Studies with Liv.52 therapy in Infective Hepatitis
Sule, C.R., M.D., Pai, V.R., M.D., Damania, R.F., M.D., and Miss. Joshi, V.S., M.B.,B.S. Medicine Unit, Sassoon General Hospitals, and B.J. Medical College, Poona, India.
INTRODUCTION
Liv.52, an indigenous product has been widely used clinically in various hepatic disorders for the last eight years. The drug has been tried in cases of diffuse hepatic fibrosis and portal hypertension (Mathur, 1957). Also a number of experimental studies have been carried out in mice (Joglekar et al, 1963) and dogs (Murkibhavi et al, 1963) and rats (Karandikar et al, 1963). These suggest the protective action of Liv.52 against hepatotoxicity. Patel et al (1963) showed its efficacy in acute hepatic toxicity.
The present studies were undertaken to evaluate the efficacy of Liv.52 (product of the Himalaya Drug Co.) in acute infective hepatitis, and to find out the clinical and biochemical changes in infective hepatitis of varying severity, with Liv.52.
Liv.52 contains Capparis spinosa 64.8 mg,, Cichorium intybus 64.8 mg., Solanum nigrum 32.4 mg., Cassia occidentalis 16.2 mg., Terminalia arjuna 32.4 mg., Achillea millefolium 16.2 mg., Tamarix gallica 16.2 mg. and Mandur bhasma 32.4 mg.
MATERIAL AND METHODS
The present work was done over a period of three years from 1964-66. In all 150 cases were studied. Of these, 25 cases were from other wards and were treated by our colleagues with antibacterial antibiotics and steroids. This group, Group I, acted as a control.
Our series of 125 cases was treated with Liv.52, two tablets t.d.s. From these 125 cases treated with Liv.52, we selected for the purpose of schematic comparison with the control group, 25 cases of infective hepatitis of identical severity and duration as the control group. This was Group II. Group III consisted of all 125 cases treated with Liv.52. The cases were treated as and when seen. A few cases which were treated with Liv.52 had to receive in addition, steroids and antibiotics. These have been excluded from the series.
Primarily the cases were clinically investigated. In all cases liver function tests were carried out. These included estimations of serum bilirubin, SGPT, SGOT and serum alkaline phosphatase. These tests were carried out on the 5th day and repeated on the 12th and 19th days.
RESULTS
Table No.1, showing the incidence of age and sex in the present trial. (The number of female patients was small because of restricted female admissions).
Table 1 |
||||||||||||||||||||
|
Age Groups |
|||||||||||||||||||
No. of cases |
11-20 yrs |
21-30 yrs |
31-40 yrs |
41-50 yrs |
51-60 yrs |
|||||||||||||||
50 |
52 |
31 |
12 |
4 |
||||||||||||||||
M |
F |
M |
F |
M |
F |
M |
F |
M |
F |
|||||||||||
150 |
45 |
5 |
43 |
9 |
29 |
2 |
11 |
2 |
4 |
— |
||||||||||
Table No. 2 shows the symptomatology of acute infective hepatitis noticed in the 150 cases studied.
Table 2 |
||||||
Symptoms |
Total No. of cases |
(25 Group I |
+ |
125) Group II & III |
Incidence % |
|
1. |
Jaundice |
90 |
( 21 |
+ |
69 ) |
60 |
2. |
Loss of weight |
60 |
(8 |
+ |
52 ) |
40 |
3. |
Abdominal pain |
58 |
(8 |
+ |
50 ) |
38.7 |
4. |
Severe constipation |
56 |
(6 |
+ |
50 ) |
37.3 |
5. |
Fever |
40 |
(3 |
+ |
37 ) |
26.7 |
6. |
Nausea |
37 |
(6 |
+ |
31 ) |
24.6 |
7. |
Vomiting |
24 |
(3 |
+ |
21 ) |
16 |
8. |
Diarrhoea |
16 |
(4 |
+ |
12 ) |
10.7 |
9. |
Fever with rigors |
12 |
(1 |
+ |
11 ) |
8 |
10. |
Malaise |
12 |
(3 |
+ |
9 ) |
8 |
11. |
Pruritus |
8 |
(2 |
+ |
6 ) |
5.3 |
12. |
Bleeding |
6 |
(3 |
+ |
3 ) |
4 |
13. |
Hiccup |
5 |
(2 |
+ |
3 ) |
3.3 |
14. |
Restlessness |
4 |
( Nil |
+ |
4 ) |
2.7 |
15. |
Comatose state |
4 |
( Nil |
+ |
4 ) |
2.7 |
16. |
Cough |
4 |
( Nil |
+ |
4 ) |
2.7 |
JAUNDICE
Incidence of jaundice at the time of admission was 60%, though it was apparent in all cases subsequently.
LOSS OF APPETITE
It was present in 40% of cases (60 cases). In the control group, Group I, the appetite improved on an average after 7 days, whereas it improved on an average in 4 days in Group II (the 25 Liv.52-treated cases). In Group III (125 Liv.52 - treated cases), it improved on an average in 5 days.
VOMITING
In the present series vomiting was present in 24 cases (16%). It took on an average 72 hours to check vomiting in the control group, Group I. the vomiting stopped on an average in 40 hours in Group III (125 Liv.52-treated cases).
NAUSEA
Nausea was seen in 24.6% (37 cases). In the control group, Group I, the nausea improved in 96 hours on an average, whereas it took only 72 hours in Group II of the Liv.52 trial series.
ABDOMINAL PAIN
Abdominal pain was present in 38.7% (58 cases). The data on the time taken to check it in the control series, Group I, was not available. In our series, Group III, the pain was relieved within a period of 72 hours.
FEVER
Fever was rather a confusing symptom in many cases. The incidence was 26.7%. Twelve cases had fever with rigors, whereas 40 cases had fever without rigors. There was no significant difference between the control and trial cases. The fever subsided on an average in 72 hours. The fever lasted for 7 days in two cases of severe infective hepatitis cases having signs of coma.
CONSTIPATION
Constipation was present in 37.3% (56 cases). The constipation required regular enemata or mild laxative therapy. The bowel regularization was achieved in an average period of five days with Liv.52 therapy (Group III).
DIARRHOEA
The pre-icteric symptom as diarrhoea was present in 10.7% (16 cases). Diarrhoea was controlled with Liv.52 within an average duration of 48 hours in Group III.
Refference: http://www.himalayahealthcare.com/pdf_files/liv200.pdf
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