title: Utility of pH test & Whiff test in syndromic approach of abnormal vaginal discharge.
abstract: OBJECTIVE
  In India, National AIDS Control Organization (NACO) introduced syndromic approach to treat patients with abnormal vaginal discharge without a need for laboratory tests. Simple tools like pH test and Whiff test can be done without high expertise, microscope and even speculum. This can improve diagnostic value of syndromic approach of abnormal vaginal discharge. The present study was conducted to evaluate sensitivity and specificity of pH test and Whiff test in diagnosis of abnormal vaginal discharge, considering microscopic diagnosis as gold standard.
  
  
  METHODS
  This prospective hospital-based study included 564 women with abnormal vaginal discharge. All women were subjected to gynaecological examination, pH test and Whiff test. The findings were compared with microscopic examination. Statistical analysis was done by calculating proportions, percentage, sensitivity and specificity.
  
  
  RESULTS
  Vaginitis was diagnosed in 301 (53.37%) women. Bacterial vaginosis (BV) was the commonest type of vaginitis (39.01%). Cervical erosion was the second most common cause (17.91%) and physiological discharge was the third (14.36%). pH >or= 4.5 and positive Whiff test had sensitivity of 94.09 per cent and specificity 87.5 per cent in diagnosing BV. Similarly pH < 4.5 and positive or negative Whiff test had sensitivity of 83.72 per cent in diagnosing candidiasis.
  
  
  CONCLUSIONS
  pH test and Whiff test can improve diagnostic value of speculum examination where microscope facilities are not available.
authors.affiliation: Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India. jthulkar@gmail.com
authors.forename: Jyoti
authors.initials: J
authors.lastname: Thulkar
authors.forename: Alka
authors.initials: A
authors.lastname: Kriplani
authors.forename: Nutan
authors.initials: N
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006176:Gynecology / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007194:India; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013577:Syndrome; D016896:Treatment Outcome; D014247:Trichomonas Vaginitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D019522:Vaginal Discharge / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents