Vaginal Discharge Research Articles

Evaluation of the Causative Microorganisms and Antibiogram Results in Women with Vaginal Swab Culture Taken with Prediagnosis of Vaginitis

Aim: Vaginitis occurs when the vaginal flora is disturbed. This study aimed to evaluate the demographic data, causative microorganisms, and antibiogram results of women who underwent vaginal swab culture with a prediagnosis of vaginitis. Methods: Vaginal swab samples from 314 women who visited the Kafkas University Department of Obstetrics and Gynecology were included in the study. Women with immunosuppressive diseases, gynecological malignancies, and IUD use were excluded. Vaginal discharge or swab samples were Gram stained and cultured on various media. Microorganisms were identified using conventional and biochemical methods, and antibiotic susceptibility tests were performed using the Kirby-Bauer disk diffusion method, according to the EUCAST guidelines. Statistical analyses were performed using SPSS, with categorical variables assessed using the chi-square test or Fisher's exact test, and continuous variables assessed using the Mann-Whitney U test. The study complied with the recommendations of the Declaration of Helsinki for human biomedical research and was approved by the Non-Interventional Clinical Research Ethics Committee of the Kafkas University Faculty of Medicine. Results: The median age of 314 women included in this study was 39 (20-69) years. . In total, 73.6% (n=231) were premenopausal, 24.5% (n=77) were postmenopausal, and 1.9% (n=6) were pregnant. The most common complaint was abdominal/pelvic pain (142, 45.2%). Vaginal cultures from 123 women (39.1%) showed the growth of different microorganisms. The most common causative microorganism was Escherichia coli (41.5%). According to the antibiogram results, the most sensitive antibiotic was gentamicin (65.9%), and ampicillin (52.8 %) was the most resistant. Conclusion: It is important to quickly and accurately identify microorganisms involved in the etiology of the correct treatment.

Interleukin-17 Gene Polymorphisms and Hepatitis B Virus Infection in a Sample of Iraqi Patients

Hepatitis B, a chronic inflammatory liver condition, constitutes a significant global health issue, with 3 million new cases and over 1 million deaths annually (when combined with hepatitis C). The infection may be acute or chronic, and it transmits horizontally by contact with biological fluids such saliva, blood, semen, tears, vaginal secretions, or perinatal fluids following childbirth, which are transferred from mother to infant. Infections can be easily prevented with immunization, typically administered shortly after birth; nevertheless, if neglected, chronic hepatitis B may lead to severe outcomes, including liver cancer or cirrhosis. Interleukin-17A, a pro-inflammatory cytokine, is essential in the immune response to many infections and is implicated in autoimmune diseases. The cytokine interleukin-17 (IL-17A) is only secreted by activated T cells. cDNA of IL-17 has been isolated and cloned from murine hybridomas (cytotoxic T lymphocyte antigen 8 (CTLA-8)). Cytokine imbalance is a crucial factor in the progression and growth of the hepatitis B virus (HBV). A cross-sectional study was conducted including 180 patients with HBV infection at the Digestive and Liver Diseases Teaching Hospital in Baghdad province, from December 14, 2022, to February 15, 2023. This study comprised two groups: the first group consisted of 40 HBV antibody-positive patients, while the second group included 40 HBV antibody-negative patients, along with a control group of 20 individuals. A blood sample of 5 ml was collected from each patient, divided into 2 ml in an anticoagulated EDTA tube and 3 ml in a gel tube. Whole blood with anticoagulated samples was utilized under optimal conditions for DNA extraction, while serum was isolated from blood for biochemical tests. The study comprised 180 patients, categorized into three groups: HBV Positive, HBV Cleared, and Control. The HBV Positive cohort consists of 99 individuals, comprising 54 males (54.45%) and 45 females (45.45%). The average age in this cohort is 42.52 years, accompanied by a standard deviation of 15.13 years. Of these individuals, 84 (84.85%) are wed. The HBV Cleared group has 45 individuals, including 24 males (53.34%) and 21 females (46.67%). The average age in this cohort is 48.43 years, with a standard deviation of 13.98 years. A predominant 39 persons (86.67%) are wed. The Control group comprises 36 individuals, primarily male, consisting of 24 men (66.67%) and 12 females (33.34%). Genotype distribution for two genetic markers, rs2275913 and rs10484879, among three groups: HBV Positive, HBV Negative, and Control. In the HBV Positive group for the rs2275913 marker, the AA genotype is present in 30 patients, the AG genotype in 36 patients, and the GG genotype in 36 patients. In the HBV Negative group, the AA genotype is observed in 9 patients, the AG genotype in 12 patients, and the GG genotype in 21 patients. Multiple research investigations have concentrated on the role of SNPs in the IL17A gene, particularly rs2275913 and rs10484879, in the susceptibility to chronic HBV infection. The polymorphisms were specifically examined for their possible impact on immune response and disease progression in patients infected with HBV. A study of the Han Chinese population demonstrated a significant correlation between the GG genotype and G allele of rs2275913 and an increased risk of HBV infection, suggesting a causal relationship with heightened susceptibility to viral infection.

