MyMedR

Diagnostic pitfalls in the evaluation and management of amenorrhea in adolescents

Azurah AG, Zainuddin AA, Jayasinghe Y

J Reprod Med, 2013 Jul-Aug;58(7-8):324-36.

Amenorrhea is a common menstrual problem seen in adolescents. Amenorrhea has been shown to have a negative impact on adolescents' quality of life. In this paper we discuss the various causes and investigations of amenorrhea in adolescents and address management dilemmas for specific conditions. Specific approaches in dealing with adolescents using the HEADSS (Home, Education, Activity, Drugs, Sexual activity, Suicidal) approach are discussed.

Matched MeSH terms: Vagina/abnormalities

Fulltext Isolation and molecular characterization of Brucella melitensis from seropositive goats in Peninsula Malaysia

Bamaiyi PH, Hassan L, Khairani-Bejo S, Zainal Abidin M, Ramlan M, Krishnan N, et al.

Trop Biomed, 2012 Dec;29(4):513-8.

PMID: 23202595

A study was carried out to isolate Brucella melitensis using established bacteriological and PCR techniques in Brucella seropositive goats in farms in Selangor, Negeri Sembilan, Melaka and Pulau Pinang. Brucella melitensis was isolated from 7 of 134 reactors with the highest isolation from the vaginal swabs (57.14%) followed by the spleen (28.57%), uterine fluid (14.29%). No Brucella was isolated from the lymph nodes. PCR confirmed all the seven isolates as B. melitensis and isolates were phylogenetically related to other isolates from India, Iran, and Israel but most closely related to isolates from Singapore.

Matched MeSH terms: Vagina/microbiology

Successful pregnancy outcome following gamete intra-Fallopian transfer in a patient with Müllerian dysgenesis

Lee CS, Lie AT

Reprod Biomed Online, 2012 May;24(5):547-9.

PMID: 22410277 DOI: 10.1016/j.rbmo.2012.01.021

A 29-year-old lady with Müllerian dysgenesis was keen to have a baby. Clinically, she was medium built with well-developed secondary female sexual characteristics. There was a short and blind vagina. She had undergone surgery for an imperforated hymen. Her FSH and LH concentrations were normal. Laparoscopy revealed a patent right Fallopian tube, a rudimentary right uterus and extensive pelvic endometriosis. She subsequently underwent gamete intra-Fallopian transfer (GIFT). Oocyte retrieval was carried out laparoscopically and a total of nine oocytes were retrieved. Four of the oocytes were transferred together with motile spermatozoa into the right Fallopian tube and the remaining five oocytes were inseminated with spermatozoa for IVF. Three embryos resulted and were frozen. She subsequently developed moderate ovarian hyperstimulation syndrome. Serum β-human chorionic gonadotrophin concentration 14 days after GIFT was 1612 IU/l. Her antenatal care was relatively uneventful until 31 weeks of gestation when she was diagnosed to have intrauterine growth retardation and oligohydramnios. She then underwent an emergency Caesarean section at 32 weeks of pregnancy delivering a normal baby. This case study describes a successful pregnancy outcome following gamete intra-Fallopian transfer (GIFT) in a woman with malformation of the vagina (Müllerian dysgenesis). A 29-year-old lady with Müllerian dysgenesis diagnosed at 16 years of age was keen to become pregnant. Upon examination, a decision was made for a William's vulvovaginoplasty but as the patient was indecisive the surgery was deferred. Clinically, she is a medium-built lady with well-developed secondary female sexual characteristics. There was a short and blind vagina. Her serum FSH and LH concentrations were normal. Laparoscopy revealed a patent right Fallopian tube, a rudimentary right uterus and extensive pelvic endometriosis. She subsequently underwent GIFT. Nine oocytes were retrieved through laparoscopy. Four of the oocytes were transferred together with motile sperm into the right Fallopian tube and the remaining five oocytes were inseminated with sperm for IVF. Three embryos resulted and were frozen. Serum β human chorionic gonadotrophin concentration measured 14 days after GIFT was 1612 IU/l. An abdominal ultrasonography performed at 5 weeks showed one intrauterine gestational sac. Her antenatal care was uneventful until 31 weeks of gestation when she developed a deficiency of amniotic fluid in the amniotic sac. She then underwent an emergency Caesarean section at 32 weeks of pregnancy. She delivered a healthy, normal 1.24 kg baby boy. Her post-natal care was uneventful.

