Vaginal Discharge In Women Research Articles

The Effect of Infusing Soursop Leaves (Annona muricata L.) on Vaginal Discharge in Women of Childbearing Age: A Randomized Clinical Trial at the Lolo Community Health Center, Kerinci Regency, Jambi, Indonesia

Introduction: Vaginal discharge (leukorrhea) is a common gynecological complaint among women of childbearing age. While physiological discharge is normal, pathological discharge can be indicative of underlying infections or conditions. This study aimed to investigate the efficacy of soursop leaf infusion (Annona muricata L.) as a complementary treatment for vaginal discharge in women of childbearing age. Methods: A randomized controlled trial was conducted at the Lolo Community Health Center, Kerinci Regency, Jambi, Indonesia. Women aged 15-49 years presenting with vaginal discharge were randomly assigned to either the intervention group (soursop leaf infusion) or the control group (standard care). The intervention group received soursop leaf infusion twice daily for seven days, while the control group received standard care as per the health center's protocol. The primary outcome was the reduction in vaginal discharge symptoms (amount, color, odor, and associated discomfort) after seven days. Secondary outcomes included changes in vaginal pH and microbiological assessment. Results: A total of 130 women participated in the study (65 in each group). After seven days, the intervention group showed a significantly greater reduction in vaginal discharge symptoms compared to the control group (p < 0.05). The amount, color, and odor of discharge improved significantly in the intervention group, along with a reduction in associated discomfort such as itching and irritation. Vaginal pH was also normalized in the intervention group, and microbiological assessment revealed a decrease in pathogenic microorganisms. Conclusion: Soursop leaf infusion (Annona muricata L) appears to be a safe and effective complementary treatment for vaginal discharge in women of childbearing age. Its antimicrobial and anti-inflammatory properties may contribute to its beneficial effects. Further research is warranted to explore its long-term efficacy and potential use in combination with conventional therapies.

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

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

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

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

TELANG FLOWER KOMBUCHA SOLID BATH SOAP AS A HALAL AND ANTIMICROBIAL PHARMACEUTICAL BIOTECHNOLOGY PRODUCT

Excellent health is part of having immunity which tends to be stable, where normal flora is the most important parameter in increasing the body's resistance. Normal flora that is not well controlled can also increase the body's immune system to become threatened so that disease and infection have the potential to attack each individual. Smelly armpits are a sign of disease or Staphylococcus hominis infection. Women's intimate organs experiencing vaginal discharge is a sign of disease or infection caused by Candida albicans. The solution that can be offered to inhibit the growth of these two microbes is to bathe using herbal soap that is environmentally friendly and antimicrobial, namely solid bath soap made from the active ingredient of telang flower kombucha. This research aims to produce environmentally friendly pharmaceutical biotechnology products in the form of solid bath soap formulations and preparations made from the active ingredient of telang flower kombucha. This research is a laboratory experiment by making a solid bath soap base without active substances and a solid bath soap made from the active ingredient of butterfly pea flower kombucha with sugar concentrations including 20%, 30% and 40%. This research has proven that solid bath soap with the active ingredient telang flower kombucha at a concentration of 40% is significantly different as a pharmaceutical biotechnology product in inhibiting the growth of the two test microbes, both bacteria that cause underarm odor and pathogenic fungi that cause vaginal discharge in women's intimate organs at concentrations of 20% and 30%. based on one-way ANOVA analysis with a P value <0.05. This research can be proven and concluded that telang flower kombucha solid bath soap at a concentration of 40% is an effective treatment as a pharmaceutical biotechnology product and as an antimicrobial for both bacteria that cause underarm odor and pathogenic fungi that cause vaginal discharge in women's intimate organs

Pengaruh Air Rebusan Daun Sirih terhadap Keputihan Fisiologis pada Wanita Usia Subur di Desa Baturono Kecamatan Salam Kabupaten Magelang

Vaginal discharge is one of the reproductive disorders often experienced by women in Indonesia caused by humid weather that affects the development of fungi. Continuous vaginal discharge affects the functioning of the female reproductive system. Overcoming vaginal discharge can be done with non-pharmacological therapy with red betel leaves. This study aims to determine the effect of betel leaf boiled water on physiological vaginal discharge in women of childbearing age in Baturono Village, Salam District, Magelang Regency. The research method used is quantitative research with a Quasy Experiment design using Two Groups Pre-Test and Post-Test with the control group. The population is 60 WUS, and the sample size is 30 respondents. The sampling technique uses Purposive Sampling. Statistical test using Paired T-Test. The result of this study was that the mean value 9pre-test0 given water treatment boiled red betel leaf was 14.80 and the mean value (post-test) was 5.27. So that the provision of red betel leaf boiled water has an effect on overcoming physiological vaginal discharge in Baturono Village based on the results of research p-value 0.000 < 0.5. So it can be concluded that there is an effect of giving red betel leaf boiled water on physiological vaginal discharge in women of childbearing age in Baturono Village, Salam District, Magelang Regency with a p-value of 0.000 < 0.5.

