Direct Microscopic Examination Research Articles

Molecular study of sapovirus in acute gastroenteritis in children: a cross-sectional study.

Background: Sapovirus has emerged as a viral cause of acute gastroenteritis. However, there are insufficient data about the presence of this virus among children with acute gastroenteritis. The present study aimed to evaluate the presence of sapovirus in children with acute gastroenteritis by reverse transcriptase-polymerase chain reaction (RT-PCR). Methods: A cross-sectional study enrolled 100 children patients with acute gastroenteritis from outpatient clinics with excluded bacterial pathogens and parasitic infestation. A stool sample was collected from each child for laboratory examination. Each stool sample was subjected to study by direct microscopic examination, study for rotavirus by enzyme-linked immunoassay (ELISA) and the remaining sample was subjected to RNA extraction and RT- PCR for sapovirus. Results: The most frequently detected virus was rotavirus by ELISA (25%). RT-PCR detected sapovirus in 7% of the stool samples. The children with sapovirus were all from rural regions and presented mainly during the winter season in Egypt (42.9%). The main presenting symptoms were fever (71.4%) and vomiting (57.1%). None of the children with sapovirus had dehydration. Rotavirus was significantly associated with sapovirus infections in 5 patients (71.4%, P=0.01). There was an insignificant difference between symptoms of gastroenteritis in children with sapovirus and children with gastroenteritis without sapovirus as regards vomiting (P=0.7), fever (P=0.46), and abdominal pain (P=0.69). Conclusion: The present study highlights the emergence of sapovirus as a frequent pathogen associated with acute gastroenteritis in children. There is a need for a national survey program for the study of sapovirus among other pathogens associated with acute gastroenteritis for better management of such infection.

Pulmonary function impairment and lung infections among tannery workers in Southern India

Background/Objectives: Tannery workers are prone to lung diseases due tohazardous operational conditions. Therefore, the present study was designed to investigate the respiratory morbidities and lung infections among tanneryworkers. Methods: This study included 110 tannery workers (83 male and 27 female). Pulmonary Function Test (PFT) was carried out among 53 workers. Direct microscopic examination and standard microbial culture were carried out to identify lung infections from clinical samples. Statistical analyses were carried using the SPSS software, version 26. Findings: Pulmonary Function Test (PFT) revealed severe restrictive, moderate restrictive and small airway obstruction among 16.9%, 18.9% and 11.3% of workers respectively. PPE usage was reported among 68% of the workers. Only 3.6% of the subjects reported being used face masks during work. The respiratory symptoms viz; cold & cough (44.5%), asthma (2.7%), wheezing (14.5%), shortness of breath (17.3%) and chronic bronchitis (3.6%) were noted among study subjects. A significant association was found between altered PFT values and the risk factors such as working sections and lack of PPE usage (p<0.05). Bacterial lung infections viz; Klebsiella pneumonia, Streptococcus pneumonia, Staphylococcus aureus and fungal infections viz; Candida albicans, Aspergillus niger and Aspergillus flavus were identified. Confounding factors of working sections and lack of PPE usage found to influence the PFT parameters. Applications: The study highlights the constant infectious hazards at the workplace. Frequent health monitoring, workplace monitoring, engineering controls and PPE use are mandate to curtail respiratory morbidity among tannery workers Keywords: Tannery workers; occupational lung disorder; Pulmonary function test; lung infections

Protective effects of dexmedetomidine on ischaemia-reperfusion injury in an experimental rat model of priapism.

The study aimed to investigate the effects of dexmedetomidine against ischaemia-reperfusion injury occurring after priapism in a model of induced-priapism in rats. A total of 18 male rats were randomised into three groups. Group 1 was the control group. A priapism model was performed rats in Group 2 and then ischaemia-reperfusion injury was evaluated. Group 3 had similar procedures to the rats in Group 2. Rats in Group 3 additionally had 100μg/kg dexmedetomidine administered intraperitoneally immediately after reperfusion. Blood and tissue samples were analysed. Biochemical analysis of blood samples revealed a decrease in the levels of the pro-inflammatory cytokines including interleukin-1 beta (IL-1 Beta), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-alpha) in Group 3 compared to Group 2 (p:.04, p:.009 and p:.009, respectively). Similarly, the highest malondialdehyde (MDA) level was in Group 2 (p:.002). The levels of antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were significantly higher in Group 3 than that of Group 2 (p:.037 and p:.045, respectively). Direct microscopic examinations revealed positive changes in desquamation, oedema, inflammation and vasocongestion scores in Group 3 compared to Group 2 (p:.007, p:.008, p:.007 and p:.006, respectively). Dexmedetomidine has a protective effect against ischaemia-reperfusion injury in penile tissue.

