Therapy of Infectious Hepatitis and Other Liver Disorders
Prof. Gupta, S., F.R.C.P., M.R.C.P., D.C.H., Head of the Department of Paediatrics, Gastroenterology Unit, Maulana Azad Medical College, New Delhi-1. Khatri, R.L., D.C.H., Resident Medical Officer, Paediatrics. Srivastava, G., M.D., Paediatrician.
INTRODUCTION
Hepatic disorders in infancy and childhood continue to pose problems in regard to their management. Even though the aetiological factors are many and some of them ill-understood today, the manifestation is the same - that of hepatic insufficiency. Since 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 hepatic disorders.
Liv.52 is an indigenous drug which has shown in the recent past to have some protective action against hepatotoxic substances like carbon-tetrachloride. It stimulates the cellular growth in the liver in the presence of hepatotoxic or necrotic substances and also promotes the metabolic functions of the liver (Joglekar, et al., 1963 and Karandikar, et al., 1963).
Liv.52 contains extracts of Capparis spinosa, Cichorium intybus, Solanum nigrum, cassia occidentalis, Terminalia arjuna, Achillea millefolium and Tamarix gallica, prepared in the juice and decoctions of various hepatic stimulants.
The drug has been used clinically in different hepatic disorders for the last ten years with beneficial effect (Sule, et al., 1957; 1968). It has been tried in cases suffering from diffuse hepatic fibrosis, portal hypertension (Mathur, 1957), acute hepatic toxicity (Patel, et al., 1963) and acute infectious hepatitis (Arora, 1969; Deshpande, et al., 1971). Since Liv.52 has been reported to be useful in the above-mentioned conditions the present study was undertaken to study the efficacy of this drug in various hepatic disorders affecting infants and children.
MATERIAL AND METHODS
The drug Liv.52 was tried on cases with the following diagnosis:
(1) Infectious hepatitis and subacute hepatitis
(2) Post-necrotic cirrhosis
(3) Cirrhosis liver and
(4) Malnutrition with hepatomegaly.
The criteria of diagnosis were based on the established clinical manifestations and biochemical data of these diseases and liver biopsy, wherever possible. In all 85 cases were taken up for study. Out of a total of 85 cases, 55 cases were studied with the drug and 30 served as control. Controls were selected as far as possible from the same age group and with similar clinical manifestations. A detailed history and physical examination were recorded in each case in a prepared proforma.
The following investigations were done in each case:
(a) Urine examination for bile salts and pigments and urobilinogen in addition to the routine examination;
(b) Haemogram;
(c) Liver function tests;
(d) Liver biopsy, wherever possible;
(e) Radiological examination wherever thought necessary and
(f) Any other investigation indicated.
All the cases attended the paediatric service of the Irwin Hospital, New Delhi and were subsequently followed up at the Liver Clinic of the Department.
Irrespective of the clinical diagnosis all patients, except in the infectious hepatitis group, were put on the following regimen:
Upto Liv.52 or Twice a day
2 years 1 tablet or 10 drops Three times a day
2-5 years 1 tablet Three times a day
Above 5 years 1 tablet Four times a day
In infectious hepatitis patients, 50 percent or even higher doses were used depending on the severity of the disease.
Each patient was followed up regularly in the liver clinic of the Department of Paediatrics at intervals of 15 days/one month. History of main symptoms and physical examination was recorded at every visit.
Distribution of cases |
Drug treated |
Control |
Total |
Infectious hepatitis |
27 |
9 |
36 |
Post-necrotic cirrhosis |
7 |
1 |
8 |
Indian childhood cirrhosis |
5 |
4 |
9 |
Malnutrition |
16 |
16 |
32 |
Total |
55 |
30 |
85 |
Refference: http://www.himalayahealthcare.com/pdf_files/liv210.pdf
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