Leucorrhea Research Articles

SHWETA PRADAR IN AYURVEDA

Shweta Pradara is one of the most common and burning problems faced by women all around the globe. No woman is an exception to this illness. Many of the gynaecological disorders present Shweta pradara as the significant complaint which, if neglected, may lead to ascending infections harming the general health and disturbing the women psychologically. Shweta pradara can be a symptom of many diseases and an independent entity. The white discharge with foul smell makes it embracing to get into social gatherings and even engage in her personal affairs. The white discharge may start as a simple problem and end in severity up to infertility if not treated at the right time. Many treatments are prescribed for this problem but are not free from side effects and recurrence. Hence, the selection of appropriate treatment without disturbing the other system is essential. The present study has been designed to substantiate the Nidana and Samprapti, Samprapti Vighantana of Shweta Pradara so that an alternative better form of therapy can be made available in those suffering from Shweta Pradara. She was taking into account the complications of untreated Shweta Pradara, like infertility, etc. Therefore, this condition must be actively treated, and the quality of life must be restored.

Primary cervical malignant melanoma: A rare entity case report

Primary malignant melanoma of female genital tract is rare, and rarer are those arising from the cervix. Pathogenesis involving BRAF & RAS pathway whether holds true for these tumours as well is a question yet to be answered. Patients come with bleeding PV as their main complain. To reach at the diagnosis of primary malignant melanoma of cervix it is important to have clinical examination with speculum assessment along with pathological evaluation of the lesion. Case presentation: We report a case of 49/F, Para 1, living 1 (P1L1), who was postmenopausal since 13 years with complains of white discharge and bleeding per vaginum since 1 week. Per vaginal examination revealed a greysih white brown growth in the cervix involving vagina. Biopsy and immunohistochemistry showed malignant melanoma (MM). Conclusion: Clinical presentation and spread pattern of primary MM of cervix is similar to that of cervical carcinoma and clinically diagnosing as melanoma is even more difficult when more than 50% tumours are amelanotic. But early diagnosis is need of the hour as these cases have poor prognosis with no standardize treatment protocol available. The FIGO staging system has been accepted by most researchers. Reporting of such cases is pertinent so as to allow the study of this extremely rare tumour for bringing up the correct and new therapies for early treatment.

Vaginal Yeast Infections: Causes, Symptoms, Diagnosis, and Treatment

Abstract Vaginal yeast infection, or vaginal candidiasis, is a common condition caused by the overgrowth of the yeast Candida albicans. Approximately 75% of women will experience at least one episode in their lifetime. Candida species, especially C. albicans, typically exist as part of the normal vaginal flora but can proliferate due to various triggers, such as antibiotic use, hormonal changes, or weakened immune systems. The infection presents with symptoms such as itching, burning, white discharge resembling cottage cheese, and discomfort during sexual intercourse. Diagnosis typically involves a pelvic examination, and treatment ranges from over-the-counter antifungal creams to prescription medications like fluconazole. Home remedies, such as applying yogurt or using probiotics, have gained popularity, though their efficacy is not consistently supported by clinical evidence. The potential complications of untreated infections include recurrent episodes, pelvic inflammatory disease, and in rare cases, increased susceptibility to sexually transmitted infections. Effective prevention strategies include avoiding douching, wearing breathable cotton underwear, and maintaining balanced vaginal flora. This communication focuses on the causes, symptoms, diagnosis, treatment, and preventive measures for vaginal yeast infection, emphasizing the need for accurate diagnosis and appropriate treatment to prevent recurrence and complications.