FREQUENCY OF BACTERIAL VAGINOSIS AMONG WOMEN PRESENTING WITH PRETERM LABOUR

Background: Preterm delivery is of major medical, economic, and social importance worldwide. The incidence is between 5–10% in most developed countries. Both short-term and long-term issues may arise from preterm delivery. Preterm delivery is the cause of almost 85% of long-term disabilities in healthy babies and 75% of new-born deaths. This study aimed to determine the frequency of bacterial vaginosis among women presenting with preterm labour. Methods: This cross-sectional descriptive study was conducted in Department of Obstetrics & Gynaecology, Women Medical College, Abbottabad, and Women & Children Hospital Abbottabad from Jun to Dec 2023. A total of 174 women with preterm labour were included in the study. All women were examined as per Amsel’s clinical diagnostic based on four factors, i.e., Thin grey homogeneous vaginal discharge, fishy smell on Amine test, clue cells of >20% on microscopy, and vaginal pH>4.5. Results: Age limit 15–45 years with mean age of 27.471±3.77 years, mean gestational age 29.546±3.45 weeks, mean parity 1.396±1.45 and mean Gravida was 2.396±1. Bacterial vaginosis was seen in 11.5% patients. Conclusion: There is a correlation between premature labour and bacterial vaginosis. It requires attention to lower morbidity and mortality. Pak J Physiol 2024;20(3):59–61, DOI: https://doi.org/10.69656/pjp.v20i3.1704

Local inflammatory factors in pregnant women with various methods of cervical insufficiency treatment

the reasons for the formation of cervical insufficiency are considred to be different from violation of the ratio of connective tissue elements due to its genetic characteristics to hormonal imbalance, and the predominance of pro-inflammatory factors of the immune system. A special attention is devoted to clinical situations, when cervical insufficiency was diagnosed in terms 22-24 weeks, the treatment means an alternative between emergency cerclage and obstetric pessary. The gaol of study – to compare dynamic of vaginal microbiota and local cervical immune factors by use of different cervical insufficiency treatment methods. Materials and methods. 81 pregnant with cervical insufficiency, diagnosed in term 22-24 weeks were observed, 47 pregnant treated by cerclage procedure (group A), and 34 were fitted with an obstetric pessary (group B). 30 healthy pregnant women in the period of 22 weeks formed group C. In all patients before treatment and every two weeks after it microscopy of vaginal discharges according to Hay/Ison criteria and evaluation of cervical cytokines were performed. Results. The balance by obstetric pessary use of type I and type III by Hay-Ison criteria being similar before treatment with pregnancy prolongation is changing dramatically to the prevalence of bacterial vaginosis be use of obstetric pessary – from 30,3% and 21,2% in 2 weeks to 25,0% and 41,7% in 6 weeks, by cerclage – from 43,5% and 14,9% in 2 weeks to 30,3% and 17,5% in 6 weeks. Patients with cervical insufficiency have increased concentration of IL-6 and IL-10, but by use of obstetrical pessary additionally growth of IL-8 from 42,3 pg/ml in 2 weeks to 187,6 pg/ml in 6 weeks is registered as well as decreasing of SLPI from 1,5 μg/ml to 0,6 μg/ml. Both changes show progression of inflammation and are associated with worth pregnancy outcomes. In the same time, cerclage is assocated with growth of SLPI from 1,9 μg/ml to 4,3 μμg/ml, what is a marker of adequate immune reaction by pregnancy. There is a difference between the groups of cerclage and obstetric pessary in dynamic of microbiota changes - a tendency to increasing of laboratory criteria of bacterial vaginosis frequency in group of obstetric pessary in 2 weeks becomes significant in 4 and more in 6 weeks comparing with group of cerclage. Proper to cervical insufficiency high concentration of proinflammatory IL-6 and IL-10 by use of obstetrical pessary is complicated by increasing of IL-8 and decreasing of SLPI, what means an activation of cervical inflammation, by cerclage – a increasing of SLPI is observed, what is favourable for pregnancy.

