Fungal Vaginitis Research Articles

Evaluating the Antimicrobial Efficacy of Apple Cider Vinegar on Bacteria and Fungi Isolated from Vaginitis

Vaginitis is a prevalent medical illness that affects a substantial proportion of women, mostly attributed to the excessive proliferation of bacteria and fungi. The objective of this study was to assess the antimicrobial effectiveness of Apple Cider Vinegar against bacteria and fungi that were obtained from cases of vaginitis. 50 vaginal swabs were collected from vaginitis patients at private clinics in Kirkuk City, Iraq (10 pregnant women and 40 non-pregnant women). The research included the isolation and identification of bacterial and fungal isolates. All isolates performed the Minimum Inhibitory Concentration and disc diffusion techniques tests. Different concentrations of apple cider vinegar (20%, 30%, 40%, 50% and 100%) were tested against the isolates and Standard antibiotic drugs were used as positive controls. The results of 50 patients were examined, showing that 22 (44%) had bacterial vaginitis and 39 (78%) had fungal vaginitis. Vaginitis was more prevalent in pregnant women compared with non-pregnant. Staphylococcus aureus recorded 14 (24.9%) out of the 54 bacterial isolates, followed by Echerichia coli, Group B- Streptococcus, Klebsiella pneumoniae, Staphylococcus epidermidis and Pseudomonas aeruginosa respectively. whereas Candida albicans recorded 30 (61.2%) out of the 49 fungal isolates, followed by Candida tropicalis and Candida parapsilosis, respectively. The findings showed a range of sensitivity to apple cider vinegar among the isolated samples. The efficacy of apple cider vinegar was found to be greater against fungal isolates compared to bacterial isolates, with a higher effectiveness observed against gram-negative bacteria in comparison to gram-positive bacteria. The highest MIC values were found for Gram-positive bacteria, which recorded 125 (µg/mL), followed by Gram-negative bacteria, 62.5 μg/ml. While the lowest MIC values for the isolated fungi were (31.25 μg/ml). A comparison to traditional antimicrobial drugs has highlighted ACV's potential as an alternative treatment for vaginitis. According to these findings, ACV may be an effective treatment choice for vaginitis.

Analysis of HPV prevalence among individuals with reproductive tract infections in a Chinese population.

The previous research has found that human papillomavirus (HPV) infection is the main cause of cervical cancer, but it is still unclear whether HPV infection, as well as the HPV genotypes, are related to reproductive tract infections in the Chinese population. Patients who underwent HPV screening at Shandong Maternal and Child Health Hospital were selected, and the HPV infection status was analyzed among patients with cervical lesions, bacterial vaginosis, cervical inflammation, fungal vaginitis, and pelvic infections. SPSS 22 statistical analysis was used to analyze the differences in HPV infection types and rates between the control group and the experimental group. The HPV infection rate of bacterial vaginosis (χ2 = 13.4; P < .001) and fungal vaginitis (χ2 = 3.3; P < .045) are both significantly different from the control group. The single HPV infections reveals significant differences from control group in bacterial vaginosis (χ2 = 7.3; P = .004), fungal vaginitis (χ2 = 4.5; P = .023), and cervical lesions (χ2 = 58.8; P < .001). In the bacterial infection group, HPV51 (1.9%; χ2 = 6.0; P = .008) and HPV58 (4.7%; χ2 = 3.3; P = .044) showed significant differences in infection compared to the control group. In the fungal infection group, HPV39 (2.7%; χ2 = 4.7; P = .032) showed a significant difference in infection compared to the control group. Cervical lesions, bacterial vaginosis, fungal vaginitis, and cervical lesions among Chinese population exhibit age-specified distribution. HPV infection rate in bacterial vaginitis, fungal vaginitis and cervical lesions was higher than that in normal group. HPV52 and HPV16 infection are different, and HPV39 is different between bacterial vaginitis and fungal vaginitis.

Diagnostic performance of DNA probe-based and PCR-based molecular vaginitis testing.

Using retrospective data from U.S. Food and Drug Administration-approved/cleared molecular vaginal panels, molecular methods were found to have higher detection for Candida vaginitis and lower detection for bacterial vaginitis when compared to probe-based methods. In addition, the differentiation of Candida and non-Candida yeast has not reached the physician community as we observed noncompliance in recommended therapy. Furthermore, the pros and cons of migrating to molecular testing from conventional microscopy for identifying bacterial vaginitis and fungal vaginitis have been examined and reported in this paper. Interestingly, the mean (SD) age for patients with Candida albicans was 40.5 (40.0-41.1) years. Patients with N. glabrata were 5.2-8.1 (mean 6.7) years older than patients with Candida albicans.