Correlation of cervical pap smears with histopathological study of cervical biopsies: A hospital-based study

Background: Cervical cancer is the second commonest cancer among women accounting for 17.7% among all cancers in women. The high incidence of disease in developing countries is mainly due to absence of effective screening programs. The Papanicolaou (Pap) smear is widely employed for initial screening of cervical epithelial changes to detect early precancerous lesions. Objective: To correlate the cervical cytological findings with histopathological diagnosis using PAP and haematoxylin and eosin stains respectively. Methods: A prospective study conducted in tertiary health care centre over a period of 6 months. Out of 680 PAP smears, 100 cases were selected who were above 21 years and corresponding histopathological samples were received in the form of cervical biopsy. The data was collected and compiled in MS Excel and analysed using SPSS (Version 26.0). The variables were expressed as frequency and percentages and p value <0.05 was considered as statistically significant. Results: In this study, most common age was between 41-50 years (30%) and were multiparous (77%). The most common presenting complaint was white discharge per vagina (34%) followed by abnormal uterine bleed (29%). On PAP smear maximum cases were reported as NILM(64%), followed by ASCUS(19%), LSIL(11%), HSIL(4%), SCC(1%) and Adenocarcinoma(1%). On histopathology 45% were diagnosed as chronic cervicitis, chronic cervicitis with squamous metaplasia(32%), CIN I(9%), CIN II(4%), CIN III(8%), SCC(2%) and Adenocarcinoma(1%). Overall sensitivity of Pap smear was 86%, specificity 79%, positive predictive value 55%, negative predictive value 95% and accuracy of 81%. Conclusion: Hence we conclude that, maximum cases diagnosed on PAP smear correlated with histopathological diagnosis from cervical biopsy. Therefore it should be encouraged as effective screening method to reduce incidence and mortality caused by cervical cancer.

Vaginal candidiasis prevalence, associated factors, and antifungal susceptibility patterns among pregnant women attending antenatal care at bule hora university teaching hospital, Southern Ethiopia

BackgroundVulvovaginitis is common in women of reproductive age group characterized by purulent white discharge. The incidence of vulvovaginitis has risen recently due to the resistance of Candida species to commonly used antifungal agents and recurrent infections.ObjectiveThe study aimed to determine the prevalence, associated factors, and antifungal susceptibility patterns of vaginal candidiasis among pregnant women attending Bule Hora University Teaching Hospital.MethodsA hospital-based cross-sectional study was conducted from May 2023 to August 2023. Using systematic random sampling, 317 pregnant women participated in the study. Sabouraud Dextrose Agar and Chromogenic Candida Differential Agar were used to isolate and identify Candida species from clinical samples. Antifungal susceptibility was performed using a modified disc diffusion method. Epi data version 4.6 was used for data entry and Statistical Packages for Social Sciences version 25 was used for statistical analysis. A P-value < 0.05 was declared statistically significant.ResultThe prevalence of vaginal candidiasis was 26.8% (95%, CI 21.9–31.72%). History of using contraceptives (AOR = 5.03, 95%CI, 1.21–11.37), past vaginal candidiasis (AOR = 6, 95%CI, 1.61–12.92), pregnant women infected with human immunodeficiency virus (HIV) (AOR = 4.24, 95%CI, 1.23–14.14), diabetic mellitus (AOR = 2.17, 95%CI, 1.02–4.64), history of antibiotic use (AOR = 3.55, 95%CI, 1.67–12.75), pregnant women in third trimester (AOR = 8.72, 95%CI, 1.30–23.07), were the significantly associated factors for vaginal candidiasis. The study revealed that itraconazole, amphotericin B, and miconazole were the most effective antifungal drugs for all Candida isolates.ConclusionThe present study has identified a high prevalence of vaginal candidiasis among pregnant women. The isolated Candida species showed resistance to fluconazole, ketoconazole, and clotrimazole. Therefore, healthcare providers should increase awareness of the risks of Candida infections to reduce Candida species among pregnant women. Physicians should prescribe suitable medications based on antifungal drug test outcomes to treat pregnant women with vaginal candidiasis.

