Complaint Of Vaginal Discharge Research Articles

Pregravid preparation for women with bacterial vaginosis and a history of early pregnancy loss

Introduction. Statistics show that about 13 to 15 in 100 pregnancies end in early miscarriage. This represents both a medical and social issue, as such outcome may be associated with maternal depression and anxiety, which inevitably affects women’s activities, performance efficiency and social inclusion. Restoration of normobiocenosis and lactobacilli pool dominance is one of the key challenges for women planning pregnancy.Aim. To evaluate the effectiveness of probiotics at the pregravid preparation stage in women with a history of early pregnancy loss and bacterial vaginosis (BV).Materials and methods. We selected 46 patients of reproductive age (24–39 years) who applied for early pregnancy loss, with complaints of vaginal discharge with an unpleasant odour, pruritus, burning, and dyspareunia, using databases of 5 medical clinics in Moscow, Tyumen and Stavropol. To treat bacterial vaginosis, two-stage therapy aimed at eliminating the increased number of anaerobic microorganisms and restoring the vaginal microbiocenosis was used.Results. The effectiveness of combination therapy was assessed at 1 month. All patients on therapy experienced clinical improvement, normalization of vaginal microbiocenosis parameters based on Femoflor-16 test findings after the end of treatment. Physiological microbiocenosis of Lactobacillus spp. > 107 was detected in 43 (94.5%). In all patients, the average vaginal pH after two-stage therapy was 4.3 ± 0.7. The safety of Acilact Duo therapy was assessed in all study participants. No negative trends were recorded.Conclusion. Superlimflife (Acilact Duo), acidophilus bacteria + vitamin-mineral protein-peptide complex, quickly restores optimal vaginal acidity (pH), stimulates the growth of lactobacilli, and reduces the incidence of BV relapses.

DETERMINAN TINGKAT STRES REMAJA PUTRI DENGAN KELUHAN KEPUTIHAN

Vaginal discharge is a perennial problem for women. The effects of this vaginal discharge include infection, pelvic inflammatory disease, infertility, and even excessive anxiety and self-confidence. Excessive and uncontrollable anxiety causes stress. Based on previous research related to adolescent vaginal discharge, there are several factors that can cause an increase in vaginal discharge including knowledge, attitudes and behavior, and age at menarche, but coping with stress and the frequency of vaginal discharge is higher in Makassar city where there are more people with 388,070 women between the ages of 15 and 19 who have the potential to experience reproductive health problems, it is important to conduct research to improve the health of young women, especially among adolescent girls. This study aims to determine the relationship between female adolescent stress levels and complaints of vaginal discharge in female adolescents at Makassar State High School in 2022. The type of research used was cross sectional using a descriptive approach. Based on the results of the analysis showed there was a relationship vaginal discharge to stress (0.017), age at menarche (0.021) and personal hygiene (0.032). It is recommended to continuously improve knowledge through technological advances, such as using the internet to search for reproductive health information for adolescents, especially young women.

Condyloma Accuminata In Pregnancy Overlapping With Bacterial Vaginosis

Background: Human Papilloma Virus (HPV) 6 and 11 are most commonly detected in genital warts, known as condyloma acuminata. Bacterial vaginosis (BV) is the most frequent vaginal infection in women aged 15 to 44 years. There may be an association between condyloma acuminata and BV. Purpose : To report a case of condyloma accuminata in a pregnant patient with combination bacterial vaginosis. Case: A 24-year-old, 8-week pregnant woman came to the clinic with a chief complaint of multiple warts in the genital area since 3 months prior to the hospital visit. The bumps on the vulva were small, and at first only one but then spread to surrounding areas. The bumps were itchy and painful. Complaints of vaginal discharge or fluor albus of yellowish-white gray color, accompanied by itchy and a fishy odor that appeared three months ago and worsened in the last two weeks. Examination results led to the diagnosis of condyloma acuminata and BV in the patient. The patient's condition improved after being given 90% trichloroacetic acid (TCA), electrocautery, and metronidazole. Discussion: Pregnancy decreases cell-mediated immunity, which may decrease immune tolerance and local physiologic changes and ultimately increase HPV infection in pregnancy. HPV infection is associated with a vaginal microbiota imbalance, making pregnant women prone to vaginal infections such as BV. Conclusion: Condyloma accuminata and BV often occur in high-risk groups for sexually transmitted infections, one of which is pregnant women. It is necessary to screen for sexually transmitted infections (STIs) in pregnant women to prevent complications.

