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      Comparing the Effectiveness of Arnebia euchroma with ClotrimazoleVaginal Cream for the Treatment of Vulvovaginal Candidiasis: A Randomized Controlled Triple-Blind Trial

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          Abstract

          Background:

          Vulvovaginal candidiasis is the second most common cause of vulvovaginal infections. Due to the increasing resistance to synthetic antifungal drugs, the use of drugs with a natural origin is a priority. The aim of the present study was to compare the effectiveness of Arnebia euchroma with vaginal cream clotrimazole 1% United States Pharmacopeia (USP) for the treatment of vulvovaginal candidiasis.

          Materials and Methods:

          This triple-blind trial study was performed on 112 women with diagnosed Candida vaginitis clinically and by a laboratory test, patients were randomly divided into two groups receiving Arnebia euchroma and vaginal clotrimazole (56 people per group) in clinics and medical centers Ahvaz (Iran) from April 2018 to April 2019. Clinical and laboratory symptoms were recorded at the beginning of the study and 1 week after the end of treatment by a researcher-made questionnaire. Data analysis were performed using SPSS software v-23. p < 0.05 was considered significant.

          Results:

          After the intervention, vaginal culture was negative in terms of Candida in 17 (36.17%) patients of the Amoeba euchroma group and 37 (69.81%) patients of the clotrimazole group. The Chi-square showed that there was a significant difference between the culture results in both groups ( χ 2 = 10.10, df = 1, p = 0.001). No differences were observed between the two groups in terms of vaginal symptoms based on adjustment for age and using a logistic regression model.

          Conclusions:

          A vaginal cream containing Arnebia euchroma could reduce the complaints of vulvovaginal candidiasis. But, future studies with larger sample sizes and different dosages are recommended.

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          Most cited references35

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          Global burden of recurrent vulvovaginal candidiasis: a systematic review

          Recurrent vulvovaginal candidiasis is a debilitating, long-term condition that can severely affect the quality of life of affected women. No estimates of the global prevalence or lifetime incidence of this disease have been reported. For this systematic review, we searched PubMed, Embase, and Web of Science databases for population-based studies published between 1985 and 2016 that reported on the prevalence of recurrent vulvovaginal candidiasis, defined as four or more episodes of the infection every year. We identified 489 unique articles, of which eight were included, consisting of 17 365 patients from 11 countries. We generated estimates of annual global prevalence, estimated lifetime incidence and economic loss due to recurrent vulvovaginal candidiasis, and predicted the number of women at risk to 2030. Worldwide, recurrent vulvovaginal candidiasis affects about 138 million women annually (range 103-172 million), with a global annual prevalence of 3871 per 100 000 women; 372 million women are affected by recurrent vulvovaginal candidiasis over their lifetime. The 25-34 year age group has the highest prevalence (9%). By 2030, the population of women with recurrent vulvovaginal candidiasis each year is estimated to increase to almost 158 million, resulting in 20 240 664 extra cases with current trends using base case estimates in parallel with an estimated growth in females from 3·34 billion to 4·181 billion. In high-income countries, the economic burden from lost productivity could be up to US$14·39 billion annually. The high prevalence, substantial morbidity, and economic losses of recurrent vulvovaginal candidiasis require better solutions and improved quality of care for affected women.
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            Emerging opportunistic yeast infections.

            A growing population of immunosuppressed patients has resulted in increasingly frequent diagnoses of invasive fungal infections, including those caused by unusual yeasts. The incidence of non-albicans species of Candida is increasing compared with that of Candida albicans, and several species, such as Candida glabrata and Candida krusei, may be resistant to azole antifungal therapy. Trichosporon species are the second most common cause of fungaemia in patients with haematological malignant disease and are characterised by resistance to amphotericin and echinocandins and poor prognosis. Rhodotorula species belong to the family Cryptococcaceae, and are a cause of catheter-related fungaemia, sepsis, and invasive disease in severely immunosuppressed patients. An increasing number of sporadic cases of invasive fungal infections by non-neoformans cryptococci have been reported in immunocompromised hosts, especially for patients with advanced HIV infection or cancer who are undergoing transplant. Other uncommon yeasts that can cause invasive disease in severely immunosuppressed patients include Geotrichum, Hansenula, Malassezia, and Saccharomyces. Host immune status is a crucial determinant of the type of invasive fungal infection a patient is at risk for. Diagnosis can be challenging and relies heavily on traditional cultures of blood and other sterile sites, although serum (1,3)-β-D-glucan testing might have an adjunctive role. Although rare yeasts are emerging as opportunistic human pathogens, diagnosis remains challenging and treatment suboptimal. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Antimicrobial activity of some Iranian medicinal plants

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                Author and article information

                Journal
                Iran J Nurs Midwifery Res
                Iran J Nurs Midwifery Res
                IJNMR
                Iranian Journal of Nursing and Midwifery Research
                Wolters Kluwer - Medknow (India )
                1735-9066
                2228-5504
                Mar-Apr 2022
                14 March 2022
                : 27
                : 2
                : 112-118
                Affiliations
                [1 ] Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
                [2 ] Department of Midwifery,Shoushtar faculty of Medical Sciences,shoushtar, Iran
                [3 ] Associate Professor of Reproductive Health, Reproductive Health Promotion Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran
                [4 ] School of Pharmacy, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
                [5 ] Department of Biostatistics and Epidemiology, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                Author notes
                Address for correspondence: Mrs. Zahra Sadat Pajohideh, Department of Midwifery,Shoushtar faculty of Medical Sciences,shoushtar, Iran. E-mail: pajohidehz@ 123456gmail.com
                Article
                IJNMR-27-112
                10.4103/ijnmr.ijnmr_330_20
                8997174
                35419264
                0ccd1cc3-80ff-478c-a2a9-9115c5d8971c
                Copyright: © 2022 Iranian Journal of Nursing and Midwifery Research

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 14 March 2021
                : 18 April 2021
                : 20 October 2021
                Categories
                Original Article

                Nursing
                clotrimazole,iran,randomized controlled trial,candidiasis,vulvovaginal
                Nursing
                clotrimazole, iran, randomized controlled trial, candidiasis, vulvovaginal

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