Vaginal Discharge Research Articles

Determinants of preterm prelabor rupture of fetal membrane among pregnant women in Ethiopia: A systematic review and meta-analysis

Introduction Ethiopia is one of the countries where persistently high neonatal and maternal mortalities are reported. Preterm prelabor rupture of membrane (PPROM) plays an important contribution to these high mortalities. However, there is a paucity of comprehensive evidence about the epidemiology of PPROM in Ethiopia. Therefore, this systematic review was conducted to assess the pooled prevalence and determinants of PPROM among pregnant women in Ethiopia. Methods A systematic review and meta-analysis were conducted following the PRISMA guideline. Relevant literatures were searched on African Journals Online (AJOL), PubMed, Scopus, Epistemonikos, CINAHL, Cochrane Library and gray literature. All statistical analyses were performed using STATA 17 software. The random effect meta-analysis model was employed to summarize the pooled estimates. Heterogeneity between included studies was evaluated using I2 statistic. Egger’s regression test and Begg’s correlation test were employed to assess publication bias, in conjunction with funnel plot. Besides, the non-parametric trim-and-fill analysis, sensitivity analysis, subgroup analysis and meta-regression were also performed. Results A total of 13 original studies with 24,386 participants were considered in this systematic review. The pooled prevalence of PPROM was 6.58% (95% CI: 5.36, 7.79). Urinary tract infection (OR: 3.44; 95% CI: 1.81, 6.53), abnormal vaginal discharge (OR: 4.78; 95% CI: 2.85, 8.01), vaginal bleeding (OR: 2.04; 95% CI: 1.03, 4.06), history of PROM (OR: 4.64; 95% CI: 2.71, 7.95), history of abortion (OR: 3.06; 95% CI: 1.71, 5.46), malnutrition (OR: 5.24; 95% CI: 2.63, 10.44), anemia (OR: 3.97; 95% CI: 2.01, 7.85) and gestational diabetes (OR: 5.08; 95% CI: 1.93, 13.36) were significantly associated with PPROM. Conclusion This meta-analysis found a high prevalence of PPROM in Ethiopia. Urinary tract infection, abnormal vaginal discharge, vaginal bleeding, history of PROM, history of abortion, malnutrition, anemia and gestational diabetes were risk factors for PPROM. Prevention and control of antenatal infections and malnutrition are highly recommended to reduce the magnitude of PPROM in Ethiopia. Additionally, healthcare providers should emphasize the identified risk factors. Protocol registration number CRD42024536647.

Predictive values of cervix length measurement based on transvaginal ultrasonography

BACKGROUND: Pregnancy is an important process in women’s life, which is widely concerned by women. In recent years, the incidence of premature delivery (PTD) becomes more and more higher due to the development of auxiliary reproduction and ovulation induction technologies and the changes of pregnant women’s lifestyle and physical quality. PTD not only affects postpartum recovery and causes great physical pains, but it also has adverse effects on the birth state of neonates and even leads to neonatal death OBJECTIVE: The predictive values of cervix length (CL) measurement based on transvaginal ultrasonography (TVUS) and pathological examination of placenta for premature delivery (PTD) were investigated and the correlation between PTD and infection was analyzed. METHODS: 120 pregnant women with PTD or high-risk factors for PTD admitted to The Affiliated Hospital of Southwest Medical University between February 2020 and March 2022 were included as the subjects and underwent pathological examination of placenta and TVUS for CL measurement. The final gestational age was set as the standard for the evaluation on the predictive values of pathological examination of placenta and TVUS. What’s more, 36 subjects in PTD group and 84 in normal delivery group (control group) underwent pathological examination of placenta for the analysis of the correlation between PTD and infection. RESULTS: The joint inspection method showed significantly better sensitivity, specificity, PPV, and NPV compared to single CL or pathological examination of the placenta (P< 0.05). Among pregnant women, those with CL ⩽ 30 mm and positive placental pathology had a higher proportion compared to those with CL > 30 mm and negative placental pathology (P< 0.05). Furthermore, the incidence of Ureaplasma Urealyticum (UU), Chlamydia Trachomatis (CT), and Chorioamnionitis (CA) in vaginal discharge of the preterm delivery (PTD) group was significantly higher than that of the control group (P< 0.05). CONCLUSION: The combination of CL ⩽ 30 mm and positive placental pathology could effectively predict PTD and placental infection was notably correlated with the occurrence of PTD.

