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.
POST-NECROTIC CIRRHOSIS - 8 CASES
Of the seven cases of post-necrotic cirrhosis included in the Liv.52-treated series there was symptomatic improvement in fever, jaundice, anaemia and oedema. The liver size showed reduction in two cases, while in one the size increased. Two cases of post-necrotic cirrhosis showed marked improvement symptomatically although there was minimum change in hepatosplenomegaly. In two of the cases the liver histopathology revealed normal structure after a follow-up of one year. Since the control series has only one case, no comparison is possible, but it is probable that with prolonged treatment there may be reversal of post-necrotic changes in the liver to the normal or near-normal pattern. Detailed studies on this condition with microphotographs are being reported separately.
INDIAN CHILDHOOD CIRRHOSIS—9 CASES
All the cases of Indian childhood cirrhosis were of moderate degree and did not show significant alteration of liver functions. However, following therapy, although the response in our cases of Indian childhood cirrhosis was unsatisfactory—and the patients showed deterioration clinically as well as biochemically—yet the duration in which the deterioration took place in these cases was more than that in the case of the control series.
MALNUTRITION - 32 CASES
Out of 32 cases of malnutrition with hepatomegaly, the cases in the trial series had an early weight gain with improvement in appetite. There was a reduction in the size of the liver in these cases. The mean values of total proteins and serum albumin showed a rise over pre-treatment values.
DISCUSSION
Liv.52, an indigenous drug combination has been reported by various laboratory and clinical workers to be of value in hepatic disorders. Pharmacological studies by Joglekar, et al (1963), Karandikar, et al (1963), Joglekar and Balwani (1967), Patel and Sadre (1963), Sheth, et al (1960), Joglekar and Leevy (1970) have repeatedly proved by various parameters the protective and regenerative action of Liv.52 against experimentally induced hepatic damage.
In their clinical studies and assessment, Dayal et al (1970), Deshpande, et al (1971), Prasad and Tripathy (1969), Prasad and Prasad (1971), Arora (1968), Mukerjee and Dasgupta (1970), Sule et al (1968) all have in different planned studied reported extremely favourable results in cases of infectious hepatitis and malnutrition; though most workers feel that in established cases of Indian childhood cirrhosis, no substance is known at present to be capable of converting interstitial tissue into cellular tissue; and, all that Liv.52 does is to prolong life for some time after which the disease marches to its fatal end.
In the present study, in 36 cases of infectious hepatitis and 32 cases of malnutrition the clinical, laboratory and histopathological response was significant as Liv.52 therapy cut short the severity, duration and the course of the disease. Liver function tests and biochemical findings tended to revert to normal earlier in the Liv.52 treated cases. Anorexia responded very favourably as there was significant improvement in appetite in the Liv.52-treated cases.
In our cases of Indian childhood cirrhosis Liv.52 delayed to some extent the progress of the disease to its inevitable end.
There was very remarkable response in our cases of post-necrotic cirrhosis. Two of the cases showed interesting changes in the histopathological picture. Probably the drug prevents further damage and necrosis in post-necrotic hepatitis and may be helpful in cases of post-necrotic cirrhosis.
Taking hepatic disorders as a whole (except established cases of Indian Childhood Cirrhosis) in the Liv.52 group there is earlier improvement in the symptoms like fever, amorexia, vomiting, jaundice, distension of abdomen. The physical signs like jaundice, anorexia, hepatomegaly regress faster.
Taking hepatic disorders as a whole there is improvement in the symptoms like fever, anorexia, vomiting, jaundice, distension of abdomen, in the cases included in the trial. The physical signs like jaundice, anaemia, hepatomegaly, distension of abdomen in these two groups of cases improved remarkably.
SUMMARY
Controlled studies on 85 cases of various hepatic disorders were carried out at the Liver Clinic, Irwin Hospital, New Delhi. There were 36 cases of infectious hepatitis, eight of post-necrotic cirrhosis, nine of Indian childhood cirrhosis and 32 of malnutrition.
