Comparison of Diagnostic Methods for Detection of Trichomonas vaginalis in Prediagnosed Vaginitis Cases and Its Association with Various Pathogens

Objective: Parasitological diagnostic methods such as direct microscopy, staining examination and culture methods are frequently used in the diagnosis of Trichomonas vaginalis (T. vaginalis). Though, nowadays, new diagnostic methods, especially DNA-based methods, are developing, enabling the simultaneous recognition of different pathogens. In our study, we evaluated whether  the choice of multiplex polymerase chain reaction (PCR), in which T. vaginalis and different pathogens can be detected, is be an alternative to classical methods and to evaluate the possible coexistence of pathogens. Methods: In our study, swab samples taken during routine examination of 100 female patients who presented to Manisa Celal Bayar University and Manisa City Hospital Outpatient Clinics Obstetrics and Gynecology were evaluated. The presence of T. vaginalis was investigated in these samples by direct microscopy, Giemsa stain and culture. Besides T. vaginalis, other possible agents were also investigated by real-time multiplex PCR method. Results: At least one agent was detected in 85 (85%) of the 100 patient samples included in our study. T. vaginalis positivity was detected in 6 (6%) of the samples by parasitological diagnosis methods and in 10 (10%) of the samples by multiplex PCR. Additionally, with real-time multiplex PCR, Chlamydia trachomatis in 4 (4%), Neisseria gonorrhoeae in 3 (3%), Ureaplasma urealyticum/parvum in 68 (68%), Gardnerella vaginalis in 68 (68%) and Herpes simplex virus 1/2 in 1 (1%) of the sample positivity was found. Mycoplasma genitalium, another agent examined by multiplex PCR, was not found positive in any sample. The Kappa value of the culture that is a parasitological test and multiplex PCR for T. vaginalis showed moderate agreement with 59.5%. Conclusion: It has been concluded that using  real-time multiplex PCR method, which has  high specificity and sensitivity, in addition to microscopy and culture methods in the diagnosis of T. vaginalis, could contribute to the correct and effective treatment by detecting multiple infections.

Possible role of asymmetric dimethylarginine (ADMA) in prediction of perinatal outcome in preeclampsia and fetal growth retardation related to preeclampsia.

OBJECTIVE: The objective of this study is to investigate maternal serum and neonatal umbilical cord asymmetric dimethylarginine (ADMA) levels in prediction of perinatal prognosis in pregnancies with preeclampsia (PE) and fetal intrauterine growth retardation (IUGR) accompanying PE (PE + IUGR). METHODS: Maternal serum ADMA (msADMA) and neonatal umbilical cord ADMA (ucADMA) levels were studied from 34 patients with PE, 25 patients with PE + IUGR, and 30 healthy pregnant controls in this prospective case-control study. Umbilical artery Doppler indices of fetuses, birth weights, Apgar scores, umbilical artery pH measurements of neonates, and admissions to neonatal intensive care unit (NICU) were recorded. RESULTS: Median msADMA was significantly higher in PE and PE + IUGR groups (p = 0.024 and p = 0.011, respectively), and ucADMA was significantly higher in PE and PE + IUGR groups than the control group (p = 0.029 and p = 0.018, respectively). Median msADMA and ucADMA levels were significantly higher in the PE + IUGR group than the PE group (p = 0.019 and 0.021, respectively). ucADMA levels did not correlate with fetal umbilical arterial blood flow neither in the PE nor in the PE + IUGR group (p = 0.518 and p = 0.892, respectively). None was related with neonatal umbilical artery pH or NICU admission rates. CONCLUSIONS: msADMA and ucADMA correlated with severity of PE. msADMA and ucADMA failed to predict perinatal outcome in patients with PE and PE + IUGR.