To study the prevalence &amp; clino-mycological profile of Otomycosis in Saurashtra &amp; Kutch region of Gujarat

Otomycosis is a superficial, sub-acute or chronic infection of the external auditory canal. It is worldwide in distribution with a higher prevalence in the hot, humid, and dusty areas of the tropics and subtropics. A wide variety of fungi can cause Otomycosis.To determine the demographic profile &amp; spectrum of fungi involved in Otomycosis in saurashtra &amp; Kutch region of Gujarat. A retrospective study of 101 clinically suspected cases of otomycosis were conducted. The sample are taken by two sterile cotton swabs comprised of secretions, pus and debris from the external auditory canal. Direct microscopic examination by 10% KOH, Gram stain &amp; cuiture on medium was done. Identification of fungi done by lacto phenol cotton blue, GERM TUBE TEST &amp; growth on CORNMEAL AGAR and Hichrome Media ysed for species identification. Out of 101 cases, 76(75.24%) were Culture Positive and 74(73.26%) were KOH positive. Out of 74 KOH positive, 65(87.83%) cases were culture positive. Predominantly males (52.6%) were affected. The most affected age group is 31-40 yrs of age (23.68%). (52.63%) was the predominant species isolated followed by Aspergillus flavus (36.84%), . . The disease is predominantly unilateral.Otomycosis should be suspected clinically and should be confirmed by laboratory diagnosis to prevent unnecessary use of antibiotics &amp; there by antibiotic resistance. Mycological diagnosis is important to differentiated from bacterial infection, since symptoms (pruritus, otalgia, otorrhea and hypacusis) are not specific.

A Comparative Randomized, Open-label, Multicenter Study of the Efficacy and Safety of Miconazole Mucoadhesive Tablets and Miconazole Gel in the Treatment of Oropharyngeal Candidiasis [Translated Article

SO-1105 is an oral mucosal adhesive tablet containing 50 mg of miconazole. It had been shown overseas that a once-daily application of the drug continues antifungal effect in the treatment of oropharyngeal candidiasis. We report the results of the phase 3 clinical study of this drug with miconazole gel as a control in Japan. The study included patients aged 20 years or older with oropharyngeal candidiasis who had oral lesions characterized by oropharyngeal candidiasis and whose fungi was confirmed by direct microscopic examination. The primary efficacy endpoint was the clinical cure rate on Day15 after 14 days of administration. The population analyzed for efficacy was per protocol set (PPS). 120 subjects were included in PPS. In detail, 59 subjects were in the SO-1105 group (SO-1105 group) and 61 subjects were in the miconazole gel group (Gel group). For efficacy, the clinical cure rate on Day15 was 47.5% in SO-1105 group and 47.5% in Gel group, showing the similar efficacy between both groups. For safety, adverse drug reactions were observed in 29.0% of SO-1105 group and 24.6% of Gel group, showing the similar safety between both groups. The efficacy of SO-1105 was shown to be similar to that of miconazole gel. Meanwhile, SO-1105 is an adhesive tablet and is administered once-daily. For this, SO-1105 is expected to better compliance and useful drug for the elderly. Therefore, SO-1105 is considered to be widely used in clinical practice as one of the therapeutic drugs for oropharyngeal candidiasis.

