A comparison of the efficacy of single-dose Cefazolin versus single-dose Cefazolin plus 7-day Mupirocin ointment wound application in preventing surgical site infection among patients undergoing major Obstetric and Gynecologic procedures at a tertiary university hospital: A single-blinded, randomized controlled trial / Philippine Journal of Obstetrics and Gynecology

Background@#Surgical site infection (SSI) is a common complication among all surgical cases. It is the most common nosocomial infection identified in the developing world with pooled incidence of 11.8 per 100 surgical procedures. In our institution, the SSI rate in major obstetric and gynecologic cases in years 2000–2013 is 12.68%. @*Objective@#To compare the efficacy of a single-dose cefazolin versus a single dose cefazolin plus 7-day mupirocin ointment wound application in preventing SSI among women undergoing major obstetric and gynecologic abdominal surgical procedures.@*Materials and Methods@#The study included are 164 female participants, aged 18–65 years old who underwent major obstetric and gynecologic surgical procedures. Participants were randomly assigned to Groups A and B, wherein all participants were given single dose of 2 g cefazolin, intravenous, 30 min before skin incision. For the participants in Group B, an additional 7-day application of mupirocin ointment on incisional wound during the postoperative period was given. Assessment for occurrence of SSI and healing time using a standardized collection tool and Southampton wound scoring system, respectively, was done on the 8th, 15th, and 30th postoperative days. @*Results@#The incidence of SSI is 2.45% (4 out of 164 participants). It was slightly higher in the Cefazolin only arm having three cases, while only one case in the Cefazolin plus mupirocin group. However, the difference of SSI occurrence between the two groups is not statistically significant. Wound healing time was also evaluated which was comparable between treatment groups.@*Conclusion@#Single dose Cefazolin plus 7-day once daily Mupirocin ointment application is comparable to single dose of cefazolin in preventing SSI in patients undergoing major low-risk obstetric and gynecologic surgeries. Therefore, the addition of mupirocin in uncomplicated major obstetric and gynecologic surgical cases is not cost-beneficial.

Comparison of the efficacy and patients' satisfaction of povidone iodine and commercially prepared guava extract feminine wash as an external genital antiseptic among women who underwent vaginal delivery with episiorraphy in a tertiary hospital: A randomized clinical trial / Philippine Journal of Obstetrics and Gynecology

Background@#One of the most common complications of episiotomy is infection. Most infections will resolve with local perineal care. Hence, episiotomy wound care is important. In preventing wound infection cleansing the vulva and external genital area with an antiseptic solution prior to, and several days after the procedure until the wound is healed is potentially beneficial. @*Objective@#To compare the efficacy and patients? satisfaction of commercially prepared guava extract with povidone iodine as external genital antiseptic wash in women who underwent vaginal delivery and had episiorraphy in a Tertiary Hospital. @*Results@#There were 248 women who underwent episiotomy and randomized to the guava leaf extract (n=122) and povidone-iodine (n=126) feminine wash groups. Episiotomy wound infection rate between guava (0.81%) and povidone iodine (2.38%) feminine wash, was not significantly different (p=0.33). Occurrence of adverse event was lower in the guava leaf extract (1, 0.81%) as compared to povidone iodine (4, 3.17%) feminine wash group, but is not statistically significant (p=0.19). The mean patient satisfaction score for the guava feminine wash is 4.4 which was significantly higher than the mean score of those in the povidone iodine feminine wash which is 3.6 (p< 0.001). @*Conclusion@#The efficacy in preventing episiotomy wound infection and rate of adverse reaction with the use of commercially prepared guava leaf extract is comparable with povidone iodine as an external genital antiseptic. With regards to patients? satisfaction and cost this was found to favor the use of commercially prepared guava leaf extract external genital wash

High grade Ovarian Serous Carcinoma associated with Chronic Schistosomiasis / Philippine Journal of Obstetrics and Gynecology

@#Schistosomiasis has been established as a causative factor in urinary bladder, liver, colorectal and cervical cancer. However, its role in ovarian malignancy has not been described. With the premise that long-standing inflammation secondary to chronic infection predisposes to cancer by promoting an environment that cultivates genomic lesions and tumor initiation, we are left with an open question: Does chronic infection with schistosomiasis also predispose to ovarian cancer? In this paper, we presented a case of a 54-year-old diagnosed with high grade serous carcinoma of the ovary and fallopian tube with a history of chronic infection with Schistosomiasis. In this case, the infection caused neoplastic lesions in the right fallopian tube with subsequent seeding of malignant cells to the right ovary, indirectly causing the high grade serous ovarian carcinoma of the patient.

