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Aim : To investigate the value of the hematological indices to differentiate bacterial vaginosis (BV) from vulvovaginal candidiasis (VVC) and predict treatment response. Materials and methods : This nested case-control study included 390 women divided into three groups: healthy women, women diagnosed with BV, and women diagnosed with VVC. Additionally, two groups (BV and VVC) were treated and followed prospectively until cured. Demographic data, blood indices, and high-sensitivity C-reactive protein (hsCRP) were obtained from the women. Results : hsCRP and neutrophil-lymphocyte ratio (NLR) showed the best diagnostic utility to predict BV with AUC=0.721 and 0.735, respectively. hsCRP showed the best specificity (99.23%), while NLR showed the best sensitivity (82.31%) to differentiate BV. Regarding percentage change after treatment, NLR showed a higher reduction percentage in the BV group (−27.41±8.151%) than VVC (0.158±5.804%). Conclusions : NLR is an efficient diagnostic instrument for distinguishing individuals with bacterial vaginosis from those with vulvovaginal candidiasis. Its diagnostic reliability is comparable to more regularly used markers such as WBC and hsCRP. Both NLR and PLR are good predictors of clinical response to treatment in bacterial vaginosis.

The primary objective of this study was to evaluate the effects of polypeptide-enriched extracts (GE) on vulvovaginal candidiasis (VVC). A VVC model induced by ( ) infection was successfully developed in BALB/c mice. After treatment, the colony-forming unit (CFU) of vaginal lavage was measured by plating. The extent of the inflammatory response was assessed by hematoxylin-eosin (H&E) staining and enzyme-linked immunosorbent assay (ELISA). GE had an inhibitory effect on the proliferation of and inflammatory reaction. Meanwhile, it had a potentially beneficial effect on the growth of . These results showed the potential application of GE as an antifungal agent in VVC treatment.

Recurrent vulvovaginal candidiasis (RVVC) is a common illness influencing childbearing women worldwide. Most women suffering from RVVC develop infection without specified risk factors. Mannose-binding lectin (MBL) is an important component of innate immune defense against Candida infection. Innate immunity gene mutations and polymorphisms have been suggested to play a role in susceptibility to RVVC. This study aimed to investigate the association between MBL 2 gene exon 1 codon 54 polymorphism and susceptibility to RVVC in childbearing women. Whole blood and serum samples were obtained from 59 RVVC cases and 59 controls. MBL serum level was measured by enzyme-linked immune-sorbent assay (ELISA). MBL2 exon 1 codon 54 polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). It was shown that MBL serum level was nonsignificantly different between RVVC cases and controls. The risk of RVVC was 3 times higher in those carrying MBL2 exon 1 codon 54 variant allele (B). It could be concluded that the carrying of MBL2 exon 1 codon 54 variant allele (B) was shown to be a risk factor for RVVC in childbearing women.

The relationship between ABO-Le secretor phenotype and susceptibility to recurrent idiopathic vulvovaginal candidiasis (RVVC) was investigated. ABO and Lewis blood typing was done for 38 women with RVVC (case-patients) and for women in 2 control groups, consisting of 58 healthy women, who were friends identified by case-patients, and 38 race-matched, healthy hospital employees. The 3 groups were similar with regard to age and race. There was no difference in the distribution of ABO phenotype between case-patients and controls. Case-patients were more likely than members of either control group to have Le(a+b−) (nonsecretor) rather than Le(a−b+) (secretor) blood type. With combined nonsecretor Le(a+b−) phenotype and absence of the Lewis gene Lea−b−, the relative risk of chronic recurring vulvovaginal candidiasis was 2.41–4.39, depending on the analysis technique and control group. In conclusion, there is an increased frequency of ABO-Le nonsecretor status among women with RVVC.

A subset of women with candidal vulvovaginitis have no known risk factors for recurrent episodes. Although there are reports of an association of blood group antigens with various infections, no such association has been described with candidal vulvovaginitis. The ABO, Pl, and Lewis group phenotypes of 35 women with recurrent vulvovaginitis but without other chronic infections were determined. These were compared with those of a control group of 40 women without a history of candidal vulvovaginitis. The distribution of ABO blood types and P blood group phenotype did not differ from those in controls. However, vulvovaginitis patients were more likely than controls to be classified as Lea-b-(χ2 = 6.4, 1 df, P =.011). Women without known predisposing factors may have a genetic predisposition to recurrent vulvovaginitis, as evidenced by a higher frequency of Lea-b-phenotype profiles compared with controls.

The in vitro production of prostaglandin E2 (PGE2) by peripheral blood mononuclear cells (PBMC) in response to viable Candida albicans, histamine, and C. albicans plus histamine was examined. With PBMC from 10 healthy women, C. albicans but not histamine induced PGE2 at a low level (100 pg/ml). However, C. albicans plus histamine acted synergistically to stimulate PGE2 production (448 pg/ml). PBMC from 8 of 10 women with recurrent candidal vaginitis also produced maximal levels of PGE2 in the presence of C. albicans plus histamine. Production of tumor necrosis factor by PBMC from patients and controls was unaffected by histamine in both the presence and absence of C. albicans. However, unlike the controls, PBMC from six of the patients who were atopic and from two nonatopic patients spontaneously released PGE2 in vitro. Addition of 4 or 10 units/ml interferon-γ inhibited spontaneous and C. albicans-induced PGE2 production by PBMC. These data reinforce the evidence that immediate hypersensitivity responses may be involved in the etiology of recurrent candidal vaginitis.

