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Background: The genotypic distribution of human papillomavirus (HPV) needs to be determined with detail as it is an important issue when it comes to public health and preparing vaccines since the HPV type may be different in various areas. Objectives: This study aimed at reporting the frequency of HPV types among women in Sari in the north of Iran. Methods: From 2018 October to 2019 April, 50 sterile swabs of vaginal and cervical discharge of women with genital warts, which were performed by a gynecologist, were examined to determine the prevalence of HPV genotyping by using polymerase chain reaction (PCR). Results: From 50 vaginal swab samples of patients with genital warts, the frequency distribution of types of HPV in women with genital warts included 5 patients (10.0%) with 2 high-risk serotypes as simultaneous serotypes 4% (16,18), 4% (18,35), 2% (66, 67), 1 patient (2%) HPV 33,1 patient (2%) HPV34,1 patient (2%) 1 patient (2%) HPV 35,2 patients (4%) HPV 66,1 patient (2%) HPV 67, and 1 patient (2%) HPV 68. Conclusions: Since HPV genotype varies in diverse areas, these results can be used for screening, management, and vaccination of the target population against the common types of virus in Sari. [ABSTRACT FROM AUTHOR]

Purpose: Sexually transmitted infections (STIs) can be transferred from one person to another through sexual contact. STIs lead to substantial morbidity and mortality and affect many different aspects of human life, including quality of life, sexual health, reproductive health and even the health of newborns and children. Despite of high rates of STIs in prisons, there are not sufficient screening, prevention and treatment programs to control STIs transmission among prisoners in Iran. This study aims to evaluate the prevalence of STIs among incarcerated women in Iran for the first time, using the active case finding strategy. Design/methodology/approach: This is a cross-sectional study conducted on 438 incarcerated women in a prison in Tehran, Iran, from 2017 to 2018. A total of 438 prisoners were screened by active case findings for STI symptoms, then evaluated by complete genital and anal examination, followed by molecular testing. Findings: A total of 189 (43.2%) prisoners announced vaginal discharge, while 194 (44.3%) individuals had vaginal discharge in the genital examination. In the cervical examination, 137 individuals (31.3%) had abnormal findings, of which 83 (18.9%) individuals had cervicitis, 40 (9.1%) individuals had cervical erosion, 38 (8.7%) individuals had cervical prolapse and 17 (3.9%) individuals had bleeding originated from the cervix. Originality/value: This study showed that it is possible to set up a system in which the diagnosis, follow-up and treatment of prisoners with STIs can be actively performed. Educating prisoners about signs and symptoms, risk behaviors and prevention routes of STIs, as much as regular screening of prisoners, and adequate treatment can help control the STIs prevalence among prisoners and in the general population. [ABSTRACT FROM AUTHOR]

Background: The current evaluation was planned to study the effect of vitamin D on improving bacterial vaginosis in premenopausal women with vitamin D deficiency. Methods: This study was an open-label clinical trial. Forty premenopausal vitamin D deficient women with bacterial vaginosis enrolled in this study. Patients received metronidazole tablet 500 mg twice daily for seven days in both groups. In the vitamin D group, patients also received 50000 IU per day for five days. Results: Fourteen days after completion of the study, the number of patients complaining of malodor vaginal discharge, vaginal itching, and discharge discoloration was significantly lower than that in the control group. Regarding the laboratory results, in the vitamin D group, the numbers of Gardnerella vaginalis, gram-negative bacilli, and clue cells in the smear of vaginal secretions were significantly less than in the control group (p<0.05). Furthermore, none of the patients had a positive whiff test after treatment in the vitamin D group (p<0.05). Fourteen days after the completion of the study, the plasma level of 25-OH vitamin D in the vitamin D group was significantly higher than that in the control group. However, the short course of high-dose vitamin D therapy did not increase the plasma concentration of 25-OH vitamin D to the average level. Conclusion: Vitamin D supplementation can improve the therapeutic response to metronidazole in vitamin D deficient women with BV. However, large-scale double-blind, randomized clinical trials must confirm this finding. [ABSTRACT FROM AUTHOR]

