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| The Indian Practitioner, (1980): December, 685 |
| The role of Cystone in urinary tract infection | Prasad,
R.R., M.D., Resident Medical Officer, Dept. of Medicine, Darbhanga Medical College and Hospital, Bihar, India. |
Urinary Tract Infections are quite common in day to day practice. The most common organism generally isolated after urine culture id E. coli. Many a times E. coli is resistant to the usual line of treatment with urinary antiseptics and anti-bacterial agents. Cystone is claimed to be effective in expelling a urinary calculus. In several recent clinical studies, its value is also claimed in urinary tract infection to E. coli in non-specific cystitis and persistent burning micturition syndrome. The object of the present clinical study is to determine the efficacy of Cystone tablet in urinary tract infection due to E. coli. Each tablet of Cystone contains: Exts. Didymocarpus pedicellata 65mg Saxifraga ligulata 49mg Rubia cordifolia 15 mg Cyperus scariosus 16 mg Achyranthes aspera 16mg Onosma bracteatum 16 mg Vernonia cinerea 16 mg Shilajeet (Purified) 13mg Hajrul yahood bhasma 16mg Hajrul yahood bhasma
is prepared with Oconum basilicum, Tribulus terrestris, Mimosa pudica,
Dolichos biflorus, Pavonia odorata, Equisetum arvense, Tectona grandis
seed.
Cystone, a drug of vegetable-mineral origin has been effective in the conservative management of urinary calculi. The principal pharmacological action of Cystone is as follows: Cystone disintegrates urinary calculi by acting on the mucin, which binds the particles together, and clears the urinary tract by flushing out the particles with the flow of urine. It also corrects the crystalloid-colloid with the flow of urine. It also corrects crystalloid-colloid balance (Vakil7, Sharma5, Agrawal1). Cystone acts as a urinary antiseptic. It does not alter the electrolyte balance (Subramaniam6). In urinary tract infections, in cystitis and in non-specific persistent burning micturition syndrome, Cystone is effective in eliminating the symptoms and to make the urine sterile and has no toxic effect on the kidney (Gupta and Singh3, Sengupta and Subrato Gutpa4 and Brijkishore2).
The present study was conducted at Darbhanga Medical College and Hospital during the period 1977 to 1979. Twenty five established cases of urinary tract infection having E. coli in urine culture were selected for the present study. All patients were subject to a thorough case history and clinical examination. In each case the routine blood, urine examination, microscopic urine examination and culture and sensitivity studies of mid-stream samples were done before administration of Cystone therapy. These patients were given Cystone in the dose of 3 tablets three times a day. In all these cases,
investigations were repeated during Cystone therapy and clinically
the patients were observed daily and their progress noted.
There was definite improvement in 13 cases. In these cases there was marked improvement in symptomatology, the pus cell count came to 10-20/h.p.f.; albuminuria became nil and the urine culture became sterile. These cases were put in to "Marked improvement" group. In 7 cases there was moderate improvement in symptoms; the pus cells came down to 10-40/h.p.f., albuminuria persisted and culture remained positive. These cases were put into "Moderate improvement" group (Table 2). In 5 cases there was
no improvement at all and these cases were put in "No improvement"
group (Table 2).
In all these cases, the treatment continued for another week, and at the end of second week, the urine culture became negative in 18 cases. The number of pus cell count came down to 2-8/h.p.f. and they were free from symptoms. The 18 cases which responded to Cystone therapy after the 2nd week were discharged with the advice to continue the treatment with Cystone for another two weeks at the dose of 2 tablets t.i.d. These cases turned up in O.P.D. after two weeks and there was no relapse; the urine culture was sterile and the pus cell count was almost normal in all cases. In 4 cases, there was moderate improvement in symptoms. The pus cells came to 5-20/h.p.f. but the culture remained positive (Table 3).
In 3 cases there was definite fall in pus cell count and also a slight improvement in symptoms, but albuminuria was present in urine and also the culture remained positive (Table 3). In cases with moderate improvement (Table 3) the treatment was continued into the third week. At the end of the 3rd week, the urine culture was still positive, but the pus cell count came to 5-10/h.p.f. and there was marked improvement in symptomatology. These 4 patients were treated with a suitable antibiotic along with Cystone and at the end of 4th week the urine culture in all these cases became negative. The pus cell count came down in all these 3 cases to 5-20/h.p.f. and the albumin also decreased. In these 3 patients, the same treatment was given for a further one week and at the end of 4th week the culture became negative in the remaining 2 cases also. The pus cell count came down to 2-5/h.p.f. The role of Cystone
in urinary tract infection due to E. coli seems to be effective
in this clinical trial, though the number of cases treated is small.
I am extremely indebted, to Prof. Mohan Mishra, M.B.,B.S., M.D. M.R.C.P. (U.K.), Professor in the Department of Medicine, Darbhanga Medical College for his inspiration, valuable suggestions and guidance without which this work would not have been possible. I must express my gratefulness to Dr. G.P. Keshari, M.B.,B.S., D.L.O. (Lond.), Superintendent Darbhanga Medical College and Hospital for kindly allowing me to undertake the trial and to make use of the hospital facilities and publish this report. My thanks to The Himalaya
Drug Company for kindly supplying me Cystone tablets for trial.
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