BACKGROUND: Bacterial vaginosis is the most common vaginal infection among reproductive age women. It has been associated with preterm labor and emerged as a formidable disease entity associated with catastrophic sequelae especially in pregnant patients. Papanicolaou smear is the most successful screening test for cervical carcinoma in the history of medicine. Albeit being used by some clinicians as screening tool for bacterial vaginosis, it was not well established.

OBJECTIVE: To determine the diagnostic accuracy of papanicolaou smear in making the diagnosis of bacterial vaginosis in pregnant patients with the vaginal gram stain used as diagnostic standard.

METHODOLOGY: A total of 321 pregnant patients who consulted for prenatal care at the outpatient department of obstetrics and gynecology of the tertiary training hospital between November 2013 to-June 2014 were included in the study. Each patient had gram-stained vaginal smear and standard pap smear done consecutively. The sensitivity, specificity, positive predictive value, negative predictive value and the likelihood ratios of pap smear were determined.

RESULTS: The sensitivity of pap smear in determining the presence of bacterial vaginosis is 70.5%, its specificity of 93.6%, positive predictive value of 80.5%, negative predictive value of 89.3%. Likelihood ratio of a positive result is 10.9 and 0.3 for a negative result with diagnostic accuracy of 87.23%.

CONCLUSION: These results support the reliability of the pap smear in the diagnosis of bacterial vaginosis in asymptomatic pregnant patients. Since pap smear and gram stain have close diagnostic accuracy, duplication of the test could reasonably be avoided in most patients.

Human ; Female ; Adult ; Young Adult ; Adolescent ; Postmenopause ; Ovary ; Neoplasms ; ROC Curve ; Endometrial Neoplasms

BACKGROUND AND OBJECTIVE

Tuberculosis (TB) remains to be prevalent in the Philippines and globally. Female genital tuberculosis has devastating and permanent consequences, hence, timely and adequate treatment is needed. Since more data regarding optimal duration of treatment of genital tuberculosis are needed, this study compares the treatment response at six months and after at least nine months of treatment, with the intention of determining the most practical management for genital tuberculosis.

METHODS

A retrospective chart review was conducted for newly diagnosed cases of genital tuberculosis who met the inclusion criteria. Treatment response was categorized into clinical, microbiologic, histologic, radiologic, and sonographic responses. Responses to treatment were evaluated as either partial or complete at the 6th month and after at least 9 months of treatment, and the proportions were compared.

RESULTS

Out of 140 charts retrieved, only 43 were included. Statistically significant difference was found only in clinical response, primarily due to patients who did not achieve resumption of menstruation within the f irst six months of treatment. The rest of the treatment responses and adverse drug events are equally the same for both time periods.

CONCLUSION

Results of this study show that the proportion of patients with microbiologic, histologic, radiologic, and sonographic response to treatment at the 6th month did not significantly differ to the proportion of patients who responded at the 9th or 12th month of treatment. This leads to a conclusion that the 6-month treatment regimen will be more practical in treating genital tuberculosis, except in amenorrheic premenopausal women who may warrant extension of treatment. Further studies on post-treatment rates of relapse and sonographic resolution are needed.

Human ; Female ; Tuberculosis, Female Genital ; Philippines