Matched MeSH terms: Vagina/abnormalities

Fulltext Preventing sexually transmitted infections: back to basics

Rompalo A

J Clin Invest, 2011 Dec;121(12):4580-3.

PMID: 22133882 DOI: 10.1172/JCI61592

Sexually transmitted infections (STIs) have plagued humans for millennia and can result in chronic disease, pregnancy complications, infertility, and even death. Recent technological advances have led to a better understanding of the causative agents for these infections as well as aspects of their pathogenesis that might represent novel therapeutic targets. The articles in this Review Series provide excellent updates on the recent advances in understanding of the pathogenesis of some very important and persistent STIs and discuss the importance of considering each pathogen in the broader context of the environment of the individual who it infects.

Matched MeSH terms: Vagina/microbiology

Use of the Gynecare Prolift system in surgery for pelvic organ prolapse: 1-year outcome

Vaiyapuri GR, Han HC, Lee LC, Tseng LA, Wong HF

Int Urogynecol J, 2011 Jul;22(7):869-77.

PMID: 21479713 DOI: 10.1007/s00192-011-1400-9

INTRODUCTION AND HYPOTHESIS: This retrospective study reports the 1-year outcome in women who underwent mesh-augmented Prolift surgery performed from 2006 to 2008. There were a total of 254 patients, with 128, 106 and 20 patients receiving total, anterior and posterior Prolift, respectively.

METHODS: Incidence of thigh pain was lower in 2008 compared to 2006 and 2007 (p < 0.0001). The percentage of patients requiring blood transfusions (p = 0.09), duration of IDC ≥ 7 days (p = 0.27), wound dehiscence and re-operation rate were lower in 2008 in contrast to 2006 and 2007 (p = 0.43). Only 209 patients (82.3%) were available for review at 1 year. There were two (1.0%) cases of recurrent vault prolapse.

RESULTS: The subjective and objective cure rates at 1 year after this mesh implant surgery in 2006, 2007 and 2008 were 92.1% and 92.1%; 97.0% and 92.4% and 100% and 97%, respectively. The mesh erosion rate was remarkably lower in 2008 as compared to 2007 and 2006 (p < 0.001).

CONCLUSIONS: This synthetic mesh-augmented implant surgery is effective and safe, and surgical outcome appears related to the learning curve of the surgeon.

Matched MeSH terms: Vagina/surgery*

Modified Field's staining--a rapid stain for Trichomonas vaginalis

Afzan MY, Sivanandam S, Kumar GS

Diagn Microbiol Infect Dis, 2010 Oct;68(2):159-62.

PMID: 20846588 DOI: 10.1016/j.diagmicrobio.2010.06.005

Trichomonas vaginalis, a flagellate protozoan parasite commonly found in the human genitourinary tract, is transmitted primarily by sexual intercourse. Diagnosis is usually by in vitro culture method and staining with Giemsa stain. There are laboratories that use Gram stain as well. We compared the use of modified Field's (MF), Giemsa, and Gram stains on 2 axenic and xenic isolates of T. vaginalis, respectively. Three smears from every sediment of spun cultures of all 4 isolates were stained, respectively, with each of the stains. We showed that MF staining, apart from being a rapid stain (20 s), confers sharper staining contrast, which differentiates the nucleus and the cytoplasm of the organism when compared to Giemsa and Gram staining especially on parasites from spiked urine samples. The alternative staining procedure offers in a diagnostic setting a rapid stain that can easily visualize the parasite with sharp contrasting characteristics between organelles especially the nucleus and cytoplasm. Vacuoles are more clearly visible in parasites stained with MF than when stained with Giemsa.