The outcome of leprosy associated asthma in pregnancy: a case report

Introduction: Asthma bronchial is a disease characterized by increased sensitivity of the tracheobronchial tree to various stimuli. During an asthma attack, there will be bronchospasm, mucosal swelling, and increased secretions in the airway. The incidence of asthma in pregnancy in Indonesia is around 3.7- 4%, most commonly occurring at 24 to 36 weeks of gestation. The effect of asthma on the mother and fetus depends on the frequency and severity of asthma attacks because it can cause effects in the form of hypoxia. The state of hypoxia affects the fetus in the form of abortion, premature delivery, and fetal weight that is not in accordance with gestational age. Symptoms that can be felt are shortness of breath, cough, wheezing and can be accompanied by chest pain. Case description: A 35-year-old woman came with complaints of heartburn for 2 hours before admission to the hospital, the patient denied amniotic fluid flow, blood was found to come out. Fetal movements felt active. The patient claimed to be 9 months pregnant with LMP on 27 December 2021, and EDD on 27 September 2022, with a gestational age of 39-40 weeks. ANC to the obstetrician was 3 times and the midwife was 5 times. No complaints of vaginal discharge, bowel and bladder within normal limits. The patient also had a history of asthma when she was 8 months pregnant, with complaints of shortness of breath, easily fatigued and coughing, the patient denied chest pain. Wheezing was also claimed sometimes. The patient had been treated by a pulmonologist, given 3 drugs to take if shortness of breath occurred. The patient complained of painless lesions on the hands, trunk and feet. This complaint has been felt since 3 months ago. There is no thickening of the nerves or numbness in the joints. The patient was diagnosed at the regional hospital with Morbus Hansen and is currently on treatment. Conclusion: Asthma in pregnancy will cause hypoxia to the fetus which affects the development of the fetus, therefore prompt and appropriate management will reduce the risk to the mother and fetus. Outcome infants showed no sign of Morbus Hansen infection.

Frequency Of Abnormal Pap’s Smears in Patients with Vaginal Discharge

Cervix malignancy is one of the common types of cancer all across the globe. Among all the types of cancers in females, cervical cancers are the major cause of mortality. The detection and management of these types of cancers are necessary. One of the easiest tests is Pap’s smear which is a rapid and painless screening test for detection of cervical dysplasia or cervical malignancy. Objective: To calculate the current magnitude and most frequent abnormal Pap’s smear in the female population of Sindh, Pakistan, and to determine the frequency of abnormal Pap’s smears in patients with vaginal discharge. Methods: It was descriptive cross-sectional research conducted for six months in department of Obstetrics & Gynecology Unit, Civil Hospital Karachi from November, 2017 to May, 2018. A total of 214 women with vaginal discharge were included in this study. Demographic variables and history of previous pelvic or abdominal surgery was recorded. All enrolled women underwent examination of cervix and cell sample was obtained with Ayr’s spatula for pap’s smear and evaluated Results: The average age of the women was 34.86 years, frequency of abnormal pap’s smears in patients with the vaginal discharge was observed in 4.67% (10/214) cases. Out of 10 cases, infection was observed in 8 women and 2 patients exhibited dysplasia. The frequency of abnormal Pap’s smears in patients with vaginal discharge was found to be low but the complaint of vaginal discharge was very common. Conclusions: It was concluded that factor such as increasing age, low socioeconomic status and high parity were the contributory factors for the vaginal discharge. So, there must be raised awareness among females about their reproductive system and self-concern for their own health

Bacterial vaginosis and Mycoplasma infections in reproductive-age women: Clarifying the association with risk factors