Ayurvedic Management of Cervical Erosion Through Ksharkarma with Tuttak Drava

Cervical erosion is a condition where the squamous epithelium of the ectocervix is replaced by columnar epithelium which is continuous with endocervix. This condition can be taken as Karnini Yonivyapada. In cervical erosion, the cervix becomes hypertrophic, clogged, and covered with small red projections that resemble sprouts. Due to this clinical appearance, Karnini Yonivyapada is likened to cervical erosion. The treatment aim to eliminate the ectopic columnar epithelium and create a healthy cellular environment, ensuring proper regression of the erosion. In the present study the complaints of patient was white discharge per vaginally with itching since 1 year associated with backache. In 'Karnini yonivyapada', the imbalanced Doshas are Vata and Kapha, and the affected Dhatu is Rakta. So the treatment principle adopted was balancing Vata and Kapha with purification of Rakta. The condition was treated with Kshara karma through Tuttak drava. Tuttak drava was prepared as aqueous solution of copper sulphate and is used because of Vranaghna, Vranadoshahara properties.

A CONCEPTUAL STUDY ON SHWETA PRADARA

The term "Shweta pradara" refers to whitish vaginal discharge, with "Shweta" meaning white and "pradara" meaning discharge. While the term is not found in the primary classical texts, it has been used by commentators such as Cakrapani on the Charaka Samhita and Vrinda Madhava. White vaginal discharge is a common symptom in various gynaecological disorders linked to imbalances in kapha or vāta-kapha. It is a cardinal symptom in conditions such as Atyānanda, Karnini, Acarana, Aticarana, Slesmala, Upaplutā, and Prasramsini. It is prevalent among women of reproductive age and is often caused by infections. In the perimenopausal group, Shweta pradara warrants careful investigation to exclude dysplasia or malignancy. Proper treatment protocols and maintaining hygiene can effectively manage and alleviate this condition.

Severe Vulvovaginal Candidiasis Associated With Sodium-Glucose Cotransporter 2 Inhibitors Use in Postmenopausal Women.

We present a case series of severe vulvovaginal candidiasis in postmenopausal women using sodium-glucose cotransporter-2 inhibitor (SGLT2i) medications for the management of their diabetes mellitus. Twenty-four cases from a private vulvovaginal specialist clinic are described. All 24 patients were referred with severe and persistent vulvar pruritus, pain, and erythema. Examination findings varied between patients and included erythema, edema, erosions, adherent white discharge, and fissuring, which were extensive and often involved the mons pubis, labia majora, and extended to the perineum and perianal region, mimicking psoriasis and/or irritant dermatitis. The clinical presentation in this postmenopausal group hindered a timely diagnosis, resulting in a delay in appropriate management. Fortunately, all patients improved on oral antifungal treatment, and in those that ceased their SGLT2i medication, there was resolution of the condition. While candidiasis is reported to occur with SGLT2i, severe genital mycotic infections are not yet a well-recognized adverse effect and may be missed. The presentation in these cases was persistent and severe. Clinicians should have a high index of suspicion in postmenopausal women presenting with vulvar pain, pruritus, and extensive erythema that mimics psoriasis or irritant dermatitis, if they are on SGLT2i therapy.

Health Care Problems of Unmarried Women in Rural Areas: A Study in Chidambaram Area, Cuddalore District, Tamil Nadu

Rural women are among the most marginalized groups in Indian society. Many welfare policies are being launched and executed in favour of rural women, who have historically been marginalized. Despite these efforts, rural women continue to be affected by various issues, particularly poor health, which is linked to their productivity and human capital. In this regard, the WHO states that "better health is central to human happiness and well-being. It also makes an important contribution to economic progress, as a healthy population lives longer, is more productive, and saves more." Rural women have limited access to and opportunities to utilize health care policies. Through our study, we intended to assess the perceptions of unmarried women regarding health-care-seeking behaviour related to problems during menstruation. In this study, 300 unmarried women aged 15–35 were selected as the sample. Although the schedules were administered to all 300 women selected in the sample villages for this study, the data were collected from the respondents using a well-structured interview schedule. The association between the health problems at various levels reported by the women in the study area and their socio-economic and demographic variables was analysed using the chi-square test. The major health problems reported by respondents in the study area were analysed with regard to the socio-economic and demographic characteristics of the women. Abdominal pain, profuse bleeding, irregular periods, breast tenderness, painful menstruation, leg pain/backache, headache/vomiting sensation, and white discharge were the major problems reported by the women in the study area. To assess the health problems of women during menstruation, unmarried women were considered for further analysis.

