Prevalence of bacterial vaginosis in Thai women attending the family planning clinic, Siriraj Hospital.

OBJECTIVES: To investigate the prevalence of bacterial vaginosis (BV) among Thai women attending a family planning clinic and to evaluate the association of BV with potential risk factors. MATERIAL AND METHOD: A cross sectional prevalence study was conducted among 800 women attending the family planning clinic, Siriraj Hospital, between August and December 2003. BV was diagnosed according to Amsel's criteria. Prevalence and risk factor models were compiled and statistically analyzed RESULTS: Among the low risk population acquiring sexually transmitted diseases, the prevalence of BV was 14.6% (117 of 800). Asymptomatic disease was recognized in up to 47.9% (56 of 117). BV was significantly more prevalent among those who used douching inside the vagina [OR = 3.98 (1.85-8.33), p < 0.01] and high a prevalence among IUD users [OR = 1.84 (1.22-2.79), p < 0.01]. Although not statistically significant, BV tended to be more prevalent among women with a lower age at first intercourse, higher numbers of lifetime partners, higher frequency of sexual intercourse and current smokers. CONCLUSION: BV is a relatively high prevalent condition. The two potential risk factors, douching inside the vagina and IUD use, can be demonstrated, adding to be more concerned about the inappropriate practice of douching and more consideration in IUD users. The other potential risk factors, the impact to adverse reproductive outcomes and the prevention of BV need further studies, particularly in various Thai populations.

Venous thromboembolism and combined oral contraception in Thai women.

Hospital-based case-control study risk of venous thromboembolism (VTE) associated with combined oral contraceptives (OC) in Thai women aged 20-44 years was 7.6. Body mass index (BMI) of cases were significantly higher than controls. The risk of VTE in women having BMI more than 25 kg/m2 was 5.8. Cigarette smoking and alcoholic used did not the risk of VTE in OC user. The OC prevalence in this study in cases and controls were 39.5% and 7.9% respectively. All combined pills composed of 0.05 mg. Or less estrogen and second generation progestogen. This study suggested that the prescription of combined oral contraception to Thai overweight women should be avoided because it increased the risk of venous thromboembolism by two risk factors.

The effect of combined oral contraceptives on thyrotoxicosis.

The influence of combined oral contraceptives, namely, ethinyl estradiol (30 µg) and levonorgestrel (150 µg) was studied in nine cases of thyrotoxicosis divided into two groups: one group of htyrotoxic woman treated with propyl thiouracil (PTU) and another untreated group. The latter group of patients were than maintained on both PTU and the combined oral contraceptive pills; some cases were studied for 16-33 months. Before, during and after treatment, all patients were tested and confirmed by clinical examinations and thyroid function tests which were divided into two group: in vivo (24h 131/I uptake and T3-suppression test) and in vivo (total serum thyroxine (TT4), total T3 (TT3), T3 uptake (T3U), free thyroxine index (FTI) and thyrotropin (TSH). The results revealed that the values of TT4, TT3 and FTI were markedly high in the untreated group but these values decreased significantly (P<0.001) and remained within normal ranges after treatment with PTU and the contraceptive pills was initiated. Improved clinical symptoms and sings were also observed. However, the levels of TT4, TT3 and T3 uptake were elevated in the long-term treatments of both groups, but the FTI and TSH values were within normal limits, indicating that the values of FTI as well as TSH gave effective measurements of thyroid activity in evaluating the patients whose total thyroid hormones were abnormal because of altered TBG concentration and binding capacity. Therefore, our finding suggested that the prolonged use of combined oral contraceptive pills dose not interfere with medical treatment of thyrotoxic patients.

A comparative trial of the three copper IUDs in nulliparous women.

A comparative trial concerning the uses of the Nova T, Multifold short and Mini Cu-7 devices in nulliparous women with 30 in each group was carried on at the Family Planning Research Center of the Department of Obstetrics and Gynecology at Siriraj Hospital in Bangkok, Thailand. After a two-year experimental period, 50% Nova T users, 40% Multiload short users and 46.7% Mini Cu-7 users continued to use these IUDs; and 20% Nova T users, 26.7% Multiload short, and 26.7% Mini Cu-7 discontinued their use as they wished to have babies for the first time. The study did not find pelvic inflammatory disease or sexually transmitted disease. At insertion time, no pain was so extensive that an analgesic tablet was needed. The study only found two women (6.7 pregnancies per 100 IUD users) become pregnant with the IUD in situ in the Mini Cu-7 group in the first 6 months of use and the net cumulative rate is still 6.7 pregnancies per 100 IUD users after the two-year period of use, and the rate of pregnancy with the IUD in situ of the other two groups was totally negative. The results of the study show that there is no statistical significance in the rate of pregnancy, expulsion and bleeding or pain. In conclusion, these three kinds of Copper IUDs are equally effective and of the same favorable qualities. All three can be used in nulliparous women.