Evaluation of polymer combinations in vaginal mucoadhesive tablets for the extended release of acyclovir

Genital herpes, caused by herpes simplex virus type 2 (HSV-2), affects nearly 500 million people, mostly women. Since the main route of transmission is sexual contact, the development of an acyclovir extended-release vaginal microbicide would be a suitable tool for the prevention of virus transmission. In this work, we evaluated the potential of three polymers with different characteristics (chitosan, xanthan gum and ethyl cellulose) for obtaining acyclovir extended-release vaginal tablets. By combining the polymers, certain useful synergies were observed to modify their mucoadhesive capacity and control drug release. In the swelling studies, it observed that a polyelectrolyte complex with more moderate swelling and sustained gelation was formed between chitosan and xanthan gum exclusively in acidic medium (simulated vaginal fluid). This complex allowed prolonging the mucoadhesion of the tablets in ex vivo studies performed with vaginal mucosa, which would translate into better retention in the vagina after administration. In addition, the combination of chitosan and xanthan gum allowed obtaining a controlled release of acyclovir for 5 days, regardless of the pH of the medium, which would guarantee that drug release continues even in the presence of seminal fluid.

Chronic lower abdominal pain in an elderly female patient: a case report about sigmoid colon fistula and pelvic abdominal infection

An elderly woman patient presented with a history of recurrent right lower abdominal pain accompanied by fever and abnormal vaginal discharge for 36 years worse for two weeks. Conservative medical treatment was ineffective, by laparoscopic exploration combined with intraoperative colonoscopy, the presence of a sigmoid colon fistula and pelvic abdominal infection with foreign bodies were confirmed. It was hypothesized that the occurrence of recurrent right lower abdominal pain and intestinal fistula may be potentially associated with tubal injection sterilization performed 36 years ago.

Creation of neovagina in women with Müllerian agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome) using fresh human amnion.

Several graft options can be used to construct a neovagina. This study aimed to evaluate the efficacy of creating a neovagina using a fresh human amnion in women with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Ten patients were analyzed retrospectively. Anatomical success was defined by a postoperative vaginal length ≥5 cm, and a width sufficient to comfortably accommodate the insertion of two fingers. Functional success was achieved when a score of >26.5 was attained on the Arabic validated version of the functional sexual function index (FSFI). The mean vaginal length before surgery was 2.15±0.85 cm (range, 1.5-4.5). The mean vaginal length after surgery was 5.5±0.53 cm (range, 5-6), and all patients (n=10) achieved anatomical success. The FSFI score after surgery was 29.2±2.4, and eight patients achieved functional success. The mean operative time and estimated blood loss were 83.5±50.31 minutes (range, 42-210) and 122.0±75.69 mL (range, 20-250), respectively. None of the patients required intraoperative blood transfusion or experienced injury to vital organs. Four patients developed postoperative leukocytosis within 48 hours, and one patient experienced chronic pelvic pain that lasted more than 6 months postoperatively. No major postoperative complications, such as pelvic abscesses, open wounds, chronic vaginal discharge, or reoperation, were reported. Surgical dissection of the vesicorectal space and utilization of fresh human amnion to create a neovagina over a vaginal mold are technically feasible and safe, and are linked to favorable anatomical and functional outcomes in MRKH patients with vaginal agenesis.