Acceptability and effectivity of four feminine wash products in maintaining the physiologic vaginal pH of reproductive and menopausal age women

@#<p><strong>OBJECTIVE:</strong> To determine whether four (4) feminine hygiene wash products maintain normal vaginal pH and are acceptable among reproductive and menopausal age women.</p><p><strong>METHODS:</strong> A randomized, double blind, three-period, three-way crossover trial on 90 reproductive age women and 30 menopausal women measuring external and internal vaginal pH levels and product acceptability after using different feminine wash for 3 weeks.</p><p><strong>RESULTS:</strong> There were significant differences in mean change in internal vaginal pH values among the three feminine wash products (p=0.0392) in the reproductive age group. Majority of the subjects expressed 'extreme satisfaction' on the different features of the products. In the menopausal age group, there was a statistically significant difference in mean pH change in the external genitalia (p=0.0279). Feminine Wash 4 appeared to be most acceptable.</p><p><strong>CONCLUSION:</strong> Using feminine wash may help maintain vaginal pH levels within the physiologic range thus prevents vaginal infections. Good acceptability of use among the subjects implies good compliance and therefore, a practice that can be adopted on a long-term basis as part of a woman's good hygienic practice.</p>

Comparison of the efficacy of metronidazole and metronidazole plus probiotics capsule in the treatment of bacterial vaginosis among non-pregnant patients seen at the outpatient department of a tertiary hospital: A single blind randomized controlled trial / Philippine Journal of Obstetrics and Gynecology

BACKGROUND: Bacterial vaginosis (BV) is the most prevalent cause of symptomatic vaginitis. In the Philippines, prevalence of BV is at 28.16%. The mainstay for the treatment of BV is Metronidazole. Although antibiotic therapy has been shown to eliminate BV associated organisms, there is extremely high recurrence rate.OBJECTIVE: To compare the efficacy of metronidazole and metronidazole plus lactobacilli tablet in the treatment of bacterial vaginosis among non-pregnant patients seen at the outpatient department of a tertiary medical center.METHODOLOGY: The population included non-pregnant women ages 15 t0 44 years old, with bacterial vaginosis diagnosed by Amsel's criteria and Nugent's scoring. The participants were randomly assigned to their treatment group, one is Metronidazole only and other received Metronidazole plus Lactobacillus tablet. All participants followed up on day 8,15,22 and 56 from initiation of treatment resolution or persistence of symptoms and collection of vaginal specimen for gram stain and inquire on adverse effects.RESULTS: On day 8 treatment, there were significantly more participant in the metronidazole plus probiotic arm with an estimated lactobacilli count of more than 30/hpf as comapred to metronidazole alone. On day 15 post treatment, there was no statistically significant difference with the estimated Gardnerella vaginalis count, lactobacilli count, presence or absence of malodorous vaginal discharge between the metronidazole plus probiotic and the metronidazole alone arm. With metronidazole plus probiotic group, the proportion of women with less than 30 per hpf Gardnella vaginalis count and absent foul smelling vaginal discharge were accounted among 100% of the participants from day 8 to 56 post treatment. The early reduction in the causative agent and symptoms can be attributed to an increase in the estimated lactobacilli count sustained until 56 days post treatment metronidazole plus probiotic. However, from day 15 to 22 and 56 post- treatment, the proportion of participants who had a nugent's score of less than 4 were greater for both the metronidazole plus probiotic (100%) and metronidazole alone (95%) arm, when compared to day 8 post-treatment. This finding for the metronidazole plus probiotic group is due to sustained reduction in the Gardnella vaginalis count and increase in lactobacilli counts. Potentially , the metronidazole plus probiotic treatment was found to be more favorable in sustaining the normal flora and probiotic can be used as an adjunct may enhance the efficacy of metronidazole in the treatment of BV.CONCLUSION: Metronidazole plus probiotic and metronidazole only treatment are comparable in treating bacterial vaginosis. In terms of restoring and maintaining the normal flora, metronidazole plus probiotic appears to be more significantly efficacious. Probiotic in the form of lactobacilli is a promising adjunct to enhance the efficacy of metronidazole in the treatment of bacterial vaginosis.