Infection in the couple may lead to failure of fertility treatment ,hence proper screening and management of the condition is mandatory before starting fertility treatment.
Sexually transmitted disease in pregnancyDR MUKESH SAH
An STI during pregnancy can pose serious health risks for you and your baby. As a result, screening for STIs , such as human immunodeficiency virus (HIV), hepatitis B, chlamydia and syphilis, generally takes place at the first prenatal visit for all pregnant women.
Most pregnant women who carry group B streptococcus (GBS) bacteria have healthy babies.
But there's a small risk that GBS can pass to the baby during childbirth.
Sometimes GBS infection in newborn babies can cause serious complications that can be life threatening, but this is not common.
Extremely rarely, GBS infection during pregnancy can also cause miscarriage, early (premature) labour or stillbirth.
GBS is one of many bacteria that can be present in our bodies. It does not usually cause any harm.
When this happens, it's called carrying GBS, or being colonised with GBS.
It's estimated about 1 pregnant woman in 5 in the UK carries GBS in their digestive system or vagina.
Around the time of labour and birth, many babies come into contact with GBS and are colonised by the bacteria.
Most are unaffected, but a small number can become infected.
If a baby develops GBS infection less than 7 days after birth, it's known as early-onset GBS infection.
Most babies who become infected develop symptoms within 12 hours of birth.
Symptoms include:
• being floppy and unresponsive
• not feeding well
• grunting
• a high or low temperature
• fast or slow heart rates
• fast or slow breathing rates
irritability
Late-onset GBS infection
Late-onset GBS infection develops 7 or more days after a baby is born. This is not usually associated with pregnancy.
The baby probably became infected after the birth. For example, they may have caught the infection from someone else.
GBS infections after 3 months of age are extremely rare.
Breastfeeding does not increase the risk of GBS infection and will protect your baby against other infections.
Group of communicable diseases in which sexual contact is the most important mode of transmission.
Importance:
1. Increasing incidence worldwide.
2. The cost and difficulties in the treatment of the diseases and their complications.
3. It is a socioeconomic problem as well as behavioral one since it is linked to addiction, low level of religious values, increase age of marriage, etc.
THE PHARMACOLOGY AND EFFICACY OF ANTIFUNGALS: A LITERATURE REVIEWPARUL UNIVERSITY
Antifungal medications, also known as antimycotic medication
are pharmaceutical fungicide or fungistatic agents used to treat
and prevent mycosis either topically or systematically. A fungal
infection may be superficial, systemic, subcutaneous, or allergic
in nature. Polyenes, echinocandins, antimetabolites, and azoles
have a major role in the antifungal classification. Many topical
antifungals have been available since the antiseptic era. Two
important antibiotics, amphotericin B, to deal with systemic
mycosis, and griseofulvin to supplement attack on
dermatophytes were introduced around 1960. Antifungal
property or flucytosine was noted in 1970, but it could serve
only as a companion drug to amphotericin. The development of
imidazoles in the mid-1970s and triazoles in the 1980s provided
safer and more convenient alternatives to amphotericin B and
griseofulvin. Terbinafine is a novel antifungal. A group of
potent semisynthetic antifungal antibiotics, the echinocandins
are the latest addition. The selection of an appropriate
antifungal agent depends upon the susceptibility of the
organism, and the adverse effects of the drug. Antifungal
pharmacokinetic properties are often the most important
consideration in drug selection because impaired GI tract
function or reduced renal/hepatic drug clearance can profoundly
influence the safety and efficacy of antifungal therapy. Despite
the advances, serious fungal infections remain problematic to
treat with emerging clinical resistance to the available drugs
Bacteriuria in Pregnant and Non Pregnant Women in Benghazi Acomparative StudyIOSRJPBS
Background: Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not well known in our community. Objectives: Determine the prevalence and predictors of bacteriuria in women of the Benghazi, Libya as well as the antibiotic sensitivity patterns of bacterial isolates. Methods: Across-sectional study was carried out amongst pregnant and non pregnant women attending many poly clinics in Benghazi. We recruited 120 consenting women (60 pregnant and 60 non pregnant) for the study. Demographic and clinical data were collected using structured questionnaire. Clean catch midstream urine was collected from each participant. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of 105 bacteria per ml of cultured urine. Identification and susceptibility of isolates was performed using API (BioMerieux, France Company) . Results: Significant bacteriuria was found in the urine of 13.3 % (16) of all women with prevalence of 16.7% in pregnant women. Asymptomatic bacteriuria was detected in 8.3 % (10). The most frequent isolates were Staphylococcus aureus(31.2%),Escherichia coli (25%), Staphylococcus saprophyticus (18.9%), and were sensitive to gentamycin (GN) 87.5%, azithromycin (AZM)75%, and the less effective antibiotics were cephalexine (CL) and ampicillin(AMP) Conclusion: Bacteriuria is frequent in women particularly pregnant women suggesting the need for routine screening by urine culture,which would allow early treatment to avoid the complications. In addition, urinary tract infections appears to be multifactorial.