Abstract C053: Racial differences in adverse sexual symptoms and implications for quality of life and adjuvant endocrine therapy adherence among women with early-stage breast cancer

Abstract Background Adjuvant endocrine therapy (AET) is effective at reducing breast cancer recurrence risk. It is associated with adverse symptoms, including sexual symptoms (e.g., vaginal dryness, reduced libido, dyspareunia), that can contribute to medication nonadherence and poor quality of life (QoL). Black women are least likely to start and maintain AET. We conducted post hoc analysis of a randomized clinical trial (RCT) to examine racial differences in how sexual symptoms affect sexual satisfaction and how these contribute to differences in AET adherence for Black and White women with early-stage breast cancer. Methods We used data from a nonblinded RCT of women diagnosed with early-stage (Stage I-III), hormone receptor-positive breast cancer and prescribed AET at a regional cancer center in the U.S. Mid-South. We restricted to Black and White participants who completed surveys at enrollment, 6-, and 12-months (N=275). The Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES) captured sexual symptoms (e.g., vaginal itchiness, bleeding, dryness, discharge, change in interest in sex, and pain with intercourse) and PROMIS Sexual Function and Satisfaction captured changes in sexual satisfaction with 5-item options ranging from “not at all” to “very much.” The 12-item Short Form Health Survey measured QoL with physical and mental health component summaries (higher scores indicated better QoL). AET adherence, captured by an electronically monitored pillbox, was measured as the proportion of days participants took their medication as prescribed over the 1-year follow-up. We conducted race-stratified linear regressions to examine associations of sexual symptoms with QoL and adherence. Results Among 275 participants, 102 (37%) were Black. Black women reported greater severity of vaginal discharge and that loss of sexual satisfaction was due to sexual symptoms at 6- and 12-months (p<0.05). Vaginal itchiness, vaginal discharge, painful intercourse, and loss of interest in sex were associated with lower mental QoL for Black and White women at all three time points. However, loss of interest in sex was associated with lower physical QoL at all three time points for Black women only. Worsening vaginal dryness was associated with lower 6-month AET adherence for Black (p=0.018) but not for White women (p=0.90). Similarly, lower sexual interest and lower sexual satisfaction was associated with lower 12-month AET adherence for Black women (p<0.05) but not for White (p=0.21 and p=0.13, respectively). Conclusion Women with early-stage breast cancer on AET reported adverse sexual symptoms with associated reductions in their sexual satisfaction and physical and mental QoL. Vaginal dryness, reduced libido, and lowered sexual satisfaction are associated with AET nonadherence among Black women, a group with known adherence barriers and recurrence risks. Our findings suggest that adverse sexual symptoms and sexual health challenges contribute to racial disparities in AET adherence and QoL. Oncosexuality care interventions for Black women are needed. Citation Format: Janeane N. Anderson, Freddie Yang, Xin Hu, Gregory A. Vidal, Ilana Graetz. Racial differences in adverse sexual symptoms and implications for quality of life and adjuvant endocrine therapy adherence among women with early-stage breast cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C053.

Saliva as a Potential Source of Biomarkers in Cows with Metritis: A Pilot Study.

Metritis affects 5-20% of cows after parturition, negatively impacting animal welfare and the profitability of dairy farms, increasing culling rates and costs, and decreasing productivity and reproduction rates. This study compared the results of a comprehensive biochemical panel consisting of 25 salivary and 31 serum analytes between healthy cows (n = 16) and cows with metritis (n = 12). Descriptive parameters such as depression, rectal temperature, body condition score (BCS), heart rate, respiratory rate, mucous color, ruminal motility, vaginal discharge, milk production, and complete hematology analyses were also assessed for comparative purposes. The biochemistry analytes comprised five analytes related to stress, five to inflammation, five to oxidative status, and nineteen to general metabolism. The two-way ANOVA analysis revealed that, in saliva, eight biomarkers (lipase, adenosine deaminase (ADA), haptoglobin (Hp), total proteins, g-glutamyl transferase (gGT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and creatine kinase (CK)) were significant higher in cows with metritis. In serum, eight biomarkers (ADA, Hp, serum amyloid A (SAA), fibrinogen, ferritin, AOPPs/albumin ratio, non-esterified fatty acids (NEFAs), and bilirubin) were significantly higher in cows with metritis, whereas six (total esterase (TEA), albumin, urea, lactate, phosphorus, and calcium) were lower. Of the total number of 23 biomarkers that were measured in both saliva and serum, significant positive correlations between the two biofluids were found for six of them (Hp, FRAP, CUPRAC, AOPPs, urea, and phosphorus). Urea showed an R = 0.7, and the correlations of the other analytes were weak (R < 0.4). In conclusion, cows with metritis exhibited differences in biomarkers of stress, inflammation, cellular immune system, and general metabolism in both salivary and serum biochemistry profiles. These changes were of different magnitudes in the two biofluids. In addition, with the exception of ADA and Hp, the analytes that showed changes in the saliva and serum profiles of cows affected by metritis were different. Overall, this report opens a new window for the use of saliva as potential source of biomarkers in cows with metritis.