Management of Intramural Uterine Fibroid by Ayurveda - A case study

Too many female gynaecological issues are a result of shifting food habits and lifestyles. One of the main concerns for women who are of reproductive age is uterine fibroids. The symptoms of uterine fibroids have a detrimental effect on women's well-being, their ability to engage in social and physical activities, and their productivity at work. A 25-year-old married female patient arrived at the outpatient clinic complaining of lower abdominal pain, heavy menstrual flow, burning during micturition, and white discharge coming from her vagina six months ago . An intrauterine fibroid measuring 24 x 10 mm size with an ET of 10.5 mm was seen during the ultrasound examination. The ovaries' B/L measurements were normal, and the wall of the gallbladder was slightly enlarged. Surgery was recommended for the same condition, but the patient refused to have it done and preferred non-hormonal treatment. The patient refused to take any allopathic medication. The patient sought Ayurvedic treatment at the OPD. She received treatment in accordance with the Ayurvedic regimen prescribed by Kanchanar Guggulu, Kuberaksha vati, Raktavardhak vati, Ashoka-arishta, Hingwashtak churna, Chandraprabha vati, Kumaryaasawa.After three months of treatment and a follow-up every 15 days, a repeat scan showed normal results and symptom alleviation.

EFFECTIVENESS OF RED BETEL (PIPER CROCATUM) EXTRACT ON LEUCORRHEA IN WOMEN OF CHILDBEARING AGE

Introduction: Reproductive health problems exist in Asia; 76% of women experience vaginal discharge. Vaginal discharge symptoms are also experienced by women of childbearing age (around 31.8%). Women of childbearing age are more at risk of fluor albus, which can be a trigger for reproductive organ infections. One of the treatments is to use betel leaves, which contain natural antiseptics and antibiotics. Objectives: This study aimed to determine the effectiveness of red betel leaf extract (Piper crocatum) against leucorrhea in women of childbearing age. Method: This research method uses a quasi-experiment design with one pre-and post-test design technique group. The research was conducted at the Independent Midwife Practice in Bandung City. The population in the study were all women of childbearing age in Bandung City. The sample consisted of women of childbearing age, according to the inclusion criteria of 36 people. The data obtained were primary data from the measurement of vaginal pH with Neco test litmus paper. The data analysis used was the Wilcoxon test to test the difference in pH scores before and after the intervention. Result: The results showed a significant difference in the use of 0.5% red betel leaf extract in women of childbearing age before and after the intervention. Conclusion: Red betel leaf extract 0.5% is effective in reducing the incidence of leucorrhea. There is a decrease in vaginal pH before and after the use of red betel leaf extract 0.5% by 1.78 (p &lt;0.05).

Atrial Fibrillation: Prevalence and Association With Outcome in Patients With Stroke Undergoing Mechanical Thrombectomy in the United States

Background How the prevalence of atrial fibrillation (AF) has changed over time in various demographic subgroups of patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT) in the United States is unknown. Whether in‐hospital outcomes differ between patients with AF versus patients without AF after MT remains uncertain. Methods We conducted a serial cross‐sectional study using all primary AIS discharges in the 2010 to 2020 National Inpatient Sample. Discharges with MT codes were identified (n = 155 277), and the proportion with AF in various age, sex, and racial subgroups were computed. We used multivariable‐adjusted negative binomial regression to compare AF prevalence between demographic subgroups and joinpoint regression to evaluate trends over time. Multivariable‐adjusted generalized linear models were used to evaluate the association of AF with in‐hospital outcomes. Results Across the study period, 45.0% of AIS discharges with MT had AF, but prevalence varied by age, sex, and race or ethnicity. After multivariable adjustment, AF prevalence was 4% higher in women versus men (prevalence rate ratio, 1.04 [95% CI, 1.01–1.07]) and was lower in Black versus White (prevalence rate ratio, 0.80 [95% CI, 0.77–0.84]) but higher in Asian compared with White discharges (prevalence rate ratio, 1.11 [95% CI, 1.05–1.18]). Prevalence increased with age (prevalence rate ratio for ≥80 years versus 18–39 years, 5.23 [95% CI, 4.28–6.39]). Following joinpoint regression, prevalence increased by 3.2% (95% CI, 1.3%–5.2%) annually across the period 2010 to 2015 but declined by −2.2% (95% CI −2.9% to −1.4%) from 2015 to 2020. AF was associated with 22% lower odds of in‐hospital death (odds ratio, 0.78 [95% CI, 0.71–0.85]) and 13% greater odds of routine home discharge (odds ratio, 1.13 95% CI, 1.04–1.22]) compared with no AF. Conclusion AF prevalence in patients undergoing MT in the United States is approximately twice that of the general AIS population. AF prevalence in MT increased from 2010 to 2015 but declined from 2015 to 2020. In the subset of patients with AIS undergoing MT, AF is associated with reduced in‐hospital death.

