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Article
Comparison Effect Of Vitamin C Vaginal Tablet Versus Oral Metronidazole For Treatment Of Bacterial Vaginosis

Author: Esraa H. humadi اسراء حسن حمودي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 4 Pages: 405-408
Publisher: Baghdad University جامعة بغداد

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Abstract

Back ground: Bcaterial vaginosis is an important gynecological problem, during reproductive age group with high relapse rate ,it is associated with high vaginal PH, vaginal vitamin C recently tried to decreased vaginal PH and treat bacterial vaginosis.Patients & Methods: One hundred and one women with Bacterial vaginosis their age range from 18-40 years enrolled in this study, the Diagnosis is confirmed by at least 3out of 4 of (Amsel criteria) which include a thin homogenous vaginal discharge, vaginal PH of ≥4.7, a characteristic ''amine odour'' release when alkali (lo% KOH) is added to a specimen of vaginal fluid, and at least 20% of epithelial cells having the appearance of clue cell in a wet mount of vaginal fluid or on gram stain . All women were randomly assigned to receive either 250mg vitamin C vaginal table at bed time for 6days (51patients) or oral metronidazole 500mg twice daily for 7days (50 patients) the patients were evaluated at two follow up visit 1st after treatment completed and 2nd one week later. Therapeutic success was defined as the presence of less than 3 Amsel criteria.Results: Regarding the infection with bacterial vaginosis no significant difference between two groups, (15.9%) of patients still infected with bacterial vaginosis at 1st follow up visit in (vagi-C) treated group. Compare to 26.7% of metronidazole group P=0.5, this confirmed at 2nd follow up visit P=0.1. Regarding vaginal PH there is significant reduction of vaginal PH in both groups at end of treatment P=0.0032 in Vagi-C, and P=0.0001 in metronidazole treated group.Conclusion: Vitamin C vaginal table 250mg has effective as oral metronidazole for treatment of bacterial vaginosis.Key Words: vaginal vitamin C, bacterial vaginosis.


Article
The Role of Asymptomatic Bacterial Vaginosis in Women Undergoing Intracytoplasmic Sperm Injection in Predicting Successful Pregnancy

Authors: Muayad S. Abood --- Lubna A. Al-Anbari --- Hourah Sh. Atiea
Journal: Iraqi Journal of Embryos and Infertility Researches المجلة العراقية لبحوث الأجنة والعقم ISSN: eISSN: 26166984 / pISSN: 22180265 Year: 2018 Volume: 8 Issue: 2 Pages: 21-26
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Bacterial vaginosis (BV)is a polymicrobial clinical syndrome resultingfrom replacement of the normal hydrogen peroxide producing Lactobacillussp. BV is the most common lower genital tract disorder among women ofreproductive age (pregnant and non-pregnant) and the most prevalent cause ofvaginal discharge and malodor.Objectives:To study the role of asymptomatic bacterial vaginosis on outcome inpatients undergoing ICSI.Patients and Methods:This prospective study was undertaken in the High Instituteof Infertility Diagnosis and Assisted Reproductive Techniques / Al-NahrainUniversity. During the period from September 2017 – April 2018. A total of 100infertile women .All of them were underwent controlled ovarian hyper stimulationfor intra cytoplasmic sperm injection cycle. Antagonist oocyte maturationused as ovulation induction protocol in all the cases. Assessment of oocyte maturationand embryo quality is done to the all the cases, bacterial vaginosis smearwas collected on the day of oocyte retrieval. B.V. smear diagnosis by Amsel’sCriteria and Nugent’s Scoring.Results: TThere was no significant difference in mean age of pregnant andnon-pregnant ladies, 29.40 ±6.47 years versus 30.78±6.84 years, respectively(P= 0.333).In addition the frequency of women under 35 years age was comparablein the two groups with no statistical significant difference, 34 (79.1%) versus33 (73.3%), respectively (P = 0.528). Wide variation and non-normal distributionwas the role followed by the duration of infertility concerning sub-fertilewomen participating in this study. However, no significant difference was observedin the duration of infertility between pregnant and non-pregnant ladies,6.00 (5.00) years versus 6.00 (5.00) years (P = 0.289). Comparison of basal hormonallevels between pregnant and non-pregnant groups revealed no significantdifference despite the presence of some minor differences in mean hormonallevels between the two groups (P> 0.05). Comparison of oocytes characteristicsbetween pregnant and non-pregnant ladies was conducted and revealed no significantdifference in mean total number retrieved oocyte (TNO), ruptured oocytes(RO), abnormal oocyte (AO), germinal vesicle oocyte (GV), metaphase I oocyteand metaphase II oocytes (P > 0.05), table Mean total number retrieved oocyte(TNO), ruptured oocytes (RO), abnormal oocyte (AO), germinal vesicle oocyte(GV), metaphase I oocyte and metaphase II oocytes was 10.81 ±4.95 versus 10.42±6.30, 0.44 ±0.73 versus 0.36 ±0.65, 1.09 ±1.56 versus 0.84 ±2.00, 0.91 ±1.00 versus0.89 ±1.47, 1.51 ±1.49 versus 2.04 ±2.09 and 6.84 ±4.01 versus 6.22 ±3.91 in pregnant andnon-pregnant groups, respectively. Mean fertilization rate was higher in pregnant ladies thanthat of non-pregnant ladies, 62.19 ±22.23 versus 57.59 ±24.95, respectively; however, the differencewas no statistically significant (P = 0.365).Mean grade I embryo number was also significantlyhigher in pregnant women than that of non-pregnant women, 2.53 ±1.53 versus 1.89±1.27, respectively (P = 0.034), Mean grade II embryo number was 0.86 ±1.52 versus 0.89±1.28 in pregnant and non-pregnant ladies, respectively and the difference was not significant(P = 0.925), moreover the difference in mean grade III embryo number between pregnant andnon-pregnant women was insignificant (P = 0.321), 0.30 ±1.01 versus 0.31 ±0.50, respectively.Rate of asymptomatic bacterial vaginosis as determined by gram stain, whiff test, wet mountand Amsel’s criteria was 32.6 % in pregnant women compared to 73.3% in non-pregnantgroup, being highly significant higher in those women who failed to get pregnant (P<0.001).Conclusion: Rate of asymptomatic bacterial vaginosis was 32.6 % in pregnant women comparedto 73.3% in non- pregnant group, being highly significant higher in those women whofailed to get pregnant.


