Prevalence of genital infections among women in reproductive age group in a rural area in North Kerala

Background: Genital infections, a major cause of illness among women in reproductive age group, affect their quality of life and social living. Early diagnosis and treatment of STI/RTI is also an important aspect in prevention of HIV transmission. As there are only a handful of studies in Kerala and none in Kannur assessing the prevalence, associated factors of genital infections and health seeking behaviour among women in reproductive age group, this study stands important.Methods: A community based descriptive study was conducted in Kulappuram area of Cheruthazham Panchayat which is the field practice area of Department of Community Medicine, Government Medical College, Kannur, Pariyaram from June, 2017 – July, 2018. A total of 404 women in reproductive a group were studied. A semi-structured, pre-tested questionnaire was used to collect relevant information. Data was analyzed using SPSS-version 19 software.Results: The mean age of the study population was 32.20±10.741years. 52.7% of the study population had genital infection, with 40.6% having symptoms of Reproductive Tract Infections (RTI) and 12.1%, symptoms of Urinary tract Infections (UTI). The presence of these was significantly associated with menstrual disorders, cloth as menstrual pad users, marriage, sexual activity and absence of infertility. Only 39.0% of the women with infections had sought treatment.Conclusions: Although there was high prevalence of genital infections among the study population, treatment seeking behaviour was very low. There is a need for sustained motivation and support to promote women to seek timely medical care than to suffer silently.

Clinicomicrobiological study of the removed intrauterine device

Background: Intrauterine contraceptive devices are one of the most efficient, cost effective long acting reversible contraceptives. But the worrying clinical symptoms, misconceptions and higher rates of genital tract infection have become a hurdle in its acceptance as the first choice of contraception. The objective of this study was to study the common reasons for removal of IUCD.Methods: An observational study was done involving 430 women who reported to the OBG Outpatient of the hospitals attached to Bangalore Medical College, over a period of 2 years, for IUCD removal. Socio-demographic details, clinical symptoms compelling IUCD removal were elicited. The removed IUCD was subjected to culture and sensitivity. Initial descriptive analysis was used and statistical tests of significance like chi-square were used to know the relation between genital infections and IUCD.  P value <0.05 was considered significant.Results: Of the 430 women, 46.9% were between 21-25 years of age, 49.3% were primipara, and 71% used IUCD for 1-3 years. Most common reason for removal in the first 2 years was heavy menstrual bleed followed by pain abdomen. 15.3% culture reports showed growth of bacteria, with maximum cultures positive in <5 years of usage, the association was statistically significant.Conclusions: Present study shows a lower risk of bacterial infections among IUCD users. Hence, effective counseling regarding the safety of IUCD over other spacing methods is essential to increase its acceptance.

Need of the hour: pharmacovigilance study of SGLT-2 inhibitors

Background: Diabetes mellitus represents a global pandemic. Various pharmacotherapy and non-pharmacotherapy measures are advocated for its control. The latest in the pharmacotherapy are Sodium Glucose Transporter -2 (SGLT-2) inhibitors, widely used. Many studies suggest adverse effects related to SGLT-2 inhibitors, evidence still not conclusive and few data from India. Hence this study was planned.Methods: Cross-sectional study over a period of 02 months, recorded demographic details and history of various adverse drug reactions reported with the use of SGLT-2 inhibitors.Results: Majority of the study participants were females (58%) and belonged to the age group of 40-70 yrs. Urinary tract infections (UTI) and genital infections was more seen in the users of dapagliflozin, followed by empagliflozin and canagliflozin.Conclusions: SGLT-2 Inhibitors offer a unique therapeutic approach to the management of Diabetes Mellitus. Further evaluation of the safety profile and the risk-benefit analysis is the need of the hour.

Evaluation of the Luminex ARIES HSV 1&2 Assay and Comparison with the FTD Neuro 9 and In-house Real-Time PCR Assays for Detecting Herpes Simplex Viruses

BACKGROUND: Human herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are responsible for a plethora of human diseases, of which cutaneous and mucocutaneous infections are the most prevalent. In its most severe form, HSV infection can cause meningitis/encephalitis. We compared the Luminex ARIES HSV 1&2 assay (Luminex Corp., Austin, TX, USA), an automated sample-to-result molecular solution, to two non-automated HSV DNA assays. METHODS: A total of 116 artificial controls were used to determine the analytical performance of the ARIES assay. Controls were prepared by spiking universal transport medium (UTM) and cerebrospinal fluid (CSF) samples from patients who tested negative for HSV by an in-house HSV-1 and -2 DNA assay with reference materials (SeraCare Life Sciences, MA, USA; ZeptoMetrix Corp., MA, USA). Another 117 clinical samples were then used to compare the clinical performance of the ARIES assay with those of an in-house assay and the FTD Neuro 9 assay (Fast Track Diagnostics, Junglinster, Luxembourg). RESULTS: The analytical sensitivity (95% limit of detection) of the ARIES assay was 318 copies/mL (UTM samples) and 935 copies/mL (CSF samples) for HSV-1 strain 96 and 253 copies/mL (UTM samples) and 821 copies/mL (CSF samples) for HSV-2 strain 09. No cross-reactivity was observed in samples spiked with 14 non-HSV microorganisms. Compared with the reference result (agreement between the in-house and FTD Neuro 9 results), the ARIES assay had overall concordance rates of 98.2% (111/113) and 100% (113/113) for HSV-1 and HSV-2, respectively. CONCLUSIONS: The ARIES assay appears to be an excellent alternative for rapid detection and differentiation of HSV in skin and genital infections, meningitis, and encephalitis.