Bacterial profile-based body fluid identification using a machine learning approach.

Identifying the origins of biological traces is critical for the reconstruction of crime scenes in forensic investigations. Traditional methods for body fluid identification rely on chemical, enzymatic, immunological, and spectroscopic techniques, which can be sample-consuming and depend on simple color-change reactions. However, these methods have limitations when residual samples are insufficient after DNA extraction. This study aimed to develop a method for body fluid identification by leveraging bacterial DNA profiling to overcome the limitations of the conventional approaches. Bacterial profiles were determined by sequencing the hypervariable region of the 16S rRNA gene,using DNA metabarcoding of evidence collected from criminal cases. Amplicon sequence variants (ASVs) were analyzed to identify significant microbial patterns in different body fluid samples. The bacterial profile-based method demonstrated high discriminatory power with a machine learning model trained using the naïve Bayes algorithm, achieving an accuracy of over 98% in classifying samples into one of four body fluid types: blood, saliva, vaginal secretion, and mixture traces of vaginal secretions and semen. Bacterial profiling enhances the accuracy and robustness of body fluid identification in forensic analysis, providing a valuable alternative to traditional methods by utilizing DNA and microbial community data despite the uncontrollable conditions. This approach offers significant improvements in the classification accuracy and practical applicability in forensic investigations.

Next-generation 3D printed multipurpose prevention intravaginal ring for prevention of HIV, HSV-2, and unintended pregnancy

Globally, nearly half of all pregnancies are unintended, ~1.3 million new human immunodeficiency virus (HIV) infections are reported every year, and more than 500 million people are estimated to have a genital herpes simplex virus (HSV-2) infection. Here we report the first 3D printed multipurpose prevention technology (MPT) intravaginal ring (IVR) for prevention of HIV, HSV-2, and unintended pregnancy. The IVRs were fabricated using state-of-the-art Continuous Liquid Interface Production (CLIP™) 3D printing technology using a biocompatible silicone-urethane based resin. Anti-HIV drug (Dapivirine, DPV), anti-herpes drug (Pritelivir, PTV) and a contraceptive drug (Levonorgestrel, LNG) were loaded in a macaque size IVR (25 mm outer diameter, OD; 6.0 mm cross-section, CS) allometrically scaled from the human size (54 mm OD; 7.6 mm CS) IVR analogue. All three active pharmaceutical ingredients (APIs) were loaded in the IVR using a single-step drug loading process driven by absorption. DPV, PTV, and LNG elicited zero-order release kinetics in vitro in simulated vaginal fluid (SVF) at pH 4 and pH 8 relevant to human and macaque vaginal pH respectively. CLIP 3D printed MPT IVRs remained stable after 6 months of storage at 4 °C with no change in physical, dimensional, or mechanical properties and no change in drug concentration and absence of drug degradation byproducts. The MPT IVRs elicited sustained release of all three APIs in macaques for 28 days with median plasma concentrations of 138 pg/mL (DPV), 18,700 pg/mL (PTV), and 335 pg/mL (LNG). Safety studies demonstrated that the MPT IVRs were safe and well tolerated in the macaques with no observed change or abnormalities in vaginal pH and no significant changes in any of the 22 mucosal cytokines and chemokines tested including pro-inflammatory (IL-1β, IL-6, IL-8, IFN-γ, TNF-α, IL-17, IL-18) and anti-inflammatory (IL-10, IL-12) cytokines while the MPT IVR was in place or after its removal. Additionally, MPT IVRs elicited no observed alterations in systemic CD4+ and CD8+ T cells during the entire study. Collectively, the proposed MPT IVR has potential to expand preventative choices for young women and girls against unintended pregnancy against two highly prevalent sexually transmitted infections (STIs).

Altered Endometrial Microbiota Profile Is Associated With Poor Endometrial Receptivity of Repeated Implantation Failure.

