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Chutikarn Thammasiri, Siriruthai Amnatbuddee, Jen Sothornwit, Teerayut Temtanakitpaisan, Pranom Buppasiri Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Siriruthai AmnatbuddeeDepartment of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Muang District, Khon Kaen, 40002, ThailandTel +66817396331Email siriruthai@kku.ac.thPurpose: To evaluate the quality of life (QoL) of women with endometrioma and explore the associated factors.Patients and Methods: A cross-sectional study was conducted between August 2020 and March 2021. A total of 99 women diagnosed with ovarian endometrioma with at least one endometriosis-associated symptom completed the Endometriosis Health Profile 30 (EHP-30) questionnaire for their QoL score before treatment for ovarian endometrioma. The questionnaire comprises a central questionnaire (30 items) and a modular questionnaire (23 items divided into 6 sections). Demographics and QoL scores were analyzed using descriptive statistics and multivariable linear regression or median regression.Results: The mean QoL score was 35.0± 15.8 (range, 16.0± 21.2 in the social support dimension to 45.1± 24.4 in the control and powerlessness dimension). In the modular questionnaire, the highest score was in the infertility domain, while the lowest was in the relationship with the physician domain. The pain score and chronic pelvic pain (CPP) were independent correlation factors for a higher total EHP-30 score: the higher the total EHP-30, the poorer the QoL. CPP was positively correlated with the QoL score in the work domain.Conclusion: The present study revealed that CPP was the factor associated with a worse QoL and work performance in women with endometrioma based on a disease-specific, EHP-30 questionnaire.Keywords: endometriosis, pelvic pain, infertility, EHP-30

The spread of antibiotic resistance is a major public health concern worldwide. Commensal bacteria from the human genitourinary tract can act as reservoirs of resistance genes playing a role in their transfer to pathogens. In this study, the minimum inhibitory concentration of 16 antibiotics to 15 isolates from the human vagina, identified as Enterococcus faecalis, Streptococcus anginosus, and Streptococcus salivarius, was determined. Eight isolates were considered resistant to tetracycline, five to clindamycin and quinupristin-dalfopristin, and four to rifampicin. To investigate the presence of antimicrobial resistance genes, PCR analysis was performed in all isolates, and five were subjected to whole-genome sequencing analysis. PCR reactions identified tet(M) in all tetracycline-resistant E. faecalis isolates, while both tet(M) and tet(L) were found in tetracycline-resistant S. anginosus isolates. The tet(M) gene in E. faecalis VA02-2 was carried within an entire copy of the transposon Tn916. In S. anginosus VA01-10AN and VA01-14AN, the tet(M) and tet(L) genes were found contiguous with one another and flanked by genes encoding DNA mobilization and plasmid replication proteins. Amplification and sequencing suggested the lsaA gene to be complete in all E. faecalis isolates resistant to clindamycin and quinupristin-dalfopristin, while the gene contain mutations rendering to a non-functional LsaA in susceptible isolates. These results were subsequently confirmed by genome analysis of clindamycin and quinupristindalfopristin resistant and susceptible E. faecalis strains. Although a clinical breakpoint to kanamycin for S. salivarius has yet to be established, S. salivarius VA08-2AN showed an MIC to this antibiotic of 128 µg mL−1 . However, genes involved in kanamycin resistance were not identified. Under the assayed conditions, neither tet(L) nor tet(M) from either E. faecalis or S. anginosus was transferred by conjugation to recipient strains of E. faecalis, Lactococc

Lactic acid bacteria can act as reservoirs of antibiotic resistance genes that can be ultimately transferred to pathogens. The present work reports on the minimum inhibitory concentration (MIC) of 16 antibiotics to 25 LAB isolates of five Lactobacillus and one Bifidobacterium species from the human vagina. Acquired resistances were detected to kanamycin, streptomycin, chloramphenicol, gentamicin, and ampicillin. A PCR analysis of lactobacilli failed to identify genetic determinants involved in any of these resistances. Surprisingly, a tet(W) gene was detected by PCR in two Bifidobacterium bifidum strains, although they proved to be tetracycline-susceptible. In agreement with the PCR results, no acquired genes were identified in the genome of any of the Lactobacillus spp. strains sequenced. A genome analysis of B. bifidum VA07-1AN showed an insertion of two guanines in the middle of tet(W) interrupting the open reading frame. By growing the strain in the presence of tetracycline, stable tetracycline-resistant variants were obtained. An amino acid substitution in the ribosomal protein S12 (K43R) was further identified as the most likely cause of VA07-1AN being streptomycin resistance. The results of this work expand our knowledge of the resistance profiles of vaginal LAB and provide evidence for the genetic basis of some acquired resistances.

Pattarawadee Sattanakho,1 Pilaiwan Kleebkaow,1 Ussanee Sangkomkumhang,2 Sukjai Booranabunyat,3 Pranom Buppasiri1 1Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Obstetrics and Gynecology, Khon Kaen Regional Hospital, Khon Kaen, Khon Kaen Province, Thailand; 3Department of Obstetrics and Gynecology, Mahasarakham Hospital, Mahasarakham Province, ThailandCorrespondence: Pranom BuppasiriDepartment of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, ThailandTel +66-43-202489Fax +66-43-348395Email bprano@kku.ac.thBackground and Objectives: To determine the rate of significant endometrial abnormalities in premenopausal women at low risk for endometrial hyperplasia and cancer presenting with abnormal uterine bleeding (AUB).Patients and Methods: This descriptive study was conducted from January 1, 2016 to March 31, 2019. The inclusion criteria were premenopausal women, 35– 50 years, presenting with AUB, low risk for endometrial hyperplasia or endometrial cancer, and having undergone endometrial sampling or uterine curettage. Nulliparous, obesity, diabetes mellitus, polycystic ovary syndrome, chronic anovulation, infertility, tamoxifen therapy and/or a family history of uterine, ovarian, breast and colon cancer were excluded. Data regarding baseline characteristics were collected, and histopathology reports were reviewed.Results: During the study period, 644 subjects were recruited, 557 of whom had adequate endometrial tissue for histopathology study. The pathology demonstrated benign in most cases (96%). The rate of significant abnormal endometrial pathology was 4% (23 cases) including 19 cases of endometrial hyperplasia without atypia (3.3%), and 4 cases of endometrial cancer (0.7%).Conclusion: The rate of significant abnormal endometrial pathology in premenopausal women at low risk for endometrial hyperplasia or endometrial cancer presenting with AUB w

