LOCAL HYPOXIA AND IMMUNODEFICIENCY. EFFECT OF OBESITY ON REDUCING THE EFFECTIVENESS OF TREATMENT FOR BACTERIAL VAGINOSIS

Проведен анализ результатов обследования 143 больных бактериальным вагинозом с учетом наличия у них алиментарного ожирения. Все женщины, принимавшие участие в нашем исследовании, дали письменное информированное согласие на участие в нем. Исследование проводили до начала лечения бактериального вагиноза. В зависимости от наличия алиментарного ожирения больных разделили на 2 группы. В I группу вошли 97 с нормальным весом телом, без признаков алиментарного ожирения. Во II группе у 46 больных отмечалось увеличение массы тела, соответствующее алиментарному ожирению II степени. Критериями для анализа являлись результатами бактериоскопического исследования мазков из влагалища, окрашенных по Грамму и выявления в них количественных показателей «ключевых клеток» и показатели оксиметрии, определение интегративного коэффициента Кслиз%, отражающий содержание кислорода в слизистой оболочке, по отношению к показателям, зарегистрированным на II пальце кисти, позволяющего прогнозировать результативность лечения. Таким образом, на фоне алиментарного ожирения еще до начала лечения интенсивность патологического процесса при бактериальном вагинозе была более выражена, чем без него. При этом локальные гипоксия и иммунодефицит свидетельствовали о риске снижения эффективности лечения The analysis of the results of examination of 143 patients with bacterial vaginosis, taking into account the presence of alimentary obesity, was carried out. All women who took part in our study gave written informed consent to participate in it. The study was carried out before starting treatment for bacterial vaginosis. Depending on the presence of alimentary obesity, the patients were divided into 2 groups. Group I included 97 people with normal body weight, without signs of alimentary obesity. In group II, 46 patients showed an increase in body weight corresponding to alimentary obesity of the II degree. The criteria for the analysis were the results of bacterioscopic examination of vaginal smears stained according to Gram and the identification of quantitative indicators of "key cells" in them and oximetry indicators, determination of the integrative coefficient Cmucous membrane% , reflecting the oxygen content in the mucous membrane, in relation to the indicators recorded on the second finger of the hand, which allows predicting the effectiveness of treatment. Thus, amid alimentary obesity, even before the start of treatment, the intensity of the pathological process with bacterial vaginosis was more pronounced than without it. At the same time, local hypoxia and immunodeficiency indicated the risk of a decrease in the effectiveness of treatment.

Genome sequence of Corynebacterium Amycolatum ICIS 99 Isolated From Human Vagina Reveals Safety and Beneficial Properties

Corynebacterium amycolatum ICIS 99 was isolated from vaginal smears of healthy women and showed promising results in antimicrobial screenings. Here, we report the draft genome sequence of this strain and analyze its main features to assess its safety and useful properties. The genome is 2,532,503 bp long and contains 2,186 CDSs with an average G+C content of 59.0%. Analyses of the ICIS 99 genome revealed the absence of true virulence genes. The genome contains genes involved in the synthesis of secondary metabolites and bacteriocins of the class sactipeptide. In the genome of ICIS 99, we identified a large number of genes responsible for adaptation and survival in the vaginal environment, including acid and oxidative stress resistance genes. The genomic information of ICIS 99 provides a basis for understanding the safety and useful properties of ICIS 99 and for considering it as a potential probiotic strain. However, further research is needed to test its probiotic efficacy in vivo. The whole genome shotgun project has been deposited at DDBJ/ENA/GenBank under the accession number JAIUSU000000000.

An impact of the combined drug containing antimicrobial, antiprotozoal, antifungal and glucocorticoid agents on local immunity in women with bacterial vaginosis and non-specific vaginitis

