Liv.52 Therapy in Viral Hepatitis
Patel, G.T., M.D., Mruthyunjayanna, B.P., M.D., Seetharam, T.D., M.B.,B.S. and Channe Gowda, A.C., M.B.,B.S., Medicine Unit, Victoria Hospital and Bangalore Medical College, Bangalore, India.
Viral hepatitis as observed in our country is frequently of prolonged duration with a predisposition to complications like post-hepatitis cirrhosis, chronic cholestasis, subacute necrosis and hepatic failure. Rarely the disease is fulminant and death ensues in the acute phase. Such cases are commonly those in whom a superimposed nutritional factor increases the susceptibility of the liver cells to necrosis due to direct deficiency in persons taking a poor diet lacking in animal protein, as it occurs commonly in Asia and Africa (Davidson, 1968).
The therapy of viral hepatitis assumes immense importance as death from this disease is much more common in India due to the poor standard of nutrition than it is in the West, though natural clinical cure may occur with or without residual liver cell damage. Hence the problem of therapy of viral hepatitis demands an ideal drug with the essential requisites of quicker recovery and convalescence without residual liver cell damage. In quest of such a drug we were prompted to undertake a study to evaluate the efficacy of Liv.52, an indigenous drug which has been widely used for more than a decade and has much published data heralding its beneficial effect in liver disorders.
REVIEW OF LITERATURE
A series of long-term experimental studies carried out by various workers substantiate the protective and regenerative action of Liv.52 on liver against a battery of hepatotoxins (Murkibhavi and Sheth, 1957; Sheth et al, 1960; Joglekar et al., Patel et al., Karandikar et al., 1963; Qazi, 1965; Captain and Syed, 1966). Joglekar and Leevy (1970) confirmed this effect in albino rats by using the latest methods — Indocyanine Green clearance and Autoradiographic patterns. Srinivasan and Balwani (1968) noted the growth-promoting effect of Liv.52 in rats, mice and guinea pigs.
Clinically, Liv.52 has been tried extensively by various workers in cirrhosis of the liver and infective hepatitis. By using different parameters of liver function tests, these workers have consistently confirmed that Liv.52 accelerates the clinical and biochemical recovery, (Sule et al, 1956; 1957; Patrao, 1957; Sheth et al, 1960; Menon and Ravindran, 1966; Jaffari and Shyamaraj, 1969; Arora, 1969). Liv.52 has been found to be beneficial in infantile cirrhosis (Mathur, 1957; Vyas, 1960; 1963; Paulose, 1963; Sheth, 1968). Prasad et al, (1969; 1971) and Dayal et al, (1971) observed remarkable improvement in cases of viral hepatitis and malnutrition after Liv.52 therapy. Liv.52 has been found to be a good anabolic agent (Damle and Deshpande, 1966; Kale et al, 1966; Sheth, 1968; Mathur, 1969; Kulkarni and Joglekar, 1970). Mukerjee and Dasgupta (1971) observed that in viral hepatitis Liv.52 improved the bodyweight, reduced the period of illness and residual liver damage.
PHARMACOLOGY AND COMPOSITION
Liv.52 (Himalaya Drug Co. Private Ltd.) is a herbal proportion and is found to have anabolic, aperient, diuretic, stomachic effects with protective and regenerative action on liver. The drug is claimed to be non-toxic in doses upto ten times the therapeutic dose. Each tablet has processed extracts of various plants in varying proportions, namely:
MATERIAL AND METHODS
Fifty two cases of viral hepatitis (including three cases of post-transfusion hepatitis and one case of syringe hepatitis) were randomised into two groups, A and B. Of these, 25 cases receiving antibiotics and steroids acted as a control, Group A. The other 27 cases receiving only Liv.52 (two tablets thrice daily) were included in Group B for a schematic comparison with the control group.
Table I, shows the incidence and age and sex in the present study of 52 cases.
Table II, shows the symptomatology of viral hepatitis observed in the 52 cases studied.
Detailed history taking and clinical examination in respect of each case was done. Liver function tests (including Serum bilirubin, SGPT, SGOT, Serum alkaline transaminase and thymol turbidity), ESR, weight recording and urine examination were carried out in each case and repeated after 14 days of treatment. Needle biopsy of the liver was done in some cases before and after the treatment.
