The Efficacy of Kundur (Boswellia serrata Roxb. Ex Colebr.) in Vulvovaginal Candidiasis: A Randomized Control 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.

Ultrastructural changes of pneumocytes of rat exposed to Arabian incense (Bakhour).

OBJECTIVE: Impacts of air pollution on the human health have been recognized over the last decades. Smokes, in particular, have deleterious effects on the respiratory system. According to a local tradition, incense "Bakhour" is burnt and the resultant heavy smokes are inhaled. The objective of the present study is to investigate the ultrastructural pulmonary changes which can be induced by Arabian incense, Bakhour, exposure. METHODS: The study was conducted from September through to December 2003, at the Animal House, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. Two groups of Wister albino rats, Rattus norvegicus, were used. One group (n=16) was exposed to 420 grams of Bakhour for 14-weeks at the rate of 4 grams/day in the exposure chamber. Additional group of rats, of equal number, was used as non-exposed control. At the end of the exposure period, lung tissues were removed from all experimental animals and processed for electron microscopy. RESULTS: Alveolar pneumocytes of exposed animals revealed significant ultrastructural changes which involved the cell organelles and surfactant material of type II cells. Hyperplasia of alveolar cells was a feature in the affected lung tissue. Neutrophils were recognized infiltrating pulmonary alveoli and accompanied with degenerative and necrotic changes of the alveolar cells. Deposition of collagen fibrils in the alveolar walls was also observed. CONCLUSION: Basing upon the results of electron microscopy, it was concluded that exposure to Bakhour can induce ultrastructural pulmonary changes which may imply compromised respiratory efficiency.