Vulval dermatoses (venereal and nonvenereal) among female patients presenting to a tertiary care hospital in North India

Background

The skin and mucosa of the vulva are different from the rest of the human body, as it is derived from all three embryological layers. It is more prone to dermatological diseases, both infectious and noninfectious.

Aims and Objectives

Our study was a prospective descriptive study on female patients attending the skin outpatient department with complaints of vulval dermatoses. Our aim was to determine the prevalence of venereal and nonvenereal dermatoses (infectious and non-infectious) along with age-wise distribution of these in our area.

Materials and Methods

All female patients presenting with visible skin lesions on the vulva from January 2019 to December 2019 were included in this study. Various diagnostic tests such as Gram staining, Tzanck smear, KOH mount, herpes simplex virus serology, and skin biopsy were performed wherever necessary.

Observations and Results

The study included 520 patients in whom 525 lesions were identified. These were grouped under venereal and non-venereal dermatoses. Nonvenereal dermatoses were further grouped under infectious and non-infectious conditions. Maximum patients were in the age group of 21-40 years (50.19%). The most common dermatoses were non-venereal infections, seen in 220 (42.30%) patients followed by non-venereal, non-infectious dermatoses seen in 177 (34.04%) patients whereas venereal dermatoses were seen in 128 (24.61%) patients.

Conclusion

Most of the patients were in the reproductive age group, and the prevalence of infectious dermatoses both venereal and non-venereal was much more than that of non-infectious conditions affecting the vulval skin as per our study.

Comparative Analysis of the Incidence of Selected Sexually Transmitted Viral Infections in Poland in 2010-2015: A Retrospective Cohort Study

Sexually transmitted infections (STIs) represent a major cause of morbidity in women and men worldwide. The main aim of this study was to perform a comparative analysis of the incidence of sexually transmitted viral infections in 2010–2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and the National Institute of Public Health-National Research Institute and constituted information from the epidemiological surveillance system in Poland. We collected data on the incidence of the following diseases: genital herpes (HSV), genital warts, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). The key groups with the highest risk of infection were young people between 20 and 29 years of age. The reported data on the incidence of genital herpes in Poland (n = 3378; 1.5/100,000) showed a downward trend, which does not coincide with global trends. Genital warts were the most frequent genital infections in Poland (n = 7980; 3.46/100,000), with significant regional variation. Over the analysed period, the situation of newly detected HIV infections seemed to be stable (n = 7144; 3.1/100,000). The incidence of these infections appeared to be highly correlated with urbanisation rates, which was not confirmed in the case of other analysed infections. The worsening epidemic situation with respect to sexually transmitted infections, the inefficiency of the current surveillance system and the reduction in funding for diagnosis and prevention, combined with inadequate legal solutions, make it necessary to undertake new legal and organisational measures aimed at improving the reproductive health in Poland in terms of sexually transmitted infections.

Gomastahs, Peons, Police and Chowdranies: The Role of Indian Subordinate in the Functioning of the Lock Hospitals and the Indian Contagious Diseases Act, 1805 to 1889

Recent scholarship on the social history of health and medicine in colonial India has moved beyond enclavist or hegemonic aspects of imperial medicine and has rather focused on the role of Indian intermediaries and the fractured nature of colonial hegemony. Drawing inspiration from this scholarship, the article highlights the significance of the Indian subordinates in the lock hospital system in the nineteenth century Madras Presidency. This study focuses on a class of Indian subordinates called the "gomastah", who were employed to detect clandestine prostitution in Madras to control the spread of venereal disease. It also underlines the role of other native and non-native subordinates such as Dhais, Chowdranies and Matrons, the ways in which they became indispensable for the smoother operation of the Contagious Diseases Act and the lock hospitals on a day-to-day basis. By emphasising how Indian subordinates were able to bring in caste biases within colonial governmentality, adding another layer to the colonial prejudices and xenophobia against the native population, it underlines the fact that there was not a one-way appropriation or facilitation of the coloniser's knowledge or biases by the colonised intermediaries. Rather, it argues for an interaction between them, and highlights the complexities of caste hierarchies and prejudice within the everyday colonial governmentality. Moreover, the article focuses on the consequent chaos and inherent power struggle between different factions of colonial staff.

Epidemiological data on HIV-infected patients and the importance of education regarding the infection rate. An analytical cross-sectional study

BACKGROUND

Sexually transmitted diseases (STIs) are an important public health problem in all countries. Knowledge of their relationship with the various socioeconomic levels is necessary for an understanding of their epidemiology and behavior in society.

OBJECTIVE

To investigate the epidemiology of human immunodeficiency virus (HIV)-positive patients and to correlate education with history of sexually transmitted diseases, especially for syphilis.

DESIGN AND SETTING

Analytical cross-sectional study carried out in the city of Juiz de Fora, Minas Gerais, Brazil.

