. In one group, Kasisadi vaginal pessary in the night followed by Udumbaradi Taila Pichu for 2 hours in the morning was given while in another a vaginal pessary (clotrimazole+ tinidazole+ clindamycin) was given for 7 days. From baseline to 7th day on the bases of assessment criteria per-speculum examination was done. A comparison of categorical variables was done using an appropriate statistical test. Results: Uduambaradi Taila and Kasisadi vaginal pessary exhibited potentially comparable effects to the conventional treatment but the recurrence rate was found more in conventional treatment. Conclusion: Uduambaradi Taila pichu and Kasisadi vaginal pessary combination is an effective, side effects-free, patient-compliant herbal alternative for the management of abnormal vaginal discharge.

Leucorrhea and its Homoeopathic Management: A Review

Leucorrhea or vaginal discharge is the commonest reproductive tract infection in adult age women. Vaginal discharge is normal when it is fluid, white, clear watery and they change in amount depending on the time of menstrual cycle. Leucorrhea becomes abnormal when it changes in colour, consistency, odour along with itching and burning pain in the vaginal area. In such cases it can be suggestive of any underlying health condition like a vaginal infection. The common cause may be due to unhygienic conditions, infections in the genital tract and impaired immune function. Its prevalence is high but women are embarrassed about the problem and refuse to seek medical help. For the treatment of leucorrhea its important to know the causation. Homoeopathy being a holistic system of medicine has a wide scope in treating leucorrhea. There are many homoeopathic medicines in materia medica which are well proved and which can be prescribed for leucorrhea. Homoeopathy not only cures the infection but also prevents its recurrence. While alleviating the suffering of the patient it also improves the quality of life in patients suffering from abnormal vaginal discharge.

Increased Risk of Infertility in Women Infected with Human Papillomavirus.

Among several causes of infertility, urogenital infections seem to be influencing factors. The effect of bacterial or viral sexually transmitted infections (STIs) on human fertility is not well understood. The aim of this study was to determine the frequency of STIs in cervical samples of infertile and fertile women and study the relationship between these agents and infertility. In this case-control study, cytobrush was used for collecting of cervical sample from each infertile and fertile woman (n=95) who attended Research and Clinical Centers for Infertility in Kerman, Iran. PCR and real-time PCR methods were used to detect the presence of bacterial (genital Ureaplasma species, genital Mycoplasma species, Chlamydia trachomatis (C. trachomatis), and Gardnerella vaginalis) and viral (herpes simplex virus, human papillomavirus (HPV), and Epstein-Barr virus) agents, respectively. Fisher's exact test and the logistic regression with the significance level of ≤5% were used for statistical analyses. In general, 78.94% and 14.73% of specimens were positive for one or more studied microorganisms, respectively. Among studied agents, only the infection with HPV was significantly different between infertile and fertile groups (p=0.005) which may enhance the likelihood of female infertility (OR=5.30, 95% CI:1.47-19.11, p< 0.05). After adjusting for age, irregular menstrual cycle, abnormal vaginal discharge, and ectopic pregnancy, the odds ratio of infertility in HPV-infected women increased (OR=7.02, 95% CI:1.52-32.3, p<0.05). Since HPV infection is asymptomatic, periodic screening of women in reproductive age especially infertile couples is recommended for early diagnosis and prevention of infection progression and cross contamination.

Sosialisasi Personal Hygiene Untuk Pencegahan Keputihan Yang Dapat Menyebabkan Infeksi Pada Kalangan Remaja Tahun 2023

Adolescence experiences physiological, psychosocial, cognitive, moral and sexual development. Physiological changes in adolescence are the result of hormonal activity under the influence of the central nervous system. Physical differences between the sexes are determined on the basis of primary sex characteristics, namely the internal and external organs that carry out reproductive functions, such as the ovaries, uterus, breasts and penis. puberty and fat accumulation) but do not play a direct role in reproduction (Wong, 2015) Leucorrhoea in medical circles is known as leukore or fluor albus, which is discharge from the vagina. Leucorrhoea is a candida yeast infection in female genitalia and is caused by a yeast-like organism, namely candida albicans. Under normal circumstances, the vagina produces a clear, odorless, colorless fluid, the amount is not excessive and is not accompanied by itching. Leucorrhoea is the most common complaint in women. Leucorrhoea can occur under normal circumstances (physiological), but can also be a symptom of a disorder that must be treated (pathological) (Clayton, 2018). The method of carrying out this activity is: education in carrying out proper personal hygiene in adolescents to prevent abnormal vaginal discharge which is characterized by itching, odor, and green color so that it has an impact on infection. This activity began with the preparation of proposals and administration of activities in February 2023.