Article
Evaluation of Serum TNF-α in Insulin Resistant Non PCOS Pa - tients Undergoing ICSI: A Randomized Clinical Trial

Authors: Manal T. Al-Obaidi --- Mohammad O. Selman --- Manar Alhoda Z. Al-Faqheri
Journal: Iraqi Journal of Embryos and Infertility Researches المجلة العراقية لبحوث الأجنة والعقم ISSN: eISSN: 26166984 / pISSN: 22180265 Year: 2018 Volume: 8 Issue: 2 Pages: 27-35
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:With the rapid evolution of assisted reproductive technologies,more and more studies are concerned about the possible influential factors onthe success rates of these procedures, with the efforts are now mainly directedtoward defining these factors in a trial to increase these rates. Of these factors,inflammation is considered among the most remarkable and is in the focus ofthe updated studies. However, most of these studies are evaluating the role ofinflammation in patients with polycystic ovarian syndrome(PCOS) , while theimpact of this inflammation in insulin resistant non PCOS patients is underestimatedand not well evaluated .Objectives:This study is a trial to elucidate the importance of one of the inflammatorymediators , Tumor Necrosis Factor-alpha (TNF – α) , in insulin resistantpatients undergoing IVF ( ICSI ) cycles .Patients and Methods:A group of 27non-PCOS infertile patients were selectedfor this clinical randomized prospective study from patients attending thehigh institute for infertility diagnosis and assisted reproductive technologies /Al-Nahrain University and subjected to intra-cytoplasmic sperm injection (ICSI)procedure. BMI was measured for all patients and they were classified accordingto WHO classification into 3 groups : Acceptable , overweight and obese . Fastingplasma level of glucose and insulin was investigated and insulin resistanceindex (HOMA) was calculated. Serum TNF-α has been measured using ELISAand the relation with insulin resistance was investigated. Finally, the pregnancyrate, as a primary reproductive endpoint was compared according to TNF -a andinsulin resistance levels between different study subjects.Results: Of the 27 infertile patients , 17(63 %) were non obese and 10 (37%)were obese , 15(55.5%) were having HOMA index < 1.6 and 12 (44.5 %) werehaving HOMA index ≥ 1.6 . BMI was found to be positively correlated with higherHOMA index ( P = 0.01 and R= 0.4 in spearman correlation). Investigating therelation between TNF-α with BMI revealed that TNF-α levels are increasing withthe increment in BMI, However , the difference in the mean TNF-α between thethree BMI groups failed to achieve statistical significance (P=0.1). In contrastto that, when stratifying for HOMA index , TNF-α was significantly correlatedwith it ( spearman correlation R= 0.4 , P=0.01 ) , and patients with HOMA index≥1.6 were found to have higher levels of TNF-α (The effect of insulin resistance was also implicated on pregnancy rates , as those with highinsulin resistance were shown to have significantly lower pregnancy rates when compared tothose with low indices of resistance (P = 0.03) . However, the impact TNF-α on pregnancyrates was apparently less significant (P= 0.5).Conclusion: Rate of asymptomatic bacterial vaginosis was 32.6 % in pregnant women comparedto 73.3% in non- pregnant group, being highly significant higher in those women whofailed to get pregnant.