Cervical cancer (CC) is 80% of global burden, the second most common cancer in women worldwide and leading cancer in Indian women. Approximately 40 Human papillomavirus (HPV) types infect cervix through sexual transmission [1,2]. HPV is a chronic disease and product of infection of sexually active women along with poverty, lower education level, low standards, multiparity, multiple sexual partners, using oral contraceptive pills, tobacco smoking, illiteracy, malnutrition and poor genital hygiene, dietary deficiencies of vitamins, co-infection with HIV, Herpes simplex virus type 2, Chlamydia trachomatis, bacterial vaginosis immunosuppressant drugs are all co-factors that progress from HPV infection to CC [3]. These co-factors are un-addressed widespread issues in the undeveloped sectors of the world. Intervention to increase program to prevent the development of unhealthy life behaviors and reduce the non-HPV risk factors can have immense impact on decreasing morbidity and mortality of genital malignancies and many preventable communicable and non-communicable human ailments [4]. It is unrecognized infection without any specific discern signs and symptoms.
#what is listeriosis #,listeria monocytoges ,#what is the mode of transmission,#food-born infection ,#vertical infection ,#early and late onset ,#meningitis و#Sepsis ;#Early vs.Late onset neonatal listeriosis ,diagnosis of neonatal listeriosis ,treatment of neonatal listeriosis ,prevention of neonatal listeriosis
Sexually transmitted disease in pregnancyDR MUKESH SAH
An STI during pregnancy can pose serious health risks for you and your baby. As a result, screening for STIs , such as human immunodeficiency virus (HIV), hepatitis B, chlamydia and syphilis, generally takes place at the first prenatal visit for all pregnant women.
Most pregnant women who carry group B streptococcus (GBS) bacteria have healthy babies.
But there's a small risk that GBS can pass to the baby during childbirth.
Sometimes GBS infection in newborn babies can cause serious complications that can be life threatening, but this is not common.
Extremely rarely, GBS infection during pregnancy can also cause miscarriage, early (premature) labour or stillbirth.
GBS is one of many bacteria that can be present in our bodies. It does not usually cause any harm.
When this happens, it's called carrying GBS, or being colonised with GBS.
It's estimated about 1 pregnant woman in 5 in the UK carries GBS in their digestive system or vagina.
Around the time of labour and birth, many babies come into contact with GBS and are colonised by the bacteria.
Most are unaffected, but a small number can become infected.
If a baby develops GBS infection less than 7 days after birth, it's known as early-onset GBS infection.
Most babies who become infected develop symptoms within 12 hours of birth.
Symptoms include:
• being floppy and unresponsive
• not feeding well
• grunting
• a high or low temperature
• fast or slow heart rates
• fast or slow breathing rates
irritability
Late-onset GBS infection
Late-onset GBS infection develops 7 or more days after a baby is born. This is not usually associated with pregnancy.
The baby probably became infected after the birth. For example, they may have caught the infection from someone else.
GBS infections after 3 months of age are extremely rare.
Breastfeeding does not increase the risk of GBS infection and will protect your baby against other infections.
Group of communicable diseases in which sexual contact is the most important mode of transmission.
Importance:
1. Increasing incidence worldwide.
2. The cost and difficulties in the treatment of the diseases and their complications.
3. It is a socioeconomic problem as well as behavioral one since it is linked to addiction, low level of religious values, increase age of marriage, etc.
