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Biomedical subjects

D Mandal

Publications and source records attributed to D Mandal.

34 records · Page 2Linked to original sources

The chronically symptomatic vulva: prevalence in primary health care.

OBJECTIVES: To examine within the primary health care setting, the frequency of chronic vulval disorders, their frequency, investigation, management and referral patterns. METHODS: A questionnaire based survey at general practitioners surrounding a district general hospital. RESULTS: A total of 79 (72%) GPs replied to the questionnaire. Thirty-six (45%) GPs saw more than one patient per month with recurrent vulval symptoms and ten (13%) GPs saw more than three patients per month. The predominant symptom amongst patients with recurrent vulval symptoms was itching (55%) followed by soreness (26%), burning (14%) and dyspareunia (5%). Topical-antifungals and steroid medications were the commonest treatments prescribed for all women with vulval symptoms. CONCLUSIONS: Women who have vulval complaints commonly attend their GP for treatment. In many instances women with chronic vulval complaints are inadequately investigated and inappropriately managed.

Anti-Inflammatory Agents↗

Comparison of cotton wool swab and cytobrush for detection of chlamydial infection in women attending a genitourinary medicine clinic.

Endocervical specimens obtained by cytobrush and conventional cotton wool swabs from 90 women attending a genitourinary medicine clinic were compared for their efficiency in detecting chlamydial infection. Isolation of Chlamydia trachomatis and detection of the chlamydial lipopolysaccharide antigen were attempted on each specimen. Antigen was detected in 18% of cytobrush and 17% of swab specimens. The cytobrush proved less suitable than swabs for isolation because 8 cytobrush specimens (9%) were toxic to the McCoy cells. Toxicity was significantly associated with an infected endocervix (2P = 0.004). Cytobrush therefore appeared to have little advantage over the much cheaper alternative, the cotton wool swab.

Antigens, Bacterial↗

Prevalence of occult human papillomavirus infection, determined by cytology and DNA hybridization, in heterosexual men attending a genitourinary medicine clinic.

One hundred and five heterosexual men without evidence of clinical anogenital warts and attending a genitourinary medicine clinic were studied. Three separate specimens for cytology were taken from (i) the distal urethra including the perimeatal area, (ii) the penile shaft and glans penis including the sub-preputial area, and (iii) from the anorectal area using a proctoscope. Pooled specimens of exfoliated cells from these sites were also taken for the detection of human papillomavirus (HPV) by DNA hybridization. Twenty-eight (27%) of the men had cytological evidence suggestive of HPV infection. HPV genome was detected in 21 (20%) of the men by DNA hybridization and 95% of them were carrying HPV 16 genotype either alone or in combination with other genotypes. A total of 42 (40%) of patients had evidence of occult HPV infection using cytology and/or DNA hybridization techniques collectively. None of the epidemiological risk factors were significantly associated with occult HPV infection in this study. The significance of this high incidence of sexually transmissible HPV genomes, mostly HPV16 in the anogenital area of heterosexual men attending genitourinary medicine clinics requires further study.

Adolescent↗

Bacterial vaginosis in a district genitourinary medicine department: significance of vaginal microbiology and anaerobes.

The aim of this study was to correlate the significance of vaginal microbiology, in particular its anaerobic component, to the presence of bacterial vaginosis (BV), and to review the clinical criteria used in the diagnosis of this condition. Ninety-two female patients who received routine STD screening were studied. After routine history, presence and character of vaginal discharge and vaginal pH were noted, an amine test performed, and a wet stain observed microscopically. Routine Gram stain smears and cultures were prepared. BV was diagnosed clinically in 28 (30%) of our sample, and Gardnerella vaginalis was cultured in 41 patients (45%). Both clue cells and anaerobes were closely associated with each other and both mutually exclusive with the presence of lactobacilli on Gram stain (P < 0.001). BV was found to be strongly associated with the presence of clue cells on the wet film, anaerobes and G. vaginalis. In conclusion, bacterial vaginosis is not only strongly associated with the presence of G. vaginalis in the vaginal flora, but more strongly with the presence of anaerobes. The study suggests that the microaerophile G. vaginalis is a commensal organism in a significant proportion of sexually active women. If the aerobic status of the healthy vagina is disrupted, anaerobes (including Gardnerella) will flourish, producing the clinical picture of bacterial vaginosis.

Bacteria, Anaerobic↗