Vaginal candidiasis, predisposing factors, symptoms and treatment

Introduction: Vulvovaginal candidiasis is a disease caused by Candida species, mainly Candida albicans species, which can be colonizing the vaginal microbiota of healthy women, without causing disease. Due to its high prevalence, it is one of the most frequent causes of gynecological consultation. It occurs mainly in women after puberty, worldwide it is estimated that at least 75% of women have had candidiasis at least once in their lives. Its clinical signs are itching, vaginal inflammation and white discharge. It is diagnosed by laboratory tests or culture. A higher frequency of candidiasis occurs in women with high estrogen load or some degree of immunodeficiency. Treatment consists of azole antifungals, particularly fluconazole. The present study consists of a systematic review of the existing literature related to vulvovaginal candidiasis, focusing on epidemiology, clinical signs, diagnosis and treatment. Material and methods: The study design is a literature review for which a search and evaluation of the existing literature and previous research on vaginal candidiasis will be carried out through the databases PubMed, Google Academic, Scielo, Sciendirect, among others. For this purpose, inclusion criteria will be used through searches related to "Candida", "vaginal candidiasis", "recurrent vaginal candidiasis", "vaginal candidiasis predisposing factors" and "candidiasis literature review". Results: Vaginal candidiasis is an infection caused by the overgrowth of Candida albicans, a type of yeast-like fungus that normally lives in the vagina. Predisposing factors include antibiotic use, increased estrogen levels, uncontrolled diabetes, overweight, pregnancy, premenstrual period, taking corticosteroids, and high doses of estrogen. Treatment of vaginal candidiasis includes antifungal medications, such as single-dose oral fluconazole, and avoidance of excess moisture. In uncomplicated vulvovaginal candidiasis, all available forms of antifungals are highly effective, both oral and topical, whereas in complicated vulvovaginal candidiasis, a longer course of 5-7 to 10-14 days of conventional therapy should be performed. Patients who have frequent recurrences require their long-term pressure with oral medications. Conclusion: It is important for health care professionals and patients to be aware of the risks of recurrence so that timely treatment can be provided to patients

Assessment and correction of local antimicrobial protection factors in women with chronic recurrent vulvovaginal candidiasis and type 2 diabetes mellitus

