The effects of lactobacillus suppositories in the recovery and recurrence of bacterial vaginosis: a double-blind randomized clinical trial

Bacterial vaginosis [BV] is the most prevalent causes of abnormal secretion in women at fertility age. Also, Bacterial vaginosis is one of the most common diseases in women who refer to gynecology clinic. The main cause of the pathogenesis is increasing pH of vagina due to reduced number of lactobacillus and growth of anaerobic bacteria. Prevalence of BV varies between 10 to 30 percent in different societies. Amsel criteria is used as diagnostic test in BV. This interventional study was designed to assess the impact of vaginal lactobacillus suppository and metronidazole compared to metronidazole alone on the recovery and recurrence of bacterial vaginosis. This study was a prospective, randomized, double-blind clinical trial which was conducted on 130 women with bacterial vaginosis to compare the effects of vaginal lactobacillus suppository and metronidazole. Bacterial vaginosis was diagnosed using Amsel criteria that based on some clinical symptoms. Patients were divided into two groups, first group were treated with oral metronidazole plus lactobacillus and second group were treated with metronidazole alone. Patients were followed-up one week and four weeks after initiation of the treatment. One hundred and thirty women completed the study. Patients were followed at one and four weeks after initiation of intervention. Amsel criteria and recovery rate in both groups compared before treatment one and four weeks after treatment. The criteria and treatment were significantly improved, but this improvement was higher and statistically significant in the metronidazole plus Lactobacillus group compared to second group [P< 0.0001]. The protective effects of lactobacillus in dealing with anaerobic pathogens as well as the negative impact of metronidazole on lactobacillus of vaginal flora, use of lactobacillus along with metronidazole especially in patients with recurrent infections is recommended. In other words, using lactobacillus with metronidazole for treatment of bacterial vaginosis is more effective than metronidazole alone

Maternal Periodontitis, Preeclampsia and adverse pregnancy outcomes

Preeclampsia is a considerable problem of pregnancy. Endothelial dysfunction and placental hypoxia are the current hypotheses for the pathogenesis of preeclampsia. Chronic inflammation, including periodontitis may provoke systemic maternal and placental pro-inflammatory endothelial dysfunction, which represent a significant risk factor for diseases of vascular origin. So this study was carried out to evaluate the possible relationship between periodontitis and preeclampsia. A total of 360 pregnant women were included, [180 pregnant women with mild or sever periodontitis in one group and 180 pregnant women with healthy periodontal status in the other group]. Periodontitis was determined by the sum of all pockets with pocket probing depth [PPD] >/= 4mm and bleeding on probing. Healthy periodontal status was defined as the absence of PPD>/= 4mm. Then two groups evaluated to determine the presence of preeclampsia. After delivery, weight birth and gestational age was also recorded. Chi square and t test were used to analyze the data. There was statistically significant difference between two groups in terms of preeclampsia development [P=0.003]. Women who had a worse periodontal condition were at higher risk for preeclampsia. In addition, birth weight and gestational age was statistically lower in the case group than the control group [P<0.001]. The results indicate that the development and severity of peridontitis increase the risk for occurrence of preeclampsia and adverse pregnancy outcomes

[Effect of iron supplementation on zinc and magnesium concentrations in maternal milk and plasma]

Iron in the diet can influence the absorption of certain elements including zinc [Zn] and magnesium [Mg]. In this study the effect of iron supplementation on zinc and magnesium concentrations in maternal milk and, plasma at puerperal period were evaluated. Ninety nine non anemic mothers with single pregnancy and normal delivery were randomly enrolled in two groups [iron and placebo group]; blood samples were collected at the time of delivery and also 140 mid 40 days after delivery. Milk samples were collected twice; at two weeks [transient milk] and 40 days after the delivery [mature milk]. They were supplemented orally with either 150mg ferrous sulfate or placebo from the time of delivery for 40 days. Zinc and magnesium concentrations were measured using atomic absorption spectrometry. The maternal dietary intake for zinc and magnesium were similar between two groups. Mean iron indexes [ferritin, serum iron and TIBC] were not significantly different between two groups at the time of delivery. No significant differences in Zn and Mg levels were detected in maternal milk between two groups but in plasma although there was no significant difference in plasma magnesium concentrations; The zinc concentrations was significantly [p<0.001] decreased in the group receiving iron supplementation [0.076 +/- 0.047mg/dL] compared with the group receiving placebo [0.163 +/- 0.137] until 40 days after delivery. Data from this study suggest that iron supplementation does not affect the contents of these elements in maternal milk but despite the possible improvement in body iron status, it can decrease the plasma zinc concentrations, so the zinc supplementation may be needed with iron

Effect of vitex agnus castus on early menopausal symptoms in postmenopausal women

Background and purpose: Nowadays due to increase in women's life expectancy, women at least live one third of their lives after menopause. Menopause is usually accompanied with some early and late symptoms, which lead to decline the quality of daily activity of women. So concerning the increase in elderly rate in the world especially in our country [Iran], prevention and treatment of these symptoms by natural therapeutic agents are obviously important. This study has been designed to examine the vitex effects on early menopause symptoms, kupperman's index and the rate of side effects in vitex group and placebo group

Methods and materials: This study is a blind clinical trial conducted on 100 menopausal teachers aged 45-60 years old, who were working in girl's school in Sari, Iran. This sample population had the required characteristics for participating in this study and they were volunteer for treatment if they had hot flushes and others menopause symptoms. Sampling method was based on study objective‚ so we divided the sampling population into two equal, [control and case] groups. The two groups were given 40 drops of vitex or placebo per day for 2 cycles continuously. Required data were collected by interview, individual characteristics questionnaire and Kupperman's index in two phases before the treatment and eight phases after the treatment. Finally there was 25 persons in case group and 16 persons in control group for statistical analysis and the others were excluded from study because of bad taste of drug and other problems

Results: The intensity of hot flushes among the two groups after 2 weeks of treatment, based on Manwittny test, had a significant statistical difference [p=0.015]. The frequency of hot flushes per day in these groups after 2 weeks of treatment, based on T test with independent sample, were of significant statistical difference [p=0.015]. Regarding Kupperman's index in these two groups after 3 weeks of treatment by means of T test with independent sample analysis, It indicated that there is a significant statistical difference [p=0.001]. Also the results showed that complete recovery rate from hot flushes after eight weeks in drug group was %80 and in placebo group %12.5 and there was significant statistical variation in two groups concerning the side effects of drug [p=0.012]

Conclusion: Vitex can reduce the intensity and frequency of hot flushes per day and regarding Kupperman's index. Vitex may reduce some other early symptoms of menopause, but there are some unimportant side effects like nausea and flatulence. So vitex could be used as a natural therapeutic agent for treatment of early menopause symptoms in subjects who can't tolerate hormone therapy