Edukasi Penatalaksanaan Keputihan dengan Pemanfaatan Rebusan Air Daun Sirih

Vaginal discharge or flour albus is an excessive discharge from the vagina that is not menstrual blood. Pathological fluoride albus caused by vaginal infections (fungi, bacteria, parasites, viruses). The prevalence of causes is 25%-50 candidiasis, 20%-40% bacterial vaginosis and 5%-15% trichomoniasis. The characteristics of pathological vaginal discharge are smelly, itchy, yellowish or greenish, thick and cloudy and large in quantity. If this condition does not receive immediate treatment, it will have a negative impact on women's health. Infection will develop and affect the function of the reproductive organs. Medical treatment efforts include administering drugs in the form of capsules, tablets and ovules (vaginal tablets). Meanwhile, for non-medical or complementary therapy, betel leaf decoction can be used (Dame, 2023). The aim of this outreach is to provide education about the benefits of boiled betel leaves for vaginal discharge in women of childbearing age. The activity was carried out at PMB Masdewati Pohan in July 2023, the subject was women of childbearing age in the PMB Masdewati Pohan area. Activity results: Counseling participants learned about the benefits of boiled betel leaf water for vaginal discharge. The results of the questionnaire measuring knowledge before and after counseling showed an increase in knowledge of women of childbearing age by an average of 78%. It is hoped that women of childbearing age can maintain personal hygiene to prevent vaginal discharge and can use boiled water from betel leaves to treat vaginal discharge that occurs.

Prevalence of sexually transmitted infections (STIs), associations with sociodemographic and behavioural factors, and assessment of the syndromic management of vaginal discharge in women with urogenital complaints in Mozambique.

In Mozambique, sexually transmitted infections (STIs) are estimated to be prevalent, but diagnosis and treatment of curable STIs rely only on syndromic management. We examined the prevalence of four non-viral STIs and HIV-1/2, based on etiological diagnosis, associations with sociodemographic and behavioural factors, and the STI diagnostic accuracy of the vaginal discharge syndromic management in women with urogenital complaints in Maputo, Mozambique. A cross-sectional study was performed in Maputo, Mozambique, February 2018-January 2019, enrolling 924 women of reproductive age with urogenital complaints. Endocervical/vaginal swabs were sampled and chlamydia, gonorrhoea, trichomoniasis and Mycoplasma genitalium infections were diagnosed using a multiplex real-time PCR (AmpliSens; InterLabServices). Serological testing was performed for HIV-1/2. A structured questionnaire collected metadata. All data were analyzed in STATA/IC 12.1 using descriptive statistics, chi-square tests and logistic regression model. About 40% of the women were less than 24 years old, 50.8% were single, 62.1% had their sexual debut between 12 and 17 years of age, and the main complaint was vaginal discharge syndrome (85%). The prevalence of chlamydia was 15.5%, trichomoniasis 12.1%, gonorrhoea 4.0%, M. genitalium 2.1%, and HIV-1/2 22.3%. The vaginal discharge syndrome flowchart had a sensitivity of 73.0%-82.5% and a specificity of 14%-15% for the detection of any individual non-viral STI in women with urogenital complaints. In total, 19.2% of the symptomatic women with chlamydia, trichomoniasis or gonorrhoea would not be detected and accordingly treated using the vaginal discharge syndromic management (missed treatment) and 70.0% of the women would be treated despite not being infected with any of these three STIs (overtreatment). In conclusion, a high prevalence of especially chlamydia, trichomoniasis, and HIV-1/2 was found in women of childbearing age with urogenital complaints in Maputo, Mozambique. Syndromic management of vaginal discharge revealed low accuracy in the detection of STIs in symptomatic women, especially low specificity, which resulted in under-treatment of STI-positive cases and incorrect or over-treatment of women with urogenital complaints, many of whom were negative for all the non-viral STIs. Etiological diagnosis is imperative for effective management of STIs in symptomatic and asymptomatic women.

