scholarly journals A High Rate of Recurrent Vulvovaginal Candidiasis and Therapeutic Failure of Azole Derivatives Among Iranian Women

2021 ◽  
Vol 12 ◽  
Author(s):  
Amir Arastehfar ◽  
Melika Laal Kargar ◽  
Shahla Roudbar Mohammadi ◽  
Maryam Roudbary ◽  
Nayereh Ghods ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Therapeutic Failure ◽  
Vulvovaginal Candidiasis ◽  
High Rate ◽  
Iranian Women ◽  
Related Factors ◽  
Therapeutic Success ◽  
Over The Counter ◽  
Factors Affecting ◽  
Recurrent Vulvovaginal Candidiasis

Recurrent vulvovaginal candidiasis (RVVC) is one of the most prevalent fungal infections in humans, especially in developing countries; however, it is underestimated and regarded as an easy-to-treat condition. RVVC may be caused by dysbiosis of the microbiome and other host-, pathogen-, and antifungal drug-related factors. Although multiple studies on host-related factors affecting the outcome have been conducted, such studies on Candida-derived factors and their association with RVVC are lacking. Thus, fluconazole-tolerant (FLZT) isolates may cause fluconazole therapeutic failure (FTF), but this concept has not been assessed in the context of Candida-associated vaginitis. Iran is among the countries with the highest burden of RVVC; however, comprehensive studies detailing the clinical and microbiological features of this complication are scarce. Therefore, we conducted a 1-year prospective study with the aim to determine the RVVC burden among women referred to a gynecology hospital in Tehran, the association of the previous exposure to clotrimazole and fluconazole with the emergence of FLZT and fluconazole-resistant (FLZR) Candida isolates, and the relevance of these phenotypes to FTF. The results indicated that about 53% of the patients (43/81) experienced RVVC. Candida albicans and C. glabrata constituted approximately 90% of the yeast isolates (72 patients). Except for one FLZT C. tropicalis isolate, FLZR and FLZT phenotypes were detected exclusively in patients with RVVC; among them, 27.9% (12/43) harbored FLZR strains. C. albicans constituted 81.2% of FLZR (13/16) and 100% of the FLZT (13/13) isolates, respectively, and both phenotypes were likely responsible for FTF, which was also observed among patients with RVVC infected with fluconazole-susceptible isolates. Thus, FTF could be due to host-, drug-, and pathogen-related characteristics. Our study indicates that FLZT and FLZR isolates may arise following the exposure to over-the-counter (OTC) topical azole (clotrimazole) and that both phenotypes can cause FTF. Therefore, the widespread use of OTC azoles can influence fluconazole therapeutic success, highlighting the necessity of controlling the use of weak topical antifungals among Iranian women.

scholarly journals Predictors of Blood Pressure in Iranian Women- A Narrative Review

2020 ◽  
Author(s):  
Maryam Etaat ◽  
Zohre Tabatabaye ◽  
Samaneh Motamed Jahromi ◽  
Poneh Yosefi ◽  
Sadegh Sedigh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Stress ◽  
Narrative Review ◽  
Iranian Women ◽  
Related Factors ◽  
Factors Affecting ◽  
Waist Size ◽  
Age Related ◽  
Diet And Exercise ◽  
Important Health

Introduction: hypertension is one of the most important health problems in the world and in developing countries, including Iran. The prevalence of hypertension among Iranian women is higher than men. This study aimed to investigate the predictive causes of hypertension among Iranian women. This study was a narrative review that was conducted by searching related studies and resources in databases of Google Scholar, SID, Pubmed, Magiran, Web of Science, and Scopus. Finally, 49 qualified articles were analyzed and the texts were reviewed. Based on the obtained data, the predictors of hypertension among Iranian women included the underlying factors of obesity (diet and exercise), psychosocial factors (stress, occupation and addiction) and age-related factors. Conclusion:  Obesity and increased waist size had a greater role in high blood pressure in Iranian women. After obesity, age and factors affecting them, lack of exercise, high stress, occupational factors, education, and addiction can also influence high blood pressure.As a result, it can be predicted that by identifying the risk factors, hypertension can be reduced among Iranian women; by teaching the causes and methods of preventing hypertension to the Iranian women as well as screening for timely diagnose and treatment, hypertension could be decreased among Iranian women.