Article
Bacterial Vaginosis and PrematureUterine Contraction among Womenin Ramadi City

Author: Wassan A.H. Al-Jobori
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 1 Pages: 31-36
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:
Background :
To study the incidence of premature uterine contraction (PUC) with bacterial
vaginosis (BV) in Ramadi city and to correlate the incidence of (PUC) with severity
(grades of BV).
Patients and Methods:
A prospective study was performed involving 250 women who consecutively
attended Gynecological ward in Maternity and Child Hospital. 150 women were
control groups (without uterine contraction), and 100 women were regarded as
patients group (with uterine contraction) at 28-34 weeks of gestation. BV was
diagnosed on the basis of four diagnostic criteria; vaginal pH>4.7, homogenous
vaginal discharge, a positive Whiff test, and the presence of clue cells.
Results:
A total of 250 high vaginal specimens, BV were diagnosed in 74% of cases
with PUC (patient group); the incidence was 8% in grade I (GI), 29% in GII, and
37% in GIII. BV was 10% of cases without uterine contraction (control group).
Conclusions:
There was statistically significant correlation between BV and PUC up to 74%.
The incidence and severity of PUC increased with increasing the severity of BV.
The patients who used more IUCD (intrauterine contraceptive device), higher
reproductive ability, used vaginal douching, and have history of PID (pelvic
inflammatory disease) are more liable to have BV and more liable to have PUC.


Article
Molecular and Bacteriological Detection of Some Bacterial Vaginosis Associate Bacteria in Women
التشخيص الجزيئي والبكتريولوجي لبعض أنواع البكتريا المرتبطة بالتهابات المهبل عند النساء

Authors: Khawlah Abdulameer Abed خولة عبد الامير --- Nuha Joseph Kandala نهى جوزيف قندلا
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2016 Volume: 57 Issue: 3B Pages: 1926-1936
Publisher: Baghdad University جامعة بغداد

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Abstract

Bacterial vaginosis (BV) is one of the most common genital infections among women in the childbearing age. Many novel, fastidious and uncultivated bacterial species are related with BV. These are called bacterial vaginosis associated bacteria (BVAB), present in trace amount and have a significant role in the infection. A total of 80 vaginal swabs were obtained from 80 pregnant and non-pregnant women. Samples were collected from different hospitals in Baghdad city and Al-Kut city.Clinically, 60 sample among 80 were gave positive results depending on Nugent score and Amsel criteria ,the Bacteriologicall test showed the percentages of gram negative bacteria (E.coli ,K.pneumoniae, P.mirabilis, Ps.aeruginosaand A. baumanniiwere) were (38.3 ,28.3, 26.6,20,16.6,15)% respectively, while, the percentages of gram positive bacteria ( Lactobacillus spp., S. epidermidis , S. aureus, S. agalactiae and S. faecaliswere( 100, 46.6, 38.3,18.3 ,11.6)% respectively.The results of molecular detection revealed that the specific primers amplified in 48 sample of vaginal swabs and produced a single band with a molecular weight of 210 bp for G. vaginalisgene, and 9 samples of vaginal swabs for Leptotrichia/Sneathia gene and produced a single band with a molecular weight of 320bp,3While negative results for other bacteria such as Atopobiumvaginae and Bacterial Vagionosis Associated Bacteria 1,2,3 ( BVAB1, BVAB2 and BVAB3) .The results of LactobacillusSpp., showed that among 60 samples of LactobacillusSpp., 28 isolates (46.66%) were L. acidophilus and the PCR product appeared as a single DNA band with a molecular weight of 192bp,while 32 isolates (53.33%) were L. fermentum,the PCR product appeared as single DNA band with a molecular weight of 600 bp. Sequencing of 16s rRNA of G.vaginalisand L.fermentumwasagreed with PCR identification give similar identity in percentages (87.5 and 100)% respectively with the standard strains in NCBI web site. While for Leptotrichia spp. it differs and related to modified nucleic acid bacteria in comparison with NCBI web site and hence is considered as a novel BV associated bacteria in vagina.

