[Discussion on application of Chinese medicine treatment of gynecological diseases].

With rapid social development rhythm, the incidence of gynecological diseases gradually rise. Traditional Chinese medicine has made irreplaceable position in the treatment of gynecological disease. Due to the characteristics of gynecological diseases, the syndrome differentiation and treatment has unique characteristics. In this paper, according to menstrual disease, leukorrheal diseases, pregnancy diseases, puerperal diseases and miscellaneous diseases in order, combining documents discussion and old doctors of traditional Chinese medicine treatment of gynecological disease experiences, illustrate the key points of drug selection in the treatment process. We can get a revelation that appropriate choice of tradition Chinese medicine is an indispensable part for healing effects. Through the analysis of characteristics of drugs, we can understand the feature of each period in disease of department of gynecology, increase the ability of usinig traditional Chinese medicine and improve the level of clinical treatment.

Ethnopharmacological use of babassu (Orbignya phalerata Mart) in communities of babassu nut breakers in Maranhão, Brazil.

AIM OF THE STUDY: Products derived from the palm tree Orbignya phalerata Mart, a species popularly known in Brazil as babassu, are used for the treatment of different diseases such as rheumatism, ulcers and inflammatory processes. The objective of this study was to perform a sociodemographic survey among communities of babassu nut breakers in the region of Médio Mearim, Esperantinópolis, Maranhão, Brazil, and to evaluate the frequency and main forms of therapeutic use of babassu products and subproducts. MATERIALS AND METHODS: A semiquantitative method was used for the survey, with the application of semistructured interviews consisting of closed and semi-open questions. The data were analyzed using the SPSS 16.0 software for Windows (2007). RESULTS: The results showed that 82% of female nut breakers had a household income of less than US$ 280.00 and only 2% earned more than US$ 500.00. With respect to race and educational level, 61% of the interviewed women were mulattoes and 33% had a low educational level. The babassu-derived products most frequently used for medicinal purposes were the mesocarp, a residue called "borra", and oil. The mesocarp flour was used by 90% of nut breakers for the treatment of gastritis and inflammation and by 77% for leukorrhea. Babassu residue was mainly used for the treatment of wounds (60%) and the oil was used for woundhealing (16%) and leukorrhea (8%). CONCLUSIONS: In conclusion, the products derived from babassu are used for the treatment of gastritis, leukorrhea and wounds. In addition, most of the interviewed subjects apply these products topically.

[Causation and treatment of infectious leucorrhoea at the Cocody University Hospital (Abidjan, Côte d'Ivoire)]. / Etiologie et prise en charge thérapeutique des leucorrhées infectieuses au CHU de Cocody (Abidjan, Côte d'Ivoire).

OBJECTIVES: to determine the frequency of different bacteria causing infectious leucorrhoea and to calculate the percentage of cures after standard treatment. PATIENTS AND METHODS: This 7-month prospective descriptive study took place from October 2003 through April 2004 in the gynaecology department of Cocody University Hospital and in the department of sexually-transmitted infections of the Pasteur Institute of Côte d'Ivoire. After identification of the organism causing each case of leucorrhoea, we prescribed treatment according to a standard protocol. Vaginal samples were taken after treatment and tested to assess its success. RESULTS: The most frequent bacteria discovered, in descending order, were: Gardnerella vaginalis (47%), Candida albicans (29.4%), Chlamydia trachomatis (13.7%), Trichomonas vaginalis (6.9%), and Neisseria gonorrhoeae (2.9%). The overall cure rate was 87%. Treatment failure was most common for C. trachomatis (8 of 14 cases, 57.1%), N. gonorrhoeae (1 of 3 cases) and T. vaginalis (2 of 7 cases, 28.6%). Treatment was 100% effective for G. vaginalis and C. albicans. CONCLUSION: The fight against sexually-transmitted infections should be intensified, and patients and physicians cautioned about use of doubtful generic drugs.

Evaluation of two clinical protocols for the management of women with vaginal discharge in southern Thailand.

