scholarly journals Comparative study of cervical-vaginal microbial flora changes in women using Cu-T380A contraceptive device and LNG-IUS in Ibadan: a two-centre clinical COHORT study

Author(s):  
Benjamin C. Oranye ◽  
Adeyemi O. Adekunle ◽  
Ayo O. Arowojolu ◽  
Olufunmilola Makanjuola ◽  
Babatunde Tayo

Background: Intrauterine devices cause various changes in the female genital tract which might result in altered microbial flora and risk of genital infections. The aim of this study was to determine the change in bacterial flora of women using Copper-bearing T380A and levonorgestrel intrauterine system and the risk of genital infections.Methods: This was a two-center clinical cohort study of women using Cu-T380A IUD and LNG-IUS in Ibadan, Nigeria. The study was conducted from March to August, 2016 and it involved 130 women (66 Cu-T380A and 64 LNG-IUS) at 2 family planning clinics in Ibadan, Nigeria. The clients were clinically assessed before admission into the study and high vaginal and endocervical swabs were taken before insertion of the devices, and at 3 and 6months after insertion.Results: Fifty-seven clients with LNG and 63 with copper T380A completed the study. The mean age in LNG-IUS was 34.4years (SD= 6.3) and Cu-T380A was 35.4 years (SD=5.6). All participants had one sexual partner. There was no previous or current STIs/PID at recruitment. The organisms isolated included coagulase negative Staphylococcus (CNS), Staphylococcus aureus, Streptococcus spp, Escherichia coli, Candida spp, Neisseria gonorrhoeae and Klebsiella spp. Cu-T380A women had an increase or persistence of CNS, Staphylococci, Klebsiella and Candida at 3 months while in the LNG-IUS group only CNS increased. The HVS revealed that participants with Cu-T380A had higher risks (33.3%) for asymptomatic genital infections than the LNG-IUS (5.3%) group at 6 months (p value <0.001).Conclusions: Cu-T380A has a higher likelihood of altering the microbial flora in the cervix and vagina and therefore encouraging the growth of a variety of other organisms compared to LNG-IUS.

Author(s):  
Tamojit Chatterjee ◽  
Shrutakirti Ghosh ◽  
Rinki Saha ◽  
Sandip Samaddar

Introduction: Conjunctiva is a transparent mucous membrane that lines inside of the eyelids and covers the sclera. It is composed of non keratinised, stratified columnar epithelium with goblet cells. Normal microbial flora constitutes organisms which are present in eyelids and conjunctiva without causing any disease. At birth eyes are sterile but they are later infected by various organisms. Gram positive organisms are mostly prevalent in ocular flora. Diabetes mellitus is a multifactorial disease that can affect all ocular structures. Aim: To compare the microbial flora between diabetic and non diabetic patients and to study there sensitivity to antibiotics. Materials and Methods: This was an analytical study conducted on a total of 100 patients attending Department of Opthalmology of Medical College and Hospital, Kolkata, India between June 2019 to July 2019. They were not using any topical ocular preparation. Conjunctival swab was taken from upper fornix of the patients and cultured and the results obtained were analysed using Chi-Square test. Results: Conjunctival flora of a total of 100 patients, 30 diabetic and 70 non diabetic, were screened. Among the 30 diabetic patients, there were 15 (50%) male and 15 (50%) female. The most common isolated bacteria in diabetic and non diabetic groups were staphylococcus aureus (diabetic 70%, non diabetic 85.7%). There was a statistically significant difference in microbial flora pattern between the diabetic and non diabetic group. There was higher proportion of staphylococcus epidermidis among diabetic patients compared to non diabetic patients (p-value<0.01) and there was a higher proportion of staphylococcus aureus among non diabetics (p-value<0.01). Conclusion: Present study found statistically significant difference in the microbial flora between diabetics and non diabetics. This will help the clinician to plan for the antibiotic prophylaxis before surgery for patients attending the Out Patient Department (OPD).


Author(s):  
Tamojit Chatterjee ◽  
Shrutakirti Ghosh ◽  
Rinki Saha ◽  
Sandip Samaddar

Introduction: Conjunctiva is a transparent mucous membrane that lines inside of the eyelids and covers the sclera. It is composed of non keratinised, stratified columnar epithelium with goblet cells. Normal microbial flora constitutes organisms which are present in eyelids and conjunctiva without causing any disease. At birth eyes are sterile but they are later infected by various organisms. Gram positive organisms are mostly prevalent in ocular flora. Diabetes mellitus is a multifactorial disease that can affect all ocular structures. Aim: To compare the microbial flora between diabetic and non diabetic patients and to study there sensitivity to antibiotics. Materials and Methods: This was an analytical study conducted on a total of 100 patients attending Department of Opthalmology of Medical College and Hospital, Kolkata, India between June 2019 to July 2019. They were not using any topical ocular preparation. Conjunctival swab was taken from upper fornix of the patients and cultured and the results obtained were analysed using Chi-Square test. Results: Conjunctival flora of a total of 100 patients, 30 diabetic and 70 non diabetic, were screened. Among the 30 diabetic patients, there were 15 (50%) male and 15 (50%) female. The most common isolated bacteria in diabetic and non diabetic groups were staphylococcus aureus (diabetic 70%, non diabetic 85.7%). There was a statistically significant difference in microbial flora pattern between the diabetic and non diabetic group. There was higher proportion of staphylococcus epidermidis among diabetic patients compared to non diabetic patients (p-value <0.01) and there was a higher proportion of staphylococcus aureus among non diabetics (p-value <0.01). Conclusion: Present study found statistically significant difference in the microbial flora between diabetics and non diabetics. This will help the clinician to plan for the antibiotic prophylaxis before surgery for patients attending the Out Patient Department (OPD).