يعد التهاب المهبل البكتيري من أكثر الأمراض التناسلية شيوعا ويصيب النساء في سن البلوغ. بعض أنواع البكتريا التي تتصف بكونها نادرة, شرهة و غير قابلة للزرع لها علاقة بهذا المرض, هذه البكتريا تسمى (البكتريا المرتبطة بالتهاب المهبل), حيث توجد باعداد قليلة وتلعب دورا مهما في الإصابة.تم الحصول على 80 عينة سريريه من 80 امرأة. جمعت العينات من مستشفى اليرموك في مدينة بغداد ومستشفيي الزهراء والكوت في مدينة الكوت . ثمانون امرأة خضعت لهذه الدراسة, ستون منها تم اختيارها كحالة مرضية اعتمادا على اختبار (Amsel criteria ,Nugent Score). اظهرت نتائج التشخيص البكتريولوجي للمسحات المهبلية تواجد انواع مختلفة من البكتريا السالبة لصبغة كرام( K.pneumoniae, P.mirabilis, P.aeruginosa and Acinetobacter spp.) ) بنسب (28,3, 26,6, 20 , 16,6 , 15) % على التوالي اما البكتريا الموجبة لصبغة كرام فكانت (Lactobacillus spp ,S. epidermidis , S. aureus , Streptococcus agalactiae and Enterococcus faecalis) بنسب(100 46,6, 38,3 , 18,3 , 11,6) %على التوالي. اظهرت نتائج التشخيص الجزيئي باستخدام تقنية PCR للكشف عن ستة انواع من البكتريا النادرة و الغير مستزرعة احتواء 48 عينة على حزمة مفردة بحجم حزيئي (210 ) زوج قاعدي تابعة الى بكتريا Gardnerella vaginalis,, بينما 9 عينات تحتوي على بكتريا Leptotrichia اذ اظهرت حزمة مفردة يحجم جزيئي (320) زوج قاعدي. بينما اظهرت النتائج عدم تواجد باقي الانواع المدروسة Atopobium vaginae والانواع المرتبطة بالمهبل Bacteria 1,2,3 BVAB1, BVAB2 and BVAB3)). واظهرت نتائج بكتريا Lactobacillus spp تواجد بكتريا Lactobacillus acidophilus في 28عينة اذ اعطت حزمة مفردة بحجم 192 زوج قاعدي. بينما 32 عينة اعطت نتيجة ايجابية لبكتريا Lactobacillus fermentum بظهور حزمة مفردة بحجم 600 زوج قاعدي. تم مقارنة نتائج التتابع للجين المتخصص لبكتريا , Gardnerella vaginalis Leptotrichia spp.و L.fermentum بوساطة قاعدة بيانات المركز القومي للمعلومات الحيوي ( NCBI ) وقد اشارت النتائج بأن Gardnerella vaginalis , L.fermentum لديها نسبة تماثل ( 92و 87,5) % مقارنة بالسلالات المعزولة عالميا, بينما Leptotrichia spp لا تتماثل وعدت نوع جديد من الانواع المعزولة من المهبل .


Article
COMPARISON BETWEEN BACTERIAL VAGINOSIS AND CANDIDIASIS IN RELATION TO ESTRADIOL LEVEL AND VAGINAL PH IN SOME INFERTILE IRAQI WOMEN
المقارنة بين الكاردينلا المهبلية والتهاب المهبل الفطري (المونيليا) وعلاقتهما بمستوى الاستروجين في الدم وحامضية المهبل في بعض النساء العراقيات العقيمات

