The Efficacy of Kohl (Surma) and Erythromycin in Treatment of Blepharitis: An Open-Label Clinical Trial

Abstract

Introduction. Blepharitis is a common and chronic form of eyelid inflammation. Blepharitis treatment aims to decrease symptoms through antibacterial effects. One of the most common treatments of eyelid diseases in traditional medicine is using kohl. This clinical trial aimed to investigate its efficacy as a complementary treatment in staphylococcal blepharitis through an open-label clinical trial. Materials and Methods. Thirty patients were randomized to receive kohl in one eye contralateral and erythromycin ointment in another eye for 90 days. At baseline and after 90 days of treatment, symptoms, clinical signs, and side effects of treatments were recorded. Statistical analysis was carried out using SPSS software, version 19. Results. Despite randomization, there was a significant difference between the intervention and control eyes in the baseline mean clinical score (intervention eye: 9.86 (2.95) and control eye: 4.30 (2.81), P < 0.001 ). The degree of reduction of related signs and symptoms in the eyes treated with kohl was significantly higher than that in the control group: (5.2 vs. 2.20, P < 0.001 ) for symptoms and (7.40 vs. 2.46, P < 0.001 ) for clinical signs. Cohen’s d statistic for mean difference of sign and symptom was 2.4 and 1.75, respectively, indicating a very strong effect. Conclusion. The present study results demonstrated a significant improvement in blepharitis-related signs and symptoms. The degree of improvement in the eyes treated with kohl was much higher than that in the control eyes.

In vivo and in vitro efficacy of the ithmid kohl/zinc-oxide nanoparticles, ithmid kohl/Aloe vera, and zinc-oxide nanoparticles/Aloe vera for the treatment of bacterial endophthalmitis

“…These results were confirmed through in vitro examination by observing the inhibition zone diameter of 17 mm against K. pneumoniae isolate. In a previous clinical trial study by Karbassi et al 19 from Iran, which was conducted on 30 patients with staphylococcal blepharitis, the efficacy of kohl in the treatment of blepharitis was significantly higher than that of erythromycin ointment. In another study by Al-Kaff et al 20 from Saudi Arabia, certain mixtures of kohl showed slight antimicrobial effects against Proteus , Staphylococcus , and Streptococcus strains.…”

“…Investigating the chemical composition of kohl can explain its antibacterial and anti-inflammatory properties. An examination of the chemical components of kohl has revealed that the primary elements are zinc, antimony, carbon, sulphur, and iron 19 . The use of kohl leads to an increase in nitric oxide production, which has antimicrobial capabilities.…”

“…The use of kohl leads to an increase in nitric oxide production, which has antimicrobial capabilities. Moreover, sulphur and antimony in the kohl possess antibacterial properties 19 . Also, the anti-inflammatory properties of kohl are due to the presence of zinc-dependent signaling pathways that reduce inflammation 19 .…”

The Position of Persian Medicine Knowledge in Psychiatry Development

“…For example, one study found that following lifestyle recommendations of Persian medicine decreases the gastrointestinal symptoms of vitiligo patients [8]. Also, one study on blepharitis patients showed the effectiveness of a Persian medicine formulation on blepharitis [9]. Also, different studies have evaluated the role of Persian medicine in depression [10], Insomnia [11], anorexia [12], etc.…”