Aim. Evaluation and correction of local antimicrobial protection factors in women with type 2 diabetes mellitus (DM 2) and chronic recurrent vulvovaginal candidiasis (rVVC). Materials and methods. The study involved 100 women undergoing outpatient follow-up at the age of 40.9±5.8 years, with a body mass index of 29.8±3.5. The period was 2022–2023. The examination included anamnesis, collection of anthropometric data, calculation of body weight, microscopic examination of smears from the cervical canal and vagina, Gram-stained before treatment, in the 1st and 3rd months after its completion, identification pathogenic microorganisms using PCR, colposcopy, ultrasound of the pelvic organs. Indicators of glycosylated hemoglobin in the subjects at the control points of the study: at 1 month the average values were 5.9±2.9%, at 3 months – 5.9±3.0%, the average value was 5.9±3.1%. Candida species were identified by the bacteriological method using Sabouraud dextrose agar (growth of colonies of fungi of the genus Candida in an amount of more than 103 CFU/ml). Immunological methods for studying antimicrobial protection factors included studying the number of neutrophil granulocytes (NG) on the surface of the mucous membranes of the vulva and vagina, their phagocytic and NBT-reducing activity in a latex test. Randomization of patients into groups: group 1 included 50 (50%) women with DM 2 who, as part of complex therapy for rVVC received the drug Genferon® 1 intravaginal suppository of 500 thousand units 2 times a day for 10 days and fluconazole 150 mg orally three times with an interval of 72 hours at the first stage of treatment; group 2 included 50 (50%) women who received therapy with fluconazole 150 mg three times with an interval of 72 hours. The maintenance anti-relapse course therapy in both groups included the use of fluconazole 150 mg once a week for 6 months. In group 1st anti-relapse therapy was supplemented by the administration of the drug Genferon® 1 intravaginal suppository of 500 thousand units at night 3 times a week for 3 months, after which the vaginal microbiota was corrected for 2 weeks using vaginal suppositories, containing Lactobacillus acidophilus in an amount of at least 108 CFU. In group 2nd, basic anti-relapse antimycotic therapy was not accompanied by the prescription of any immunomodulatory or probiotic drugs. Results. The etiological agents of rVVC in women of late reproductive age in 79% (n=79) и 28% (n=28), respectively, were C. albicans and C. glabrata, which during the period of acute of the disease were detected by culture in the vaginal discharge at more than 104 CFU/ml. Chronic recurrent course of vulvovaginal candidiasis in women with DM 2 was characterized by exacerbations 4 or more times a year, accompanied by the corresponding clinical picture: white or yellowish-white cheesy discharge from the genital tract, itching or burning in the anogenital area, discomfort in the external genital area, dyspareunia, dysuria, decreased phagocytic activity of NG in vaginal secretions by 25.8%, impairment of their spontaneous and latex-induced NBT-reducing activity by 35.2%, functional reserve by 23.0% relative to reference values. The use of the drug Genferon® as part of complex therapy for rVVC contributed to a decrease in the number of Candida spp. in 1st and 3d months of observation after completion of anti-relapse therapy, normalization of cellular factors of innate immunity of the mucous membranes, faster resolution of the clinical manifestations of an episode of the disease. The decrease in the number of relapses over a 12-month observation period compared to the control group was also facilitated by an increase in the protective properties of the vaginal mucosa due to the restoration of the vaginal microbiota with the help of lactobacilli acidophilus. Conclusion. The etiological agents of rVVC in women of late reproductive age are C. albicans and C. glabrata. Subcompensated DM 2 is a risk factor for rVVC, which requires additional monitoring of microbiological parameters of the vaginal microbiota. rVVC in women with DM 2 is associated with an increase in the number of NG in the vaginal secretion, a decrease in their phagocytic activity and functional reserve compared to the reference values. Combination therapy of rVVC with topical recombinant interferon α2b, benzocaine and taurine in the formulation of Genferon® (suppositories) is an effective method to improve the clinical and immunological efficacy of therapy.

Cervical cancer screening in 48000 females over two decades: Feasibility and success of community-based screening in Kerala, India.

