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Background and Purpose: Vulvovaginal candidiasis (VVC) is an opportunistic infection due to Candida species, one of the most common genital tract diseases among reproductive-age women. The present study aimed to investigate the prevalence of VVC among non-pregnant women and identify the epidemiology of the involved Candida species with the evaluation of antifungal susceptibilities. Materials and Methods: Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed to identify Candida species isolated from the genital tract of 350 non-pregnant women. Moreover, antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute broth microdilution method guidelines (M27-A3 and M27-S4). Results: Vaginal swab cultures of 119 (34%) women yielded Candida species. Candida albicans was the most frequently isolated species (68%), followed by Candida glabrata (19.2%). Voriconazole was the most active drug against all tested isolates showing an MIC50/MIC90 corresponding to 0.016/0.25 µg/mL, followed by posaconazole (0.031/1 µg/mL). Overall, resistance rates to fluconazole, itraconazole, and voriconazole were 2.4%, 4.8% and, 0.8% respectively. However, posaconazole showed potent in vitro activity against all tested isolates. Conclusion: Results of the current study showed that for the effectual therapeutic outcome of candidiasis, accurate identification of species, appropriate source control, suitable antifungal regimens, and improved antifungal stewardship are highly recommended for the management and treatment of infection with Candida, like VVC.

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BACKGROUND: Doing and repairing episiotomy in a natural vaginal delivery is a painful phenomenon and various methods have been used to reduce its pain. Nowadays, topical ointments are being increasingly used due to low systemic absorption and ease of use. OBJECTIVES: The present study aimed to compare the effects of lidocaine-prilocaine cream (XYLA cream) and lidocaine injection on the reduction of pain while doing and repairing episiotomy. METHODS: This randomized clinical trial was conducted on 98 pregnant women with the gestational age of > 37 weeks. In the intervention group that contained 50 women, 5 gr XYLA cream was applied to the episiotomy area one hour prior to delivery. It was also applied to healthy wound edges to numb the area while repairing episiotomy. In the control group, lidocaine 2% injection was used at the time of delivery. The two groups were compared regarding demographic characteristics, delivery characteristics, pain intensity based on visual analogue scale (VAS), and satisfaction with the applied technique. RESULTS: The results showed no significant differences between the two groups with respect to age, occupation, mother's weight and education level, gestational age, parity, number of deliveries, and infant's weight and head circumference (P > 0.05). Also, no significant difference was found between the two groups concerning the length of the active, second, and third phases of labor (P > 0.05). Considering postpartum complications (episiotomy wound infection), the infection was detected in three participants in the XYLA cream group and four individuals in the lidocaine group, but the difference was not statistically significant (P = 0.376). It should be noted that the application of XYLA cream did not cause eye irritation in any of the infants. The results also revealed no significant differences between the two groups regarding pain intensity and satisfaction with the applied technique after doing and repairing episiotomy (P = 0.288). CONCLUSIONS: The results indicated that XYLA cream had no specific complications and had an effect similar to lidocaine injection while doing the episiotomy.

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BACKGROUND: To determine the frequency of postpartum stress urinary incontinence (SUI) in women undergoing vaginal delivery or elective cesarean section and to investigate the sociodemographic determinants of SUI in a sample of Iranian patients. METHODS: This prospective cohort study was performed during a 1-year period from 2014 to 2015 including 286 healthy nulliparous women in the third trimester of pregnancy without prepregnancy urinary incontinence. Participants were categorized based on the mode of delivery, i.e., vaginal delivery (n=148) and elective cesarean section (n=138). SUI was evaluated in all the participants before delivery and at 1 month, 6 months, and 12 months after delivery using a previously validated Persian questionnaire. The frequency of postpartum SUI was recorded in both study groups and was compared between them. We also determined the sociodemographic determinants of SUI. RESULTS: Baseline characteristics were comparable. The frequency of postpartum SUI was significantly higher in vaginal delivery than in cesarean section after a 1-month (p<0.001), 6-month (p<0.001), and 12-month (p<0.001) period. Age was found to be associated with increased frequency of postpartum SUI in both vaginal delivery (p=0.021, r=0.286) and cesarean section groups (p=0.043, r=0.125). SUI was associated with tool-assisted vaginal delivery (p<0.001) and episiotomy (p<0.001). The birth weight was positively correlated with increased frequency of postpartum SUI in both vaginal delivery (p=0.011, r=0.546) and cesarean section (p=0.034, r=0.311). Patients with SUI had a significantly higher body mass index than the normal individuals (p=0.038). SUI was associated with lower income (p=0.028) and lower neighborhood residence (p=0.033). CONCLUSION: Vaginal delivery is associated with a twofold increased risk of postpartum SUI in primipara women compared with elective cesarean section. Age and birth weight are the main risk factors of postpartum SUI in both modes of delivery. Tool-assisted delivery and episiotomy were determined as the risk factors of postpartum SUI in vaginal delivery.

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The aim of this study was to determine the most effective and suitable time to remove the urinary catheter (Foley) after anterior and posterior colporrhaphy surgery. Patients who experience anterior Colporrhaphy operation for genuine stress incontinency or pelvic organ prolapsed will have post operative voiding dysfunction. These patients need postoperative drainage. One of the methods preferred for this purpose is to apply Foley Catheter, but there is no particular regimen available for the exact time of catheter removal in these patients. We have tried to find out the best time to remove Foley catheter after which the repeated Foley catheter is not required or minimized. One hundred and eighty nine patients who have been undergone Colporrhaphy have been selected randomly and divided into three groups' as 1, 2 and 4 days of catheter removal. The number of patients in each group was 62, 63 and 64 respectively. In all three groups, before removing urinary catheter, it was clamped every 4 hrs, for 3 times. After removing of Foley, the patients were guided for urination; the voiding and residual volume was measured. In the patients with an increase of residual volume, the repeated Foley requirement was increased. However, 5.6 % of the patients with residual volume of < or = 33 percent and 23.9% of the patients with residual volume between 33 to 68 percent, and finally 64.8% of the patients with residual volume of > or = 68% had repeated Foley insertion. When considering the number of days, 85, 65 and 35.7 percent of the patients needed repeated Foley after 1, 2, and 4 days of catheter removal respectively. Interestingly, in the third group (4 days of the catheter removal) with residual volume of < or = 33% the repeated Foley requirement was nil, with no increase risk of urinary infection. We suggest that the best time to remove the urinary Foley catheter after anterior and posterior Colporrhaphy is the day four.

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