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

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. Medical College, Berhampur (Ganjam) Orissa.

Current Medical Practice Vol. No. 15 No. 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 Maharas­nadi quath with Gold in Bhasma form. Mahayog­raj guggul"is an ayunredic 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.

Maharasnadi quath is prepared from 25 standard herbs, its chief ingredient being Rasna. It is antirheumatic, analgesic and an­tipyretic: It is also nontoxic.

 

Gold Bhasma is an antiseptic and is a gen­eral Metabolic stimulant. It is nontoxic having no harmful effect on kidney or any other tissues of the body.

 

MATERIAL AND METHODS

Out of cases attending the M. K. C. G. Medi-cal 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, hepatop­lenomegaly, cardiac involvement, anemia, uri­nary abnormality, were looked for.

 

age group from 20 to 50 years YRS

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 white 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 (four) weeks. The effect of this drug on liver, Kidney and blood were studied by means of liver function 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 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 steriods. 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 satisfactroy response was maintained.

 

TABLE-1

Clinical Response with R. Compound

 

Fever

subsided

in

Pain in joints

decreased

Swelling in joints

E.S.R.

touched

Total W.B.C.

count comes

to normal in

in                         decreased in

normal in

 

 

Rheumatoid Arthritis

One Week

2 Weeks

2 Weeks

.10-15 days

1-2 Weeks

Ankylosing Spondylitis

 

4 Weeks

4 Weeks

3-4 Weeks

 

Filarial Arthritis

7-10 days

2-3 Weeks

2-3 Weeks

-

1-2 Weeks

Osteoarthritis

 

3 Weeks

3 Weeks

-

 

 

 

TABLE-II Average Value (Following Up in Months)

 

1 St

2nd

3rd

4th

5th

6th

7th

8th

Urine Bilesalts &

 

 

 

 

 

 

 

 

Pigments/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 Phosphatase

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 seen 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 definetly less. Two cases of ankylosing spondylitis and filarial arthritis re­sponded quite favourably 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 Ahujafrom 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 hospitalisation 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 on

30 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., "R. Compound in Osteo Arthritis". (Paper at 1 st Congress of SEAPALAR 1968).

2. Sardesai H. V., (Deshpande S. S. "Use of R. Compound in Rheumatoid Arthritis" (Paper read at 1 st Congress of SEAPALAR 1968).

3. Bansod M. V. (Paper read at the 31 st 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. Tiwari C. P., Prasad M. Paper read at 31 st All India Medical Conference Indore, 1959.

8. Variava N. S.: The Indian Practitioner. Jan. 1954.

 

for information on ALARSIN products please write to :

ALARSIN, Alarsin House, A/32, Road No. 3, M.LD.C., Andheri (E), Bombay