Dr Mohindra

for the use only of a registered medical practitioner or a hospital or a laboratory

for the use only of a registered medical practitioner or a hospital or a laboratory.

R. COMPOUND (ALARSIN) IN CHRONIC

NONSPECIFIC ARTHRITIS

by

Prof. Y. MOHINDRA, M.S. (Ortho.) D.T.S. (Vienna), Z. Ortho. (Vienna),

Head of the Orthopaedic Department,

and

Dr. S. MOHAN, AA.B.B.S., D. Ortho., L.L.R.M. Medical College and S,V.B.P. Hospital, Meerut (U.P.)

 

CURRENT MEDICAL PRACTICE Vol. 23 No. 1 p.p. 33 to 36 Jan. 1979

 

 

INTRODUCTION

Chronic nonspecific arthritis is a crippling disease and has no satisfactory remedy as yet. Although a number of anti-inflammatory and anti-rheumatic drugs are in use, unfortu­nately they are not without side effects, and particularly in their long term use. So the chal­lenge for an effective and safe drug for ar­thritis continues. With this in view we decided to try R. Compound as it is a combination of Ayurvedic drugs, said to be in traditional use in our country since centuries for rheumatic and collegen diseases. On reviewing the liter­ature on R. Compound, we found that this drug has been extensively tried by many

workers at all levels, and papers were read at the national and international conferences and articles have appeared in many medical jour­nals. This was an encouragement to us to try this drug at our own hospital.


R. COMPOUND

This preparation contains Mahayograj gug­gul, the main ingredient being guggul (Bal­samodendron Mukul), maharasnadi quath and gold bhasma. Though the usefulness of gold in rheumatic diseases is acknowledged in al­lopathy, its main drawback is that it causes damage to liver and kidneys as it is given only in an injectable form. Gold bhasma prepared in accordance with the processes mentioned and practised in ayurveda is said to, render gold non-toxic and is said to cause no dam­age to liver and kidneys. It is administered or­ally and is said to be therapeutically effective without toxicity.

 

MATERIALS AND METHODS

This study was carried out at the Sardar Vallabhai Patel Hospital, Meerut, between Oc­tober, 1977 and May 1978. The cases of Ar­thritis were taken at random for the trial and chosen mainly from the city area and around the medical college campus, so that maximum number of cases could be followed-up. Sixty cases were taken up for the study, but there were drop-outs and only 52 cases could be followed for the duration of the clinical trial of eight weeks. Only R. Compound was given and no other anti-inflammatory or anti­rheumatic drug was used. After the trial period, patients were followed up from 4 weeks to 24 weeks (average 14 weeks) de­pending upon the cooperation of the patient.

The grading of arthritis was done in accor­dance with the ARA criteria. The diagnosis was made clinically and radiologically. Most of the patients had knee and spinal joint involve­ment. In all the patients, haemoglobin, total and differential WBC count, ESR and estima­tion of serum proteins, serum calcium and serum phosphates was done. X-ray of the af­fected joints were taken in all the patients. Rose-Waller test was done in a few cases where it was felt as essential. Synovial biopsy of the knee joint was done only in two cases. Haemoglobin, total and differential WBC count, ESR, and estimation of serum proteins, serum calcium and serum phosphates were repeated' in all the patients at the end of the clinical trial of eight weeks. For the purposes of drug response, the criteria of relief in pain, stiffness, swelling and tenderness were consi­dered. Increase in range of movements was observed. Attention was given to note any side effects.

 

AGE GROUP - MALES AND FEMALES:

In our series there were 21 males and 31 females. The maximum number of cases were in the age group 31-40 years with 24 cases (46.2%). 75.0% of the patients were in the age groups of 31-50 years. Females to males ratio was 3:2. The details are given in Table 1.

TABLE 1 

Age groups - Males and Females

Age group

Males

Females

Total

%

20-30 years

1

-

1

1.9%

31-40 years

9

15

24

46.2%

41-50 years

6

9

15

28.8%

51-60 years

3

4

7

13.5%

Over 60 years

2

3

5

9.6%

Total °

Percent

21

31

52

100.0%

40.4%

59.6%

 

100.0%

 

Degree of Severity of Arthritis:

Arthritis was severe (acute), in 18 cases (34.6%), moderate in 27 cases (51.9%) and mild in 7 cases (13.5%). The details are given in Table: 2.

