Detection of Candida albicans in the screening of cervical cancer in rural population of Lucknow

Background Study of Candidal infection is very essential in rural women who being illiterate and financially weak are not aware of personal genital hygiene and thus harbour persistent vaginal infections due to poor availability of medical amenities. Method Rural cervical cancer screening is in progress in the western region of Lucknow, India since May 2013 through camp approach and till date, a total of 2949 women have been cytologically examined. Candidal infection has been observed in the 143 cervical smears of women and findings have been analyzed in relation to the different predisposing factor of cervical carcinogenesis. Result The incidence of Candida albicans seen in cervical smears of the total 2949 women examined was found to be 4.8% which is much higher than in their urban counterparts (1.2%). The Candida was seen more in the inflammatory smears (9.4%) and those showing squamous intraepithelial lesions of cervix (SIL). – (8.2%). The fungus was found more prevalent in the reproductive age group and women complaining of vaginal discharge and was result of persistent vaginal infections in the rural women which should be treated. The Candida was commonly seen in erosion cervix cases but its incidence was high in women with cervicitis and cervix bleeds on touch. Conclusions This persistent vaginal infections were seen in the illiterate and poor rural women who are not aware of personal genital hygiene. There is a need to create awareness for personal genital hygiene through health workers for making any cancer screening program meaningful and successful.

The Expanded Role of Chitosan in Localized Antimicrobial Therapy

Chitosan is one of the most studied natural origin polymers for biomedical applications. This review focuses on the potential of chitosan in localized antimicrobial therapy to address the challenges of current rising antimicrobial resistance. Due to its mucoadhesiveness, chitosan offers the opportunity to prolong the formulation residence time at mucosal sites; its wound healing properties open possibilities to utilize chitosan as wound dressings with multitargeted activities and more. We provide an unbiased overview of the state-of-the-art chitosan-based delivery systems categorized by the administration site, addressing the site-related challenges and evaluating the representative formulations. Specifically, we offer an in-depth analysis of the current challenges of the chitosan-based novel delivery systems for skin and vaginal infections, including its formulations optimizations and limitations. A brief overview of chitosan’s potential in treating ocular, buccal and dental, and nasal infections is included. We close the review with remarks on toxicity issues and remaining challenges and perspectives.

Evaluation of the effectiveness of dequalinium chloride vaginal tablets in aerobic vaginitis: A placebo-controlled study

Background: Aerobic vaginitis is a disturbance of vaginal homeostasis caused by the colonization of enteric bacteria. They are not clinically well-defined and do not have standard treatment regimes. Hence, the present study was conducted to evaluate the effectiveness of dequalinium chloride topical vaginal administration in aerobic vaginitis in a placebo-controlled manner. Materials and Methods: This study was conducted in a placebo-controlled manner to demonstrate the effectiveness of vaginal 10 mg dequalinium chloride. A total of 30 patients with different vaginal infections were included in the study. The patients included in the study were divided between the drug group and the placebo group and were treated with one vaginal tablet daily for 6 days. The total symptom score, which consists of the assessment of discharge, itching, and burning sensation, and the lactobacillus grade evaluated microscopically, was determined. Results: It was found that the effectiveness of dequalinium chloride was very high compared to placebo (92% vs. 0%). The reproduction frequency in the first visit was statistically significantly lower in the drug group compared to the placebo group (P < 0.001). Conclusion: It was found that dequalinium chloride is effective for the treatment of aerobic vaginitis. However, studies containing a larger sample group, including the long-term effects (efficacy and side effects) of the drug, should be conducted to prove our conclusion.

An overview of vaginal infections’ etiologies in south-eastern Gabon

Discomfort in women of childbearing age associated with vaginal infections, namely Bacterial Vaginosis (BV), Aerobic Vaginitis (AV), VulVovaginal Candidiasis (VVC), and Trichomoniasis (TV), represent a serious and ongoing gynecological complication throughout the world. This study aimed to investigate the etiologies of vaginal infections among outpatients in south-eastern Gabon. A cross-sectional study was designed using participants referred directly by their treating doctor for a vaginal swab. Socio-demographic data were collected using a structured questionnaire. Microscopic examinations were used for TV and BV diagnostic. All vaginal swabs were cultured for AV and VVC isolates using standard microbiology methods. A total of 573 women of reproductive age participated in the study. The most common identified vaginal infections were BV (62.8%) and AV (51.1%) followed by VVC (34.1%). No significant difference was observed for each etiology compared to socio-demographic data. Streptococcus B (23.9%), Staphyloccocus aureus (17.7%), Klebsiella spp. (11.6%), and E. coli (5.8%) were the bacteria most associated with AV. A high incidence of Non-C. Albicans Candida (NCAC) strains causing vulvovaginitis were found. The prevalence of TV (2.1%) was low. Mixed infections had been common among participants. No association was found with TV and other vaginal infections, unlike others studies. The present study identified BV 228 (83.5%) and AV 227 (83.2%) as the main cause of mixed infections. The mixed infection AV-BV 113 (41.4%) was the most represented. Also, that simultaneous AV-BV-VVC represented 69 (25.3%) of mixed infections. Molecular analyses would be needed to identify the key species commonly associated with these vaginal infections.