Mucormycosis: An epidemic within a pandemic

There has been a steep rise in the incidence of mucormycosis in India during the second wave of COVID-19 infection. This outbreak has principally been attributed to uncontrolled diabetes mellitus and injudicious use of corticosteroids. However, many nondiabetics and those never on steroids have also suffered from this deadly disease recently. Thus, research is under the way to look for other offending factors. Mucormycosis is an opportunistic, potentially fatal, fungal infection caused by a group of saprophytic fungi belonging to family Mucoraceae. Rhino-orbito-cerebral mucormycosis is the most common reported type. The fungi are angioinvasive in nature, leading to thrombosis and rapid tissue necrosis. It also shows neurotropism. We have conducted current literature review using the electronic database of PubMed and recent mycology books, to analyze the possible risk factors, pathogenesis, clinical features, and management protocol of mucormycosis, giving special emphasis on the Indian data. Medline search was supplemented by the personal communication with some researchers, since the problem is of recent origin and publications are still in progress. Our personal experience and current data declared by, or orders issued by union health ministry or state ministries have also been referred to. A high index of suspicion is essential for the early detection as the initial signs and symptoms might go unnoticed as they are nonspecific. The diagnosis requires the sample collection by nasal and sinus endoscopy, direct microscopic examination under potassium hydroxide (KOH), culture, imaging, and molecular tools. Histopathology and KOH mount are the cornerstones for the confirmation of diagnosis. A combination of aggressive medical therapy and surgical debridement can improve the survival. Amphotericin B continues to be the drug of choice.

Diagnostic performance of leukocyte count in direct microscopic examination in the diagnosis of septic arthritis

Diagnostic performance of leukocyte count in direct microscopic examination in the diagnosis of septic arthritis

Epidemiology of dermatophytoses in paediatric population in Southwestern Poland, 2011-2016.

IntroductionDermatophytoses are the most common superficial fungal infections in paediatric population. Its pathogen pattern has changed over years.AimTo analyse the spectrum of dermatophytoses in children living in Southwestern Poland, in the years 2011–2016.Material and methodsA total of 1705 patients were diagnosed with fungal skin infection in the Mycological Laboratory, Dermatology Department of the Wroclaw Medical University. Of them, 163 were under 18 years of age.ResultsIn 105 cases, dermatophytoses were detected. The collected specimens were examined using direct microscopy examination, staining, culture on specific media and PCR technique. The most common dermatophytes were Trichophyton rubrum and Trichophyton tonsurans (31.4% each), followed in the descending order by Trichophyton mentagrophytes (21.9%), Microsporum canis (13.3%) and Epidermophyton floccosum (1.9%). The most commonly affected body sites were glabrous skin of the trunk and extremities (41.7%), followed by face (22.2%), scalp (15.7%) and toe nails (14.8%).ConclusionsThis study revealed the most common types of dermatophytoses and their pathogens in children in Southwestern Poland. In comparison to earlier data obtained from this region, new epidemiological trends have been revealed. We observed the shift towards anthropophilic dermatophyte infections and an increasing number of onychomycosis in children. Because of climatic variations, migration, and changing lifestyle practices, further studies on dermatophytoses are necessary to improve our knowledge on the epidemiology of fungal infections.

Post-COVID mucormycosis: Ascertainment of the pathological diagnostic approach.

Post-COVID mucormycosis: Ascertainment of the pathological diagnostic approach.

Eğirdir Gölü’nde (Isparta) Cryptosporidium spp. ve Giardia spp. Varlığının Araştırılması§

Objective: The aim of this study was to assess both the presence and seasonal variability of Cryptosporidium spp. and Giardia spp. in Eğirdir Lake within the borders of Isparta province, which is used for drinking, agricultural irrigation and recreational purposes. Method: The research was carried out between July 2016 and January 2017 and water samples were taken from five different stations in three different seasons in Lake Eğirdir. After direct microscopic examination of the samples (Native-Lugol method), they were stained with Modified Acid Fast (MAF), and examined under the light microscope for parasites. Results: Cryptosporidium spp and Giardia spp were detected in 15 water samples in summer months, with an average density of 99.2% and 93.3% respectively, in Lake Eğirdir. In addition, both parasites were also detected intensively in autumn and winter Conclusion: The use of Lake Eğirdir for daily needs of people, agriculture andrecreational purposes cause increase in protozoal density. Thus, it is necessary to conduct parasitological studies on Lake Eğirdir, especially during the periods of swimming tourism, to determine the protozoal epidemiology in humans and animals. In addition, it is important to carry out adequate disinfection processes and plan the necessary control programs in terms of public health in the regions where Lake Eğirdir is used as drinking water.

Diagnosis of Acanthamoeba keratitis in Mashhad, Northeastern Iran: A Gene-Based PCR Assay.