Background: The hepatitis B virus (HBV) is a major public health problem worldwide. Vertical and horizontal transmission of HBV could affect neonates and partners. This transmission can vary in populations. Also, high-risk behaviors and clinical records affect the transmission of this virus. Due to the lack of information on vaginal discharge related to HBV in the north of Iran, we aimed to assess the presence of HBV in pregnant women's vaginal secretion referred to Sayyad Shirazi Hospital in Gorgan City, north of Iran. Methods: This cross-sectional study was performed on 315 cervicovaginal lavages from pregnant women. Viral DNA was extracted, and the gene fragments of the virus were checked by polymerase chain reaction (PCR). Clinical, demographic, and behavioral data were entered into SPSS version 16. The chi-square tests were used to determine any association between categorical data. Results: Hepatitis B virus DNA was detected in 2.2% (7/315) of samples. The age range of patients was from 14 to 43 years. Anal sex (P = 0.043) and not using a condom (P = 0.047) were significantly associated with HBV-positive cases. Abortion, unusual discharge, and some other clinical and demographic information showed no related statistical correlation. Conclusion: The results showed a similar rate of infection in the general Iranian population. In pregnant women, the risk of HBV transmission and chronic HBV can be critical in newborns; therefore, it is strongly recommended to conduct screening and provide management for women during pregnancy. [ABSTRACT FROM AUTHOR]

Trichomoniasis is a sexually transmitted infection (STI) caused by the flagellated protozoan Trichomonas vaginalis. Little information is available on the epidemiology and genetic diversity of T. vaginalis in Ilam City, southwestern Iran. A descriptive cross-sectional investigation was carried out between July 2017 and December 2018 on the suspected women patients referred to eight gynecology clinics of Ilam City for probable Trichomonas infection. They were undergone a set of clinical, parasitological, and molecular examinations. During clinical consultation, posterior vaginal fornix secretions and urine samples were gathered from the participants. For the reasons such as physical conditions and cultural and religious constraints, most of participating women, especially young girls due to their virginity, preferred to give urine samples instead of vaginal discharge. The presence of Trichomonas was diagnosed by microscopic examination and molecular detection using conventional PCR targeting ITS1-rDNA. A total of 1765 suspected individuals were examined clinically via vaginal secretions (495 specimens) and urine samples (1270 specimens). Of them, 21 (1.18%) cases, including 13 vaginal secretions and 8 urine samples, were positive for Trichomonas infection by microscopy. Slightly more than half of the patients (11/21, 52.4%) complained of vulvar itching, burning, and frequent urination. Cervical lesions, patchy erythema, and vaginal discharge were recorded in 28.6%, 23.8%, and 19% of the patients respectively. All patients with positive microscopic identification were confirmed by amplification of 450-bp fragment of ITS1-rDNA. Phylogenetic analysis revealed a high rate of genetic homogeneity in which all our isolates together with homologous sequences from China, Philippines, Austria, and USA were clustered within the same clade. A statistically significant relationship was recorded between the patients positive for trichomoniasis and the presence of chronic disease (e.g., diabetes, immune system deficiency). [ABSTRACT FROM AUTHOR]

