scholarly journals Study of Trichomonas Vaginalis and Bacterial Vaginosis in Pap smear at a Tertiary Health Care Centre of Nepal

2020 ◽  
Vol 22 (1-2) ◽  
pp. 8-12
Author(s):  
Rakesh Pathak ◽  
P Pradhan ◽  
S Pudasaini ◽  
S Maharjan ◽  
AS Basnyat
Keyword(s):  
Bacterial Vaginosis ◽  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Disease Diagnosis ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Vaginal Infections ◽  
Health Care Centre ◽  
Pap Screening

Cervical-vaginal infections are common problems in women of reproductive age presented with clinical features like white vaginal discharge, foul smelling odor and pruritis. Trichomonas vaginalis, Candidia and Gardnerella vaginalis are responsible for infectious vaginitis in creating anaerobic environment favoring Bacterial vaginosis caused by organisms like Gardnerella vaginalis, Chlamydia Trachomatis. Papanicolaou (Pap) smear examination is the simple, quick, painless routine screening test used for identification and detection of precancerous changes of uterine cervix as well as the cervico-vaginal infections resulting from bacterial, fungal and candida infections. The prime objective of the study was to identify the age wise distribution of cervical-vaginal infections and determine the frequency of Trichomonas vaginalis (TV) and Bacterial vaginosis (BV). A descriptive cross-sectional study was carried out in the Department of Pathology, Nepal Medical College and Teaching Hospital, Kathmandu. A total of 163 cases of TV and BV diagnosed on Pap smear were taken for the study. However, 564 Pap smears were received in the Department of Pathology for cytological evaluation during the study period. Once the smears were stained, the presence of clue cells, cannon balls and Trichomonas were observed. Out of 564 Pap smears received during the study period, 163 cases were of BV, TV and combined BV and TV. These 163 cases were included in our study. The age ranged from 20 to 65 years with majority (19.1%) of the women belonging to 35-39 years and the mean age was 38.18 ± 10.18 years. There were 97 cases (17.2%) of BV, 50 cases (8.9%) of TV and 16 cases (2.8%) of TV and BV co-infection. Bacterial vaginosis was the most predominant type of cervicovaginal infection followed by TV infection and TV and BV co-infections. Trichomonas vaginalis may create an environment favoring the development of BV. Pap screening could be the beneficial tool in early disease diagnosis and helps in preventing further complications by starting appropriate treatment.

scholarly journals Comparative study of pap smear and microbiological pattern in bacterial vaginosis

2018 ◽  
Vol 7 (3) ◽  
pp. 1039
Author(s):  
Girishma J. ◽  
Rupakala B. M. ◽  
Sunil Chavan
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Pap Smear ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Gram Stain ◽  
Medical College ◽  
Gram Staining ◽  
Gynecology And Obstetrics

Background: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age group. It is characterized by an increased vaginal pH and loss of normal lactobacilli and overgrowth of anaerobes like Gardnerella vaginalis and other gram-negative rods. Purpose of this study is to compare the characteristics of pap smear and microbiological pattern in patients with abnormal vaginal discharge.Methods: The study was conducted in the Department of Gynecology and Obstetrics of Rajarajeswari Medical College and Hospital (RRMCH) Bangalore, India. All patients with vaginal discharge were included in the study. Vaginal discharge samples were sent to gram staining, culture and pap smear examination.Results: Of the 52 patients, 18 patients (34.6%) showed positive for bacterial vaginosis according to Nugent’s score. Of the 18 patients with positive Gram stains, 8 of them were positive for bacterial vaginosis according to pap’s smear (44%) and 10 had negative pap smears. In our study, of the 18 patients with positive Gram stains, 14 (77%) of them were positive for bacterial vaginosis according to culture.Conclusions: In the present study we found out that correlation of gram stain and pap smear was 44% whereas correlation of gram stain and culture was 77%. Hence, we conclude that gram stain and culture are preferred for the diagnosis of bacterial vaginosis rather than the pap smear evaluation.

scholarly journals Significance of Reporting Cannon Balls in Diagnosing Bacterial Vaginosis Infection in PAP Smear

2021 ◽  
Vol 23 (2) ◽  
pp. 109-113
Author(s):  
Kricha Pande ◽  
Shraddha Koirala ◽  
Astha Shrestha
Keyword(s):  
Bacterial Vaginosis ◽  
Pap Smear ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Cross Sectional ◽  
Medical College ◽  
The Mean ◽  
One Year

