The effectiveness of the Gram stain of high vaginal swabs in the diagnosis of bacterial vaginosis at the University Hospital of the West Indies [abstract]

OBJECTIVE: To correlate the gram-stain of high vaginal swabs (HVS) with the diagnosis of bacterial vaginosis (BV) and to compare this with bacterial culture reports to determine whether any useful additional information is gained by culture. METHODS: HVS submitted to the microbiology laboratory (UWI) from patients diagnosed clinically with vaginal infection were used in this study. Specimens were submitted from the Family Planning, Gynaecology and Antenatal clinics at the University Hospital of the West Indies. Swabs were placed in Stuart's Transport Medium and taken to the microbiology laboratory within 24 hours. The specimens were subjected to standard bacteriological procedures of culture on blood and MacConkey agar and microscopic procedures of wet prepartion and gram stain. The gramstain was recorded on a specially designed data sheet for each patient with a standardized scoring method for the evaluation of gram-stained smears based on the recognition of both presence and amount of significant morphotypes. This result was then compared with the bacterial culture, available a few days later, to see the degree of correlation and to determine whether any relevant additional information was gained. Almost 60 percent of the specimens collected yielded no pathogens on culture. However, one-third of this 60 percent was diagnosed as BV by standardized scoring method. One-third of all specimens submitted yielded yeast (Candida albicans and yeast not-Candida albicans) on culture and by gram stain. Streptococcus group B was isolated in < 4 percent of all specimens and a miscellaneous group of organisms including Klebsiella sp, Pseudomonas sp and anaerobic Streptoccus made up the rest of bacterial isolates. CONCLUSIONS: The standardized scoring method of evaluating the HVS gram stains yielded a more accurate and rapid diagnosis of BV than the traditional culture method. This is worthy of further study, as implementation of this method would result in considerable cost and time saving. (AU)

Estrus synchronization and artificial insemination of hair sheep ewes in the tropics

Hair sheep ewes (St. Croix White and Barbados Blackbelly) were used to evaluate 3 methods of estrus synchronization for use with transcervical artificial insemination (TAl). To synchronize estrus, ewes (n=18) were treated with PGF2alpha (15 mg, im) 10 d apart, with controlled internal drug release (CIDR) devices containing 300 mg progesterone for 12 d (n=18), or with intravaginal sponges containing 500 mg progesterone for 12 d (n=18). On the day of the second PGF2alpha injection or at CIDR or sponge removal, sterile rams were placed with the ewes. Jugular blood samples were collected from the ewes at 6-h intervals until the time of ovulation, and daily for 16 d after estrus (Day 0). Plasma was harvested and stored at -20 degrees C until LH, and progesterone concentrations were determined by RIA. There was no difference (P>0.10) in time to estrus among the CIDR-, PGF2 alpha- or sponge-treated ewes. All of the ewes in the CIDR group and 94.4 percent of the sponge treated ewes exhibited estrus by 36 h after ram introduction, while only 72.2 percent of PGF2alpha-treated ewes showed signs of estrus by this time (P<0.06). The time from ram introduction to ovulation was not different (P>0.10) among CIDR, PGF2alpha- or sponge-treated ewes. The time to preovulatory LH surge was similar (P>0.10) among treatment groups. Hair sheep ewes (n=23) were synchronized using PGF2alpha and bred by TAI using frozen-thawed semen 48 h after the second injection. The conception rate to TAI was 2/23 (8.7 percent) and produced 3 ram lambs. In a subsequent trial, 17 ewes were synchronized with CIDR devices and bred by TAI using frozen-thawed semen 48 h after CIDR removal, resulting in a conception rate of 52.9 percent (9/17). It is possible to synchronize estrus in hair sheep using either CIDRs, sponges or PGF2alpha. Even though there were no significant differences in the timing of ovulation or the LH surge among the treatment groups, a higher concentration rate was achieved in ewes synchronized with CIDR devices during the second trial. This may reflect an increase in the skill level of the TAI technician.(AU)

Intravaginal misoprostol versus dinoprostone as cervical ripening and labor-inducing agents

OBJECTIVE: To compare dinoprostrone (prostaglandin E2) and misoprostol (prostaglandin E1) for ripening the cervix and inducing labour at term. METHODS: Sixty-three women are randomized to receive 100 micrograms misoprostol or 3mg dinoprostone, both are intravaginal tablets. RESULTS: There was no statistical difference between the groups of pre-induction status. The mean Bishop scores before drug insertion were almost identical. Twelve hours after insertion, the mean score in the Bishop score was significantly higher in those receiving misoprostol (5.0 versus 3.3) (P= .008). However, there was no significant difference in induction-to-delivery interval, spontaneous labor rates, types of delivery, fetal outcome, or maternal complications. CONCLUSION: Misoprostol is as effective as dinoprostone for inducing labor at term. (AU)