Background: The prevalence of vaginal candidiasis is high in women and proper treatment is essential in this regard. Materials and Methods: This single-blind randomized controlled clinical trial was conducted on 120 women who were referred to Hamadan health centers in 2019. The patients were randomly divided into Clotrimazole cream and Nika vaginal cream groups each including 60 cases. The intervention group received Nika vaginal cream once a day for a week and those in the control group were given Clotrimazole vaginal cream in the same way. The clinical symptoms were studied by clinical examinations and the culture of vaginal discharge before and 7 days after the treatment to confirm the diagnosis of Candida albicans. The results were analyzed by SPSS 21.0 using an independent t test, Mann-Whitney U test, and Chi-square, Fisher's exact, and McNemar's tests, the significance level was set at 0.05. Results: Most patients in both groups reported no clinical symptoms after the intervention, and no significant difference was observed between the two groups in this regard (χ² = 2.23, p = 0.566). Conversely, a significant difference was found in Nika and Clotrimazole groups before and after the intervention regarding improving Vulvovaginal Candidiasis (VVC) symptoms χ² = 86.01, χ² = 99.41, respectively (p < 0.001). Finally, 84.48% and 75.86% of women in the Nika χ² = 45.02 (p < 0.001) and Clotrimazole cream χ² = 40.02 (p < 0.001) groups had negative culture results after the intervention. Conclusions: In general, the Nika and Clotrimazole vaginal creams have the same effects concerning improving the symptoms of vaginal candidiasis and thus can be used to treat VVC. [ABSTRACT FROM AUTHOR]

Objective: Trichomonas vaginalis is considered to be the most prevalent cause of non-viral sexually transmitted infections globally and is a major health issue in developing countries. Since this flagellate protozoan parasite is associated with vaginitis, urethritis, cervicitis, and also pregnancy is one of the factors affecting trichomoniasis in women. Our aim is to identify the prevalence of trichomoniasis and the associated risk factors in pregnant women in the age group of 17-40 in the city of Zahedan (Southeast of Iran). Methods: A cross-sectional study was conducted on 514 pregnant women who had referred to a midwifery clinic in Zahedan. Direct microscopic examination and Dorset egg medium culture were used to detect T. vaginalis in pregnant women. The demographic and personal records, along with the associated risk factors were collected using a questionnaire and then analyzed using the Frequency to calculate the age average, chi-square test, independent t-test with SPSS software version 20. Results: The results showed that in 514 pregnant women, by the direct method, both the direct and culture methods and only culture method, 29(5.64%), 24(4.67%), and 24(4.67%) were reported positive sample for T. vaginalis, respectively. According to this result, there were significant differences between trichomoniasis and history of STI (OR=12,6; 95%CI=3,9-40,6) and previous abortion (OR = 6.840, CI:2.906-16.100) and vaginal discharge (OR= 2.9; 95%CI= 1.2-7.1) and antenatal care (OR=0.2; 95%CI= 0.1-0.7) in the studied infected pregnant women (p<0.05). Conclusion: This study has raised several important points that could contribute to the research on infectious diseases of pregnancy were also discussed. This data proves that trichomoniasis during pregnancy should be considered an important health issue. Furthermore, by using parasitological diagnostic tests in pregnant women, the complications of trichomoniasis can be prevented for both the mother and the fetus. [ABSTRACT FROM AUTHOR]

Quercus infectoria (Fagaceae family) is traditionally used for treatment of vaginal discharge, prolapse, laxity, and many other female genital disorders. Two important parts of plant including oak fruit hulls (Jaft-E-Baloot) and oak galls (Mazo) are recommended to use for female genital disorders, although, they have many other medicinal applications on skin, urinary and respiratory tract. Tannins as the main ingredients of this genus are the main characteristic for their medicinal properties. Therefore, the aim of this review article was chosen in order to increase the information on Jaft-E-Baloot or Mazo in management of female genital disorders. For preparing the manuscript, the information was gathered from electronics resources (PubMed, Science Direct, Wiley, Magiran, and Springer), books, thesis, etc. up to Feb 2020. Our results exhibited that Jaft-E-Baloot is the thin inner woody hulls of oak fruits, while Mazo is produced in reaction of plant to insect bite. Mazo is a popular compound in different traditional medicines, while Jaft-E-Baloot is known only in Iran. There is any investigation on these two parts in European countries. In Traditional medicine, the same applications are for these two parts especially for female genital disorders, while the majority of modern investigations are on the efficacy of Mazo on cancer, vaginal infections, cervicitis, utero-vaginal prolapse, and there is one clinical study for Jaft-E-Baloot on vaginal laxity. The safety doses of two parts are high and due to their good potency in management of female genital disorders especially vulvovaginitis, they can be the subject of further clinical studies. [ABSTRACT FROM AUTHOR]

