Asociación entre la exposición a violencia íntima de pareja contra la mujer y el reporte de secreción y úlceras genitales

Objetivo: Evaluar la asociación entre la violencia íntima de pareja emocional, física y sexual con el auto reporte de secreción y úlcera genital en mujeres participantes de una encuesta poblacional. Métodos: Se realizó un análisis de la Encuesta Demográfica y de Salud Familiar del Perú, 2021. Los criterios de inclusión fueron tener 15 a 49 años, ser casadas o convivientes, y estar seleccionadas y entrevistadas para el módulo de violencia doméstica. Se estimó la prevalencia de auto reporte de secreción y úlcera genital. La asociación con la violencia íntima de pareja fue realizada mediante regresión logística binaria con la estimación de la razón de momios, considerando el diseño muestral complejo. Resultados: La prevalencia del reporte de úlcera o secreción genital fue 10,0%. La razón de momios para reportar secreción o úlcera genital entre las mujeres que sufrieron violencia física leve comparado con las no expuestas fue 2,25 (IC95%: 1,72 a 2,94), el riesgo incrementó a 3,42 (IC95%; 2,39 a 4,90) entre las mujeres que sufrieron violencia física severa. La razón de momios generada por la exposición a violencia sexual para reportar secreción o úlcera fue mayor (OR: 3,84, IC95%: 2,47 a 5,96). Conclusiones: Las mujeres expuestas a cada uno de los tres tipos de violencia íntima de pareja tuvieron mayor chance de reportar secreción o úlcera genital en los últimos 12 meses. El riesgo se incrementa cuando coexisten la forma física y sexual.

Objective: To assess the association between emotional, physical, and sexual intimate partner violence with self-reported discharge and genital ulcer in women from participants in a population-based survey. Methods: An analysis of the Demographic and Family Health Survey of Peru, 2021 was performed. Inclusion criteria were 15-49 years of age, married or cohabiting, and selected and interviewed for the domestic violence module. The prevalence of self-reported discharge and genital ulcer was estimated. The association with intimate partner violence was performed by binary logistic regression with odds ratio estimation, considering the complex sample design. Results: The prevalence of reporting genital ulcer or discharge was 10.0%. The odds ratio for reporting genital discharge or ulcer among women who suffered mild physical violence compared with those not exposed was 2.25 (95%CI: 1.72-2.94), the risk increased to 3.42 (95%CI: 2.39-4.90) among women who suffered severe physical violence. The odds ratio generated by exposure to sexual violence for reporting discharge or ulcer was higher (odds ratio: 3.84, 95% CI: 2.47-5.96). Conclusions: Women exposed to each of the three types of intimate partner violence had a higher chance of reporting genital discharge or ulcer in the last 12 months. The risk increases when physical and sexual violence coexist.

The Burden and Risk Factors of Reproductive Tract Infections among Married Women Aged 15-49 Years in Urban Slum of Agra Uttar Pradesh

Introduction: In developing countries, reproductive tract infection among women commonly goes undiagnosed and their sequel causes various complications. Objectives: To find out the prevalence of RTI/STI through a syndromic case approach and its correlates among women of reproductive age group. Material and Methods: A community-based cross-sectional study was carried out among 500 eligible married women residing in urban slums of Agra by using WHO Syndromic case approch for diagnosis of RTIs/STIs. Results: The overall prevalence of RTI/STD was found to be 32.80% where vaginal discharge (22.60%) and lower abdominal pain (8.20%) were the most common syndromes. On multivariate analysis, religion, caste, type of absorbent used during menses, and history of IUD use were found to be significantly significant. Conclusion: The result of this study highlights the high prevalence and potential risk factors that contribute to the occurrence of RTI. It also emphasizes the need of training and education session of the participants to identify the early symptoms of RTI.

Kandughna Gana Varti in Vulvo Vaginalcandidiasis - A Case Series

Vulvovaginal candidiasis is an infection caused by yeast like micro organisms called candida albicans. It is the second most common cause of vaginitis affecting women of reproductive age group. It is most distressing and irritating to women, hampers their day to day life and makes them irritable, depressed, anxious and disturbs their interpersonal relationships including marital life. In vulvovaginal candidiasis patients complain of vaginal discharge with intense vulvovaginal pruritus. The pruritus is out of proportion to the discharge. The symptoms of vulvovaginal candidiasis appear similar to the symptoms of Slaishmiki yoni vyapath mentioned in Ayurvedic classics. It is due to the vitiation of Kapha caused by usage of Abishyandi aharas and has symptoms like Pichila yonisrava, Kandu, Alpa vedhana or Avedhana in Yoni. Topical treatments have great importance in the treatment of several gynecological conditions (Yoni vyapaths). Yoni varti or vaginal pessary is used to cleanse the vaginal walls and make the local environment more healthy. It acts directly on the vaginal mucosa and enables easier and target specific action. They are also hygroscopic in property and act in accordance with the drugs they contain. Kandughna gana varti have Tiktha, Kashaya rasa, Laghu, Ruksha guna, Krimighna, Kandughna and Kaphaghna properties and all the ingredients have potent antifungal action also. This facilitates faster absorption of drugs through vaginal mucosa and relieves the symptoms more quickly. A pilot study was conducted in 5 cases to assess the effect of Kandughna gana varti in vulvovaginal candidiasis. It was found to be effective in vaginal discharge and vulvovaginal pruritus.

