Rhesus negative, first trimester miscarriage and the need for Rhogam

A question was asked on the need for Rhogam following a first-trimester miscarriage in a Rhesus negative mother, to which I replied viz-

"Thank you for your email. If you are unsensitized(this is confirmed by a blood test in the hospital called indirect Coomb's test), then you qualify for Rhogam. However, you have had a very early miscarriage, in the first trimester. If it was spontaneous, not induced, and did not warrant any intervention like MVA and D and C, then you do not need Rhogam."

Abnormal vaginal discharge with irregular bleeding, not responding to mycoten and fluconazole

 A question was asked on abnormal vaginal discharge with irregular bleeding, not responding to oral and vaginal antifungals. Find below, my reply.

"Thank you for your email. By abnormal cycle, I believe you mean she has irregular bleeding. She seems to have received treatment only for fungal infection. In any case, irregular bleeding with abnormal vaginal discharge may be signs of chronic pelvic inflammatory disease. She needs complete workup including samples taken from the mouth of the womb(cervix) and vagina to check for the exact organisms causing this. She will then be given antibiotics based on the result. She should try and complete the treatment to completely get rid of the infection. If she is more than 21 years old and sexually active, she should get a pap smear done too."

I should add that if results point to a fungal infection, then causes of depressed immunity should be ruled out, including diabetes mellitus.