Introduction:Bacterial vaginosis (BV) is one of the most prevalent infections in women of reproductive age. Amsel’s criteria and Nugent scoring system are among the most commonly used diagnostic methods. Although Nugent scoring system is considered the gold standard for diagnosing BV, it is time consuming and costly, and its interpretation needs lab equipment and experts. Hence, most physicians are inclined to use simpler clinical criteria that are yet accurate instead. The present study aimed to determine the diagnostic value of Amsel’s criteria in diagnosing BV.Material and Methods:This present study was conducted to validate diagnostic tests of BV in 120 married women in 2013. Amsel’s criteria and Nugent scoring system were used to diagnose BV. Nugent scoring system was considered the gold standard and sensitivity, specificity, positive predictive value and negative predictive value of Amsel’s criteria were compared with those of Nugent scoring system.Results:Kappa coefficient was used to assess the diagnostic value of Nugent scoring system and Amsel’s criteria. Kappa coefficient was found 0.8, which confirms the reliability of both diagnostic methods. McNemar test did not reveal a significant difference between Nugent scoring system and Amsel’s criteria in terms of diagnosing BV. As compared to Nugent scoring system, Asmel’s criteria enjoy sensitivity of 0.91, specificity of 0.91, positive predictive value of 0.86, negative predictive value of 0.94, and accuracy of 0.91.Conclusion:If lab equipment is not available for diagnosing BV, Amsel’s criteria can be as good as Nugent scoring system at diagnosing this infection.
Background: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection. Objective: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin. Materials and Methods: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables. Results: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient’s age contributes significantly to the heterogeneity for azithromycin treatment failure rate (β = 0.826; p = 0.017). Conclusion: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections. Key words: Azithromycin, Chlamydia trachomatis, Urogenital, Treatment failure, Meta-analysis.
Background: The chronic condition of polycystic ovary syndrome (PCOS) in adolescents can affect different aspects of quality of life in them. This study aimed to determine the correlation between the quality of life with emotional states of depression, anxiety, and stress in adolescents with PCOS. Methods: This is a cross-sectional study conducted on 120 adolescents with PCOS in Tehran, Iran in 2019. The sociodemographic checklist, quality of life, depression, anxiety and stress (DASS) were assayed by valid and reliable questionnaires. The Pearson's correlation coefficient and linear regression were used for data analysis, which was performed by SPSS (V.22). Results: The mean (SD) age and menarche age of participants were 16.58 (1.36) and 12.52 (1.19) years, respectively. The most common clinical symptoms of adolescence were irregular menstruation (85%) and acne (61.7%). According to the result of this study, there was a significant reverse correlation between total score of SF-12 with total scores of depression, anxiety and stress (r=−0.395, p=0.001) and a significant reverse correlation was also found between each dimension of DASS scale and 12-Item Short Form Survey (SF-12) (p<0.001). Based on the linear regression model and after controlling the demographic variables, there was a linear regression relationship between total DASS score and SF-12 (Beta= −0.367, p= 0.003). Conclusion:The study results reveal the role of emotional states of depression, anxiety, and stress in the quality of life of adolescents with PCOS. Based on our findings, we emphasize the interventional studies and guides for improving all dimensions of quality of life and reducing the psychological burden of PCOS in later life of adolescence.
Pelvic floor dysfunction is one of the most common disorders in women that is associated with social and economic consequences. In general, this disorder imposes direct and indirect costs on the economy of various societies. This review aimed to investigate pelvic floor dysfunction in women with polycystic ovary syndrome (PCOS). In this narrative review, the published articles on pelvic floor dysfunction were examined in PubMed, Scopus, Web of Sciences and Google Scholar. We searched for terms related to polycystic ovary syndrome and pelvic floor dysfunction. Inclusion criteria of this research were observational, experimental, and review studies. In this investigation, the complications associated with polycystic ovary syndrome were examined as risk factors for pelvic floor dysfunction. In this narrative review, we discuss about changes in hormone levels, obesity and overweight, hormonal medications and complications such as diabetes and metabolic disorders and obstetric complications of PCOS can be involved in the pathophysiology of pelvic floor dysfunctions, including stress urinary incontinence and pelvic organ prolapse in women with PCOS. This review highlights knowledge gaps about protective effect of hyperandrogenism on pelvic floor dysfunction as well as destructive effect of metabolic changes on pelvic floor dysfunction in women with PCOS. Further cohort and prospective studies are recommended in women with PCOS to investigate the concept of pelvic organ dysfunction in these women.
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