Nonoxynol 9 as an additive therapy in metronidazole-resistant cases of vaginal trichomoniasis

The present study was conducted on 30 female patients with rnetronidazole resistant vaginal trichomoniasis to investigate the efficacy of nonoxynol 9 [N-9], a non hormonal contraceptive with spermicidal effect, as an additive therapy to metronidazole [MNZ]. Study population were randomly divided into 3 groups according to treatment regimen: G.I: patients received high dose MNZ [2g daily for 7 days] n = 10; G. II patients received [100mg N-9 vaginal suppository daily for 7 days] n = 10; G. III: patients receiving conventional MNZ dose [1g daily for 7 days] plus [a 100mg N-9 suppository for 7 days] n = 10. Clinical and parasitological evaluation of cure was performed at return visits 1, 2, 4 and 6 weeks post treatment. Negative T. vaginalis vaginal smears were ensured by direct microscopic visualization and In Pouch TV culture technique. Most of the patients were in the 30-39 years age group [60%] and burning was the most frequent symptom [96.67%]. The cure rates were 70%, 40% and 90% for Gs I, II and III respectively, while adverse effects of treatment were recorded most frequently by patients of G.I. So, MNZ resistant trichomoniasis incidence seems to be on the rise. Topical therapy alone has a low cure rate while combined oral conventional doses of MNZ and intravaginal nonoxynol 9 treatment appears to be a good clinical trial with fairly good cure rate thus, avoiding the adverse side effects of high doses MNZ therapy and T. vaginalis health hazards potentiality

study on demodex folliculorum mite density and immune response in patients with facial dermatoses

In the present study, 40 patients with facial skin lesions and Demodex folliculorum [DF] mite density > 5/cm2 by SSSB were evaluated for their immune response through counting T-cell subsets [CD3-CD4-CD8] and NK cells [CD16] numbers and IgG, M, D concentrations in peripheral blood in relation to DF mite density. They were 26 females and 14 males with overall mean age was 48.57 +/- 15.33 years. A control group of 40 healthy individuals without any skin diseases was enrolled. The mean DF mite density [MD] was 11.82 +/- 3.72/cm2 in patients compareed to 1.77 +/- 2.39 /cm2 and a prevalence of 47.5% in controls. The difference was statistically significant. MD significantly correlated with age both in study and controls, but not with sex. A significant decrease in the absolute numbers of lymphocytes, T-cell subsets and NK cells was found in the study group in comparison with controls. Mean IgM level was significantly higher in patients. No significant correlation was observed between MD and the immune response. So, DF mites modulate the host cellular immune response to their advantage, as T-cell subsets and NK cells seem to be the target of immuno-suppression, favouring dermatosis development