Optimizing Human Papillomavirus (HPV) Screening: Urine Sample Analysis and Associated Factors in Uzbekistan.

Objective This study assessed the accuracy of detecting Human Papillomavirus (HPV) DNA in urine samples compared to cervical samples and identified factors associated with HPV DNA positivity in Uzbekistan. Methods A total of 218 paired urine and cervical samples were collected from women in Uzbekistan. HPV DNA was detected using polymerase chain reaction (PCR) with genotyping. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's Kappa coefficient were calculated. Univariate and multivariate analyses were conducted to identify factors associated with HPV DNA positivity. Results The study included 32.6% (71/218) positive HPV DNA by cervical samples, which demonstrated 19.7% (43/218) HPV DNA presence by urine samples. Urine HPV testing had a sensitivity of 57.7%, specificity of 98.6%, PPV of 95.3%, NPV of 82.9%, and Kappa coefficient of 60.1. To reveal factors associated with HPV DNA positivity, we set the positive 71 cases as the main group, and 147 negative samples as the control group. The results of the multivariate analysis found the association between HPV DNA positivity and included age 31-40 years (AOR=8.2), working as medical staff (AOR=7.51), condom use (AOR=0.12), having foamy (AOR=7.26) or purulent (AOR=6.84) vaginal discharge. Conclusion Urine HPV testing showed good agreement with cervical samples, although sensitivity was lower than some previous reports. Several sociodemographic and clinical factors were associated with HPV DNA positivity. Further optimization of urine collection, storage, and testing methods may improve sensitivity. Targeted screening of high-risk groups could enhance HPV prevention strategies in Uzbekistan.

Vertical transfer of gut microbiota from dam to neonate calf in the early of life

The aim of this study was to investigate the vertical transfer of microbiota from dams to the offspring. We studied a pair of 20 dams and its offspring. Maternal sources (colostrum, feces and vaginal secretion) and newborn fecal samples were analyzed using 16S rDNA amplicon sequencing on days 1, 3, 7, 14 and 28. Overall, newborns were maintained healthy and did not receive antimicrobial therapy. The Source Tracker analysis indicated that the newborn fecal microbiota was similar to colostrum and vaginal secretion from day 1 up to 7. However, an unknown source (probably from the environment) showed a gradual increase in its similarity with fecal samples from calves measured from day 3 to 28. The most abundant bacteria groups on meconium (day 1) and calf fecal samples on day 3 were Escherichia-Shigella and Clostridium, respectively. On day 7, the predominant genus were Bifidobacterium and Lactobacillus, while Fusobacterium was the most abundant genus on day 14, coinciding with the diarrhea peak. Faecalibacterium showed a gradual increase throughout the neonatal period. Maternal sources contribute to the neonatal microbiota, however other unknown sources (probably environment) had a strong influence on development of the gut microbiota later in the neonate period.

