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Alternative Therapies in Health and... Oct 2023Kundur, Boswellia serrata Roxb. ex Colebr., is prescribed by Unani (Greco-Arab) scholars clinically under conditions similar to vulvovaginal candidiasis (VVC) and has... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Kundur, Boswellia serrata Roxb. ex Colebr., is prescribed by Unani (Greco-Arab) scholars clinically under conditions similar to vulvovaginal candidiasis (VVC) and has been supported by recent pharmacological studies, but scientific evidence is scarce.
OBJECTIVES
The study intended to investigate the drug's scientific parameters and to compare its efficacy and safety to that of Miconazole nitrate (2% w/w) in treatment of VVC.
DESIGN
The research team designed a randomized controlled trial (RCT).
SETTING
The RCT was performed in the Department of Ilmul Qabalat wa Amraze Niswan at Luqman Unani Medical College Hospital and Research Center in Vijaypura, India, between November 2018 and March 2020.
PARTICIPANTS
Participants were 40 married women, aged 18 to 45 years, who had been clinically examined and diagnosed with VVC.
INTERVENTIONS
Participants were randomly allocated to the Boswellia serrata (Kundur) group, the intervention group (n = 20), or to the miconazole group, the control group (n = 20). The Kundur group took a one-gram tablet of Kundur as a vaginal insert every day at bedtime for 21 days, while the control group used vaginal suppositories with 100 mg of miconazole (2% w/w) every day at bedtime for seven days.
OUTCOME MEASURES
The primary outcome measures were changes: (1) in vulval itching (pruritus), (2) in vaginal discharge, (3) in painful urination (dysuria), (4) in recurrent genital pain (dyspareunia), and (5) in quality of life (QoL). The secondary outcome measures were mycological clearing on a potassium hydroxide (KOH) test and a per-speculum pelvic examination for the presence or absence of curdy discharge, vulval erythema, and vulval swelling.
RESULTS
The response to the intervention was greater than that of the control in reducing pruritus vulvae and vaginal discharge. However, both drugs were equally effective in improving the rest of the parameters, including QoL.
CONCLUSION
The VVC symptoms were equally and significantly improved in both the intervention and the control groups, and Boswellia serrata Roxb. ex Colebr. was shown to be efficacious in the management of VVC. Further studies with a rigorous design and larger sample size are needed to reinforce scientific evidence.
Topics: Adolescent; Adult; Female; Humans; Middle Aged; Young Adult; Antifungal Agents; Boswellia; Candidiasis, Vulvovaginal; India; Miconazole; Vaginal Discharge
PubMed: 35751891
DOI: No ID Found -
Journal of Minimally Invasive Gynecology 2015Vulvar pruritus is typically associated with fungal, bacterial, and/or dermatological conditions that routinely resolve with the use of topical medications. Pruritus... (Review)
Review
Vulvar pruritus is typically associated with fungal, bacterial, and/or dermatological conditions that routinely resolve with the use of topical medications. Pruritus rarely becomes chronic in nature without a definable pathological diagnosis. However, when this occurs, management is difficult and has limited treatment options. Few cases have reported resolution of vulvar pain or discomfort with sacral neuromodulation implantation. We report a case in which a patient experienced chronic vulvar pruritus that was refractory to medical treatments and did not have a pathological diagnosis. A neurological etiology was suspected, and upon replacement of the patient's sacral neuromodulation device, complete resolution of the vulvar symptoms occurred.
Topics: Chronic Disease; Device Removal; Electric Stimulation Therapy; Electrodes, Implanted; Female; Humans; Lumbosacral Plexus; Middle Aged; Pruritus Vulvae; Treatment Outcome; Urinary Bladder, Neurogenic
PubMed: 25757813
DOI: 10.1016/j.jmig.2015.02.020 -
Journal of Obstetrics and Gynaecology :... Jan 2015Pruritus of the vulva is a common symptom among patients attending to outpatient clinics. In the present study, we aimed to assess pathologies causing vulval pruritus in...
Pruritus of the vulva is a common symptom among patients attending to outpatient clinics. In the present study, we aimed to assess pathologies causing vulval pruritus in the reliability of biopsy in a tertiary referral centre. A total of 137 patients undergoing vulval colposcopy because of vulval pruritus were reviewed from the hospital records retrospectively. The mean age of the patients was 47.61 ± 11.88 years and 36.5% of the patients were postmenopausal. In 101 (73.7%) of the patients, macroscopic lesions were present. In 88 (64.2%) of the patients, tolidine-positive stained areas were determined under colposcopy. In total, 68 (49.6%) of the lesions were plain, whereas 51 (37.2%) of them were depigmented. Lichen simplex chronicus, lichen sclerosis and chronic inflammation were the major pathologies associated with vulval pruritus (25.5%, n = 35; 20.4%, n = 28; 14.6%, n = 20). In conclusion, several pathologies out of vulvovaginal candidiasis may lead to vulval pruritus and clinicians should be aware of the importance of biopsy in determining the underlying pathology.