THE PHARMACOLOGY AND EFFICACY OF ANTIFUNGALS: A LITERATURE REVIEWPARUL UNIVERSITY
Antifungal medications, also known as antimycotic medication
are pharmaceutical fungicide or fungistatic agents used to treat
and prevent mycosis either topically or systematically. A fungal
infection may be superficial, systemic, subcutaneous, or allergic
in nature. Polyenes, echinocandins, antimetabolites, and azoles
have a major role in the antifungal classification. Many topical
antifungals have been available since the antiseptic era. Two
important antibiotics, amphotericin B, to deal with systemic
mycosis, and griseofulvin to supplement attack on
dermatophytes were introduced around 1960. Antifungal
property or flucytosine was noted in 1970, but it could serve
only as a companion drug to amphotericin. The development of
imidazoles in the mid-1970s and triazoles in the 1980s provided
safer and more convenient alternatives to amphotericin B and
griseofulvin. Terbinafine is a novel antifungal. A group of
potent semisynthetic antifungal antibiotics, the echinocandins
are the latest addition. The selection of an appropriate
antifungal agent depends upon the susceptibility of the
organism, and the adverse effects of the drug. Antifungal
pharmacokinetic properties are often the most important
consideration in drug selection because impaired GI tract
function or reduced renal/hepatic drug clearance can profoundly
influence the safety and efficacy of antifungal therapy. Despite
the advances, serious fungal infections remain problematic to
treat with emerging clinical resistance to the available drugs
Bacteriuria in Pregnant and Non Pregnant Women in Benghazi Acomparative StudyIOSRJPBS
Background: Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not well known in our community. Objectives: Determine the prevalence and predictors of bacteriuria in women of the Benghazi, Libya as well as the antibiotic sensitivity patterns of bacterial isolates. Methods: Across-sectional study was carried out amongst pregnant and non pregnant women attending many poly clinics in Benghazi. We recruited 120 consenting women (60 pregnant and 60 non pregnant) for the study. Demographic and clinical data were collected using structured questionnaire. Clean catch midstream urine was collected from each participant. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of 105 bacteria per ml of cultured urine. Identification and susceptibility of isolates was performed using API (BioMerieux, France Company) . Results: Significant bacteriuria was found in the urine of 13.3 % (16) of all women with prevalence of 16.7% in pregnant women. Asymptomatic bacteriuria was detected in 8.3 % (10). The most frequent isolates were Staphylococcus aureus(31.2%),Escherichia coli (25%), Staphylococcus saprophyticus (18.9%), and were sensitive to gentamycin (GN) 87.5%, azithromycin (AZM)75%, and the less effective antibiotics were cephalexine (CL) and ampicillin(AMP) Conclusion: Bacteriuria is frequent in women particularly pregnant women suggesting the need for routine screening by urine culture,which would allow early treatment to avoid the complications. In addition, urinary tract infections appears to be multifactorial.
Cervical cancer (CC) is 80% of global burden, the second most common cancer in women worldwide and leading cancer in Indian women. Approximately 40 Human papillomavirus (HPV) types infect cervix through sexual transmission [1,2]. HPV is a chronic disease and product of infection of sexually active women along with poverty, lower education level, low standards, multiparity, multiple sexual partners, using oral contraceptive pills, tobacco smoking, illiteracy, malnutrition and poor genital hygiene, dietary deficiencies of vitamins, co-infection with HIV, Herpes simplex virus type 2, Chlamydia trachomatis, bacterial vaginosis immunosuppressant drugs are all co-factors that progress from HPV infection to CC [3]. These co-factors are un-addressed widespread issues in the undeveloped sectors of the world. Intervention to increase program to prevent the development of unhealthy life behaviors and reduce the non-HPV risk factors can have immense impact on decreasing morbidity and mortality of genital malignancies and many preventable communicable and non-communicable human ailments [4]. It is unrecognized infection without any specific discern signs and symptoms.
#what is listeriosis #,listeria monocytoges ,#what is the mode of transmission,#food-born infection ,#vertical infection ,#early and late onset ,#meningitis و#Sepsis ;#Early vs.Late onset neonatal listeriosis ,diagnosis of neonatal listeriosis ,treatment of neonatal listeriosis ,prevention of neonatal listeriosis
Yeast infections are generally caused by an organism called Candida albicans. Natural cures are simple, less expensive, and by far the most important point, they actually work. Get few tips for avoiding this disease with ease.
http://www.yeastinfectionheal.com/
Yeast infections are generally caused by an organism called Candida albicans. Natural cures are simple, less expensive, and by far the most important point, they actually work. Get few tips for avoiding this disease with ease.
http://www.yeastinfectionheal.com/
Pathogenesis, Diagnosis and Treatment of Vaginitis and Cervicitis in Clinic...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Discussing sexually transmissible diseases, body defense, resistance to infection, susceptibility of infection, prevention and possible management and conclusion.