Vulvovaginal candidiasis clinical signs, and distribution of Candida species

Background: Vulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection. The aim of this study was to determine clinical signs and species distribution of Candida species causing vulvovaginal candidiasis. Methods: A cross-sectional study was conducted from December to June 2021-2024 among 400 women attending Obstetrics and Gynecology outpatient clinics in Sana'a City. The study involved collecting vaginal swabs from each participant and analyzing them in a microbiology laboratory. The swabs were used to identify yeast cells, fungal culturing, and germ tube formation tests. The study also used the VITEK II system to confirm species identification, with the VITEK® 2 YST ID identification card being used to identify Candida species. Results: A study of 400 women found that 91.8% were infected with Candida albicans, while 8.2% were infected with other non-Candida albicans. The majority were aged 26-35, with secondary education being the most common. Most were married, with 1-3 pregnancies. The most common sign distribution was vaginal discharge with a 99.5% prevalence. Dysuria was the lowest, with a 65.0% prevalence. Candida species were most frequently isolated, with Candida albicans being the most common. Candida tropicalis was found in 1 out of 6 women, while Candida dubliniensis, Candida famata, Candida glabrata, and Candida lusitaniae were found in 1 out of 6 women. Conclusions: The high prevalence rate of vulvovaginal candidiasis and observation of a low prevalence rate of nonalbicans Candida species in the present study substantiate the importance of conducting continuous epidemiological surveys to measure changes in species distribution from C. albicans to non-albicans Candida species in Yemen.

Case Report : Management of Open Pyometra on the Persian Queen

Pyometra commonly occurs in female cats. There are two types of pyometra: open pyometra and closed pyometra. Open pyometra refers to purulent and bloody discharge from the vulva, while closed pyometra does not have any vaginal discharge; however, there is an enlarged abdomen from the fluid-filled uterus. A 2-year-old Persian queen with an enlargement abdomen was clinically diagnosed with open pyometra as there was vaginal discharge. Additional examination, such as ultrasonography, was also performed to establish the diagnosis. Using ultrasonography, hyperechoic imaging clearly showed in the uterine lumen of the uterus. Based on the following examinations, an ovariohysterectomy was performed to eliminate the source of infection. Anti-inflammatory and antibiotic drugs were administered post-surgery, and the patient fully recovered after one week of intensive care.

A CONCEPTUAL STUDY ON SHWETA PRADARA

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

Prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics at public hospitals in West Shoa Zone, Oromia, Ethiopia

Bacterial vaginosis is a polymicrobial syndrome characterized by the decrease of Lactobacilli and an overgrowth of facultative and anaerobic bacteria in vaginal fluid. Though it has received little attention, it has been associated with poor pregnancy outcomes, such as pre-term labor and delivery, premature rupture of membranes, low birth weight, spontaneous abortion, and postpartum infections. This study aimed to determine the prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics from September 15 to December 14, 2021, at public hospitals in West Shoa Zone, Oromia, Ethiopia. An institutional-based cross-sectional study was conducted on 260 pregnant women, and systematic random sampling was employed to recruit the study participants. Data were collected through a structured questionnaire and the vaginal swab was collected using a sterile cotton swab. The gram staining result was interpreted using the Nugent scoring system. Data was entered into an Excel spreadsheet and exported to STATA-14 for analysis. Data were presented using tables and graphs. Binary and multivariable logistic regressions were performed. Variables with a P value ≤ 0.25 at the binary logistic regression were entered into the multivariable logistic regression. Finally, variables with a P value ≤ 0.05 were considered predictors of bacterial vaginosis and interpreted using adjusted Odds Ratios (AOR) with a 95% confidence interval (CI). A total of 260 pregnant women attending antenatal care were included in the study. The prevalence of bacterial vaginosis according to the Nugent scoring system was 22.3% (95% CI 17.4 to 27.9%). Pregnant women with other marital status were at reduced risk of bacterial vaginosis as compared with married pregnant women (AOR = 0.260, 95% CI 0.068 to 0.9995; P = 0.05). Rural residence (AOR = 2.1, 95% CI 1.05 to 4.24; P = 0.036), use of one pant per week (AOR = 2.7, 95% CI 1.04 to 7.2; P = 0.041), and use of two or more pants per week (AOR = 4.96, 95% CI 1.49 to 16.57; P = 0.009) were significantly associated with bacterial vaginosis. In the current study, a high magnitude of bacterial vaginosis was reported. Residence, marital status, and number of pants used per week were found significantly associated among pregnant women. Hence, screening for the disease should be integrated into the recommended basic laboratory investigations during antenatal visits.

