ABSTRACT
Background: Vaginal discharge is a common complaint among women attending the sexually transmissible infections (STIs) clinic and is a cause for concern and mental distress. It can be attributed to physiological or pathological causes. This study aims to understand the prevalence of various etiologies of vaginal discharge, which would help frame health policies based on local needs. Objectives: (1) To estimate the prevalence of discharge per vaginum among sexually active women attending the STI clinic at a tertiary care center during a 1-year period, (2) To identify the organisms causing vaginal discharge, (3) To have a clinicoetiological correlation of the cases, and (4) To identify the subspecies of Candida causing vaginal candidiasis. Materials and Methods: A total of 126 patients with vaginal discharge attending the STI clinic at a tertiary care center were included in the study. A detailed clinical history, physical examination of the external genitalia, and vaginal examination were done on each patient. Five swabs were taken from the posterior fornix and lateral vaginal wall for evaluation of the organisms. Results: The mean age of the study population was 31.51 ± 7.9 years. Vulvovaginal candidiasis (VVC) was found to be the most common cause of vaginal discharge, followed by bacterial vaginosis, mucopurulent cervicitis, herpes genitalis, and trichomoniasis. The most common species of Candida was found to be Candida albicans. Conclusion: Even though VVC still remains the major cause, other viral infections like herpes significantly contribute. Vaginal discharge is an important indicator of women's reproductive health and its detailed evaluation helps identify the prevalence of various STIs in the community.
ABSTRACT
Objetivos: 1. Evaluar la immunohistoquimica de los granulomas de la lepra en las muestras de biopsias cutáneas de pacientes con lepra tuberculoide y lepromatosa, con respecto a la presencia y distribución de células T CD4+, CD8+ y CD28+, células CD 68+ y células CD1a+. 2. Evaluar los hallazgos inmunohistoquimicos observados en leprorreacciones. Metodología: Estudio descriptivo. Se seleccionaron para el estudio biopsias cutaneas, en las que se había diagnosticado clínica e histopatologicamente lepra entre el 1.8.2016 al 31.5.2017 en el Instituto Medico Gubernamental, Kozhikode. Se estudió la immunohistoquimica de las lesiones cutáneas en lepra y leprorreacciones, observando específicamente la distribución de células CD4/ CD8/ CD28/ CD68/ CD1a en la lepra en distintos escenarios. Resultados: En el estudio se incluyeron veintiséis casos tuberculoides y 14 lepromatosos. Todos los granulomas independientemente del tipo de enfermedad presentaron tinción positiva por CD4 y CD68. Dos de los 14 casos lepromatosos (14・3%), y 15/26 (57・7%) de las muestras tuberculoides presentaron expresion CD4 de moderada a fuerte. Se detectó negatividad CD28 en cuatro casos tuberculoides (15・4%) y en 10 lepromatosos (71・4%). La expresion CD4 moderada a fuerte se detectó en más del 70% de los T1R incremento mientras que en los demás grupos solo fue de 20%-50%. Más del 80% de las T1R estáticas e incremento presentaban positividad CD28, mayor de que el 30%-50% registrado en otros grupos. Conclusiones: Los resultados revelan que la inmunohistoquimica tiene un papel en aclarar los complejos procesos inmunológicos empleados en la lepra y las leprorreacciones
Objectives: 1. To study the immunohistochemistry of leprosy granulomas in the skin biopsy specimens of patients with tuberculoid and lepromatous leprosy, with respect to the presence and arrangement of CD4+, CD8+ and CD28+ T cells, CD 68+ cells and CD1a+ cells. 2. To study the immunohistochemistry findings observed in leprosy reactions. Design: Descriptive study. Skin biopsies in which the clinical and histopathological diagnosis of leprosy was reported between 1.8.2016 to 31.5.2017 in the Government Medical College, Kozhikode, were selected for the study. Immunohistochemistry of the skin lesions in leprosy and leprosy reactions was studied, looking specifically for the distribution of CD4/ CD8/ CD28/ CD68/ CD1a positive cells in leprosy at different scenarios. Results: Twenty-six tuberculoid and 14 lepromatous cases were included in the study. All granulomas irrespective of disease type showed positive staining for CD4 and CD68. Two of the 14 lepromatous leprosy cases (14・3%), and 15/26 (57・7%) tuberculoid specimens manifested moderate to strong CD4 expression. CD28 negativity was documented in four tuberculoid (15・4%) and 10 lepromatous cases (71・4%). Moderate to strong CD4 expression was noted in more than 70% of upgrading T1R while a similar finding was documented in only 20%-50% of other groups. More than 80% of static and upgrading T1R showed CD28 positivity, which was higher than the 30%-50% positivity recorded in other groups. Conclusions: The observations of the current study indicate a role for immunohistochemistry analysis in delineating the complex immunological processes involved in leprosy and leprosy reactions