OBJECTIVES: (1) To compare the effectiveness of two clinical protocols for the management of vaginal discharge in the situations where no laboratory facilities are available but speculum examination is possible and where basic laboratory facilities are available. (2) To determine clinical and simple laboratory indicators for diagnosis of patients with vaginal discharge in the local setting. DESIGN: Alternate allocation of subjects to one of two management protocols. SUBJECTS: Women presenting to university gynaecology outpatients department with a complaint of vaginal discharge. METHODS: Subjects were alternately allocated management according to one of two protocols: one without (group A) and one with (group B) immediate access to results of basic laboratory tests. Full clinical assessment including speculum examination and microbiological assessment for infection with gonorrhoea, chlamydia, candida, trichomonas, and bacterial vaginosis was performed on all women. Follow up assessment of clinical and microbiological response was performed 1-2 weeks later. RESULTS: At initial assessment, both groups were similar in all respects except that more group B women had inflammation of the vulva. The prevalences of various conditions were: candidiasis 22%, bacterial vaginosis 38%, trichomoniasis 4%, chlamydia 4%, gonorrhoea 0.4%. There was no association between any demographic characteristic and diagnosis of cause of the discharge. Both protocols resulted in clinically and statistically significant improvements for women with candidiasis, bacterial vaginosis, and trichomoniasis. There were no clinically important differences in outcomes between the two protocols. The sensitivities and specificities of various indicators were: curd-like vaginal discharge for candidiasis, 72% and 100%; homogeneous vaginal discharge for bacterial vaginosis or trichomoniasis, 94% and 88%; absent or scanty lactobacilli for bacterial vaginosis, 99% and 68%; > 20% clue cells for bacterial vaginosis, 81% and 99%; visible endocervical mucopus for chlamydia or gonorrhoea, 36% and 86%; microscopic endocervical mucopus for chlamydia or gonorrhoea, 64% and 69%. CONCLUSIONS: Both protocols were equally effective in managing women with abnormal vaginal discharge. Simple clinical indicators for candidiasis, bacterial vaginosis, or trichomonas as in protocol A are sufficiently sensitive and specific for use in situations with no laboratory support. A modification to protocol A could increase detection of bacterial vaginosis at basic health service level. Further work is needed to identify appropriate indicators for infection with chlamydia or gonorrhoea.

Leucorrea: causas infecciosas e inbalances en el ecosistema vaginal

La alteración del escosistema vaginal puede ser mas dificil de tratar que una infeción dado que con frecuencia los factores precipitantes son desconocidos y, además porque el diagnóstico incorrecto puede llevar a tratamientos que complican el cuadro

Vaginal discharge in the adult: a practice guideline.

A practice guideline as a preformatted chart is presented. It is designed to be simple in concept and design, easy to use, parsimonious of data, easily scanned for quality assurance, and to provide clinical and cost-effectiveness prompts. It has supporting medical information for all recommendations that is literature- and experience-based. A patient aftercare instruction sheet is appended. An abbreviated "pocket practice guideline" is also provided. This format is clearly appropriate only for simple, not complex, clinical encounters.

Pharmacotherapeutic effects of toki-shakuyaku-san on leukorrhagia in young women.

Toki-shakuyaku-san is a traditional Chinese herbal prescriptions that is composed of 6 herbal plants, i.e., peony root, atractylodes lancea rhizome, alisma rhizome, hoelen, cnidium rhizome and Japanese angelica root. Administration with Toki-shakuyaku-san normalized irregular menstrual cycle, healed cervical pseudo-erosion and reduced leukorrhagia in young women who had insufficient luteal function.

Estudio descriptivo sobre gardnerella vaginalis asociada a leucorrea en 112 pacientes

Se describe un estudio sobre leucorrea asociada a Gardnerella vaginalis demostrada en 112 pacientes que consultaron entre el 1 de Octubre de 1989 y el 31 de Marzo de 1993. La infección por Gardnerella se estableció según los siguientes criterios: Flujo homogéneo y adherente a la pared vaginal, pH mayor de 4.5, prueba de aminas positiva si se alcaliniza la secresión vaginal y presencia de "células guía" o "clave" en los extendidos citológicos. Se describen las principales manifestaciones clínicas encontradas en el presente estudio que pueden sugerir leucorrea asociada a G. vaginalis haciendo énfasis en la nila o escasa reacción inflamatoria y la ausencia de bacilos de Doderlein.