Teerayut Temtanakitpaisan,1 Suvit Bunyavejchevin,2 Pranom Buppasiri,1 Chompilas Chongsomchai1 1Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandCorrespondence: Teerayut TemtanakitpaisanDepartment of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandTel +66819656423Email jacktemtanakitpaisan@hotmail.comObjective: To assess knowledge, attitude, and practices (KAP) of pelvic floor muscle training (PFMT) among Thai pregnant women.Patients and Methods: One hundred and ten Thai pregnant women who attended the antenatal clinic of a tertiary care hospital were recruited. They were classified as “aware” if they could recognize PFMT. Questionnaires regarding the participants’ attitudes and practice toward PFMT were subsequently collected from “aware” group.Results: The mean ±SD of age and gestational age were 30.5 ± 5.4 years and 20.8 ± 10.8 weeks, respectively. Sixty-one participants (55.5%) recognized PFMT, but only seventeen (27.9%) correctly answered all of the questions, which is classified as perceptive. There was no association between their educational level and PFMT knowledge (p = 0.63). Most of them (98.4%) understood that PFMT can be performed during pregnancy and believed that PFMT did not affect the pregnancy outcomes. However, only 10.7% of the aware women performed PFMT irregularly during pregnancy.Conclusion: Half of the pregnant women in this study were aware of PFMT. The majority of women felt that PFMT had positive effects on their health, emotions, sex, and quality of life. Education concerning PFMT and motivation to maintain the adherence of practicing the exercises are required.Keywords: KAP, pelvic floor muscle training, pregnant women

Chokchai Chotboon,1 Sukree Soontrapa,1 Pranom Buppasiri,1 Benja Muktabhant,2 Kiattisak Kongwattanakul,1 Jadsada Thinkhamrop1 1Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Faculty of Public Health, Research Group on Prevention and Control of Diabetes in the Northeast, Khon Kaen University, Khon Kaen, Thailand Background: Calcium is an essential element for the body, which is taken through the dietary sources. Calcium supplements may be needed to achieve the dietary reference intake (DRI). Dietary calcium and supplemental calcium intake for calcium balance might be necessary. However, increasing evidence shows that calcium supplementation may enhance soft tissue calcification and cause cardiovascular diseases. Calcium requirement during pregnancy is markedly increased. If calcium supplementation depends on the dietary style of a region, then the adequacy of dietary calcium intake may guide the calcium supplementation. Materials and methods: A cross-sectional descriptive study was conducted among pregnant women who attended prenatal care at Srinagarind Hospital, Khon Kaen University. We used semiquantitative food frequency questionnaire (SFFQ) to evaluate the amount of daily calcium intake, and 3 days food record to assess the SFFQ reliability. We used the INMUCAL-N V.3.0, based on the Thai food composition table for nutritional calculation. Results: Among 255 recruited pregnant women, the mean daily dietary calcium intake was 1,256.9 mg/day (SD: 625.1) and up to 1,413.4 mg/day (SD: 601.3) in daily milk consumed group. Based on Thai DRI for pregnant women, with 800 mg/day as adequate intake of calcium, 74.9% had adequate calcium intake, and majority of them had milk daily. Conclusion: The majority of pregnant women in a province of Northeast Thailand had adequate calcium intake, particularly those who had milk with their meal every day. Keywords: calcium intake, pregnant women

Iyara Wongpia, Jadsada Thinkhamrop, Kanok Seejorn, Pranom Buppasiri, Sanguanchoke Luanratanakorn, Teerayut Temtanakitpaisan, Kovit Khampitak Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Background: The purpose of this study was to assess the incidence of and risk factors for postoperative febrile morbidity after laparoscopic-assisted vaginal hysterectomy (LAVH). Methods: This retrospective study was carried out using the medical records of women with benign gynecologic conditions who underwent LAVH between June 2007 and May 2012 at Srinagarind Hospital in Thailand. Data were collected to assess baseline patient characteristics, occurrence of body temperature ≥38°C on two occasions at least 6 hours apart in the 24 hours following the surgical procedure, and possible risk factors related to postoperative febrile morbidity. Results: In total, 199 women underwent LAVH during the study period. They had a mean age of 46±6 years, a mean body mass index of 24.0±3.2 kg/m2, a mean surgical duration of 134±52 minutes, median estimated blood loss of 200 mL, a mean total hospital stay of 5±2 days, and a mean postoperative hospital stay of 3±2 days. Postoperative febrile morbidity was documented in 31 cases (15.6%). The cause of postoperative fever was unknown in most cases, with only two cases having an identifiable cause. The risk of postoperative febrile morbidity was highest in women treated with more than two antibacterial agents and with a regimen of more than 3 days. Conclusion: This study shows a moderately high rate of febrile morbidity after LAVH, for which the main risk factors were use of multiple drugs and doses for antibiotic prophylaxis. Keywords: laparoscopic-assisted vaginal hysterectomy, febrile morbidity, incidence, risk factors