Presence of Chlamydia abortus in colostrum, milk, and vaginal discharge samples of sheep

Background: The main transmission route of Chlamydia abortus is by ingesting the microorganism that has been eliminated in vaginal secretions, placental membranes or abortions that contaminate the environment and, possibly, through milk and colostrum. Elimination through vaginal secretions is well documented. However, there are no reports about isolation and identification of C. abortus in the colostrum or milk of infected sheep, so it is important to determine whether or not C. abortus may be present in these secretions, which are the only food of lambs. Objective: To detect C. abortus in colostrum, milk, and vaginal secretions of sheep with a history of reproductive disorders. Methods: Colostrum, milk, and vaginal exudates were collected from 66 sheep. The samples were inoculated in mouse fibroblast cell cultures and the presence of C. abortus determined by direct immunofluorescence. Results: 19 out of 66 colostrum samples (28.7%), 14 out of 66 milk samples (21.2%) and 17 out of 66 vaginal swabs (25.7%) were positive for C. abortus. The 50 samples positive for isolation and detected by immunofluorescence, together with 42 negative samples were subjected to qPCR to amplify a fragment of the ompA gene from C. abortus. Thirty-eight of the 92 samples processed by this technique were positive for C. abortus. Conclusion: The results demonstrated the presence of C. abortus in a high proportion in colostrum, milk and vaginal secretions of infected sheep. To the best of our knowledge, this is the first field study confirming the presence of C. abortus in colostrum, which shows that excretion of Chlamydia by lactogenesis could occur in the first hours after birth.

Antecedentes: La principal vía de transmisión de C. abortus es la ingestión del microorganismo que ha sido eliminado en las secreciones vaginales, membranas placentarias, abortos y, posiblemente, a través de la leche y el calostro. La eliminación a través de secreciones vaginales está bien documentada. Sin embargo, no existen reportes del aislamiento e identificación de C. abortus en el calostro o la leche de ovejas infectadas, por lo que es importante determinar si la bacteria puede o no estar presente en estas secreciones, que son el único alimento de los corderos. Objetivo: Detectar la presencia de C. abortus in calostro, leche y secreciones vaginales de ovejas con antecedentes de problemas reproductivos. Método: Con el propósito de aislar e identificar C. abortus en estas secreciones, se recolectó calostro, leche y exudado vaginal de 66 ovejas. Las muestras fueron inoculadas en cultivos celulares de fibroblastos de ratón y se determinó la presencia de la bacteria por inmunofluorescencia directa. Resultados: Fueron positivas 19 de 66 muestras de calostro (28,7%), 14 de 66 muestras de leche (21,2%) y 17 de 66 hisopos vaginales (25,7%). Las 50 muestras positivas al aislamiento y detectadas por inmunofluorescencia, junto con 42 negativas se sometieron a qPCR para amplificar un fragmento del gen ompA de C. abortus; 38 de las 92 muestras procesadas por esta técnica fueron positivas para C. abortus. Conclusión: Los resultados del presente estudio demostraron la presencia de C. abortus en una alta proporción en el calostro, la leche y las secreciones vaginales de ovejas infectadas. Este es el primer estudio de campo que confirma la presencia de C. abortus en calostro, lo que demuestra que la excreción de clamidia por lactogénesis podría ocurrir en las primeras horas después del nacimiento.

Antecedentes: A principal via de transmissão da Chlamydia abortus é a ingestão do microrganismo que foi eliminado nas secreções vaginais, membranas placentárias ou abortos que contaminam o meio ambiente e, possivelmente, através do leite e colostro. A eliminação pelas secreções vaginais está bem documentada. No entanto, não há relatos de isolamento e identificação de C. Abortus no colostro ou leite de ovelhas infectadas, por isso é importante verificar se a bactéria pode estar ou não presente nessas secreções, único alimento dos cordeiros. Objetivo: Detectar a presença de C. Abortus no colostro, leite e secreções vaginais de ovelhas com histórico de distúrbios reprodutivos Métodos: Para isolar e identificar C. Abortus nessas secreções, foram coletados colostro, leite e exsudato vaginal de 66 ovelhas. As amostras foram inoculadas em cultura de células de fibroblastos de camundongo e a presença da bactéria determinada por imunofluorescência direta. Resultados: 19 de 66 amostras de colostro (28,7%), 14 de 66 amostras de leite (21,2%) e 17 de 66 esfregaços vaginais (25,7%) sendo positivos. As 50 amostras positivas para isolamento e detectadas por imunofluorescência, juntamente com as 42 negativas, foram submetidas a qPCR para amplificar um fragmento do gene ompA de C. Abortus. Trinta e oito das 92 amostras processadas por esta técnica foram positivas para C. Abortus. Conclusão: Os resultados do presente estudo demonstraram a presença de C. Abortus em alta proporção no colostro, leite e secreções vaginais de ovelhas infectadas. Este trabalho é o primeiro estudo de campo na literatura científica confirmando a presença de C. Abortus no colostro, o que mostra que a excreção da clamídia por lactogênese pode ocorrer nas primeiras horas após o nascimento.

