Dr S. S. Yadav

Reprinted from MAHARA5HTRA MEDICAL JOURNAL

for the use only of a 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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