‘TO ASCERTAIN THE ROLE OF STAPHYSAGRIA IN THE MANAGEMENT OF RECURRENT STYES’
- A RANDOMISED STUDY THROUGH CLINICAL TRIAL.
BRIEF RESUME OF THE INTENDED WORK:-
6.1 NEED FOR STUDY:
Though the pattern of persons suffering with recurrent styes is not clear; It is seen to affect individuals of all groups of age, both sexes and belonging to any socio economic strata of the society. It is an extremely irritating condition in which no one is sick enough to get into bed yet not well enough to lead a normal life.
According to the ophthalmologists; modification of diet, maintenance of hygiene and administration of analgesics, systemic anti-biotics and steroids orally and locally as ointment or cream are the answer to styes. Finally when unable to suppress the disease they resort to surgical excision and drainage. But still, these measures only remove the existing stye and not the tendency of recurrence of styes.
Homeopathy, being a wholistic science is capable of bringing cure to many curable diseases, prevent complications and remove the tendency of recurrence of complaints.
In Homoeopathic clinical practice Staphysagria has been used as most specific medicine for styes by some homoeopaths across the world. On the contrary, styes have been effectively checked by many when a constitutional therapy is advocated. It has been a burning issue for debate amongst homoeopathic fraternity as to which approach is the best method for managing recurrent styes. No separate work has been done so far to take up a study on different types of Styes and assessing the effectiveness of Staphysagria in managing them. Therefore this study is proposed in that direction for drawing a logical conclusion.
Null hypothesis - Staphysagria as a specific medicine is useful in the treatment of Recurrent styes.
6.2 REVIEW OF LITERATURE:
Definition- Inflammation of one or more sebaceous glands of an eyelid. Also called hordeolum.
It is an infection of the sebaceousglands of Zeis at the base of the eyelashes, or an infection of the apocrine sweat glands of Moll.1
It is an inflamed oil gland on the edge of the eyelid, where the lash meets the lid. It appears as a red, swollen bump that looks like a pimple. It is tender, especially to touch.2
External styes form on the outside of the lids and can be seen as small red bumps. Internal styes are infections of the meibomian sebaceous glands lining the inside of the eyelids.3
They also cause a red bump underneath the lid with only generalized redness and swelling visible on the outside. Styes are characterized by an acute onset and usually short in duration (7–10 days without treatment) and usually do not resolve without intervention.
A stye can become a chalazion -- this is when an inflamed oil gland becomes fully blocked. Patient suffering with blepharitis are more likely to get styes.4
Caused by Staphylococcus aureusbacterial infection, or by the blocking of anoil glandat the base of theeyelash. Although common ininfants, styes are experienced by people of all ages. Age: No age limit, at any age mostly young adults.
Associated with: Boils, acnes of face & neck, Eyestrain, Constant rubbing of eyes, allergy to kajal, Environmental pollution, and Uncorrected error of refraction.
Common in patients with Poor nutrition, Vitamin A deficiency, changed dietary patterns, debilitating diseases such as diabetes mellitus.5
Stages of appearance of a stye:- Stage of cellulitis (2-4days): It gives rise to a throbbing pain which might be out of proportion and is accompanied by redness, swelling, edema of eyelid & conjunctiva.
Stage of abscess formation (4-8days): A Visible pus point starts appearing on lid margin in relation to the affected cilia, may be multiple. The infection sometimes disappears quickly; some styes worsen rapidly lasting for long period.
Stage of resolution (1-2 days): Finally a stage comes where a stye discharges pus making eyelids stick together. But if not treated properly, complications may arise.5
The first sign is a small, yellowish spot at the center of the bump that develops as pus expands in the area. Other symptoms include - A lump on the eyelid, swelling of the eyelid, Localized pain, Redness, Tenderness, Crusting of the eyelid margins, Burning in the eye, Droopiness of the eyelid, Scratchy sensation on the eyeball, Blurred vision, Mucous discharge from the eye, Irritation of the eye, Photophobia, Lachrymation, Sensation of a foreign body in the eye.5
Homoeopathic approach: Therapeutics of staphysagria in styes-
Dr Hering - Pain as if a hard substance were lying beneath left upper lid, Blepharitis, margins of lids dry, with hardened styes, or tarsal tumors. Styes, nodosities, chalazae on eyelids, one after another, sometimes ulcerating.6
Dr T.F. Allen - A constrictive sensation in the upper lid, that forces out tears. Pain as if a hard substance were lying beneath the left upper lid. Pressure in the upper lid all day, worse on closing the eye. Tearing pressure in the outer canthus and in the region of the lachrymal gland. Violent sharp-cutting pain beneath the left upper lid.7
Dr Clarke - Smarting and burning sensation in eyes when writing. Inflammation of
eyes, Styes. Nocturnal agglutination of eyes. Pain in upper lid, agg. on closing eye. Pain as if a hard substance were beneath left upper lid.8
Based on therapeutic utility mentioned in various materia medica books staphysagria is given as specific medicine for treatment of recurrent styes.