Background:The genus Acanthamoeba is a free-living opportunistic protozoan parasite, which widely distributed in soil and fresh water. Acanthamoeba keratitis, which causes a sight-threating infection of the cornea, is going to rise in Iran and worldwide. The aim of this study was to compare direct microscopy, culture and PCR for detection of Acanthamoeba spp. in clinical samples and to determine the genotypes of Acanthamoeba spp. by sequencing 18SrRNA gene.Methods:Among patients clinically suspected to AK referred to a tertiary ophthalmology center at Mashhad, northeastern Iran. During 2017-18, twenty corneal scrapes specimens obtained. The samples were divided into three parts, subjected to direct microscopic examination, culture onto non-nutrient agar and PCR technique. Sensitivity, specificity, accuracy and likelihood ratio were evaluated.Results:Among 20 persons clinically suspected to amoebic keratitis, 13(69.2%) patients definitely diagnosed as Acanthamoeba keratitis. Wearing contact lens, eye trauma due to foreign particle and swimming in fresh water were the main predisposing factors. Most of patients suffered from pain and photophobia. Corneal ring infiltration and epithelial defect were common clinical sings. Direct examination had the lowest sensitivity and sensitivity of both Nelson-PCR and JDP-PCR methods were equal and highest. In addition, the results of sequencing identified that all strains belonged to T4 genotype.Conclusion:Amoebic keratitis is a sporadic parasitic keratitis, which is mainly seen in contact lens user in Mashhad. PCR based on 18S ribosomal DNA with JDP primers is a reliable and highly sensitive method for diagnosis of Acanthamoeba keratitis in clinically suspected cases.

In vivo reflectance confocal microscopy for the diagnosis of scabies

Scabies is a common, contagious skin parasitosis typified by generalised pruritus and determined by Sarcoptes scabiei hominis . Standard diagnostic techniques for scabies consist of identification of the mite or...

Molecular epidemiology of zygomycosis and their related factors in tertiary referral centers in southern Iran.

For the best management of the zygomycosis in immunocompromised patients, the present study aims to detect and identify the etiologic agents by DNA sequencing method and their related factors in clinical samples of patients. Clinical samples from 1,058 patients admitted in 11 university hospitals in Shiraz, Southern Iran were collected between July 2015 and July 2018. All samples (bronchoalveolar lavage, sputum, blood, tissue) were examined by routine microscopic and culture tests for zygomycetes. The etiologic agents were identified by the molecular method and sequencing. Direct microscopic examinations or pathology smear, culture, and PCR were positive in 61 (5.8%), 15 (1.4%), and 103 (9.7%) patients, respectively. According to EORTC/MSG criteria, the rates of proven, probable, and possible zygomycosis were 59.2% (61/103), 14.6% (15/103), and 26.2% (27/103 patients), respectively. The most prevalent etiologic agents according to sequencing were Rhizopus oryzae (44 cases), Rhizopus microsporus (31 cases), Rhizopus stolonifer (15 cases). Twenty-two patients (21.4%) with positive PCR died. There were significant relations between zygomycosis and the underlying disease (p = 0.043) and prior antifungal therapy (p = 0.023). White blood cell count was in the normal range in 14.1% of patients, and the means of erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were 65 mm/hour and 57 mg/L, respectively. Molecular methods and sequencing may have considered as suitable tools to diagnose zygomycosis. Identification of the etiologic agents may be considered as the future antifungal therapy and management of the respective patients.

Contribution de la PCR en temps réel dans le diagnostic biologique de la leishmaniose cutanée : expérience de l’institut Pasteur de Tunis

The aim of this study was to assess the performance of real-time PCR (qPCR) in the diagnosis of cutaneous leishmaniasis (CL). Culture, direct microscopic examination (DE) and qPCR were performed on dermal exudate samples collected from 235 confirmed CL cases. The qPCR was found to be more sensitive than other diagnostic techniques and was able to correct the diagnosis in 49 patients (20.9%) with negative dermal smears. Median parasitic load (PL) of the 49 dermal exudates with negative DE was lower than that of positive ones in microscopy. This suggests that PL likely impact the sensitivity of microscopy. On the other hand, qPCR was performed on DNA extracts of scraped products collected from the 23 out of 49 archived negative Giemsa-stained slides and showed 11 positive. Parasitic loads in the latter smears were lower than those in corresponding exudates. The results highlight qPCR relevance for the diagnosis of CL and recommend its use directly on dermal exudates collected from CL lesions.

