Comparing the effect of ferula oral capsule and metronidazole oral pill on improvement of clinical signs of infection by Trichomonas Vaginalis: A Controlled Clinical Trial

Document Type : Original Article

Authors

1 M.Sc. Student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor, Department of Obstetrics and Gynecology, Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant Professor, Department of Traditional Medicine, School of Complementary and Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Professor, Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Instructor, Department of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Vaginitis is a general term for vaginal disorders which is caused due to infection, inflammation or a change in the normal vaginal flora. Trichomonas vaginalis is the third most common cause of vaginitis. Antibacterial, antifungal and anti trichomoniasis effects of ferula have been shown by in vitro and in vivo studies. This study was performed with aim to compare the effects of ferula oral capsule and metronidazole oral pill on improving clinical symptoms of trichomonas vaginalis infection.
Methods: This clinical trial was performed on 70 non-pregnant women referred to gynecology clinics of Imam Reza and Ommolbanin hospitals due to vaginal infection symptoms in 2019. The subjects were placed in two groups: ferula and metronidazole. Trichomoniasis vaginalis infection was detected by wet smear test. Oral ferula capsule was prescribed to ferula group and oral metronidazole tablet to second group for 7 days. Data were collected by observation and interview forms. Data were analyzed by paired and independent t-tests, Chi-square, Mann-Whitney, Mcnemar and Wilcoxon tests. P<0.05 was considered statistically significant.
Results: The findings of the study indicated that improvement of clinical symptoms was 100% in the ferula group and 40% in the metronidazole group ( p<0.001).14 cases (40 %) of metronidazole group had drug side effects including digestive disorders (54.3%) and nausea (45.7%). In ferula group, none of cases showed side effects (p<0.001). Moreover, 19 cases in metronidazole group (54.3%) and all in ferula group (100%) were agree to reuse the medicine or to suggest it to others (p<0.001).
 Conclusion: The improvement percentage in clinical symptoms caused by oral ferula capsule is higher than oral metronidazole tablet. Therefore, by performing further studies, ferula capsule can be a replacement for metronidazole in order to improve the clinical symptoms of Trichomonas vaginalis infection for.