Matched MeSH terms: Trichomonas vaginalis/isolation & purification*; Vagina/parasitology

Fulltext Uncomplicated term vaginal delivery following magnetic resonance-guided focused ultrasound surgery for uterine fibroids

Zaher S, Lyons D, Regan L

Biomed Imaging Interv J, 2010 04 01;6(2):e28.

PMID: 21611041 DOI: 10.2349/biij.6.2.e28

A 35 year-old para 1+0 underwent MRgFUS per study protocol for multiple uterine fibroids, the largest of which measured 5 cm. She conceived 10 months following the procedure. The patient was induced at 41+6 weeks and underwent a normal vaginal delivery.

Matched MeSH terms: Vagina

Fulltext The effects of Tualang honey on female reproductive organs, tibia bone and hormonal profile in ovariectomised rats--animal model for menopause

Zaid SS, Sulaiman SA, Sirajudeen KN, Othman NH

BMC Complement Altern Med, 2010;10:82.

PMID: 21194469 DOI: 10.1186/1472-6882-10-82

Honey is a highly nutritional natural product that has been widely used in folk medicine for a number of therapeutic purposes. We evaluated whether Malaysian Tualang honey (AgroMas, Malaysia) was effective in reducing menopausal syndrome in ovariectomised female rats; an animal model for menopause.

Matched MeSH terms: Vagina/anatomy & histology; Vagina/drug effects*

Micro-dose transdermal estradiol for relief of hot flushes in postmenopausal Asian women: a randomized controlled trial

Haines C, Yu SL, Hiemeyer F, Schaefers M

Climacteric, 2009 Oct;12(5):419-26.

PMID: 19479489 DOI: 10.1080/13697130902748967

To compare the effect of micro-dose transdermal estradiol and placebo on the incidence and severity of menopausal symptoms and well-being in postmenopausal Asian women with vasomotor symptoms.

Matched MeSH terms: Vagina/chemistry

Fulltext Screening of antenatal mothers and prevention of perinatal group B streptococcal infection

Raj, M., Razali N,, Sulaiman, S.

JUMMEC, 2009;12(1):27-30.

MyJurnal

The objectives of this study were: (1) to detect group B streptococcus (GBS) carriers among antenatal patients during pregnancy ( 35 to 37 weeks) in the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, and (2) to give antibiotic prophylaxis during the intrapartum period for the GBS carrier patients. The aim is to prevent early onset of GBS infection in newborn. This pilot study was carried out from 1st July 2005 to 31st August 2005. It is a prospective study involving 56 pregnant women who were seen at the antenatal clinic in the UMMC between 35 to 37 weeks gestation. High vaginal swab and low vaginal together with endoanal swab were taken for culture and sensitivity. The antibiotic prophylaxis was started early in the intrapartum period for patients with positive culture for GBS. GBS was detected in 18 patients which contributes to about 32% of the study population. The proper choice of antibiotic is important in successful disease prevention.

Study site: Obstretic and gynaecological clinic, University Malaya Medical Centre (UMMC)

Matched MeSH terms: Vagina

Fulltext Parasitic leiomyoma in the vagina

Noraziana, A.W., Mokhtar, A., Norra, H.

International Medical Journal Malaysia, 2008;7(1):1-4.

MyJurnal

Leiomyomas are the most common benign tumour of the uterus, occurring in 20-40% of women in reproductive age.Most of the myomas arise in the uterus, however extrauterine sites include fallopian tubes, cervix, round ligament, ovary and urethra. A single or polypoidal mass in the vagina is usually a leiomyomatous polyp arising from the cervix or from the cavity of the uterus. Leiomyoma developing de novo from the fibromuscular elements of the vagina is a rare entity. When such a tumour arises from anterior wall of the vagina it is often mistaken for a cervical fibroid. Parasitic leiomyoma is the rarest type of leiomyoma and develop when a leiomyoma attaches itself to another organ. Vaginal leiomyomas usually arise from anterior vaginal wall. We report a case of parasitic leiomyoma in the vagina together with uterine leiomyoma in a 48 year old lady presented with palpable mass perabdomen and anaemic symptoms. The size and location of the tumours necessitated abdominal and vaginal approach for better surgical access.

