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7.PREVALENCE AND DIAGNOSIS OF SEXUALLY TRANSMITTED PATHOGENS IN A SAMPLE OF IRAQI WOMEN: A MOLECULAR STUDY

Authors: Mariam K. Ali مريم كريم علي --- Huda D. Hathal هدى ظاهر هذال --- Hala A. Almoayed هالة عبد القادر المؤيد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 4 Pages: 364-376
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Sexually transmitted infections (STI), also referred to as sexually transmitted diseases (STD) and venereal diseases (VD), are infections that are commonly spread by sex, especially vaginal intercourse, anal sex and oral sex. Most STIs initially do not cause symptoms. This results in a greater risk of passing the disease on to others. Symptoms and signs of disease may include: vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain.Objective: To detect the two microorganisms (Gardnerella vaginitis (G. vaginalis) and Trichomonas vaginalis (T. vaginalis)) in the same sample taken from women with genital tract infection by microbiological and molecular methods and to investigate the contributions of some socioeconomic factors and clinical features.Methods: Two hundred samples were collected from females attending the Gynecology out-patient department in the Al-Imamein Al-Kadhimein Medical City and Baghdad Teaching Hospital during the period from May 2014 to April 2015. Based on availability of full clinical information about each patient, high vaginal swabs were taken from females at different ages (15-54 years) representing patients group complaining of abnormal vaginal discharge with or without other symptoms, questionnaire was applied. The two diseases associated with vaginal infection include G. vaginalis and T. vaginalis. Each of the vaginal swabs collected was examined microscopically, whilst the remaining was preserved at -20 °C for DNA extracts were analyzed with the real-time poly meres chain reaction (RT-PCR). Results: In RT-PCR, the rate of infection was 120 (60%) G. vaginalis, and 34 (17%) T. vaginalis. Highest rate of infection in women with G. vaginalis was among age group (15-24) years and (25-34) years 38.3%, 35.0% respectively, the lowest rate was among age group (45-54) years 8.3 %. In T. vaginalis, the highest rate of infection was among age group (15-24) years 61.7 %, the lowest was among age group (35-44) years 8.8 % and on infection in age 45-54years.Conclusion: The commonest genital tract infections among women were G. vaginalis and T. vaginalis. Molecular methods are considered the gold standard for diagnosis, given the excellent sensitivities and specificities in diagnosis. Presence of clinical symptoms helps and lab diagnosis of infection. Vaginal swab samples showed that most common co-infection is between G. vaginalis cases and T. vaginalis.Keywords: Sexually transmitted infections, Gardnerella vaginalis, Trichomonas vaginalis, molecular studyCitation: Ali MK, Hathal HD, Almoayed HA. Prevalence and Diagnosis of sexually Transmitted Pathogens in A Sample of Iraqi Women: A Molecular Study. Iraqi JMS. 2017; Vol. 15(4): 364-376. doi: 10.22578/IJMS.15.4.7


Article
Bacterial vaginosis and other infectious agents in preterm labour in Kirkuk province.
داء المهبل الجرثومي ومسببات عوامل الأمراض الأخرى في النساءاللواتي يعانين من الحمل السابق لأوانها في محافظة كركوك

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Abstract

Preterm labour was known as occurrence of delivery before completing 37 weeks of gestation, through which reduction in normal vaginal flora will occur specially lactobacilli in addition to change of pH, which may lead to increases of some aerobic bacteria such Gardnerella vaginalis , so this study was conducted to assess bacterial vaginosis rate among women with preterm labour. From the period of 1st of December2008 to 31th 2009 retrospective study was carried on in Suliamania teaching and Azadi teaching Hospitals. Seventy five women were enrolled in the study, their age ranged from 15 to 45 years. For each patient special questionnaire form was filled ,also for each high vaginal swab(HVS) was tested for color,pH,whiff test and Clue cells in addition to cultivation of HVS & urine for detecting other bacterial isolates. Women with polyhydraminos, multiple pregnancy, cervical incompetence, malformed uterine & drug addict were discharged from the study. The results were revealed the all rate of infection 76.67 % which included bacterial infection 42.67%(high rate 16.07 % with Escherichia coli and the low rate was with Proteus species),followed by 33.33 %,18.67 % & 8 % for, Gardnerella vaginalis, Candiada albicans & Trichomonas vaginalis respectively P<0.05.Gardnerella vaginalis was seen in 21 samples as pure cases with the rate 84 % mostly associated with clue cells & pH ranged from 6 to 8 with the rate of 26.42 %, Moblincus species rate was 9.12 %. Relationship between patient residency, age in regard bacterial vaginosis & other microorganisms’ distribution were not statistically significant. History of vaginal discharge, disparunia, rupture membrane & vaginal itching in association to microbial distribution were significant P<0.05.

تعرف الولادة السابقة لأوانها بولادة مولود قبل إتمام الأسبوع السابع و الثلاثون من الحمل .اختزال أعداد البكتريا الطبيعية للمهبل وبخاصة العصيات اللبنية وكذلك التغيير في باهاء المهبل إلى المعتدل يؤدي إلى زيادة في تكاثر البكتريا المسببة لداء المهبل الجرثومي (Bacterial vaginosis) وتشمل: Gardenella vaginalis وغيرها من الجراثيم .تم أقتراح اجراء الدراسة لمعرفة نسبة انتشار الداء المهبلي بين النساء الواتي يعانين من الولادة السابقة لاوانها في مستشفى الولادة التعليمي في السليمانية و مستشفى ازادي التعليمي في كركوك،من كانون الاول 2008 ولغاية حزيران 2009. شملت الدراسة 75 امرأة تتراوح أعمارهم بين (15-45) سنة ،حامل بين أسبوع (24-37 ) يعانون من الولاده السابقة للاوانها سواء ولادة بكر او ولادة متكررة ،تم اختيارهم بطريقة عشوائية .تم جمع المعلومات عن طريق استبيان معد لهذا الغرض،و تضمنت الطرق المختبرية: فحص القطيلات المهبلية من حيث اللون ،الباهاء واستخدام طريقة الويف (Whiff test)لتحديد رائحة الأمين المتحررة من تواجد المستديمة المهبلية،وتم التاكد من الفحص بتحديد خلايا كلو(Clue cell) في المسحات المحضرة من الإفرازات المهبلية المصبوغة بطريقة غرام . المسحة الماخوذة من أعلى المهبل ( high vaginal swab) لغرض الزرع الجرثومي وتضمن البحث ايضا فحص البول العام والأستنبات الجرثومي للبول ومسحات اعلى المهبل وتم استعمال فحص السونارواغراض تشخيصية أخرى .النساء الحوامل اللواتي تم استبعادهم من البحث: زيادة السائل الامنيوسي, الحمل متعدد الاجنه ,رخاوة في عنق الرحم ,تشوهات الرحم والمدمنات على الكحول ,كافائين والتدخين.

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