Among 1337 Iranian adult female sex workers in 2015, we assessed the diagnostic value of 4 self-reported sexually transmitted infection (STIs) symptoms for detecting laboratory-confirmed gonorrhea, chlamydia, trichomoniasis, human papillomavirus (HPV), and syphilis. While 37.7% reported vaginal discharge (VD), 25.9% reported pain or burning (P/B), 3.0% reported genital ulcers (GU), and 1.4% reported genital warts (GW), the prevalence of laboratory-confirmed syphilis, gonorrhea, chlamydia, trichomoniasis, and HPV was 0.4, 1.3, 6.0, 11.9, and 41.9%, respectively. The sensitivity of VD was 40.3% for detecting tricomoniasis, 37.5% for chlamydia, and 37.5% for gonorrhea. The sensitivity of P/B ranged from 12.5% for gonorrhea to 25.2% for trichomoniasis. The sensitivity of GU and GW was very low for 5 STIs. The sensitivity of all symptoms combined was also lower than 50%. Among asymptomatic participants, 41.2% tested positive for HPV, 11.8% for trichomoniasis, and less than 6.6% for other STIs. Symptom-based case management and surveillance of STIs can lead to misclassification of a large proportion of cases. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine the diagnostic value of vaginal discharge concentrations of β human chorionic gonadotropin (β‐hCG), creatinine, and urea to identify premature rupture of membranes (PROM). Methods: An observational cross‐sectional study was conducted between 12 June, 2014, and 11 June, 2015, among 120 women who were admitted to an Iranian hospital at 28–41 weeks of pregnancy. Women with positive pooling and nitrazine test results were assigned to the PROM group (n=60), whereas those with negative test results were assigned to the control group (n=60). Samples of vaginal discharge were obtained. Results: Mean concentrations of β‐hCG, urea, and creatinine were all higher in the PROM group than in the control group (all P=0.001). The diagnostic accuracies as defined by area under the curve for creatinine, urea, and β‐hCG were 0.891, 0.895, and 0.908, respectively. The corresponding optimal cutoff values were 20.33 μmol/L, 0.94 mmol/L, and 39.5 IU/L, respectively. Conclusion: The vaginal discharge concentrations of all three markers exhibited favorable predictive value for the diagnosis of PROM; however, β‐hCG showed greater diagnostic accuracy than either urea or creatinine. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the prevalence of genital and sexually transmitted infections and its related factors in married women in Iran. Methods: We conducted a cross-sectional study of 4 274 married women living in urban and rural areas of the Zanjan province from 2012 to 2013. We used stratified cluster sampling to select the participants. Data collection included demographic characteristics, reproductive status, and cervical cytology results. Results: The prevalence of lower genital infections and sexually transmitted infections were 20.1% and 7.4%, respectively. The most common vaginal infection was bacterial vaginosis with a prevalence of 8.5%, and the most common sexually transmitted infection was Trichomonas vaginalis (1.4%). The use of the intrauterine device (IUD) as a contraceptive, living in an urban area, and experiencing vaginal discharge were significantly related to genital tract and sexually transmitted infections. Conclusions: There was a high prevalence of genital infection among women living in Zanjab. Screening and treatment of genital infection are necessary to prevent adverse consequences in women who use an IUD or live in urban areas. [ABSTRACT FROM AUTHOR]

Background: The aims of this study were to examine the prevalence of trichomoniasis among women aged 18 to 48 yr in Ardabil, northwestern Iran and the relationship between demographic factors and the risk of infection. Methods: Vaginal discharge samples of 914 women aged 18 to 48 yr, referred to Gynecology Clinic of Sabalan Hospital of Ardabil, Iran in 2014, were collected and Trichomonas vaginalis infection was examined using wet mount and Dorset culture medium. In addition, demographic data was collected using a questionnaire as well as clinical examination, and analyzed with SPSS ver. 16, using Chi-square test, and t-test. Results: Of the 914 samples studied, 3.38% by wet mount and 4.48% by parasite culture were infected by T. vaginalis. Sensitivity of direct or wet mount method was 75.6% compared to culture method (standard). We found a significant statistical relationship between trichomoniasis infection and preterm birth (P=0.011). Conclusion: The prevalence of trichomoniasis in Ardabil compared to global statistics (5%-74%) is low. Interestingly, the results of this study (4.84%) were consistent with the results obtained in Tabriz (4.46%). [ABSTRACT FROM AUTHOR]