PSIV-13 Changes in Interferon-γ and Tumor necrosis factor-α in the vaginal environment of cattle during early gestation

Abstract The embryo must create an immuno-tolerant uterine environment via cytokine signaling to prevent rejection and facilitate embryo attachment. Cytokines have a variety of roles in both reproductive and pregnancy-related processes. Cytokines and chemokines are important in inflammatory pathways for uterine remodeling and recruitment of immune cells during pregnancy. Interferon-γ (INFγ) and tumor necrosis factor-a (TNFα) influence T-helper cell immune responses, which can assist in early pregnancy establishment. Therefore, we hypothesized that INFγ and TNFα concentrations following breeding will be differentially expressed based on mating type, time, and pregnancy outcome. To test this, we completed two experiments in which INFγ and TNFα were quantified in vaginal fluid samples on d 0, d 7, d 14, d 21, d 28, and d 35 following mating. In experiment one, Angus heifers (n = 9) were used to determine cytokine concentrations in the vaginal environment between d 0 to d 35, and between artificial insemination (AI) and natural mating. In experiment 2, lactating dairy cows (n = 88) were used to determine if cytokines could be used as a potential biomarker for successful pregnancy. All vaginal flush samples were collected via Foley catheter in 20 mL of sterile saline. Statistical analysis was completed in SAS 9.4 to determine differences in cytokine concentrations based on day of gestation, mating type, and pregnancy outcome. In experiment 1, vaginal concentrations of TNFα were least (P = 0.05) in AI-bred heifers on d 35 (1.15 ± 2.97 pg/mL) and intermediate in non-pregnant heifers (4.39 ± 2.97 pg/mL) compared with natural service-bred heifers on d 7 (18.09 ± 2.97 pg/mL). INFγ was increased (P = 0.05) on d 7 following natural service (3.86 ± 0.76 pg/mL) compared with AI (0.86 ± 0.76 pg/mL). TNFα was increased (P = 0.02) on d 7 following natural service (18.09 ± 2.89 pg/mL) compared with AI (1.93 ± 2.89 pg/mL) and was increased (P = 0.02) by d 7 after a natural mating compared with a pregnancy resulting from AI mating. In experiment two, concentrations of IFNγ were greater (P = 0.04) on d 7 (1.36 ± 0.57 pg/mL) compared with d 8 (0.24 ± 0.57 pg/mL) of gestation. There was also a tendency for TNFα concentrations to decrease (P = 0.09) from d 7 (60.06 ± 26.94 pg/mL) to d 8 (19.67 ± 26.94 pg/mL) of gestation. In conclusion, concentrations of INFγ and TNFα may not be indicative of a viable embryo or pregnancy outcome but do differ based on day of gestation and mating type, which may aid in understanding the role these cytokines play during early gestation.

Staging of Estrous Cycle in Rats using Vaginal Cytology and Visual Assessment

The determination of different phases of estrous cycle in lab animals is important for reproductive interventions and other experiments related to animal reproduction where rats are used as experimental models. A total 21 Wistar albino (which had completed their pubertal stage ( greater than 4 weeks) weighing approximately 100- 200 g were used in this experiment. Visual assessment was done to observe vaginal opening during different phases of the estrous cycle. This was followed by collection of vaginal discharge samples by flushing it with 0.1 ml of distilled water using micropipette. Vaginal cytology was performed in 21 rats thrice daily, along with visual assessment. The average length of estrous cycle in rats was recorded to be 4-5 days with average duration of proestrus, estrus, metestrus and diestrus of 24, 24-36, 12 and 48 hours, respectively. The average length of estrous cycle in rats was 4-5 days with recorded average duration of proestrus, estrus, metestrus and diestrus of 24, 24-36, 12 and 48 hours, respectively. Vaginal cytology can be considered as a better option compared to visual assessment for assessment of reproductive status in rats.