Bacterial vaginosis is the most common cause of vaginitis. It is caused by depopulation of lactobacilli from the normal vaginal flora and overgrowth of Gardnerella vaginalis and other anaerobic species. Pap smear being a screening and diagnostic tool for malignancy, is equally important to diagnose infective pathology as well. This study tried to establish the significance of reporting the presence of cannon balls in Pap smears and whether their presence suggested bacterial vaginosis or not. This was a cross sectional study conducted at Nepal Medical College, Teaching Hospital (NMCTH), Kathmandu for duration of one year (January 2020 to December 2020). Pap smears were sent from gynaecology department and standard routine Pap stain was done in Pathology Department. Presence of bacterial vaginosis and cannon balls were noted. Total of 799 Pap smears were received. The mean age of bacterial vaginosis was 38.2 ± 9.6 years. The age group of 31-40 years (n=32, 39%) was most commonly affected. Bacterial vaginosis was seen in 81 pap smears out of 799 pap smears. The prevalence of bacterial vaginosis was 10.1%. Of the total of 799 cases of Pap smears, cannon balls were seen in 9.1% cases and among the bacterial vaginosis, cannon balls were seen in 48% cases. There was significant association between cannonballs and bacterial vaginosis (p < 0.0001). Thus, the present study re-enforces the fact that Pap smear is also very effective tool to diagnose bacterial vaginosis.

scholarly journals Clinicopathological Pattern of Cervical Papanicolaou (PAP) Smears: A hospital based experience

2018 ◽  
Vol 5 (2) ◽  
pp. 27-34
Author(s):  
Sujan Shrestha ◽  
Ranjan Suwal ◽  
Shyam Nandan Gupta
Keyword(s):  
Significant Relationship ◽  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Clinical Findings ◽  
Reproductive Age ◽  
Pap Smears ◽  
Medical Sciences ◽  
Medical College ◽  
Pap Smear Screening ◽  
Intraepithelial Lesion

Background and Objectives: Cervical cancer is very common type of cancer in women globally. The objective of this study was to compare the cytopathological findings of the cervical pap smears using the revised 2001 Bethesda system and to compare the cytopathological findings with the clinical features.Material and Methods: A total of 1016 pap smear sent to the Department of Cytopathology at Peoples Dental college general hospital (PDCH), Kathmandu over a period of three years were studied. Relevant history and clinical findings were retrieved for the study. The age, caste, location, gravida of the patient, the nature of complaint of patient to the doctor along with the per speculum findings, per vaginal examination findings of the patient and their relation to the cytopathological findings of pap smears were evaluated.Results: No significant relationship was observed between the (30-39 years) aged women and the available outcome of pap smear (p=0.404). Most of the females were Brahmin and Newars. The statistical analysis showed no significant relationship (p>0.05) between the ethnicity and pap smear result. The number of asymptomatic women in this study was found 22.9%. This study found 20.37% of intraepithelial lesion or malignancy. Trichomonas vaginalis and bacterial vaginosis combinely contributed to 0.7% of the total cases in this study. Three smear cases were detected having malignant epithelial cell which were diagnosed with adenocarcinoma, squamous cell carcinoma.Conclusion: In this study cervical pap smear was able to differentiate inflammatory, benign precursors and malignant cases. So, it is desirable to conduct routine Pap smear screening in women of all reproductive age regardless of race, ethnic background and socioeconomic status.Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 27-34

scholarly journals Treatment of vaginal infections: effectiveness of the association of metronidazole and clotrimazole

2010 ◽  
Vol 4 (1) ◽  
pp. 7-17
Author(s):  
Simone Ferrero
Keyword(s):  
Bacterial Vaginosis ◽  
Trichomonas Vaginalis ◽  
Laboratory Tests ◽  
Reproductive Age ◽  
Gram Stain ◽  
Women Of Reproductive Age ◽  
Vaginal Infections ◽  
Vaginal Ph ◽  
Vaginal Secretions ◽  
Vaginal Candidosis

The normal vagina of women of reproductive age is colonised by lactobacilli that produce lactic acid, hydrogen peroxide and bacteriocins; these substances contribute to lowering the vaginal pH. A low vaginal pH creates an environment hostile to the growth of other microrganisms. When the number of lactobacilli is decreased, the resulting increase in the pH may favour vaginal infections. The three most common vaginal infections are bacterial vaginosis, trichomoniasis, and vaginal candidosis. There are multiple clinical and laboratory tests for diagnosing vaginal infections; the most commonly used methods for diagnosing bacterial vaginosis are the Amsel’s criteria and the Nugent’s Gram stain scale. Infections caused by Candida and Trichomonas vaginalis can be diagnosed by microscopic examination of vaginal secretions. Clotrimazole and metronidazole, especially when administered topically, are highly effective in treating vaginal infections.