To gain insight into the endometrial pathophysiology of unexplained repeated implantation failure (RIF), we examined the characteristics of genital tract microbiota and explored the correlation between the microbiota and endometrial receptivity. Vaginal secretion (VS) and endometrial biopsy (EB) samples were collected from patients with RIF (RIF group, n=32) and those with infertility who had achieved pregnancy during their initial embryo transfer cycle (control group, n=18). 16S ribosomal RNA sequencing and quantitative PCR were performed to characterize the microbiota of the two groups. Spearman's correlation analysis was performed to determine the relationship between endometrial receptivity markers and endometrial microbiota. Endometrial microbiota exhibited distinct characteristics from vaginal microbiota, with a higher alpha-diversity. Alpha-diversity of the endometrial microbiota was higher in the RIF group than in the control group. Compared with the control group, the RIF group had a significant decrease in endometrial Lactobacillus abundance and an increase in Gardnerella and Acinetobacter abundances. The expression levels of endometrial receptivity markers, including homeobox A11, integrin αvβ3, leukemia inhibitor factor, matrix metalloproteinase-9, and vascular endothelial growth factor, were lower in the RIF group than in the control group. Moreover, the expression levels of these markers were correlated with endometrial Lactobacillus, Gardnerella, and Acinetobacter abundances. RIF is characterized by endometrial microbiota dysbiosis and poor endometrial receptivity. Moreover, abnormal endometrial microbiota is associated with impaired endometrial receptivity, which may be a potential cause of unexplained RIF.

The microbiome biomarkers of pregnant women’s vaginal area predict preterm prelabor rupture in Western China

IntroductionIntraamniotic infection is crucial in preterm prelabor rupture of membranes(PPROM), a clinical condition resulting from the invasion of vaginal opportunistic microbes into the amniotic cavity. Although previous studies have suggested potential associations between infection and PPROM, the role of vaginalopportunistic bacteria in PPROM has received limited attention.MethodsThis study aimed to confirm the vaginal bacterial etiology of PPROM. We investigated vaginal microbiotas using automatic analysis of vaginal discharge, microbiological tests, and 16s rRNA genehigh-throughput sequencing.ResultsThe research findings revealed that the proportion of parabasal epitheliocytes, leukocytes, toxic leukocytes, and bacteria with diameters smaller than 1.5 um was significantly higher in the PPROM group than that in the normal full-term labor (TL) group. The top three vaginal opportunistic bacterial isolates in all participants were 9.47% Escherichia coli, 5.99% Streptococcus agalactiae, and 3.57% Enterococcus faecalis. The bacterial resistance differed, but all the isolates were sensitive to nitrofurantoin. Compared with the vaginal microbiota dysbiosis (VMD) TL (C) group, the VMD PPROM (P) group demonstrated more operational taxonomic units, a high richness of bacterial taxa, and a different beta-diversity index. Indicator species analysis revealed that Lactobacillus jensenii, Lactobacillus crispatus, and Veillonellaceae bacterium DNF00626 were strongly associated with the C group. Unlike the C group, the indicator bacteria in the P group were Enterococcus faecalis, Escherichia coli, and Streptococcus agalactiae.DiscussionThese findings provide solidevidence that an abnormal vaginal microbiome is a very crucial risk factorclosely related to PPROM. There were no unique bacteria in the vaginalmicrobiota of the PPROM group; however, the relative abundance of bacteria inthe abnormal vaginal flora of PPROM pregnancies differed. Antibiotics should bereasonably selected based on drug sensitivity testing. The findings presented in this paper enhance our understanding of Streptococcus agalactiae, Enterococcus faecalis, and Escherichia coli vaginal bacterial etiology of PPROM in Western China.

Determinants of Delayed Menstrual Period among Students of Tertiary Institutions in Rivers State

Menstrual period is a normal and significant process that every female who have attained the age of puberty must experience in life and it is a monthly process. However, delayed in having this normal process every monthly is a concern. Several factors may be responsible for delayed menstrual period experienced by females. This research states to examine the Determinants of Delayed Menstrual Period among Students of Tertiary Institutions in Rivers State. Sample size for the study was 250 and participant were randomly selected and the questionnaire were issued to the participants to fill and return it to the researcher. Data was analyzed with SPSS version 26 and P value < 0.05 was considered significant. Results from the study revealed that some of the determinants that are precursors of delayed menstrual period observed were unprotected sex, use of contraceptives, alcohol consumption, use of public toilet, unwanted pregnancy, vaginal discharge, abortion, stress and infection. Also, 98.8% of the responders have started dating and 78.00%) respondents agreed that they have been involved in intermittent sex without protection. The findings revealed that 98.4% of the participants have used contraceptives for more 5 years. However, 62.8% of the responders affirmed that they experienced milky discharge from their breast and 69.2% have done abortion. The study shows that 68.4% of the respondents used public toilet and 62.4% respondents experienced vaginal discharge. Furthermore, 65.20%) of responders have been pregnant without knowing. Results also shows that 73.2% of the respondents have conducted hormonal profile and 64.4% of respondents have hormonal imbalance while 94.4% of the participants consumed alcohol.

