Efficacy of an Indigenous Compound Preparation Liv.52 in Acute Viral Hepatitis – A Double Blind Study

Sama, S.K., Assistant Professor Krishnamurthy, L., S.R.O., Gastroenterology Ramachandran, K., Associate Professor and Head of the Bio-Statistics Division and Krishan Lal, Senior Technician. Department of Gastroenterology All-India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Table II: Comparison of Liv.52 and placebo groups Initial data on the two groups of patients at the time of admission
Treatment	Age (Yrs.)			S. Bilirubin (mg.) on admission			Duration of illness (days) on admission
Mean		S.D.			Mean	S.D.		Mean		S.D.
Liv.52	23.4		8.55	8.01		3.63	6.71		3.42
Placebo	23.9		6.84	9.35		3.82	8.23		2.97
(No. significant difference in the two groups)

Table III outlines the results of treatment. Clinical recovery and a 50 percent fall in bilirubin took place in a significantly shorter time in the drug-treated group. (Text Figs. a and b). However, the total recovery, as evidenced by the normalisation of biochemical parameters especially pyruvic transaminase took more or less the same time in the two sets of patients. While weight loss was recorded in twelve of the drug-treated group and in ten of the placebo group, the degree of weight loss was significantly higher in the placebo group. One case in placebo group had to be dropped from the trial on account of impending fulminant hepatitis.

Table III: Response to treatment in the two groups

Treatment

No. studied

No. recovered

Weight loss (kg.)

Time for 50 per cent fall in bilirubin (days)

Clinical recovery (days)

Biochemical* recovery (days)

Mean ± S.D.

Mean ± S.D.

Mean ± S.D.

Mean ± S.D.

Liv.52

17

17

1.00 0.83

6.53 2.45

9.71 4.30

36.41 11.87

Placebo

17

16

2.40 0.94

12.62 4.57

18.00 10.35

37.06 8.66

Significance

Not Significant

p<0.01

p<0.001

p≈0.01

Not Significant

* Time taken for SGPT to attain normal levels

Patients receiving the drug did not show any side effects or complications for a period of three months. Liv.52 thus seems to be a useful drug for therapy of acute viral hepatitis. There was rapid amelioration of clinical symptoms and signs, though total period of recovery was not materially affected. The response seems to be very similar to that of steroids, but without the latter's side effects. Weight loss is also minimum with Liv.52. It would be worthwhile to undertake more controlled trials in HBAg positive hepatitis and also in progressive and chronic liver disease.

Figure 1: Diagram showing  Figure 2: Diagram showing time                                              pre-treatment level of taken for                                              50 per cent

REFERENCES
1. Arora, J.K. Role of various types of treatment in infectious hepatitis. Armed Forces Med. J.(1969): 3, 362-368.

2. Blum, A.L., Stutz, R., Haemmerli, U.P., Schmid, P. and Grady, G.F. A fortuitously controlled study of steroid therapy in acute viral hepatitis. I. Acute disease. Am. J. Med. (1969): 47, 82-92.

3. Dave, D.S., Rajput, V.J. and Gupta, M.R. Clinico-biochemical study of infective hepatitis with special reference to Liv.52 therapy. Probe (1972): 4, 214-220.

4. Deshpande, R.S., Sheth, Shantilal C. and Joykutty, M.D. Infectious hepatitis - Study of 100 cases. Curr. Med. Pract. (1971): 6, 810-816.

5. Gupta, S., Khatri, R.L. and Srivastava, G. Therapy of infectious hepatitis and other liver disorders. Probe (1972): 2, 93-99.
6. Jaffari, S.M.H. and Shyam Raj. Liv.52 in infective hepatitis. The Antiseptic (1969): 5, 353.

7. Joglekar, G.V. and Balwani, J.H. Allyl alcohol induced hepatotoxicity in rats and its protection by Liv.52. J. Expt. Med. Sci. (1967): 11, 7-9.

8. Joglekar, G.V., Chitale, G.K. and Balwani, J.H. Protection by indigenous drugs against hepatotoxic effects of carbon tetrachloride in mice. Acta Pharmacol. et Toxicol. (1963): 20, 73-79.

9. Joglekar, G.V. and Leevy, C.M. Effect of an indigenous drug on ICG (indocyanine green): clearance and autoradiographic patterns in albino rats with experimentally induced hepatotoxicity. J. Ind. med. Prof. (1970): 12, 7480-7485.

10. Kale, A.K., Kulkarni, S.D., Joglekar, G.V. and Balwani, J.H. Effect of Liv.52 on growth and alcohol induced hepatic dysfunction in rats. Curr. Med. Pract. (1966): 10, 240.

11. Karandikar, S.M., Joglekar, G.V., Chitale, G.K. and Balwani, J.H. Protection by indigenous drugs against hepatotoxic effects of carbon tetrachloride-a long-term study. Acta Pharmacol. et Toxicol. (1963): 20, 274-280.

12. Mehrotra, M.P. and Mathur, D.C. Liv.52 trial in infective hepatitis. The Antiseptic (1973): 2, 114-118.

13. Mukerjee, A.B. and Dasgupta, M. Treatment of viral hepatitis by an indigenous drug-Liv.52. Indian Practitioner (1970): 6, 357-366.

14. Patel, J.R. and Sadre, N.L. Effect of Liv.52 on structural and functional damage caused by some hepatotoxic agents. Probe (1963): 1, 19-24.

15. Ramalingam, V., Sundaravalli, N. and Balagopal Raju, V. Liv.52 studies in acute hepatitis. Indian Paediat. (1971): 12, 839-842.

16. Sheth, Shantilal, C., Northover, B.J., Tibrewala, N.S., Warerkar, U.R. and Karande, V.S. Therapy of cirrhosis of liver and liver damage with indigenous drugs experimental and clinical studies. Indian J. Paediat. (1960): 149, 202-210.

17. Sherlock, S. The course of long incubation hepatitis. Brit. Med. Bull. (1972): 28, 109-113.

18. Sule, C.R., Pai, V.R., Damania, R.F. and Joshi, V.S. Studies with Liv.52 therapy in infective hepatitis. J. Indian Med. Prof. (1968): 14, 6391-6397.

Refference: http://www.himalayahealthcare.com/pdf_files/liv229.pdf