Constitutional approach -
According to constitutional approach, the choice of remedy is based on a consideration of the totality of an individual's symptoms and circumstances, including personality, behaviors, fears, responses to the physical environment, food preferences and so on. The `similimum' is that remedy that has produced the closest matching cluster of features based upon recorded reactions of healthy subjects to the drugs, as well as clinical drug symptoms. ‘Constitutional prescribing' is selection of a curative remedy based on the total symptom picture and individuating characteristics. One cannot separate the susceptibility and predispositions of the mind/body complex from the disease suffered by the patient. As Hahnemann said, one symptom is no more the disease than one foot is an entire human being. "The totality of these symptoms is the outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force." (§7) Disease is the mistuning of this harmonious tone by a dissonant dynamic influence (§11). It is the disease-tuned life force that manifests as the essence of the disease-Gestalt through the totality of the symptoms (§12). This is the Essence of Hahnemann’s treatment method. 9
6.3 OBJECTIVES OF STUDY: To study the mode of presentation of different types of Styes in clinical practice.
To assess the miasmatic background of different types of Styes.
To assess the effectiveness of Staphysagria as specific medicine with its fixed profile of PARTICULARS in managing different types of Styes.
MATERIAL AND METHODS:-
7.1 SOURCE OF DATA:
The subjects for the study will be taken from OPD’S Village camps, satellite OPD ‘S of A. M. Shaikh Homoeopathic Medical College And P. G. Research Centre, Nehru Nagar, Belgaum.
7.2 METHOD OF COLLECTION OF DATA: Study design: Non control trial of Probability type.
Type of research: Prospective study.
Selection criteria of participant subjects: Subjects who fit into the Inclusion criteria and Exclusion criteria as mentioned below.
Sampling method: A Randomised sampling procedure will be adopted for selection of sample.
Sample size: Minimum 30 in number.
Duration of study: from 1st May 2012 to 30thnovember 2013. No cases shall be registered after 30th May 2013.
Follow up: Follow up of each case will be done for period of at least 6 months. All cases will be reviewed every one month and as & when necessary.
Remedy prescription; Staphysagria will be given as a first drug of choice to every subject who fits in to Inclusion criteria. A sufficient time will be given to note the changes depending upon merit of the case. If no improvement is observed in three months time a suitable constitutional remedy will be indicated.
Prognosis: Prognosis of the case shall be assessed on clinical changes in the patients and assessed with RESULT CRITERIA as-
FOLLOWING IS THE INCLUSION CRITERIA FIXED FOR THE STUDY-
Subjects suffering from Styes with a recurrence of complaints for at least 4 times in one year.
Subjects who fit into the following 2 of 4 domain of Staphysagria –
Pain as if a hard substance were beneath upper lid.
A constrictive sensation in the upper lid, that forces out tears.
Smarting and burning sensation in eyes.
Violent sharp cutting pain in upper lid, agg. on closing eye.
FOLLOWING IS THE EXCLUSION CRITERIA FIXED FOR THE STUDY-
Common complaints of Recurrent styes which do not fit into the domain of Staphysagria.
Cases with other associated eye pathologies like
Surgical conditions of eyes
Consent form of subjects.
Standard Performa sheet prepared for the topic.
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE CONDUCTED ON THE PATIENTS OR OTHER HUMANS OR ANIMALS? IF SO, PLEASE DESCRIBE BRIEFLY.
Since styes are easily visible on clinical examination, and since this study is not focused on causative organisms causing styes therefore no investigations are advocated or sort for this study.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3:
Yes, the ethical clearance has been obtained from the institution for research study on human subjects.