 

TABLE 2

Showing degree of severity of arthritis

Degree

Males

Females

Total

%

Severe

6

12

18

34.6%

Moderate

12

15

27

51.9%

Mild

3

4

7

13.5%

Total

21

31

52

100.0%

 

DOSAGE OF R. COMPOUND:

R. Compound was given, two tablets, three times a day, in all the cases for 8 weeks. Those cases where there was clinical remis­sion earlier were advised a reduced dose of 1 tablet four times a day for a total period of 8 weeks, the duration of the clinical trial. Those who had remission at the end of 8 weeks, were kept under observation to maximum of 24 weeks. During the period of observation and follow-up, the patients were put on a ma­intenance dose of R. Compound, 1 tablet three times a day.

 

ASSESSMENT OF RESULTS:

The relief was classified as Good when the relief obtained was 60-100%; it was taken as Fair when the relief was 40-60% ; it was taken as Poor when the relief was less than 40%; when there was practically no change in the condition, it was taken as nil.

The patients were treated with R. Com­pound for eight weeks (the period of clinical trial). Later, they were followed-up to a

maximum period of 24 weeks, depending upon the cooperation of the patient.

 

RESULTS OF R. COMPOUND TREATMENT:

Good relief was obtained in 12 cases (23.1%); the relief was Fair in 31 cases (59.6%) On the whole, the response to R. Compound treatment was satisfactory in 82.7%. The re­sponse was Poor in 6 cases and Nil in 3 cases; that is, a total of 17.3% showed no satisfactory response.

As to individual symptoms, the relief was maximum in 49 cases (94.3%) of joint stiff­ness. 47 cases (90.4%) showed relief in swel­ling; 45 patients (86.6%) showed relief in pain; 37 patients (71.7%) showed relief in tenderness; and 37 patient (71.7~ should bet­ter range of joint movements. The details are shown in Table 3.

 

TABLE 3

Showing results of R. Compound treatment

Sign/Symptom

Total

cases

Good

Fair

satisfactory

relief

%

Poor

Nil

Total

%

1. Pain

52

12

33

45

(86.6%)

5

2

7

(13.4%)

2. Swelling

52

14

33

47

(90.4%)

4

1

5

( 9.6%)

3. Stiffness

52

15

34

49

(94.3%)

2

1

3

( 5.7%)

4. Tenderness

52

10

27

37

(71.1%)

10

5

15

(28.9%)

5. Range of movement

52

9

28

37

(71.1%)

9

6

15

(28.9%)

Mean

52

12

31

43

 

6

3

9

 

Per cent

100.0%

23.1%

59.6%

82.7%

 

11.5%

5.8%

17.3%

 

 

Toxic or Side Effects:

No toxic or side effects were seen with the use of R. Compound during the eight weeks of clinical trial. Cases were observed for 4 weeks to 24 weeks after the trial as follow up (aver­age 14 weeks), during which a maintenance dose of R. Compound 1 tablet tds, was given. No adverse effects were observed even with this prolonged use.

 

CONCLUSION

R. Compound is found beneficial in the treatment of chronic non-specific arthritis. There was satisfactory relief in joint stiffness, swelling, pain and tenderness; there was satisfactory increase in the range of joint movements. The most notable advantage is that it is devoid of side effects, even in long term treatment. While R. Compound which contains gold bhasma, gives the benefit of gold therapy in treating arthritis, it has no ad­verse effects, like damage to liver and kid­neys, as seen with the gold therapy by paren­teral administration which is the only way used in allopathy. The importance of gold therapy in treating chronic cases of arthritis cannot be minimised.

 

SUMMARY

R. Compound was tried in 52 cases of chronic, nonspecific arthritis at the Sardar Vallabhai Patel Hospital, Meerut, during 1977­78. The trial period was of 8 weeks. Patients were followed up from 4 weeks to 24 weeks after that, depending upon cooperation of the patient. Pain, swelling, stiffness, tenderness and range of joint movements was considered for the evaluation of drug response. On the whole, the response was satisfactory in 43 cases (82.7%) and it was not satisfactory in 9 cases (17.3%). No adverse effects were seen with the use of R. Compound showing that this drug is safe and beneficial one in the treatment of chronic nonspecific arthritis.