Towards the identification of body fluids using RT-LAMP isothermal amplification coupled with CRISPR-Cas12a

While often necessary in sexual assault cases, confirmatory identification of body fluids can be a lengthy and/or costly process. In particular, the detection of vaginal fluid and menstrual fluid in forensic casework is limited to endpoint reverse-transcription PCR to detect fluid-specific messenger RNA (mRNA) markers as there are no robust chemical or enzymatic techniques available for these fluids. Similarly, testing for rectal mucosa is not possible with standard methods, the presence of which would provide probative value in cases of alleged anal penetration, although mRNA-based markers have recently been described. Reverse-transcription loop-mediated isothermal amplification (RT-LAMP) is an alternative technique that enables detection of mRNA at a single temperature (usually 60–65℃) for 10–30 minutes and has comparable sensitivity to PCR. We describe the coupling of RT-LAMP amplification (60℃ for 30 minutes) with CRISPR-mediated fluorescent detection of the body fluid specific mRNA markers MMP3 (menstrual fluid), CYP2B7P (vaginal material), TNP1 (spermatozoa), KLK2 (semen), and MUC12 (rectal mucosa). Following temperature optimization and final selection of RT-LAMP-CRISPR assays, their specificity across circulatory blood, buccal, menstrual fluid, vaginal material, semen, and rectal mucosa was assessed. Most assays were specific for their intended target body fluid, although MMP3 and CYP2B7P were detected in some rectal mucosa samples, the latter of which has been observed previously in the literature. A preliminary sensitivity assessment in target fluids was determined by a dilution series over six logs of RNA input. A range of assay approaches were investigated to develop a protocol suitable for use in a forensic screening laboratory. This included the determination of fluorescent assay results by eye, use of lyophilised reagents, and RT-LAMP and CRISPR reactions undertaken in one-tube in a lower resource setting.

Classification of Vaginal Cleanliness Grades through Surface‐Enhanced Raman Spectral Analysis via The Deep‐Learning Variational Autoencoder–Long Short‐Term Memory Model

In this study, it is aimed to establish a novel method based on a deep‐learning‐guided surface‐enhanced Raman spectroscopy (SERS) technique to achieve rapid and accurate classification of vaginal cleanliness levels. We proposed a variational autoencoder (VAE) approach to enhance spectral quality, coupled with a deep learning algorithm long short‐term memory (LSTM) neural network to analyze SERS spectra produced by vaginal secretions. The performance of various machine learning (ML) algorithms is assessed using multiple evaluation metrics. Finally, the reliability of the optimal model is tested using blind test data (N = 10/group for each cleanliness level). The data quality of the SERS fingerprints of four types of vaginal secretions is significantly improved after VAE decoding and reconstruction. The signal‐to‐noise ratio of the generated spectra increased from the original 2.58–11.13. Among all algorithms, the VAE–LSTM algorithm demonstrates the best prediction ability and time efficiency. Additionally, blind test datasets yielded an overall accuracy of 85%. In this study, it is concluded that the deep‐learning‐guided SERS technique holds significant potential in rapidly distinguishing between different levels of vaginal cleanliness through human vaginal secretion samples. This contributes to the efficient diagnosis of vaginal cleanliness levels in clinical settings.

Pilot study on the impact of HIFU treatment on miRNA profiles in vaginal secretions of uterine fibroids and adenomyosis patients