ObjectivesThis study seeks to examine the association between predisposing risk factors and the prevalence of bacterial vaginosis (BV) as well as Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) infections in reproductive age women and investigate its relationship with infertility. MethodsThis cross-sectional, prospective study was carried out using sexually active females who presented at the Gynaecology Clinic with complaints of vaginal discharge. Two cervical smear samples were taken from the endocervical canal using sterile cotton swabs for each patient. The patients were questioned to obtain their demographic data and potential risk factors for lower genital tract infections, and their responses were recorded. ResultsOf 348 patients, BV was detected in 46.3%, UU in 26.7%, MH in 3.7% and UU and MH co-infection in 13.2%. The prevalence of BV concomitant with UU and/or MH was significantly high (p=.001). The most prominent risk factors for BV were UU and MH infection (AOR=6.79, 95% confidence interval (CI): [2.63–17.56]), vaginal douche use (AOR=6.80, 95% CI: [03.60–12.83]), abortion history (AOR=2.82, 95% CI: [1.55–5.12]) and high body mass indexes (BMI) (AOR=.81, 95% CI: [.74–.89]). The prevalence of BV, UU and MH was significantly higher in infertile patients than fertile patients (p=.002). ConclusionsBacterial vaginosis, MH, and UU co-infection were common in patients with vaginal discharge, and it was detected considerably higher in infertile patients than in fertile patients.

INVESTIGATION OF SOME MICROBIAL AGENTS IN VAGINAL AND ENDOSERVIX SWAP SAMPLES OF 18 – 50 AGED WOMEN WITH VAGINAL DISCHARGE

Detecting sexually transmitted infectious agents in women by traditional methods is often troublesome. In this study, it was aimed to investigate bacterial vaginosis and vaginitis agents by culture, microscopic examination and molecular methods in women with vaginal discharge complaints. A total of 100 female patients aged 18-50 years, who applied to the Dicle University Faculty of Medicine, Department of Obstetrics and Gynecology with the complaint of vaginal discharge, were included in the study. Gram and Giemsa staining, culture and multiplex PCR processes were performed from vaginal and endocervix samples taken with sterile swabs. Gram-stained specimens were evaluated with the Nugent score; the presence of leukocytes with polymorph nuclei, Clue-Cells, and different shaped bacteria. Culture-grown agents were identified at the species level by MALDI TOF-MS. There was at least one microbial agent in 63% of the samples included in the study. According to Nugent scores, 27 specimens were determined positive, and 39 specimens had intermediate values for bacterial vaginosis(BV). Candida spp. (29%), Streptococcus agalactiae (9%) and S. aureus (3%) grew in culture while M. hominis (23%), U. urealyticum (13%), T. vaginalis (9% ) and C. trachomatis (3% ) DNAs were detected by multiplex PCR. In our study, it was determined that vaginal discharge could be caused by bacterial, fungal, and parasitic microorganisms as well as bacterial vaginosis agents. It is very difficult, laborious and necessary to determine dysbiosis and infection in the vagina which has an important microbiome. Gram staining and culture methods are insufficient for the detection of vaginal infection agents. Therefore, it would be beneficial to use molecular methods in addition.

The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing fluid as a predictor of Premature Rupture of Membrane (PROM)

Background: Several biomarkers have been investigated as predictors of Premature rupture of membrane (PROM), but these biomarkers have not been applied in clinical practice due to their high cost and complexity. Beta-HCG is thought to be an easy, cost-effective and promising predictor of PROM in clinical practice. This study aims to determine the relationship between beta-hCG level in vaginal washing fluid with the PROM and the cut-off value of beta-hCG level in vaginal washing fluid in predicting the incidence of PROM.Methods: This diagnostic study was conducted in the Sanglah General Hospital, Denpasar, from May to July 2020. The subjects involved in this study are all pregnant women with gestational age ?24 weeks who came with complaints of vaginal discharge and were treated in the delivery room of the Emergency Ward, Sanglah General Hospital. The beta-HCG level was evaluated using the immunoassay method and the ROC curve analysis was performed to determine the beta-hCG level in vaginal washing cut-off point that can predict the incidence of PROM. Data were analyzed using SPSS version 22 for Windows.Results: Thirty-five subjects who met the inclusion and exclusion criteria were involved in this study. The cut-off value of beta-hCG vaginal washing fluid to predict PROM obtained in this study was 118.1 mIU/ml with sensitivity of 95.83%, specificity of 81.81%, PPV of 92.00%, NPV of 90.00%, and accuracy of 91.43% (AUC: 0.947; 95%CI: 0.870-1.000; p<0.001).Conclusion: Beta-hCG level in the vagina washing fluid can be used as a fast and non-invasive predictor of PROM in pregnant women.

