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• Chronic
• Systemic
• Inflammatory disease
• Chiefly affects the synovial membranes of multiple joints

Charactrisits

1. Course prolongs with exacerbations & Remmission
2. Atypical, asymmetrical & incomplete forms common

Epidemiology

1. Occurs throughout world in all the ethnic groups
2. Most common between 3rd & 5th decades
3. Annual incidence of new cases is about 200/million
4. The female : male ratio is 3:1

 
Aetiology of RA has not been elucidated
Possible factors may include  following

• Genetic predisposition
• Female sex
• Psychological stress
• Immune response
• Hormone interaction
• Viral infection

Local features
Insidious onset

• Joint involvement typically polyarticular & symmetrical
• Edema
• Effusion
• Warmth
• Tenderness to palpation
• Destruction (a late finding)
• Subcutaneous rheumatoid nodules
• Swan-neck deformities
• Ulnar deviation of fingers

 
Systemic features

• General malaise
• Weakness
• Fever of undetermined etiology
• Weight loss
• Myalgias
• Tendonitis
• Bursitis

Pathology

1. Factors associated with RA include
                                       Possibility of infectious triggers
                                       Genetic predisposition
                                       Autoimmune response
    
2. The primary targets of inflammation are Synovial membranes and articular structures
    
3. Sequence of synovial membrane involvement
                           Inflammation
                           Proliferation
                           Degeneration
4.  Erosion & destruction of synovial membranes leads to
   Joint deformities and disability

Investigations

1. Anemia – normocytic & normochromic  approx. In 80%
2. Thrombocytosis may be present
3. ESR –  elevated in approx. In 90%
4. Serum RF –  positive in approximately 70%
5. ANA –  antinuclear antibodies  present approx. In 30%

Exclusion criteria
• Patients having cardiac, renal, endocrine disorders
• Patients having osteo arthritis
• Patients having inconclusive diagnosis
• Patients of age <20 & >60 years

Selection of patients
25 patients were selected from OPD / IPD of Dayanand ayurvedic hospital

Research Design
A clinical study of within group comparison With pre & post test design

Aam Pramathini Vati
(Herbo Mineral Formulation)

Processed in cassia fistula (amaltas) leaves juice
Dose : 500 mg twice / day

Rasna Saptak Kwath

Dose : decoction 30 ml twice / day

Results

Objectives

1. To assess the effect of the combination
2. Of both the formulations in patients
3. Suffering from rheumatoid arthritis
    

Observations

• Majority of the patients were females
• Belonged to the age group of 25 – 60
• Majority of the patients were married
• Majority belonged to middle class
• Majority belonged urban background
• Majority were of mixed diet

Results
Highly significant results in all the Subjective symptoms / e.s.r. Was seen Within 30 days of treatment as shown in The table

Conclusion

1. With combined use of both the medicines progression of rheumatoid arthritis was checked in early stages of disease with minimal or no Osteoarthritis.
2. Observations & result of this study open newer vistas for further research.
3. This combination is advised as an effective regimen for the use in general practice.