CLINICAL TRIAL WITH R. COMPOUND IN
RHEUMATOID
AND OTHER ARTHRITIC DISORDERS
By
Dr, BANKIM CHARAN PATNAIK, M.B.B.S. M.D.A,
Assistant Professor of Medicine, M.K.C.G. Medicai College, Berhampur
(Ganjam) Orissa.
Current
Medical Practice Vol. No. 15No.
2 Page 625 to 627 Feb. 1971
Rheumatoid arthritis is commonly met in clinical practice. It is one of the major crippling diseases
affecting the adults. It runs a prolonged course with spells of exacerbations
and remission. At present various anti-inflammatory and analgesic drugs like
salicylates, butazolidine and corticosteroids are being used in the management
of such disorders. It is quite known that whatever drug is administered for
treatment of Rheumatoid disorders, is to be continued for a long period to induce
clinical amelioration as well as to prevent relapse. But as the conventional
drugs are not free from toxicity and side effects, a drug which can be given
over a long period without undesirable side effects is always welcome. With
this end in view R. Compound was clinically tried in 30 cases of Rheumatoid as
well as other common arthritic disorders.
R. Compound (Alarsin) is a compound consisting
of Mahayograj guggul, and Maharasnadiquath with Gold in Bhasma form. Mahayograj
guggul is an ayurvedic preparation, processed from about 30 different
ingredients. It has multiple actions and is a broad-spectrum drug. Besides
having anti-rheumatic, analgesic and antipyretic effects, it also possesses
carminative, diuretic, haematinic and expectorant properties. It is a
harmless constituent and can be used for children as well as old patients.
Maharasnadiquath is prepared from 25 standard
herbs, its chief ingredient being Rasna. It is antirheumatic, analgesic and antipyretic. It is also nontoxic.
Material and Methods
Out of cases attending the M. K. C. G. Medical
College Hospital, medical outdoor 30 cases were selected for clinical trial
with R. Compound tablets. This trial was conducted during the period, from
January 1969 to August 1970,
Amongst these cases, 18 cases were rheumatoid
arthritis, out of which four (4) were of acute type. Rest belonged to chronic
type. 2 patients suffered from ankylosing spondylitis. 8 patients had
Osteoarthritis affecting knee joints. 2 patients had filarial arthritis.
In all these cases clinical features like,
pain in joints, swelling in joints , fever, deformity, backache, with or
without sciatica, hepatosplenomegaly, cardiac involvement, anemia, urinary
abnormality, were looked for.
Age group from 20 to 50 years
20 – 30 ---------------------- 6
30 - 40 ----------------------- 18
40 – 50 ----------------------- 6
Sex Incidence
Male ------------------------- 22
Female ----------------------- 8
All 8 female patients were that of rheumatoid
arthritis. Laboratory investigations like leucocyte count, differential while
cell count, erythrocyte sedimentation rate, estimation of red cell count and
hemoglobin, urinary analysis, blood for micrafilaria were done. Liver function
tests were done in all the cases of rheumatoid arthritis receiving R. Compound
for more than 4 weeks. The effect of this drug on liver, kidney and blood were
studied by means of liver functions tests, urinary analysis and periodical
blood counts.
Dosage
The usual dosage of R. Compound adopted was 2
tabs three times daily. After alleviation of acute symptoms, the dose was
halved to 1 tab. Three times daily. Relief of pain and swelling in the joints,
mainly interphalangeal joints and that of the knees in some cases, was taken as
sign of improvement. The range of movement which was restricted in early stages
was examined daily in interphalangeal, knee, hip joints and shoulder joints
during this trial with R Compound. The treatment was continued from 8 months to
one year in 60% of cases (18 cases). Complete relief of pain and swelling in
joints was considered as good response. In 8 out of 18 cases of rheumatoid
arthritis, the patients were already given drugs like aspirin, butazolidine and
steroids. Due to different side effects arising out of these drugs, they were
put on R. Compound regime. Rest were treated by R.Compound from the start. In 4
cases of acute rheumatoid arthritis R. Compound was given along with
salicylates as R.Compound could not control the pain and swelling of joints.
