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Mitra, D.K., Reader in Medicine, Ashrafuddin, S., Lecturer in Medicine, and Talib, S.H., Registrar in Infectious Diseases, Department of Medicine, Medical College, Aurangabad, India.
During their stay in the hospital bleeding and clotting time and biochemical tests were done biweekly. In cases of precoma and coma, bleeding time, clotting time and Prothrombin time were done daily. Cases were discharged on the following biochemical criteria: 1. Serum bilirubin less than 4 mg%. 2. S.G.O.T. below 50 units. 3. Prothrombin time showing normal values.
The results of this study were compared with the retrospective analysis of an earlier trial on 50 patients treated with corticosteroids and supportive therapy. Criteria for selection in these cases were similar as in the current study. All these patients had received corticosteroids (Prednisolone 30-40 mg. a day or beta-methasone 4-8 mg. six hourly initially and later tapered off).
OBSERVATIONS
In the uncomplicated cases the rate of recovery in all the three groups was more or less the same till the patients left the hospital (Table 2A). However, results in the group with complications showed remarkably significant difference in the survival rate in the Liv.52 treated group (Tables 5 and 6).
Liv.52 in Viral Hepatitis with Special Reference to its use in Precoma and Coma
Mitra, D.K., Reader in Medicine, Ashrafuddin, S., Lecturer in Medicine, and Talib, S.H., Registrar in Infectious Diseases, Department of Medicine, Medical College, Aurangabad, India.
During their stay in the hospital bleeding and clotting time and biochemical tests were done biweekly. In cases of precoma and coma, bleeding time, clotting time and Prothrombin time were done daily. Cases were discharged on the following biochemical criteria: 1. Serum bilirubin less than 4 mg%. 2. S.G.O.T. below 50 units. 3. Prothrombin time showing normal values.
The results of this study were compared with the retrospective analysis of an earlier trial on 50 patients treated with corticosteroids and supportive therapy. Criteria for selection in these cases were similar as in the current study. All these patients had received corticosteroids (Prednisolone 30-40 mg. a day or beta-methasone 4-8 mg. six hourly initially and later tapered off).
| Table 1: Table showing sex distribution in the control and trial groups | |||
| Sex | Control group on standard supportive therapy without Liv.52 | Trial group on standard supportive therapy plus Liv.52 | Group on corticosteroids |
| Male | 30 | 33 | 38 |
| Female | 20 | 17 | 12 |
| Total No. of cases | 50 | 50 | 50 |
OBSERVATIONS
| Table 2: Table showing incidence of various symptoms encountered in 100 cases of viral hepatitis | ||
| Sl. No. | Symptoms | No. of cases |
| 1. | Loss of appetite | 80 |
| 2. | Yellowness of urine | 100 |
| 3. | Yellowness of eye | 100 |
| 4. | Fever | 21 |
| 5. | Easy fatiguability | 45 |
| 6. | Nausea | 60 |
| 7. | Vomiting | 43 |
| 8. | Abdominal discomfort | 65 |
| 9. | Itching | 23 |
| 10. | Oedema feet | 13 |
| 11. | Disturbances of consciousness | 29 |
| 12. | Bleeding diathesis | 24 |
In the uncomplicated cases the rate of recovery in all the three groups was more or less the same till the patients left the hospital (Table 2A). However, results in the group with complications showed remarkably significant difference in the survival rate in the Liv.52 treated group (Tables 5 and 6).
| Table 2A: Table showing the mean biochemical findings in uncomplicated cases of infective hepatitis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Normal prothrombin time is 18-22 seconds. There is no statistical difference in the biochemical recovery as analysed by ‘t’ test. + Values of P.T. in corticosteroid group were not available hence not analysed. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Table 3: Table showing the mean biochemical findings in complicated cases of infective hepatitis in three groups | |||||||
| Trial group on Liv.52 Uncomplicated cases | Control group without Liv.52 Uncomplicated cases | Corticosteroids group Uncomplicated cases | |||||
| Sl. No. | Biochemical investigation | O/A Mean+SD | O/DMean+SD | O/AMean+SD | O/B Mean+SD | O/A Mean+SD | O/BMean+SD |
| 1. | Serum bilirubin (mg%) | 12.08 ±3.62 | 3.25±1.73 | 12.216±1.935 | - | 12.264 ±2.811 | 4.26±2.09 |
| 2. | SGOT (Units/ml) | 128.25 ±41.44 | 31.15±11.46 | 118.75±30.837 | - | 119.65 ±22.96 | 40.43±9.47 |
| 3. | Prothrombin time (Sec.) | 142.533 ±133.257 | 21.6 | 100.750±120.624 | - | - | - |
| Normal prothrombin time is 18-22 secs. Since all the patients with complications expired in the control group within a short period, subsequent biochemical values could not be assessed. | |||||||
| Table 4: Table showing incidence of infective hepatitis in cases associated with pregnancy and relative incidence of precoma/coma in the same group | |||||||||||||||||||||||||||||||||||
| Sl. No. | Type of cases | No. of cases studied | Cases showing precoma and coma | Cases of improvement from percoma and coma | Remarks | ||||||||||||||||||||||||||||||
| No. | % | No. | % | ||||||||||||||||||||||||||||||||
| 1. | Pregnant antenatal-post-natal patients | 29 | 15 | 51.7 | 7 | 46.6 | All the 11 cases which showed improvement | ||||||||||||||||||||||||||||
| 2. | Cases not associated with pregnancy | 71 | 12 | 16.9 | 4 | 33.3 | Belonged to the trial group on Liv.52. | ||||||||||||||||||||||||||||
| 3. | Total no. of cases | 100 | 27 | 11 | 40.7 | ||||||||||||||||||||||||||||||
| This table indicates that the incidence of precoma and coma in cases of viral hepatitis associated with pregnancy is quite high (51.7%). | |||||||||||||||||||||||||||||||||||
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