OBSERVATION AND RESULTS
(a) Jaundice: All the patients had jaundice at the time of admission. In control group (A) four cases had deep jaundice of which two cases were restless and the other two cases were pre-comatose.
(b) Loss of Appetite: Appetite improved on an average of nine days in control group (A) and five days in group B.
(c) Loss of weight: In group A (control), marked loss of weight occurred in all the 25 cases with an average loss of 4.1 kg. as against 1.6 kg. in group B (Liv.52). In group B, loss of weight occurred in 16 out of 27 cases, in two cases bodyweight remained fairly constant and in 9 cases (33.3%) an average gain of 1.1 kg. was recorded.
(d) Abdominal Pain: Relief of pain was noticed after an average duration of 5 days in group A, as against 3 days in group B.
(e) Nausea and Vomiting: Nausea was relieved in an average duration of four days in group A as against three days in group B, and vomiting stopped within three days in group A as against two days in group B.
(f) Constipation: In control group (A), constipation was present in 10 out of 25 cases and needed mild laxatives or enemata. In group B, constipation was present in 7 out of 27 cases and bowel regularisation resulted within 4 days of Liv.52 therapy, without any recourse to laxatives or enemata.
(g) Pruritus: In group A, pruritus continued upto six days and required antihistaminics to alleviate itching. In group B, with Liv.52 therapy remarkable relief of itching resulted within two days.
Refference: http://www.himalayahealthcare.com/pdf_files/liv209.pdf
The therapy of viral hepatitis assumes immense importance as death from this disease is much more common in India due to the poor standard of nutrition than it is in the West, though natural clinical cure may occur with or without residual liver cell damage. Hence the problem of therapy of viral hepatitis demands an ideal drug with the essential requisites of quicker recovery and convalescence without residual liver cell damage. In quest of such a drug we were prompted to undertake a study to evaluate the efficacy of Liv.52, an indigenous drug which has been widely used for more than a decade and has much published data heralding its beneficial effect in liver disorders.
REVIEW OF LITERATURE
A series of long-term experimental studies carried out by various workers substantiate the protective and regenerative action of Liv.52 on liver against a battery of hepatotoxins (Murkibhavi and Sheth, 1957; Sheth et al, 1960; Joglekar et al., Patel et al., Karandikar et al., 1963; Qazi, 1965; Captain and Syed, 1966). Joglekar and Leevy (1970) confirmed this effect in albino rats by using the latest methods — Indocyanine Green clearance and Autoradiographic patterns. Srinivasan and Balwani (1968) noted the growth-promoting effect of Liv.52 in rats, mice and guinea pigs.
Clinically, Liv.52 has been tried extensively by various workers in cirrhosis of the liver and infective hepatitis. By using different parameters of liver function tests, these workers have consistently confirmed that Liv.52 accelerates the clinical and biochemical recovery, (Sule et al, 1956; 1957; Patrao, 1957; Sheth et al, 1960; Menon and Ravindran, 1966; Jaffari and Shyamaraj, 1969; Arora, 1969). Liv.52 has been found to be beneficial in infantile cirrhosis (Mathur, 1957; Vyas, 1960; 1963; Paulose, 1963; Sheth, 1968). Prasad et al, (1969; 1971) and Dayal et al, (1971) observed remarkable improvement in cases of viral hepatitis and malnutrition after Liv.52 therapy. Liv.52 has been found to be a good anabolic agent (Damle and Deshpande, 1966; Kale et al, 1966; Sheth, 1968; Mathur, 1969; Kulkarni and Joglekar, 1970). Mukerjee and Dasgupta (1971) observed that in viral hepatitis Liv.52 improved the bodyweight, reduced the period of illness and residual liver damage.
PHARMACOLOGY AND COMPOSITION
Liv.52 (Himalaya Drug Co. Private Ltd.) is a herbal proportion and is found to have anabolic, aperient, diuretic, stomachic effects with protective and regenerative action on liver. The drug is claimed to be non-toxic in doses upto ten times the therapeutic dose. Each tablet has processed extracts of various plants in varying proportions, namely:
Capparis spinosa |
23% |
Cichorium intybus |
23% |
Solanum nigrum |
12% |
Cassia occidentalis |
6% |
Terminalia arjuna |
12% |
Achillea millefolium |
6% |
Tamarix gallica |
6% |
Mandur bhasma |
12% |
MATERIAL AND METHODS
Fifty two cases of viral hepatitis (including three cases of post-transfusion hepatitis and one case of syringe hepatitis) were randomised into two groups, A and B. Of these, 25 cases receiving antibiotics and steroids acted as a control, Group A. The other 27 cases receiving only Liv.52 (two tablets thrice daily) were included in Group B for a schematic comparison with the control group.