10550 Background: Cervical Cancer is still significant cause of mortality and morbidity among females in India. Various methods of cancer screening are currently practiced for cervical cancer prevention including human papilloma virus (HPV) screening, pap smear, visual inspection with Lugol’s iodine (VILI), visual inspection with acetic acid (VIA) etc. The success of any cancer screening method is based on the feasibility of large-scale implementation at community level and the scientific validity of the screening test. VIA/VILI has been proven to prevent mortality in cervical cancer. This study is based on analysis of prospectively maintained database of community based cervical cancer screening using VIA/VILI in northern Kerala from 2002 to 2020. Methods: Retrospective analysis of prospective database of cervical cancer screening from 2002 to 2020 done by Malabar Cancer Care Society in Kerala, a non-governmental organization with support from governmental bodies like ISRO. Data was collected into excel sheets and were rechecked. The data on demography, type of screening, detection of precancerous and cancerous lesions was analyzed. Descriptive statistics were used to analyze the data using SPSS Version 20.0. Results: A total of 48008 individuals were screened over 18 years. 55% were premenopausal. 33% were fully asymptomatic and remaining 66% had white discharge per vaginum (25%), bleeding per vaginum (14%) or combination of symptoms (25%). 18% had abnormal per speculum findings (bleeds on touch, discharge etc.) 86% had unhealthy cervix.26% (12650) had VIA/VILI and 74% (35658) had pap smear. The pap smear findings were normal (41%), atrophic (17%), inflammatory (40%) and 2% had pre-cancerous/ cancerous changes. Of these lesions, 46% were HSIL, 36% were LSIL, 5% ASUS and 13% were squamous cell carcinoma (52 cases). Screen positive rate was 325 (0.005%) out of 48008. Treatment of precancerous lesions was by Cryotherapy (54%), LEEP (10%) and Surgery (36%). Treatment of invasive carcinoma was by surgery (91%) and radiation (85%). Referral to regional cancer center was done in 26% patients. The screen positive rate shows decreasing trend over the last two decades. Conclusions: Cervical Cancer screening in large scale in low resource setting is feasible in India by both pap smear and VIA/VILI with community based interventions led by NGO with support from governmental bodies. This model can be considered ideal for India and other low middle income countries with logistic difficulties for large scale HPV based screening.

Penyuluhan Personal Hygiene Saat Menstruasi dengan Kejadian Keputihan pada Remaja Putri Kelas X di SMA Negeri 3 Ambon

Feminine hygiene (personal hygiene), especially during menstruation is often ignored by adolescents, if they do not maintain genital hygiene properly, then in a humid state, fungi and bacteria that are in the female area will thrive. The use of underwear that uses thin materials and not absorbing sweat can also make the female area moist and smelly, making it easier for fungi and bacteria to grow. smells can make it easier for fungi and bacteria to nest and the length of time using sanitary napkins that are more than 2-3 hours can make it easier for fungi and bacteria to nest.The aim is to provide new insights to adolescent girls about how to maintain personal hygiene during menstruation. about how to maintain personal hygiene during menstruation and the incidence of vaginal discharge in high school students in class X.I at SMA Negeri 3 Ambon. The method of this community service was carried out using the lecture method and question and answer discussions as well as pre and post tests. The result is an increase in knowledge of adolescent girls regarding menstrual hygiene and the incidence of whitish discharge.

Transcriptomics Reveals Effect of Pulsatilla Decoction Butanol Extract in Alleviating Vulvovaginal Candidiasis by Inhibiting Neutrophil Chemotaxis and Activation via TLR4 Signaling.

The Pulsatilla decoction is a well-known herbal remedy used in clinical settings for treating vulvovaginal candidiasis (VVC). However, the specific mechanism that makes it effective is still unclear. Recent studies have shown that in cases of VVC, neutrophils recruited to the vagina, influenced by heparan sulfate (HS), do not successfully engulf Candida albicans (C. albicans). Instead, they release many inflammatory factors that cause damage to the vaginal mucosa. This study aims to understand the molecular mechanism by which the n-butanol extract of Pulsatilla decoction (BEPD) treats VVC through transcriptomics. High-performance liquid chromatography was used to identify the primary active components of BEPD. A VVC mouse model was induced using an estrogen-dependent method and the mice were treated daily with BEPD (20 mg/kg, 40 mg/kg, and 80 mg/kg) for seven days. The vaginal lavage fluid of the mice was analyzed for various experimental indices, including fungal morphology, fungal burden, degree of neutrophil infiltration, and cytokines. Various assessments were then performed on mouse vaginal tissues, including pathological assessment, immunohistochemistry, immunofluorescence, Western blot (WB), quantitative real-time PCR, and transcriptome assays. Our results showed that BEPD reduced vaginal redness and swelling, decreased white discharge, inhibited C. albicans hyphae formation, reduced neutrophil infiltration and fungal burden, and attenuated vaginal tissue damage compared with the VVC model group. The high-dose BEPD group even restored the damaged vaginal tissue to normal levels. The medium- and high-dose groups of BEPD also significantly reduced the levels of IL-1β, IL-6, TNF-α, and LDH. Additionally, transcriptomic results showed that BEPD regulated several chemokine (CXCL1, CXCL3, and CXCL5) and S100 alarmin (S100A8 and S100A9) genes, suggesting that BEPD may treat VVC by affecting chemokine- and alarmin-mediated neutrophil chemotaxis. Finally, we verified that BEPD protects the vaginal mucosa of VVC mice by inhibiting neutrophil recruitment and chemotaxis in an animal model of VVC via the TLR4/MyD88/NF-κB pathway. This study provides further evidence to elucidate the mechanism of BEPD treatment of VVC.

