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TEST ON VAGINA DISCHARGE  The normal vaginal discharge is white, nonhomogeneous, and viscous. It contains vaginal squamous epithelial cells in a serous transudate, as well as material from sebaceous, sweat, and Bartholin's glands, and secretions from the cervix. A small number of polymorphonuclear leukocytes may be seen, probably coming from the cervix. The pH is below 4.5, usually between 3.8 and 4.2. The predominant organisms are lactobacilli, large gram-positive rods. The quantity of normal discharge varies from woman to woman and increases during ovulation, premenstrually, and during pregnancy. A normal discharge does not have an offensive odor and is not associated with vaginal irritation, itching, or burning. Technique A variety of tests and cultures can be done on secretions obtained at the time of pelvic examination. None is more important than the microscopic examination. Using a Q-tip, obtain some secretions from the posterior fournix. To prepare a  wet

                                Sandfly   The group is the  Phlebotominae , a subfamily of flies. Parasitic diseases spread by the flies include leishmaniasis, bartonellosis and pappataci fever. In the New World leishmaniasis is spread by sand flies in the genus  Lutzomyia .  Lutzomyia  often live in caves, where their main hosts are bats. In the Old World sand flies in the genus  Phlebotomus  spread leishmaniasis. Phlebotomine females, and only females, suck blood from various mammals, reptiles and birds. Some species are selective, whereas others bite any suitable host they find. As far as is known all species need a blood meal for every following clutch of eggs after the first. Proteins and other nutrients in the blood enable the female to produce eggs. The flies use their mouthparts to start the host bleeding. They then suck up the exposed blood. Like practically all blood-feeding parasites, they inject biochemicals that inhibit blood clotting, plus some that stimul