Matched MeSH terms: Vagina

Fulltext Effects of L-arginine on the reproductive system of male rabbits

Sukardi, S., Yaakub, H., Ganabadi, S., Cheng, L.H.

Malays J Nutr, 2006;12(2):201-211.

MyJurnal

L-arginine is an amino acid, which serves as the sole substrate for nitric oxide (NO) synthesis with the concomitant formation of L-citrulline in biologic system. NO has been demonstrated to be involved in smooth muscle relaxation and vasodilation, immune regulation and neurotransmission. It also has an important function as both intercellular and intracellular signals in many physiological systems, including the reproductive system where NO mediates penis erection. This study was undertaken to determine the effects of L-arginine on sperm motility, sperm count, and the nitric oxide level in the seminal plasma. Twelve sexually matured male rabbits (Oryctolagus cuniculus) were randomly divided into four groups with three rabbits each, which were control, low, medium, and high concentration groups. The treatment groups were force-fed with 100mg/kg, 200mg/kg, and 300mg/kg body weight of L-arginine for four weeks, whereas the control group was force-fed with water. Semen samples were collected every three days alternatively for a week before starting treatment and then after four weeks of treatment. Pre-treatment and post-treatment results were compared. Semen samples were collected using artificial vaginas from each group for sperm analysis such as sperm motility, sperm count and NO level in seminal plasma. Sperm motility and sperm count were analysed manually under microscope (twenty power objective), using a Makler counting chamber. NO levels in the seminal plasma were determined using Griess reaction. The results obtained from this study showed that oral consumption of L-arginine exerted a significant (p

Matched MeSH terms: Vagina

Fulltext Vaginal and Cervical Agenesis – Hysterectomy in A Young Girl.

Roszaman Ramli, Ghazali Ismail

International Medical Journal Malaysia, 2006;5(2):1-8.

MyJurnal

Vaginal agenesis is a rare event occurring at a frequency of 1 case per 4000-10 000 female lives born. The most common etiology of vaginal agenesis is congenital absence of the uterus and vagina called mullerian agenesis (Mayer-Rokitansky-Hauser Syndrome). Although most patients with mullerian agenesis have small rudimentary 2 ‘mullerian bulbs’ without any endometrial activity, 7-8% of these cases possibly have a functioning uterus 3. In vaginal agenesis, genetic females are thought to have persistence of mullerian inhibiting factor MIF, resulting in failure of the vagina and uterus to develop 4. The ovaries, given their separate embryonic source, are normal in structure and function. This condition usually goes undetected until these patients reach puberty, when they start to experience cyclic pelvic pain due to the accumulation of menstrual blood.

Matched MeSH terms: Vagina

Fulltext Extrapelvic Endometriosis: A report of two cases

Nor Azlin, M.I., Amelia, A.Z., Zainul Rashid, M.R.

International Medical Journal Malaysia, 2006;5(1):1-4.

MyJurnal

Extrapelvic endometriosis is fairly rare and may occur in numerous sites throughout the body. Unnecessary investigation may be performed before the diagnosis could be made. Here we present two cases where endometriotic nodules occurred on a caesarean section scar and in the vagina. Further management is discussed in the report.

Matched MeSH terms: Vagina

Fulltext The pudendal thigh fasciocutaneous flap for vaginal atresia reconstruction

Azman WS, Halim AS, Samad IA

Med J Malaysia, 2005 Oct;60(4):505-7.

PMID: 16570718

Vaginal defects can either be congenital or acquired due to tumor or trauma. The reconstructions are aimed in producing a good physical and functional result with the least donor site morbidity. The pudendal thigh flap is a sensate fasciocutaneous flap based on the terminal branch of the superficial perineal artery, the continuation of the internal pudendal artery. Although various flaps have been described for vaginal reconstruction, the pudendal thigh flap offers a very attractive alternative.