Focused ultrasound: a novel therapy for improving vaginal microecology in patients with high-risk HPV infection

Objectives To investigate changes in vaginal microecology in women with high-risk human papillomavirus (HR-HPV) infection after focused ultrasound (FU) treatment. Materials and methods We collected vaginal secretions at the time of admission and 3 months after FU treatment from 169 women who received FU treatment for cervical HR-HPV infection between July 2020 and September 2022. Among them, there were 101 patients with cute vaginitis, we also collected their vaginal secretions after one week of drug treatment. These samples were evaluated for vaginal microecology and HPV-DNA examination. Results Of the 169 patients, 101 (59.7%) suffered from acute vaginitis at the time of admission. After one week of targeted antibiotics drug treatment, there were no pathogens or pus cells on the field of microscopic vision, but there was no significant difference(p > 0.05) in the diversity and density of vaginal flora, the proportion and function of Lactobacillus (H2O2 negative rate) between one week after treatment and at the time of admission. At the time of admission of the 169 patients, the normal flora rate was 40.3%, which increased to 93.5% three months after FU treatment. The differences in vaginal secretion parameters at the time of admission and 3 months after FU treatment were as follows: H2O2 negative rate (37.3% vs. 3.6%), leukocyte esterase positive rate (54.4% vs. 5.9%), sialidase positive rate (38.5% vs. 4.1%), bacterial vaginitis positive rate (55% vs. 4.7%), fungal vaginitis positive rate (44.4% vs. 5.9%), and trichomonal vaginitis positive rate (7.1% vs. 0). The difference was statistically significant (p < 0.01). The pH value and Nagent score at the time of admission were significantly higher than those three months after FU. Three months after FU, the positive rate of HPV was 5.8% in the group of patients with normal vaginal microecology at the time of admission and post-FU; it was 6.7% in the group of patients with abnormal vaginal microecology at the time of admission and normal vaginal microecology post-FU; and it was 100% in the group patients with abnormal vaginal microecology at the time of admission and post-FU. A significant difference was observed among the three groups (p < 0.01). Conclusion FU is an effective treatment for patients with cervical HR-HPV infection. FU does not interfere with the vaginal microecology of HR-HPV positive patients with normal vaginal microecology.FU followed by antibiotic drug therapy for pathogens is beneficial to restore the function of Lactobacillus vaginalis in HR-HPV positive patients with acute vaginitis,so as to improve the vaginal microecology of HR-HPV positive patients with abnormal vaginal microecology.

Effectiveness of combined use of sodium bicarbonate sitz bath prescription and vaginal nystatin suppository in the treatment of patients with fungal vaginitis

Purpose: To investigate the clinical effect of a combination of sodium bicarbonate sitz bath prescription and vaginal nystatin suppository in the treatment of patients with fungal vaginitis.&#x0D; Methods: Ninety patients with mycotic vaginitis admitted to Tianchang Hospital of Traditional Chinese Medicine from April 2018 to April 2019 were selected and divided into control group (vaginal sitz bath with 5 % sodium bicarbonate solution, n = 45) and study group (vaginal nystatin suppository in addition to vaginal sitz bath with 5 % sodium bicarbonate solution, n = 45) based on the order of admission. The therapeutic effectiveness of the two treatments was compared with respect to time of relief of various clinical indicators, incidence of adverse reactions, rate of recurrence after 3 and 6 months of drug withdrawal, and vaginal pH.&#x0D; Results: The time taken to relieve itching was longer in the control group (5.21 ± 2.12 days) than in the study group (3.74 ± 2.03 days; p &lt;0 .05). There was a higher recurrence rate of itching in the control group after drug withdrawal for 3 and 6 months than in the study group (p &lt; 0.05). Total treatment effectiveness was significantly higher in the study group than in the control group (p &lt;0 .05). However, the incidence of adverse reactions was comparable in the two groups (p &gt; 0.05). Vaginal pH significantly improved (less acidic) in the study group, when compared to the control group (p &lt; 0.05).&#x0D; Conclusion: Application of a combination of vaginal sitz bath using 5 % sodium bicarbonate solution and vaginal nystatin suppository is effective in the treatment of fungal vaginitis. The combination produces a favorable vaginal pH environment and low recurrence of infection. However, the combined treatment should be subjected to further clinical trials prior to application in clinical practice.

