Studies with Liv.52 in the Treatment of Infective Hepatitis, Chronic Active Hepatitis and Cirrhosis of the Liver
Prof. Mandal, J.N., M.B. (Cal.), D.C.H. (Lond.), F.R.C.P. (Edin.), Professor - Director
and Roy, B.K., M.D. (Cal.), Senior House Physician to Professor-Director, Department of Medicine, Medical College and Hospital, Calcutta, India.
Liv.52 in chronic active hepatitis and cirrhosis
(iii) SGOT / SGPT: In the Liv.52 Group 22 out of 30 patients (73.33%) showed earlier improvement in 2-3 weeks, whereas 4 out of 15 (26.66%) patients in Control Group showed the same response within that time, and rest of the cases in Control Group took 3-6 weeks to become normal (Table VI).
(iv) Total Protein / Albumin / Globulin: In Liv.52 Group the Serum albumin values showed significant early rise in majority of cases than in Control cases (Table VII).
The distribution of cases showing duration for improvement of subjective symptoms and objective signs as well as in biochemical profiles in cases of Infective Hepatitis both in Liv.52 Group (30 cases) and Control Group (15 cases) is summarised in Table VIII.
Thus in 45 cases of Infective Hepatitis following observations in respect of results of treatment have been made:
Criteria for Assessment of Results as “Good”, “Fair” and “Poor” in Infective Hepatitis:
Good : Improved clinically and biochemically within a period of 1-3 weeks.
Fair : Improved clinically and biochemically within a period of 4-6 weeks.
Poor : Improved clinically and biochemically only after 6 weeks or showing indifferent or no improvement.
Group B: Chronic Active Hepatitis: In the present study of 32 cases of Chronic Active Hepatitis, 24 patients were put on Liv.52 and the remaining 8 received only conventional therapy (minus steroids) and served as Control Group.
The major symptoms and signs of the cases, number of cases involved and their age and sex-wise distribution both in the Liv.52 and Control Groups are presented in Table IX.
RESULTS
Chronic Active Hepatitis
1. Clinical: Clinical improvement in respect of fever, anorexia, yellow urine, weight loss, flatulence, dyspepsia, jaundice etc. was observed early in majority of cases of Liv.52 Group, as compared to Control Group (Table X).
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| Table VI:Serum GOT and GPT in infective hepatitis (in Karmen Units) | ||||||||||||||||||||||||||||
| On admn. | 1st week | 2nd week | 3rd week | 4th week | 5th week | 6th week | ||||||||||||||||||||||
| GOT | GPT | GOT | GPT | GOT | GPT | GOT | GPT | GOT | GPT | GOT | GPT | GOT | GPT | |||||||||||||||
| Liv.52 group (Mean: 30 cases) | 73.7 | 152.5 | 70.4 | 137.7 | 47.4 | 81 | 28.9 | 48.2 | – | – | – | – | – | – | ||||||||||||||
| Control group (Mean: 15 cases) | 89.6 | 154.9 | 74.1 | 123.3 | 60.9 | 100 | 46.8 | 75.9 | 48.5 | 78.5 | 43 | 63.5 | 21.5 | 31.5 | ||||||||||||||
| (Normal: less than 40 units) | ||||||||||||||||||||||||||||
(iv) Total Protein / Albumin / Globulin: In Liv.52 Group the Serum albumin values showed significant early rise in majority of cases than in Control cases (Table VII).
| Table VII: Serum total protein, Albumin: Globulin ration in infective hepatitis (in gm%) | ||||||||||||||||||||||||||||||
| On admn. | 3rd day | 1st week | 2nd week | 3rd week | ||||||||||||||||||||||||||
| TP | A | G | TP | A | G | TP | A | G | TP | A | G | TP | A | G | ||||||||||||||||
| Liv.52 group (Mean: 30 cases) | 5.6 | 3.0 | 2.6 | 5.7 | 3.2 | 2.5 | 5.8 | 3.4 | 2.4 | 6.1 | 3.7 | 2.4 | 6.3 | 3.8 | 2.5 | |||||||||||||||
| Control group (Mean: 15 cases) | 5.2 | 2.9 | 2.3 | 5.1 | 2.9 | 2.2 | 5.1 | 3.0 | 2.1 | 5.3 | 3.2 | 2.1 | 5.7 | 3.5 | 2.2 | |||||||||||||||
| (Normal: Serum albumin 3.5 to 5: Serum globulin 2 to 3.5) (T.P. =Total protein; A = Albumin; G = Globulin) | ||||||||||||||||||||||||||||||
The distribution of cases showing duration for improvement of subjective symptoms and objective signs as well as in biochemical profiles in cases of Infective Hepatitis both in Liv.52 Group (30 cases) and Control Group (15 cases) is summarised in Table VIII.