Fluconazole resistance in candida isolates from vaginal discharge in women attending an Apex Regional Sexually Transmitted Infections Center

Background: Globally, vulvovaginal candidiasis (VVC) is a common infection in women. Candida albicans is the most common agent. There is an increasing prevalence of non-albicans Candida (NAC) species, mostly in vulnerable populations, responding poorly to fluconazole, the drug of choice for VVC. It leads to treatment failure, especially in clinical isolates with intrinsic fluconazole resistance; hence, appropriate identification and antifungal susceptibility testing (AFST) are of paramount importance to ensure better clinical outcomes. Aims and Objective: The aim of this study was to identify different Candida species isolated from women with VVC and to evaluate their antifungal drug susceptibility pattern. A retrospective observational study including a total of 286 isolates of Candida spp. isolated from 729 women with vaginal discharge attending the Outpatient Department of an Apex Regional Sexually Transmitted Infections Center in North India over 1 year (June 2022–May 2023) was performed. Identification and AFST were performed as per standard microbiological procedures. Statistical analysis was carried out using the SPSS version 22.0 (SPSS Inc., Chicago, IL, USA). Data were presented as percentages and proportions. Results: Candida isolates were detected in 39.23% of women. The median age was 26–35 years. C. albicans was the most common isolate (60.8%), followed by Candida glabrata (31.8%), Candida tropicalis (4.19%), Candida parapsilosis (2.09%), Candida krusei (0.699%), and Candida kefyr (0.34%). Fluconazole resistance was seen in 29% of the isolates and susceptible dose-dependent in 32.15%. Conclusion: Increasing isolation of NAC species (39.2%) causing VVC and responding poorly to fluconazole (29% resistant strains) is a major concern. Timely and appropriate AFST will help improve the clinical outcome and quality of life.

Doderlein’s cytolytic vaginosis: a camouflage of white discharge per vaginum in pregnancy: a case report

White discharge per vaginum (WDPV) in women is a routinely encountered gynaecological symptom in day today practice. Thorough history taking, per speculum and vaginal examination helps to identify the cause and also to further investigate it for pH and pap smear. The most frequent causes of WDPV are candidiasis, bacterial vaginosis and trichomoniasis. Interestingly lactobacillus/doderlein bacillus, a normal vaginal flora overgrow under the effects of oestrogen, can produce vaginal discharge in women of reproductive age group. Pap smear shows plenty of bare nuclei due to significant cytolysis of vaginal epithelial cells and lactobacillus overgrowth. The importance of vaginal discharge due to lactobacillus overgrowth is that it is refractory to routine medical management for other causes of vaginal discharge. We report doderlein cytolysis diagnosed by pap smear examination in a pregnant woman with history of vaginal discharge.

Correlation Between Vulva Hygiene And Intrauterine Device Use And The Event Of Vaginal Discharge In Women Of Reproductive Age

Pathological leucorrhoea is an abnormal disorder in women of childbearing age that occurs in the body in the form of thick white, yellowish, greenish discharge. This is because the composition of the vaginal microflora fluctuates as a function of internal factors such as age,hormonal changes during menarche,menstruation,and pregnancy. External factors such as hygiene practices, sexual relations, and contraceptive use.In the use of Intrauterine devices, there is vaginal discharge that occurs as a result of the initial reaction to the presence of a foreign body, the use of intrauterine contraceptives which can change the chemical balance of the vagina and is thought to cause vaginitis. The research method for this literature review analyzed 8 research articles and assessed the articles based on predetermined inclusion and exclusion criteria. This literature reviews various risk factors that influence the occurrence of vaginitis due to the use of non-hormonal intrauterine contraceptive devices that occur in women of childbearing age and through good vulva hygiene behavior,can reduce the risk of physiological and pathological vaginal discharge.Based on these sources,it can be concluded that there is a relationship between vulva hygiene and the use of Intrauterine device with the incidence of vaginal discharge in women of childbearing age.