After 2 weeks salicylates were withdrawn and patients were treated only with
R.Compound and satisfactory response was maintained.
|
TABLE - 1 |
|||||
|
Clinical Response with R. Compound |
|||||
|
|
Fever
subsided in |
Pain
in joints decreased |
Swelling
in joints decreased in |
E.S.R
touched normal in |
Total
W.B.C count comes to normal in |
|
Rheumatoid
Arthritis |
One
week |
2
weeks |
2
weeks |
10
– 15 days |
1-2
weeks |
|
Ankylosing |
|
|
|
|
|
|
Spondylitis |
|
||||
|
Filarial
Arthritis |
2-3
weeks |
2-3
weeks |
- |
1-2
weeks |
|
|
Osteoarthritis |
3
weeks |
3
weeks |
- |
|
|
|
TABLE – 2 Average Values (Following up in months) |
||||||||
|
|
1st |
2nd |
3rd |
4th |
5th |
6th |
7th |
8th |
|
Urine
Bilesalt& Pigment/ Sugar/ casts |
Nil |
Nil |
Nil |
Nil |
Nil |
Nil |
Nil |
Nil |
|
Blood
Urea |
30mg% |
35mg% |
25mg% |
28mg% |
30mg% |
30mg% |
30mg% |
30mg% |
|
Total
W.B.C count |
6500/c |
7000/c |
8000/c |
6500/c |
7000/c |
8500/c |
8500/c |
8500/c |
|
H % |
10gm% |
9.5gm% |
10.5gm% |
9.5gm% |
10.5gm% |
11gm% |
11gm% |
11gm% |
|
T.R.B.C.
count |
4m/cm |
3.8m/cm |
4m/cm |
3.5m/cm |
4m/cm |
4.5m/cm |
4.5m/cm |
4.5m/cm |
|
Serum
Bilirubin |
0.6mg% |
0.5mg% |
0.6mg% |
0.65mg% |
0.7mg% |
0.5mg% |
0.5mg% |
0.5mg% |
|
Liver
function test: Thymol Turbidity, Serum Alkaline Phosphate |
Normal |
Normal |
Normal |
Normal |
Normal |
Normal |
Normal |
Normal |
OBSERVATIONS
In chronic cases of rheumatoid arthritis, R.
Compound was found to be quite useful. Relief of pain and swelling of joints
was soon within 2 weeks of starting of R. Compound.The range of movement
also improved within the same period. Cases having deformities of
interphalangeal joints did not substantially improve, though pain and swelling
were definitely less. Two cases of ankylosing spondylitis and filarial
arthritis responded quite favorably with R. Compound
In all the cases of rheumatoid arthritis treatment has been continued up to 8 months and In some cases one year. Relapses were not noticed in any case. But it was necessary in some cases to step up the maintenance dose of 1 tab td. to 2 tab. td. for getting the clinical improvement during the follow up period. Remission period was from 4 months -10 months.
DISCUSSION
Favourable responses with this drug R.
Compound has been reported by R. Subramaniam and Parthasarathy from Madras,
Gupta and Ahuja from Kanpur, Bansod (Bangalore), Sancheti (Poona), Sardesai
and Deshpande (Poona) and Vasavada (Baroda). In acute cases of rheumatoid
arthritis R. Compound can be conveniently combined with selected drugs and if
required hospitalization to get the desired response. In chronic cases it gives
excellent results. R. Compound induces maximum remissions. It is nontoxic and
in this clinical trial, no toxic effects were noticed over a period of 8
months-1 year. The dosage is also simple and safe, infact, there is no need for
special medical supervision and laboratory tests.
SUMMARY
R. Compound (Alarsin) was clinically tried
on30 cases of rheumatoid Arthritis and other arthritic disorders. The results
were good in all cases. The dosage was 2 tabs tds. in acute stage and
maintenance dose was 1 tab. tds.The duration of treatment extended over 8
months-1 year. No toxic effects were noticed.
R. Compound has no deleterious action on
liver, kidney or blood. It was found to be safe for prolonged use, which is
quite essential inrheumatoid arthritis. Cases of degenerative arthritis in
older patients tolerated this drug with good response.
ACKNOWLEDGEMENT
The author is grateful to the
Superintendent,M. K. C. G. Medical College Hospital for giving permission to
conduct this clinical trial and publish this paper. I am thankful to
"Alarsin" for supplying me samples of R. Compound tablets.
REFERENCES
1.
Subramaniam R., Parthasarathy M. S.p
"R. Compound in Osteo Arthritis". (Paper at 1st
Congress of SEAPALAR 1968)
2.
Sardesai H. V., (Deshpande S. S. "Use of R. Compound
in Rheumatoid Arthritis" (Paper
read at 1st Congress of SEAPALAR 1968).
3.
Bansod M. V. (Paper read at the 31st All India
Medical Conference, Lucknow, 1953.)
(Antiseptic, 1954)
4.
Herd and Mundy. Toxicity tests on R. Compound.
London, 1952.
5.
Kaikini V. M. The Antiseptic. Jan. 1953.
6.
Motawani N. R. An Ayurvedic Adjuvant in Management
of Arthritis and fractures. The
Maharashtra Medical Journal Aug. 1965.
7.
TiwariC. P., Prasad M. Paper read at 31st All India
Medical Conference Indore, 1959.
8.
Variava N S. The Indian Practitioner. Jan 1954.