Corrimento vaginal: uma nova proposta terapêutica com hipoclorito de sódio / Vaginal disharge: a new therapeutic proposal with sodium hypochlorite

Em estudo comparativo, randomizado, duplo-cego, foram estudadas 85 mulheres no menacme, que procuraram o Setor de Doenças Sexualmente Transmissíveis (MIP/CMB/CCM) da Universidade Federal Fluminense com queixas de corrimento vaginal. Neste estudo tratou-se um grupo de 43 pacientes com água bidestilada (placebo), e outro grupo de 42 com soluçao estabilizada a 750ppm (750mg/l ou 0,075 por cento) de hipoclorito de sódio. Em ambos os grupos as soluçoes foram utilizadas em aplicaçao de 250ml de cada soluçao por ducha vaginal diariamente, ao deitar, por um período de 10 dias. Foram feitas análises microbiológicas, colpocitológicas, dosagens plasmáticas de sódio, cloro e potássio, entre outras análises, antes e após o tratamento. Como parte dos resultados encontrados destacamos que 4,66 por cento (2/42) das pacientes do grupo placebo tiveram acentuada melhora da sintomatologia e no grupo hipoclorito o resulutado excelente ocorreu em 76,19 por cento (32/42).

Itraconazole versus placebo in the management of vaginal candidiasis.

A randomized double-blind trial was carried out with itraconazole versus placebo in the treatment of vaginal candidiasis, confirmed by clinical evaluation, direct microscopic examination and Sabouraud culture. Fifty patients were studied, 25 in the itraconazole group and 25 in the placebo group. Both groups received two capsules once daily (100 mg itraconazole/cap) for 3 days. One week after treatment patients were re-evaluated according to the same parameters as in selection. The scores for clinical symptoms, leukorrhea, vulvar pruritus, vaginitis and vulvitis, were compared in both groups before and after treatment. Statistically significant differences were found for the itraconazole group in pruritus and vaginitis (P less than 0.05) and vulvitis (P less than 0.001), with no significant difference for leukorrhea. As to the mycological evaluation, 7 days after treatment there were negative results for the itraconazole group in 92% of the patients in comparison to 52% in the placebo group (chi-square, P = 0.005).

[Infections by Mycoplasma hominis and Ureaplasma urealytycum in vaginal discharge. Incidence and treatment]. / Infections à Mycoplasmes hominis et Ureaplasma urealytycum dans les écoulements vaginaux. Fréquence et traitements.

This report summarizes the studies carried out on 100 patients who were examined for vaginal discharge. The following observations were made: Mycoplasma hominis in 13.59% of the cases, Ureaplasma urealytycum in 8.73% of the cases, that is, the presence of at least one of these microorganisms in 22.32 of the cases. All these infections were treated by tetracyclines administered in appropriate doses.

A prospective single-blind trial of minocycline and doxycycline in the treatment of genital Chlamydia trachomatis infection in women.

A total of 2124 women who attended the Richmond Family Planning Association Clinic in Melbourne consecutively were screened for the presence or absence of Chlamydia trachomatis. One hundred and three women were found to have Chl. trachomatis infection of the cervix and were invited to participate in a clinical trial of minocycline and doxycycline for the treatment of chlamydial infection. A 10-day course of either drug resulted in a negative result of a chlamydial culture for all patients at the follow-up assessment, which occurred between 11 days to 12 weeks after the therapy. Minocycline and doxycycline showed equal effectiveness in the eradication of mycoplasmas in over 80% of the treated patients. Minocycline appeared to have a slight advantage with respect to the resolution of the gynaecological symptoms that were associated with the chlamydial infection. The number of adverse events that were recorded during the trial was similar for both treatment regimens. Gynaecological symptoms were associated with chlamydial infection in approximately 50% of the women in the study. The lack of association between chlamydial infection and gynaecological symptoms has led to the instigation of routine testing for the presence of Chlamydia spp. in young women who have more than one sexual partner.

Corrimento vaginal: estudo de 380 casos do Ambulatório de Ginecologia da FAMECA / Vaginal discharge: study of 380 cases from the Ambulatório de Ginecologia da FAMECA

Os autores estudaram 380 casos de corrimento vaginal atendidos no Ambulatório de Ginecologia e Obstetrícia do Departamento de Ginecologia e Obstetrícia da FAMECA, no Hospital "Emilio Carlos", da Faculdade de Medicina de Catanduva, entre janeiro de 1986 e julho de 1987. Os 380 casos compunham 2 grupos. O primeiro de 259 pacientes submetidos a cultura e antibiograma, e que receberam tratamento específico. O segundo, de 121 pacientes tratadas sem a identificaçäo laboratorial do agente causal. Após analisarem a incidência, o diagnóstico e o tratamento, concluem pela grande diversidade dos agentes causais e pela necessidade de ser o tratamento orientado pela cultura e antibiograma, para serem obtidos melhores resultados