Abnormal vaginal discharge in reproductive age group women with special implication to antifungal susceptibility of candida species

Introduction And Background: Vaginal discharge is a common complaint in reproductive age group women2. Vaginal discharge is one of the common reasons in women of reproductive age group seeking gynecological consultation. It is the second most common clinical problem after menstrual disorders. Globally, it is estimated that one in ten women will present with vaginal discharge in the course of one year and approximately, ten million office visits each year are attributed to vaginal discharge complaints. The prevalence of vaginal discharge in India is estimated to be 30%3. Ÿ Abnormal vaginal discharge predisposes to significant morbidity to the women in the form of pelvic inflammatory disease, infertility, endometriosis, cuff cellulitis, urethral syndrome, pregnancy loss, and preterm labour.5 Ÿ Certain conditions such as prolonged use of combined oral contraceptive, pregnancy, malnutrition, diabetes, neutropenia, prolonged antibiotic therapy, candida become pathogenic and causes candidiasis.8 Ÿ Isolation, identification, characterization, and susceptibility of candida species became critical management of fungal infections.9 Need For The Study: The study was done to emphasize the role of laboratory investigations in patients with vaginitis, as presumptive clinical diagnosis alone can lead to false interpretation and treatment mismanagement. TheMethods: present study is a cross sectional observational study conducted from January 2019 to February 2020 for about a period of one year among 300 women aged 15-49 years with vaginal discharge attending gynecology OPD, Government Maternity Hospital, Tirupati. This study included 300 subjects with a mean age of 30.4 ± 7.26 years. Nearly halfResults: of (49.33%) our study population was aged between 25 to 34years, a majority (47%) of women had bacterial vaginosis, followed by Candida in 39.33%, trichomonas vaginalis in 14.33%, mixed infections in 6.67% and 6% with no organisms. Among Candida species, 48.31% of participants had candida albicans, 23.73% had candida tropicalis, 19.49% had candida krusei, and 8.47% had candida glabrata, and of them 38.33% participants had voriconazole sensitivity, 32.33% participants had ketoconazole sensitivity, 26% participants had clotrimazole sensitivity, and 21.33% participants had fluconazole sensitivity. Among 118 candida infected 106 (89.83%) participants came for follow-up, of which symptoms subsided in 90 (84.91%) participants. In conclusion, our study with 300 women patients complaining ofConclusion: vaginal discharge found a majority of them belonging to the sexually active age group. Vaginal discharge was more prevalent in lower economic status and rural areas. Bacterial vaginosis was the most common and frequent etiology, followed by Candida. TV was the least common etiology for vaginal discharge

Mesenteric metastasis of granulosa cell tumor in a bitch: a case report / Metástasis mesentérica de tumor de células de granulosa en una perra: reporte de caso / Metástase mesentérica de tumor das células da granulosa em uma cadela: relato de caso

Abstract Anamnesis: A 5-year-old mixed breed entire bitch was presented with bloody vaginal discharge and abdominal distension. Clinical and laboratory findings: Physical examination and abdominal ultrasonography suggested the presence of a left ovarian tumor. At histopathological examination it was diagnosed as granulosa cell tumor. Treatment approach: An exploratory laparotomy was performed followed by ovariohysterectomy to remove the intra-abdominal mass. Conclusion: The clinical, ultrasonographic and histologic signs in this case support other literature reports. Ultrasonography, in combination with histopathologic analysis is a fundamental tool for detection of ovarian tumors, especially tumors of the granulosa cells.

Resumen Anamnesis: Una perra entera sin raza definida, con cinco años de edad, presentando secreción vaginal sanguinolenta con una distensión abdominal acentuada. Hallazgos clínicos y de laboratorio: El examen clínico y la ultrasonografía abdominal sugirieron la presencia de la neoformación ovárica izquierda. En el examen histopatológico fue diagnosticado como tumor de células de la granulosa. Aproximación terapéutica: Se realizó una laparotomía exploratoria seguida de ovariohisterectomía para eliminar la masa intra-abdominal. Conclusión: Los signos clínicos, ecográficos e histológicos en este caso respaldan otros informes de la literatura. La ecografía, en combinación con el análisis histopatológico, es una herramienta fundamental para la detección de tumores ováricos, especialmente tumores de las células de la granulosa.