scholarly journals Agents causing genital infections in routine cytological tests: frequency and characteristics of Papanicolaou smears

2022 ◽  
Vol 82 ◽  
Author(s):  
F. S. Carvalho ◽  
N. K. A. Porto ◽  
P. V. M. Azevedo ◽  
P. K. A. Magalhães ◽  
E. N. de Araújo ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Clinical Pathology ◽  
Infectious Agent ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Candida Spp ◽  
Pathology Laboratory ◽  
Genital Infections ◽  
Tract Infections

Abstract Urinary tract infections are responsible for most human infections, these are caused by bacteria, fungi, protozoa and associated microorganisms. The goal of this study was to determine the rate of vaginal infection-causing agents in routine cytological exams and also to evaluate the characteristics of positive tested Pap smears. A retrospective documental with descriptive aspect research was performed in a Clinical Pathology laboratory from Maceió-AL. The results of the Pap smears exams for Trichomonas vaginalis, Gardnerella vaginalis, Candida spp and HPV were arranged in a database as well as other data such as bacterial, protozoan, fungal and viral coinfections. The sample was composed by 18.645 women who have undergone Pap smear exams from 2013 to 2017. Of these analyzed exams, 27.4% in 2013, 10.9% in 2014, 10.6% in 2015, 15.2% in 2016 and 13.67% in 2017 were within normal range, however more than half of these exams presented some infections caused by unspecific or microbiological agents. By analyzing all the reports, 4.073 (21.84%) presented inflammations caused by some species of infectious agent with the following rate order: G. vaginalis and T. vaginalis. Furthermore, it was possible to confirm high rates of coinfection by and Candida spp. The rate of genital infections in this study highlights that there is a public health matter that must be controlled, which points a greater need for monitoring, guidance and actions towards greater awareness in order to prevent these problems.

scholarly journals Role of the Vaginal Microbiological Ecosystem and Cytokine Profile in the Promotion of Cervical Dysplasia: A Case–Control Study

2002 ◽  
Vol 10 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Kian Behbakht ◽  
Jennifer Friedman ◽  
Ira Heimler ◽  
Alla Aroutcheva ◽  
Jose Simoes ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Cervical Dysplasia ◽  
Intraepithelial Neoplasia ◽  
Cytokine Profile ◽  
Gardnerella Vaginalis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Vaginal Smear ◽  
Pap Smears ◽  
Vaginal Lavage

Objective:To identify alterations in the cytokine profile and microbial ecosystem of the vagina in association with cervical dysplasia.Methods:Demographics, lifestyle variables and Papanicolau (Pap) smear results of subjects presenting to the same site for gynecologic complaints, obstetric visits or colposcopy were prospectively recorded. Vaginal smear for Gram stain, aerobic and anaerobic culture, pH, and wet mount and KOH examination forTrichomonas vaginalis,Gardnerella vaginalisand yeast organisms were performed. Vaginal lavage specimens were centrifuged, and the pellets and supernatants were assayed for human papillomavirus (HPV) by polymerase chain reaction and for cytokines interleukin (IL)-1ß IL-6, IL-10 and IL-12 by enzyme-linked immunosorbent assay (ELISA) respectively. Subjects with abnormal Pap smears underwent colposcopy and biopsy as indicated.Results: Of 51 patients, 32 were referred for colposcopy, 12 presented with gynecologic needs, and seven presented for obstetric visits. Median age was 24 years. Demographics did not differ significantly between the dysplasia and control groups except for a trend towards more sexual partners in the dysplasia group. Biopsies were performed in 81% (26/32) of patients presenting for colposcopy and 17 revealed cervical intraepithelial neoplasia. IL-1ß, IL-6, IL-10, and IL-12 levels were elevated in 63% (20/32), 38% (15/39), 4% (2/49), and 0% of samples respectively. Elevated vaginal lavage IL-1ß was associated with a 6.1 odds ratio (95% confidence interval 1.06–35) of cervical dysplasia. Alterations in other variables studied were not associated with cervical dysplasia.Conclusions: Elevated IL-1ß, possibly representing a complex host inflammatory response to multiple pathogens, was demonstrated in patients with cervical dysplasia.