METHODS

The medical records of HIV/acquired immunodeficiency syndrome (AIDS) patients who started antiretroviral therapy (ART) between January 2010 and July 2018 were assessed. These patients were attended at the specialized assistance service for HIV/AIDS) of the Department of Sexually Transmitted Diseases (STD/AIDS) of the city of Juiz de Fora. In total, 335 patients were selected.

RESULTS

In our sample, 73.13% were male; 57.36% were aged between 25 and 45 years and 24.23% were over 45 years of age. Regarding sexual orientation, 61.78% were homosexual. Regarding education, 52.88% had "unskilled education", while 47.12% had "qualified education". Analysis on the relationship between schooling and syphilis, a positive relationship between qualified schooling and syphilis was observed: odds ratio = 3.588; 95% confidence interval: 1.090-11.808.

CONCLUSION

Homosexual male patients are most affected by HIV. Furthermore, this disease is not limited only to individuals with low education. Syphilis should be suspected in all individuals.

Comparative Analysis of the Incidence of Selected Sexually Transmitted Bacterial Infections in Poland in 2010-2015: A Retrospective Cohort Study

Sexually transmitted infections are common infectious diseases. The main aim of this study was to perform a comparative analysis of the incidence of bacterial sexually transmitted infections in 2010-2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and constituted information being the epidemiological surveillance system in Poland. The analysis included data on the incidence of primary and secondary syphilis, gonorrhoea and non-gonococcal urethritis and genital infections. The overall incidence rates were disproportionately lower than European rates and those presented in studies from other countries. Young people, between 20 and 29 years of age, were the key groups at the highest risk of infection. The incidence rate of primary and secondary syphilis was lower in Poland than in Europe or America, but some regions, such as Mazovia and Lodz provinces, were found to have a higher incidence rate than other European rates. The reported incidence of gonorrhoea in Poland was also significantly lower compared with other countries, with a significantly higher number of infections in males than in females, and this was also one of the highest rates in EU countries. During the study period, the number of non-gonococcal genital infections systematically decreased, while in other countries of the European region, the incidence was among the highest of all sexually transmitted infections.

Survey of beef bulls in Brazil to assess their role as source of infectious agents related to cow infertility

Poor reproductive performance in beef cattle caused by infectious agents results in major financial losses as a result of reduced pregnancy rates and extended calving intervals. Bulls can be subclinical chronic carriers of bacterial and protozoal agents involved in cow infertility, such as Campylobacter fetus subsp. venerealis, Ureaplasma diversum, Mycoplasma bovigenitalium, Mycoplasma bovis, and Tritrichomonas foetus. Bulls harbor these microorganisms in their preputial crypts and transmit the agents to cows during natural mating. To obtain an overview of the etiologic agents in the preputial mucus of bulls, we aimed to identify, by PCR assay, C. fetus subsp. venerealis, M. bovis, U. diversum, M. bovigenitalium, and T. foetus in Brazilian bulls from farms with high infertility rates. We collected preputial mucus from 210 bulls on 18 beef cattle farms in Brazil between 2019 and 2020. We found at least one of the infectious agents that we were studying in bulls on 16 of the 18 beef cattle farms tested. We detected at least one infectious agent from 159 of 210 (76%) bulls tested, namely C. fetus subsp. venerealis, M. bovis, U. diversum, M. bovigenitalium, and T. foetus in 87 (55%), 84 (53%), 45 (28%), 28 (18%), and 1 (0.6%) animal, respectively. We found 95 bulls (60%) positive for only 1 etiologic agent (single infection) and 64 bulls (40%) carried multiple agents. Our results demonstrate the occurrence of bacterial and protozoal infectious agents that may be related to infertility in Brazilian beef cattle herds.

Susceptibility patterns in Neisseria gonorrhoeae in Nuuk, Greenland, 2015-2018: a short communication

Antimicrobial resistance in Neisseria gonorrhoeae (GC) has made gonorrhoea control and treatment more complex globally. In Greenland, the incidence of gonorrhoea is high and there is a need for continued surveillance of antimicrobial susceptibility.This study investigated gonococcal isolates obtained in Greenland's capital Nuuk between January 2015 and June 2018. Subsequent to collection, isolates were tested for ciprofloxacin and ceftriaxone susceptibility in order to monitor the resistance pattern among GC strains. 150 GC strains were isolated in Nuuk during the observation period (139 males, 93%; 11 females, 7%). All strains were fully susceptible to ceftriaxone. 49% of the GC strains were susceptible to ciprofloxacin. The median minimal inhibitory concentration (MIC) for ceftriaxone among GC strains resistant to ciprofloxacin was higher than among GC strains susceptible to ciprofloxacin. No differences in ciprofloxacin susceptibility and median MICs for ceftriaxone were observed by collection year. In conclusion no ceftriaxone resistance has been found in Nuuk to date. Continued easy access to diagnostics and treatment combined with increased and more systematic surveillance of antimicrobial susceptibility in Nuuk is recommended. Further, it is advisable to investigate the possibilities for intermittent sampling in Greenland outside of Nuuk, if obstacles in relation to sending sampling material to Nuuk can be bypassed.

