- Clinical management of uterine cervical mullerian adenosarcoma: A clinicopathological study of six cases and review of the literature. [Journal Article]
- TJTaiwan J Obstet Gynecol 2018; 57(4):479-482
- CONCLUSIONS: The presence of sarcomatous overgrowth and deep cervical stromal invasion are associated with poor prognosis. Along with adequate counseling, fertility-preservation surgery may be an acceptable option for exophytic cervical mullerian adenosarcoma in the cases that do not show sarcomatous overgrowth and deep cervical stromal invasion.
- Vaginal pessaries in the management of symptomatic pelvic organ prolapse in rural Kilimanjaro, Tanzania: a pre-post interventional study. [Journal Article]
- IUInt Urogynecol J 2018 Aug 18
- CONCLUSIONS: Vaginal pessary improves symptoms and quality of life associated with symptomatic POP. Therefore, it may be a treatment option in managing POP in low-income countries such as Tanzania.
- Prior caesarean section and likelihood of vaginal birth, 2012-2016, China. [Journal Article]
- BWBull World Health Organ 2018 Aug 01; 96(8):548-557
- CONCLUSIONS: Promotion of vaginal birth after caesarean section could increase the rate even further in China. To ensure the safety of mothers and their newborns, national policies and guidelines on vaginal birth after caesarean section are needed.
- The changes of antifungal susceptibilities caused by the phenotypic switching of Candida species in 229 patients with vulvovaginal candidiasis. [Journal Article]
- JCJ Clin Lab Anal 2018 Aug 12; :e22644
- CONCLUSIONS: In the study, C. albicans was the commonest pathogenic species in patients with VVC, in which the phenotypic switching was easy to occur. The susceptible rates of C. albicans to all antifungal drugs were higher than that of non-albicans Candida species. The susceptible rate to fluconazole was all influenced by the phenotypic switching in C. albicans and non-albicans Candida species.
- Effects of crowding and water restriction stress on creole goat reproduction in the Oaxacan Sierra Mixteca, Mexico. [Journal Article]
- RDReprod Domest Anim 2018 Aug 09
- Chronic stress disrupts reproductive efficiency. Yet, the manner in which stress disturbs reproduction in goats is currently unknown. The Oaxacan Mixteca region is one of Mexico's poorest, with high ...
Chronic stress disrupts reproductive efficiency. Yet, the manner in which stress disturbs reproduction in goats is currently unknown. The Oaxacan Mixteca region is one of Mexico's poorest, with high levels of deforestation, high ambient temperatures, and lack of water. Native goats of the Oaxacan Mixteca Region live in these stressful conditions, as well as in overcrowded and water restricted conditions. Therefore, the aim of this study was to evaluate the effects of these very stressful conditions on the reproduction of male and female goats. Control group was uncrowded, with daily water supply; stress group was overcrowded, with water restriction. The study was conducted from September 2015 to February 2016; the expression of reproductive behaviour and variations of cortisol levels were assessed. In females, oestradiol and progesterone were evaluated during the oestrous cycle. In males, testosterone levels were evaluated before and during reproductive activity. Sexual behaviour decreased in stressed goats: approaching, tail swishing, urination, vaginal discharge and flank contraction decreased in stressed females. Anogenital sniffing, licking, Flehmen reflex, bleating, mount attempts and mounts decreased in male goats. Cortisol levels in stressed animals were higher compared with control animals. Oestradiol and Progesterone levels in stressed females were significantly lower during the follicular and luteal phase, respectively, compared with control females. Testosterone levels in stressed males were lower than in control males, both before and during reproduction. These results indicate that even though goats from the Oaxacan Mixteca Region are habituated to their environmental conditions, they are still stressed by them, as shown by a higher activation of the adrenal axis in stressed goats than in control goats. High cortisol levels may induce low oestradiol levels in females and low testosterone levels in males, as well as a disruption in the expression of their reproductive behaviour.
- Effect of vaginal suppository on bacterial vaginitis based on Persian medicine (Iranian traditional medicine): a randomised double blind clinical study. [Journal Article]
- JOJ Obstet Gynaecol 2018 Aug 07; :1-5
- This trial was conducted on 127 women aged 18-50 years with bacterial vaginosis to compare the vaginal suppository of metronidazole with Forzejeh, a vaginal suppository of herbal Persian medicine com...