Topics: Adult; Biopsy; Female; Humans; Middle Aged; Neurodermatitis; Pruritus Vulvae; Retrospective Studies; Vulva; Vulvar Lichen Sclerosus
PubMed: 25010568
DOI: 10.3109/01443615.2014.935711 -
Journal of Lower Genital Tract Disease Jul 2015Chronic vulvar pruritus and vulvodynia are common vulvar diseases. The aim of this study was to compare gynecologic and sexual and physical abuse histories from patients...
OBJECTIVE
Chronic vulvar pruritus and vulvodynia are common vulvar diseases. The aim of this study was to compare gynecologic and sexual and physical abuse histories from patients with these diagnoses and from healthy controls.
MATERIALS AND METHODS
Questionnaires were self-completed by patients diagnosed with vulvar itch-scratch (n = 93), patients diagnosed with vulvodynia (n = 232), and patients presenting for annual gynecologic examinations (n = 104) at the University of Michigan Hospitals, Ann Arbor, MI.
RESULTS
Patients who came for annual examinations were less likely to report past gynecologic infections (p < .05) and indicated higher interest in and more frequent sexual activity than the other 2 groups (p = .003). Vulvodynia patients had the highest scores on the McGill Pain Questionnaire (p < .001). Subjects with either vulvar disorder were more likely to self-report a history of gynecologic infections than annual examination controls. Rates of sexual (p = .78) and physical abuse (p = .12) were similar for all 3 groups.
CONCLUSIONS
Patients with vulvar pruritus and vulvodynia report similar rates of sexual and physical abuse.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Case-Control Studies; Female; Hospitals, Teaching; Humans; Interpersonal Relations; Michigan; Middle Aged; Pain Measurement; Parity; Physical Abuse; Pruritus Vulvae; Risk Factors; Sex Offenses; Sexual Behavior; Sexually Transmitted Diseases; Surveys and Questionnaires; Vulvodynia; Women's Health; Young Adult
PubMed: 26111040
DOI: 10.1097/LGT.0000000000000075 -
Pediatric Dermatology Sep 2016
Topics: Adolescent; Anal Canal; Biopsy, Needle; Combined Modality Therapy; Crohn Disease; Diagnosis, Differential; Edema; Female; Follow-Up Studies; Humans; Immunohistochemistry; Proctoscopy; Pruritus Vulvae; Rare Diseases; Risk Assessment; Severity of Illness Index; Time Factors; Treatment Outcome; Vulvar Diseases
PubMed: 27595873
DOI: 10.1111/pde.12921 -
Post Reproductive Health Sep 2020Vulval irritation and discomfort can be a common presentation to both primary and secondary care. These symptoms can become increasingly prevalent due to physiological...
Vulval irritation and discomfort can be a common presentation to both primary and secondary care. These symptoms can become increasingly prevalent due to physiological changes, which occur to the female genitalia following menopausal transition or due to inflammatory conditions. The correct diagnosis and management can have a huge impact on the patients' quality of life. However, due to the nature of the symptoms, there can be delayed presentation to healthcare professionals. This article gives an overview of the most common benign vulval conditions in the post-menopausal woman, their clinical features and the diagnosis and initial management.
Topics: Aged; Diagnosis, Differential; Female; Gynecological Examination; Humans; Lichen Planus; Patient Care Management; Postmenopause; Pruritus Vulvae; Quality of Life; Vulvar Lichen Sclerosus
PubMed: 32997591
DOI: 10.1177/2053369120924166 -
Clinical Case Reports Jul 2020Our case highlights the need to perform a skin biopsy in patients presenting with persistent vulvar itching, especially if they have not responded to conventional...
Our case highlights the need to perform a skin biopsy in patients presenting with persistent vulvar itching, especially if they have not responded to conventional treatment for benign conditions.
PubMed: 32695391
DOI: 10.1002/ccr3.2862 -
African Health Sciences Dec 2014To investigate the risk factors associated with candida infection of the genital tract in the tropics.
OBJECTIVE
To investigate the risk factors associated with candida infection of the genital tract in the tropics.
METHODS
We performed questionnaire survey and experiments at the Hainan branch of General Hospital of People's Liberation Army, Hainan General Hospital and Sanya Maternity and Child Health Care Hospital in 2013. Controls were without Candida infection of genital tract, and cases had from Candida infection.