Management of Shweta Pradara (Leucorrhoea) Through Ayurveda- A Case Series

Leucorrhoea or vaginal discharge is generally whitish, yellowish or greenish vaginal discharge in females that might be normal or a symptom of infection. It is almost mucus discharge, which exhibit exfoliation of vaginal epithelial cells due to estrogen influence on the vaginal mucosa. It is important to identify the differences between physiological and pathological discharges. In Ayurveda, leucorrhoea is known as Shweta Pradara, where Shweta means white and Pradara mean discharge. Yoni vyapadas which are caused by Kapha or Vatakaphaja doshas are the main causative factors of Shweta pradara. It also depends on the Nidana which may lead to vitiation of any of the Doshas An attempt was made to manage Shweta pradara by Ayurvedic treatment protocol in dispensary at OPD level. This study was conducted on five unmarried female patients having symptoms of Shweta pradara. These patients came with complaints of vaginal discharge, itching in vaginal area, backache etc., and were treated with Shunthi Dhanyak Siddha Jala for Deepan Pachan, Haritaki churna for Anuloman, Jeevak plus capsule, Gynaevin syrup for oral medication, and Triphala Kwatha for Yoni Prakshalan, Himtone forte as Rasyana and Balya aushadhi. The whole treatment was done for 4 weeks and marked improvement was achieved in all the patients

“TRICHOMONIASIS: MOST COMMON SEXUALLY TRANSMITTED INFECTION (STI) WORLDWIDE”

BACKGROUND: Trichomoniasis is the most common cause of sexually transmitted infection worldwide. Clincal presentation vary from person to person. The management of trichomoniasis is largely syndromic and empirical, it is usually based on naked eye examination of vaginal discharge and that is unsatisfactory because the diagnostic accuracy is lost without microscopic examination. The modern management of trichomoniasis demands a specic diagnosis which is a combination of naked eye examination plus laboratory workup. METHOD: The study was carried out on 183 females with complaint of vaginal discharge in the outpatient Department of Obstetrics and Gynecology. Specimens were collected in OPD of Jhalawar Medical College in associated Zanana Hospital. The laboratory work was conducted in the Department of Microbiology in Jhalawar Medical College, Jhalawar. RESULT: The prevalence of microbial positivity in our study was 79.9%. Trichomoniasis was diagnosed in 14 (7.7%) cases. Maximum patients presented with complaint of copious amount of thin; foul smelling; yellow discharge. CONCLUSION: The study concludes that it is important to know the various presentations, conrm the diagnosis by proper microbiological tests, and provide appropriate treatment to patients to prevent resistance and recurrence of Trichomoniasis.

IMPACT OF SOCIODEMOGRAPHIC FACTORS ON VAGINAL DISCHARGE

Introduction:- Vaginal discharge is one of the most common complaint in women attending obstetrics and Gynecology outpatient department. It increases the morbidity in women. AIM : The study is aimed at identifying the impact of the social and demographic variables associated with the complaint of vaginal discharge. Method :This is a hospital based prospective observational study conducted in the obstetries and gynecology outpatient department of Jawaharlal Nehru Medical college , Bhagalpur , Bihar. Pretested questionnaire was done on women with Vaginal discharge . Results : The total number of cases mere 60. The results were vaginal discharge common among 26-35 yr of age . 15.6% among lower socio economic class women , 33.6% among women living with their husband , 27.6% has vaginal discharge who got married before 18 yrs of age. 44% women perceived no specic symptoms. Conclusion : Awarness regarding personal and menstrual hygiene is mandatory among women to lower the incidence of vaginal discharge