Background High intensity focused ultrasound (HIFU) ablation treatment for uterine fibroids and adenomyosis has been long developed. The aim of this study is to investigate miRNA profile changes in vaginal secretions after HIFU treatment and their clinical relevance. Methods We prospectively collected vaginal secretions samples from 8 patients (1 with adenomyosis and 7 with fibroids) before and after HIFU treatment. RNA was isolated and miRNA profiles were analyzed using next-generation sequencing (NGS) sequencing. Results Our study showed miRNA profile change in vaginal secretion samples after HIFU treatment for uterine fibroids/adenomyosis, with 33 miRNAs upregulated and 6 downregulated overall. In fibroid cases, 31 miRNAs were upregulated and 7 downregulated, while in adenomyosis case, 41 miRNAs were upregulated and 71 downregulated. Four miRNAs (hsa-miR-7977, hsa-miR-155-5p, hsa-miR-191-5p, hsa-miR-223-3p) showed significant differences after HIFU treatment in fibroid cases, except in case 5 with the lowest treatment sonications (425 sonications) and energy input (170000 J). hsa-miR-7977 consistently showed downregulation after HIFU treatment. hsa-miR-155-5p were downregulated in case 4 with lowest treatment efficiency (2439.64 J/cm3), while they were upregulated in other cases. hsa-miR-191-5p and hsa-miR-223-3p were downregulated in cases 4 and 7, with case 7 influenced by high sonication and energy due to multiple fibroids. Conclusions HIFU treatment altered miRNA profiles in fibroids/adenomyosis patients. Notably, hsa-miR-7977, hsa-miR-155-5p, hsa-miR-191-5p, and hsa-miR-223-3p showed significant changes in fibroid cases, except in low-energy treatments. hsa-miR-7977 consistently decreased post-treatment, while hsa-miR-155-5p decreased in the least efficient cases. Further research is needed for validation.

First detection of multidrug-resistant and toxigenic Pasteurella aerogenes in sow vaginal discharge: a novel threat to swine health in Thailand

Pasteurella aerogenes has been implicated in reproductive disorders in sows, yet its prevalence and characteristics in vaginal discharge are not well understood. This study aimed to detect P. aerogenes in sow vaginal discharge samples and investigate its antibiotic resistance profile, toxin genes, and toxicity. P. aerogenes was isolated from 40% (8/20) of samples. Antimicrobial susceptibility testing revealed universal resistance to amoxicillin-clavulanate (4:1), with 87.5% of isolates also resistant to oxytetracycline, amoxicillin, ceftriaxone, and enrofloxacin. The colistin resistance gene mcr-2 was detected in 75% of isolates, while class 1 integron (int1) was found in 12.5%. The pax toxin gene cluster was present in 75% of isolates. Toxicity assays using Panagrellus redivivus demonstrated dose-dependent effects of P. aerogenes supernatant containing pax toxins. This study represents the first report of P. aerogenes isolation from sow vaginal discharge in Thailand. The high prevalence of antibiotic resistance, presence of the mcr-2 gene, and toxicity of pax toxin-positive isolates suggest that P. aerogenes may be an underestimated factor in swine reproductive health. These findings highlight the need for further investigation into the role of P. aerogenes in sow reproductive disorders and its potential impact on swine production.

Comparative efficacy of oral and vaginal probiotics in reducing the recurrence of bacterial vaginosis: a double-blind clinical trial

ObjectiveThe primary goal of this study is to discern the optimal adjuvant treatment for patients diagnosed with bacterial vaginosis, focusing on reducing recurrence rates.MethodsThis study is a double-blind clinical trial with no previous similar trials conducted to date. The study population consisted of non-pregnant, married women visiting teaching hospitals’ clinics in Mashhad, complaining of vaginal discharge. After informed consent and questionnaire completion, samples were obtained from vaginal discharge surrounding the cervix of clinically diagnosed bacterial vaginosis patients. Using Gram staining, a gold standard method for bacterial vaginosis diagnosis, samples were examined under a microscope according to the Nugent score. After initial treatment with metronidazole, patients were divided into two groups receiving either vaginal or oral probiotics.ResultsOf the 55 participating women, 20 were in the vaginal probiotic group and 35 were in the oral probiotic group. No significant demographic or clinical differences existed between groups at baseline. The Nugent score decreased from 8.5 to 3 in the vaginal group and from 9 to 3 in the oral group, suggesting the effectiveness of both treatments. While the difference between groups was not statistically significant, each group showed significant improvements from their initial states (p-value < 0.001).ConclusionNo significant difference was observed in the effectiveness of oral versus vaginal probiotics in reducing the recurrence of bacterial vaginosis after routine treatment. Therefore, the type of probiotic to be used could be chosen based on patient preference.