Background: Chlamydia trachomatis (CT) is a common cause of sexually transmitted infections (STI) and a prevalent microorganism found in the vaginal discharge of sexually active women. The infection usually has no symptoms; although it may cause chronic complications such as pelvic inflammatory disease (PID), ectopic pregnancy, chronic pelvic pain, tubal infertility and cervical cancer. This study was done, for the first time, in Shiraz (southern Iran) to determine the prevalence of genital C.T in women. Materials and Methods: A total of 402 women who referred for routine pap smears to randomly selected health centers in Shiraz were tested with the IMAGEN Chlamydia test, a direct immunofluorescence test for the detection of Chlamydia in human urogenital specimens. The results of this test were compared to the socio-demographic condition of each participant as well as their sexually transmitted disease (STD) symptoms, both present and past. Results: The prevalence rate of Chlamydia infection was 8% (32/402). No correlation was found between this infection and age, marital age, number of children, education and occupational status of the participants. On the other hand, the correlation between the presence of infection and a positive history of STD symptoms, both present and past was significant. Conclusion: Chlamydia infection is quite frequent in our society, where knowledge about STD infections is scant. Considering the sequelae of this infection and the fact that this is a quiet disease, it seems rational to screen sexually active women and inform them more about this issue. [ABSTRACT FROM AUTHOR]

Background: Trichomoniasis is a worldwide sexually transmitted disease (STD), and is associated with important public health problems, including enhancement of HIV transmission. The prevalence of the parasite, Trichomonas vaginalis, depends on host factors such as age, sexual activity, number of sexual partners and sexual behavior. The aim of the study was to evaluate the prevalence of trichomoniasis in high-risk behavior women, such as drug addicts and those who had multiple sexual partners, attending Gynecology Clinics in penitentiaries of Tehran province to help gynecologists with the diagnosis and treatment of the disease. Methods: Samples of posterior vaginal fornix discharges and urines of 450 women attending Gynecology Clinics of three prisons in Tehran province were collected. All samples were examined by direct smear and cultured in TYI-S-33 culture media. Results: 10.2% of subjects were positive for trichomoniasis. 82.7% of infected patients were symptomatic individuals who complained of vaginal discharge and itching and/or burning sensation. Most of the infected women in the high risk behavior group were drug users (54.3%). Physical examination showed that 50% of T. vaginalis positive subjects had a normal appearance of vagina and cervix. The peak prevalence (32.8%) of the disease occurred in the age range of 31-40 years. Conclusion: T. vaginalis infection is commonly associated with other STDs, and is a marker of high-risk sexual behavior. Due to the side effects of the drugs used to treat the infection, it is suggested that the treatment be performed after definite diagnosis using a diagnostic method with a higher sensitivity. [ABSTRACT FROM AUTHOR]

Background: Trichomonas vaginalis is a parasitic protozoan with a predilection for human urogenital tract and causative agent for vaginitis, cervicitis and urethritis in females. T. vaginalis is known as a cofactor in transmission of human immunodeficiency virus and may lead to adverse outcomes in pregnant women. The goal of this study was to determine the prevalence of T. vaginalis infection in females attending Mirzakuchak Khan Hospital, Tehran, Iran. Methods: During May 2008 to March 2009, 500 vaginal discharges samples were obtained from women attending sexual transmitted disease (STD) clinic of Mirzakuchak Khan Hospital in Tehran, Iran. The samples were examined by Dorsse culture medium and wet-mount methods. The prevalence of T. vaginalis was determined using culture based method and wet-mount examinations. Results: Sixteen positive (3.2%) and 484 negative (96.8%) samples for T. vaginalis were detected by culture based methods. The wet mount examination revealed 13 positive (2.6%) and 487 negative (97.4%) samples. In the above population, prevalence of trichomoniasis was estimated as 3.2% based on culturing method. Conclusion: Due to adverse outcomes of vaginal trichomoniasis and its correlation with HIV transmission, there is a great need for public education regarding implementation of personal hygienic measures and prevention of inappropriate sexual contacts. [ABSTRACT FROM AUTHOR]