[The Narkomzdrav of the Russian Socialist Federal Republic Organizational Input into Struggle with Social Diseases During 1920s]

The organizational input into struggle with social diseases became one of priority directions of functioning of the Narkomzdrav of the Russian Socialist Federal Republic during 1920s. The legal foundation base was developed. The network of medical organizations was organized. The scientific research and education activities were implemented.

Despite Being "Known, Highly Promiscuous and Active": Presumed Heterosexuality in the USPHS's STD Inoculation Study, 1946-48

The Sexually Transmitted Disease Inoculation Study of the United States Public Health Service (USPHS) was a short-term deliberate exposure experiment into the prevention of venereal diseases. Between 1946 and 1948, over 1,300 Guatemalan prisoners, psychiatric patients, soldiers, and sex workers were exposed to syphilis, gonorrhoea, and chancroid. USPHS researchers initially proposed hiring sex workers to "naturally" transmit venereal diseases to male subjects who would then be given various prophylaxes. The researchers were interested in studying the effectiveness of new preventative measures. In other words, the USPHS study was designed to transmit venereal diseases heterosexually from an "infected" female body to the men who, it was assumed, were sexually isolated subjects. However, the researchers did record instances of male-to-male disease transmission among their subject populations, instances that challenged the presumption of heterosexuality on which the study was based.

Medicinal Plants Used for Treating Reproductive Health Care Problems in Cameroon, Central Africa1

Medicinal Plants Used for Treating Reproductive Health Care Problems in Cameroon, Central Africa. Approximately 80% of the African population uses traditional plants to deal with health problems, basically because of their easy accessibility and affordability. This study was carried out to document indigenous knowledge of medicinal plants used by traditional healers and elders in the treatment of reproductive health care in the Bamboutos Division of the West Region in Cameroon, Central Africa. The research methods used included semi-structured interviews and participative field observations. For the interviews, 70 knowledgeable respondents (40 traditional healers and 30 elders) were selected via purposive sampling. Voucher specimens were collected with the help of respondents, processed into the Cameroon National Herbarium in Yaoundé following standard methods, identified with the help of pertinent floras and taxonomic experts, and submitted to Department of Botany at the University of Dschang. Descriptive statistics were used to analyze and summarize ethnobotanical information obtained. Informant consensus factors (ICF) were used to elucidate the agreement among informants on the species to be used in the treatment within a category of illness. The results showed that a total of 70 plant species from 37 families (mostly of the Asteraceae [8 species], Euphorbiaceae [7], and Acanthaceae and Bignoniaceae [4 each]) are used in the treatment of 27 reproductive ailments, with the highest number of species (37) being used against venereal diseases, followed by female (29) and male infertility (21), respectively. Leaves (47.3%) were the most commonly harvested plant parts and the most common growth forms harvested were the herbs (45.7%), followed by shrubs (30%). Sixty percent of plant material was obtained from the wild ecosystems. Herbal remedies were mostly prepared in the form of decoction (66.2%) and were taken mainly orally. Informant consensus about usages of medicinal plants ranged from 0.5 to 1.0 with an average value of 0.91. It can be concluded that medicinal plants have played and will continue to play major roles in the management of reproductive healthcare in the study area.

Co-infection assessment in HBV, HCV, and HIV patients in Western Saudi Arabia

To estimate the prevalence of diagnosed and undiagnosed coinfections among HIV, HBV, and HCV infected patients. Retrospective analysis of laboratory records for HIV, HBV, and HCV patients presenting at the HIV outpatient clinic. Serological data including hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg), hepatitis B e-antibody (anti-HBe), antibodies to HIV and HCV, anti-toxoplasmosis IgG and IgM antibodies, and anti-syphilis antibodies (VDRL) were collected. We obtained data for 628 (218 HCV, 268 HBV, and 142 HIV) patients. Male-to-female ratios were 1:1 for HCV, 3:4 for HBV, and 5:3 for HIV. Age means (SD) were 54.24 (16.40), 44.53 (18.83), and 40.39 (15.92) years for HCV, HBV, and HIV, respectively. In HIV group, the prevalence of HBV and HCV coinfections was 8.5% and 2.8%, respectively. In HBV group, the prevalence of HCV and HIV coinfections was 1.1% and 1.5%, respectively. In HCV group, HIV or HBV coinfections occurred at the same frequency (1.4%). An absence of screening for coinfections was detected in 7.0-48.5% patients as per the group and the infectious agent; which represents an estimated proportion of 20 out of 1,000 patients with an undiagnosed coinfection. Despite a relatively low prevalence of coinfections, a significant proportion of cases remain undiagnosed because of a lack of systematic screening. J. Med. Virol. 88:1545-1551, 2016. © 2016 Wiley Periodicals, Inc.