 

ACKNOWLEDGEMENT

We are thankful to the Senior Medical Superintendent, S.V.B.P. Hospital for permis­sion to conduct this clinical trial.

We are also thankful to Alarsin Pharmaceuticals, Bombay 400 023, for their cooperation.

 

REFERENCES

1. Bansod, M.V.: Treatment of Rheumatism and arthritis with indigenous drugs: 31st All India Medical Conference, Lucknow, 1954.

2. Chaudhari, S.S.: The use of an Ayurvedic preparation for chronic arthritic conditions with special reference to post plaster stiff­ness:Jnt. Conf. of Indian Rheumatism As­sociation and Associations of Physical Medical and Rehabilitation, Bombay 23­24, Nov:: Mah. Med. Journal 24-2, May, Pg. 71, 1977.

3. Ethirajulu, G. and Venkata Reddy, J.: R. Compound in rheumatoid arthritis and other chronic arthritides : 4th Annual Conf. of the Association of Orthopaedic Sur­geons of A.P., Hyderabad, July, 1972.

4. Gaikwad, C.J.: A clinical study with R. Compound. The antiseptic, 64:6-423, June, 1967.

5. Gupta, AX: Value of R. Compound in Rheumatoid Arthritis, at First Congress of SEAPALAR, Bombay, Feb., 1968.

6. Kaikini, V.M.: Use of gold preparations in rheumatoid arthritis. The Antiseptic, 50:1, Jan., 1953.

7. Makhani, J.S.: Experience with R. Com­pound in Rheumatoid arthritis, XXIX An­nual Conf. of the Assocn., of Physicians of India, Patna, Jan., 1974 and XXXIII An­nual Conf. of Assoc. of Surgeons of India, Trivandrum, Jan., Feb. 1974 and The Clini­cian, Vol. 40, No. 8, PP. 312-17, Aug 1976

8. Moholker, N.W.: R. Compound an Ayur­vedic drug in rheumatic diseases. Mah. Med. Jr. 13:9-527. Dec., 1966.

9. Patnaik, B.C.: Clinical trial with R. Com­pound in rheumatoid and other arthritic disorders. Current Med. Pract. 15:2-625, Feb., 1971.

10; Pradhan, C.G.: Use of an Ayurvedic Compound in chronic orthopaedic condi­tions. Bombay Hospital Jr. Oct., 1965.

11. Ramchandra, K. et al: R. Compound in rheumatoid arthritis. Mediscope, Vol. XV, 6: 253-8, Sept., 1972.

12. Sancheti, K.H.: R. Compound - an Ayur­vedic drug in management of arthritis: First Congress of SEAPALAR, Bombay, Feb., 1968.

13. Sandhu, R.S. et al: Clinical evaluation of R. Compound in rheumatoid arthritis and in certain other orthopaedic disorders: 5th Annual Conf. of Indian Rheumatism Assocn., Amritsar, Dec., 1975.

14. Sardesai et al: Use of R. Compound in rheumatoid arthritis: First Congress of SEAPALAR, Bombay, Feb., 1968.

15. Shanmugasundaram, T.K. et al: Control­led trial of R. Compound, V Conf. of Tamil Nadu Ortho. Assoc., Madras, April, 1973.

16. Subramaniam, R. and Parthasarathy, M.S. : R. Compound in rheumatic arthritis: First Congress of SEAPALAR, Bombay, Feb., 1968.

17. Lt. Col. Variava, N.S.: Treatment of rheumatic and collagen diseases with an Ayurvedic drug (A clinical study of 203 pa­

tiients in a period of ten years) : Current Med. Pract. 9:1, Jan., 1965.

18. Vasavada, K.V.: A study of the use of an Indian indigenous drug in rheumatic and allied conditions: First Congress of SEA­PALAR, Bombay, Feb., 1968.

19. Yadav, S.S.: Clinical trial of R. Compound in rheumatoid arthritis. Current Med. Pract. Vol. 19, No. 11, 509-511, Nov., 1975.

20. Tiwari, C.P.: Observatior3s on indigenous drugs in chronic joint lesions, at 34th All India Med. Conf., Indore, Dec. 1959.

 

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