Hubungan Penggunaan Kontrasepsi Pil Oral Kombinasi (POK) dengan Kejadian Obesitas dan Keputihan di Wilayah Puskesmas Simpang IV Sipin Kota Jambi Tahun 2022

The aim of the research is to determine the relationship between the use of combined oral contraceptive pills (POK) and the incidence of obesity and vaginal discharge in Simpang IV Sipin Community Health Center Area, Jambi City in 2022. This research is a quantitative study using a cross sectional design. This research was conducted in the Simpang IV Sipin Community Health Center working area, Jambi City from 14 to 20 December 2022. The total population was 130 respondents with samples using total sampling techniques. The data analysis technique used was univariate and bivariate analysis. The results of the study is that there is a relationship between contraceptive users and the incidence of obesity and there is no relationship between contraceptive users and the incidence of vaginal discharge in the Simpang IV Sipin Health Center Area, Jambi City in 2022

Does a Tuberculosis Peritonitis Imitate an Advanced Ovarian Cancer?: A Case Report at Iringa Regional Referral Hospital in Tanzania

Tuberculosis (TB) Peritonitis is unexpected tuberculosis that happens in less than 2% of the patients worldwide. The incident rates are higher in the developing countries as a result of the inadequate diagnostic equipment. The mimicking of the tuberculosis peritonitis with an advanced ovarian cancer affects the decision of the gynecologist even after coming up with the confirmatory investigation of image findings. A 34-year-old female presented with progressive abdominal distension for 2 months, discomfort, abnormal vaginal discharge, which was foul smell and yellowish in color, painful sex intercourse, and denied history of diarrhea or constipation. Furthermore, present the history of passing black stool, but she denied history of vomiting blood or epigastric pain. A pelvic scan revealed the adnexal masses and ascites, with a conclusion of advanced ovarian cancer. A laparotomy was done; total abdominal hysterectomy and bilateral salpingoophorectomy were done. A specimen sent for histopathology, which revealed tuberculosis peritonitis and not ovarian cancer. A patient was administered anti-tuberculosis drugs, and on follow-up, the patient showed an improvement. Therefore, in this case, the gynecologist should think of tuberculosis peritonitis as a differential diagnosis of advanced ovarian cancer, and this can be confirmed by the laparoscope and histopathology of the specimen hence preventing unnecessary total abdominal hysterectomy.  Implication for policy makers: The diagnostic tools in the health care facilities should be readily accessible and available for such rare cases hence more on job training to equip the gynecologists with updated knowledge and skills.  Implication for public: The public health should be emphasized in the community by offering health promotion, encouraging screening, and prevention of diseases so as to prevent the consequences which affects the life of an individual.

Ultrasonic diagnosis of hepatic ectopic pregnancy: a case report

Hepatic ectopic pregnancy is an extremely rare ectopic pregnancy. Ectopic pregnancy is one of the reasons for acute abdominal pain. Ectopic pregnancy refers to the growth and development of zygotes outside the uterine cavity, and tubal pregnancy is the most common. Abdominal ectopic pregnancy is very rare, accounting for only 1.3% of all ectopic pregnancy including small intestine and large intestine, sigmoid colon, omentum, liver, diaphragm, pancreas, peritoneum and spleen [1], of which the incidence of hepatic ectopic pregnancy is about 1:15,000 per inner uterus pregnancy [2]. The present report describes the case of a 36-year-old woman who presented with continuous brown vaginal secretions after 57 days of amenorrhea. The patient was initially diagnosed with liver ectopic pregnancy by abdominal ultrasound and this was confirmed by laparoscopic exploration. The pathological examination revealed a pregnancy material in the liver tissue. The patient made good progress post-surgery, with serum levels returning to normal during a follow-up examination 1 month later. Overall, ultrasound and β-HCG levels are crucial in diagnosing ectopic pregnancy before patients show clinically consistent symptoms.

Women's self-reported symptoms of reproductive tract infection, medical consultations, and factors influencing them in less developed regions: perimenopausal and older women in need of urgent attention.

