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registered medical practitioner or a hospital or a laboratory
CLINICAL
TRIAL OF R. COMPOUND
IN RHEUMATOID ARTHRITIS
by
Dr. S. S. YADAV, M.S., (Ortho) Asst. Professor & Head of the Dept. of Orthopaedic
Surgery Jawaharlal Institute of Post-Graduate Medical Education and Research,
PONDICHERRv
* Current Medical Practice Vol. 19 No. 11, 509-511
November 1975
INTRODUCTION:
RHEUMATOID ARTHRITIS is a
crippling disease and has been known since the times of Hippocrates. The
disease has been mentioned in Ayurveda and was described by Charak, Sushrut
and Vagbhat. Although the lesions may be wide-spread, joint inflammation is
the dominant manifestation of the disease. The disease may occur at any age
and there are no clear cut racial, familial or occupational factors involved.
From the etiopathogenesis
view point the disease continues to be a challenge to the clincians and
research workers. ,It is well-known that any drug used in the treatment of
Rheumatoid Arthritis has to be given for a long time. Most of the available
anti-rheumatic drugs offer symptomatic relief but show toxic effects sooner or
later.
SELECTION OF THE DRUG
The Ayurvedic system of
medicine offers various therapeutic agents which no doubt need a careful
assessment. The object of this study is to evaluate the anti-inflammatory and
analgesic action of the Ayurvedic combination drug, R. COMPOUND (Alarsin) in
the management of rheumatoid arthritis.
R. COMPOUND contains:
Mahayogaraj Guggul, Maharasnadi Quath and Gold Bhasma. The combination is well
known for its anti-rheumatic, analgesic and antipyretic effects. It is said to
act as carminative,
haematinic and diuretic
and it has also detoxicatEng action. Maharasnadi Quath is used in painful
skeleto-muscular conditions along with Mahayogaraj Guggal for better efficacy.
The role of Gold
preparations in arthritic conditions is known since the Vedic times. Gold
Bhasma is not a gold salt, but gold is reduced to `ash' form and is made
absolutely safe by various special Ayurvedic processes. It is non-toxic and
does not affect the kidneys and is said to be safe even in prolonged use. Gold
Bhasma is described as metabolic stimulant and that it activates the
reticulo-endothelial system and builds up body resistance, while inhibiting degenerative
processes.
MATERIALS & METHODS
36 patients of definite
Rheumatoid Arthritis attending the department of Orthopaedic Surgery, at
JIPMER, Pondicherry, during 1974-75 were included in this study. The criteria
for diagnosis and selection of the cases were strictly based on those laid down
by the American Rheumatology Association. As a rule all other medication was
stopped, well before starting R. Compound. The trial was continued for about 8
months.
SEX & AGE
DISTRIBUTION:
There were 17 males (47%)
and 19 females (53%). The largest age-group was of 10-20 Years, with 17
patients (47%) and the next largest was that of 21-30 years with 7 pa-
tients (20%). The age
groups ot 10-30 years. together form 67%.
TABLE-1
Sex and Age distribution
|
Age in years |
Male |
Female |
Total |
Percentage |
|
10-20 Yrs.: |
8 |
9 |
17 |
47% |
|
21-30 Yrs.: |
3 |
4 |
7 |
20% |
|
31-40 Yrs.: |
3 |
2 |
5 |
14% |
|
41-50 Yrs.: |
2 |
3 |
5 |
14% |
|
51-60 Yrs.: |
1 |
1 |
2 |
5% |
|
TOTAL : |
17 (47%) |
19 (53%) |
36 |
100% |
DURATION OF THE
DISEASE:
As per the duration of the
disease, the maximum of 11 patients (30.5%) had rheumatoid arthritis of 4-6
years. 52.7% had the disease ranging from 1-6 years.
TABLE-II
Duration of the disease
|
Duration of the disease |
No. of cases |
Percentage |
|
Less than 6 mths: |
9 |
25.0% |
|
6 months -12 mths |
2 |
5.6% |
|
1- 3 Years: |
8 |
22.2% |
|
4- 6 Years: |
11 |
30.5% |
|
7- 9 Years: |
4 |
11.1% |
|
10-12 Years: |
1 |
2.8% |
|
13-15 Years: |
1 |
2.8% |
|
TOTAL |
36 |
100.0% |
EVALUATION AS PER
SEVERITY OF THE DISEASE:
The severity of the
disease was evaluated on the following criteria: 1) Pain. 2) Tenderness. 3)
Joint Mobility. 4) Morning stiffness. 5) Pain on Movement. On the basis of
these criteria, the severity of the disease was classified as 1. Severe, 2.
Moderate, and 3. Mild.