A comparison of single-dose versus divided-dose of metronidazole on bacterial vaginosis among female sex workers in Surakarta

  Background : Bacterial vaginosis (BV) is the most common vaginal infection in sexually active women. Metronidazole (MTZ) is still one of the recommended regimens for BV either as a single-dose or divided-dose. In addition to its affordability and availability, oral metronidazole also produces fewer adverse effects. This study aimed t o determine the efficacy of single-dose versus divided-dose metronidazole for BV among female sex workers (FSWs) in Surakarta. Methods:  A single-blind randomized clinical trial was conducted in Surakarta. FSWs with BV ( ⩾ 3 Amsel criteria) were enrolled. The subjects were grouped into two, and treated with MTZ either as a single-dose of 2 gr (single-dose group) or 500 mg twice daily for one week (divided-dose group).  After two weeks, we performed second  vaginal swabs and reassessed the Amsel criteria, complaints and  adverse events .  Results:  Out of 75 FSWs, 30 (42%) were diagnosed with BV. The efficacy between two groups was not significantly different. However, patients in the single-dose group were 2 times more likely to develop recurrent BV (OR = 2.000; 95% CI 0.146 – 27.447), and 1.5 times more likely to have vaginal discharge complaints    (OR = 1,500; 95% CI 0,181-12,459) than divided-dose group. Conclusion:  Single-dose and divided-dose metronidazole produce similar efficacy for treating BV in sexually active women. Single-dose metronidazole has a higher risk of BV recurrence and vaginal discharge complaint. Divided-dose metronidazole is recommended for treating BV.    Keywords: bacterial vaginosis, female sex workers ,  metronidazole

A Study on role of socio demographic status of women in excessive vaginal discharge at teaching hospital

Introduction: The complaint of excessive vaginal discharge is very common in women attending the gynecology out-patient department. It is associated with considerable emotional stress, health seeking associated cost and has a substantial impact on female health and behavior. Objective: To find out socio-demographic variables associated with the complaint of vaginal discharge wherein no biomedical cause of leucorrhoea can be detected. Socio-cultural perspectives have an exaggerative effect on the normal vaginal discharge and in absence of pathological diagnosis, they create fear and anxiety in couples. The problem of vaginal discharge can be best understood not only in the biomedical perspective but also in the socio cultural perspective. Materials and Methods: This is a hospital based study, conducted in out-patient department of obstetrics and gynecology department, AIIMS, Udaipur (Raj). Women with complaint of vaginal discharge without any evident pathological or infectious causes were counted in the study. The women with vaginal discharge which is non-infected, non-blood stained, non-purulent, without pruritus vulvae were interviewed with a pretested questionnaire. Socio-demographic details, personal and menstrual hygiene, obstetric history and contraceptive practices were noted and tabulated. Conclusion: To mitigate the problem of vaginal discharge, socio-demographic status of women should be taken in consideration. Improvement of literacy rate, economic status and women’s empowerment are the key areas of interventions. Proper understanding of this problem helps in initiating appropriate medical education programs and framing health policies. Keywords: Excessive vaginal discharge, Socio-demographics, Somatic symptoms, Leucorrhoea, Pruritus tubectomy.

Frequency of common organisms causing vaginal discharge in sexually active women in reproductive age group.

Objective: To determine the frequency of organisms causing vaginal discharge. Study Design: Descriptive study. Setting: Department of Gynecology and Obstetrics Unit-II of Kausar Hospital Khairpur Mirs, Sindh. Period: 23rd, October 2019 to 22nd January 2020. Material & Methods: Study population include sexually active females aged 18-45 visiting to the OPD for complain of vaginal discharge. A complete history and examination was done for assessment of the patient for reproductive tract infections. Results: In one year time period 420 females reported to the OPD of the hospital. Out of total 1783 patients, 23.5% patients (n=420) had complaint of vaginal discharge. Out of 420 patients enrolled in the study, 43.8% (n=184) patients were diagnosed having non-infective vaginal discharge. Bacterial vaginosis had the highest prevalence among common reproductive tract infection estimating about 46.1% (n=109) cases. Conclusion: Multiple researches must be conducted on large scale to determine the actual ratio of reproductive tract infections in sexually active females. Furthermore awareness session should be delivered to the rural and urban population. Awareness to women regarding their sexual health and their positive influence on society should be given.