RESULTS
We recruited 689 cases and 652 controls. The average age of cases with Candida infection of the genital tract was higher than that of controls. In the multivariate modeling, marriage (adjusted odds ratio: 2.49, 95% confidential interval: 1.09-5.67) and vaginal lavage (adjusted odds ratio: 4.41, 95% confidential interval: 1.13-5.14) were significantly associated with Candida infection of genital tract in tropics.
CONCLUSION
Candida infection was related with age. Marriage and Vaginal lavage were significant risk factors. Attention should be paid to health education for the prevention of these infections.
Topics: Age Factors; Candida; Candidiasis, Vulvovaginal; Case-Control Studies; China; Female; Health Surveys; Humans; Leukorrhea; Male; Multivariate Analysis; Pruritus Vulvae; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; Tropical Climate
PubMed: 25834491
DOI: 10.4314/ahs.v14i4.10 -
The American Journal of Dermatopathology Apr 2015Epidermolytic acanthoma (EA) is a rare benign acquired tumor that most commonly presents as a solitary lesion on the trunk, extremities, male genitalia, and face with a... (Review)
Review
Epidermolytic acanthoma (EA) is a rare benign acquired tumor that most commonly presents as a solitary lesion on the trunk, extremities, male genitalia, and face with a male predominance. Cases occurring on the female genitalia have rarely been reported. We describe the case of multiple localized EAs occurring on the vulva of a 31-year-old woman presenting with the chief complaint of vulvar pruritus. Although rare to occur in the vulvar area, EAs should be included in the differential diagnosis of multiple vulvar papules.
Topics: Acanthoma; Adult; Biopsy; Diagnosis, Differential; Female; Humans; Neoplasms, Multiple Primary; Predictive Value of Tests; Pruritus Vulvae; Skin Neoplasms; Vulvar Neoplasms
PubMed: 25051105
DOI: 10.1097/DAD.0000000000000101 -
Menopause (New York, N.Y.) Feb 2018Vulvovaginal atrophy (VVA) is characterized by vaginal changes, dyspareunia, and itching/irritation. Efficacy and safety of a lower-dose estradiol vaginal cream (0.003%)... (Randomized Controlled Trial)
Randomized Controlled Trial
A randomized, multicenter, double-blind study to evaluate the safety and efficacy of estradiol vaginal cream 0.003% in postmenopausal women with dyspareunia as the most bothersome symptom.
OBJECTIVE
Vulvovaginal atrophy (VVA) is characterized by vaginal changes, dyspareunia, and itching/irritation. Efficacy and safety of a lower-dose estradiol vaginal cream (0.003%) were evaluated in postmenopausal women with VVA-related dyspareunia.
METHODS
This was a phase 3, randomized, double-blind, placebo-controlled study. Sexually active postmenopausal women with moderate-severe dyspareunia as the most bothersome symptom, ≤5% vaginal superficial cells, and vaginal pH >5.0 were randomized (1:1) to 0.003% estradiol vaginal cream (15 μg estradiol; 0.5 g cream) or placebo (0.5 g cream) applied daily for 2 weeks followed by three applications/week for 10 weeks. Coprimary outcomes were changes in dyspareunia severity, vaginal cytology, and vaginal pH from baseline to final assessment. Additional efficacy outcomes and safety were assessed.
RESULTS
A total of 550 participants (average age, 58 y) were randomized. Compared with placebo, estradiol reduced dyspareunia severity (mean change from baseline ± SD: -1.5 ± 1.0 estradiol vs -1.2 ± 0.9 placebo), decreased vaginal pH (-1.36 ± 0.89 vs -0.53 ± 0.92), and improved vaginal cytology (percentage superficial and parabasal cells 10.1 ± 16.7 vs 1.4 ± 6.1 and -48.5 ± 45.1 vs -14.6 ± 39.6; P < 0.001, all) at the final assessment. In addition, estradiol decreased dyspareunia severity at weeks 8 and 12, vaginal/vulvar irritation/itching at weeks 4 and 12, and dryness at week 12 versus placebo (P < 0.01, all). VVA severity, pH, and cytology improved at week 12 with estradiol versus placebo (P < 0.001, all). Vulvovaginal mycotic infections were more frequent with estradiol. One serious event leading to discontinuation occurred with estradiol. No deaths occurred.
CONCLUSIONS
Lower-dose estradiol vaginal cream (0.003%) dosed three applications/week is an effective and well-tolerated treatment for VVA-related dyspareunia.
Topics: Administration, Topical; Aged; Atrophy; Candidiasis, Vulvovaginal; Double-Blind Method; Dyspareunia; Estradiol; Estrogens; Female; Humans; Hydrogen-Ion Concentration; Middle Aged; Postmenopause; Pruritus Vulvae; Severity of Illness Index; Vagina; Vaginal Creams, Foams, and Jellies; Vulva
PubMed: 28926514
DOI: 10.1097/GME.0000000000000985