A study on the accuracy of a new fluorescent detection method for vaginal fungi

BackgroundTo investigate the positive rate and clinical applicability of liquid—based fungal method for detecting of vaginal fungi. We collect the secretions from the posterior vaginal fornix and the vaginal wall of 198 patients with clinically suspected fungi vaginitis patients for study.MethodsThe vaginal fungi of vaginal discharge were detected by fluorescence method, i.e., by liquid—based thin-layer fungi fluorescence morphology staining detection kit (liquid—based fungal method), saline smear method and fungal culture method.ResultsThe positive rate of liquid-based fungal method, saline smear method was 50%, 25.75% respectively. The positive rate of liquid-based fungal method were 50%. The true positive rate of liquid-based fungal method (87.85%) was higher than that of saline smear method (45.79%, P < 0.001), which was easy to miss diagnosis. Moreover, the Kappa (K) of liquid-based fungal method was 0.81, and P < 0.01, which was statistically significant, indicating that the consistency of the two detection methods is good. Of the eight common symptoms of fungal vaginitis, the positive symptom coincidence rate of liquid-based fungal method was consistent with that of fungal culture method. It was also easier to see fungi under a microscope than with saline smear method.ConclusionThe liquid-based fungal method has a high positive coincidence rate and accuracy in the detection of vaginal fungi, and it is convenient to operate and implement steps. Therefore, it may be applied in clinical practice. Or a combination of several detection methods can be used.

Analysis of Ureaplasma urealyticum, Chlamydia trachomatis, Mycoplasma genitalium and Neisseria gonorrhoeae infections among obstetrics and gynecological outpatients in southwest China: a retrospective study

BackgroundThe aim of this study was to analyze the present situation of Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Neisseria gonorrhoeae (NG) infections among obstetrics and gynecological outpatients in southwest China.MethodsA total of 3225 urogenital swabs were included in this study. All swabs were tested by RNA-based simultaneous amplification and testing (SAT) methods. Routine analysis of leucorrhea smear and drug susceptibility were performed in UU positive patients.ResultsOf these 3225 outpatients, the positive rate was 27.07% for UU, 4.99% for CT, 3.10% for MG, and 0.09% for NG. UU, CT, and MG infections were more common in women of reproductive age (aged 25–34 years), while NG infection was more prominent in women aged 30–34 years and over 40 years. Overall, the infection rate of UU was significantly higher than that of the other three infections, and UU also played a major role even in the mixed infections. 65.07% of the UU positive patients had negative results on routine leucorrhea smear analysis, and the remaining patients may have bacterial vaginitis (15.79%), fungal vaginitis (11.48%), trichomonas vaginitis (0.96%) or other vaginal inflammation (6.70%). We have observed that maternal UU infection can lead to low birth weight, neonatal pneumonia, and premature delivery. The results of the drug susceptibility test of UU showed a higher sensitivity to pristinamycin, doxycycline, tetracycline, clarithromycin, and josamycin (100%, 97.0%, 96.4%, 95.9%, and 95.3%, respectively), and lower sensitivity to ciprofloxacin and ofloxacin (2.4% and 4.7% respectively).ConclusionsThis study could contribute to a better understanding of the current epidemiological features of UU, CT, MG, and NG among obstetrics and gynecological outpatients in southwest China, and thus facilitate to development of the more effective intervention, prevention, and treatment of reproductive tract infection.

Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the "Grey Zones" of Clinical Practice.

Bacterial vaginosis (BV) affects one-third of reproductive age women, increasing the risk of acquiring sexually transmitted infections (STIs) and posing a risk for reproductive health. The current diagnosis with Gram stain (Nugent Score) identifies a transitional stage named partial BV or intermediate microbiota, raising the problem of how to clinically handle it. We retrospectively analyzed cervicovaginal swabs from 985 immunocompetent non-pregnant symptomaticspp. women (vaginal discharge, burning, itching) by Nugent score and qPCR for BV, aerobic or fungal vaginitis, and STIs (Mycoplasmas spp., Chlamydia t., Trichomonas v., and Neisseria g.). Nugent scores 0–3 and 7–10 were confirmed in 99.3% and 89.7% cases, respectively, by qPCR. Among Nugent scores 4–6 (partial BV), qPCR identified 46.1% of BV cases, with 37.3% of cases negative for BV, and only 16.7% of partial BV. Gram staining and qPCR were discordant (p value = 0.0001) mainly in the partial BV. Among the qPCR BV cases, the presence of aerobic vaginitis and STIs was identified, with a significant association (p < 0.0001) between the STIs and partial BV/overt BV. qPCR is more informative and accurate, and its use as an alternative or in combination with Gram staining could help clinicians in having an overview of the complex vaginal microbiota and in the interpretation of partial BV that can correspond to vaginitis and/or STIs.

