Effects of intrauterine device and oral contraceptive on vaginal flora and epithelium

To investigate the microbial and cytopathological changes and genital symptoms in oral contraceptive pill [OCP] and intrauterine contraceptive device [IUCD] users. Included in the study were 34 women using OCP and 34 women using IUCD for 24 to 36 months period and 34 women as control group. We conducted the study between March to September 2005 in Antakya Maternity Hospital, Turkey. Vaginal discharge was subjected to wet mount examination, gram staining, and culture. Cervical smears were examined and reported using the Bethesda system as reference. In the IUCD group, women with intermediate score was 20.6%, while those with bacterial vaginosis was 11.7%. In the OCP group however, women with intermediate score was 8.8%, while those with bacterial vaginosis was 5.9%. Compared to the control group, these rates were 2.9% for those with intermediate score and 2.9% for those with bacterial vaginosis. Escherichia coli vaginal colonization increased by 5-fold in the IUCD users [p<0.05]. Cervical erosion was found in 14.7% of the women using IUCD as compared to the other groups [p<0.05]. Actinomyces like organisms was detected in 11.7% of the IUCD users [p<0.05]. The use of IUCD clearly alter the normal vaginal flora, although OCP appears to have minimal effects on the vaginal microbial flora. The data support the hypothesis that IUCD might change cervico vaginal environment, and suggests that women with IUCD may be at a higher risk for vulvovaginal infection

Anti-Toxoplasma gondii antibodies in hemodialysis patients receiving long-term hemodialysis therapy in Turkey

Toxoplasma is a globally distributed pathogen for humans and animals. In situations of immunodeficiency, Toxoplasma gondii [T. gondii] emerges as a life-threatening infection. Toxoplasma gondii is transmitted parenterally, flourish in state immunosuppression and, most toxoplasma infections are asymptomatic. In the present study, we aimed to investigate the prevalence of anti-T. gondii antibodies in hemodialysis patients with chronic renal failure. We undertook a prospective study of our maintenance hemodialysis patients to determine whether these sources posed a risk for transmission of T. gondii. This study was carried out on patients undergoing regular hemodialysis in the dialysis units [Hemodialysis Center of Antakya State Hospital, Emir Hemodialysis Center and Antakya Hemodialysis Center, Hatay, Turkey] between January 2004 and June 2004. Two hundred and fifty-five hemodialysis patients and 50 healthy controls were studied for the prevalence of anti-T. gondii antibodies by enzyme-linked immunosorbent assay. Anti-immunoglobulin G [IgG] and immunoglobulin M [IgM] T. gondii antibodies positivity were found to be 195 [76.5%] of the 255 hemodialysis patients and 24 [48%] of the 50 control subjects. The difference between them was statistically significant [p<0.05]. In addition, an increase of the seropositivity rate was detected with increasing length of time on hemodialysis treatment, indicating a statistically significant difference between these 2 parameters [p<0.05]. These findings confirm a high prevalence of toxoplasma infection in hemodialysis patients. These patients are a risk group for toxoplasma infection. Moreover, it is recommended that hemodialysis patients who are susceptible to toxoplasma infections should be identified by T. gondii IgG and IgM specific serological tests. Therefore, patients undergoing hemodialysis should be screened for toxoplasma before dialysis to prevent the dissemination of this infection through the hemodialysis procedure