Study of Liv.52 therapy in infective hepatitis in children

(Mrs.) Shakuntala Saxena, M.D., D.C.H., Professor and Head, Ashok Kumar Garg, Postgraduate Student
and Ashok Jain, M.D., (Paed.), Lecturer, Department of Paediatrics, S.M.S. Medical College and Hospital,
Jaipur (Rajasthan), India.

Infective hepatitis is one of the common hepatic disorders of infancy and childhood. It is endemic in our country and occasionally assumes epidemic proportion. To date no specific therapy is available for the treatment of infective hepatitis. Liv.52 has been tried in infective hepatitis by various workers and has been reported to reduce the duration of symptoms and the return of biochemical changes earlier as compared to control children. So a double blind study was undertaken to observe the effect of Liv.52 therapy in children suffering from infective hepatitis.

MATERIAL AND METHODS

The present study was undertaken on 30 children suffering from infective hepatitis admitted to the medical paediatric ward of S.M.S. Hospital, Jaipur. Diagnosis was based on typical history, characteristic clinical picture, course and laboratory findings. A detailed history was recorded and baseline biochemical investigations were done in all cases. The biochemical investigations were repeated at weekly intervals for five weeks. Out of these 30 children, 14 were kept on Tab. ‘A’ (Liv.52) and 16 were kept on Tab. ‘B’ (placebo) therapy. Decoding regarding Tabs. A and B was done after completion of the study. The dosage of Liv.52 was as follows: 0-1 year 15 drops t.i.d. 1-3 years 2 t.s.f. t.i.d. (syrup) Above 3 years 2 tablets, t.i.d.

RESULTS

Table 1 shows that 16 children received Liv.52 therapy and 14 children received placebo therapy.

Table 1: Total number of cases
Cases	Male	Female	Total
Liv.52	12	4	16
Control	12	2	14

Table 2 shows age and sex distribution of the children studied. Two children (males) were below 1 year of age. Ten children were between 1-3 years of age and 18 were above 3 years of age. Male to female ratio in the present study was 4:1.

Table 2: Age and sex distribution
Age	Male	Female	Total
0 - 1 year	2	—	2
1 - 3 years	8	2	10
Above 3 years	14	4	18
Total	24	6	30

Table 3 shows presenting complaints in the order of frequency. Jaundice, loss of appetite, yellow-coloured urine, nausea and vomiting were the most common presenting complaints.

Table 3: Presenting complaints in order of frequency
Symptoms and Signs				Liv.52 Group (Tab. A) No. of cases												Control Group (Tab. B) No. of cases
Before									After		Before									After
1st wk			2nd wk		3rd wk		4th wk		5th wk		1st wk				2nd wk		3rd wk							4th wk																								5th wk
Jaundice				14		10		4		2		1		-		12		9	7		5	4	4
Loss of appetite				12		6		2		-		-		-		11		9	6		5	3	3
Fever				13		3		1		-		-		-		12		6	3		-	-	-
Distension of abdomen				5		1		-		-		-		-		6		3	2		1	1	1
Yellow-coloured urine				16		10		4		2		2		-		13		10	7		5	4	4
Loss of weight				4		2		-		-		-		-		6		4	3		3	3	1
Nausea and vomiting				10		4		1		-		-		-		8		4	2		2	1	1
Pain in abdomen				7		3		1		-		-		-		4		2	2		-	-	-
Clay-coloured stools				5		2		2		-		-		-		2		2	1		-	-	-
Diarrhoea				-		-		-		-		-		-		1		-	-		-	-	-
Bleeding from orifices				-		-		-		-		-		-		-		-	-		-	-	-
Swelling				-		-		-		-		-		-		-		-	-		-	-	-

After the first week of treatment with Liv.52 as compared to control group, significantly more children had relief in symptoms. After 2 weeks of therapy, relief in symptoms was marked in children receiving Liv.52 as compared to children receiving placebo. Tables 4 (a) and (b) show that the L.F.Ts. in children receiving Liv.52 returned to normal earlier as compared to children receiving placebo therapy. Although, the course of infective hepatitis is self-limiting in most of the cases, yet it was obvious that Liv.52 did help in restoring the L.F.Ts. to normal significantly faster, as compared to the placebo group.

Table 4(a): Laboratory investigations in Infective Hepatitis (Liv.52 group)
Investigations							Before				After
1st week									2nd week				3rd week				4th week										5th week
Serum bilirubin							4.25 mg%				3.8				2.6				2.0			1.5			1.0
Serum transaminase			S.G.O.T.				100.5				85.0				70.0				50.0			25.0			20.0
S.G.P.T.						136.5				100.0				65.0				40.0			15.0			10.0
Alkaline Phosphatase							10.2				7.5				6.0				4.5			4.0			3.5
L.F.Ts.	Icterus Index						25.0				20.0				15.0				10.0			10.0			5.0
Thymol turbidity								4.8				4.0				3.5				3.0			2.0			1.5
Thymol flocculation								+				+				+				±			—			—
Serum total proteins							7.7 gm%				7.7				7.8				7.8			7.8			7.75
Albumin							4.1 gm%				4.2				4.2				4.2			4.1			4.5
Globulin							3.6 gm%				3.5				3.6				3.6			3.7			3.15

Refference: http://www.himalayahealthcare.com/pdf_files/liv240.pdf