Resumo Anamnese: Uma cadela sem raça definida, com cinco anos de idade, não castrada, apresentando secreção vaginal sanguinolenta com acentuada distensão abdominal. Achados clínicos e laboratoriais: O exame clínico e ultrassonografia abdominal sugeriram a presença de neoformação ovariana esquerda. No exame histopatológico foi diagnosticado como tumor de células da granulosa. Abordagem terapêutica: Foi realizada laparotomia exploratória seguida de ovariohisterectomia para remoção da massa intra-abdominal. Conclusão: Os sinais clínicos, ultrassonográficos e histológicos corroboram a literatura, concluindo que a modalidade ultrassonográfica, em associação a análise histopatológica é uma ferramenta fundamental na detecção de neoformações ovarianas, contribuindo significativamente no diagnóstico final.

Urogenital myiasis - An atypical presentation

The infestation of the human body by maggots has been reported worldwide and occurs most commonly in people of lower socioeconomic status and poor personal hygiene. Urogenital is the rarest site of myiasis presentations. Here we report the case of a 20-year-old, sexually inactive female student who presented with a necrotic growth in the paraurethral region infested with numerous maggots. The lesion involved the urethra and the bladder base. She was treated with debridement and bladder irrigation. The cystoscopy and local examination performed 2 weeks after admission, confirmed the complete healing of the urogenital lesion. Managing this patient's unique challenge was to assess the extent of the involvement and removal of all maggots from the deepest wound portion. The female internal and external urogenital myiasis is a very occasional and under-reported health hazard. Reporting such cases increases the public and physician awareness about the mode of presentation, right diagnosis, and available treatment options.

Concordance Between Clinical and Laboratory Diagnosis of Abnormal Vaginal Discharge in Chilean Women / Concordância entre o diagnóstico clínico e laboratorial de corrimento vaginal anormal em mulheres chilenas

Abstract Objective To determine the concordance between the clinical diagnosis of women with abnormal vaginal discharge (AVD) and laboratory results using molecular detection and observation of the vaginal microbiota. Methods Cross-sectional study conducted in 2018 in Temuco, Chile. A total of 25 midwives from 12 health centers participated. A total of 125 women>18 years old, volunteers, were recruited. The sample of the posterior vaginal fornix was obtained by speculoscopy. Characteristics of the discharge and of the external and internal genitalia were observed. Gram staining was used to observe vaginal microbiota, blastoconidia and pseudohyphae, and polymerase chain reaction was used for the detection of Trichomonas vaginalis and Candida albicans. The Cohen kappa coefficient was used in the concordance analysis. Results Out of a total of 125 women with AVD, 85.6% consulted spontaneously and 14.4% were diagnosed clinically during a routine check-up. Absolute concordance was significant (p=0.0012), with an agreement of 13.6%. The relative concordance was significant, but fair for bacterial vaginosis (Kappa=0.21; p=0.003) and candidiasis (Kappa=0.22; p=0.001), and slight for trichomoniasis (Kappa=0.14; p=0.009). The percentage of coincidence of the diagnoses (single or mixed) by laboratory and midwives was: bacterial vaginosis 63.2% (12/19), candidiasis 36.5% (27/74), and trichomoniasis 12.5% (4/32). There was 20% coinfection. A total of 36% of the clinical diagnoses of AVD had negative laboratory tests. Conclusion The vulvovaginitis conditions candidiasis and trichomoniasis appear to be overdiagnosed, and bacterial vaginosis appears to be underdiagnosed by the clinical diagnosis when compared with the laboratory diagnosis. The low concordance obtained shows the importance of complementing the clinical diagnosis with a laboratory study of AVD, particularly in women with failed treatments and/or coinfections with unspecific and varying signs and symptoms.

Resumo Objetivo Determinar a concordância entre o diagnóstico clínico de mulheres com corrimento vaginal anormal (AVD) e os resultados laboratoriais por meio da detecção molecular e observação da microbiota vaginal. Métodos Estudo transversal realizado em 2018 em Temuco, Chile. Participaram 25 parteiras de 12 centros de saúde. Um total de 125 mulheres>18 anos, voluntárias, foramrecrutadas. A amostra do fórnice vaginal posterior foi obtida por especuloscopia. Foram observadas características da secreção e da genitália externa e interna. A coloração de Gram foi usada para observar a microbiota vaginal, blastoconídios e pseudo-hifas, e a reação em cadeia da polimerase foi usada para a detecção de Trichomonas vaginalis e Candida albicans. O coeficiente kappa de Cohen foi usado na análise de concordância. Resultados De um total de 125 mulheres com AVD, 85,6% consultaram espontaneamente e 14,4% foram diagnosticados clinicamente durante um check-up de rotina. A concordância absoluta foi significativa (p=0,0012), com concordância de 13,6%. A concordância relativa foi significativa, mas razoável para vaginose bacteriana (Kappa =0,21; p=0,003) e candidíase (Kappa=0,22; p=0,001), e leve para tricomoníase (Kappa=0,14; p=0,009). O percentual de coincidência dos diagnósticos (solteiros ou mistos) por laboratório e parteiras foi: vaginose bacteriana 63,2% (12/19), candidíase 36,5% (27/74) e tricomoníase 12,5% (4/32). Houve 20% de coinfecção. Umtotal de 36% dos diagnósticos clínicos de AVD tiveram exames laboratoriais negativos. Conclusão As condições de vulvovaginite candidíase e tricomoníase parecem ser sobrediagnosticadas, e a vaginose bacteriana parece ser subdiagnosticada pelo diagnóstico clínico quando comparado com o diagnóstico laboratorial. A baixa concordância obtida mostra a importância de complementar o diagnóstico clínico comestudo laboratorial de AVD, principalmente emmulheres com falha de tratamento e / ou coinfecções com sinais e sintomas inespecíficos e variáveis.