This trial was conducted on 127 women aged 18-50 years with bacterial vaginosis to compare the vaginal suppository of metronidazole with Forzejeh, a vaginal suppository of herbal Persian medicine combination of Tribulus terrestris, Myrtus commuis, Foeniculum vulgare and Tamarindus indica. The patients (63 in metronidazole group and 64 in Forzejeh group) received the medications for 1 week. Their symptoms including the amount and odour of discharge and cervical pain were assessed using a questionnaire. Cervical inflammation and Amsel criteria (pH of vaginal discharge, whiff test, presence of clue cells and Gram staining) were investigated at the beginning of the study and 14 days after treatment. The amount and odour of discharge, Amsel criteria, pelvic pain and cervical inflammation significantly decreased in Forzejeh and metronidazole groups (p = <.001). There was no statistically significant difference between the metronidazole and Fozejeh groups with respect to any of the clinical symptoms or the laboratory assessments. This study showed that Forzejeh, which is an herbal Persian medicine preparation, has a therapeutic effect the same as metronidazole in bacterial vaginosis. Impact statement What is already known on this subject? Bacterial vaginosis (BV) is a common problem in women. Common antibiotics for the treatment of BV include: metronidazole, tinidazole and clindamycin. Unfortunately, treatments often occur with a recurrence and failure. Therefore, alternative treatments are necessary. Many natural treatments are recommended for this condition in Persian Traditional Medicine sources. One of them is the vaginal suppository "Forzejeh" which is the combination of Tribulus terrestris, Myrtus commuis, Foeniculum vulgare and Tamarindus indica. These plants have antimicrobial activities. Forzejeh has been used for the treatment of BV in folk medicine for many years and has been formulated and standardised recently. What do the results of this study add? This study showed that the therapeutic effect of Forzejeh on bacterial vaginosis is similar to metronidazole. What are the implications of these findings for clinical practice and/or further research? A clinical study with a longer follow-up time is suggested for assessing the recurrence of BV after treatment with Forzejeh metronidazole.
- [Primary study on the relationship between high-risk HPV infection and vaginal cervical microbiota]. [Journal Article]
- ZFZhonghua Fu Chan Ke Za Zhi 2018 Jul 25; 53(7):471-480
- Objective: To understand characteristics of vaginal cervical microbiota in high-risk HPV (hrHPV) infected women and to uncover the relationship between hrHPV infection and vaginal cervical microbiot...
Objective: To understand characteristics of vaginal cervical microbiota in high-risk HPV (hrHPV) infected women and to uncover the relationship between hrHPV infection and vaginal cervical microbiota. Methods: All participants were randomly selected from Peking University First Hospital from September to October of 2017, including 5 subjects of control group, 5 cases of HPV16/18 group, 5 cases of other hrHPV infected group and 3 cases of cervical squamous carcinoma group. All subjects were required to fill in a questionnaire, and cervical and vaginal discharges were separately collected for microscopic examination and new generation sequencing targeting the variable region (V3-V4) of bacterial 16S rRNA gene. Results: Vaginal microbiota analysis: (1) 6 major phylum were found in vaginal microbiota:Firmicutes, Bacteroidetes, Fusobacteria, Actinobacteria, Tenericutes and Proteobacteria. Firmicutes contributed to the majority of normal vaginal flora, Bacteroidetes and Fusobacteria increased in hrHPV infected ones, while Fusobacteria showed significant difference in cervical carcinoma group. (2) Lactobacillus occupied most of normal vaginal flora while genus like Gardnella, Prevotella, Atopobium, Megasphaera and Sneathia increased in hrHPV infected subjects, Sneathia showed significant difference in cervical carcinoma group. (3) No significant difference had been calculated in Alpha diversity of four groups (P=0.073) . Cervical microbiota analysis: (1) Microbial diversity of cervical microbiota was higher than that of vaginal microbiota. (2) Significant difference had been found in Alpha diversity of four groups (P=0.046) . (3) Proteobacteria in normal cervical flora was much more than that in vagina, and Proteobacteria increased significantly in hrHPV infected cervical discharge. (3) Chlamydia increased significantly in cervical carcinoma group. Conclusions: The diversity of cervical microbiota is higher than that of vaginal microbiota. Change in cervical microbiota is more obvious than that of vagina in hrHPV infected subjects. Fusobacteria-Sneathia and Chlamydia significantly increase in cervical carcinoma group. Proteobacteria might relate to hrHPV infection.
- Metritis diagnosis and treatment practices in 45 dairy farms in California. [Journal Article]
- JDJ Dairy Sci 2018 Aug 01
- Minimizing the risk of antimicrobial-resistant organisms and antimicrobial residues in dairy and dairy beef products is a topic of nationwide interest. To design an effective outreach program on judi...