scholarly journals Oteseconazole: an advance in treatment of recurrent vulvovaginal candidiasis

2021 ◽  
Author(s):  
Jack D Sobel ◽  
Paul Nyirjesy
Keyword(s):  
Treatment Option ◽  
Symptom Control ◽  
Vulvovaginal Candidiasis ◽  
High Rate ◽  
Tolerability Profile ◽  
Cytochrome P450 Enzyme ◽  
Recurrent Vulvovaginal Candidiasis ◽  
Development Of Resistance ◽  
P450 Enzyme

Recurrent vulvovaginal candidiasis (RVVC) has significant disease, financial and quality-of-life burdens, affects women from all strata of society worldwide, and lacks an approved therapeutic solution. Fluconazole emerged in 2004 as an antifungal for RVVC; it provides symptom control and has been accepted worldwide as a first-line treatment. Its limitations include the development of resistance and a high rate of vulvovaginal candidiasis recurrence after therapy cessation. There is now an improved treatment option on the horizon: oteseconazole – a novel, oral, selective fungal cytochrome P450 enzyme 51 inhibitor, designed to avoid off-target toxicities. In clinical studies to date, oteseconazole has demonstrated impressive efficacy, a positive tolerability profile and hope for a superior RVVC treatment option.

scholarly journals Recurrent Vulvovaginal Candidiasis: An Immunological Perspective

2020 ◽  
Vol 8 (2) ◽  
pp. 144 ◽  
Author(s):  
Diletta Rosati ◽  
Mariolina Bruno ◽  
Martin Jaeger ◽  
Jaap ten Oever ◽  
Mihai G. Netea
Keyword(s):  
Fungal Infections ◽  
Protective Role ◽  
Vulvovaginal Candidiasis ◽  
Candida Colonization ◽  
Childbearing Age ◽  
Recurrent Vulvovaginal Candidiasis ◽  
Long Time ◽  
Different Populations ◽  
New Hypothesis

Vulvovaginal candidiasis (VVC) is a widespread vaginal infection primarily caused by Candida albicans. VVC affects up to 75% of women of childbearing age once in their life, and up to 9% of women in different populations experience more than three episodes per year, which is defined as recurrent vulvovaginal candidiasis (RVVC). RVVC results in diminished quality of life as well as increased associated healthcare costs. For a long time, VVC has been considered the outcome of inadequate host defenses against Candida colonization, as in the case of primary immunodeficiencies associated with persistent fungal infections and insufficient clearance. Intensive research in recent decades has led to a new hypothesis that points toward a local mucosal overreaction of the immune system rather than a defective host response to Candida colonization. This review provides an overview of the current understanding of the host immune response in VVC pathogenesis and suggests that a tightly regulated fungus–host–microbiota interplay might exert a protective role against recurrent Candida infections.

Consumer Online Buying Decisions: A Critical Appraisal of Literature

2017 ◽  
Vol 10 (1) ◽  
Author(s):  
Amit Kishore Sinha ◽  
Gyanendra B. S. Johri ◽  
Shanti Rai
Keyword(s):  
Research Paper ◽  
Business Environment ◽  
Buying Behavior ◽  
Related Factors ◽  
Factors Affecting ◽  
Goods And Services ◽  
Online Stores ◽  
Online Buying ◽  
Indian Cities ◽  
Buying Decisions

Since last two decades buying of goods and services from online stores using Internet started off. But players of this industry could reach to the general public residing in second and third category Indian cities in recent past only. Now companies are eagerly interested in understanding the factors affecting Indian consumers so that their needs and wants can be understood and served profitably. This research paper is an attempt to critically evaluate those factors which affect consumer buying behavior in Indian Internet based business environment. For the purpose of coverage of topic researcher has classified the literature under three categories which are Literature related to vendor related factors, Literature related to consumer related factors and Literature related to other factors. Vendor related factors include those factors which are primarily controlled by the companies that are engaged in selling their goods and services on internet along with their intermediaries through which such sales take place. Consumer related factors have been bifurcated under two heading that are consumer demographic factors and consumer psychographic factors. Besides this there are several other factors which may affect consumer’s buying decisions and they are classified as other factors. This research paper also tries to identify the gaps (if any) in the available literature of the factors affecting consumer online buying decisions.

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