In cases of infectious hepatitis, the clinical laboratory and histopathological response was significant. It cut short the duration, course and severity of the attack and showed regression of disease with remarkable improvement of appetite and toxic symptoms.
The clinical, biochemical and histopathological changes in the group with malnutrition were significant and the patients improved and gained in weight.
In cases of post-necrotic cirrhosis there was remarkable improvement with impressive results.
In nine cases of Indian childhood cirrhosis, there was some symptomatic relief, though no significant alteration of liver function or pathology.
No toxic or untoward side effects were observed in any of the cases studied.
ACKNOWLEDGEMENTS
We acknowledge the help and co-operation rendered to us by the Departments of Pathology and Biochemistry, M.A.M. College.
We are thankful to Himalaya Drug Co., for providing the facilities for research and the drug.
REFERENCES
1. Achar, S.T. Indian Journal of Child Health (1955): 6, 291.
2. Arora, J.K. ‘Role of Various Types of Treatment in Infectious Hepatitis’, Armed Forces Medical Journal (1969): 3, 362.
3. Deshpande, R.S., Sheth, S.C. and Joykutty, M.D. ‘Infectious Hepatitis — A study of 100 cases’, Current Medical Practice (1971): 6, 810.
4. Joglekar, G.V. and Balwani, J.H. ‘Allyl alcohol induced Hepatotoxicity in Rats and its Protection by Liv.52’, Journal of Experimental Medical Science (1967): 11, 7.
5. Joglekar, G.V. and Leevy, C.M. ‘Effect of Indigenous Drugs on I.C.G. (Indocyanine Green) Clearance and Autoradiographic Patterns in Albino Rats with Experimentally Induced Hepatotoxicity’, Journal of the Indian Medical Profession (1970): 12, 7480.
6. Joglekar, G.V., Chitale, G.K. and Balwani, J.H., ‘Protection of Indigenous Drugs against Hepatotoxic effects of Carbon tetrachloride in Mice’, Acta pharmacol et toxicol (1963): 20, 73.
7. Karandikar, S.M., Joglekar, G.V., Chitale, G.K. and Balwani, J.H., ‘Protection by Indigenous Drugs against Hepatotoxic effects of Carbon tetrachloride—A Long Term Study’, Acta pharmacol et toxicol (1963): 20, 274.
8. Mathur, P.S., ‘Some Clinical Observations on the use of Liv.52 (An Indigenous Drug) In Cases of Cirrhosis of Liver in Children’, Current Medical Practice (1957): 2, 107.
9. Mukerjee, A.B. and Dasgupta, M., ‘Treatment of Viral Hepatitis by an Indigenous Drug–Liv.52’, The Indian Practitioner (1970): 6, 357.
10. Patel, Jal R. and Sadre, N.L., ‘Effect of Liv.52 on Structural and Functional Damage caused by some Hepatotoxic Agents’, Probe (1963): 1, 19.
11. Prasad, Lala Surajnandan and Prasad, Kaleshwar. ‘Some Observations on Liv.52 in the Treatment of Infective Hepatitis and Cirrhosis of Liver’, Probe (1971): 3, 114.
12. Prasad, Lala Surajnandan and Tripathy, Devendra, ‘Studies with Liv.52’, Probe (1969): 1, 1.
13. Sherlock, S., Diseases of the Liver and Biliary System, Blackwell Scientific Publication, Oxford and Edinburgh, 1961.
14. Sheth, S.C., Northover, B.J., Tibrewala, N.S., Warerkar, U.R. and Karande, V.S., ‘Therapy of Cirrhosis of Liver and Liver Damage with Indigenous Drugs—Experimental and Clinical Studies’, Indian Journal of Paediatrics (1960): 149, 202.
15. Sule, C.R., Pai, V.R., Damania, R.F. and Joshi, V.S., ‘Studies with Liv.52 Therapy in Infective Hepatitis’, Journal of the Indian Medical Profession (1968): 12, 6391.