Table I, shows the incidence and age and sex in the present study of 52 cases.
Table I: Age groups |
|||||||||
11-20 years |
21-30 years |
31-40 years |
41-50 years |
51-60 years |
|||||
16 |
20 |
9 |
5 |
2 |
|||||
M |
F |
M |
F |
M |
F |
M |
F |
M |
F |
10 |
6 |
13 |
7 |
6 |
3 |
4 |
1 |
1 |
1 |
Table II, shows the symptomatology of viral hepatitis observed in the 52 cases studied.
Table II |
||||||
Symptoms |
Total no. of cases |
Group A |
|
Group B |
Incidence |
|
1. |
Jaundice |
All cases |
(25 |
+ |
27) |
100.0 |
2. |
Loss of appetite |
45 |
(24 |
+ |
21) |
85.4 |
3. |
Loss of weight |
41 |
(25 |
+ |
16) |
78.7 |
4. |
Abdominal pain |
20 |
(11 |
+ |
9) |
38.4 |
5. |
Constipation |
17 |
(10 |
+ |
7) |
32.6 |
6. |
Nausea |
13 |
(8 |
+ |
5) |
25.0 |
7. |
Vomiting |
9 |
(6 |
+ |
3) |
17.3 |
8. |
Fever |
8 |
(4 |
+ |
4) |
15.4 |
9. |
Malaise |
8 |
(5 |
+ |
3) |
15.4 |
10. |
Pruritus |
7 |
(3 |
+ |
4) |
13.4 |
11. |
Diarrhoea |
5 |
(3 |
+ |
2) |
9.6 |
12. |
Cough |
4 |
(2 |
+ |
2) |
7.7 |
13. |
Bleeding |
3 |
(2 |
+ |
1) |
5.8 |
14. |
Hiccup |
2 |
(1 |
+ |
1) |
3.8 |
15. |
Restlessness |
2 |
(2 |
+ |
Nil) |
3.8 |
16. |
Comatose state |
2 |
(2 |
+ |
Nil) |
3.8 |
17. |
Arthralgia |
1 |
(Nil |
+ |
1) |
1.9 |
Detailed history taking and clinical examination in respect of each case was done. Liver function tests (including Serum bilirubin, SGPT, SGOT, Serum alkaline transaminase and thymol turbidity), ESR, weight recording and urine examination were carried out in each case and repeated after 14 days of treatment. Needle biopsy of the liver was done in some cases before and after the treatment.
OBSERVATION AND RESULTS
(a) Jaundice: All the patients had jaundice at the time of admission. In control group (A) four cases had deep jaundice of which two cases were restless and the other two cases were pre-comatose.
(b) Loss of Appetite: Appetite improved on an average of nine days in control group (A) and five days in group B.
(c) Loss of weight: In group A (control), marked loss of weight occurred in all the 25 cases with an average loss of 4.1 kg. as against 1.6 kg. in group B (Liv.52). In group B, loss of weight occurred in 16 out of 27 cases, in two cases bodyweight remained fairly constant and in 9 cases (33.3%) an average gain of 1.1 kg. was recorded.
(d) Abdominal Pain: Relief of pain was noticed after an average duration of 5 days in group A, as against 3 days in group B.
(e) Nausea and Vomiting: Nausea was relieved in an average duration of four days in group A as against three days in group B, and vomiting stopped within three days in group A as against two days in group B.
(f) Constipation: In control group (A), constipation was present in 10 out of 25 cases and needed mild laxatives or enemata. In group B, constipation was present in 7 out of 27 cases and bowel regularisation resulted within 4 days of Liv.52 therapy, without any recourse to laxatives or enemata.
(g) Pruritus: In group A, pruritus continued upto six days and required antihistaminics to alleviate itching. In group B, with Liv.52 therapy remarkable relief of itching resulted within two days.
Refference: http://www.himalayahealthcare.com/pdf_files/liv209.pdf
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