Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

Penile intraepithelial neoplasia (PeIN) is now the new term for premalignant penile skin lesions. It is psychologically devastating to the patient and can pose a challenge to clinicians in the diagnosis. Risk factors for the development of PeIN include phimosis, uncircumcised state, poor genital hygiene, human papillomavirus infection, and smoking. When the condition is more advanced, inguinal lymphadenectomy may be needed, which has considerable morbidity. These lesions are classified separately as Bowenoid papulosis, Bowen disease, Erythroplasia of Queyrat, and squamous cell carcinoma in situ of the penis. Initial treatment of early-stage disease is surgical and has a good prognosis.

Background: Vaginal discharge is one of the most common gynecological complaints among women, with significant implications for physical, psychological, and social well-being. Diagnosis and management are essential to improve patient outcomes and quality of life (QOL).

Aim: To identify the cause of vaginal discharge, associated comorbidities, and its impact on QOL using the Dermatology Life Quality Index (DLQI).

Materials and methods: This prospective cross-sectional study was conducted over 1 year at the STD clinic of a tertiary care center. A total of 125 married women aged 18 years and above with abnormal vaginal discharge were enrolled. Clinical history, gynecological examinations, and laboratory investigations, including the Whiff test, KOH mount, Wet mount, Gram staining, and culture on Sabouraud dextrose agar, were performed. QOL was assessed using the DLQI questionnaire. Statistical analysis was carried out to evaluate associations between DLQI scores and clinical parameters.

Results: Candida species was the most commonly isolated pathogen (54.4%), followed by bacterial vaginosis (32%) and nonspecific causes (10.4%). Moderate-to-very large effects on QOL were observed in 62% of patients. Significant associations were found between DLQI scores and volume of discharge (P = 0.005) and itching (P = 0.0001), highlighting the distress caused by these conditions.

Conclusion: Abnormal vaginal discharge has a significant impact on QOL of affected women, particularly in cases with recurrent symptoms and higher symptom severity. Early diagnosis and targeted treatments are essential to alleviate symptoms and improve overall well-being.

Background and objectives: Timely HIV testing and diagnosis is critically important to achieve an AIDS free world. We previously reported a severe disruption in HIV testing and diagnosis during 2020 due to COVID-19 pandemic. The objective of this study was to assess the impact of COVID-19 pandemic on HIV testing and diagnosis during 2021.

Materials and methods: The documents/records on HIV testing and diagnosis during 2021 were evaluated. Data was analyzed on Microsoft excel and Graph Pad prism v6 software.

Results: During 2021, we observed only 3% rise in the number of people tested for HIV compared to 2020. The number of people tested for HIV during 2021 was 55.6% lower than the average number during 2016-2019. Compared to 2020, the number of people tested during 2021 under Client-initiated testing increased by 26.9% but under provider-initiated HIV testing further declined by 15.7%. There was 43.7% decline in the number of individuals diagnosed as HIV positive during 2021 compared to the average number during 2016-2019 due to low HIV testing. HIV testing in 15-34 year-old people (which included young adults) was significantly decreased; HIV testing in other age groups was non-significantly affected. There was 30.9% increase in number of males diagnosed as HIV positive despite <1% change in male HIV testing during 2021 compared to 2020.

Conclusion: COVID-19 pandemic during 2020 and 2021 severely disrupted HIV testing and diagnosis. This disruption may fuel HIV transmission and thereby AIDS cases in the coming decade.

Background: Nonvenereal genital dermatoses (NVGD) are dermatological conditions that can mimic sexually transmitted infections (STIs), leading to misdiagnosis and unnecessary anxiety.

Objective: The objective is to determine the prevalence of NVGD.

Materials and methods: This was an observational, descriptive study conducted in the Department of Dermatology, Venereology, and Leprology, Dhanalakshmi Srinivasan Medical College and Hospital, Tamil Nadu.

Results: During the 12-month study, 350 patients (2.4%) presented with genital complaints. Among them, 106 (30.3%) were diagnosed with STIs, while 244 (69.7%) had NVGD and were enrolled in the study. The overall prevalence of NVGD was found to be 69% among patients presented with genital complaints. The most affected age group was 31-40 years (32.0%). The mean age of patients was 39.1 years. Males (52.9%) were slightly more affected than females (47.1%). Most patients (56.6%) were from rural areas, and 60.3% were married. Infections and infestations were the most common NVGD category (34.8%), with scabies (13.1%) and tinea cruris (13.1%) being the predominant conditions. Eczematous disorders accounted for 20.1%, primarily lichen simplex chronicus (13.9%). Sclerosing disorders, mainly lichen sclerosus, were more frequent in females (15.7%) than males (6.2%). Other conditions included pigmentary disorders (8.6%), physiological conditions (8.6%), papulosquamous disorders (5.3%), lichenoid disorders (4.1%), and drug reactions (4.1%). Malignancies were rare (0.8%), with only two cases of squamous cell carcinoma. Vascular lesions (1.2%) and miscellaneous conditions (1.6%) were also observed.

Conclusion: This study highlights the significant burden of NVGD, emphasizing the need for awareness, accurate diagnosis, and appropriate management to prevent misdiagnosis and psychological distress.

Background: The human immunodeficiency virus (HIV) leads to acquired immunodeficiency syndrome (AIDS), which weakens the immune system, making individuals more susceptible to sexually transmitted infections (STIs), and these infections, in turn, can increase the risk of HIV transmission.

Materials and methods: A retrospective study of STIs in HIV/AIDS patients was conducted at the outpatient Department of Dermatology, Venerology, and Leprosy, Chigateri General Hospital, and Babuji Hospital attached to JJM Medical College, Davangere, from January 2021 to December 2023. We examined the number and type of STIs, age distribution, gender, occupation, and antiretroviral treatment of patients with HIV/AIDS. The data were presented in a descriptive analysis.

Results: The percentage of STI patients was 8.9% of all patients with HIV/AIDS in the outpatient Department of Dermatology, Venerology, and Leprosy, Chigateri General Hospital, and Babuji Hospital attached to JJM Medical College, Davangere. Most patients were between 31 and 40 years old (40.4%). The male-to-female ratio was 1.74: 1. Viral STIs were more common than bacterial STIs among people with HIV.

Conclusion: Over the years, the trend in STIs has shifted, showing an increase in viral infections and a decline in bacterial infections.

Granuloma inguinale is one of the ulcerative sexually transmitted infections (STIs), and the incidence is very low almost worldwide. When it is associated with HIV infection, it poses a real challenge to the physician as the recommended guidelines often won't work well. Granuloma inguinale is comparatively less contagious than other STIs as the conjugal infection and vertical transmission are rare. In the present case, the patient denied any extramarital contact after marriage (for 32 years). His wife was not having any genital lesion, and their contacts were protective one. It raises the suspicion whether there could be a possibility of a latent infection in the presence of HIV as that of tuberculosis, CMV infection, and herpes zoster infection.