Condiloma acuminado en adolescentes y adultos jóvenes del área de salud "Tula Aguilera" en el municipio de Camagüey / Condyloma acuminata in adolescents and young adults from "Tula Aguilera" health area in Camagüey municipality

Introducción: las infecciones de transmisión sexual se propagan de persona a persona, principalmente a través de contactos sexuales; entre estas se encuentra el condiloma acuminado. Objetivo: determinar la manifestación del virus del papiloma humano en su forma de condiloma acuminado, en un área de salud. Métodos: se realizó un estudio transversal de 63 pacientes con dicha infección, pertenecientes a 5 consultorios del médico de la familia del Policlínico Universitario "Tula Aguilera Céspedes" del municipio de Camagüey (provincia de Camagüey), de febrero a agosto del 2008. Los datos se obtuvieron del modelo de cuestionario que constituyó el registro primario. Resultados: en la serie el grupo etario más vulnerable fue el de 15-19 años, el mayor número de infectados correspondió al sexo masculino y al estado conyugal soltero, y entre las afecciones asociadas más frecuentes figuraron el herpes simple y la candidiasis. Conclusiones: se observó un incremento del número de individuos con condiloma acuminado en los meses de junio, julio y agosto, con predominio en los varones, fundamentalmente los adolescentes.

Introduction: sexually transmitted infections are spread from person to person, mainly through sexual contacts; among them is the condyloma acuminata Objective: to determine the manifestation of the human papillomavirus in its form of condyloma acuminata in a health area. Methods: a cross-sectional study was carried out in 63 patients with this infection, belonging to 5 family doctor's offices of "Tula Aguilera Céspedes" University Polyclinic in Camagüey municipality (province of Camagüey), from February to August 2008. The data were obtained from questionnaire model, which constituted the primary record. Results: in the series the most vulnerable age group was that of 15-19 years, the highest number of people infected corresponded to the male sex and those who were single, and among the most frequent associated conditions were the herpes simplex and candidiasis. Conclusions: an increase of number of individuals with condyloma acuminata was observed in June, July and August, with predominance in males, especially in adolescents.

Female Genital Schistosomiasis, Genital Tract Infections and HIV Co-infection in the Volta Basin of Ghana.

Aims: This research is aimed to determine the occurrence of female genital schistosomiasis (FGS), Candida albicans, Trichomonas vaginalis, Bacteria vaginosis and HIV concomitant infections among women of reproductive age in schistosomiasis endemic communities in the Volta Basin of Ghana. Study Design: Cross-sectional study. Place and Duration of Study: Schistosomiasis endemic communities in the Volta Basin. July 2005 to June 2006. Methodology: During the conduct of the study, 402 out of 420 women who volunteered to participate were screened for genital infections by collecting high vaginal swabs (HVS). These were analysed for T. vaginalis by wet mount, C. albicans by wet mount and culture and B. vaginosis by wet mount and Whiff test. HIV infection was diagnosed from venous blood using HIV1/2 immunochromatographic test. Also 395 of the women were screened for female genital schistosomiasis (FGS) using cervical biopsy which was analysed using the compressed biopsy technique. Results: About one third, 24/402 (30. 9%) of women screened were positive for at least one of the genital infections assessed. C. albicans was the most frequently occurring infection, with a prevalence of 15. 6%. This was followed by B. vaginosis (13. 5%) and T. vaginalis (1. 5%). HIV prevalence rate found in this study was 7. 2% and FGS 10. 6%. Almost half (46.3%) of FGS positive women were diagnosed with at least one of the genital pathogens compared to 30% of the FGS negative women. Candida albicans infection was significantly associated with FGS (P=0. 005). As much as a third (31. 6%) of women with FGS were diagnosed with C. albicans infection. Conclusion: This study revealed a positive association between FGS and C. albicans infection among study participants. The lack of association between FGS and HIV was not conclusive because of low sample size. Findings from this study provide baseline data for conducting further studies between FGS, C. albicans and HIV infection.

Frequency of Mycoplasma hominis and Ureaplasma urealyticum infections in women with systemic lupus erythematosus

Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) have been detected in the urine of women with systemic lupus erythematosus (SLE). We evaluated the presence of these mycoplasma in the endocervix of women presenting SLE. A total of 40 SLE patients (mean age 40.2 years), and 51 healthy women (mean age 30.9 years), were studied. Endocervical swabs were cultured in specific liquid media for MH or UU, detected by a quantitative color assay, and considered positive at >10(3) dilutions. Statistical analysis was performed using the two-tailed Fisher test. UU was detected in 52.5 % of patients and in 11.8% of controls (p= 0.000059). MH was detected in 20% of patients and 2% controls (p=0.003905). Both mycoplasmas were detected in 7.3% patients and 0% controls (p<0.000001). The results reported here corroborate the association of the mycoplasma infection and SLE. Thus, these agents may stimulate the production of autoreactive clones.

Ureaplasma urealyticum (UU) e Mycoplasma hominis (MH) têm sido detectados em urina de mulheres com lupus eritematoso sistêmico (LES). Avaliamos a presença destes mycoplasmas no endocervix de mulheres apresentando LES. Um total de 40 pacientes com LES (idade média de 40,2 anos), e 51 mulheres sadias (idade média de 30.9 anos), foram estudadas. Swabs do endocervix foram cultivados em meio líquido específico para MH e UU, detectados por teste colorimétrico quantitativo, considerando positivo diluições > 103 . Análise estatística foi feita usando teste de Fisher. UU foi detectado em 52,5% das pacientes e em 11,8% dos controles (p= 0.000059). MH foi detectado em 20% das pacientes e 2% dos controles (p=0.003905). Ambos mycoplasmas foram detectados em 7,3 % das pacientes e 0% dos controles (p<0.000001). Os resultados aqui reportados corroboram com a associação de infecção por mycoplasma e LES. Estes agentes podem estimular a produção de clones autoreativos.