The Association between Abnormal Vaginal Flora and Cytological Evidence of HPV with Prematurity in High-Risk Pregnant Women

Objective: To evaluate the association between abnormal vaginal flora and cytological evidence of HPV with prematurity in high-risk pregnant women. Study design: A prospective cohort study was designed with high-risk pregnant women who delivered singletons between 20-42 gestational weeks between January to November 2018. Vaginal specimens were collected to obtain material from the upper lateral vaginal vault and cervix for direct microscopic examination of vaginal contents and preparation of Gram-stained and pap smear slides. Potential determinants of infection were assessed using the chi-square test. Poisson regression was used to determine the prevalence ratio and 95% confidence interval of the association between the vaginal flora and cytology with prematurity and a p &lt;0.05 was considered as statistical significance. Results: A total of 68 pap smear and high vaginal swab samples were collected from high-risk pregnant women with a mean age of 30.3 years. There were 26 (38.2%) cases of abnormal vaginal flora and 6 (8.8%) of HPV-induced cytological abnormalities. The preterm delivery rate was comparable between women with normal and abnormal vaginal flora (11.9% vs. 11.5%, prevalence ratio 1.0 [95% confidence interval: 0.8-1.2], aPR 1.0 [95% confidence interval: 0.8-1.2]) and between women with and without abnormal cytology (16.7% vs. 11.3%, prevalence ratio 0.9 [95% confidence interval: 0.6-1.4], aPR 0.9 [95% confidence interval: 0.6-1.4]). Conclusions: We determined no association between abnormal cytology or altered vaginal flora in high-risk pregnancy in terms of overall preterm birth rate.

A NEW RECORD OF Leishmania (Viannia) guyanensis (Trypanosomatidae) FROM THE PACIFIC COAST OF COLOMBIA

The aim of this study wasthe identification of Leishmaniaspecies that causescutaneous leishmaniasisin a patient from Buenaventura, Valle del Cauca, on the Pacific coast of Colombia.Clinical samples were obtained from a 29 years-old male who presented a distinct ulcer with raised borders on his neck. Samples were taken for direct microscopic examination, parasite culture, and molecular identification of the infecting Leishmania species by sequencing of the cytochrome b gene. Direct examination was positive for amastigotes of Leishmaniabut the culture was negative. The infecting parasite species was identified as L. (V.) guyanensisby means of the nucleotide sequence of a 509 bp fragment of the cytochrome b gene. We report the presence of L. (V.) guyanensisin rural areas of Buenaventura in Valle del Cauca, and the expansion of the geographical distribution of this species in the Pacific region of Colombia.

Estimation of serum Adenosine Deaminase (ADA) level in sickle cell disease (SCD) and its association with reticulocyte count in a rural population of Chhattisgarh state

Prevalence of Sicklecell disease (SCD) is ranging from 1 to 40% and more in state like Chhattisgarh because of more share of Tribal population by this state in India. Genetic mutation at a sixth position of the β-globin chain (replacement of glutamic acid by valine) is the biochemical basis of this abnormality. Tissue specific increase of adenosine deaminase is related with lysis of RBC membrane in sickle cell disease. To know the pathology and biochemical basis of increase in serum adenosine deaminase in SCD is ardent. Prospective case-control study is conducted by taking thirty SCD cases [from Durg District of Chhattisgarh State] attending General Medicine OPD in our Medical College. Thirty age and sex matched healthy volunteers were selected as controls from same population. ADA estimation done by enzymatic-kinetic method. Complete hemogram done by Beckman Coulter and retiuculocyte count done by direct microscopic examination. Adenosine deaminase level in SCD was higher as compare to control group and difference is statistically highly significant i.e. p value 0.00 (

Examination of Giardia intestinalis with Direct Microscopy and Direct Fluorescent Antibody in Patients with Diarrhea.