Matched MeSH terms: Vagina/abnormalities; Vagina/surgery*

Fulltext Malignant mixed mullerian tumour, heterologous in a 66-year-old malay lady - a case report

Rahman MT, Naik VR, Noor SR, Mahmud NM, Isa M

Malays J Med Sci, 2003 Jul;10(2):93-5.

PMID: 23386805

A 66-year-old Malay woman, known hypertensive, presented with post menopausal bleeding associated with clot for three months. She was postmenopausal for last ten years. She also complaints of developing a mass in the abdomen which was growing in size also for last three months. Abdominal examination revealed a twenty week size mass, movable from side to side but unable to get below the mass. Vaginal examination revealed a fleshy fungating mass arising from the uterus coming out through the vagina. Cervix could not be visualized properly. Subsequent histopathology of the removed mass was reported as a Malignant Mixed Mullerian Tumour - Heterologous.

Matched MeSH terms: Vagina

Isolation of Neissseria meningitidis from an unusual site

Karunakaran R, Ngeow YF, Mashor M

Malays J Pathol, 2002 Dec;24(2):103-5.

PMID: 12887169

A 59-year-old post-menopausal lady who had returned from a pilgrimage to Mecca about a month earlier presented with a three days' history of profuse vaginal discharge. Neissseria meningitidis was isolated from high vaginal swab specimens taken from her on 2 occasions, five days apart. Her symptoms disappeared without treatment after two weeks. We conclude that although the organism may have been a colonizer, it is possible that it was responsible for the self-limiting genital infection in this patient.

Matched MeSH terms: Vagina/microbiology*; Vaginal Diseases/microbiology; Vaginal Diseases/pathology*

Male circumcision and penis enhancement in Southeast Asia: matters of pain and pleasure

Hull TH, Budiharsana M

Reprod Health Matters, 2001 Nov;9(18):60-7.

PMID: 11765401

This paper reviews some uniquely male sexual health concerns in Southeast Asia, with particular attention to Indonesia. These include various forms of male circumcision, different types of 'penis enhancement' carried out across the region and the use of dry sex by women. These practices appear to be motivated by specific notions of sexual pleasure, based on indigenous gender constructs. Although they may or may not pose a serious public health problem, as markers of misguided or exploitative gender relations they do reveal important aspects of social psychology related to sexuality and sexual health. Male circumcision provides an ideal opportunity to consider male reproductive health needs and risks in Indonesia, Malaysia and the Philippines. Practices that involve cutting the male genitals need to be addressed in ways that stress the importance of sexual relationships based on mutual respect and open communication. Penis implants and inserts and other penis augmentation devices, as well as dry sex practices, are potentially dangerous to both men and women, and of questionable value in bringing pleasure to either, and should be discouraged.

Matched MeSH terms: Vagina/secretion

An unusual cause of antepartum haemorrhage

Soh EB, Lim JM

Aust N Z J Obstet Gynaecol, 1999 Aug;39(3):389-90.

PMID: 10554965

This is a rare case of antepartum haemorrhage arising from the nonpregnant uterus in a woman with uterine didelphys. The bleeding and subsequent passage of a decidual cast did not have any adverse effect on the ongoing pregnancy.

Matched MeSH terms: Vagina/abnormalities*

Fulltext The role of endovaginal ultrasonography and the value of endometrial biopsy in breast cancer patients on tamoxifen therapy

Sivalingam N, Pathmalingam A

Singapore Med J, 1999 Jun;40(6):402-4.

PMID: 10489508

Endometrial changes have been observed when tamoxifen is used as an adjuvant therapy for carcinoma of the breast in postmenopausal women with positive estrogen receptors status.

Matched MeSH terms: Vagina/ultrasonography*

Displaying publications 61 - 80 of 99 in total