16. Sule, C.R. and Sathe, P.M.: ‘Liv.52 in the Treatment of Ascites’, Current Medical Practice (1957): 1, 42.
Refference: http://www.himalayahealthcare.com/pdf_files/liv210.pdf
Of the seven cases of post-necrotic cirrhosis included in the Liv.52-treated series there was symptomatic improvement in fever, jaundice, anaemia and oedema. The liver size showed reduction in two cases, while in one the size increased. Two cases of post-necrotic cirrhosis showed marked improvement symptomatically although there was minimum change in hepatosplenomegaly. In two of the cases the liver histopathology revealed normal structure after a follow-up of one year. Since the control series has only one case, no comparison is possible, but it is probable that with prolonged treatment there may be reversal of post-necrotic changes in the liver to the normal or near-normal pattern. Detailed studies on this condition with microphotographs are being reported separately.
INDIAN CHILDHOOD CIRRHOSIS—9 CASES
All the cases of Indian childhood cirrhosis were of moderate degree and did not show significant alteration of liver functions. However, following therapy, although the response in our cases of Indian childhood cirrhosis was unsatisfactory—and the patients showed deterioration clinically as well as biochemically—yet the duration in which the deterioration took place in these cases was more than that in the case of the control series.
MALNUTRITION - 32 CASES
Out of 32 cases of malnutrition with hepatomegaly, the cases in the trial series had an early weight gain with improvement in appetite. There was a reduction in the size of the liver in these cases. The mean values of total proteins and serum albumin showed a rise over pre-treatment values.
DISCUSSION
Liv.52, an indigenous drug combination has been reported by various laboratory and clinical workers to be of value in hepatic disorders. Pharmacological studies by Joglekar, et al (1963), Karandikar, et al (1963), Joglekar and Balwani (1967), Patel and Sadre (1963), Sheth, et al (1960), Joglekar and Leevy (1970) have repeatedly proved by various parameters the protective and regenerative action of Liv.52 against experimentally induced hepatic damage.
In their clinical studies and assessment, Dayal et al (1970), Deshpande, et al (1971), Prasad and Tripathy (1969), Prasad and Prasad (1971), Arora (1968), Mukerjee and Dasgupta (1970), Sule et al (1968) all have in different planned studied reported extremely favourable results in cases of infectious hepatitis and malnutrition; though most workers feel that in established cases of Indian childhood cirrhosis, no substance is known at present to be capable of converting interstitial tissue into cellular tissue; and, all that Liv.52 does is to prolong life for some time after which the disease marches to its fatal end.
In the present study, in 36 cases of infectious hepatitis and 32 cases of malnutrition the clinical, laboratory and histopathological response was significant as Liv.52 therapy cut short the severity, duration and the course of the disease. Liver function tests and biochemical findings tended to revert to normal earlier in the Liv.52 treated cases. Anorexia responded very favourably as there was significant improvement in appetite in the Liv.52-treated cases.
In our cases of Indian childhood cirrhosis Liv.52 delayed to some extent the progress of the disease to its inevitable end.
There was very remarkable response in our cases of post-necrotic cirrhosis. Two of the cases showed interesting changes in the histopathological picture. Probably the drug prevents further damage and necrosis in post-necrotic hepatitis and may be helpful in cases of post-necrotic cirrhosis.
Taking hepatic disorders as a whole (except established cases of Indian Childhood Cirrhosis) in the Liv.52 group there is earlier improvement in the symptoms like fever, amorexia, vomiting, jaundice, distension of abdomen. The physical signs like jaundice, anorexia, hepatomegaly regress faster.
Taking hepatic disorders as a whole there is improvement in the symptoms like fever, anorexia, vomiting, jaundice, distension of abdomen, in the cases included in the trial. The physical signs like jaundice, anaemia, hepatomegaly, distension of abdomen in these two groups of cases improved remarkably.
SUMMARY
Controlled studies on 85 cases of various hepatic disorders were carried out at the Liver Clinic, Irwin Hospital, New Delhi. There were 36 cases of infectious hepatitis, eight of post-necrotic cirrhosis, nine of Indian childhood cirrhosis and 32 of malnutrition.
In cases of infectious hepatitis, the clinical laboratory and histopathological response was significant. It cut short the duration, course and severity of the attack and showed regression of disease with remarkable improvement of appetite and toxic symptoms.