In this study, our objective was to compare direct microscopic examination and direct fluorescence antibody (DFA) method for Giardia diagnosis in stool samples and to evaluate the possible risk factors related to Giardia infections. Stool samples of 185 patients with diarrhoea collected between June 2019 and July 2019 in Erzurum Yakutiye Research Hospital were included in the study. Microscopic examination of the samples was performed with native-lugol, and they were subsequently scanned by the indirect fluorescent assay microscope using the DFA method at 100-200X magnification. In addition, all patients filled a questionnaire prepared to determine the possible risk factors related to Giardia infection. The age of the 185 participating patients who belonged to different groups was between 0 and 94 years. Giardia spp. cysts were detected in five stool samples (2.7%) using direct microscopic examination. Nine samples (4.9%) were DFA-positive. The incidence of giardiasis was noted to be 7.5% in children, 3.8% in adults, 7.3% in people living in rural areas, 2.9% in people living in urban areas, 10% in people having pets and 4.2% in people who do not have pets. By taking the DFA method as a reference, the sensitivity and specificity of the microscopic examination were found to be 44.4% and 99.4%, respectively. The Giardia positivity rate was higher in children, those living in rural areas, those having pets and those using well water as drinking water.

Topical Treatment of Feline Dermatophytosis

Dermatophytosis is one of the most frequent fungal skin diseases of pet animals, with high cost of treatment, and difficult control measures. Also, the disease has an important public health consequence. In our study, during a period of 2 year, 183 cats with cutaneous lesions were examined using direct microscopic examination and by fungal culture on Sabouraud Dextrose Agar (SDA). Out of 183 suspected samples, 94 cultured positive (51.4%). Where 73 samples showed colonies of M. canis (77.7%), while 13 showed T. mentagrophytes colonies (13.8%) and only 4 samples (4.3%) yielded mixed infection (M. canis and T. mentagrophytes). One sample (1.1%) was positive for M. gypseum, one sample (1.1%) for T. verrucosum, one sample (1.1%) for T. phaseoforme and one sample (1.1%) for T. violaceum. Randomly, 25 dermatophytes-infected cats were allocated into 5 groups (5 cats each) where they are treated using topical antifungal agents; Terbinafine, Miconazole, Enilconazole, Ketoconazole as well as combined essential oils (EOs) where they were tested for their curative antifungal effects. Results showed that topical treatment with combined essential oils have had a very effective antifungal curative effect. Also, antifungal agents showed clinical improvement of skin lesions in the following order: combined essential oils, Enilconazole, Miconazole, Terbinafine and Ketoconazole. The results also proved that local treatment appears to be effective in most cases with no need for systemic treatment.

Relationship between Vulvovaginitis in Women with the Candida Species

Background: Vulvovaginal candidiasis refers to the vaginal infection that is caused most commonly by candida species, especially candida albicans, women in their lifetime at risk to infect by candida species. The objectives of this study were to determine the relationship of Vulvovaginal infection with Candidiasis and its association with some risk factors and the incidence of different species of Candida among patients with vulvovaginitis. Methods: 300 samples from high vaginal swabs obtained from females attending maternity teaching hospital in Erbil City complained from signs and symptoms of valvovaginitis from the period September 2019 to February 2020. A questionnaire form prepared for each patient, who includes: age, clinical presentation and history of pregnancy, diabetes, and history of using contraceptives and the type of contraceptives. High vaginal swabs collected from patients and direct microscopic examination performed, cultured onto Sabouraud Dextrose Agar (SDA), Blood agar and Macconkey agar and species identification done by using an automated VITEK 2 compact system. Results: From the total of 300 high vaginal swabs collected at Maternity hospital in Erbil city and prevalence of vulvovaginal candidiasis was (57%). The highest prevalence of positive cases were in the age range (30-34) years and the positive culture among pregnant women was 73(63.4%) and also the incidence of vulvovaginal candidiasis was higher among diabetic females 49(80.3%), The incidence of positive cultures of Candida spp. in the antibiotic users group were 61(64.4%) and also the positive culture for candida spp was higher among the contraceptive pills 40(60.6%) however for IUCD user the positive culture was 31(68.9%). The species of Candida species which identified by using Vitek system were distribute as follow: Candida albicans was 147(86%) Candida glabrata16 (9.4%),CandidaParapsilosis 6(3.5%)and, Candida krusei 2(1.2%). Conclusion: In the present study, vulvovaginal candidiasis is more in the young age group and more frequent in the pregnant ladies and the diabetic patients and those using antibiotic and contraceptives, either the pills or Intrauterine contraceptive device. Candida albicans had the highest percentage among other positive isolated from high vaginal swab and there was a significant relation between clinical presentation of the patient with the result of culture.