Foreign body in vagina: a cause of persistent vaginal discharge in a prepubescent child

Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In paediatric case persistent foul smelling, blood stained discharge not responding to medical therapy should arouse suspicion of foreign body. Authors report an interesting case of 2 years old child who presented with persistent vaginal discharge and was found to have a retained foreign body in the vaginaneonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted.

Clinical presentation, diagnosis and management of bacterial vaginosis: a hospital based cross-sectional study

Background: Bacterial vaginosis is most common cause of vaginal discharge. Clinical presentation varies from person to person. The management of bacterial vaginosis is largely syndromic and empirical, it is usually based on naked eye examination of vaginal discharge and that is unsatisfactory because the diagnostic accuracy is lost without microscopic examination. The modern management of bacterial vaginosis demands a specific diagnosis which is a combination of naked eye examination plus laboratory workup.Methods: The study was carried out on 183 females with complaint of vaginal discharge in the outpatient department of obstetrics and gynecology. Specimens were collected in outpatient department of Jhalawar Medical College in associated Zanana Hospital. The laboratory work was conducted in the department of microbiology in Jhalawar Medical College, Jhalawar, Rajasthan, India.Results: The prevalence of microbial positivity in our study was 79.9%. Bacterial vaginosis was the most common diagnosis seen in 86 (47.0%) cases. Maximum patients presented with complaint of copious amount of foul-smelling yellow discharge.Conclusions: The study concludes that it is important to know the various presentations, confirm the diagnosis by proper microbiological tests, and provide appropriate treatment to patients to prevent resistance and recurrence of bacterial vaginosis.

Cytological and cultural evaluation of abnormal vaginal discharge in pregnancy and its co-relation with maternal and neonatal outcome

Background: Pregnancy represents a risk factor in the occurrence of vaginal infection. This study was undertaken to define the persistence of vaginal flora in 280 pregnant women at 14 to 34 weeks' gestation and to evaluate the role of cytology in diagnosis of vaginal infections. It aims to study the maternal and neonatal outcome in pregnancy with vaginal discharge.Methods: High vaginal swab samples and data on epidemiological characteristics were collected from 280 pregnant women between 14-34 weeks with complaints of abnormal vaginal discharge at booking clinic of Indira Gandhi Government Medical College, Nagpur. Vaginal swab was collected and sent to laboratory for further investigation to establish etiological diagnosis. After diagnosis by vaginal swab report, subjects were treated with the specific treatment to individual infection. Subjects were followed up during antenatal period for complications. A birth weight of delivered baby was noted. The data was analysed using software Graph Pad in stat 3.Results: The incidence of abnormal vaginal discharge in pregnancy was 23.9% in one year. The frequency of abnormal discharge was 53% among those aged 20-24 years (97/183), 49.2% in primigravida (65/132). Pain in lower abdomen and back was the most common symptoms i.e. 88.19% in Cases, while 17.36% had vulval pruritus and 14.58% had dysuria.Conclusions: This study recommend that women complaining of vaginal discharge in pregnancy should be evaluated for infections. this study supports CDC-P recommendation as all women who have symptomatic vaginitis, should be treated regardless of pregnancy status.

A study of cervical Papanicolaou smears examination in patients with abnormal vaginal discharge

Background: Reproductive tract infection represents major public health problem in developing countries. Cervical infections are common problems among women of reproductive age and associated with clinical complaints of vaginal discharge. Pap smear is a screening test to diagnose various abnormal pathology of cervix. Aims and objectives of this study was to identify various causes of vaginal discharge and frequency of various pathogenic microorganisms in cervical smear.Methods: This was hospital based descriptive study carried out on 300 female patients who attended obstetrics and gynecology clinic at tertiary care hospital with compliant of vaginal discharge. Cervical smear samples were collected, conventional smears were prepared by trained technical staff and stained using Papanicolaou (Pap) technique.Results: The most common age group affected with vaginal discharge was 26 to 35 years with 115 cases. The most common associated symptom was lower abdominal pain seen in 75 cases. Most frequent findings on per speculum examination was thick whitish discharge in 186 cases and the most common pathogenic organism found was Bacterial Vaginosis (BV) in 177 cases.Conclusions: The study emphasizes the need for educating women of rural community to raise the awareness for cervical Pap screening.