The clinical, biochemical and histopathological changes in the group with malnutrition were significant and the patients improved and gained in weight.
In cases of post-necrotic cirrhosis there was remarkable improvement with impressive results.
In nine cases of Indian childhood cirrhosis, there was some symptomatic relief, though no significant alteration of liver function or pathology.
No toxic or untoward side effects were observed in any of the cases studied.
ACKNOWLEDGEMENTS
We acknowledge the help and co-operation rendered to us by the Departments of Pathology and Biochemistry, M.A.M. College.
We are thankful to Himalaya Drug Co., for providing the facilities for research and the drug.
REFERENCES
1. Achar, S.T. Indian Journal of Child Health (1955): 6, 291.
2. Arora, J.K. ‘Role of Various Types of Treatment in Infectious Hepatitis’, Armed Forces Medical Journal (1969): 3, 362.
3. Deshpande, R.S., Sheth, S.C. and Joykutty, M.D. ‘Infectious Hepatitis — A study of 100 cases’, Current Medical Practice (1971): 6, 810.
4. Joglekar, G.V. and Balwani, J.H. ‘Allyl alcohol induced Hepatotoxicity in Rats and its Protection by Liv.52’, Journal of Experimental Medical Science (1967): 11, 7.
5. Joglekar, G.V. and Leevy, C.M. ‘Effect of Indigenous Drugs on I.C.G. (Indocyanine Green) Clearance and Autoradiographic Patterns in Albino Rats with Experimentally Induced Hepatotoxicity’, Journal of the Indian Medical Profession (1970): 12, 7480.
6. Joglekar, G.V., Chitale, G.K. and Balwani, J.H., ‘Protection of Indigenous Drugs against Hepatotoxic effects of Carbon tetrachloride in Mice’, Acta pharmacol et toxicol (1963): 20, 73.
7. Karandikar, S.M., Joglekar, G.V., Chitale, G.K. and Balwani, J.H., ‘Protection by Indigenous Drugs against Hepatotoxic effects of Carbon tetrachloride—A Long Term Study’, Acta pharmacol et toxicol (1963): 20, 274.
8. Mathur, P.S., ‘Some Clinical Observations on the use of Liv.52 (An Indigenous Drug) In Cases of Cirrhosis of Liver in Children’, Current Medical Practice (1957): 2, 107.
9. Mukerjee, A.B. and Dasgupta, M., ‘Treatment of Viral Hepatitis by an Indigenous Drug–Liv.52’, The Indian Practitioner (1970): 6, 357.
10. Patel, Jal R. and Sadre, N.L., ‘Effect of Liv.52 on Structural and Functional Damage caused by some Hepatotoxic Agents’, Probe (1963): 1, 19.
11. Prasad, Lala Surajnandan and Prasad, Kaleshwar. ‘Some Observations on Liv.52 in the Treatment of Infective Hepatitis and Cirrhosis of Liver’, Probe (1971): 3, 114.
12. Prasad, Lala Surajnandan and Tripathy, Devendra, ‘Studies with Liv.52’, Probe (1969): 1, 1.
13. Sherlock, S., Diseases of the Liver and Biliary System, Blackwell Scientific Publication, Oxford and Edinburgh, 1961.
14. Sheth, S.C., Northover, B.J., Tibrewala, N.S., Warerkar, U.R. and Karande, V.S., ‘Therapy of Cirrhosis of Liver and Liver Damage with Indigenous Drugs—Experimental and Clinical Studies’, Indian Journal of Paediatrics (1960): 149, 202.
15. Sule, C.R., Pai, V.R., Damania, R.F. and Joshi, V.S., ‘Studies with Liv.52 Therapy in Infective Hepatitis’, Journal of the Indian Medical Profession (1968): 12, 6391.
16. Sule, C.R. and Sathe, P.M.: ‘Liv.52 in the Treatment of Ascites’, Current Medical Practice (1957): 1, 42.
Refference: http://www.himalayahealthcare.com/pdf_files/liv210.pdf
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