Ayurvedic Management of Vulvovaginal Candidiasis with Local Application of Guduchi-Triphala-Danti Gel

Vulvovaginal candidiasis is the infection of the vaginal mucosa and/or vulva caused by the Candida species, a gram-positive yeast-like fungus. It is the second most common vulvovaginal infection characterized by thick-curdy white-cottage-cheese type vaginal discharge and intense vulvovaginal pruritus. Symptomatically vulvovaginal candidiasis can be compared with Slaishmiki yonivyapat in Ayurveda, the line of management of which is the use of Ruksha and Ushna aushadha. Local application of gel has the advantages of easy administration, more bioavailability of drugs, and prolonged retention without much local irritation. The classical Guduchi-Triphala-Danti pariseka yoga, mentioned in Yonivyapat chikitsa has been modified into a gel form, facilitating self-administration by women. Methodology: Here is a case report of a 31-year-old multiparous woman who presented with complaints of curdy white vaginal discharge associated with itching over the vulvar region for the last 6 months. She was diagnosed with vulvovaginal candidiasis by vaginal swab culture. Intervention with Guduchi-Triphala-Danti gel was carried out for 14 days for 2 consecutive cycles excluding days of menstruation and followed up after the next 30 days without medication. Results: After completion of the treatment protocol there was substantial relief of symptoms like curdy white vaginal discharge and itching over the vulvar region, wet-mount microscopy was negative for pseudohyphae, and the vaginal swab culture showed no growth. Conclusion: Local application of Guduchi-Triphala-Danti gel was found to be effective in the management of vulvovaginal candidiasis.

Edukasi Tentang Flour Albus pada Ibu Hamil di Desa Bangun Rejo Kecamatan Tanjung Morawa Kabupaten Deli Serdang Provinsi Sumatera Utara Tahun 2024

In the health life of a woman there are several complaints of disease, one of the complaints that is very disturbing is fluor albus (leucorrhoea). The purpose of this outreach activity is to make young women understand the causes and treatment of vaginal discharge. This activity was carried out at the Bangun Rejo village,Deli Serdang District. This activity begins by asking questions about the knowledge of pregnant women about vaginal discharge. Followed by giving material using power point. The result of this activity is that there is an increase in pregnant women knowledge about vaginal discharge by 60%. This activity is the first step to improve reproductive health, especially for pregnant women who will one day give birth to the next generation of this nation.

Sexual development disorder in a dog

A 1-year intact, phenotypic female Doberman Pinscher dog, was evaluated for suspected sexual development disorder. Patient had a history of white mucoid vaginal discharge with no estrous signs or behavior. Clitoral hypertrophy with a palpable os clitoris were noted. Transabodminal ultrasonography revealed a right gonad and tubular structures (possibly uterus). Exploratory laparotomy revealed 2 underdeveloped gonads in caudodorsal abdomen and a markedly underdeveloped right uterine horn. Histopathology confirmed bilateral ovotestes. Karyotyping (number and morphology of chromosomes) and fluorescence in situ hybridization (XX and XY cells) results were normal. Samples were PCR positive for sex-determining region Y (SRY) and X-linked androgen receptor gene. We concluded that the patient was either a mosaic or chimera with normal female 78,XX and normal male 78,XY cells and genetically a mix of male and female. Final diagnosis was sex chromosome (78,XX/XY), SRY-positive, ovotesticular, disorder of sexual development with female phenotype.