Keywords

References

  1. Byun SW, Park YJ, Hur SY. Affirm VPIII microbial identification test can be used to detect gardnerella vaginalis, Candida albicans and trichomonas vaginalis microbial infections in Korean women. J Obstet Gynaecol Res 2016; 42(4):422-6.
  2. Alizadeh M, Kolecka A, Boekhout T, Zarrinfar H, Ghanbari Nahzag MA, Badiee P, et al. Identification of Candida species isolated from vulvovaginitis using matrix assisted laser desorption ionization-time of flight mass spectrometry. Curr Med Mycol 2017; 3(4):21-5.
  3. Khorsand I, Nehzag G, Ali M, Zarrinfar H, Fata A, Naseri A, et al. Frequency of variety of Candida species in women with Candida vaginitis referred to clinical centers of Mashhad, Iran. Iran J Obstet Gynecol Infertil 2015; 18(168):15-22. (Persian).
  4. Kord Z, Fata A, Zarrinfar H. Molecular Identification of Candida species isolated from patients with vulvovaginitis for the first time in Mashhad. Iran J Obstet Gynecol Infertil 2017; 20(4):20-7.
  5. Cudmore SL, Delgaty KL, Hayward-McClelland SF, Petrin DP, Garber GE. Treatment of infections caused by metronidazole-resistant Trichomonas vaginalis. Clin Microbiol Rev 2004; 17(4):783-93.
  6. Petrin D, Delgaty K, Bhatt R, Garber G. Clinical and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev 1998; 11(2):300-17.
  7. Kissinger P. Epidemiology and treatment of trichomoniasis. Curr Infect Dis Rep 2015; 17(6):484.
  8. Azadbakht M, Ziaie H, Abdolahie F, Shabankhanie B. Effect of essential oil of artemisia artemisia, shirazi and thyroid cyst on trichomonas vaginalis. J Med Plants 2003; 4(8):35-40. (Persian).
  9. McClelland RS, Sangaré L, Hassan WM, Lavreys L, Mandaliya K, Kiarie J, et al. Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition. J Infect Dis 2007; 195(5):698-702.
  10. Lossick JG. Treatment of Trichomonas vaginalis infections. Rev Infect Dis 1982; 4:S801-18.
  11. Bakht R, Modares Gilani M. A comparative study of trichomonas vaginitis treatment with single and seven day metronidazole regimen. Avicenna J Clin Med 2003; 9(4):38-42. (Persian).
  12. Sereshti M, Yusefi H, Zebardast N, Rafiean M, Manucheri K, Yousefi H. Effect of ethanolic and watery extract of aerial parts of stachys lavandulifolia on trichomonas vaginalis, In vitro. J Med Plants 2012; 1(41):159-65. (Persian).
  13. Abbaspoor Z, Goudarzi F, Abbaspoor M. Comparison effects of vitamin C vaginal tablet and metronidazole vaginal gel on treatment and relapse of bacterial vaginosis. Sci Med J 2010; 8(4):423-30.
  14. Sedighi J, Maftoon F, Ziai S. Herbal medicine: Knowledge, attitude and practice in Tehran. Journal of Medicinal Plants. 2005;1(13):60-7. (Persian).
  15. Azadbakht M, Ziaiye H, Abdollahi F, Shabankhani B. Effect of Methanolic essence and extract of Myrtus Communis on Trichomonas Vaginalis. J Guilan Univ Med Sci 2004; 12(48):8-13. (Persian).
  16. Vazini H, Esboei BR. In vitro study of the effect of hydroalcholic extracts of Carum copticum and Ferula asafetida against Trichomonas vaginalis. Sci J Kurdistan Univ Med Sci 2018; 23:76-83.
  17. Sarkari B, Tadayon H, Askarian S, Farnia E, Askarian M. In Vitro anti-Trichomonas activity of Freula assafoetida and garlic extracts. J Gorgan Univ Med Sci 2009; 11(3):13-7. (Persian).
  18. Salehi L, Asghari G, Yousofi H, Yousofi-Darani H. The effects of different extracts of viola odorata on trichomonas vaginalis in culture medium. J Isfahan Med Sch 2014; 31(266):1-10.
  19. Ziaiye H, Azadbakht M, Abdollahi F, Shabankhani B. Effect of methanolic extracts of Artemisia aucheri Boiss, Zataria multiflora Boiss and Myrtus communis L. on Trichomonas vaginalis (In Vitro). J Gorgan Univ Med Sci 2006; 8(1):34-8. (Persian).
  20. Niyati M, Joneidi Z, Kamalinejad M, Haghighi A, Valaei N, Abdi A, et al. Anti-trichomonas effect of Rheum ribes and Foeniculum vulgare extracts on Trichomonas vaginalis in vitro. J Islamic Iran Traditional Med 2015; 6(3):198-208. (Persian).
  21. Khalili B, Rafieian M, Hejazi SH, Yusefi HA, Yektaian N, Shirani BL. Effect of Achillea millefolium, Artemisia absinthium & Juglans regia leaves extracts on Trichomonas vaginalis, in vitra. Shahrekord Univ Med Sci J 2011; 12(4):62-9. (Persian).
  22. Matini M, Bakhtiarnejad S, Dastan D, Maghsood AH, Fallah M. In-vitro efficacy of Plantago lanceolata L. extracts on Trichomonas vaginalis. J Arak Univ Med Sci 2017; 20:74-82.
  23. Nasiri S, Razavizade R, Olumi H. Evaluation of content of phenylpropanoid compounds of latex and chemical composition of essential oil of Ferula assa-foetida L. in some natural pasturelands of Kerman, Iran. J Plant Res 2017; 30(3):644-55. (Persian).
  24. Morshedi A, Dashti-R MH, Dehghan HM, Bagherinasab MA, Salami AS. The effect of artemisia sieberi besser on infkammatory and neurogenic pain in mice. J Med Plants 2011; 4(40):48-57.
  25. Khosravi H, Mehrabi A. Economic study of Ferula harvesting in Tabass region. Iran J Natural Resour 2006; 58(4):933-44.
  26. Bagheri SM, Asl AA, Shams A, Mirghanizadeh-Bafghi SA, Hafizibarjin Z. Evaluation of cytotoxicity effects of oleo-gum-resin and its essential oil of Ferula assa-foetida and ferulic acid on 4T1 breast cancer cells. Indian J Med Paediatr Oncol 2017; 38(2):116.
  27. Sultana A, Asma K, Rahman K, Rahman S. Oleo-gum-resin of ferula asafoetida: a traditional culinary spice with versatile pharmacological activities. Res J Rec Sci 2015; 22(4):25-30.
  28. Emami A, Fasihi S, Mehregan I. Reference book on medicinal plants. Tehran: Institute of Medical History Studies, Islamic and Complementary Medicine at Iran University of Medical Sciences; 2010.
  29. Farhadi A, Yousefi M, Abouhoseini TM. Evaluation of the anticestode and anti nematod effects of the methanol extract of Asafoetada on experimentally infected rats. J Babol Univ Med Sci 2016; 8(6):47-51.
  30. Bashir S, Alam M, Ahmad B, Aman A. Antibacterial, anti-fungal and phytotoxic activities of Ferula narthex Boiss. Pak J Pharm Sci 2014; 27(6):1819-25.
  31. Unnikrishnan M, Kuttan R. Tumour reducing and anticarcinogenic activity of selected spices. Cancer Lett 2000; 51(1):85-9.
  32. Golmakani N, SharifiSistani N, Taghi Shakeri M, Hasanzade Mofrad M, Sajadi Tabassi A. Comparing two treatment methods of vitamin E suppository and conjugated estrogen vaginal cream on the quality of life in menopausal women with vaginal atrophy. J Midwifery Reprod Health 2014; 2(4):253-61.
  33. Sadoughi SD. Effect of aqueous extract of Ferula assa-foetida’s resin on wound healing of streptozotocin induced diabetic rats. Horizon Med Sci 2013; 19(3):129-35.
  34. Nagatsu A, Isaka K, Kojima K, Ondognii P, Zevgeegiin O, Gombosurengyin P, et al. New Sesquiterpenes from Ferula ferulaeoides (S TEUD.) K OROVIN. VI. Isolation and identification of three new Dihydrofuro [2, 3-b] chromones. Chem Pharm Bull 2002; 50(5):675-7.
  35. Iranshahy M, Iranshahi M. Traditional uses, phytochemistry and pharmacology of asafoetida (Ferula assa-foetida oleo-gum-resin)—A review. Journal of ethnopharmacology. 2011;134(1):1-10.
  36. Spence MR, Rein MF, Danzig MR, McCormack WM. Multicenter comparison of clotrimazole vaginal tablets, oral metronidazole, and vaginal suppositories containing sulfanilamide, aminacrine hydrochloride, and allantoin in the treatment of symptomatic trichomoniasis. Sex Transm Dis 2000; 24(3):156-60.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 22, Issue 9
November 2019
Pages 55-63

Files

Share

How to cite

Statistics