TABLE III
Severity of Rheumatoid
Arthritis
|
Severity |
No. of cases |
Percentage |
|
1. Severe |
10 |
27% |
|
2. Moderate |
19 |
53% |
|
3. Mild |
7 |
20% |
|
|
|
|
INVESTIGATIONS:
X-Ray, Haemoglobin, total
& Differential WBC count, ESR, Rose-Waller test were done before the trial
with R. Compound and were repeated after the trial. Rose-Waller test was
positive in 28% and ESR was 57 mm (means).
DOSAGE OF R. COMPOUND
R., Compound 2 tablets
were given 3 times a day till satisfactory improvement was obtained. The
symptoms were usually alleviated in two to three weeks. Then the dose of R.
Compound was reduced to 1 tablet 3 times a day and was continued for six to
eight months. In 6 cases of Severe attack, R. Compound was given along with
salicylates so that the patient was relieved of pain as early as possible.
Salicylates were continued for two to three weeks and were later withdrawn and
then, only R. Compound was continued.
OBSERVATION &
RESULTS:
R. Compound was found
effective especially in chronic cases of Rheumatoid Arthritis. Relief of pain,
diminution of swelling and improvement of joint mobility, especially of the
interphalangeal, wrist and knee joints were observed within two to three weeks
of R. Compound treatment. In patients with joint deformities, though no effect
was observed on the deformities, there was immense relief of pain and
swellings. ESR came down from 57 mm (mean) to 33 mm (mean) after treatment with
R. Compound. The overall results are given in Table No. 4
TABLE-IV
Overall Results
Relief No. Percentage
Good: (60-100%) 6
16%
Satisfactory: (40-60%) 23
64%
Poor: (Below 40%) 7
20%
TOTAL 36 100%
DISCUSSION:
When seen in comparison
with other antiinflammatory and anti-rheumatic agents in common use, the
incidence of adverse reactions with R. Compound seems to be insignificant. By
using R. Compound in rheumatoid arthritis, the common hazards like GIT complications,
bone-marrow depression, renal damage, moon-like face etc. of the commonly used
anti-rheumatic drugs can be avoided. R. Compound is an effective therapeutic
agent and brings about significant relief in large number of cases of
Rheumatoid Arthritis.
SUMMARY:
R. Compound (Alarsin) was
clinically tried in 36 cases of Rheumatoid Arthritis in patients attending the
Dept. of Orthopaedic Surgery, Jawaharlal Institute of Post-Graduate Medical
Education & Research, Pondicherry, for about eight months duration. In 80%
of cases, the results have been good and satisfactory. The drug was well
tolerated by the patients and there had been no side or toxic effects.
ACKNOWLEDGEMENT:
The author is very much
thankful to Dr. D.B. Bisht, Principal, JIPMER for permission to publish this
paper. Thanks are due to Alarsin Pharmaceuticals, Bombay, and their, representative
Mr. S. Jacob George, for the supply of R. Compound tablets necessary for the
trial.
REFERENCES
1. Chaudhari, S.S. - Paper
before Joint Conf. of Indian Rheumatism Associn. & Indian Assocn. of
Physical Medicine & Rehabilitation, Bombay, Nov. 1974.
2. Choudhari, Ravindra -
Jr. of MML Centre for Rheumatic Diseases 1:4-1965.
3. Ethirajulu G. &
Venkata Reddy. J. (1972) - Paper before 4th Annual Conf. of the Assocn. of
Ortho. Surgeons of A.P. - Hyderabad July 1972.
4. Gaikwad, C.J. &
Gupta, A.K. - The Antiseptic, 64:6-423, June 1967.
5. Gupta, AX; Rallan R.C.
& Ahuja S.C. - Paper before 1st Congress of SEAPALAR, Bombay, Feb. 1968.
6. Makhani, J.S. (1973) -
Paper before 6th Conf. of Tamil Nadu Ortho. Assocn. at C.M.C., Vellore, Dec. 1973.
7. Patnaik, B.C. - Current
Med. Practice, 15:2-625, Feb. 1971.
8. Pradhan, C.G. - Bombay
Hosp. Jr. 7:4 Oct. 1965.
9. Ramchandra K. Pari L. -
Mediscope, Vol. XV. No. V, P. 253-8. Sept 1972.
10. Mrs. Sanghavi, S.M. -
Paper before Joint Conf. of Indian Rheumatism Assocn. & Indian Assocn. of
Physical Medicine & Rehabilation, Bombay, Nov. 1974.
11. Sardesai, H.V &
Deshpande, S.S. - Paper before 1 st Congress of SEAPALAR, Bombay, Feb. 1968.
12. Shanmugasundaram T.K.
& Hendry Desa - Paper before V Conf. of Tamil Nadu Ortho. Assocn. Madras,
April 1973.
13. Subramaniam, R. &
Parthasarathy, M.S. - Paper before 1st Congress of SEAPALAR, Bombay, Feb.
1968.
14. Lt. Col. Variava, N.S.
- Current Med. Practice, 9:1, 1965.
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