فهرست مطالب فریبا حیدری کهن

2-phenylethanol is a colorless and aromatic compound with antimicrobial effects which is used extensively in perfumes and cosmetics, as well as in the food industry. Chronic vulvovaginal candidiasis is a vulvovaginal inflammation which is caused by Candida spp. Resistance to clotrimazole which is one of the most common drugs in the treatment of this disease was reported in many patients. In order to improve the treatment, the effect of 2-phenyl ethanol was investigated in combination with clotrimazole on Candida species isolated from chronic vulvovaginal candidiasis.
This interventional study was performed in Iran University of Medical Sciences from February, 2016 until December, 2016 on Candida species isolated from women with chronic candidial vulvovaginitis who had been referred to Lolagar Hospital of Tehran. All specimens were examined by direct microscopy, culturing on Candida CHROMagar medium (to primary identification), sabouraud dextrose agar medium) to preservation the isolates) and determining the internal transcribed spacer (ITS) sequence (in order to final determination of Candida species). Then clotrimazole and 2-phenyl ethanol alone and in combination, was examined on isolated species, according to Clinical and Laboratory Standards Institute (CLSI) M27-A3 protocol (micro-broth dilution method). Finally, findings were analyzed.
From 40 detected strains of Candida species in this study, 95% were Candida albicans and 5% were Candida africana. The mean minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of clotrimazole were 24.73±28.87 µg/ml and 30.18±33.004 µg/ml, respectively and the mean MIC and MFC of 2-phenylethanol were 2580±932.38 µg/ml and 3200±1403.29 µg/ml, respectively. The MIC50 and MIC90 of clotrimazole were 16 and 64 µg/ml, respectively. The MIC50 and MIC90 of 2-phenylethanol were both 3200 µg/ml. Most of the isolates were resistant to clotrimazole (82.5%). In combination test, the mean MIC of 2-phenylethanol and clotrimazole alone were 3200±0 µg/ml and 56±40.16 µg/ml, respectively. The fractional inhibitory concentration index (FICI) range was 0.14-0.37. Also, there was a significant difference between clotrimazole MIC values alone and in combination (P= 0.021).
The synergistic effect was observed in combination of clotrimazole and 2-phenylethanol.

Nystatin is a polyene with antifungal effect which is used in treatment of cutaneous and mucocutaneous candidiasis in diverse forms. Increasing its utilization in recent years has led to predominant increasing of resistances. Nowadays for increasing of antifungal effect and decreasing of resistance and side effects of drugs they are used in combination with each other. So we decided to investigate antifungal effect of Nystatin in combination with nanosilver particles. This was an experimental study which has been accomplished on 30 samples of isolated candida species from patients effected to chronic candidal vaginitis. In this study the antifungal effects of Nystatin and silver nanoparticles each of them alone and in combination with each other by microdilution broth، were examined. Findings were described on the base of logestic regression and man-vitni exam. Findings suggested that Nystatin was able to inhibit the growth of candida species at an expanded range of concentration between 16-128 microgeram per milliliter. As well antifungal activity of Nystatin with silver nanoparticles was increased in comparision with using Nystatin alone. Introduce of nanosilver in drug formation of Nystatin can be useful in treatment of chronic vaginal candidiasis.

Candidal vulvovaginitis is a female genital infection that is occured by the over growth of candida species and specially Candida - albicans and occasionally it appears as recurrent and chronic and resist to therapy. Fluconazole is one of the current drugs that is used in treatment of this disease and sometimes resistance is observed to this. Therefore indirection of making the therapy better we decided to investigate the activitiy of fluconazole in combination with silver nanoparticles against candida species isolated from chronic and recurrent candidal vaginitis. This was an experimental study with convenient sampling that was performed on 30 patients. All specimens were examined in direct microscopy, culturingand differential tests to identify different candida species from each other such as culture on candida chrom agar, germ tube, temperature test and sugar assimilation with API. Then the antifungal effects of fluconazole and silver nanoparticles, each of them alone and in combination with each other, were examined. Findings were described on the base of logestic regression and man-vitni exam. In our study 30 specimens of chronic genital candidiasis were diagnosed with isolated agents Candida albicans, glabrata, krusei, tropicalis, parapsilosis and Candida famata respectively. Also findings suggested that fluconazole was able to inhibit the growth of candida species at an expanded range of concentration between 4-128 microgeram per milliliter.As well antifungal activity of Fluconazole with silver nanoparticles was increased in comparision with using Fluconazole alone. For the prevention of recurrent cases and to stabilish correct diagnosis it is essential to carry out sensitivity and diagnostic tests in laboratory and also administration of silver nanoparticle in combination with fluconazole in drug formulation for topical uses in treatment of chronic vaginal candidiasis and inhibition of recurrent cases, can useful.

Vulvovaginal candidiasis occurs due to the overgrowth of candida in genital system mucosa of females. Symptoms and signs of vulvovaginal candidiasis are unspecific, therefore its diagnosis based on them (symptoms and signs) is not certain. The aim of this research was comparison the result of indirect immunofluorescence and ELISA with culture and direct microscopy examination in patient with vulvovaginal candidiasis. This was acomparative-descriptive study that was performed on 87 patients and 50 normal cases. All specimens were examined under direct microscopy, culturing and complimentary test to differentiate the candida species from each other. Serological tests such as indirect immunofluorescence and ELISA were performed on sera of the patients. To compare the quantitative and qualitative data in order t-student test, chi-square and exact fisher test were used, if necessary. Out of 87 specimens, 50 cases were diagnosed as vulvovaginal candidiasis. In order, frequency of the isolated pathogens were: C.albicans, C.glabrata,C.kefyr, C.inconspicua and C.famata. Also in order frequency of control groups were: C.albicans, C.glabrata and C.kefyr. In this study all of normal cases were negative in indirect immunofluorescence test and in patients group 42 person(84%) were positive and 8 (16%) negative. Control groups were negative in ELISA and in patient group 40 person(80%) were positive and 10 person(20%) negative. It seems in cases that are not possible to perform direct microscopic and culturing methods, ELISA and indirect immunofluorescence can be used as a replacement method.