BACKGROUND: Bacterial vaginosis (BV) is a very common gynecologic infection associated with a vast number of complications both in gynecologic and obstetric patients. One of the major concerns in its treatment is a high recurrence rate which was multifactorial and the choice of the suitable antimicrobial is important to decrease the treatment failure.

METHODS: All gynecologic patients aged 18 years old and above in a tertiary hospital diagnosed with bacterial vaginosis according to Amsel's criteria. A total of 80 patients were randomly assigned into two groups; one group to receive oral Probiotics (Protexin) while the other group to receive Metronidazole. The patients will be followed up accordingly on Days 1, 3, 7 and 30 and will be graded according to Amsel's criteria. The primary endpoint of the study is the treatment of bacterial vaginosis based on the mentioned criteria. (Anukam, 2006)

RESULTS: The results showed that there was a significant improvement in the character of the vaginal discharge based on the Amsels criteria on Day 1 of treatment for the Metronidazole group (0/40; 100%, p value <0.001) and Day 3 for Oral Lactobacillus arms. (7/40; 20%, p value 0.01). The Metronidazole arm showed a significant improvement in the fishy odor on vaginal examination with addition of 10% KOH on day 1 (0/40; 100%, p value <0.001) and Day 3 for oral Lactobacilus (0/40; 100%, p value 1.00). Then vaginal pH was noted to be more acidic in the Metronidazole compared to the Protexin arm on Day 1 of treatment (0/40; 0% and 40/40; 100% p value

CONCLUSION: The Metronidazole remains to be the standard treatment for Bacterial vaginosis. There was also faster recovery and clinical improvement in the character of the vaginal discharge, amount and smell based on the Amsel's criteria as early as Day 1 of follow-up; however, there was a small number of population with poor compliance resulting to higher recurrence rate which was evident on the 30 th day of follow-up. The oral lactobacillus rhamnosus showed advantage over Metronidazole due to lower recurrence rate of BV as noted on Day 30 of follow up.

Human ; Female ; Aged ; Middle Aged ; Adult ; Pregnancy ; Vaginosis, Bacterial ; Lactobacillus Rhamnosus ; Metronidazole ; Lactobacillus ; Probiotics ; Anti-infective Agents ; Gynecological Examination ; Odorants ; Smell ; Vaginal Discharge

BACKGROUND: Bacterial vaginosis (BV) is a very common gynecologic infection associated with a vast number of complications both in gynecologic and obstetric patients. One of the major concerns in its treatment is a high recurrence rate which was multifactorial and the choice of the suitable antimicrobial is important to decrease the treatment failure.

METHODS: All gynecologic patients aged 18 years old and above in a tertiary hospital diagnosed with bacterial vaginosis according to Amsel's criteria. A total of 80 patients were randomly assigned into two groups; one group to receive oral Probiotics (Protexin) while the other group to receive Metronidazole. The patients will be followed up accordingly on Days 1, 3, 7 and 30 and will be graded according to Amsel's criteria. The primary endpoint of the study is the treatment of bacterial vaginosis based on the mentioned criteria. (Anukam, 2006)

RESULTS: The results showed that there was a significant improvement in the character of the vaginal discharge based on the Amsels criteria on Day 1 of treatment for the Metronidazole group (0/40; 100%, p value <0.001) and Day 3 for Oral Lactobacillus arms. (7/40; 20%, p value 0.01). The Metronidazole arm showed a significant improvement in the fishy odor on vaginal examination with addition of 10% KOH on day 1 (0/40; 100%, p value <0.001) and Day 3 for oral Lactobacilus (0/40; 100%, p value 1.00). Then vaginal pH was noted to be more acidic in the Metronidazole compared to the Protexin arm on Day 1 of treatment (0/40; 0% and 40/40; 100% p value

CONCLUSION: The Metronidazole remains to be the standard treatment for Bacterial vaginosis. There was also faster recovery and clinical improvement in the character of the vaginal discharge, amount and smell based on the Amsel's criteria as early as Day 1 of follow-up; however, there was a small number of population with poor compliance resulting to higher recurrence rate which was evident on the 30 th day of follow-up. The oral lactobacillus rhamnosus showed advantage over Metronidazole due to lower recurrence rate of BV as noted on Day 30 of follow up.

Human ; Female ; Aged ; Middle Aged ; Adult ; Pregnancy ; Vaginosis, Bacterial ; Lactobacillus Rhamnosus ; Metronidazole ; Lactobacillus ; Probiotics ; Anti-infective Agents ; Gynecological Examination ; Odorants ; Smell ; Vaginal Discharge

OBJECTIVE: To compare the efficacy, refractive predictability, stability and safety of Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser In-Situ Keratomileusis (F-LASIK) for the correction of myopia and astigmatism.

METHOD: This study was approved by the Institutional Review Committee of the St. Luke's Medical Center. A retrospective chart review was conducted at the Vision Laser Center of the St. Luke's Medical Center-Global City. All patients that underwent SMILE from January 2014 to July 2014, with adequate follow-up at 1 day, 1 week, 1 month, 3 months and 1 year, were included in the study. Age-matched and refraction-matched patients, who underwent F-LASIK from January 2012 to April 2014, were chosen as comparators. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), attempted refraction versus achieved refraction and adverse events at 1 day, 1 week, 1 month, 3 months and 1 year were compared postoperatively in both groups. Primary outcome measures were efficacy expressed as the percentage of eyes achieving UCVA of 20/25 or better during the postoperative follow-up, refractive predictability, safety and stability. 

RESULTS: Thirty-five eyes of 18 patients who underwent SMILE and 38 eyes of 19 patients who underwent FLASIK were included in the study. The mean preoperative spherical equivalent of both groups had no statistical difference, with -3.84 ± 1.31 D and -4.07 ± 1.39 D for SMILE and F-LASIK, respectively (p=0.801). At 1 week postoperatively, 51% and 97% achieved UCVA of 20/25 or better in the SMILE and F-LASIK groups. At 3 months, 97% had 20/25 vision or better for the SMILE group, while 100% had 20/25 vision or better for the F-LASIK group. At 1 year, both groups achieved 100% 20/25 or better vision. Three percent lost one line of BCVA in both groups at 1 year. Mean spherical equivalent (SE) between groups at 1 year showed no statistically significant difference (p=0.21), with 0.05 ± 0.18 D in the SMILE group and -0.1 ± 0.15 D in the F-LASIK group. No significant change in mean SE was observed within groups from 1 day to 1 year post op, p=0.166 for SMILE and p=0.226 for F-LASIK. At 1 year, 100% of the SMILE and F-LASIK groups were within ± 0.5 D of target refraction. No adverse events were noted in either group. 

CONCLUSION: SMILE was comparable to F-LASIK in terms of visual outcomes (efficacy, refractive predictability, stability) and safety for the treatment of myopia and astigmatism. However, a slight delay in visual improvement during the first week was observed in the SMILE group.

Human ; Male ; Female ; Adult ; Keratomileusis, Laser In Situ ; Astigmatism ; Eyeglasses ; Advisory Committees ; Myopia ; Visual Acuity ; Eye ; Outcome Assessment (health Care)