الفهرس 
Microbiology of the VaginaOnly 14 pages are availabe for public view
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Abstract
Vaginal discharge is the most common symptom in our gynecologic clinics. There are common types of vaginitis are bacterial vaginosis, vaginal candidiasis and trichomonas vaginalis. Other types that sexually transmitted like Chlamydia trachomatis.
The assessment of vaginitis should be performed by accurate history taking, clinical examination and other microscopic tests.
Pap smear screening is effective tool for early detection of epithelial cell abnormalities. The objective of this study was to evaluate relationship between vaginal discharge as patient complaint and cytological abnormalities of vagina and cervix through Pap smear using.
In the current study, 105 patients who are above 25years, non pregnant and no history of diagnosed cervical cancer before.
All patients were attending Early Cancer Detection Unit in Ain Shams Maternity Hospital. History and clinical examination were taken from all patients, non lubricated vaginal speculum was inserted. The cervix, vaginal wall and fornices were carefully inspected for the presence of any pathlogical lesion and vaginal discharge charachers (amount, colour, odour and blood stained), then cervico-vaginal smear was collected. All slides are fixed in 95% concentrated alcohol which used for fixation. The results of Pap smear interpretation were done according to Bethesda system.
The results of study reports of different variables related to vaginal infections and cervical neoplasia show: No infection 5( 4.8%), Non-specific infection (56) 53.3% with commonest complaint with vaginal discharge was soreness(92.2%), Candida albicans(19) 18.1% with commonest complaint itching and soreness(100%), Gardnerella vaginalis (12)11.4%,Trichomonas (9) 8.6% with , Chlamydia (3) 2.9%, and Herpes simplex (1) 0.9%.
Epithelial cell abnormalities were diagnosed in four patients only about 3.80% of all our patients, three have low grade Squamous intraepithelial lesion about 2.85% and one has atypical endo-cervical columnar cells about 0.95%. Their mean age of first intercourse 17.2 years, with single marriage, all were passive smokers with 2 out of 4 (50%) having genital warts.
The results of Pap test are widely variable. The organisms should be reported when identified. The less sensitive and specific tests can be combined with a confirmatory test as wet mount examination or culture or PCR, if necessary, to provide the best result for the patient. This study cannot found correlation between patients with vaginal discharge and cytological abnormalities using Pap smear.
The current study recommends cervico-vaginal smears should be taken at 21years or within three years of marriage as most of cervical epithelial abnormalities more common in younger age. Liquid based preparation (Thin Prep) can be used with advantage of ancillary testing for HPV, gonorrhea, and Chlamydia. Cases with cytological Pap smear abnormalities should confirmed either with colposcopic examination or HPV DNA testing assesy.