Authors: AL-Najar S. صباح النجار --- Khaki I. A. إكرام أمين خاكي --- Rehab S. AL-Maliki رحاب شفيق عبد السيد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2009 Volume: 7 Issue: 3 Pages: 24-31
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Female fertility are affected by several factors including microbial and non microbial agents. Microbial infection is one of the most important causes for female infertility. The level of pathogenicity of microbial infections are affected by wide range of factor including age, physiological status, phase of menstrual cycle and race.Objective: Comparison between bacterial vaginosis (B.V) and candidiasis in relation to Estradiol (E2) level and vaginal pH in some infertile Iraqi womenMethods: The study population was a subset of 109 infertile women attending Institute of Embryo Research and Infertility Treatment at Baghdad University, throughout the period from June till November 2004. Those infertile women were subjected to clinical examination by measuring vaginal pH, vaginal swabs collection to diagnosis of B.V using Amsel clinical criteria beside various micro-biological methods and diagnosis of candidiasis using mycological methods and serum collection from aspirated venous blood at late follicular phase for detection of E2 level. Result: Forty eight infected infertile women were diagnosed with B.V from 109 infertile women. In those women the Estradiol mean was 41.17 Pg/mL near to lower limit of normal range of E2 level ( 18-147 pg/mL) and lower than E2 mean of healthy control group 132.5 Pg/mL in this study and most of them 93.75% had vaginal pH greater than 4.5. 24 cases with candidiasis were diagnosed from 109 infertile women. In those women the E2 mean was 183.2 Pg/mL higher than upper limit of normal range of E2 level and higher than E2 mean of healthy control group and candidial infection occur in normal pH range of 3.5 to 4.5 Conclusions: The results of the present study appeared that the hormonal disturbance which was associated with different infertility conditions may be predisposing factor in development of B.V and develop candidiasis among infertile women.Elevated vaginal pH in infertile women who had B.V could be due to estrogen deficiency while normal pH in candidial infection because estrogen hormone increases cellular glycogen content which favors growth of Lactobacilli that metabolize glycogen to lactic acid and then producing an acidic environment.Kay words: Bacterial vaginosis, candidiasis, Estradiol level, infertile women

خلفية الدراسة: تُعرّض خصوبة النساء لعده عوامل تتضمن العوامل الجرثومية وغير الجرثومية . الإصابات الجرثومية هي واحده من أهم مسببات العقم في النساء، مستوى أمراضيه الاصابه الجرثومية تتأثر بمدى واسع من العوامل والتي تتضمن العمر والحالة الفسلجية (طور الدورة الشهرية) والعرق أو الجنس.هدف الدراسة: هدفت هذه الدراسة إلى المقارنة بين الإصابة بالكاردينلا المهبلية والتهاب المهبل الفطري (المونيليا) وعلاقتهما بمستوى الاستروجين في الدم وحامضيه المهبل في بعض النساء العراقيات العقيماتطرق العمل : نفذت هذه الدراسة على 109 امرأة عقيمة راجعن معهد أبحاث الأجنة وعلاج العقم في جامعة بغداد للفترة من حزيران حتى تشرين الثاني لعام 2004 . تلك النساء خضعن للفحص السريري وقياس حامضيه المهبل كما وجُمعت منهن المسحات المهبلية لغرض تشخيص الإصابة بالكاردينلا باستخدام معيار Amsel السريري مع عدد من طرق التشخيص الجرثومية. كما تم تشخيص الإصابة بالمونيليا باستخدام طرق تشخيص الفطريات. بالإضافة إلى ذلك تم جمع عينات المصل بواسطة سحب الدم من النساء وهّن في الطور الجريبي المتأخر لغرض معرفه مستوى الاستروجين.النتائــج: ثمانية وأربعون امرأة عقيمة ُشخّصت بأنها مصابه بالكاردينلا المهبلية من 109 امرأة عقيمة وكان معدل الاستروجين في هذه النساء حوالي 41.17 بيكوغرام /مل قريب من الحد الأدنى للمعدل الطبيعي لمستوى الاستروجين (18-147 بيكوغرام /مل) واقل من معدل الاستروجين لنساء مجموعه السيطرة 13.25 بيكوغرام /مل وفي هذه الدراسة كانت حامضيه المهبل لحوالي 93.75% من تلك النساء أكثر من 4.5.شُخّصت أربعه وعشرون امرأة عقيمة بأنها مصابه بالمونيليا المهبلية من 109 امرأة عقيمة وكان معدل الاستروجين لديهن 183.2 بيكوغرام /مل أعلى من الحد الأعلى للمعدل الطبيعي لمستوى الاستروجين وأعلى من معدل الاستروجين لمجموعه السيطرة , وان الإصابة بالمونيليا المهبلية قد حدثت في مدى حامضيه المهبل الطبيعية التي تتراوح بين 3.5-4.5 .الاستنتاج : أظهرت نتائج هذه الدراسة بان الاضطراب الهرموني الذي يكون مرافق لمختلف حالات العقم عند النساء قد يكون المهيئ للإصابة بالكاردينلا المهبلية والمونيليا المهبلية بين النساء العقيمات، وان ارتفاع حامضيه المهبل بين النساء العقيمات المصابات بالكاردينلا المهبلية قد يكون نتيجة نقص الاستروجين، بينما الحامضيه المهبلية تكون طبيعيه في النساء المصابات بالمونيليا المهبلية لان الاستروجين يزيد محتوى الكلايكوجين الخلوي الذي يزيد من نمو عصيات حامض اللبنيك التي تؤيض الكلايكوجين الى حامض اللبنيك منتجا المحيط الحامضي.مفتاح الكلمات: الكاردينلا المهبليه ، المونيليا ، مستوى الاستروجين ، النساء العقيمات.