Hubungan Personal Hygiene, Kecemsan, Peran Petugas Kesehatan Terhadap Kejadian Keputihan pada Wanita Usia Subur (WUS) di Kampung Panahegan RT.02 RW.02 Desa Gasol Cianjur Tahun 2023

Vaginal discharge is a common female reproductive health problem. Vaginal discharge can be caused by various factors, one of which is poor personal hygiene. The aim of this research is to determine the relationship between personal hygiene, anxiety and the role of health workers on the incidence of vaginal discharge in women of childbearing age. This research method uses a quantitative research design with a cross sectional approach with a population of 40 women of childbearing age in KP. Panahegan, Gasol Village, Cianjur. The researcher took a sample of 40 people. The results of research using the Chi-square test show that there is a significant relationship between personal hygiene and the incidence of vaginal discharge (P value = 0.019). The better the personal hygiene, the lower the incidence of vaginal discharge. There is a relationship between anxiety and the incidence of vaginal discharge (P value = 0.009). There is a significant relationship between the role of health workers and the incidence of vaginal discharge (P value = 0.026). The better the respondent's perception of the role of health workers, the lower the incidence of vaginal discharge.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PENGETAHUAN IBU HAMIL TENTANG KEPUTIHAN DI WILAYAH KERJA PUSKESMAS KOTA JANTHO ACEH BESAR TAHUN 2023

Vaginal discharge is excessive discharge from the birth canal or vagina. The incidence of vaginal discharge in women in the world reaches 75%, while in Indonesia women who experience vaginal discharge reach 70% including pregnant women. One of the complaints often encountered in clinics and maternal and child health (MCH) is vaginal discharge (fluor albus), 16% of patients with vaginal discharge are pregnant women, caused by candida albicans 53%, trichomonas 3.1% and classified by bacteria 40.1%. Candida albicans is the most common group found in patients with vaginal discharge. Objective To determine the factors associated with the knowledge of pregnant women about vaginal discharge in the Jantho City Health Center Area, Aceh Besar in 2023. The research method is analytical using a Cross Sectional approach conducted on July 8-11, 2023 in the Jantho City Health Center Area of Aceh Besar with a population of 30 pregnant women. The research instrument is a questionnaire. Data analysis using univariate and bivariate analysis with the SPSS statistical program. The results of statistical tests with Chi Square obtained p value = 0.14 (P<0.05) means there is a relationship between sources of information with knowledge, the results of statistical tests with Chi Square obtained p value = 0.001 (P<0.05) means there is a relationship between age and knowledge, the results of statistical tests with Chi Square obtained p value = 0.000 (P<0.05) means there is a relationship between experience and knowledge, and the results of statistical tests with Chi Square obtained p value = 0.000 (P<0.05) means there is a relationship between education and knowledge. The conclusion is that there is no relationship between information sources and knowledge, and there is a relationship between age, experience, and education on knowledge.

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

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

Associated Vulva Hygiene And Contraception Utilization With Leucorrhoea In Bearchild Age Women

According to WHO about 75% of women in the world will definitely experience vaginal discharge at least once in their lifetime, and around 45% will experience vaginal discharge twice or more. The purpose of this study was to determine the relationship of Vulva Hygiene and the use of contraception with vaginal discharge in women of BA women at Pratama Ananda Clinic in Medan in 2019. This type of research used an analytic survey, with a cross-sectional approach, the population in this study were all BA women and the samples were taken using accidental sampling technique amounted 38 respondents. data Analysis used Univariate and Bivariate Analyses to prove the correlation between the independent and dependent variables with the chi-square test. Results of the study were tested using chi-square obtained Vulva Hygiene results with p-value (.008) < (.05) and contraception use with p-value (.032) < (.05). This study is that there is a relationship between Vulva Hygiene and Use of contraception with Leucorrhoea in BA Women in Ananda Clinic, Medan.

MENGATASI KEJADIAN KEPUTIHAN PADA REMAJA PUTRI DI SMAN 2 RAMBAH HILIR

Vaginal discharge (Flour Albus) is a vaginal condition when removing fluid or mucus resembling pus. In Indonesia, around 90% of women experience vaginal discharge because The State of Indonesia is an area with a tropical climate, so fungi are easy to grow and develop, resulting in a lot of vaginal discharge in women in Indonesia. If not treated properly, vaginal discharge can be fatal, such as infertility, ectopic pregnancy (pregnant outside the womb) and is an early symptom of uterine cancer. The purpose of this study was to determine the factors related to the incidence of vaginal discharge at SMA N 2 Rambah Hilir This research method is carried out using a quantitative analytic research type with a cross sectional design. The sample was taken using the Proportional Random Sampling technique so that a large sample of 140 people was obtained. Data analysis was performed univariately, bivariately with chi-square and T-Independent tests. The results of this chi-square study are, pantyliner: Pvalue 0.003, vaginal cleanser: Pvalue 0.041, and the results of the T-Independent test are, body mass index (BMI): Pvalue 0.862 there is no meaningful relationship between BMI and the incidence of vaginal discharge, and personal hygiene:. The conclusion in this study is that there is a relationship between knowledge, pantyliners and vaginal cleansers.

