HISTOPATHOLOGICAL, BIOCHEMICAL AND PHYSIOLOGICAL ANALYSIS OF CERVICAL EPITHELIAL CHANGES IN WOMEN WITH RECURRENT VAGINAL INFECTIONS IN RURAL COMMUNITIES
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Keywords
Recurrent vaginal infections; Cervical histopathology; Oxidative stress; Chronic cervicitis; Biochemical markers; Inflammtion; Rural women; Poonch Medical College
Abstract
Background: Recurrent vaginal infections are among the most common gynecological disorders affecting women in rural settings. Persistent infections often lead to chronic inflammation, oxidative stress, and microscopic epithelial alterations that may progress to precancerous conditions if undiagnosed. Limited access to healthcare and low health literacy further worsen outcomes in underprivileged communities. This study was conducted to evaluate the histopathological and biochemical changes in the cervical epithelium of women with recurrent vaginal infections and to determine their relationship with oxidative stress and inflammation.
Methodology: This retrospective cross-sectional study was carried out in the Department of Pathology, Poonch Medical College and Teaching Hospital, Rawalakot, between January 2024 and January 2025. Archived medical and laboratory records of 72 women aged 18–55 years were reviewed. Patients were categorized into two groups: infected (n = 42) and controls (n = 30). Histopathological data were obtained from cervical biopsies and Pap smear reports, while biochemical parameters—including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), C-reactive protein (CRP), and lactate dehydrogenase (LDH) were retrieved from laboratory archives. Data were analyzed using SPSS version 26.0, applying the Student’s t-test and Chi-square test; statistical significance was set at p < 0.05.
Results: Most women affected were in their reproductive years, with a majority showing low literacy and limited access to medical care. Chronic cervicitis (30.6%), squamous metaplasia (13.9%), and koilocytosis (11.1%) were the most frequent tissue changes, while mild to moderate dysplasia occurred in 6.9% cases. Infected participants had significantly higher mean levels of MDA, CRP, and LDH, indicating oxidative and inflammatory stress, whereas SOD, CAT, and GSH were notably reduced (p < 0.05). A positive link between MDA and tissue inflammation (r = 0.71) and a negative correlation between SOD and dysplasia (r = –0.65) were observed, suggesting oxidative imbalance contributes to epithelial injury.
Conclusion: The findings show that recurrent vaginal infections cause both microscopic and biochemical damage to cervical tissue, largely through oxidative stress and inflammation. Regular cervical screening, timely treatment, and improved hygiene awareness are essential to prevent these changes from advancing. Combining histopathological and biochemical evaluation could help identify women at early risk for epithelial transformation, particularly in low-resource settings
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Shabir Ahmad
Assistant Professor, Department of Community Medicine, Poonch Medical Collage Rawalakot, Azad Kashmir
Fouzia Jehangir
Assistant Professor, Department of Pathology, Ayub Medical College, Abbottabad, Pakistan
Sana Gul
Assistant Professor, Department of Obstetrics and Gynaecology, Women and Children Teaching Hospital, MTI / Bannu Medical College, Bannu, Pakistan
Hamayun Mumtaz
Assistant Professor, Department of Pathology, Poonch Medical College, Rawalakot, Azad Kashmir
Afshan Iftikhar
Assistant Professor, Department of Physiology, Rehman Medical College, Peshawar, Pakistan
Amena Arif
MPhil Biochemistry, Assistant Professor, Department of Biochemistry, Federal Medical College, Islamabad, Pakistan