scholarly journals Comparison of the Effect of VaginalZataria multifloraCream and Oral Metronidazole Pill on Results of Treatments for Vaginal Infections including Trichomoniasis and Bacterial Vaginosis in Women of Reproductive Age

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Khadijeh Abdali ◽  
Leila Jahed ◽  
Sedigheh Amooee ◽  
Mahnaz Zarshenas ◽  
Hamidreza Tabatabaee ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Trichomonas Vaginalis ◽  
Clinical Symptoms ◽  
Reproductive Age ◽  
Control Group ◽  
Vaginal Infections ◽  
Zataria Multiflora ◽  
Significant Difference ◽  
Oral Metronidazole

Effect ofZataria multifloraon bacterial vaginosis andTrichomonas vaginalisis shown in vivo and in vitro. We compare the effectiveness ofZataria multifloracream and oral metronidazole pill on results of treatment for vaginal infections includingTrichomonasand bacterial vaginosis; these infections occur simultaneously. The study included 420 women with bacterial vaginosis,Trichomonas vaginalis, or both infections together, who were randomly divided into six groups. Criteria for diagnosis were wet smear and Gram stain. VaginalZataria multifloracream and placebo pill were administered to the experiment groups; the control group received oral metronidazole pill and vaginal placebo cream. Comparison of the clinical symptoms showed no significant difference in all three vaginitis groups receiving metronidazole pill and vaginalZataria multifloracream. However, comparison of the wet smear test results was significant in patients with trichomoniasis and bacterial vaginosis associated with trichomoniasis in the two treatment groups (p=0.001andp=0.01). VaginalZataria multifloracream had the same effect of oral metronidazole tablets in improving clinical symptoms of all three vaginitis groups, as well as the treatment for bacterial vaginosis. It can be used as a drug for treatment of bacterial vaginosis and elimination of clinical symptoms ofTrichomonasvaginitis.

scholarly journals Bacterial vaginosis, the leading cause of genital discharge among women presenting with vaginal infection in Dar es Salaam, Tanzania

2021 ◽  
Vol 21 (2) ◽  
pp. 531-537
Author(s):  
Mtebe V Majigo ◽  
Paschal Kashindye ◽  
Zachariah Mtulo ◽  
Agricola Joachim
Keyword(s):  
Bacterial Vaginosis ◽  
Low Income ◽  
Vaginal Discharge ◽  
Dar Es Salaam ◽  
Referral Hospital ◽  
Reproductive Age ◽  
Low Income Countries ◽  
Vaginal Infection ◽  
Vaginal Infections ◽  
Regional Referral Hospital

Background: Pathological vaginal discharge is a common complaint of women in reproductive age worldwide caused by various agents. The prevalence and etiologic agents vary depending on the population studied. Management of vaginal discharge in low-income countries, typically depend on the syndromic approach, which limits understanding the specific causative agents. We determined the proportion of bacterial vaginosis, candidiasis, and trichomoniasis among women with vaginal discharge at a regional referral hospital in Dar es Salaam, Tanzania. Methods: We conducted a cross-sectional study between June and August of 2017 among nonpregnant women at Amana Regional Referral Hospital. Experienced staff performed physical examination to establish a clinical diagnosis, and collection of the high vaginal swab for microscopic examination. Descriptive statistics were performed to assess the characteristics of study participants and the proportion of vaginal infections. Results: A total of 196 samples were collected, of all, 128 (65.3%) had either bacterial vaginosis, candidiasis, or trichomo- niasis. Bacterial vaginosis was the leading infection at 33.2%, followed by candidiasis (19.4%) and trichomoniasis (13.3%). Laboratory confirmed vaginal infection were generally found more in age below 25, unmarried, and those employed or petty business. Conclusion: The proportion of bacterial vaginosis in women with vaginal discharge was relatively higher than others, and the presence of vaginal infection relate to socio-demographic characteristics. Further advanced studies are needed to understand the potential role of aetiologic agents in causing vaginal infections. Keywords: Bacterial vaginosis; vaginal discharge; genital infection.