| Table VIII: Period taken for clinical and biochemical improvement in infective hepatitis (in weeks) | ||||||
| Age group | Liv.52 group (30 cases) | Control group (15 cases) | ||||
| 1-3 weeks | 4-6 weeks | Above 6 weeks | 1-3 weeks | 4-6 weeks | Above 6 weeks | |
| 10-30 years | 17 | 5 | 1 | 4 | 5 | – |
| 31-45 years | 3 | 1 | – | – | 5 | – |
| 46-60 years and above | 2 | 1 | – | – | – | 1 |
| 22 | 7 | 1 | 4 | 10 | 1 | |
| % | 73.33 | 23.33 | 3.33 | 26.66 | 66.6 | 6.6 |
Thus in 45 cases of Infective Hepatitis following observations in respect of results of treatment have been made:
| > | Liv.52 group | Control group | |
| (i) | Good | 22 (73.33) | 4 (26.66) |
| (ii) | Fair | 7 (23.33) | 10 (66.66) |
| (iii) | Poor | 1 (3.33) | 1 (6.66) |
| > | 30 | 15 |
Criteria for Assessment of Results as “Good”, “Fair” and “Poor” in Infective Hepatitis:
Good : Improved clinically and biochemically within a period of 1-3 weeks.
Fair : Improved clinically and biochemically within a period of 4-6 weeks.
Poor : Improved clinically and biochemically only after 6 weeks or showing indifferent or no improvement.
Group B: Chronic Active Hepatitis: In the present study of 32 cases of Chronic Active Hepatitis, 24 patients were put on Liv.52 and the remaining 8 received only conventional therapy (minus steroids) and served as Control Group.
The major symptoms and signs of the cases, number of cases involved and their age and sex-wise distribution both in the Liv.52 and Control Groups are presented in Table IX.
| Table IX: Symptoms, signs, age, sex distribution in chronic active hepatitis | ||||||||
| Liv.52 group (24) | Control group (8) | |||||||
| 10-30 years | 31-45 years | 46-60 years & above | Total | 10-30 years | 31-45 years | 46-60 years & above | Total | |
| Fever (20) | 6 | 8 | 1 | 15 | 3 | 2 | – | 5 |
| Anorexia (32) | 10 | 12 | 2 | 24 | 3 | 5 | – | 8 |
| Weakness (28) | 10 | 12 | – | 22 | 2 | 4 | – | 6 |
| Weight loss (16) | 5 | 8 | 1 | 14 | 1 | 1 | – | 2 |
| Flatulence (18) | 6 | 7 | 2 | 15 | 1 | 2 | – | 3 |
| Yellow urine (32) | 10 | 12 | 2 | 24 | 3 | 5 | – | 8 |
| Joint pain (3) | 2 | 1 | – | 3 | – | – | – | – |
| Dyspepsia (32) | 10 | 12 | 2 | 24 | 3 | 5 | – | 8 |
| Jaundice (32) | 10 | 12 | 2 | 24 | 3 | 5 | – | 8 |
| Hepatomegaly (32) | 10 | 12 | 2 | 24 | 3 | 5 | – | 8 |
| Splenomegaly (5) | 1 | 2 | 1 | 4 | 1 | – | – | 1 |
| Pedal oedema (6) | 1 | 2 | 1 | 4 | 1 | 1 | – | 2 |
| Ascites (2) | – | 1 | – | 1 | – | 1 | – | 1 |
| Spider naevi (1) | – | 1 | – | 1 | – | – | – | – |
| Palmar erythema (2) | – | 1 | – | 1 | – | 1 | – | 1 |
| Gynaecomastia (1) | – | 1 | – | 1 | – | – | – | – |
| Figures in parenthesis indicate number of cases | ||||||||
RESULTS
Chronic Active Hepatitis
1. Clinical: Clinical improvement in respect of fever, anorexia, yellow urine, weight loss, flatulence, dyspepsia, jaundice etc. was observed early in majority of cases of Liv.52 Group, as compared to Control Group (Table X).
| Table X: Period taken for clinical improvement in chronic active hepatitis | ||||||||||||
| Age group | Liv.52 group | Control group | ||||||||||
| 3-6 months | 7-12 months | 13-24 months & above | 3-6 months | 7-12 months | 13-24 months & above | |||||||
| 10-30 years | 5 | 5 | – | – | 2 | 1 | ||||||
| 31-45 years | 4 | 6 | 2 | – | 2 | 3 | ||||||
| 46-60 years & above | – | 1 | 1 | – | – | – | ||||||
| 9 | 12 | 3 | – | 4 | 4 | |||||||
| % | 37.5 | 50 | 12.5 | – | 50 | 50 | ||||||
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