Relistif

Product Monograph

Jeevanjyoti Herbaceuticals…..

Health for all naturally

Osteo arthritis is a slowly progressive musculoskeletal disorder that typically affects the joints of the hand , spine and weight-bearing joints (hips, knees) of the lower extremity. It is not associated with systemic symptoms or joint inflammation. Joint pain and loss of function are due to defects in articular cartilage and underlying bone. These defects arise because of excessive loads on normal joints or normal loads on abnormal joints. It is sometimes called degenerative joint disease (DJD).

  1. Risk factors
  2. Increasing age
  3. Female gender
  4. Obesity
  5. Previous joint damage
  6. Family history (especially OA of hands)
  7. Early Pathologic Changes
  8. Swelling of articular cartilage
  9. Loosening of collagen framework restraint
  10. Chondrocytes increase proteoglycan synthesis but also release more degradative enzymes
  11. Increased cartilage water content
  12. Late Pathologic Changes
  13. Degradative enzymes break down proteoglycan faster than it can be produced by chondrocytes, resulting in diminished proteoglycan content in cartilage
  14. Articular cartilage thins and softens
  15. Fissuring and cracking of cartilage; repair is attempted but inadequate
  16. Underlying bone is exposed, allowing synovial fluid to be forced by the pressure of weight into bone (cyst or 'geode' on xray)
  17. Rremodeling and hypertrophy of the subchondral bone results in subchondral sclerosis (whitening) and osteophyte (spur) formation

Osteo arthritis is a most common degenerative joint disorder . Obesity is one of the major risk factor of osteo arthritis.Osteo arthritis is a wear and tear phenomenon that is associated with the degenerative changes in articular cartilage. Obese women’s are more prone for osteo arthritis then men. It is seen that 5 kg weight loss reduce the likeness of osteo arthritis by 50%. It is the most common joint Proteoglycans are responsible for the compressive stiffness of the tissues and its ability to withstand load. Collagen helps to increase the tensile strength and resistance of the joint. Morphological changes observed in OA include cartilage erosion as well as a variable degree of synovial inflammation. Current research attributes these changes to a complex network of biochemical factors, including proteolytic enzymes, that lead to a breakdown of the cartilage macromolecules. Cytokines such as IL-1 and TNF-alpha produced by activated synoviocytes, mononuclear cells or by articular cartilage itself significantly up-regulate metalloproteinases (MMP) gene expression.
Moreover, in OA synovium, a relative deficit in the production of natural antagonists of the IL-1 receptor (IL-1Ra) has been demonstrated, and could possibly be related to an excess production of nitric oxide in OA tissues. This, coupled with an upregulation in the receptor level, has been shown to be an additional enhancer of the catabolic effect of IL-1 in this disease.IL-1 and TNF-alpha significantly up-regulate MMP-3 steady-state mRNA derived from human synovium and chondrocytes. The neutralization of IL-1 and/or TNF-alpha up-regulation of MMP gene expression appears to be a logical development in the potential medical therapy of OA. Indeed, recombinant IL-1receptor antagonists (ILRa) and soluble IL-1 receptor proteins have been tested in both animal models of OA for modification of OA progression. The important role of TNF-alpha in OA may emerge from the fact that human articular chondrocytes from OA cartilage expressed a significantly higher number of the p55 TNF-alpha receptor which could make OA cartilage particularly susceptible to TNF-alpha degradative stimuli. In addition, OA cartilage produces more TNF-alpha and TNF anglealpha convertase enzyme (TACE) mRNA than normal cartilage. Three such cytokines - IL-4, IL-10, and IL-13 - have been identified as able to modulate various inflammatory processes. Their anti inflammatory potential, however, appears to depend greatly on the target cell. Interleukin-4 (IL-4) has been tested in vitro in OA tissue and has been shown to suppress the synthesis of both TNF-alpha and IL-1beta in the same manner as low-dose dexamethasone. Naturally occurring anti inflammatory cytokines such as IL-10 inhibit the synthesis of IL-1 and TNF-alpha and can be potential targets for therapy in OA Prostaglandins and leukotrines are the two main factors responsible for pain in degenerative joint disorder. These two factors are synthesized from essential fatty acids that play a major role in developing inflammation and pain in the joints. Contemporarily used pain killers are mostly potent prostaglandin inhibitors. As leucotrine synthesis is not blocked by these regularly used analgesics pain is not totally subsided. Apart from this, these prostaglandin inhibitors impart severe side effects like gastritis, G.I.bleeding and nephrotoxicity.
Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit cartilage repair (by inhibiting the production of the collagen matrix). Since osteoarthritis is caused or characterized in part by cartilage degeneration, the NSAIDs which suppress the symptoms may worsen the target condition by inhibiting cartilage formation and hastening its destruction
There are four primary objectives in the treatment of arthritis: reduction of inflammation and pain; preservation of the joint’s function prevention of deformity; and treatment of the cause (if known)
The best treatment is to remove weight from the joints. This may entail using a walking stick, going on a balanced weight reduction diet, sleeping on a bed, which properly conforms to the shape of the body, and getting frequent rest. Regular exercise, both active and passive, will keep the affected muscles from weakening. The individual may benefit from a hydrotherapy program under trained supervision. Heat and cold applications to the joint may induce muscle relaxation and an analgesic effect.