Incidence of syphilis in Greenland 2010-2014: the beginning of a new epidemic?

OBJECTIVE

To estimate the incidence of syphilis from 2010 to 2014 and to assess whether contact tracing has been performed.

STUDY DESIGN

Observational cross-sectional study.

METHOD

Data on reported cases were collected from the national register of the chief medical officer in Greenland. Unreported cases were found by searching the electronic medical record system for patients who had received an electronic prescription of benzathine penicillin, doxycycline or tetracycline. Medical records were reviewed to verify the diagnosis of syphilis and to evaluate if contact tracing had been performed.

RESULTS

Ninety-four cases of syphilis (51 males and 43 females) with a median age of 27 years (20-40) were included. The incidence of syphilis in Greenland has increased from zero cases in 2010 to 95.7 per 100,000 inhabitants in 2014 affecting mainly young people. Contact tracing was performed in 80.9% (76/94) of the cases.

CONCLUSION

Syphilis has re-occurred in Greenland and a new epidemic may be underway. Sustained awareness of treatment, contact tracing, monitoring and preventive initiatives are desirable.

The clinical and trichoscopic features of syphilitic alopecia

BACKGROUND

Syphilitic alopecia is not common in patients with secondary syphilis. Though the clinical and histopathological findings of syphilitic alopecia have been described, the trichoscopy features are unknown yet.

MAIN OBSERVATION

A 42-year-old Chinese man was admitted to our clinic with a complaint of hair loss. The patient presented clinically with moth-eaten alopecia over the whole scalp without any previous discomfort or skin rashes. The serology for syphilis was positive. Trichoscopy showed black dots, focal atrichia, hypopigmentation of hair shaft and yellow dots.

CONCLUSIONS

On the basis of trichoscopy, along with serology testing syphilitic alopecia can be differentiated from other hair loss diseases with similar clinical presentation.

The Prevalence of Syphilis in England and Wales on the Eve of the Great War: Re-visiting the Estimates of the Royal Commission on Venereal Diseases 1913-1916

Public fears of widespread venereal disease led in 1913 to the appointment of The Royal Commission on Venereal Diseases (RCVD). In 1916 its Final Report offered only a single cautious and somewhat imprecise summary statement about the likely prevalence of venereal diseases in England and Wales. Although the significance of contemporary attitudes to venereal disease has attracted a good deal of historiographic attention, no historian or demographer has since investigated this aspect of the Royal Commission's work. This article critically re-examines the most important quantitative evidence presented to the Royal Commission relating to the years immediately prior to the First World War. It utilises this evidence to produce new estimates of the probable prevalence of syphilis among adult males, both nationally and among certain geographical divisions and social groups in the national population; and also to offer a comment on the likely prevalence of gonorrhoea.

Venereology in India

Venereology-the study of venereal diseases or more recently, the sexually transmitted infections (STI) includes a variety of pathogens namely viruses, bacteria, fungi and protozoa for which the common factor is the mode of transmission and acquisition: Sexual relations between human beings. Medical and other historians have often suggested that well-known diseases such as syphilis, gonorrhea, chancroid and lymphogranuloma venereum have existed since earliest times. However, it is difficult to identify modern disease entities based on written historical record. Studying the origin of STIs helps us to learn the political, economic and moral conditions that led to the disease. Effective management of STI rests on three pillars of diagnosis, prevention and treatment. For most of past 50 years in India, the diagnostic pillar has been the least well-supported. Until well into present century, diagnosis of STI in India was clinical. Treatment of STIs in India followed the methods used in England. Of course in the 19^th century, in many parts of the world, only a few had access to modern methods of treatment; in India, there was extensive use of Ayurvedic treatment with traditional medicines. This article thus gives just an overview and evolution of venereology in India with regard to venereal diseases (now more often known as STIs/disease), control measures, academic, association and journal development and finally future perspective.

Medical confidentiality in the late nineteenth and early twentieth centuries: an Anglo-German comparison

Professional secrecy of doctors became an issue of considerable medico-legal and political debate in the late nineteenth and early twentieth centuries in both Germany and England, although the legal preconditions for this debate were quite different in the two countries. While in Germany medical confidentiality was a legal obligation and granted in court, no such statutory recognition of doctors' professional secrecy existed in England. This paper is a comparative analysis of medical secrecy in three key areas--divorce trials, venereal disease and abortion--in both countries. Based on sources from the period between c.1870 and 1939, our paper shows how doctors tried to define the scope of professional secrecy as an integral part of their professional honour in relation to important matters of public health.