Inflammatory diseases of the vagina related to imbalanced microflora composition represent one of the most common gynecological diseases primarily dealt with by obstetrician/gynecologists. Such diseases markedly worsen female patient quality of life as well as affect female reproductive system resulting both in altered fertility and adverse pregnancy outcomes. By now, multiple therapeutic and preventive protocols have been proposed to manage such diseases, but insufficient therapeutic efficacy and frequent relapses require further investigations. The aim of the study was to evaluate an effect of the drug Elgyna (Wertex, Russia) consisting of antibacterial, antifungal and glucocorticoid agents on local immunity in females with bacterial vaginosis and nonspecific vaginitis. For this, there were examined and treated 24 females enrolled to the study, who underwent gynecological examination (speculum and bimanual vaginal examination), cervical epithelium microscopy, and calculating karyopicnotic index. Special attention was paid to quantifying level of cytokines IL-6, IL-10, TNFα in vaginal smears before and after therapy with the drug Elgyna. It was found that by the end of the therapy course vaginally administered Elgyna resulted in significantly ameliorated clinical symptoms and normalized microscopic parameters of vaginal discharge. Moreover, this drug consisting of antibacterial, antifungal and glucocorticoid agents did not suppress vaginal epithelium proliferation, but lowered production of pro-inflammatory cytokine TNFα in vaginal smears and shifted toward anti-inflammatory cytokine production. This evidence pathogenetically justifies administration of the drug Elgyna in females with bacterial vaginosis and nonspecific vaginitis as an anti-inflammatory medicine. Efficacy and safety of the two-step therapeutic approach consisting of antibacterial therapy followed by vaginal microbiota recovery for treating inflammatory diseases of vaginal mucosa were confirmed in multiple randomized clinical trials. We envision that such therapeutic concept might be added with a third component implying correction of local vaginal immunity aimed at normalizing the balance between pro- and anti-inflammatory cytokines.

Primary results of a prospective comparative non-interventional study for the treatment of asymptomatic bacteriuria in pregnant women

Introduction. Over the past three decades, the views on the diagnosis and treatment of asymptomatic bacteriuria in pregnant women have not undergone any changes. However, the majority of randomized clinical trials concerning the treatment of pathients with this nosology are of low methodological quality and date back to the 60-80s. Since then, diagnostic and treatment protocols have changed dramatically, so the quality of the evidence base is low. In a recent Scandinavian study of higher methodological quality, there was no clear benefit of antibiotic therapy in pregnant women with asymptomatic bacteriuria. Material and methods. This publication is devoted to the interim results of a study that analyzed the efficacy and safety of herbal medicinal product Canephron® N in the treatment of asymptomatic bacteriuria in 29 pregnant women aged 22 to 34 years at a gestation period of 14-28 weeks. When included in the study, as well as on days 14, 30 and 60, the following laboratory control was performed: general urine analysis, urine bacteriological examination, clinical analysis of vaginal smears, analysis of vaginal microbiota by quantitative PCR Results. In the group of our patients, the distributions by age and gestational age differed from normal, the mean values are presented by the median and were 29 years and 14 weeks, respectively. Already had children – 13 (44.8%) women. In total, 35 microorganisms were isolated in a diagnostically significant titer. Most of the representatives of the Enterococcaceae family were traditionally 57.1%. At the time of inclusion, the median pyuria was 2.5 μl and exceeded the reference values only in 10.3% of patients. Clinical examination of vaginal smears revealed no inflammatory changes. However, an assessment of the vaginal microbiota showed the presence of dysbiosis due to an increase in the amount of obligate-anaerobic microflora in 58.6% and vaginal candidiasis in 10.3% of pregnant women. After 2 months, the 28 pregnant women remaining in the study had no episodes of symptomatic urinary infection. During the herbal drug therapy, there was a decrease in diagnostically significant bacteriuria and signs of the inflammatory process in all patients. The frequency of vaginal dysbiosis was recorded in 10.7% of pregnant women (р>0,05). Conclusion. Thus, our preliminary results shows that the use of Canephron N in pregnant women with asymptomatic bacteriuria (ABU) may be an effective alternative approach comparing the use of antibiotics. The treatment with Canephron N promotes the normalization of the urinary tract microflora and save the intactness of the saprophytic flora, in contrast to antibacterial drugs, and this is especially important in the paradigm of the antibiotics stewardship and the fight against growing antibiotic resistance. Comparative results of the use of antibacterial agents and Canephron N will be analyzed in the next publication, on the basis of which final conclusions will be drawn about the advisability of using herbal medicines to control bacteriuria in pregnant women Conclusion. We have obtained encouraging results from the use of Canephron-N® in patients with asymptomatic bacteriuria in pregnant. To obtain an evidence base of a recommendatory level, it is advisable to increase the number of observations.