Gynecologic diseases in childhood are common. This review is intended to enable careful and sound management of pediatric patients as the initial assessment is paramount to proper management.
Endometriosis is a painful disorder and can reduce fertility if not treated early. Endometriosis most commonly involves ovaries, fallopian tubes and the tissue lining pelvis.Endometriosis can be a challenging condition to manage.
Fertility enhancing surgeries are usually advised to young women with suspected minimal to moderate disease of tubes, ovaries or uterus.
https://www.femelife.com/ivf-fertility-care/fertility-enhancing-surgeries/
PCOS- An insight into polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is extremely prevalent and probably constitutes the most frequently encountered endocrine (hormone) disorder in women of reproductive age
Melatonin, a pineal hormone that regulates circadian rhythms, has also been shown to exhibit unique oxygen scavenging abilities. Melatonin supplementation in IVF may lead to better pregnancy rates. Hence role for melatonin in gamete biology is under research.
PGD combines advances in Molecular genetics and in assisted reproductive technology and is conducted before the embryo is placed inside the womb of the woman.Pre implantation genetic diagnosis was introduced to prevent the inheritance of sex linked diseases
A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility
Significant increase in live birth rate is found when IUI is done with stimulation compared with IUI in natural cycle in women with Unexplained Infertility .
Embryogenesis is the process by which the embryo forms and develops. In mammals, the term refers chiefly to early stages of prenatal development from conception to 8 weeks of pregnancy .Later it is referred to as fetogenesis
Sperm is the male reproductive cell and its main sperm function is to reach the ovum and fuse with it to deliver two sub-cellular structures called embryoOn average, each time a man ejaculates he releases nearly 100 million sperm but it takes only one to make a baby .To meet the waiting egg, semen must travel from the vagina to the fallopian tubes, a tough journey that few sperm survive.
An oocyte is a female gametocyte or germ cell involved in reproduction.It is an immature ovum or an egg
An oocyte is produced in the ovary during female gametogenesis.The female germ cells produce a primordial germ cell pgc which undergoes mitosis to form an oogonium
During oogenesis the oogonium becomes a primary oocyte
Oogenesis consists of several sub processes – oocytogenesis, ootidogenesis and the maturation to form an ovum
Folliculogenesis is a separate sub process and supports all three oogenetic sub process
Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilisation. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilisation.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
Dr. David Greene R3 stem cell Breakthroughs: Stem Cell Therapy in CardiologyR3 Stem Cell
Dr. David Greene, founder and CEO of R3 Stem Cell, is at the forefront of groundbreaking research in the field of cardiology, focusing on the transformative potential of stem cell therapy. His latest work emphasizes innovative approaches to treating heart disease, aiming to repair damaged heart tissue and improve heart function through the use of advanced stem cell techniques. This research promises not only to enhance the quality of life for patients with chronic heart conditions but also to pave the way for new, more effective treatments. Dr. Greene's work is notable for its focus on safety, efficacy, and the potential to significantly reduce the need for invasive surgeries and long-term medication, positioning stem cell therapy as a key player in the future of cardiac care.
This document is designed as an introductory to medical students,nursing students,midwives or other healthcare trainees to improve their understanding about how health system in Sri Lanka cares children health.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...The Lifesciences Magazine
Cold Sores, medically known as herpes labialis, are caused by the herpes simplex virus (HSV). HSV-1 is primarily responsible for cold sores, although HSV-2 can also contribute in some cases.
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
Feeding plate for a newborn with Cleft Palate.pptxSatvikaPrasad
A feeding plate is a prosthetic device used for newborns with a cleft palate to assist in feeding and improve nutrition intake. From a prosthodontic perspective, this plate acts as a barrier between the oral and nasal cavities, facilitating effective sucking and swallowing by providing a more normal anatomical structure. It helps to prevent milk from entering the nasal passage, thereby reducing the risk of aspiration and enhancing the infant's ability to feed efficiently. The feeding plate also aids in the development of the oral muscles and can contribute to better growth and weight gain. Its custom fabrication and proper fitting by a prosthodontist are crucial for ensuring comfort and functionality, as well as for minimizing potential complications. Early intervention with a feeding plate can significantly improve the quality of life for both the infant and the parents.