Minimizing the risk of antimicrobial-resistant organisms and antimicrobial residues in dairy and dairy beef products is a topic of nationwide interest. To design an effective outreach program on judicious use of antimicrobials, it is imperative to describe actual practices on dairies. Thus, our objective was to report current practices for metritis treatment in 45 dairies in California. Data were collected using a survey tool that included questions on systemic antimicrobial treatments, intrauterine treatments, supportive treatments, and treatment records. Researchers collected information based on cow-side observations and responses from fresh cow evaluators. Most dairies (n = 33; 70%) performed rectal exams for vaginal discharge (VD) evaluation and based systemic antimicrobial administration on the presence of (a) abnormal VD (fetid and nonfetid), regardless of fever (n = 11; 25%); (b) fever regardless of the odor of abnormal VD (n = 11; 25%); (c) fetid VD and fever (n = 1; 2%); (d) fetid VD (n = 3; 9%); or (e) fetid VD or fever (n = 3; 9%). Some dairies (n = 11; 24%) only detected abnormal VD if visible on tail, vulva, or floor; treatment decisions were based on the presence of abnormal VD (n = 9; 20%) or abnormal VD and fever (n = 2; 4%). On 3 (6%) dairies, VD characteristics were evaluated after rectal palpation, but no systemic treatments were administered. Cows exhibiting 1 nonspecific sign of health disorder (depressed general appearance, lack of appetite, or drop in milk yield) plus fever (n = 13; 29%), or even regardless of fever (n = 6; 13%), were treated with systemic antimicrobials. Overall, 8 (18%) dairies justified systemic antimicrobial treatment based on fever alone. Systemic antimicrobials used were ceftiofur products [ceftiofur hydrochloride (n = 26; 55%), ceftiofur sodium (n = 3; 7%), and ceftiofur crystalline-free acid (n = 8; 18%)], penicillin procaine (n = 8; 18%), and ampicillin (n = 3; 7%). Intrauterine infusions were done with penicillin procaine (n = 1; 2%) or oxytetracycline (n = 12; 27%). The dose and treatment length varied across dairies for i.m. ceftiofur hydrochloride (15 to 45 mL/d for 3 to 5 d), s.c. ceftiofur crystalline-free acid (20 to 25 mL once or twice), i.m. ceftiofur sodium (15 to 30 mL/d for 3 to 5 d), i.m. penicillin procaine (20 to 60 mL/d for 3 to 6 d), and i.m. ampicillin (25 to 35 mL/d for 3 to 6 d). The antimicrobial drug of choice, the dose, and the treatment length for metritis varied across the study dairies. Based on accepted industry best-management practices for metritis, a need exists to educate fresh cow evaluators on signs of health disorder indicative of metritis and on appropriate antimicrobial treatment regimens.
- Effect of incomplete milking during the first 5 days in milk on udder and reproductive tract health: Results from a randomized controlled trial. [Journal Article]
- JDJ Dairy Sci 2018 Aug 01
- The aim of this study was to investigate the effect of an incomplete milking on risk of mastitis and reproductive tract disease. Multiparous dairy cows (n = 878) from 13 commercial herds were enrolle...
The aim of this study was to investigate the effect of an incomplete milking on risk of mastitis and reproductive tract disease. Multiparous dairy cows (n = 878) from 13 commercial herds were enrolled in a randomized controlled trial. Cows were randomly assigned to either a control (milked conventionally) or a treatment group, which consisted of an incomplete milking (10-14 L of milk collected/d) from 1 to 5 d in milk (DIM). Quarter milk samples were collected at approximately 11 and 18 DIM to measure somatic cell count (SCC). Quarters were considered negative for intramammary infection if SCC was <100,000 cells/mL and positive if SCC was ≥200,000 cells/mL. To calculate intramammary infection incidence, negative quarters of the initial samples collected were tested again 1 wk later. This was done to deter incidence of positive quarters. To calculate elimination rate, positive quarters were tested again 1 wk later to detect mastitis elimination. Farmers recorded clinical mastitis events. Cows were also examined at approximately 35 DIM with a Metricheck device (Simcro, Hamilton, New Zealand) for detection of purulent vaginal discharge (PVD) and with an endometrial cytobrush for presence of leukocytes [endometrial cytology for smear (ENDO) and for leukocyte esterase test (LE)]. A threshold ≥3 was used to define a positive PVD or LE test, whereas a polymorphonuclear cell count ≥6% was used to define a positive ENDO. Five generalized mixed models with cow or herd as random intercepts were used to determine the effects of incomplete milking on odds of new intramammary infection, odds of intramammary infection elimination, and odds of a positive PVD, LE, or ENDO status. To investigate time until first clinical mastitis event, a Cox model with a herd frailty term was used. The odds of new intramammary infection and intramammary infection elimination for incompletely milked cows were 0.90 [95% confidence interval (CI): 0.49, 1.7] and 2.9 (95% CI: 1.4, 6.0) times those of conventionally milked cows, respectively. The hazard of clinical mastitis in incompletely milked cows was 0.96 (95% CI: 0.59, 1.6) times that of conventionally milked cows. The odds of PVD, LE, and ENDO for incompletely milked cows were 1.4 (95% CI: 0.89, 2.1), 1.3 (95% CI: 0.88, 1.8), and 1.2 (95% CI: 0.81, 1.7) times those of conventionally milked cows. These results suggest that incomplete milking during the first 5 DIM increases the odds of a decrease in SCC from 11 to 18 DIM but does not affect odds of increase in SCC in the same period. The incomplete milking had no effect on clinical mastitis incidence in the first 90 DIM or on reproductive tract health at 35 DIM.
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- A Randomized, Open-labelled, Interventional Study to Evaluate the Incidence of Infection with or Without Use of Prophylactic Antibiotics in Patients of Episiotomy in a Normal Vaginal Delivery. [Journal Article]
- JOJ Obstet Gynaecol India 2018; 68(4):294-299
- CONCLUSIONS: To summarise, in our study, it was seen that prophylactic antibiotics did not decrease the incidence of infection in episiotomy following normal vaginal delivery in uncomplicated cases, but further studies are required to evaluate this topic and come to a more definitive conclusion.