Nine hundred (79.3%) women in this analysis were African American and 235 (20.7%) were non-Hispanic white (Table 1). Many characteristics differed between black women and whites including that blacks were less likely to have any education past high school or family incomes >$20,000, to be current smokers, and to have more than one sexual partner or a new partner in the past two months. Black women were more likely to be 25 years or older, to have a history of a sexually transmitted disease including PID, to have been pregnant, and to have douched in the past two months. Frequent douching (>once per month) and recent douching (within zero to seven days) were also more common among black women.

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Between May 1999, and June 2001, women 13 to 36 years of age were recruited from five sites located in the eastern, southern, and western regions of the US into the GYN Infections Follow-through (GIFT) Study, a cohort investigation of the health consequences of douching. Human subjects approval was obtained at each participating institution and all women signed informed consent. Women enrolled from public and private gynecology clinics, student health services, and health departments, were eligible for the GIFT study if they were not specifically seeking care for an STI, yet were at elevated risk based on a previous risk stratification paradigm for chlamydial cervicitis, as described below.

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Growing literature suggests that black women are more likely than non-Hispanic white women to have clinical and microbiologic evidence of bacterial vaginosis (В V), a condition in which the normally protective hydrogen peroxide producing (H₂0₂+)  lactobacilli are over­ grown by disease-promoting endogenous anaerobic and facultative aerobic bacteria, including Gardnerella vaginalis, Mycoplasma hominis, Mobiluncus species, and anaerobic Gram negative rods. Reported rates of BV range from 9% to 57% among reproductive age women with the variability explained by sexual patterns, В V definition, and race. The association between black race and BV has been demonstrated among both pregnant and non-pregnant women in the US and non-pregnant women in the UK. Caution in the interpretation of this link is warranted, however, since a number of sociode-mographic and lifestyle factors increase the risk of BV and are more common among black women. These sociodemographic and lifestyle factors, which include douching, low income and low educational attainment, number of sexual partners, a history of sexually transmitted infection including PID, previous pregnancies, and lack of hormonal contraceptive use, may produce the appearance of a relationship between race and BV when, indeed, such a relationship does not, in truth, exist. Since race is a social construct, it is rational to suggest that relevant lifestyle, sociodemographics and healthcare factors could explain racial differences in the occurrence of В V.

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Assessment of quality of life in chronic illnesses has become a vital tool not only in the monitoring of treatment outcomes but also because it has been established to significantly influence morbidity and mortality. HRQOL assessment can be carried out using general or disease-specific instruments, which could be objective or subjective, or satisfaction- or function-based. It could be subdivided into measures of functional status, health status, and well-being and patient satisfaction. Each has its recognized merits and demerits, which include ease of interpretation, applicability and validation for different communities and comparability of results. A number of researchers utilize multiple instruments to be able to assess different subscales of HRQOL, as suggested by Gill and Feinstein.

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Data analysis was based on the 55 patients (27 males and 28 females) that completed the study. The age range was 20-65 years (mean=40.76 ± 11.05 years). Table 2 shows the baseline data, while Table 3 shows the mean laboratory parameters and body mass index (BMI) of the studied population. Table 4 shows the means, minimum and maximum scores for the eight SF-36 domains and KPSS. Comorbid conditions found in these patients included anemia (hemoglobin <1 lg/dL) in 82%, clinical features of osteodystrophy in 11.2% and hypertension in 61.8%.

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Patients

This comparative study was carried out between July 2001 and February 2002. Sixty-two patients on regular maintenance HD in the King Fahd and Ghonaimy Dialysis Units of the Cairo University Hospital were recruited after an informed consent. Patients being prepared for renal transplantation were excluded as well as those that did not consent.

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INTRODUCTION

Health-related quality of life (HRQOL) is often defined as “the value assigned to duration of life as modified by impairments, functional states, perceptions and social opportunities that are affected by disease, injury, treatment or policy.” Its assessment has become a vital tool not only in the monitoring of treatment outcomes in patients on various modalities of renal replacement therapy but also because it has been established to significantly influence morbidity and mortality. The assessment of HRQOL is important, as it determines how closely the treatment modality achieves the fundamental principles of prolonging life, relieving distress, restoring function and preventing disability, consequently leading to a more productive and effective life. This is pertinent, as the World Health Organization definition of health brings to limelight the need for holistic approach to treatment.

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