PENGARUH PEMBERIAN AIR REBUSAN DAUN SIRIH TERHADAP KEPUTIHAN PADA WANITA PASANGAN USIA SUBUR DI WILAYAH KERJA KLINIK MANDING KABUPATEN POLEWALI MANDAR

Leucorrhoea (Flour Albus) is excessive discharge from the birth canal or vagina. Normal vaginal discharge occurs in women, which occurs before and after the fertile period. According to WHO (World Health Organization) the number of women in the world in 2013 was 6.7 billion people and those who had experienced vaginal discharge were around 75%, while European women in 2013 were 739,004,470 people and those who had vaginal discharge were 25%. In Indonesia, about 90% of women have the potential to experience vaginal discharge because the country of Indonesia is a tropical climate, so mushrooms are easy to grow and develop which results in many cases of vaginal discharge in Indonesian women. The method used in this study is EkprerimentalQuasywith pre and post test without control research plans. Sampling using the Total Sampling technique and obtained 17 Respondents in accordance with the Inclusion criteria, Data collection was carried out using observation sheets. Observation was carried out before and after being given betel leaf stew water. The collected data is then processed using a T-test. P-value was obtained after giving betel leaf boiled water which is 0,000. The conclusion in this study is the provision of betel leaf boiled water affects the treatment of vaginal discharge in women of childbearing age in the Manding clinic

СОВРЕМЕННЫЕ ИЗМЕНЕНИЯ МИКРОБИОЦЕНОЗА ВЛАГАЛИЩА НА ПРИМЕРЕ ЖЕНЩИН РЕПРОДУКТИВНОГО ПЕРИОДА Г. НОВОСИБИРСКА

Introduction. Bacterial vaginosis is associated with a large number of pregnancy complications as well as pelvic inflammatory diseases. However, it is necessary to take into account the species composition of pathogens before starting empirical therapy. Aim of the research. Study of the species composition of vaginal discharge in women of reproductive age in the city of Novosibirsk. Materials and methods. To assess the species composition of the vaginal microflora in women with complaints of pathological discharge from the genital tract, 485 women of the reproductive period of the Central District of Novosibirsk were selected who applied to the antenatal clinic and were diagnosed with bacterial vaginosis. All women underwent a bacteriological examination of the discharge from the genital tract, and 240 women with complaints of pathological discharge from the genital tract were assessed for microbiocenosis using the real-time PCR method. Results. According to the bacteriological examination, the majority of patients did not reveal opportunistic pathogens (75.05%). Representatives of the genus Candida sp. predominated among the identified microorganisms (11.55%), Enterococcus sp. – 9.07%. Representatives of the genus Proteus were detected least often during bacteriological examination – 0.21%. According to the RT-PCR study, representatives of Gardnerella vaginalis + Prevotella bivia + Porphyromonas (89.17%), Eubacterium spp. (68.33%), Megasphaera spp. + Veillonella spp. + Dialister spp. (37.5%) and Atopobium vaginae (30.83%) predominated. Staphylococcus spp., Mycoplasma ho-minis – 2.83% and Enterobacterium spp. were detected less frequently – 4.17%. Conclusion. Since in more than 50% of cases it is not possible to isolate an infectious agent in the presence of pathological discharge from the genital tract of women by the bacteriological method of research, while the real-time PCR method is not always available, an understanding of the microbial landscape of the vagina in women with pathological discharge from the genital tract will allow to prescribe an effective empiric therapy.