Probiotics and Reduction of the Inflammatory Response for Prevention of Preeclampsia

Introduction: In the field of medicine and obstetrics, the most common hypertensive disorders are preeclampsia and it constitutes a great question that has not yet been completely resolved. Objective: To identify the effectiveness of the use of probiotics and the reduction of the inflammatory response in the prevention of pre-eclampsia. Method: This search took place in large databases both globally and locally, being Elsevier, La Reference, Scielo, Pubmed, Google Scholar, Redalyc, Scopus, among others, where probiotic and pre‐eclampsia terms were found. Results: 37 articles were found which were preselected, after correct appreciation 32 articles were selected and 5 articles were discarded, the selected ones met the inclusion and exclusion criteria, therefore they are related to the topic and objective of the present study review. Discussion: The epithelial cells of the intestine produce TNF‐α, once mixtures of different strains of probiotics are made, causing the immune response to be generated, especially if consumed before pregnancy or in early pregnancy and continued throughout of the same. the administration is safe and has a protective role in pre-eclampsia, gestational diabetes, vaginal infections, maternal, infant, and subsequent weight gain. Conclusion: The preventive effect occurs as long as probiotics are administered mainly in the second and third trimesters of pregnancy, although the consumption of probiotics before these results in a much greater benefit, and is even more potent if probiotic mixtures are made. Keywords: probiotics, preeclampsia, hypertensive disorder. RESUMEN Introducción: En el campo de la medicina y obstetricia, los trastornos hipertensivos más comunes son preeclampsia y compone una gran interrogante que aún no está resuelta completamente. Objetivo: Identificar la efectividad del uso de probióticos y la reducción de la respuesta inflamatoria en la prevención de la preeclampsia. Método: Esta búsqueda tuvo lugar en grandes bases de datos tanto a nivel mundial como local, siendo Elsevier, La Referencia, Scielo, Pubmed, Google Académico, Redalyc, Scopus, entre otras, donde se encontraron términos de probióticos y preeclampsia. Resultados: Se encontró 37 artículos los cuales fueron preseleccionados, luego de la correcta apreciación se seleccionaron 32 artículos y se descartaron 5 artículos, los seleccionados cumplían con los criterios inclusión y de exclusión por lo tanto van en relación con el tema y objetivo del presente estudio de revisión. Discusión: Las células epiteliales del intestino producen TNF‐α, una vez que se realicen mezclas de distintas cepas de probióticos, haciendo que se genere la respuesta inmunitaria, en especial si se consume antes del embarazo o en el embarazo temprano y continua a lo largo del mismo. La administración es segura y tiene un papel protector en la preeclampsia, diabetes gestacional, infecciones vaginales, aumento de peso materno, infantil, y posteriores. Conclusión: El efecto preventivo se da siempre y cuando se administre probióticos principalmente en el segundo y tercer trimestre de embarazo, aunque el consumo de probióticos con anterioridad a estos resulta de mucho mayor beneficio, y se potencia aún más si se realizan mezclas de probióticos. Palabas clave: probióticos, preeclampsia, trastorno hipertensivo.

Treating (Recurrent) Vulvovaginal Candidiasis with Medical-Grade Honey—Concepts and Practical Considerations

Recurrent vulvovaginal candidiasis (RVVC) is a relapsing vaginal fungal infection caused by Candida species. The prevalence varies among age populations and can be as high as 9%. Treatment options are limited, and in 57% of the cases, relapses occur within six months after fluconazole maintenance therapy, which is the current standard of care. The pathogenesis of RVVC is multifactorial, and recent studies have demonstrated that the vaginal microenvironment and activity of the immune system have a strong influence on the disease. Medical-grade honey (MGH) has protective, antimicrobial, and immunomodulatory activity and forms a putative alternative treatment. Clinical trials have demonstrated that honey can benefit the treatment of bacterial and Candida-mediated vaginal infections. We postulate that MGH will actively fight ongoing infections; eradicate biofilms; and modulate the vaginal microenvironment by its anti-inflammatory, antioxidative, and immunomodulatory properties, and subsequently may decrease the number of relapses when compared to fluconazole. The MGH formulation L-Mesitran Soft has stronger antimicrobial activity against various Candida species than its raw honey. In advance of a planned randomized controlled clinical trial, we present the setup of a study comparing L-Mesitran Soft with fluconazole and its practical considerations.

