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

Objective: This study aimed to compare the clinical profile of prepubertal and pubertal female child sexual abuse. Methods: A cross-sectional analytical study involving 43 sexually abused children was done. Each patient was categorized as prepubertal or pubertal based on the Tanner stage. Medical history was gathered using a structured interview and physical examination done with proper documentation after obtaining consent. Blind review by child protection specialists was done on genital images. Descriptive statistics were utilized for all variables. Results: This study showed 11.97% and 22.22% prevalence for prepubertal and pubertal child sexual abuse, respectively. Most prepubertal children disclosed digital vaginal penetration by the father and non-relative household members, while most pubertal children reported penile-vaginal penetration by the boyfriend. Fondling was common to both groups. The majority were repeated abuse and usually happened at the perpetrator’s house. Behavioral changes and genital symptoms were common in prepubertal children. Findings of hymenal trauma were found in 25% of prepubertal girls and half of the pubertal adolescents. The interobserver variability of these hymenal findings was fair. The prevalence of sexually transmitted infections (STIs) was low, none for the prepubertal children, and only 6% of the adolescent had STI, which was Hepatitis B. Conclusion The clinical profile of sexually abused prepubertal children differed from that of pubertal adolescents. There was a higher incidence of hymenal trauma and STIs in adolescents.
Child Abuse, Sexual