Application of Nursing Intervention in the Treatment of Fungal Vaginitis

Application of Nursing Intervention in the Treatment of Fungal Vaginitis

Antifungal Activity of Topical Microemulsion Containing Ziziphus spina-christi L. for the Treatment of Fungal Vaginitis

Background: vulvovaginal candidiasis (VVC) caused by Candida albicans and other Candida species are high-risk event in patients admitted to hospital. Ziziphus genus is a rich source of medicinal compounds, effective for the treatment or prevention of some diseases. Objectives: This study aimed to evaluate the antifungal effect of topical microemulsion containing Ziziphus spina-christi L (ZSC) extracts against Candida spp.Methods: Z. Spina-Christi was collected and extracted in a Soxhlet apparatus using the ethanol and methanol solvents. Microemulsions were formulated by varying the composition of surfactant (Tween 80) along with cosurfactant (propylene glycol), oil, and water and were characterized regarding their stability. The microemulsion without extract as placebo and the active microemulsion containing ZSC extract as active formulation were applied to test the antifungal activity against C. albicans, C. parapsilosis and C. krusei using well diffusion test. The optimal microemulsion was selected and then analyzed for average diameter of droplets, pH, viscosity and zeta potential.Results: The microemulsion containing ZSC ethanolic extract had a significant inhibitory effect on the different species of Candida, but the most inhibitory effect was found against C. albicans. Conclusion: The results of this study indicate that the ethanol extract has interesting antimicrobial properties and can used for the treatment of fungal infections. More research is required to check this plant performance to treat the Candidiasis.

REFRACTORY FUNGAL VAGINITIS TREATED BY TOPICAL AMPHOTERICIN B. Review

Vaginitis is a common problem for women regarding a worldwide health challenge with many side effects. Vaginitis is among the most visiting to gynecology clinics. About 75% of all reproductive women had at least one fungal vaginitis infection in their life, and more than 40% will have two or more than two. Candida spp is the most prevalent in fungal vaginitis, while reports for unusual fungi were observed as mucor spp.&#x0D; Amphotericin B (AmB) belongs to the polyene group has a wide spectrum in vitro and in vivo antifungal activity. All of the known available formulas of AmB are administrated via intravenous injection to treat severe systemic fungal infections, while the development of the topical formula of AmB is still under preliminary development including topical vaginal AmB.&#x0D; Due to the revealing of antimicrobial-resistant fungi in recent years, this study explains the role of topical AmB in treating refractory fungi vaginitis that may not a response to other drugs reported in many cases that may help researchers to develop new effective formula of AmB regarding fungal vaginitis.

DIAGNÓSTICO BIOQUÍMICO Y MICROBIOLÓGICO

Las infecciones del tractor urinario (ITUs) se producen cuando las bacterias y hongos colonizan la uretra y ascienden hacia la vejiga y el riñón, y generan una infección. Se necesitan estudios bioquímicos y microbiológicos para confirmar el diagnóstico y la etiología infecciosa que orientarán la terapéutica antimicrobiana. Existen distintas etapas para estudiar la orina: toma de la muestra, refrigeración y procesamiento con el estudio físico-químico y urocultivo que identifica el organismo causal y cuantifica el número de bacterias por mililitros que se expresan como unidades formadoras de colonias/ml (UFC/ml). En pacientes asintomáticos para diferenciar infección de contaminación, el crecimiento bacteriano debe ser ≥105 UFC/ml. Debe investigarse rutinariamente en embarazadas el estreptococo grupo B y en personas con diabetes los más frecuentes son Escherichia coli. y enterobacterias. La presencia de Cándida debe considerarse en pacientes hospitalizados, con uso de sonda vesical, diabéticos, pacientes con neoplasias, antecedente de uso de antibióticos de amplio espectro, uso de esteroides, procedimientos urológicos o vaginitis fúngica. El antibiograma permite conocer la sensibilidad de un germen ante la exposición con un antibiótico.