Author(s):  
Sougata Kumar Burman ◽  
Jayeeta Mukherjee ◽  
Ranita Roy Chowdhury ◽  
Soumen Deb

Introduction: Contraception is one of the proximate determinants of fertility and the most important predictor of fertility transition. Depot Medroxy Progesterone Acetate (DMPA) and Intrauterine contraceptive device share some common features- both are Long Acting and Reversible Contraceptives (LARC), but the mechanisms are different. DMPA is a noninvasive, hormonal manoeuvre IUCD is an invasive, nonhormonal one. Aim: To compare the acceptance and reasons for refusal or non-compliance between DMPA and Postpartum Intrauterine Contraceptive (PPIUCD). Materials and Methods: A longitudinal cohort study was done in which total of 110 post partum women (55 in each group) using either DMPA or IUCD were selected randomly and were interviewed and followed up for minimum of six months. Data (variables- number of candidates accepting or refusing PPIUCD or DMPA) from the questionnaires were entered in Microsoft Office Excel 2007 and was transferred to IBM SPSS software, version 20.0 (SPSS Inc. Chicago, IL, USA). Pearson’s Chi-square test was used for variables and p-values were calculated using to find out the statistical significance of the variables and p-value <0.05 was considered statistically significant. Results: The overall acceptance of DMPA (87.3%) was found to be much more than that of PPIUCD (63.6%). In respect to different age groups, the acceptances of both PPIUCD and DMPA were significantly higher in women of age group 21-25. In respect to parity, acceptance of PPIUCD was more in women with one child, whereas the acceptances of DMPA were almost similar in women with either one or two children. Women using PPIUCD, 36.4% refused to continue with the method, whereas only 12.7% of DMPA users refused further injections, the main reason for both the groups being the same irregular bleeding. Conclusion: The acceptance as well as compliance of DMPA as a method of postpartum contraception is much better than PPIUCD in women of this part of part of rural Bengal.


Author(s):  
Sharmistha Sarkar ◽  
Dhruba Prasad Paul ◽  
Jayanta Ray

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.


Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 372
Author(s):  
Léna Royston ◽  
Eva Royston ◽  
Stavroula Masouridi-Levrat ◽  
Nathalie Vernaz ◽  
Yves Chalandon ◽  
...  

Background: Real-life data on the administration of letermovir as cytomegalovirus (CMV) primary prophylaxis after allogeneic hematopoietic cell transplantation (HCT) remain limited. Methods: We conducted a retrospective single-center matched cohort study, comparing consecutive high-risk allogeneic HCT recipients (cases) receiving primary prophylaxis with letermovir and untreated matched historical controls, during a study period of 180 days. The primary outcome was the incidence of clinically significant (cs) CMV infection. Secondary outcomes included duration and costs of CMV-antiviral treatments, hospital resource utilization, hematology and laboratory parameters. Results: Letermovir prophylaxis decreased csCMV infection incidence from 82.7% (controls) to 34.5% (cases; p-value < 0.0001). Controls were more likely to have >1 episode of csCMV infection (59.6%) compared to cases (11.5%; p-value < 0.0001). Letermovir was associated with: shorter overall CMV-associated treatment duration (49 days vs. 77.8 days; p-value: 0.02) and a trend for lower costs of CMV-associated treatments ($4096 vs. $9736; p-value: 0.07) and reduced length of stay (44.8 days vs. 59.8 days; p-value: 0.16). Letermovir administration was associated with significantly shorter duration (27.3 days vs. 57.1 days; p-value: 0.008) and lower costs ($1089 vs. $2281; p-value: 0.008) of valganciclovir treatment. Compared to controls, higher platelet counts were observed in cases (138 G/L vs. 92 G/L; p-value: 0.03) and renal function was improved (94 mL/min/1.73 m2 vs. 74 mL/min/1.73 m2; p-value: 0.006). Conclusions: Primary anti-CMV letermovir prophylaxis decreased the incidence of csCMV infection and the administration of CMV-associated treatments and costs, particularly those associated with valganciclovir. An effect of letermovir on platelet reconstitution and renal function of csCMV post-HCT was observed and needs further investigation.


2016 ◽  
Vol 22 (14) ◽  
pp. 1830-1840 ◽  
Author(s):  
Neda Razaz ◽  
Helen Tremlett ◽  
Ruth Ann Marrie ◽  
K.S. Joseph

Background: Although many individuals with multiple sclerosis (MS) experience depression, there are no studies on the frequency and effect of peripartum depression among parents with MS. Objective: To examine the frequency of peripartum depression in individuals with MS and its potential association with children’s psychiatric disorders. Methods: We conducted a cohort study in British Columbia, Canada, using linked health databases, of parents with MS and their children, and age-matched unaffected parent–child dyads. The diagnosis of peripartum depression, MS and psychiatric disorders in children was based on information from hospital admission, physician visit and drug prescription claims. Results: Peripartum depression was significantly more common among MS parents ( n = 360) versus unaffected ( n = 1207) parents (25.8% vs 18.5%, p value 0.02), especially among MS affected fathers versus unaffected fathers (25.7% vs 10.2%, p value < 0.001). The incidence of psychiatric disorders in children was 3.3 and 2.7 per 100 child-years among children with and without an MS parent, respectively. The rate of psychiatric disorders was significantly higher in children with an MS parent (vs without, hazard ratio (HR): 1.34; 95% confidence interval (CI): 1.03–1.74) and among children with parents who had peripartum depression (HR: 1.87; 95% CI: 1.36–2.55). Conclusion: Parental MS is associated with a higher risk of peripartum depression and increases the risk of psychiatric disorders in children.


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