music It's a typical day. A patient has noticedsome itching, or maybe an unpleasant vaginal odor. During her exam, the ian willcheck vaginal pH, examine any discharge that's present, and collect a sample. Then, it'son to the microscope. music This is where you'll gather more specificinformationabout what's causing those vaginal symptoms. We'll show you how to prepare andexamine vaginal wet preps and how to do a whiff test. The results, combined with the patient's vaginal pH test, will aid in the diagnosis.
Under the microscope, you'll be looking for trichomonads, yeast, and the clue cells associated with bacterial vaginosis. We'll show you how to recognize them. music First, the microscope itself: This is a compoundlight microscope. It has several objective lenses on a rotating mount. For our purpose,one of these has to be a 10x low power objective, and one has to be a 40x for greater magnification.This flat part, under the objectives, is the stage. Under the stage is the condenser. Belowthat, at the base of the microscope, is the light source. There are two knobs that controlfocus; one for coarse adjustment and one for
fine adjustment. And these are the oculars,or eyepieces. We'll come back to the microscope in a minute, but first, let's look at how to prepare wet mount slides. The complete vaginal wet mount involves botha saline prep and a potassium hydroxide, or KOH, prep. When the vaginal sample was collected,the swab was placed in a test tube with approximately half a milliliter of saline. So, for the salineprep, you only have to take a drop of the suspension and place it on a slide. Add acoverslip, being careful to avoid trapping air bubbles. Your saline slide is ready.Place a second drop of the vaginal sample on another slide and add one drop of 10 percentKOH. Sniff the preparation immediately, using
your hand to waft any odor toward your nose.This is the whiff test. Note if there's a fishy or amine odor. Then add a coverslip,avoiding air bubbles. Keep in mind that you must work quickly to prepare and examine thewet mounts. That's because trichomonads may lose their characteristic motility within15 to 20 minutes. Before we move on now, though, let's lookat the cast of characters you may discover. These are normal squamous epithelial cellsfound in the vagina. They're large, flat cells with a small nucleus and a large area of cytoplasm.Note that there is some granularity in the cytoplasm.
Polymorphonuclear leukocytes are known asPolys, or PMNs. They may also be called white blood cells, or WBCs. These are small roundcells. Several lobes of the nucleus are visible within the surrounding cell cytoplasm. Findingmany PMNs may indicate infection. Trichomonads are pearshaped protozoa whichmove by means of flagella. Trichomonads are similar in size to PMNs and are identifiedby their characteristic jerking movement. The actual flagella may be too thin and toorapidlymoving to be seen. A clue cell is a squamous epithelial cellcoated with enough small bacteria that at least 75 percent of the cell's border is obliterated.It may look as if someone has spread glue
over the cell and pressed it in sand. Cluecells are associated with bacterial vaginosis, a condition in which the normal microbialflora of the vagina is disrupted. Yeast may be found in two forms. Pseudohyphaeare the long, tubular, branching forms. Budding yeast are paired yeast cells that resemblea shoe print. The larger part is the sole and the smaller bud is the heel of the shoe. The saline prep will allow you to see epithelialcells, PMNs, trichomonads, and clue cells. You can also see yeast in saline, but sometimesit's hidden by epithelial cells or by PMNs. Red blood cells, sperm, and bacteria can alsobe seen.
What are Vitamin D Deficiency Symptoms
Hey guys, Axe here. I want to talk aboutthe many benefits of vitamin D as well as vitamin D deficiency. So many people are strugglingwith vitamin D deficiency. In fact, according to a lot of medical studies today, they'reshowing that quite possibly the top deficiency we have in America is a vitamin D deficiency,and for a lot of us there are several reasons for that. But let me talk about the symptomsof vitamin D deficiency. I'm then going to get into what's causing vitamin D deficiency,then go over the best foods, supplements and things you can do to correct this type ofissue. But first and foremost, the big thing thatcan cause or the big symptoms you might have
with a vitamin D deficiency are immune issues.If you have a weakened immune system, that could be correlated with a vitamin D deficiency.If you have candida or bacterial overgrowth, it can be caused from a vitamin D deficiency.If you struggle with let's say emotional ups and downs, like depression and anxiety, thatcan be a cause. Hormone imbalance, major cause of vitamin D deficiency. If you have troubleputting on muscle or losing weight, those are all correlated with a vitamin D deficiency.If you have weak bones or teeth, osteoporosis or osteopenia, those are warning signs youhave a vitamin D deficiency. So again, you can see there are a lot of things and I didn't even get into certain other
things like cancer and diabetes and heartdisease but those are all warning signs you could have a vitamin D deficiency. Vitamin D is responsible for really supportinga healthy immune response, digestive health, hormone balance, and here's a key thing toremember. Vitamin D is not just a vitamin. It's also a pro hormone. So it's responsiblefor so many hormone producing reactions within your body. You've got to have vitamin D. Now here are the biggest causes of vitaminD deficiency. Number one is not getting enough sunlight. The sun should be your number onesource of vitamin D. We live in a world today
where we live inside, especially if you'rein the northern states, whether it be in Canada or northern US or northern Europe. But ifyou are not getting outside enough and not getting enough direct sunlight on your skin,that will create a vitamin D deficiency. So starting off, the majority of people are vitaminD deficient because we don't get outside enough. And the other thing can be certain chemicals,especially things that are plastic in nature, those can block vitamin D absorption. So ifyou're drinking out of plastic bottles that have something called BPA, that's bisphenolA, that can cause vitamin D deficiency and really affect the way vitamin D is absorbedand utilized and created by your liver in
your body. The other thing is toxicity. If you're exposedto toxins on a regular basis, that affects the liver. Your liver is actually responsiblefor producing and creating vitamin D within your body. So again, toxicity another majorcause of vitamin D deficiency. So if you want to start to correct vitaminD deficiency and see improvements in your immune function, in your metabolism, in yourhormones and things like your thyroid and your adrenal glands and improving your overallmood and bone strength, you've got to get more vitamin D.
Again, your number one source by far is sunlight.I recommend getting outside 20 minutes to 30 minutes every single day. Even if it'scold outside, getting a little bit of sun on your face and hands, it's so importantfor getting Vitamin D. So again, number one is get sunlight 20 to 30 minutes a day. Now, apart from that, certain foods will containsmall amounts of vitamin D. Number one source will be wild caught salmon or fish, so againgetting wild caught fish on a regular basis. Also, raw fermented milk, like a goat's milkyogurt, may have small amounts of vitamin D, as will mushrooms and eggs. But again,you're going to get very small amount in diet.