Office intrauterine morcellation for retained products of conception

Objective Proposing hysteroscopic morcellation (HM) as a surgical-therapeutic approach in the treatment of retained products of conception (RPOC) to prevent intrauterine adhesions (IUAs). Design Prospective analysis. Setting A teaching and university hospital. Patients Women with RPOC. Interventions Office -HM with ‘Truclear 5 C’. Material and methods Twenty-two consecutive patients presenting with trophoblastic residue retention after miscarriage and interruption of pregnancy or placenta remnants after cesarean section or delivery were enrolled. These women underwent office-HM with ‘Truclear 5 C’. Primary outcomes were median time and rate of hospitalization. The quality of the specimen was also analyzed. A hysteroscopic second look for IUAs was performed. Results Mean procedure time was six minutes (SD ± 5). Tissue samples had a mean collection size 2.5 cm3+0.9. 38% of the samples had spotting or abnormal vaginal discharge. Dilatation of the cervical canal was not performed in any case. Second-look hysteroscopy did not show any de novo IUAs in any of the enrolled patients. Conclusions In the hysteroscopic treatment of RPOC, HM is a valid choice in an office setting without the use of cervical dilatation. Removal of RPOC was uneventful in all cases, simple and carried out faster without any adverse outcomes.

Clinical Performance and Safety of Vaginal Ovules in the Local Treatment of Nonspecific Vaginitis: A National, Multicentric Clinical Investigation

PurposeNonspecific vaginitis is a distinct clinical entity with particular microscopic and immunologic features. There is currently no standard of care for women with nonspecific vaginitis. The aim of our study was to assess the change in vaginal symptoms score after 3 months of treatment with an intravaginal medical device in participants with abnormal vaginal discharge and specific signs and symptoms. As secondary objectives, the study analyzed other clinical and microscopic features, such as vaginal discharge aspect, change in vaginal pH, change in vaginal microbiome, and vaginal inflammation. MethodsThe study population included 47 participants with symptomatic vulvovaginitis, distinct from candidiasis, trichomoniasis, or bacterial vaginosis. The study design included 2 research sites from Romania. The treatment protocol consisted of 1 ovule per day inserted intravaginally during 15 consecutive days. The total study duration was 3 months. FindingsThe intravaginal medical device had a positive impact on the vaginal symptoms score for 72.34% of the study participants. Topical administration of the ovules balanced vaginal pH values and significantly reduced signs of inflammation between study visits. ImplicationsThis intravaginal medical device had curative effects that support its use as a stand-alone treatment in women with nonspecific vaginitis. A second clinical investigation is ongoing to evaluate the clinical efficacy of the device in postoperative care of cervical and vaginal wounds traumatic or secondary to surgical interventions. ClinicalTrials.gov identifier: NCT04735705.

Imiquimod for Cervical and Vaginal Intraepithelial Neoplasia: A Systematic Review and Meta-analysis.

To evaluate the treatment efficacy and the risk of adverse events of imiquimod for cervical intraepithelial neoplasia (CIN) and vaginal intraepithelial neoplasia (VAIN), compared with placebo or no intervention. We searched Cochrane, PubMed, ISRCTN registry, ClinicalTrials.gov , and the World Health Organization International Clinical Trials Registry Platform up to November 23, 2022. We included randomized controlled trials and prospective nonrandomized studies with control arms that investigated the efficacy of imiquimod for histologically confirmed CIN or VAIN. The primary outcomes were histologic regression of the disease (primary efficacy outcome) and treatment discontinuation due to side effects (primary safety outcome). We estimated pooled odds ratios (ORs) of imiquimod, compared with placebo or no intervention. We also conducted a meta-analysis of the proportions of patients with adverse events in the imiquimod arms. Four studies contributed to the pooled OR for the primary efficacy outcome. An additional four studies were available for meta-analyses of proportions in the imiquimod arm. Imiquimod was associated with increased probability of regression (pooled OR 4.05, 95% CI 2.08-7.89). Pooled OR for CIN in the three studies was 4.27 (95% CI 2.11-8.66); results of one study were available for VAIN (OR, 2.67, 95% CI 0.36-19.71). Pooled probability for primary safety outcome in the imiquimod arm was 0.07 (95% CI 0.03-0.14). The pooled probabilities (95% CI) of secondary outcomes were 0.51 (0.20-0.81) for fever, 0.53 (0.31-0.73) for arthralgia or myalgia, 0.31 (0.18-0.47) for abdominal pain, 0.28 (0.09-0.61) for abnormal vaginal discharge or genital bleeding, 0.48 (0.16-0.82) for vulvovaginal pain, and 0.02 (0.01-0.06) for vaginal ulceration. Imiquimod was found to be effective for CIN, whereas data on VAIN were limited. Although local and systemic complications are common, treatment discontinuation is infrequent. Thus, imiquimod is potentially an alternative therapy to surgery for CIN. PROSPERO, CRD42022377982.