Retrospective Study of Pattern of Sexually Transmitted Infections in a Tertiary Care Center in South India

Introduction: Sexually transmitted infections (STIs) continue to be the major social and economic problems leading toconsiderable morbidity, mortality, and stigma in the developing world. Unprotected sex with an infected partner is the majorrisk factor for STIs and it further increases the risk of human immunodeficiency virus (HIV) infection. There is an immenseneed to understand the patterns of STIs prevailing in various regions of a country for proper planning and implementation ofSTI control strategies.Aims and Objectives: The aims of the study were to the pattern of various STI in patients attending the sexually transmitteddisease (STD) clinic of a tertiary care hospital in South India.Materials and Methods: A retrospective study was done with the case records in the STD outpatient department, CoimbatoreMedical College, Coimbatore, during the period from January 2014 to December 2018. The patient’s data and laboratory resultswere compiled and studied.Results: Of 2455, STI cases studied, there were 1127 male STI and 1281 female STI, and the male to female ratio is (1.1:1.2).There was 47 transgender with STIs. The most common complaint was vaginal and cervical discharge (27.04%) followed bysyphilis (20.17%) and the least common complaint was non-herpetic ulcer (5.7%). In our study, 105 cases (4.27%) were foundto be HIV positive.Conclusion: In our study, the common STI found was cervical and vaginal discharge followed by syphilis. The combinedapproach of mass screening and behavioral changes in the population can decrease spread of STIs and HIV rapidly.

Etiopathogenesis of vaginal discharge among married women in reproductive age group residing in rural area of Bhojipura District, Western Uttar Pradesh

Background: Vaginitis is one of common medical problem in women that often results in frequent medical consultations. Aim was to study the clinico-epidemiological profile and etiopathogenesis of various causes of vaginal discharge among females in age group 18-45 years residing in rural area of Bhojipura district.Methods: This Hospital based cross sectional study was conducted over a period of one year (March 2011 to February 2012) among 150 females aged 18-45 years presenting with the complaint of vaginal discharge. Information on sociodemographic data was obtained with the aid of questionnaires. Samples were obtained with two dry cotton-wool tipped swabs from vaginal fornices and were sending to department of microbiology.Results: The prevalence rate of vaginal discharge was found to be 24.6% among females in reproductive age group attending the outpatient department from rural background. Out of 150 patients who were enrolled for study 86 (57.30%) were diagnosed with non-infective discharge while 64 (42.60%) patients with infective discharge. Bacterial vaginosis was detected in 25 (39.1%), Candida albicans was detected in 23 (35.9%), T. vaginalis in 4 (6.3%) and mixed infections were found in 12 (18.7%). According to vagina flora morphology 85 (56.6%) had normal morphology, 30 (20%) had shift from normal flora and 35 (23.3%) had definitive bacterial vaginosis. About 20.5% females with Candida based etiology were diabetic.Conclusions: Some common reproductive tract infections can be diagnosed and managed at primary level health facilities. This promotes community awareness through behavior change communication which includes safer sex practices, awareness of HIV and appropriate and timely health care seeking behavior.

Reactional changes in short-term levonorgestrel-releasing intrauterine system (lng-ius) use

SUMMARY OBJECTIVE: To evaluate endocervical and vaginal environment changes in women using a levonorgestrel-releasing intrauterine system (LNG-IUS). METHODS: A quasi-experimental study included sixty women who had an LNG-IUS inserted in the Family Planning Clinic of UNICAMP between April and November of 2016. Women in reproductive age, non-pregnant, without the use of antibiotics and contraceptives seeking for LNG-IUS insertion were selected for this study. All women were evaluated with regard to vaginal and endocervical pH, vaginal and endocervical Gram-stained bacterioscopy, and Pap-smear before and two months after LNG-IUS insertion. Clinical aspects such as cervical mucus, vaginal discharge, and cervical ectopy were also observed. RESULTS: After LNG-IUS insertion, there was an increase in the following parameters: endocervical pH>4.5 (p=0.02), endocervical neutrophil amount (p<0.0001), vaginal cytolysis (p=0.04). There was a decrease in vaginal discharge (p=0.01). No statistically significant changes were found in vaginal pH, neutrophils amount in the vaginal mucosa, vaginal discharge appearance, vaginal candidiasis, bacterial vaginosis, vaginal coccobacillary microbiota, cervical mucus appearance, or cervical ectopy size. CONCLUSIONS: Short-term LNG-IUS use did not increase vulvovaginal candidiasis or bacterial vaginosis, and led to diminished vaginal discharge. Notwithstanding, this device promoted reactional changes in the vaginal and endocervical environment, without modification on cervical ectopy size.