FEATURES OF VIOLATIONS OF THE STATE OF THE VAGINAL ECOSYSTEM IN PREGNANT WOMEN WITH BACTERIAL VAGINOSIS

The aim: To assess the condition of the vaginal ecosystem in pregnant women with BV. Materials and methods: The main group consisted of 60 pregnant women with BV in the II trimester. The bacterioscopic examination, of vaginal smears was carried out. DNA diagnostics of the microbial spectrum of vaginal contents was performed. Bacteria with biofilm were visualized by fluorescence hybridization in situ. Results: Biofilms were found in 25 women (41.65%) of the main group, the main component of which was bacteria belonging to the Gardnerella cluster at a concentration of 7.9 ± 0.13 log CFU/ g. Atopobium vagine cluster bacteria gave positive hybridization signals in more than half of the patients and amounted to 6.8 ± 0.15 lg CFU / g. In addition, Snethia spp. was determined as a part of the biofilm at a concentration of 5.8 ± 0.3 lg CFU / g. Conclusions: Thus, the use of the proposed treatment regimen for women with vaginal dysbiosis led to the elimination of pathogenic and conditionally pathogenic microflora. However, the effectiveness of treatment in 5 cases was lower than expected, which indicates the emergence of bacterial resistance.

THE PREVALENCE OF TRICHOMONAS VAGINALIS PARASITE AMONG WOMEN IN SOME REGIONS OF MAYSAN PROVINCE

Trichomonas vaginalis is an extracellular flagellated parasitic protozoan. It adapts to live in anaerobic conditions of the women's vagina and causes Trichomoniasis, a non-viral, sexually transmitted disease (STD). This parasite spreads in all regions of the world, and the global prevalence rate of vaginal Trichomoniasis in women is higher than in men. It is considered a neglected disease in Iraq, as there are few studies about this parasite, especially in Maysan province, where researches are near absent. In this study, two hundred and twentysix vaginal swabs were collected from women who visited hospitals, health centers, and medical clinics in some areas of Maysan province (Amara district, Al-Kahla district, Al-Maymouna district, Al-Majar Al-Kabir district) during the period from November 10, 2019 to February 10, 2020. The microscopic examination of vaginal smears showed that the overall infection rate was 75.22% (170/226). AL-Kahla district had the highest rate of infection (96.15%), while the lowest was in the Maimouna district (60.00%). The age group 34-40 years had the highest infection rate (86.95%), while the age group 15 years had the lowest infection rate (37.50%). Married women had a higher infection (80.92%) than unmarried women (40.62%). The infection rate among nonpregnant women was high (81.11%) than with pregnant women (78.57%). This study showed that vaginal pH has a significant role in protecting the women vagina from Trichomoniasis, once the highest rate of infection (96.63%) was recorded in the vagina with a pH 6, while no infection was recorded at pH 4. It can be concluded that Trichomoniasis is widely spread among women of the Maysan communities, and the condition was affected significantly by some demographic factors such as age, occupation, marital status, husband polygamous, vaginal secretions, and itching and pH of the vagina.

Determine Cyp17a1 and Ki67 Expressions in Pcos Induced Rat Model Treated with Sepia pharaonis Ink Extract Proves Effective

Background: The present study aims to evaluate the therapeutic action of Sepia pharaonis ink extract in experimentally induced polycystic ovary syndrome (PCOS) rat model and perform Immunohistochemistry to confirm the findings.Methods: The female rats were grouped into 5 consisting of six animals each. Only water was given to the control group. For inducing PCOS, Letrozole 1mg/kg.b.wt was administered to the subsequent four groups for 21 days. To the third group, an allopathic drug, clomiphene citrate 1mg/kg was given for 19 days after PCOS induction. The SPIE was subjected to lyophilisation to make a black powder and next two groups were administered orally with two different dosages of SPIE (100mg and 200mg respectively) mixed with water after PCOS induction. Vaginal smears were taken from all groups till 21 days and then treatment was started with clomiphene citrate (CC) and SPIE. After 21 days, vaginal smears were taken from all groups till ovulation was induced. The test drug effects were studied using ovary weight both right and left, body weight, hormonal levels, histopathology of ovary and Immunohistochemistry. Result: PCOS group showed rapid increase in the ovarian weight when compared to control and was reduced by CC and SPIE treatment. The levels of progesterone and estradiol were found lower and testosterone levels were found higher in PCOS rats which were favourably altered. Vaginal smears coincided with the histopathology and immunohistochemistry findings. SPIE can be used as a therapeutic drug for PCOS in future, reduce infertility complaint of females and prevent early inception of diabetes mellitus.