Distribution and risk factors of Trichomonas vaginalis infection with relevance to interleukin profile among population in Duhok city, Iraq

BackgroundVaginal trichomoniasis is a sexually transmitted disease causes adverse health outcomes, the causative agent is Tichomonas vaginalis. Infected women develop abnormal vaginal discharge with vaginitis. While, men mostly suffer from prostatitis and urethritis. ObjectivesThis study aimed to detect the rate of T.vaginalis infection in association with risk factors, measurement of blood parameters, interleukine-2 (IL-2) and interleukine-8(IL-8) levels among individuals. MethodsA total of 500 females were tested, a vaginal swab and blood were collected from the participants, and they were within the age range of 18–70 years old. High vaginal swabs were examined microscopically using wet mount preparation, the blood used for measurement of blood parameters using coulter count machine and IL-2 and IL-8 levels were evaluated using ELISA technique. ResultsOut of 500 individuals, the prevalence of T. vaginalis infection was 45(9.0 %). The maximum infection rates were reported among age group (18–28) years, rural residents, illiterates, married women (16.7 %), (15.9 %),(30.0 %),(11.7 %),respectively. Moreover, high positivity of infection revealed among low economical level 12.5 % compared to only 1.7 % in high economy group. Unemployed women, those with bad vaginal hygiene showed high incidence of infection 10.5 % and 6.3 %, respectively. It was noted a significant decrease in red blood cells and hemoglobin concentration, however, there was a significantly increased in white blood cells among infected subjects. Furthermore, the levels of both interleukin-2 and interleukin-8 were significantly higher among infected individuals compared to healthy ones. ConclusionsEffective strategies for disease awareness are needed and should include health promotion, education, and prevention.

Temporal dynamics changes in the vaginal fluid microbiome: Implications for body fluid identification and estimating time since deposition (TsD) for forensics

Vaginal fluid analysis plays a crucial role in sexual assault investigations. However, vaginal fluid found at crime scenes is usually subject to a certain duration of exposure. This study thus aimed to assess the influence of different durations of exposure to indoor environment on the vaginal microbiota. The 16S rDNA high-throughput sequencing was used on vaginal fluid samples exposed for short-term (30 days) and long-term (240 days), respectively. Despite potential contamination from environmental microorganisms, particularly following long-term exposure, the results indicated that the vaginal microbiota after exposure was still dominated by Lactobacillus. Both in short-term and long-term exposure involving vaginal fluid, there were clusters with time-dependent characteristics, wherein the relative abundances of associated microbial genera showed a trend of increasing or decreasing over time. In addition, each bodily fluid presented with a unique array of dominant bacterial genera, enabling the differentiation of exposed vaginal fluid samples from other bodily fluids (semen, skin, saliva, feces) with a remarkable 98.75 % accuracy rate. Furthermore, the mean absolute error achieved by the long-term deposition time prediction model was 13.54 days. The mean absolute error for the short-term deposition time prediction model was notably lower, reaching just 2.05 days. In summary, this study investigates the variations in microbial communities within vaginal fluid subjected to different indoor exposure durations and explores their potential in body fluid identification and estimating the time since deposition, thereby contributing valuable supporting evidence in forensic investigations.

Study of Knowledge, Attitudes, Acceptability and Preference of Home-based HPV Self-Sampling Among a Population of Moroccan Women.

In Morocco, cervical cancer screening rate is still low, which determines the need to adopt new screening approaches. Vaginal self-sampling for HPV testing is one of these strategies. Anticipating changes in screening plans for CC, we would like to present to health authorities a global view about the acceptability and preference of vaginal self-sampling for HPV testing among a population of Moroccan women. The aim of this pilot study is to assess the acceptability and preference of vaginal self-sampling for HPV testing among a population of Moroccan women. A cross-sectional study surveyed 400 Moroccan women aged between 25 and 65years, who are recruited from various healthcare facilities in three Moroccan regions, between March and November 2022. Data were collected via interviews, using a questionnaire. Among the 400 participants, 380 (95%) were ready to undergo a vaginal self-sampling for HPV testing. Among participants who expressed their willingness to perform this test, 295 (73.6%) prefer to carry out it at home. A decreased likelihood of HPV self-sampling was determined by belief that only women with vaginal discharge or bleeding need to be screened. Age, marital status, perceived severity of CC, practice CC screening, and perceived self-efficacy were identified as the main factors influencing the preference for home based vaginal self-sampling for HPV testing. Vaginal self-sampling for HPV testing is an alternative option that could overcome a set of screening barriers defined in the Moroccan context, in order to increase CC screening coverage.