Changes in the Vaginal Microbiota of Women With Secondary Localized Provoked Vulvodynia.

OBJECTIVE: The etiology of localized provoked vulvodynia (LPV) remains unknown, but observations suggest the involvement of the vaginal microbiota. We examined the vaginal microbiota of women with LPV and healthy controls, upon after a low-oxalate diet (LOD). MATERIALS AND METHODS: A total of 9 women diagnosed with secondary LPV and 21 healthy controls were recruited from the Galilee Medical Center in Israel and subjected to prospective evaluations of their vaginal microbiota. Total DNA was extracted from vaginal discharge samples provided before and after following LOD for 3 weeks and was then subjected to 16S sequencing. Data obtained were then used to evaluate α and ß diversity, identify differentially abundant bacterial taxa in LPV, and determine their impact on the metabolism. RESULTS: These evaluations revealed decreased diversity in the vaginal microbiota of women with LPV and identified the Ochrobactrum genus and Pseudomonadaceae family as indicators for LPV. In addition, we identified 23 differentially expressed bacterial metabolic pathways between the LPV and control samples and revealed that LOD could induce changes in the ß diversity of LPV vaginal microbiomes, which was further supported by some degree of pain reduction in patients. CONCLUSIONS: Localized provoked vulvodynia and LOD were associated with shifts in the vaginal microbiota. However, the impact of these changes on the development of LPV requires additional studies with a larger cohort.

Automated external defibrillator. Trends of automated external defibrillator training in Saudi Arabia, and global perspectives on use and deployment.

Cardiopulmonary resuscitation (CPR) and the use of automated external defibrillator (AED) training have become widespread in Saudi Arabia and the need permeated in all sectors of healthcare profession. Healthcare providers are required to renew their certification every 2 years for an optimal practice, and it has become a requisite for healthcare providers in Saudi Commission for Health Specialties and medical and nursing students prior to internship. The disparity between the goal of AED training and the use is no more overstatement. We attempt to collate, review and appraise articles related to training, cost-effectiveness, innovation, and policy, and to extrapolate a meaningful agenda of the current training provision in the region, and to possibly attract policy makers to reflect on a strategy on AED use and implementation for Saudi Arabia bringing it closer to a healthcare practitioner and a layperson to achieve the goal of decreasing out-of-hospital cardiac arrest.