Огляд міжнародних наукових даних щодо використання поліжинаксу в лікуванні та профілактиці вагінітів різної етіології

A significant prevalence of infectious-inflammatory diseases of female genital organs is one of the most urgent problems of gynecology. The combination of various bacterial and bacterial-fungal associations of microorganisms in the vaginal biotope leads to the formation of complex indistinct clinical manifestations, which complicates diagnosis. Incorrect diagnosis and inadequate treatment increase the frequency of vaginal infection relapses and contribute to prolonged course of the disease. Polygynax as one of the long-established drugs in Ukraine has not lost its significance despite the emergence in the national pharmaceutical market of an increasing number of drugs for local treatment and prevention of vulvovaginal infections. This medicinal product contains neomycin sulfate, polymyxin B sulphate and nystatin. The choice in its favor is based on a large array of accumulated data, which has shown its high efficiency and safety for the treatment and prevention of vulvovaginal infections in reproductive aged women. Based on the described in the article researches, the wide spectrum of the polygynax encompasses the main pathogens of bacterial and fungal vaginitis. Polygynax showed high efficacy against C. albicans strains, and especially in C. non-albicans resistant strains (including fluconazole resistant strains). Unlike oral medications, local treatment makes it possible to avoid the development of resistance to pathological microflora. Polygynax does not suppress normal vaginal flora and does not disturb its balance. Due to its characteristics, it is a drug of choice for local therapy of vaginitis. This is especially true in cases where, for a number of reasons, treatment should be initiated immediately, before obtaining the results of a microbiological study. In addition, the benefits of this drug should also include the simplicity and ease of use, the absence of absolute contraindications, the possibility of use in patients with extragenital pathology, in adolescents and postmenopausal women, and the local route of administration can reduce the pharmacological burden on the body.

Genotypic analysis of secreted aspartyl proteinases in vaginal Candida albicans isolates

ABSTRACT Introduction: Candida albicans is the most common etiologic agent of fungal vaginitis. These yeasts produce secreted aspartyl proteinases encoded by a family of 10 genes (SAP1-10). Objective: The purpose of this study was to analyze the presence of genes SAP1-7 in vulvovaginal C. albicans. Materials and method: The study included 26 C. albicans vaginal isolates. Detection of aspartyl proteases genes (SAP1-7) was performed by polymerase chain reaction (PCR). Results: The most frequent gene in C. albicans isolated from colonization was SAP6 (93.33%), and from infection, SAP7 (100%). We observed a statistical difference (p = 0.049) in SAP1 gene frequency between isolates from vulvovaginal colonization and infection. Conclusion: High frequency of SAP genes was observed in vulvovaginal C. albicans. The results suggest SAP1 participation in vulvovaginal candidiasis infection.

Comparing the Effect of Garlic, Zataria multiflora and Clotrimazole Vaginal Cream 2% on Improvement of Fungal Vaginitis: A Randomized Controlled Trial

Background: Garlic and Zataria multiflora boiss (ZMB) are herbal medicines used traditionally in the treatment of infections, including candidal vaginitis. Objectives: This study aimed to examine the effect of garlic and ZMB vaginal cream 2%, in the treatment and recurrence of candidal vaginitis. Methods: This randomized, double-blinded clinical trial was conducted on 240 married women with candidal vaginitis. The patients used 5 gr garlic, ZMB or clotrimazole vaginal cream 2% daily, for 7 days. Complaints of the patients, clinical observations and laboratory parameters were recorded before treatment, on days 7 and 30, after treatment. The data were analyzed by SPSS v. 21 through chi-square, Fisher, ANOVA with repeated measures, McNemar and Kruskal-Wallis tests. A P 0.05). Mean scores of candidal symptoms reduced significantly in all groups at on 7 and 30, after treatment (P < 0.001). Conclusions: Garlic and ZMB vaginal cream 2% can be used as an effective treatment option in cases of drug resistance and, also, by the people who are interested in treating with herbal medicines.

Frecuencia de infecciones vaginales y lesiones intraepiteliales en las usuarias de los laboratorios clínicos de Dinámica IPS de la ciudad de Medellín (Colombia), 2005-2010: estudio descriptivo

