Liv.52 Studies in Acute Hepatitis
Vimala Ramalingam, Sundaravalli, N. and Balagopal Raju, V. Institute of Child Health and Hospital for Children, Egmore, Madras, India.
| Table IV | ||
No. of Days of Jaundice on Admission |
|
|
0-5 d |
162 |
(65%) |
5-10 d |
74 |
(30%) |
10-15 d |
11 |
(4%) |
15 d |
3 |
(1%) |
| Table V | |||
No. |
Mild |
Moderate |
Severe |
250 |
122 |
105 |
23 |
on Liv.52 (125) |
56 |
56 |
13 |
Control (Vit. C & B-complex, prednisone-125) |
66 |
49 |
10 |
| Table VI | |||||||||
Days taken for improvement |
|||||||||
|
Liv.52 |
B.Complex |
Prednisone |
||||||
|
+ |
++ |
+++ |
+ |
++ |
+++ |
+ |
++ |
+++ |
Vomiting |
1 |
2 |
3 |
2 |
4 |
6 |
1 |
3 |
5 |
Anorexia |
1 |
4 |
6 |
5 |
13 |
24 |
4 |
8 |
9 |
Fever |
1 |
2 |
3 |
3 |
6 |
7 |
1 |
2 |
3 |
Pain abdomen |
2 |
5 |
5 |
4 |
7 |
10 |
2 |
4 |
6 |
High coloured yellow urine |
5 |
7 |
8 |
8 |
10 |
16 |
6 |
8 |
9 |
Pale stools |
2 |
4 |
4 |
3 |
5 |
6 |
4 |
6 |
6 |
Jaundice |
5 |
6 |
8 |
7 |
9 |
16 |
6 |
8 |
8 |
The symptomatology like vomiting, anorexia, fever, etc., have improved earlier in the Liv.52 group compared to the placebo group. However there is no significant difference between Liv.52 and Prednisone group. |
|||||||||
| Table VI | |||||||||
Days taken for improvement |
|||||||||
|
Liv.52 |
B.Complex |
Prednisone |
||||||
|
+ |
++ |
+++ |
+ |
++ |
+++ |
+ |
++ |
+++ |
Vomiting |
1 |
2 |
3 |
2 |
4 |
6 |
1 |
3 |
5 |
Anorexia |
1 |
4 |
6 |
5 |
13 |
24 |
4 |
8 |
9 |
Fever |
1 |
2 |
3 |
3 |
6 |
7 |
1 |
2 |
3 |
Pain abdomen |
2 |
5 |
5 |
4 |
7 |
10 |
2 |
4 |
6 |
High coloured yellow urine |
5 |
7 |
8 |
8 |
10 |
16 |
6 |
8 |
9 |
Pale stools |
2 |
4 |
4 |
3 |
5 |
6 |
4 |
6 |
6 |
Jaundice |
5 |
6 |
8 |
7 |
9 |
16 |
6 |
8 |
8 |
The symptomatology like vomiting, anorexia, fever, etc., have improved earlier in the Liv.52 group compared to the placebo group. However there is no significant difference between Liv.52 and Prednisone group. |
|||||||||
Table VII: Biochemical Results (in percentages) |
||||||||||||
|
Liv.52 |
B-Complex |
Prednisone |
|||||||||
Weeks |
1 |
2 |
4 |
8 |
1 |
2 |
4 |
8 |
1 |
2 |
4 |
8 |
Bilirubin-fall to 2.5 mgm and less. |
30 |
50 |
15 |
5 |
15 |
45 |
20 |
20 |
20 |
50 |
20 |
10 |
Plasma Protein Status Quo |
|
|
10 |
|
|
|
20 |
|
|
|
30 |
|
Raise by 0-5 gm% |
|
|
30 |
|
|
|
40 |
|
|
|
50 |
|
0.5-1.0 gm |
|
20 |
40 |
|
|
15 |
25 |
|
|
|
20 |
|
Fall of SGOT to 40 |
20 |
56 |
20 |
4 |
10 |
50 |
30 |
10 |
15 |
50 |
33 |
2 |
Fall of SGPT to 40 |
25 |
58 |
10 |
7 |
8 |
57 |
20 |
15 |
16 |
45 |
24 |
15 |
1. |
Serum Bilirubin level at the 8th week falls to 2.5 mg and less in 80% in Liv.52 group, 60% in placebo, and 70% in Prednisone groups. |
2. |
Rise of Plasma protein to 1 gm is seen in 60% of cases in Liv.52 group, 40% in placebo group and 20% in the Prednisone group (within 4 weeks). |
3. |
Fall of SGOT to 40 units and below is seen in 76% in Liv.52, 60% in placebo and 65% in Prednisone group within 2 weeks. |
4. |