Reproductive tract infections (RTIs) represent a critical public health concern impacting women's health, particularly pronounced in developing countries. We aim to investigates the prevalence of self-reported RTI symptoms in women aged 18 to 65 and the factors influencing gynecological examination behavior and associated risks are explored. From May 6, 2022, to September 20, 2022, a comprehensive survey engaged 20,864 women aged 18 to 65 in 19 townships in Lueyang, Shaanxi. Each survey team, comprising a gynecologist, two female health center staff, and a master's student, conducted face-to-face questionnaire surveys in villages and households. The questionnaire featured three sections: prevalence of self-reported RTI symptoms, gynecological examination history, and factors influencing examination behavior. The high response rate of 98.69% yielded 20,590 valid questionnaires. Among surveyed women, 42.04% reported RTI symptoms, with a higher prevalence in those aged 30 and above, peaking at 44.88% in the 50-59 age group. Vulvar itching (24.73%), abnormal vaginal discharge (17.41%), and urinary tract irritation signs (11.73%) were most common. Older adult women (≥60) reported higher frequency and longer duration of symptoms. Only 9.88% of symptomatic women underwent gynecological examinations in 2022. Examination likelihood decreased with age, presenting a critical gap in healthcare utilization among older women. Reasons for checkups included routine checkups (47.02%), symptom concerns (41.29%), and the availability of free medical checkup programs (9.82%). Barriers included perceived lack of serious symptoms (23.7%), lack of necessity (4.41%) and lack of time (3.98%). Among those examined, 40.58% had a diagnosis of gynecological disorders, including pelvic inflammatory disease, human papilloma virus infection and cervical cancer. Widespread RTI symptoms, particularly in perimenopausal and older women, underscore the need for enhanced healthcare. Barriers to gynecological examinations include awareness, education, and accessibility issues. Strategies must prioritize health education, routine examinations, and improved healthcare infrastructure in underdeveloped regions.

Microbiological and Haemato-biochemical Studies in Canine Pyometra

Background: Canine pyometra, is a pathological condition that results in the accumulation of purulent exudate in the uterus due to hormonal imbalance in female dogs. This is the most prevalent hormonally mediated reproductive disorder and life threatening disease of intact female dogs. The objective of the present study was to assess the physiological, haematological and biochemical changes and isolate the pathogenic microorganism present in the uterus of pyometra bitches. Methods: This study was carried out in ten bitches with a history of lethargy, depression, in appetence, polydipsia, occasional vomiting and vaginal discharge presented for treatment at the Veterinary Poly Clinic, Coimbatore, Tamil Nadu. The disease was diagnosed by history, clinical signs, physical examination, imaging techniques haematology and biochemical study. The involvement of the pathogenic organism was confirmed by microbial examination of the pus-filled uterus after the ovariohysterectomy. Result: The result showed that physiological parameters rectal temperature, heart rate and respiration rate were increased in pyometra affected dog than healthy one. The haematological parameters of red blood cell count, haemoglobin and packed cell volume were decreased in pyometra affected dogs than healthy dogs. Leukocytosis, neutrophilia, lymphocytosis, monocytosis and eosinophilia condition also observed in pyometra affected dogs. Biochemically, increased Blood urea nitrogen (BUN) creatinine and hyperprotenimia were observed in pyometra dogs. Increased activity of hepatic enzyme Alanine transaminase (ALT), Aspartate aminotransferase (AST) and Alkaline phosphatase (ALP) were also observed in pyometra dogs. The major pathogenic microorganisms involved in pyometra are Escherichia coli (40.25%), Staphylococcus (20.46%), Streptococcus (20.32%), Pseudomonas (6.41%), Proteus (6.32%) and Pasteurella (6.24%). Thus the dogs with pyometra show significant changes in physiological, haematological, biochemical parameters and growth of pathogenic microorganism in uterine fluid were the important indications of pyometra affected dogs.

Three-Dose Antifungal Treatment Improves the Efficacy for Severe Vulvovaginal Candidiasis

Vulvovaginal candidiasis (VVC) is a prevalent gynecological infection characterized by high incidence and recurrent episodes, causing significant distress in women. This study aims to assess the effectiveness of different clotrimazole and fluconazole treatment regimens for severe vulvovaginal candidiasis (SVVC). A retrospective analysis was conducted on 1303 cases of SVVC among first-time visitors to the gynecology outpatient department at Peking University Shenzhen Hospital between January 2013 and December 2022. Vaginal secretions were systematically collected for fungal culture, with species identification conducted using Chromogenic culture medium and API Candida test reagents. Mycological cure rates were assessed at days 7–14, days 25–35, and day 35 to 6 months after treatment. The three-dose clotrimazole regimen demonstrated significantly higher mycological cure rates (85.7%, 80.0% and 74.6% at three follow-up periods, respectively) compared to the two-dose clotrimazole regimen (76.0%, 61.6%, and 59.8%, all P < 0.05). The three-dose fluconazole regimen showed no significant difference to three-dose clotrimazole regimen, with cure rates of 82.8%, 79.3%, and 75.9% (all P > 0.05). The two-dose fluconazole regimen had cure rates of 74.3%, 56.4% and 51.1%, with no significant difference from two-dose clotrimazole regimen at days 7–14 and 25–35, but lower than three-dose fluconazole regimen at days 25–35 and 35 to 6 months. The three-dose clotrimazole regimen demonstrated higher cure rates in Candida albicans and non-albicans Candida SVVC cases than two-dose regimen. These findings suggest that three-dose antifungal regimens may be more efficacious than two-dose regimens for SVVC. The three-dose clotrimazole regimen could serve as a promising alternative for SVVC management.