We studied host factors that could predispose women to develop recurrent vulvovaginal candidiasis (RVVC), including glycemia, insulin resistance, chronic stress, antioxidant capacity, overall immune status, local inflammation and vaginal microbiota. The presence of yeasts in vaginal culture was screened in 277 women, with or without signs and symptoms of VVC and RVVC. The presence of an inflammatory process and microbiota were analyzed through vaginal bacterioscopy and cervical-vaginal cytology, respectively. Fasting-blood samples were collected by standard venipuncture for biochemical analyses. Flow cytometry was employed to obtain the T helper/T cytotoxic lymphocyte ratio, and insulin resistance was assessed by the HOMA index (HI). Yeasts were isolated from 71 (26%) women: 23 (32.4%) with a positive culture but without symptoms (COL), 22 (31%) in an acute episode (VVC), and 26 (36.6%) with RVVC. C. albicans was the main yeast isolated in all clinical profiles. The control group (negative culture) comprised 206 women. Diabetes mellitus and insulin resistance were more associated with the positive-culture groups (COL, VVC and RVVC) than with negative ones. The RVVC group showed lower mean levels of cortisol than the control group and lower antioxidant capacity than all other groups. The T Helper/T cytotoxic lymphocyte ratio was similar in all groups. The RVVC group showed a similar level of vaginal inflammation to the control group, and lower than in the COL and VVC groups. Only the CVV group showed a reduction in vaginal lactobacillus microbiota. Our data suggest that both chronic stress (decreased early-morning cortisol levels) and reduced antioxidant capacity can be host predisposing factors to RVVC.

Vulvovaginal candidiasis (VVC) represents a universal health hazard that contributes to significant morbidity in HIV-positive women. Antifungal resistance is a worldwide increasing health problem that reduces treatment options while increasing treatment costs. The purpose of this study was to determine the prevalence of VVC, identify associated risk factors, characterize the distribution of Candida species, and assess their antifungal susceptibility patterns among HIV-positive women attending Mbarara City Health Centre IV. A laboratory-based, cross-sectional study design was conducted on 146 high vaginal swabs collected from HIV- positive women aged 18 years and above attending routine HIV care that presented with signs and symptoms of vulvovaginal candidiasis. These were subjected to microscopy and culture on Sabouraud Dextrose Agar. Candida isolates were identified by gram stain, germ tube, CHROM agar™, and Analytical profile index (API ® Candida ) tests. Susceptibility to fluconazole, clotrimazole, voriconazole, amphotericin B, miconazole, and nystatin by the disc diffusion method on Mueller Hinton agar supplemented with 2%w/v glucose and 0.5 µg/ml methylene blue dye. Out of the 146 high vaginal swabs collected, 71(49%) were colonized with Candida species with 43(62%) being Candida albicans while 26 (37.6%) were non- Candida albicans. Candida species were susceptible to amphotericin B (68/71, 95.7%) and resistant to fluconazole and clotrimazole (33/71, 45%). Elevated blood glucose levels were significantly associated with vulvovaginal candidiasis ( p  = 0.018; odds ratio = 2.93). Candida albicans is the leading cause of VVC, with a higher prevalence than non- Candida albicans . It also demonstrates that amphotericin B and nystatin are the most effective antifungal medications. Furthermore, diabetes is associated with VVC compared to other studied factors. We recommend the use of nystatin for the management of vulvovaginal candidiasis among HIV adult women.

Introduction Vulvovaginal candidiasis (VVC) is a public health problem with an estimated 138 million women globally experiencing recurrent VVC annually. The microscopic diagnosis of VVC has low sensitivity, but it remains an essential tool for diagnosis as the microbiological culture methods are limited to advanced clinical microbiology laboratories in developing countries. The study retrospectively analyzed the presence of red blood cells (RBCs), epithelial cells (ECs), pus cells (PCs) and Candida albicans positive in wet mount preparation of urine or high vaginal swabs (HVS) samples to test for their sensitivity and specificity for the diagnosis of candidiasis. Methods The study is a retrospective analysis at the Outpatient Department of the University of Cape Coast between 2013 and 2020. All urine and high vagina swabs (HVS) cultures samples using Sabourauds dextrose agar with wet mount data were analyzed. 2 × 2 contingency diagnostic test was used to ascertain the diagnostic accuracy of red blood cells (RBCs), epithelial cells (ECs), pus cells (PCs), and Candida albicans positive in wet mount preparation of urine or high vaginal swabs (HVS) samples for the diagnosis of candidiasis. The association of candidiasis among patients' demographics was analyzed using relative risk (RR) analysis. Results The high prevalence of candida infection was among female subjects 97.1% (831/856) compared to males 2.9% (25/856). The microscopic profiles which characterized candida infection were pus cells 96.4% (825/856), epithelial cells 98.7% (845/856), red blood cells (RBCs) 7.6% (65/856) and Candida albicans positive 63.2% (541/856). There was a lower risk of Candida infections among male patients compared to female patients RR (95% CI) = 0.061 (0.041–0.088). The sensitivity (95%) for detecting Candida albicans positive and red blood cells (0.62 (0.59–0.65)), Candida albicans positive and pus cells (0.75 (0.72–0.78)) and Candida albicans positive and epithelial cells (0.95 (0.92–0.96)) with corresponding specificity (95% CI) of 0.63 (0.60–0.67), 0.69 (0.66–0.72) and 0.74 (0.71–0.76) were detected among the high vaginal swab samples. Conclusion In conclusion, the study has shown that the presence of PCs, ECs, RBCs or ratio of RBCs/ECs and RBCs/PCs in the wet mount preparation from urine or HVS can enhance microscopic diagnosis of VVC cases.