Fall of SGPT to 40 units and below in 83% in Liv.52 group, 65% in placebo, 60% in Prednisone groups within 2 weeks. |
Table VIII: Improvement After Treatment (in percentage) |
|||
|
Mild |
Moderate |
Severe |
Liv.52 |
90 |
86 |
86 |
Controls |
75 |
60 |
30 |
Vitamins Prednisone |
85 |
79 |
80 |
As in many of disease conditions in children, males are more often affected than females, we do not consider any genetic predisposition for infective hepatitis.
Like any hospital group, majority are from lower economic strata.
Table III presents the symptom complex of infective hepatitis. We have graded the severity as +, ++ and +++. As expected, most of them had fever, vomiting anorexia and high coloured yellow urine; pain abdomen was not a prominent feature. 65% are brought within 5 days of appearance of symptoms of jaundice, and 30% within 10 days.
The distribution according to severity also happens to be more or less the same, even though the selection of cases on Liv.52 and placebo was strictly alternate.
In mild cases improvement with Liv.52 is 90%, improvement with Vitamins 75%, improvement with Prednisone 85%. In moderate, improvement with Liv.52 is 86%, with Vitamins 60% and with Prednisone 79%. In severe, improvement with Liv.52 is 86% with Vitamins 30% and with Prednisone 80% (assessment after 3 months).
PATHOLOGICAL RESULTS
1. |
Liver biopsy was done in 112 during the acute stage. Repeat biopsy was done in 52 after 3 months, of which 26 belonged to the Liv.52 group and 26 to the steroid and placebo group. |
2. |
Twenty-one cases belonging to the Liv.52 and 21 in control group, Liver biopsy changes were minimal. In 8 (4 of each group) they were in the subsiding phase, 2 cases (one of each group) showed progressive phase. |
CONCLUSIONS
1. |
Definite improvement in symptomatology in Liv.52 group and Prednisone group. |
2. |
Better improvement in weight in Liv.52 group compared to the placebo and prednisone. |
3. |
Restoration of Liver Function tests to normal earlier in Liv.52 group than in the Prednisone group and Vitamin Group. |
4. |
Liv.52 has not produced any side-effects while Prednisone has produced moon face in a few cases. |
5. |
Comparatively Liv.52 is more economical than Prednisone (Cost is about one third). |
ACKNOWLEDGEMENT
We are thankful to Dr. Sriramachari and Dr. T.V. Madhavan of the Pathology, New Delhi for their valuable help in the pathological study.
BIBLIOGRAPHY
1. |
Athavale V.B.: The effect of Liv.52 on food intake, Probe 6: 12, 1966. |
2. |
Chafekar V.D.: Liv.52 in Physiological Jaundice in the Neonates, Probe, 7: 85, 1968. |
3. |
Damle V.B., Desphande, K.J.: Effect of Liv.52 on underweight patients, Indian Practitioner, 19: 357, 1966. |
4. |
Sule, C.R. et al: Ascites due to Liver Deficiency created with an indigenous drug, Indian Practitioner, 9: 357, 1956. |
5. |
Vyas, K.J.: Clinical and Histopathological Evaluation of Liv.52 in cirrhosis of Liver, Probe 2: 66, 1963. |
Refference: http://www.himalayahealthcare.com/pdf_files/liv205.pdf