Clinical Evaluation of Aluretic

Introduction

The use of substances producing increase in urine output can be traced back to the dawn of medicine. Ayurveda, the oldest medical system of India mentioned several medicinal plants in the management of odema, ascites and urinary disorders.

During the early phase of this century some attempts have been made to study indigenous drugs on scientific lines. Beginning with the work of Sir R. N. Chopra in 1923, a large number of plant extracts have been studied in experimental animals.

In 1955 Gujral et al., undertook a systemic study of 33 different medicinal plants selected from Ayurvedic classics for diuretic property. Aqueous extracts were prepared and screening was carried out in rats according to the method of lipcnitx. Urine was collected in metabolic cage for the period of 5 hours. Urea was used as a standard for comparison.

According to this study Saccharum efficinarum (Ikshumul), Tribulus terestris (Gokshura), Glycyrrhiza glabra (Yashtimadhu), Achyranthes aspera (Apamarga) and Pinus deodara (Devdar) showed good diuretic activity 1. It was also concluded that the diuretic activity of Gokshura and Punarnava was due to their high potassium content.

A controlled clinical trial of Punarnava has been done in 40 patients suffering from Nephrotic syndrome. It induced notable degree of diuresis. The diuretic effect was slow but prolonged. Besides relief in clinical oedema the patients also showed over-all improvement such as decrease in albuminuria, rise in serum protein and fall in serum cholesterol level 2.

Juice of leaves of Azadirachata indica (Neem leaf) has been reputed to possess diuretic activity (Chopra et al.). 3 In a preliminary study Berberine alkaloid (Daruharidra) showed moderate diuretic activity both in rats and unanesthetized dogs when compared with hydrochlorthiazide 4. The diuretic activity of Oleo-resin of Guggulu was reported by Gujral et al; 5 at the dose of 6.25 mg/100 gm. of rat weight the oleo-resin cited moderate degree of diuretic action.

In an experimental study it was observed that the alcoholic extract of Pashanabhed has no effect in preventing the stone formation in rats but it is helpful in dissolving the preformed stones. 7.

The drug Guduchi (T. cordifolia) has been proved to possess anti-rheumatic and diuretic properties (Sesodia and - Lashminarayana, 1966). Rai and Gupta (1966) have carried out experimental evaluation of Guduchi for dissolution of urinary calculi. In 22 rats the stone formation was induced by implanting Zinc pellets into the bladder. The deposition of secondary salts over the Zinc pellets was inhibited by aqueous extracts of T. cordifolia. 8.

ALURETIC is a compound medicine evolved by Alarsin Pharmaceuticals which consists of some of the above reviewed safe herbal diuretics. It has been reported that ALURETIC is highly efficacious as a step 1 drug in the management of mild to moderate hypertension. 9.

Contents of Aluretic

Aim of the Study

To assess the diuretic effects of ALURETIC (ALARSIN) in oedematous conditions.

Methods and Materials

In the present study 10 patients suffering from oedema of various origins have been included associated with the following symptoms/signs.

1. Swelling of legs
2. Swelling of abdomen
3. Swelling of face.
4. Swelling all over the body.
5. Breathlessness on exertion
6. Cough
7. Flatulence
8. Anemia
9. Hypertension
10. Giddiness

The patients attending O.P. at Dr. A. L. Government Ayurvedic Hospital, Vijayawada were selected and taken up for complete clinical assessment. Routine investigations like urinary cytology, urinary analysis, HB%, R.B.C. count, TC, ESR and X-ray were done before and after treatment.

The clinically evaluated cases were given ALURETIC-2 tablets three times a day for a period of six weeks. The response of the drug has been graded as follows:

1. Good: relief noticed at the end one-week treatment.
2. Fair: relief noticed at the end of two weeks treatment.
3. Poor: relief obtained at the end of six weeks treatment.

Out of 10 subjects 5 were males and 5 were females. The minimum age was 40 years and the maximum age was 69 years.

The following diseases were diagnosed as causative factors for oedema.

1. Ascites (due to cirrhosis of liver) — 2
2. Congestive cardiac failure — 7
3. Anemia — 1

Results & Discussion

In the present study 10 patients with oedematous state were administered ALURETIC 2 tablets at a time, thrice a day for a period of six weeks for evaluating diuretic action. Blood pressure was also recorded in sitting posture at weekly intervals.

9 out of 10 patients were having mild to moderate hypertension. (mild hypertension: diastolic BP 90-100 mm/Hg. moderate hypertension: diastolic BP 100-105 mm/Hg).

The response was good in 8 patients suffering from Ascites. (2 cases) and congestive cardiac failure (6 cases), fair in one patient (suffering from CCF) and poor in one case (Anemia).

Appreciable reduction in blood pressure was observed only after 2 weeks. The diuretic response was noticed evidently after 24 hours and no side effects were reported in this study.

Symptoms of Hypokalaemia like muscular weakness, constipation and anorexia were not complained by the patients during the trial periods. 10 So it is deemed that Aluretic can be classified as potassium sparing diuretic.

Since the Aluretic contains the drugs namely Goskhura and Punarnava which are having large quantities of potassium, the loss of potassium through diuresis will almost be near to nil.

Aluretic contains the drugs namely Guduchi which is useful in preventing stone formation and Pashanbhed which helps in dissolving preformed stone in the bladder or kidney. Hence it can also be indicated in urolithiasis.

The follow up study was carried out upto 2 months and it was observed that the effect of Aluretic is temporary.

To sum up ALURETIC is found to be the most effective diuretic in the management of oedema due to cardiac, renal and hepatic disorders. It can be administered as an adjuvant therapy in Hypertension and Urolithiasis.

Acknowledgement

The authors are thankful to Alarsin Pharmaceuticals, Bombay for the generous supply of samples of ALURETIC tablets.

References