Liv.52 Therapy in Infective Hepatitis
Khetarpal, S.K., M.D., D.C.H., Professor of Paediatrics, II Unit and Veera Kumar, E., M.B.,B.S., Research Scholar, Department of Paediatrics, Medical College, Amritsar, India.
INTRODUCTION
Infective hepatitis though not one of the commonest diseases affecting children, certainly does not belong to the group of uncommon diseases. There are a few points about this disease which merit special consideration. They are:
1. Being viral in origin its treatment is not laid down in specific terms but treatment is imperative when it affects every year an appreciable percentage of the population in a country like India.
2. The most frustrating complaint in this disease is marked anorexia and the patient wants early relief from this symptom.
3. Infective hepatitis if not properly treated is likely to end in chronic active hepatitis, post-hepatitis cirrhosis, subacute necrosis and hepatic failure. The therapy of viral hepatitis assumes immense importance as death from this disease is much more common in India, due to poor standards of nutrition, than in the West, though natural clinical cure may occur with or without residual liver cell damage. Since the liver performs many functions of the body—some understood well, some not so well, and others not at all—a drug that would help in keeping the liver functioning would go a long way in solving the problem of treating infective hepatitis.
In quest of such a drug we decided to evaluate the efficacy of Liv.52, an indigenous drug which has much published data heralding its beneficial effect in liver disorders. The drug Liv.52 has been observed to have experimental and clinical evidence of powerful hepatic stimulant and choleretic actions, which markedly increase the functional efficiency of the liver. This drug is supposed to protect the hepatic parenchyma against toxic agents besides improving digestion and relieving flatulence and discomfort. (Sule et al., 1956; Murkibhavi and Sheth 1957; Sheth et al., 1960; Joglekar et al., 1963; Patel and Sadre, 1963; Karandikar et al., 1963; Captain and Syed, 1966 and Joglekar and Leevy, 1970). MATERIAL AND METHODS The present trial on Liv.52 was carried out in 49 cases of infective hepatitis.
In none of the 49 cases was there a history of ingestion of any hepatotoxic drug, pruritus, diarrhoea or clinical evidence of rash, bleeding episode, oedema, ascites and collateral veins. Detailed history pertaining to infections, blood transfusion within the past 50 to 160 days was asked and in none was there a positive history. In all the cases liver was palpable by about 3 to 5 cm. There was no evidence of liver being displaced downwards. In 41 cases liver was soft in consistency with soft edge and smooth surface. In 8 cases liver was firm in consistency. In all the cases there was hepatic tenderness. The 49 cases were divided into two groups: Group A 30 cases—they were given Liv.52 drops, B complex tablets and Vitamin C tablets. Group B 19 cases—they were given B complex and Vitamin C tablets. This group served as control. DOSAGE Dose of Liv.52 was 20 drops t.i.d. in younger age groups and one teaspoonful t.i.d. in the older age group. Diet in each group was essentially the same fat-free, rich carbohydrate diet. In this trial emphasis was laid on the following points. 1. Disappearance of nausea 2. Control of vomiting 3. Improvement of appetite 4. Disappearance of fever 5. Disappearance of jaundice 6. Disappearance of hepatic tenderness 7. Clearance of bile salts and pigments from urine 8. Normalcy of Liver function tests.
Infective hepatitis though not one of the commonest diseases affecting children, certainly does not belong to the group of uncommon diseases. There are a few points about this disease which merit special consideration. They are:
1. Being viral in origin its treatment is not laid down in specific terms but treatment is imperative when it affects every year an appreciable percentage of the population in a country like India.
2. The most frustrating complaint in this disease is marked anorexia and the patient wants early relief from this symptom.
3. Infective hepatitis if not properly treated is likely to end in chronic active hepatitis, post-hepatitis cirrhosis, subacute necrosis and hepatic failure. The therapy of viral hepatitis assumes immense importance as death from this disease is much more common in India, due to poor standards of nutrition, than in the West, though natural clinical cure may occur with or without residual liver cell damage. Since the liver performs many functions of the body—some understood well, some not so well, and others not at all—a drug that would help in keeping the liver functioning would go a long way in solving the problem of treating infective hepatitis.
In quest of such a drug we decided to evaluate the efficacy of Liv.52, an indigenous drug which has much published data heralding its beneficial effect in liver disorders. The drug Liv.52 has been observed to have experimental and clinical evidence of powerful hepatic stimulant and choleretic actions, which markedly increase the functional efficiency of the liver. This drug is supposed to protect the hepatic parenchyma against toxic agents besides improving digestion and relieving flatulence and discomfort. (Sule et al., 1956; Murkibhavi and Sheth 1957; Sheth et al., 1960; Joglekar et al., 1963; Patel and Sadre, 1963; Karandikar et al., 1963; Captain and Syed, 1966 and Joglekar and Leevy, 1970). MATERIAL AND METHODS The present trial on Liv.52 was carried out in 49 cases of infective hepatitis.
| Table I: Showing sex incidence in infective hepatitis | |
| Males | Females |
| 34 | 15 |
| Total: 49 cases Ratio: 2 : 1 (approximately) | |
In none of the 49 cases was there a history of ingestion of any hepatotoxic drug, pruritus, diarrhoea or clinical evidence of rash, bleeding episode, oedema, ascites and collateral veins. Detailed history pertaining to infections, blood transfusion within the past 50 to 160 days was asked and in none was there a positive history. In all the cases liver was palpable by about 3 to 5 cm. There was no evidence of liver being displaced downwards. In 41 cases liver was soft in consistency with soft edge and smooth surface. In 8 cases liver was firm in consistency. In all the cases there was hepatic tenderness. The 49 cases were divided into two groups: Group A 30 cases—they were given Liv.52 drops, B complex tablets and Vitamin C tablets. Group B 19 cases—they were given B complex and Vitamin C tablets. This group served as control. DOSAGE Dose of Liv.52 was 20 drops t.i.d. in younger age groups and one teaspoonful t.i.d. in the older age group. Diet in each group was essentially the same fat-free, rich carbohydrate diet. In this trial emphasis was laid on the following points. 1. Disappearance of nausea 2. Control of vomiting 3. Improvement of appetite 4. Disappearance of fever 5. Disappearance of jaundice 6. Disappearance of hepatic tenderness 7. Clearance of bile salts and pigments from urine 8. Normalcy of Liver function tests.
| Table II: Showing age distribution in infective hepatitis | |
| Age | Number of cases |
| Above 3 years to less than 5 years | 18 |
| Above 5 years to less than 8 years | 22 |
| Above 8 years to less than 10 years | 9 |
| Total | 49 |
| Table III: Presenting symptoms | ||
| 1. | Fever, jaundice and anorexia | 44 |
| 2. | Fever and anorexia — Jaundice appearing 1-3 days after the admission | 5 |
| Table IV: Showing clinical features in infective hepatitis | ||
| Sl. No. | Clinical features | No. of cases |
| 1. | Jaundice | 49 |
| 2. | Passage of yellow urine | 49 |
| 3. | Fever | 49 |
| 4. | Anorexia, nausea, vomiting | 49 |
| 5. | Clay coloured stools | 40 |
| 6. | Palmar erythema | 32 |
| 7. | Palpable splelen | 30 |
| 8. | Irritability | 30 |
| 9. | Peevishness | 30 |
10. | Lack of playfulness | 30 |
11. | Abdominal discomfort | 26 |
12. | Headache | 25 |
13. | Anaemia | 25 |
14. | Halitosis | 5 |
15. | Constipation | 3 |
Refference: http://www.himalayahealthcare.com/pdf_files/liv221.pdf
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