RESUMO OBJETIVO: Avaliar as alterações do ambiente endocervical e vaginal em mulheres usuárias de sistema intrauterino liberador de levonorgestrel (SIU-LNG). MÉTODOS: Um estudo quase-experimental incluiu 60 mulheres que inseriram o SIU-LNG na Clínica de Planejamento Familiar da UNICAMP entre abril e novembro de 2016. Mulheres em idade reprodutiva, não gestantes, sem uso de antibióticos e contraceptivos, em busca pela inserção do SIU-LNG, foram selecionadas para este estudo. Todas as mulheres foram avaliadas quanto ao pH vaginal e endocervical, bacterioscopia vaginal e endocervical por coloração de Gram, exame de Papanicolau antes e dois meses após a inserção de SIU-LNG. Aspectos clínicos como muco cervical, corrimento vaginal e ectopia cervical também foram observados. RESULTADOS: Após a inserção do SIU-LNG houve aumento nos seguintes parâmetros: pH endocervical >4,5 (p=0,02), quantidade de neutrófilos endocervicais (p<0,0001), citolise vaginal (p=0,04). Houve diminuição do conteúdo vaginal (p=0,01). Não foram encontradas alterações estatisticamente significativas no pH vaginal, na quantidade de neutrófilos na mucosa vaginal, apecto do corrimento vaginal, candidíase vaginal, vaginose bacteriana, microbiota cocobacilar vaginal, aparência de muco cervical ou tamanho da ectopia cervical. CONCLUSÃO: O uso do SIU-LNG em curto prazo não aumentou a candidíase vulvovaginal ou a vaginose bacteriana, levou à diminuição do conteúdo vaginal. No entanto, este dispositivo promoveu mudanças reacionais no ambiente vaginal e endocervical, sem modificação no tamanho da ectopia cervical.

Perceptions and practices of rural Indian women in contraception, abortion, and sexual health: a cross sectional study

Background: Maternal mortality is an important target of health care policies, especially in India. While numerical indicators of maternal health improve, this can only be sustained with change in the knowledge, attitudes, and practices of women. Gender empowerment is a neglected aspect of health care policy, and there is a need to assess the perceptions of Indian women, the true torch-bearers of change.Methods: This was a hospital based cross sectional quasi-quantitative study in a sub-district hospital in the town of Ballabgarh, Haryana, India. Married women attending the outpatient clinic, antenatal clinic, labor ward, and primary health centres in the age group of 20 to 40 years were interviewed using a semi-structured questionnaire with both closed and open-ended questions. Health concerns were concurrently addressed.Results: Author interviewed 956 women. No form of modern contraception had ever been used by 58.36% of the women. Intra-uterine contraceptive devices were discontinued by 76.12% of the women who had used them. Emergency contraception was a concept known to 49.89% of the women, but fraught with misconceptions. Induced abortions was being used as a form of family planning, with nearly 90% of the women having taken over-the-counter abortifacients. Women were receptive to contraception, and many expressed an interest in long acting contraceptives other than IUCDs.Conclusions: This study provides insight into the thinking of Indian women regarding family planning. This may help guide family planning policies.

Syndromic approach to identify cases of vaginal discharge: a cross-sectional study among females of Shaheed Nagar, Bhopal, Madhya Pradesh

Background: Management of Sexually Transmitted Infections (STIs) is important in controlling STIs and to break the chain of infection and transmission.Syndromic case management is a standardized evidence-based approach which utilizes clinical management algorithms and flowcharts that are handy and can be consistently used across health care providers. The objectives of the study were to identify cases of vaginal discharge in Shaheed Nagar, Bhopal and to provide them treatment following syndromic approach.Methods: Prospective cross-sectional study carried out over a period of three months among reproductive age group females (15-45 years) in Shaheed Nagar, Bhopal. Purposive sampling by conducting door- to- door survey until 150 women fulfilling study criteria was interviewed. A pre-designed questionnaire used for data collection. Educational intervention given to all participants. 37 participants identified with vaginal discharge syndrome and were assisted by study team to gynecological OPD for obtaining treatment based on syndromic approach. Data entered in MS Excel 2007 and statistical analysis carried out using epi-info 7.2. Proportions and percentages were calculated. Chi-square was used to find out association between prevalence of vaginal discharge and qualitative variables. P value <0.05 considered statistically significant.Results: Prevalence of vaginal discharge was 24.67%. The most common presenting complaint was general weakness (52%). The most common diagnosis was cervicitis (8.67%) followed by vaginitis (4.67%). Statistically significant correlation was found between presence of disease (STI) and use of intra- uterine device (IUD), non-use of sanitary pads, marital status, occupation and socio- economic class.Conclusions: Abnormal vaginal discharge can both be the cause as well as the effect of pelvic inflammatory disease.