Biofilm-forming fluconazole-resistant Candida auris causing vulvovaginal candidiasis in an immunocompetent patient: A case report

Rationale: Candida auris is a potential emerging pathogen among Candida and causes serious health threats globally. Patient concerns: We reported a case of vulvovaginal candidiasis caused by Candida auris. A 26-year-old female presented with complaints of vaginal discharge, itching and low back pain. Diagnosis: High vaginal swab culture yielded Candida. The strain was confirmed as Candida auris by amplification and sequencing the internal transcribed spacer region. Antifungal susceptibility testing revealed that the isolate was resistant to fluconazole, amphotericin B and clotrimazole and susceptible to ketoconazole and nystatin. The isolate also exhibited biofilm forming ability. Interventions: Her symptoms did not subside with initial management with fluconazole and clotrimazole. Later, she was started on ketoconazole therapy. The patient responded well to ketoconazole. Outcome and lessons: To the best of our knowledge, this is the first report about the presence of a drug resistant biofilm forming Candida auris strain isolated from a vaginal swab sample from Chennai area. Biofilm forming ability might contribute to its drug resistance. Nucleic acid analysis helps in rapid and accurate identification of such rare species.

Prevalence of Bacterial Vaginosis in Females of Child-Bearing Age and Utility of pH and Whiff Test in Diagnosis

Background: To determine the prevalence of bacterial vaginosis among females of reproductive age and assessment of the effectiveness of pH and the Whiff test in its diagnosis. Methods: This was a cross-sectional study. A total of 100 subjects were included, coming with a complaint of vaginal discharge. The bacterial vaginosis was diagnosed by using the Nugent scoring system, Whiff and pH tests. The prevalence was calculated by descriptive statistics and using the Chi-square test and results were shown in percentages and mean with standard deviation. Results: The estimated prevalence of bacterial vaginosis among the local population of females of child-bearing age was found to be 39%. The mean age of females with bacterial vaginosis was 33.33±10.46 years. The Whiff test was positive in 89.74% cases, while pH was elevated in 94.87% females with bacterial vaginosis. Conclusion: Bacterial vaginosis is a frequent cause of vaginal discharge in females of reproductive age in Pakistan. The diagnosis can be easily made by using Whiff and pH tests even at resource-poor settings. Keywords: Bacterial vaginosis, Child-bearing age, pH test, Whiff test.

Comparison between different diagnostic tests used for bacterial vaginosis

Background: Bacterial vaginosis is the primary reason for unusual vaginal expulsion in females of fertile age resulting in poor pregnancy ending, pelvic seditious disease, chorioamnioitis, endometritis and increased susceptibility to HIV.As the prevalence is high, and usual investigative tests require laboratory expertise, a future study was therefore performed to compare different diagnostic methods for making an precise diagnosis of bacterial vaginosis. Materials and Methods: This study was conducted in Department of Microbiology which included females of reproductive age group, attending Obstetrics and Gynaecology OPD of TMMC & RC, Moradabad, over a period of one year (March 2017- March 2018). A total of 400 patients with complaints of vaginal discharge and other associated complaints like pruritus, pain lower back, primary or secondary infertility were included in the study. Diagnosis of Bacterial vaginosis was done by using an array of both conventional techniques which included Gram’s staining, Nugent’s score, vaginal pH etc., and a newer diagnostic technique (OSOM BV Blue test). The patients were also examined PV and the relevant clinical findings were also noted. Results: Out of a total of 400 patients listed for the study, 240 were diagnosed as having bacterial vaginosis. Comparison of the different methods for the diagnosis of bacterial vaginosis revealed that bacterial vaginosis could be detected by ‘clue cells’ in 100% patients, by OSOM BV Blue test in 97.6% patients, by Amsel’s criteria in 67.1% patients, and by evaluation of vaginal pH and vaginal amines in 63.4% and 62.2% patients respectively. Conclusion: Different diagnostic techniques have varied sensitivity and specificity in diagnosis of bacterial vaginosis. OSOM B.V. blue test is found to be highly sensitive and can be performed easily in clinical settings where microscopic facilities are not available.