Apium graveolens (Celery seeds )

The chemistry of celery seed and its essential oil, in particular, have been extensively studied. The essential oil contains deltalimonene, selinene, various sesquiterpene alcohols, and the characteristic flavor principles of celery, phthalides, primarily 3-n-butylphthalide, and sedanenolide. The seed also contains a fixed oil with ubiquitous fatty acids, including petroselinic, oleic, linoleic, myristic, palmitic, and stearic acids. 1.5-3% volatile oil (containing the terpenes limonene and b-selinene, and phthalides); coumarins (seselin, osthenol, apigravin, celerin, umbelliferone); furanocoumarins (including bergapten), flavonoids (apigenin, apiin), phenolic compounds, choline, ascorbate, fixed oil, fatty acids and unidentified alkaloids. Various pharmacological activities attributed to the seed or essential oil include antispasmodic, mild sedative, and anti-inflammatory activity, among others. Celery Seed can also ease joint discomfort that occurs due to inflammation and is, in fact, mainly used for the relief of symptoms Celery seeds are known to have potent prostaglandin and leucotrine inhibiting activities. Thus it is useful to relive pain in osteoarthritis like degenerative diseases without creating any un towards effect. Combination of Celery seeds and Turmeric are useful in treating conditions like gout.This condition is caused by deposition of sodium urate crystals in the joints and tendons. It occurs in people whose blood uric acid is abnormally high. Uric acid is a waste product of cell breakdown and is produced in excess when there is large-scale cell destruction. Celery seeds are known to have diuretic activity which helps to relive pain and odema over the joints by flushing out the urate crystals. The seeds increase excretion of uric acid and improve the circulation to the muscles and joints and are also a urinary antiseptic

In a survey of celery seed preparations 23 celery-based preparations induced a significant anti-arthritic activity, which was equivalent to a 50 mg/kg body weight of ibuprofen. "The activity of the celery seed appears to depend on careful processing of celery seed at low temperatures,"

Curcuma longa

Turmeric (Curcuma longa) is an important internal and external anti-inflammatory agent in both Traditional Chinese Medicine and Ayurvedic Medicine. Its long history of use is backed by recent clinical research.

Turmeric is a common ingredient in curries. Its active ingredient is curcumin, which is thought to have antioxidant and anti-inflammatory properties.

In the study, Dr. Michael W. Whitehouse of the University of Queensland and Princess Alexandra Hospital in Woolloongabba, Australia, purchased a variety of herbal and Ayurvedic preparations from manufacturers, pharmacies and health-food stores in Australia, New Zealand, Britain and the United States. The preparations included celery (Apium graveolens), frankincense/olibanum (Boswellia serrata), ginger and turmeric (Curcuma longa).

"All these products have been widely advocated as 'herbal' aspirins or anti-inflammatory agents, implying they are the herbal equivalent of nonsteroidal anti-inflammatory drugs, antipyretics or analgesics," Whitehouse said. An antipyretic is a drug used to bring down fever.

Turmeric's therapeutic effects are comparable to potent drugs, such as phenylbutazone and hydrocortisone - but with a major difference: One compound in turmeric (curcumin) inhibits the synthesis of substances called prostaglandins in the body that are involved in pain. The mechanism is similar to the one involved in the pain-relieving action of aspirin and ibuprofen, only weaker. Still, at high doses, curcumin stimulates the adrenal glands to release the body's own cortisone, a potent reliever of inflammation and the pain it often causes. Turmeric is largely non-toxic, and relatively free of side-effects. Turmerics ability to reduce post-operative inflammation out performed the drug phenylbutazone and a placebo in a double-blinded clinical trial, and produced comparable improvement in duration of morning stiffness, walking time, and joint swelling among rheumatoid arthritis patients treated with phenylbutazone. Phenylbutazone, an early non-steroidal anti-inflammatory, remains the standard measure of anti-inflammatory activity, though it is no longer prescribed - mainly due to significant side effects, such as gastric erosion. While a mechanism of action has not been established, both animal trials and clinical evidence indicate that Turmeric inhibits inflammatory action, by limiting the potentially damaging effects of increased leukotrine production. Its pharmacological effects are similar to common over-the-counter remedies used for arthritis, such as aspirin

The researchers tested the herbal medicines in rats, giving the animals oral doses.

Cyperus rotundus –

Cyperus rotundus is a famous herb used as alterative, analgesic, antibacterial, anti-inflammatory, antimalarial, antimicrobial, anti-pyretic, astringent, demulcent, diaphoretic, diuretic, emmenagogueue, emollient, febrifuge, hypoglycemic, hypotensive, immunostimulant, .

Dose - One capsule bd before meals or as directed . In case of severe osteo arthritis dose cam be increased upto 1 capsule three times a day.

contraindication - Persons having hypersensitivity for any of the ingredients of Cap.Relistif are contraindicated.

Adverse effects - No adverse effects of Relistif capsules are noted till date.

Drug interaction - No drug interaction with Capsule Relistif in documented.

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