title: Study to Evaluate Targeted Management and Syndromic Management in Women Presenting with Abnormal Vaginal Discharge.
abstract: BACKGROUND
  Vaginal discharge is a commonest complaint among women in reproductive age group. Infective vaginal discharge can be broadly categorized into vaginitis or mucopurulent cervicitis. Vaginitis is predominantly caused by bacterial vaginosis, vaginal candidiasis, vaginal trichomoniasis, etc. Mucopurulent cervicitis is due to chlamydia or gonococcal infection. The targeted management is based on identification of causative organism and targeting the therapy against it, while syndromic management is based on high risk factors's presence.
  
  
  OBJECTIVE
  To study the effect of targeted management as compared to syndromic management in achieving a complete cure for abnormal vaginal discharge and to study the microbial flora of women presenting with abnormal vaginal discharge.
  
  
  METHODS
  The study is a randomized control trial conducted at tertiary health care on 200 women who presented with abnormal vaginal discharge, distributed in two groups A and B each consisted of 100 women. Group A underwent laboratory investigations, and treatment was started as soon as reports were available. Group B was given syndromic management based on high risk factors's presence. Both groups were followed up after 2 weeks.
  
  
  RESULTS
  The prevalence of various organisms in vaginal discharge was candidiasis 39 %, bacterial vaginosis 28 %, trichomoniasis 5 %, N. gonorrhoeae 5 % and chlamydia 2 % among the 100 women in group A. Response to treatment for vaginitis was 76.3 % in group A, whereas it was 41 % in group B. With cervicitis, 71.4 % women responded to treatment in targeted group as compared to 54 % in syndromic management group.
  
  
  CONCLUSIONS
  There is a potential disadvantage of syndromic management because of its total reliability on a subjective clinical assessment.
authors.affiliation: Department of Obstetrics and Gynaecology, Smt. Sucheta Kriplani Hospital and Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Veena
authors.identifier: 0000-0001-7804-8192
authors.initials: V
authors.lastname: Meena
authors.affiliation: Department of Obstetrics and Gynaecology, Gangori Hospital, SMS Medical College, Jaipur, Rajasthan India.
authors.forename: Charu Lata
authors.initials: CL
authors.lastname: Bansal
keywords: Abnormal vaginal discharge; Syndromic management; Targeted management