Objetivo: determinar la frecuencia de infecciones vaginales y lesiones intraepiteliales los resultados de laboratorio de las usuarias de los laboratorios clínicos de Dinámica IPS de la ciudad de Medellín atendidas entre el 2005 y el 2010.Materiales y Método: estudio descriptivo transversal con fuentes secundarias de los resultados de pruebas realizadas a usuarias de Dinámica IPS atendidas en el periodo de estudio en el que se evaluaron variables como la edad y los resultados de citología vaginal (n= 261 789), Gram (n= 70 447) y directo de flujo vaginal (n= 89 527). Se excluyeron registros con información incompleta. Se realizó análisis estadístico con medianas y proporciones.Resultados: del total de muestras analizadas(n=261 789), el 1,99% correspondían a lesiones escamosas, de éstas el 0,038% corresponde a muestras positivas de cáncer de cuello uterino confirmada por patólogo; el 8,01% corresponde a lesiones intraepiteliales de alto grado y el 36,13% a lesiones escamosas de bajo grado. En el examen de flujo vaginal por directo se encontraron 14 803 pruebas positivas (16,51%) para vaginitis por hongos, 19 079 (21,31%) para vaginosis bacteriana y 414 (0,46%) para vaginitis por Trichomona; en el Gram se observó que las infecciones vaginales generadas por Gardnerella ocupan la mayor frecuencia con 19 186 resultados positivos (27,23%).Conclusiones: los datos encontrados con relación a las frecuencias de lesiones escamosas intraepiteliales y para las infecciones vaginales guardan relación con lo reportado en la Literatura nacional; sin embargo, para el casos del ASCUS se encuentra variación, probablemente por las características mismas de este tipo de atipias.

Enhanced antifungal efficacy of tebuconazole using gated pH-driven mesoporous nanoparticles.

pH-sensitive gated mesoporous silica nanoparticles have been synthesized. Increased extracellular pH and internalization into living yeast cells triggered molecular gate aperture and cargo release. Proper performance of the system was demonstrated with nanodevices loaded with fluorescein or with the antifungal agent tebuconazole. Interestingly, nanodevices loaded with tebuconazole significantly enhanced tebuconazole cytotoxicity. As alterations of acidic external pH are a key parameter in the onset of fungal vaginitis, this nanodevice could improve the treatment for vaginal mycoses.

Nystatin-Neomycin-Polymyxin B Combination: Efficacy and Tolerance as 1st-Line Local Treatment of Infectious Vaginitis

Objective: To evaluate the efficacy and tolerance of a local treatment combining two antibacterials and one antifungal in patients with a clinical presentation suggesting infectious vaginitis. Patients and methods: 169 patients presenting with clinical criteria for vaginitis were included in an open, multicenter trial. Vaginal samples were taken for microbiological analyses and a triple-combination product of nystatin, neomycin and polymyxin B was then started as local treatment, without waiting for the test results. The treatment was continued with the usual dosage (1 vaginal capsule at bedtime for 12 days) for vaginal infections in the scope of the combination product with approved labeling. A second vaginal sample was performed at the end of the treatment. The main efficacy criterion was the clinical success rate (cure or improvement of the clinical signs and symptoms) according to the investigator.Results: 93 patients were included in the efficacy population. Non-exclusively fungal vaginitis (strictly bacterial or bacterial + fungal) represented 31.2% of the cases. The clinical success rate was 97.8% according to the investigator and 95.7% according to the patients. The microbiological success rate was 81.3%, with no differences between etiologies (Candida spp., bacteria or both). The combination product was well-tolerated, despite the local inflammation before treatment. Discussion and conclusion: Given the etiological diversity of vaginitis, this trial supports the efficacy of a triple-combination product (nystatin, neomycin, polymyxin B) as a first-line local treatment of Candida, bacterial or mixed vaginitis.

The possible efficacy of artichoke in fluconazole related hepatotoxicity.

Although fluconazole related hepatotoxicity (FRH) is rare, mortal acute hepatic necrosis and jaundice were reported in immunocompromised states such as acquired immunodeficiency syndrome (AIDS) and bone marrow transplant (BMT). We present a case of a patient with multiple sclerosis who developed hepatotoxicity with the use of a single 150 mg fluconazole tablet for fungal vaginitis, 10 days after methylprednisolone pulse treatment. Our patient's alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were decreased, 1200 U/L and 800 U/L, respectively, and bilirubin levels were consistent at 37 mg/dL. Artichoke which has anticholestatic and antioxidant properties was used by our patient. She consumed a 30 mg artichoke leaf extract tea 3 times a day. The bilirubin levels significantly declined at the end of the first week and all liver function tests were normalized within 2 months.

P2.136 Sexual Transmission Infection Situation in People Living with HIV (PLHIV)In 6 Provinces in Vietnam from 2008–2011

BackgroundMultiple studies have suggested that STIs (sexual transmission infections) are important cofactors in the transmission and acquisition of HIV infection. Thus control of one may have beneficial effects on the...