Article
Prevalence of aerobic bacterial vaginosis among Intrauterine Contraceptive Device users women in Hilla city

Author: Sura Ihsan Abed Jabuk
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2014 Volume: 22 Issue: 9 Pages: 2431-2424
Publisher: Babylon University جامعة بابل

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Abstract

Intra uterine device (IUD) is the most popular method of contraception among Iraqi women. It is one of the very effective contraceptive methods with very small failure rate. Infection has been the main problem that faces women using IUD all over the world. The aim of this study is to explore the Prevalence of bacterial vaginosis among Intrauterine Device users women in Hilla . A study sample included fifty vaginal swabs taken from women IUD users suffering from vaginosis, who admitted to Babylon hospital for maternity and pediatrics in Babylon province, Iraq during the period from November 2012 to April 2013. These women were randomly selected, interviewed, then cervical swabs were collected and cultured for aerobic bacteria. The results showed that the total number of positive cultures was 32(64%) . The positive cultures predominant among women age between 20-40 years . The first group of isolated organisms was the Escherichia coli (16%), followed by Staphylococcus aurous and Klebsiella pneumoniae (12%) , then Bacillus subtilis., Proteus mirabilis., Actinomycetes israelii. is 10% , 8% , 6% respectively. The percent of pathogenic swabs decrease with increasing duration of use. The most frequently reported symptom was the presence of abnormal vaginal discharge . When examined for the effects of 5 different antibiotic on bacterial isolated present a variable degree of sensitivety by bacterial isolates .It ranged between 100% to Impenem & Ertapenem and 0% to Penicillin .

يعتبر اللولب من اكثر الوسائل شيوعا بين النساء العراقيات ,حيث يعتبر من اكثر الوسائل فاعلية بسبب انخفاض نسبة الفشل في استخدامه , وتعتبر التهابات الجهاز التناسلي من أهم المشاكل التي تواجه السيدات اللواتي يستخدمن اللولب في جميع انحاء العالم ,تهدف هذه الدراسة الى معرفة الانواع المسببة لالتهاب المهبل بين السيدات اللواتي يستخدمن اللولب في مدينة الحلة , تم اختيار العينة الدراسية المكونة من 50 سيدة يستخدمن اللولب والمراجعات مستشفى الولادة والاطفال في محافظة بابل وقد تم اجراء مقابلة شخصية مع كل سيدة للفترة مابين 2012 و 2013 تم اختيار النساء بصورة عشوائية ومن ثم اخذ عينة من عنق الرحم للزراعة والكشف عن البكتريا الهوائية بينت النتائج ان النسبة المؤية للعينات موجبة الزرع هي 32 (64%) والنسبة الاكبر كانت في المرحلة العمرية مابين 20-40 سنة وكانت بكتريا Escherichia coli هي الاكثر شيوعا وبنسبة 16% ثم تليها بكتريا klebsiella وstaphylococus aureeus penumomine بنسبة 12% ثم bacillus subtilis , proteus mirabilis , actinomycetes israelii . بنسبة 10% , 8% ’ 6% على التوالي وقد وجد ان نسبة الاصابة تقل مع زيادة فترة استعمال اللولب ,كانت الاعراض المرضية الاكثر شيوعا هي الافرازات المهبلية , تم دراسة تأثير خمسة مضادات حيوية على الاجناس البكتيرية وجد ان هناك درجات متفاوتة من الحساسية للمضادات تراوحت مابين 100% للمضادين impenem & ertapenem و 0% لمضاد penicillin .