Bacterial vaginosis, the leading cause of genital discharge among women presenting with vaginal infection in Dar es Salaam, Tanzania

Background: Pathological vaginal discharge is a common complaint of women in reproductive age worldwide caused by various agents. The prevalence and etiologic agents vary depending on the population studied. Management of vaginal discharge in low-income countries, typically depend on the syndromic approach, which limits understanding the specific causative agents. We determined the proportion of bacterial vaginosis, candidiasis, and trichomoniasis among women with vaginal discharge at a regional referral hospital in Dar es Salaam, Tanzania. Methods: We conducted a cross-sectional study between June and August of 2017 among nonpregnant women at Amana Regional Referral Hospital. Experienced staff performed physical examination to establish a clinical diagnosis, and collection of the high vaginal swab for microscopic examination. Descriptive statistics were performed to assess the characteristics of study participants and the proportion of vaginal infections. Results: A total of 196 samples were collected, of all, 128 (65.3%) had either bacterial vaginosis, candidiasis, or trichomo- niasis. Bacterial vaginosis was the leading infection at 33.2%, followed by candidiasis (19.4%) and trichomoniasis (13.3%). Laboratory confirmed vaginal infection were generally found more in age below 25, unmarried, and those employed or petty business. Conclusion: The proportion of bacterial vaginosis in women with vaginal discharge was relatively higher than others, and the presence of vaginal infection relate to socio-demographic characteristics. Further advanced studies are needed to understand the potential role of aetiologic agents in causing vaginal infections. Keywords: Bacterial vaginosis; vaginal discharge; genital infection.

Restoration and preservation of the vaginal ecosystem in postmenopausal women

The article is devoted to the problem of restoring the physiological conditions of vaginal contents with improving the degree of vaginal cleanliness and reducing atrophic manifestations of the vagina in postmenopausal patients, which reduces the recurrence of vaginal infections and improves the quality of life of menopausal women. The use of a combination of low concentrations of estriol and acidophilic lactobacilli, after the main etiotropic therapy allows to restore the vaginal ecosystem and reduce the manifestations of atrophic vaginitis in menopause.The objective: saving and recovering of the vaginal ecosystem after anti-inflammatory therapy and prevention of vaginal disorders in women in menopause; establishment of clinical effects of complex treatment of sexually transmitted infections, followed by normalization of vaginal flora using a combination of low doses of estriol with lactobacilli and lactose in the form of vaginal suppositories at menopause.Materials and methods. During the examination and treatment of women were divided as follows: I — the main group — 58 women with physiological menopause, who after a comprehensive treatment of colpitis with vaginal suppositorium with a combination of a minimum dose of estriol with lactobacilli and lactose (1 time per day for 12 days, then — 1 time per week for six weeks); ІІ — comparative — 29 patients who underwent only etiotropic therapy with no further correction of vaginal biocenosis.Results. The first control was performed 3–5 days after the end of the main therapy, the second control was performed two months later. After our proposed treatment, the percentage of women with pathological secretions in group I was 12% (7), in II — 66% (19). After 2 months in the main group there was no atrophic changes of the vagina in 39 (67,2%) patients, insignificant — 12 (20,7%), moderate — 6 (10,4%), pronounced — only in 1 (1,7%), and the absence of high atrophy. In the comparison group, the indicators remained unchanged. Conclusions. The combination of low doses of estriol, acidophilic lactobacilli and lactose contributes to sufficient population and maintenance of healthy vaginal flora, as well as the restoration of physiological properties of the vaginal mucosa in women during menopause, as evidenced by the reverse dynamics of atrophic disorders in the main group.

Sociodemographic profile of women with abnormal vaginal flora: a prospective study

<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate the prevalence and association of abnormal vaginal flora with socio demographic profile of patients.</p><p class="abstract"><strong>Methods:</strong> The present study was undertaken in outpatient’s department of obstetrics and gynaecology, government medical college, Patiala. We studied 300 cases with symptoms and signs of vaginal infections in the reproductive age group (15-49 years). After taking detailed history, examination and collecting samples of vaginal discharge, patients were subjected to colposcopy followed by microbiological analysis of vaginal discharge. Recorded data was analysed for prevalence and sociodemographic profile of affected women.</p><p class="abstract"><strong>Results:</strong> The prevalence rate of vaginal infections was 31% among patients who had reported to us with symptoms and signs of vaginal infections. The most common micro-organism detected was <em>B. vaginosis</em> (BV) in 14%, <em>C. albicans </em>(C) in 12% and <em>T. vaginalis</em> (T) in 3.33%. It was analysed that association is more with 25-34 years age, low education level, lower socioeconomic status, unemployed and with married and multiparous group. White and watery discharge characteristic were found to be more common. Lower abdominal pain, dysuria and backache were the most prevalent co-morbidities associated with vaginal infections.</p><p class="abstract"><strong>Conclusions: </strong>We concluded that vaginal discharge is a common gynaecological complaint and vaginal infections are an important cause of vaginal discharge thus leading to significant proportion of female morbidity in sexually active age group. Education and women’s empowerment can prove powerful methods to solve this feminine issue.</p>