2. Genital infection is an important cause of infertility
worldwide, affecting not only Fallopian tubes but all
anatomic urogenital sites, both male and female.
Chlamydia trachomatis , gonococus, Candida,
Escherichia coli and Klebsiella
pneumoniae,Ureaplasma urealyticum and
Mycoplasma hominis are commonly found
organisms.
3. Chlamydia is the predominant pathogen detected in
about 20% of cases of acute salpingitis
In a study of 286 women undergoing 344 oocyte
retrievals, seropositivity for chlamydia and the
presence of bacterial vaginosis were highly
associated with tubal disease
4. subclinical infection and fertility –
focused on two potential pathogens: Chlamydia
trachomatis and Mycoplasma species.
Positive Chlamydia cultures may be higher among
infertile patients than among controls
Mycoplasma - recovered from the cervical mucus
and semen of infertile couples.
5. Pelvic inflammatory disease is still a frequent cause
of infertility.
approximately 5-10% of the time, women with pelvic
inflammatory disease (PID) develop the most severe
form which is a tubo-ovarian abscess (TOA)
Sexually transmitted diseases or STDs, are the
most common infection associated with male
infertility.
6. Infectious processesmay lead to
deterioration of spermatogenesis,
impairment ofsperm function and/or
obstruction of the seminal tract
7. Ureaplasma urealyticumin human semen varies from 10
to 40%.
Enterobacteria can evenbe found in up to 90% of semen
samples
Chlamydia trachomatis is the mostfrequent sexually
transmitted bacterial organism in industrializedcountries
It is suggested that its main influence is due tosexual
transmission resulting in tubal disease and subsequent
infertility in the female partner rather than a direct
influenceon male reproductive functions
8. Detectionof bacteria in semen does not necessarily
signify infectionsince bacteriospermia may represent
contamination, colonizationor infection.
The effect of leukocytospermiaon male fertility is
controversial. This is probably due todifferent detection
methods, different populations studied andto the fact that
leukocyte subtypes in semen may have different
functions. In addition to potentially negative effects,
leukocytesmay even have protective effects on
spermatozoa
9. Human immunodeficiency virus type-1 (HIV-1)
affects mostly menand women in their reproductive
years.
For those who have accessto highly active
antiretroviral therapy (HAART), the courseof HIV-1
infection has shifted from a lethal to a chronic
disease
10. Both sexual and perinataltransmission
the level ofviral replication
(being almost negligible in patients withundetectable
viremia)
Assisted reproductionafter ‘sperm washing' may further
reduce the chances ofinfection
11. The predictors ofsuccess of intrauterine insemination
following sperm washingin HIV+
men, as well as
assessing the effect of HIV on spermparameters -James
D.M. Nicopoullos1(
Human Reproduction 2004
19(10):2289-2297)
When sperm characteristics were correlated with
markers of HIVinfection a significant positive correlation
between CD4 cellcount and ejaculate volume, sperm
concentration, total spermcount, sperm motility,
progressive motility and sperm morphology was found
12. In the USA in 1990, the Centers for Disease Control
recommendedagainst insemination of women with
semen from men infected withHIV, following a single
report of HIV transmission to a womanwho
underwent IUI using sperm from her HIV+
husband
Undetectable viral load andthe use of anti-retrovirals
improve the outcome of IUI/spermwashing in HIV+
men.
13. HPV is the most common viral sexually transmitted
disease affecting reproductive aged women.
Each year, 30 million people contract the HPV virus
according to the World Health Organization
. In most women, HPV infections do not produce any
illness or symptoms
14. the medical journal Fertility and Sterility reported a
study performed in New York.
patients with HPV were less likely to become
pregnant after undergoing IVF. The pregnancy rate
in HPV positive patients was 23.5%; in those without
HPV it was 57%.
15. The long-term studies conducted in Sweden found
that women's risk of infertility increased with each
episode of PID:
The risk of infertility with one PID episode was 8
percent; with two, 19 percent; and with three or
more, 40 percent.