Article
Frequency of Bacterial Vaginosis in Babylon Governorate and its association with intrauterine contraceptive device

Author: Raed F. AL-Aouadi
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2016 Volume: 24 Issue: 5 Pages: 1401-1413
Publisher: Babylon University جامعة بابل

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Abstract

This study aimed to assess the frequency of bacterial vaginosis (BV) and its association with some risk factors like intrauterine contraceptive device (IUCD). A total number of 111 patients with vaginal discharge were enrolled in this study in addition to control group (30 women). Case and control groups were taken from Babylon Hospital and some out patients clinics between January and December 2009. Only 46 out of 111 (41.44%) patients had BV while it was only (10%) in the control group with statistically significance ( P value < 0.05). The most commonly affected age groups were (20-29 years) and (30-39 years) with the following percentages respectively(28.26 % ; 36.95%).The leukocyte cells in gram staining of vaginal swabs showed that ( 84.79% ) of BV have leukocyte cells less than 10 cells /HPF while only (15.21%) have leukocyte cells > 10/HPF (P value < 0.05). Thirty three out of 46 (71.73% ) patients with BV had urinary tract infections (UTI) in comparison to (28.27%) without UTI ( P value <0.05). The study showed that BV had a high frequency rate (67.39%) in pregnant women when compared to non-pregnant women (32.61%). Twenty out of 31 (64.51%) pregnant women have premature uterine contractions (PUC ) while only 11 out of 31 (35.49%) presented without PUC ( P value <0.05). Ten out of 15(66.66%) non pregnant women patients were used IUCD in comparison to only 5 out of 15 (33.34%) patients with BV. PCR detection of16S rRNA gene for Gardnerella vaginalis (G. vaginalis) reveal insignificant change in frequency of G. vaginalis in patients with BV (45.65 %) in comparison to control group (36.6%) ( P value > 0.05). As the BV is treatable medical disorder and it's frequently ignored as the symptoms are frequently irrelevant but the clinical consequences could be vital, it can be concluded that medical screening for BV is mandatory specially in antenatal care of pregnancy in Primary Health Care Centers and women using IUCD to avoid future complications.

الهدف من هذه الدراسة هو لتقييم نسبة حدوث الالتهابات المهبلية ومدى علاقتها مع بعض عوامل الخطورة مثل مانع الحمل الرحمي. تمت دراسة (111) حالة مرضية لنساء تعاني من افرازات مهبلية بالإضافة الى 30 حالة كمجموعة سيطرة .تم اخذ العينات المرضية وعينات السيطرة من مستشفى بابل وبعض العيادات الخاصة في الفترة (كانون الثاني- تشرين الثاني 2009). تبين من هذه الدراسة ان 46 من اصل 111 (41.44%) حالة كانت تعاني من الالتهابات المهبلية بالمقارنة مع (10%) من حالات السيطرة مع فارق معنوي. كانت اكثر الحالات المرضية في الاعمار (20-29 سنة)و(30-39 سنة) بالنسب التالية(28.26% :36.95 % بالتتابع). أظهر تعداد الخلايا البيضاء في صبغة الغرام للمسحات المهبلية ان 84.79 % من الحالات المرضية هي اقل من 10 خلية و( 15.21 %) من الحالات اكثر من 10 خلية مع فارق معنوي .كذلك تبين من هذه الدراسة ان 33 من اصل 46(71.73%) حالة التهاب مهبلي كانت تعاني من التهاب المجاري البولية بالمقارنة مع (28.27%) حالة بدون التهاب المجاري البولية مع فارق معنوي. كذلك وجد ان نسبة حدوث الالتهابات المهبلية تكون اكثر في النساء الحوامل (67.39%) بالمقارنة مع غير الحوامل(32.61%). وكان 20 من اصل 31( 64.51%) حالة التهاب مهبلي مع الحمل تعاني من تقلصات رحمية مبكرة بالمقارنة مع 11 من اصل 31 حالة (32.61%) بدون تقلصات رحمية. وتبين كذلك ان 10 من اصل 15 (66.66%) حالة التهاب مهبلي بدون الحمل كان لديها مانع حمل رحمي بالمقارنة مع 5 من اصل 15 (33.34%) حالة وبينت نتائج فحص تفاعل البلمرة المتسلسل عدم وجود فرق احصائي في الكشف الجيني عن بكتريا الغاردنريلة المهبلية بين المرضى الذين يعانون من التهاب مهبلي (45.65%) ومجموعة السيطرة (36.6%). ولكون مرض الالتهابات المهبلية من الامراض التي من الممكن علاجها والتي يتم تجاهلها في اغلب الاحيان بسبب قلة اعراضها ولكون مضاعفاتها مهمة للغاية, يستنتج من هذه الدراسة انه من الواجب ان يتم التحري الطبي خصوصا اثناء مراجعة المرضى الحوامل لمراكز الرعاية الصحية وكذلك النساء اللاتي يستخدمن مانع الحمل الرحمي لتجنب المضاعفات المستقبلية.