Bacterial Vaginosis and its Relation with Sociodemographic Determinants in married reproductive age females

2021 ◽  
Vol 15 (6) ◽  
pp. 1249-1252
Author(s):  
R. Mukhtar ◽  
A. U.- Rehman ◽  
A. Ilyas ◽  
M. J. Khan ◽  
R. Liaqat ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Pap Smear ◽  
Reproductive Age ◽  
Age Group ◽  
Women Of Reproductive Age ◽  
Sociodemographic Determinants ◽  
Reproductive Age Group ◽  
Nonspecific Inflammation

Aim: To determine the frequency of Bacterial vaginosis by pap smear cytology and find its association with its sociodemographic determinants. Study design: Cross sectional analytical study Place and duration of study: Department of Histopathology, Shaikh Zayed Hospital, Lahore from 1st January 2016 to 31st October 2016. Methodology: Two hundred and sixty pap smears of married women of reproductive age group with vaginal discharge who attended Gynecology OPD were included. Proper history regarding age, socioeconomic status, age of marriage, literacy level, smoking, and nutritional status was taken. Results: Disease prevalence was found to be 19.2%(50)in this sample of 260 while 9.1% had Candidiasis, 47%, 17.2% ,3.7%, 4.1% had Mild nonspecific inflammation, Moderate nonspecific inflammation, Moderate to severe nonspecific inflammation, and negative smears respectively. Bacterial vaginosis was associated with age, monthly income, illiteracy, early age at marriage, history of abortion and nutritional status with significant p-value ≤ 0.05. However no association was found between the disease and marital status, smoking and pallor. Conclusion: Low socioeconomic status, literacy, age >35, nutritional status is strongly related to occurrence of bacterial vaginosis in women of reproductive age group with vaginal discharge. Key Words: Bacterial vaginosis, Pap smear, Sociodemographic determinants

scholarly journals Features of Pap smears in women of reproductive life with papillomavirus 16, 18

2021 ◽  
pp. 96-97
Author(s):  
Shafag Eldar Aliyeva ◽  
Keyword(s):  
Cervical Cancer ◽  
Epithelial Cells ◽  
Pap Smear ◽  
Reproductive Age ◽  
Pap Smears ◽  
Pathological Changes ◽  
Women Of Reproductive Age ◽  
Hpv 16 ◽  
Sexually Transmitted ◽  
Cervical Disease

Introduction. According to modern data, cervical diseases do not occur by chance. Precancerous lesions vary from person to person and become invasive over time. The need for specific diagnostic methods for early detection of cervical cancer in women of reproductive age always remains relevant. Over the years, numerous diagnostic, cytological and histological studies have been carried out to identify malignant lesions of the cervix. Human papillomavirus (HPV) is a widespread sexually transmitted infection that affects both women and men around the world and plays an important role in the development of cervical disease. It is the most common sexually transmitted virus in the United States of America. For the first time in 1942, Papanicolaou emphasized the possibility of using smears (PAP smears) from the cervix and from the vagina to diagnose cervical disease. PAP preparations of smears are mainly multilayered flat epithelial cells of the ectocervix and vagina, endocervical cylindrical cells, including mononuclear and polynuclear inflammatory cells that enter the vagina through diapedesis from the surface of the epithelial layer, mixing with the mucoid fluid produced by the endocervical epithelial fluid. Purpose — using objective criteria for cytological examination to identify neoplastic changes in the cervix. Materials and methods. The study included 100 women of reproductive age (18–45 years old) during 2015–2020. Of these, 20 were in the control group (group I — control) and 80 — in the high-risk group for cervical cancer (group II — the main group). Group II women were also divided into 2 subgroups: II A — with pathology of the cervix (n=41), II B — without pathology of the cervix (n=39). The study included patients with a positive result on HPV 16/18 including patients whose PAP smears revealed intracellular damage. Pap smears were included in the study according to the following criteria. The smears contained a sufficient number of squamous epithelial cells and their integrity was preserved. Endocervical cells were monitored in all PAP smears. The examination was carried out with at least 5 cells in each, not completely, and with 2 clusters of endocervical glandular or squamous metaplastic cells. Squamous epithelial cells covered at least 10% of the preparation. Bloody, technically artifactic preparations without clinical data have not been studied. The deficit rate did not exceed 3%, and high interest rates on artifacts were not included in the study. Despite the small number of cells in the presence of abnormal cells, this was unequivocally considered sufficient. Results. Interpretation of PAP smear results identified n=35 ASCUS patients, n=24 LSIL, n=21 HSIL patients in the PAP smear positive reproductive age group. HPV serotypes 16.18 were found in 24 of these patients. In women of the II B subgroup, no pathological changes in the cervix were observed. Conclusions. In women of reproductive age with positive HPV 16, 18, for the diagnosis of precancerous diseases of the cervix, taking pap smears is an integral part of the study. As a result of the study, it was revealed that, despite the absence of a clinical picture, pathological changes at the cell level are detected. Key words: HPV16, 18, ASCUS, LSIL, HSIL, PAP.

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