Context: In Persian medicine, topical ingredients such as Rosa damascena Mill. (Rosaceae), are usually recommended for the treatment of uterine diseases. Scientific evaluation of these historical documents can be valuable for finding new potential use in conventional medicine. Objective: This clinical trial was performed to determine whether the use of the 'ward' vaginal tablet, which contains Rosa damascena, Punica granatum L. (Punicaceae), Querqus infectoria Oliv. (Fagaceae), Myrtus communis L. (Myrtaceae) and Nardostachys jatamansi (D.Don) DC. (Caprifoliaceae) could alleviate the symptoms of vulvovaginal candidiasis. Materials and methods: A parallel double-blinded placebo-controlled study was done. Eighteen to fifty-year-old women with vulvovaginal candidiasis were divided into the 'ward' and placebo groups, 46 individuals in each group. The 'ward' group received the 'ward' vaginal tablet containing 200 mg of dried extract. Placebo group received a placebo (composed of corn starch and lactose). One tablet was applied through the vagina for 7 consecutive nights. Results: Two weeks after medication administration, the vaginal discharge sample of patients was re-cultured; 29 patients (63.045%) in the 'ward' group and 6 (13.04%) patients in the placebo group had negative culture ( p  < 0.001). All clinical symptoms including itching, irritation, and vaginal discharge were significantly reduced in the 'ward' group compared with the placebo group following the intervention and the follow up ( p  < 0.05). Discussion and conclusions: The findings suggest the 'ward' vaginal tablet could ameliorate vulvovaginal candidiasis. Future larger studies are recommended due to compare the therapeutic effect of the 'ward' vaginal tablet with common treatments.

Objective: To determine the diagnostic value of vaginal discharge concentrations of β human chorionic gonadotropin (β-hCG), creatinine, and urea to identify premature rupture of membranes (PROM).Methods: An observational cross-sectional study was conducted between 12 June, 2014, and 11 June, 2015, among 120 women who were admitted to an Iranian hospital at 28-41 weeks of pregnancy. Women with positive pooling and nitrazine test results were assigned to the PROM group (n=60), whereas those with negative test results were assigned to the control group (n=60). Samples of vaginal discharge were obtained.Results: Mean concentrations of β-hCG, urea, and creatinine were all higher in the PROM group than in the control group (all P=0.001). The diagnostic accuracies as defined by area under the curve for creatinine, urea, and β-hCG were 0.891, 0.895, and 0.908, respectively. The corresponding optimal cutoff values were 20.33 μmol/L, 0.94 mmol/L, and 39.5 IU/L, respectively.Conclusion: The vaginal discharge concentrations of all three markers exhibited favorable predictive value for the diagnosis of PROM; however, β-hCG showed greater diagnostic accuracy than either urea or creatinine. [ABSTRACT FROM AUTHOR]

This study was undertaken to assess the seroprevalence of Brucella canis at a kennel in Iran. Serum samples (n=21) were examined for the presence of B. canis antibodies with immunochromatography assay. Out of these, 57.2% were positive for B. canis antibodies. All sero positive dogs were more than 2 years old. Of these, majority (75%) was female dogs and 66.6% had the history of late abortion between 40 and 55 days of gestational period accompanied with brownish or gray-green vaginal discharge. The aborted puppies usually appeared partially autolysed. Scrotal dermatitis and orchitis were the only signs in male dogs. Prevention measures were also performed to control the infection in this kennel. [ABSTRACT FROM AUTHOR]