“COMPARATIVE STUDY TO CHECK THE EFFICACY OF pH STRIP & pH GLOVES FOR DETECTION OF BACTERIAL VAGINOSIS IN A TERTIARY CARE HOSPITAL” Original Article MOHAMMAD NIYAZ ALAM a* , ALOK BHARDWAJ a , MOHAMMAD QUAISUL HODA a , CHITRA GUPTA Faculty of Pharmacy, Ram-Eesh Institute of Vocational and Technical Education 3, Knowledge Park-1, Kasna Road, Greater Noida, Gautam Budh Nagar, U. P, India Email: niyazpharma@yahoo.co.in a Received: 11 Mar 2015 Revised and Accepted: 21 May 2015 ABSTRACT Objectives: Comparative study to check the efficacy of pH Strip & pH Gloves for Detection of Bacterial Vaginosis in a Tertiary Care Hospital. Methods: It was a duly approved, cross-sectional study in which 50 subjects were enrolled from Tertiary care hospital, New Delhi, India. Written informed consent was obtained from all women. Vaginal swabs were collected for vaginal pH measurement. Vaginal pH was evaluated immediately with the pH strips and vaginal pH glove simultaneously. Results: The study was done on to check the efficacy of pH strip & pH gloves in pregnant as well as non-pregnant women by regularly visiting the tertiary care hospital. Among 50 subjects 8(16%) were Pregnant and 42(84%) were Non-pregnant. The mean age of the patients included in the study was found to be 26.1±19.5 years. After a Gram stain and microscopic examination of samples obtained from 50 women, those with intermediate flora and Candida infection were excluded and the final analysis was done on 40 samples. Among 40, 15 were diagnosed with BV and 25 had normal vaginal flora based on Nugents’ score. Conclusions: Our findings show that vaginal pH determination is relatively sensitive, but less specific in detecting women with BV. Both pH glove and pH strip are equally suitable for screening women with BV on an outpatient basis. Further studies are required to explore the possibility of self- evaluation of vaginal pH with pH glove at community level. Keywords: Bacterial Vaginosis, Cross-sectional study, pH Strip, pH Gloves, Nugents’ score. INTRODUCTION Vagina is a fibro muscular elastic tubular tract which is a sex organ and has two main functions: sexual intercourse and childbirth. In humans, this passage leads from the opening of the vulva to the uterus (womb), but the vaginal tract ends at the cervix. Unlike males, who have only one genital orifice, females have two, the urethra and the vagina. The vaginal opening is much larger than the urethral opening, and both openings are protected by the labia [1]. The vagina of a newborn is affected by the residual maternal estrogen still present. At birth, the vaginal mucosa is rich in glycogen and the vagina becomes colonized by lactic-acid producing bacteria, such as Lactobacillus spp., within the first day after birth [2]. These estrogen effects will slowly disappear by the fourth week after birth and the glycogen content will diminish. The vaginal pH becomes neutral or alkaline, likely due to the almost absence of lactic-acid producing microorganisms [3]. The healthy vagina of a woman of child-bearing age is acidic, with a pH normally ranging between 3.8 and 4.5 [4]. This is due to the degradation of glycogen to the lactic acid by enzymes secreted by the Döderlein's bacillus. The acidity retards the growth of many strains of pathogenic microbes [5]. The pH of the upper vagina is normally acidic (pH 3.8-4.5). Leakage of amniotic fluid (normal pH 7.0-7.5) raises the pH in vaginal fluid to>4.5. Similarly, bacterial overgrowth, as occurs in bacterial vaginosis and trichomonas, may increase vaginal pH to>4.5. Vaginal yeast infections do not change the pH of the vagina [6]. An increased pH of the vagina (with a commonly used cut-off of pH 4.5 or higher), can be caused by bacterial overgrowth, as occurs in bacterial vaginosis and trichomoniasis, or rupture of membranes in pregnancy [4]. The pH paper is impregnated with the indicator dye nitrazine (phenapthazine). The color of the paper changes from bright yellow at pH 4.5 and lower to dark blue at pH 7.0 and higher. Changes in color shades occur with pH increments of 0.5 from pH 4.5 to 7.5. The pH of vaginal fluid is determined by comparing the color of pH paper that has come in contact with a fluid sample to a standard color chart provided with each roll of pH paper [7]. Bacterial Vaginosis (BV) is the most common vaginal infection among women in reproductive age. It is a condition of vaginal flora imbalance, in which the typically plentiful H2O2 Women with BV are at higher risk of infection with human papilloma virus (HPV), Herpes simplex virus type 2 (HSV-2), Trichomonas vaginalis, Neisseria gonorrhoeae and HIV [10, 11]. Given the high prevalence and gravity of associated morbidity, it is critical to diagnose and treat women, particularly pregnant women affected by BV appropriately. Conventional diagnostic methods for BV include the methods of Amsel criteria and Nugent. [12, 13]. An easy, rapid and inexpensive self-diagnostic test for BV may help to minimize the tendency to self-treat symptomatic BV blindly with antibiotics or treating inappropriately. Assessment of intra vaginal pH is a helpful, but frequently neglected procedure that can be used to evaluate vaginal health [14]. Bacterial vaginosis (BV) is highly prevalent among women in the reproductive age group. producing lactobacilli are scarce and other bacteria such as Gardnerella vaginalis, Mycoplasma hominis, Ureaplasma urealyticum and anaerobes (e. g. Prevotella, Mobiluncus, Bacteroides) are overly abundant. [8, 9]. Bacterial vaginosis (BV) is a vaginal infection characterized by loss of the normal protective lactobacilli and overgrowth of diverse anaerobes [15]. This infection is one of the leading causes of vaginal discharge and is more prevalent in HIV-1- infected women compared to uninfected women. Vaginal pH is a useful indicator for bacterial vaginosis. pH more than 4.5 of vaginal fluids is found to be indicative of bacterial vaginosis. In this regards pH determination if made a part of routine gynaecological examination can serve as a useful tool for preliminary diagnosis of bacterial vaginosis, moreover when the gloves, being used for routine examination are themselves pH sensitive and no additional procedures need to be carried out. Further these gloves can prove handy in self examination of vaginal pH and early detection of infections. The results of the study may be useful in developing a self diagnostic kit for bacterial vaginosis. Thus, pH determination during gynaecological examination which International Journal of Pharmacy and Pharmaceutical Sciences ISSN- 0975-1491 Vol 7, Issue 7, 2015 Innovare Academic Sciences