The DEVA trial: protocol for a randomised controlled trial of dequalinium chloride versus usual care antibiotics for the treatment of bacterial vaginosis

BackgroundBacterial vaginosis (BV) is the most common cause of vaginal discharge in women of reproductive age, and it is estimated that up to a third of women will experience it at some point in their lives. BV produces an offensive vaginal odour and it is associated with serious sequelae. The most frequently prescribed treatment for BV in the UK is 7-day oral metronidazole but recurrences are common following it. Dequalinium chloride (Fluomizin©) is an anti-infective, antiseptic agent administered as a vaginal tablet. Small studies have shown this to be an effective alternative to antibiotics as a BV treatment. This trial aims to investigate whether dequalinium is as effective as current antibiotic treatments for the treatment of BV 1 month after treatment start.MethodsDEVA is a multi-centre, randomised, open-label, parallel group, non-inferiority trial of dequalinium chloride versus usual care antibiotics for the treatment of BV. Recruitment will take place in 15 GUM clinics in the UK with Leeds Sexual Health also managing remote recruitment via the trial website. Women will be randomised 1:1 to receive dequalinium or usual care antibiotics. The primary outcome is to determine if the proportion of women reporting resolution of BV symptoms 4 weeks after treatment (without the need for additional treatment) is not worse in women treated with dequalinium chloride compared to usual care antibiotics. Questionnaire follow-up will take place 4 and 12 weeks after starting treatment, and remotely recruited patients will also provide a week 4 BV vaginal smear. The sample size is 904.DiscussionThis trial will provide high-quality evidence on the use of dequalinium chloride as a BV treatment, which could result in patients reducing the number of antibiotics they take.Trial registrationISRCTN ISRCTN91800263. Prospectively registered on 20 January 2020.

The Role of Probiotics in Preventing Recurrent Bacterial Vaginosis and Vulvovaginal Candidiasis: A Literature Review

Bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) are the most common vaginal infections that cause vaginal discharge in women. An imbalance of the normal vaginal microbiota can make it easier for the vagina to become infected with bacteria and fungi. The recurrence rate for both diseases is 40–60%. Therefore, alternative therapies are needed to prevent the recurrence of these two diseases. Probiotics are believed to be able to maintain a normal microbiota balance in the vagina. This study aims to determine the role of probiotics in BV and VVC therapy, to prevent recurrence of these two diseases. A literature search was performed on two databases namely PubMed and Science Direct, using several keyword combinations to obtain relevant results. There were 12 studies that met the inclusion and exclusion criteria. There are six studies explaining the role of probiotics in BV and VVC, respectively. The use of probiotics intravaginally or orally can significantly reduce the recurrence rate of these two diseases, restore normal vaginal conditions in BV as well as improve clinical symptoms in VVC. The combination of antibiotics and probiotics can increase the effectiveness of the therapy.

Assessment of the prevalence of abnormal vaginal discharges in women of reproductive age who have undergone urgent gynecological surgery

The problem of restoring women’s reproductive health after emergency operations for acute gynecological pathology has been social and medical significance in recent years. This is due to both the increase in its frequency and long-term negative outcomes – a decrease fertility rate, the development of pain syndrome, changes in hormonal homeostasis, etc. One of the manifestations of postoperative dysfunction in the organism is the appearance of an excessive amount of vaginal secretions in female patients. However, the targeted studies about the state of the vaginal microbiota in women after urgent surgical interventions for acute gynecological pathology are rare, and the results are contradictory.The objective: to assess the prevalence and nature of vaginal discharge in women of reproductive age after urgent gynecological operations. Materials and methods. The studied cohort included 125 women of reproductive age. The main group included 60 women of reproductive age after urgent operations because of ovarian apoplexy, ectopic pregnancy, complicated ovarian neoplasm; the comparison group – 35 patients after planned surgery for gynecological pathology; the control group consisted of 30 healthy women. The diagnosis of the causes of vaginal secretions and infection with sexually transmitted pathogens was carried out by the method of pH-metry, bacterioscopic and molecular biological research. The examination was carried out on the 5th day after the operation. Results. Before planned surgical operations, bacterial vaginosis was diagnosed in 22.9% of women in the comparison group, vulvovaginal candidiasis – in 2.9%. The urgency of the operation because of acute gynecological pathology led to the preoperative determination of the state of the vaginal microbiota in only 56.7% of patients in the main group, with the detection of bacterial vaginosis in 26.5%, aerobic vaginitis in 17.7%. After surgery, vaginal microbiota was abnormal in 78.3% of patients in the main group and in 34.3% – in the comparison group (bacterial vaginosis – 53.3% and 31.4%, respectively). Conclusions. Dysbiosis and inflammatory diseases (aerobic vaginitis) of the lower genital organs should be considered as one of the risk factors for acute gynecological pathology. Dysbiotic processes have a tendency to progress after surgery, which makes it necessary to carry out preoperative sanitation of the vagina to reduce the risk of postoperative complications development.