Article
Isolation of Candida spp. from Women with Yeast Vaginitis and Study the Effect of Different Types of Douching on Candida spp.

Author: Alaa M. Hasan
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2017 Volume: 16 Issue: 1 Pages: 61-70
Publisher: Baghdad University جامعة بغداد

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Abstract

The interest of current research was to determine the effect of different types of vaginal douching (which are commercially available in pharmacies and legally prescribed by gynecologist to female patients with vaginal yeast candidiasis on Candida species). From ninety seven vaginal swab samples which were collected in the presence of specialized Gynecologist, sixty seven samples were positive, while thirty samples were negative. Candida isolates includes different species as follows, Candida albicans 46 isolates (68.65 %), C. tropicales 11 isolates (16.41 %), C. parasilopses 7 (10.44 %), and C. kyfer 3 isolates (4.47 %). The inhibitory effect (inhibition diameter) of douches was ranged from 50 mm in Gyno Baking Soda to 5 mm in Women Care, while some types of douches had no effect at all. Finally, it was concluded that despite the inhibitory effect for many types of douching on yeast isolates, such douches were cannot be used as a treatment for yeast vaginitis since they may increase the risk of yeast vaginal infection.


Article
Vaginal Flora among Women with and without Bacterial Vaginosis
* الفلورا المھبلیة بین النساء المصابات بالتھاب المھبل البكتیري والنساء غیر المصابات

Author: Rana S. Al-Taweel رنا صالح الطویل†
Journal: journal of al-qadisiyah for pure science(quarterly) مجلة القادسية للعلوم الصرفة (فصلية). ISSN: 19972490 Year: 2016 Volume: 4 Issue: 21 Pages: 39-50
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

This study has been conducted in Al-Diwaniya city through the period from December 2012 toDecember 2013, in order to investigate the prevalence of bacterial vaginosis, and to compare thecomposition of vaginal flora between women with bacterial vaginosis (BV) and those without thesyndrome. Results showed that, according to Nugent ׳s scores, 18 women had BV with aprevalence of 16.07%. Culturing out of vaginal swabs from women has been revealed thatcoagulase-negative staphylococci were the dominant microorganisms in women without BVfollowed by lactobacilli (frequency of 20.63 and 16.66% respectively), while in BV patients thedominant microflora were non-hemolytic streptococci and coagulase-negative staphylococci(frequency, 21.95 and 17.07% respectively). Actinomyces israelii, has been isolated from a BVpatient with a cervical ulcer, this result can assumed as a new record in Iraq .

اجریت الدراسة الحالیة في مدینة الدیوانیة للفترة من شھر كانون الاول 2012 ولغایة شھر كانون الاول 2013 من اجل دراسةانتشار التھاب المھبل البكتیري، بالاضافة الى مقارنة تركیب الفلورا المھبلیة في النساء المصابات بالتھاب المھبل البكتیري والنساء غیر المصابات بالمرض. بینت النتائج بانھ وفقا لنظام نوكنت للعد وجد ان 18 امراة كانت مصابة بالتھاب المھبل بنسبةانتشار 16.07 %. اظھرت نتائج زرع المسحات المھبلیة ان المكورات العنقودیة السالبة لاختبار التخثر كانت اكثر الاحیاءالمجھریة سیادة في النساء غیر المصابات تلتھا عصیات الحلیب بنسب تردد 20.63 % و 16.66 % على التوالي.اما في النساءالمصابات بالالتھاب فكانت الفلورا السائدة ھي المسبحیات غیر الحالة للدم و المكورات العنقودیة السالبة لانزیم التخثر و بنسبمن امراة مصابة بالتھاب ،Actinomyces israelii تردد 21.95 % و 17.07 % على التوالي. تم خلال الدراسة عزل النوعالمھبل البكتیري و تعاني من قرحة في عنق الرحم، ھذه النتیجة یفترض انھا تسجیل لاول مرة لھذا النوع في العراق

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