Clinical, microbiological, cytological and biochemical differences which play a critical role in the diagnosis of candidiasis and cytolytic vaginosis

Vulvovaginal candidiasis (VVC) and cytolytic vaginosis (CV) are gynecological conditions that affect a significant number of women, both with very similar symptoms, being frequently mistaken by one another. In this study we identify some clinical, microbiological, cytological and biochemical differences which play a critical role in the diagnosis and treatment, essencials for a better conduct for women with vaginal discharge complaints.

Comparison of methods for assessing the inflammatory response of the lower parts of the female reproductive tract

Hypothesis/aims of study. A lack of timely diagnosis and treatment of inflammatory diseases of the lower genital tract in a woman can lead to serious reproductive disorders. The detection of inflammation is an important component of the diagnosis of these diseases. This study was undertaken to compare methods for detection of local inflammation in women with complaints of vaginal discharge.
 Study design, materials, and methods. A total of 87 women having vaginal discharge were enrolled in the study. For the detection of inflammation, vaginal discharge was examined using microscopy and reverse transcriptase polymerase chain reaction (the ImmunoQuantex® test, DNA-Technology Ltd., Moscow, Russia).
 Results. Vaginal infections caused by opportunistic microorganisms were detected in 27 women (31%), as follows: candidal vulvovaginitis (CVV) in 10 patients (11.5%), aerobic vaginitis (AV) in 14 patients (16.1%), and bacterial vaginosis (BV) in 14 patients (16.1%), with 8 (9.2%) of them having BV combined with CVV, AV or both infections. The results of the two methods fully agreed in the analysis of samples from women with CVV and AV as vaginal infections characterized by local inflammation. Testing samples from women with BV, which is a non-inflammatory syndrome, as well as women without vaginal infections resulted in significant discrepancies between the two methods. The sensitivity and specificity of the ImmunoQuantex® test compared to the microscopic method were 85.7% and 48.9%, respectively.
 Conclusion. The new reverse transcriptase polymerase chain reaction based test for the evaluation of expression profiles of selected genes of immune response enables to assess the local immune status in the vagina. Determination of the presence or absence of inflammatory reaction in the vagina can be used as a diagnostic criterion for resolving discrepancies between laboratory data and clinical manifestations, as well as for choosing effective therapy.

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

Background and Objectives: Acute uncomplicated cystitis (AC) is common among women. Acute onset of specific typical symptoms may serve as reliable criteria for developing a cost-effective strategy to make an accurate diagnosis of AC. We aimed to evaluate the diagnostic values of most common symptoms and signs of AC depending on their presence and severity. Methods: The current trial was designed as a case-control study. Data derived from the Acute Cystitis Symptom Score (ACSS) database were analyzed. Diagnostic values of the symptoms and their severity were assessed via the calculations of the sensitivity and specificity, odds ratio, positive and negative likelihood ratios. The strength of associations was estimated by the coefficient of correlation (Pearson’s R). Results: Data from 819 female subjects (423 Patients, 396 controls) with the mean age of 37.1 ± 15.3 were analyzed. Highest diagnostic values for AC in this study belonged to dysuria, urgency, and frequency. Interestingly, complaints of vaginal discharge was not found to decrease the odds for having AC in the study population. Conclusions: The severity of the symptom is even more essential than just its presence for an accurate diagnosis. The ACSS is an accurate tool and may be recommended for clinical practice and studies for diagnosis of AC in women. Further studies and unification of terms are need.