The risk of infertility increased directly with the
observed severity of tubal inflammation
16. DO ALL NEED TREATMENT ?
WHICH INFECTIONS NEED TREATMENT ?
DOES THE PARTNER NEEDS TREATMENT ?
TREATMENT VS NO TREATMENT- EFFECT ON INFERTILITY
OUTCOME
17. bacterial vaginosis is a condition that results when high
concentrations of anaerobic bacteria replace the normal H2 O2
-producing lactobacillus species in the vagina.
. Blackwell et al. have contrasted treatment of 7 days of
metronidazole with a regimen of 2 g of metronidazole divided over
12 hours. They described a 95% cure rate with 7 days versus a 75%
cure rate with single-day therapy.
Purdon et al. found similar results, with 67% of women treated with
single-day therapy and 86% of patients cured receiving the 7-day
course.
18. Women who are allergic to metronidazole, or
resistant cases, should be treated with oral
clindamycin 300 mg every 12 hours for 7 days.
Concurrent treatment of the male partner is
controversial.
The male partner should be treated if there is
recurrent vaginitis or any suspicion of associated
upper genital tract infection.
19. Many women who harbor Trichomonas in their
vaginal secretions are free of symptoms
T. vaginalis is a highly contagious sexually
transmitted disease
Metronidazole (Flagyl, Protostat) is the treatment of
choice for T. vaginalis infection.
20. The asymptomatic female who has Trichomonas
identified in the lower genital urinary tract definitely
should be treated
Women who have recurrence have in most cases
either been reinfected or complied poorly with
therapy
If the conventional regimen is not successful, the
woman should be treated with a single 2 g dose of
metronidazole once a day for 5 days
21. One of the continuing debates regarding therapy is treatment of the
asymptomatic male partner.
Gardner and Dukes documented a 2.5-fold greater reinfection rate
when the sexual partner was not treated.
Some physicians elect to treat the male partner only when the
vaginitis is recurrent.
Trichomonas infection should be treated in a similar fashion to any
sexually transmitted disease.
Male sexual partners are treated with 2 g of metronidazole (single-
day therapy).
22. Greater than 75% of cases are caused by Candida
albicans, with 5% to 20% of vaginal fungal infections
produced by C. glabrata or C. tropicalis
The greatest enigma of this condition is the
recurrence rate after an apparent cure, varying from
20% to 80%. Approximately 3% to 5% of these
women experience recurrent vulvovaginal
candidiasis.
23. Treatment of recurrent or persistent vulvovaginal
candidiasis using ketoconazole (400 mg daily), an
oral preparation has shown 50% recurrence rates
after the drug was discontinued
Potential therapy for recurrent disease includes
gentian violet, boric acid, povidone-iodine douching
etc.
Optimal treatment of recurrent vaginal infections
related to C. albicans often involves therapy similar
to treating recurrent urinary tract infections- patient
initiated therapy.
24. The treatment of choice for mucopurulent
cervicitis(non gonococcal) is oral doxycycline 100
mg twice a day for 7 days or azithromycin 1 g orally
in a single dose
The male partner should receive identical therapy
25. Generally leukocytospermia (WBC in the semen)
affects 5-10% of the patient population, but can rise
to 20% in certain patients groups.
Semen has to be cultured for aerobic and anaerobic
infection as well as Chlamydia and Mycoplasma.
Detection of pathogens in significant number (colony
forming units) needs treatment.
Potential pathogens are- E.coli, proteus,
streptococcus, klebsiella etc
26. Treatment of mycoplasma , enterobacter species is
controversial as it has not shown any improvement
in conception rates.
27. CRYOPRESERVED SAMPLE should be used
Should be free from all sexually transmitted
diseases.
HIV screening should be repeated at an interval of 6
months before cryopreservation .
28. Asymptomatic, or occult, infection of the upper
female genital tract and the male genital tract can be
a cause of infertility
Although some studies have shown that treatment of
infertile couples with antibiotics, such as tetracycline or
doxycycline, that eradicate mycoplasma resulted in high
pregnancy rates, controlled studies have reported no
difference in pregnancy rates between couples treated
with antibiotics and those not treated.
Pathogenic organisms in semen need treatment before
proceeding for ART.