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Background

The
“vulvovaginal candidiasis” is one of the most common gynecologic problems in reproductive
aged women and it considered as the second most common cause of vaginitis after
bacterial vaginosis. It is defines as the presence of Candida species in the
mucous membrane of the lower genital system1.

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Though
VVC is the second most common cause of vaginitis, we are now faced with an
increase in the incidence of this disease2. Narayan Khedkar (2014) reported
the prevalence of VVC in India 30% as the most common vaginitis3. Brandolt et
al. (2014-2013) reported that 13% of the 249 women referring to one of the
educational-treatment centers in Rio Grande, Brazil, had VVC4. Not referring to
the all affected women to the health centers and the arbitrary use of
pharmaceutical compounds of azoles made it difficult to accurately quantify the
incidence of candidate vaginitis5.

VVC
is known as a mental disease. Patients with the symptoms of this problem such
as itching and vaginal discharge have a feeling of dissatisfaction and reduced
self-confidence, which leads to reluctance to have sex and reduce sexual satisfaction
in any of the couples6.

Currently,
the most commonly used standard treatment agents are azole antifungal
compounds. It is worth mentioning that the widespread use of a drug class after
some time increases the resistance of that sensitive species to drugs like
ketoconazole7. The major concern regarding this disease is the increase in Candida
glabrata colonies instead of Candida Albicans in the vaginal environment, which
can the reason why many patients complain of non-relief of clinical symptoms of
illness after completing the course of treatment8.

Recent
studies show the antifungal effects of curcumin, the effective ingredient found
in the rhizome of turmeric. Curcumin significantly inhibits the release of
hydrogen ion from fungal cells (in the absence or presence of peripheral
glucose) and decreases the level of cellular ergosterol, leading to a decrease
in the secretion of proteinase from fungal cells, which ultimately breaks down
the membrane, intracellular fluid leakage and death of fungal cells9,10.
Karaman et al.(2011) and Dovigo et al. (2005) suggested that the antifungal
activity of curcumin is effective in improving oral candidiasis in the rats11,12.
A pilot study by Petil et al. on 25 chemotherapy patients reported improvement
of oral mucositis through mouthwash containing curcumin13.

Given
the antifungal effects of curcumin proven in in-vitro and animal studies  and that no clinical trial studies have been
conducted to evaluate the effect of curcumin on treatment of VVC, this study
was conducted to compare the effect of curcumin-based vaginal cream with
clotrimazole vaginal cream in the treatment of VVC.

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