ABSTRACT
Background: Candida species is known as the most commonopportunistic yeast affecting the genitourinary tract. Thetriazoles are commonly used for the treatment of candidiasis.But the increasing resistance of Candida to different azolescreated a demand for newer drugs.Objective: Voriconazole is a second generation azoleantifungal agent that shows excellent in vitro activity against awide variety of yeast and moulds. This study was done toassess the therapeutic efficacy of Voriconazole in Fluconazoleresistant vaginal candidiasis.Material and Methods: This one-group pretest-posttest quasiexperiment was conducted in a specialized private chamber ofFaridpur, Bangladesh from January 2018 to July 2019. Vaginalcandidiasis was diagnosed by clinical features, microscopicexamination, culture and sensitivity of high vaginal swab.Voriconazole was used only in Fluconazole resistant vaginalcandidiasis.Results: During the study period, 568 patients were presentedwith vulvovaginitis. Among them, in 267 (47%) patients,Candida albicans were isolated. All patients were treated byFluconazole as first-line treatment. 160 (60%) of those patientsdid not improve clinically and were treated by Voriconazole.Success rate was 93% (149). Regarding side effects ofVoriconazole, transient visual disturbance occurred in 35% ofthe patients, nausea and vomiting in 20% of the patients.Conclusion: Due to wide species variety of Candida andincreasing resistance, Voriconazole may be the second linetreatment of vaginal candidiasis.
ABSTRACT
Background: Cervical cancer is the second most commoncancer among women in Bangladesh where CIN is theforerunner. Visual inspection of cervix with acetic acid (VIA) isadopted as national cervical cancer screening programme inBangladesh. All positive VIA cases are evaluated bycolposcopy.Objective: This population-based study was conducted inFaridpur Medical College Hospital for 6 years (2013 - 2018) toevaluate the prevalence of CIN among the VIA positive casesand performance of the clinic for colposcopic management ofCIN.Materials and Methods: A total of 2102 VIA positive caseswere evaluated by colposcopy during the study period.International Federation of Cervical Pathology and Colposcopy(IFCPC) 2011 nomenclature was used for colposcopicdiagnosis. Diagnosed CIN were treated accordingly.Results: During the study period, 548 (26.1%) cases werecolposcopically diagnosed as CIN. Among them, 370 (65.5%)were low grade squamous intraepithelial lesion (CIN-I) and 178(32.5%) were high grade squamous intraepithelial lesion (CINII and III). Colposcopicaly diagnosed 237 (64.1%) of low gradesquamous intraepithelial lesion (LSIL) and 132 (74.2 %) of highgrade squamous intraepithelial lesion (HSIL) casesreceived treatment and histopathological confirmation.Treatment produces were used like thermocoagulation, LoopElectrosurgical Excision Procedure (LEEP), biopsy,hysterectomy and post treatment follow up.Conclusion: From this study, we got information about thedemography and prevalence of CIN among VIA positive casesat the same time management of CIN to prevent invasivecervical cancer. We adopted ‘See and treat’ protocol formanagement, which is well accepted, feasible and useful inBangladesh.