Women’s perceptions and responses towards abnormal vaginal discharge: Focus Group Discussions in a socially marginalized community

OBJECTIVE:Vulvo-vaginal discharge, which is a common gynaecological complaint, can be a normal phys- iological discharge or a symptom of an underlying reproductive tract infection, genital tract neoplasm, or other reproductive tract disorder. It is pertinent to differentiate physiological discharge from a pathological vulvo-vaginal discharge in order to prevent complications of untreated reproductive tract infections. Women are not seeking health advices for most of their gynaecological health issues and have different cultural practices to manage them. This study was conducted to explore the different cultural practices associated with vulvo-vaginal discharge among females aged 18–49 years living in an estate community in Colombo district, Sri Lanka.METHODS:This descriptive qualitative study used three Focus Group Discussions (FGDs) with a total number of 20 women. Transcribed verbatim data were analyzed using qualitative content analysis.RESULTS:Majority of the participants were Indian Tamils (n = 17, 85%) and Hindu (n = 15, 75%). Most (65%) of women were employed in the estate labour and educated up to grade 11 (n = 13). The major themes identified in the present study were difficulty in differentiating normal from abnormal vaginal discharge, lack of knowledge on causative factors, cultural influences and beliefs, unstable/limited source of income, fear of disclosing, and lack of support system. Many participants explained that they have difficulty in accessing health care as they are busy with their employment, household work, fear of internal examination, and fear of being admitted to the hospital ward. The common practice was to use home remedies such as polpala herbal drink (Balipoovu, Aerva lanata) or Neeramulliya (Asteracantha longifolia Linn) herbal drink, king coconut, Sauw (sago) Kanji, Uluhal (Fenugreek), and Aloe vera juice prior consulting medical advice for abnormal vaginal discharge.CONCLUSIONS:The findings of this study revealed the need of support for women in estate sector for their repro- ductive and sexual health matters. There is a high need of public health care worker’s guidance and counselling to overcome barriers for health care utilization in this community.

Prevalence of urinary tract infection among school going adolescent girls in rural part of Chennai

Background: A urinary tract infection (UTI) is a common infection that can affect any part of the urinary system, including the kidneys, bladder, and urethra (the tube through which urine exits the body). The most common cause of UTIs is the transfer of bacteria from the rectum or vagina to the urethra. Around 80 percent are caused by E. coli bacteria commonly found in the gut or feces. Others, like Staphylococcus saprophyticus, are naturally found in the vagina and can be transferred to the urethra. The aim of the study: The study objectives were to assess the knowledge of adolescent girls regarding urinary tract infection and determine the association between knowledge regarding urinary tract infection and selected demographic variables. Materials and methods: This observational study was done in 2017-2018 at Department of Urogynecology, Institute Of Social Obstetrics, Government Kasturba Gandhi Hospital, Chennai. 200 female adolescents were included in the study. BMI was calculated from height and weight. Height, weight, and BMI were considered for assessing malnutrition in adolescent girls. Urine samples were collected from 23 girls for microscopic examination for pus cells. The faculty members followed the investigators and guided them during the survey. The survey was completed within two days. Any girl complaining of three criteria of the case definition of UTI viz: increased frequency of micturition with; burning during micturition and pus cells in the urine were considered as a case of UTI for the purpose of the study. Results: There was a significant association between prevalence of UTI and improper perineal washing technique (CI = 95%, p< 0.001), malnutrition (CI = 95%, p< 0.001), presence of vaginal discharge (CI = 95%, p< 0.001) and use of unsanitary pads during menses (CI = 95%, p< 0.001). T. Srikala Prasad, Jessima Subahani. Prevalence of urinary tract infection among school going adolescent girls in rural part of Chennai. IAIM, 2019; 6(3): 278-282. Page 279 Misconception included not taking bath during periods and not eating certain foods. Low socioeconomic status was chiefly responsible for frequent use of the same piece of cloth as sanitary pads during menstrual bleeding leading to urinary tract infection. UTI was more (7.7%) in malnourished girls than in those with normal nutritional status. Significantly more (7.7%) girls having symptoms of vaginal discharge were suffering from a urinary infection. Conclusion: For the short term, the need is to give immediate health education about the causes, prevention, and treatment of UTI among adolescent girls of both the villages and treatment of the identified cases with the urinary antibiotics etc. Long term measures include a periodical screening of the adolescent girls for UTI.

Usefulness Analysis of Urine Samples for Early Screening of Human Papilloma Virus Infection

Human papilloma virus (HPV) is known to be a major cause of cervical cancer. In Korea, although the mortality of cervical cancer has decreased, HPV infection rates are increasing rapidly in young women. One of the reasons for a high rate of human immunodeficiency virus (HIV) infection appears to be associated with a low frequency to visit gynecology clinics because of the uncomfortable sampling process for HPV testing. Therefore, it is necessary to develop a non-invasive method, such as urine testing to diagnose cervical cancer rather than use of the existing invasive method. This study aimed to test validity of HPV DNA detection in urine specimens that can be easily collected from women. Paired vaginal discharge and urine samples were collected prospectively from 203 women who visited the local hospital between January and August 2018 in Busan, Korea. By using the Virocheck® assay kit (Optipharm), we found that 17.2% (35/203) of vaginal discharge samples were HPV positive and 82.8% (168/203) were HPV negative. In urine samples, 15.8% (32/203) were HPV positive and 84.2% (171/203) were HPV negative. The co-incident rate for HPV DNA detection was 84.8% in both vaginal discharge and urine samples. These results suggest that the HPV DNA detection using urine samples might be an alternative way to diagnose HPV infection in a non-invasive way. This analytical approach can be utilized as a screening test to identify HIV-infected patients who need a follow-up process by using urine samples.