Double umbilical artery converging into a single umbilical artery: A case report.

The normal structure and Doppler parameters of the umbilical cord are closely related to many diseases, including fetal infection, chromosomal abnormalities, hypoxia, and growth and development restrictions. We report a case of bilateral umbilical artery confluence resulting in the formation of a single umbilical artery in the free segment of the fetal umbilical cord, diagnosed at 24 weeks and 4 days gestation. The fetus was born prematurely after premature membrane rupture at 31 weeks and 3 days gestation. The Toxoplasma, Others, Rubellavirus, Cytomegalovirus, Herpesvirus test showed positive results for Toxoplasma gondii, rubella virus, and herpes simplex virus IgG antibodies. A 36-year-old woman had vaginal discharge for > 1 hour at 31 weeks + 3 days gestation and came to our obstetrics department for treatment. The pregnant woman sought treatment due to premature membrane rupture and vaginal discharge for > 1 hour. The vaginal discharge was caused by Escherichia coli. After cesarean section, the Toxoplasma, Others, Rubellavirus, Cytomegalovirus, Herpesvirus test revealed positive results for the following: T gondii, rubella virus, and herpes simplex virus IgG antibodies. The patient underwent 2 ultrasound examinations and was diagnosed with umbilical artery malformation (the free segment of the umbilical cord on the fetal side converged into a single umbilical artery), which may have been related to fetal infection. The patient received anti-inflammatory and fetal lung maturation treatment for 2 days before undergoing a cesarean section. The mother and newborn received anti-inflammatory, symptomatic, and supportive treatment and were discharged after 1 week of improvement. After 1 month, 6 months, and 1 year of follow-up after birth, the growth and development of the infant (height and weight) were significantly lower than those of her peers, and her responses to sound and light were slightly delayed. Umbilical artery malformation is extremely rare and may be related to intrauterine parasitic and viral infections. Ultrasound has the advantages of being noninvasive and cost-effective and can be used to dynamically observe umbilical artery structure. An abnormal change in umbilical artery structure found during ultrasound examination can indicate intrauterine infection risk, which provides clinical guidance for further examination of pregnant women, early diagnosis, timely targeted treatment, and fetal prognosis improvement.

Intention to Use Leucorrheea Self-Test Innovation Kit and Collection Data through Mobile Application in Bangkok

Leukorrhea, or abnormal vaginal discharge (fungi, bacteria, and protozoa), can be indicated bacterial vaginosis or STIs. If not treated, these infections may lead to complications impacted fertility such as pelvic inflammatory disease (PID). Therefore, the goal is to develop a self-test kit for vaginal discharge detecting all three pathogens in one device. This study examines the acceptance of innovative technologies and factors affecting the intention to self-administered leucorrhoea test kits (SALTK) with results presentation and data transmission via mobile phones. Factors influencing such intention included technology acceptance (Technology Acceptance Model: TAM), facilitating conditions, social influence, and perceived privacy risk. The data were collected using an online Google Form questionnaire. A total of 450 valid questionnaires were used for analysis. The descriptive statistics employed in this study included percentage, means, and standard deviation, and the hypothesis was tested using multiple regression analysis. It was found that the factors impacting the intention to use SALTK with a statistical significance level of .05 were facilitating condition, social influence, perceived privacy risk, and three key technology acceptance components, namely perceived usefulness, perceived ease of use, and attitude toward using, respectively. SALTK modulates the beneficial for public health policies in Thailand and government agencies, the Food and Drug Administration and the Department of Disease Control, establishing prevention to reach the international standards.