Comparison of vaginal culture and pap smear in the diagnosis of bacterial vaginosis

Background: Amongst the myriad of physiological and pathological conditions presenting as vaginal discharge, bacterial vaginosis is the most frequently encountered complaint in women of child bearing age, all over the world. It involves the replacement of normally predominant hydrogen-peroxide producing lactobacilli, by an overgrowth of anaerobic bacteria. We want to examine the diagnostic efficacy of Pap-Smear and vaginal culture in the diagnosis of bacterial vaginosis, while Amsel's clinical criteria is used as the gold standard

Methods: It was a descriptive study expanding over a period of 5 months, from January 2013 to May 2013, enrolling 150 patients, from the outpatient's department of lady reading hospital and Hayatabad medical complex, Peshawar. All patients who complained of vaginal discharge were eligible for study. Patients using antibiotics, vaginal suppositories as well as those who were pregnant were excluded from the study. All patients were subjected to simultaneous testing for Amsel's criteria, vaginal culture, and Pap-staining. Sensitivity, specificity, positive predictive value and negative predictive values were calculated for vaginal culture and Pap smear, with amsel's criteria being the gold standard

Results: Sensitivity, specificity, positive and negative predictive values for culture was determined as 75%, 92.1%, 64.3% and 95.1%. Pap smear was found to be 62.5% sensitive, 93.7% specific, positive and negative predictive values being 65.2% and 92.9% respectively

Conclusion: Out of these two tests, vaginal culture was labeled as the more sensitive test for the diagnosis of bacterial vaginosis

Frequency of pelvic pain and bleeding per vaginum in first trimester of pregnancy in a tertiary care hospital of Karachi

Objective: The objective of this study was to determine the frequency of pelvic pain and per vaginal bleeding, in the first trimester of pregnancy

Methods: A total of 150 pregnant women 18 to 35 years in first trimester were recruited in this crosssectional study, conducted from July 2015 to July 2016. Non-probability sampling technique was used to collect the data. The collected information from patients were entered in pre-designed proforma after taking informed consent. Data was analysed by using SPSS version 20

Results: The average age of the patients was 26.33 +/- 4.23 [range 18-35] years. Frequency of pelvic pain and per vaginal bleeding in first trimester of pregnancy was observed in 29.33% [44/150] and 12% [18/150] respectively. Stratification analysis was performed and it was observed that rate of pelvic pain and per vaginal bleeding was not statistically significant among different age groups. Rate of pelvic pain was significantly high in women with primigravida as compare to multigravida [p=0.003]

Conclusion: We found in our sample a significant number of women experiencing pelvic pain and vaginal bleeding in first trimester of their pregnancy. The practitioner must employ sound clinical and diagnostic skills in the management of the patient as early pregnancy complications can cause significant distress for some women and their partners