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An open-label prospective noncomparative study was conducted to examine the efficacy and safety of Beliv tablet, a polyherbal Ayurvedic medicine, in 30 adult patients suffering from liver disorders. Two tablets were administered daily for 56 days. Patients were evaluated at Day 0, Day 21, Day 42 and at Day 56. The primary end point of the study was a change in liver function test parameters measured by the levels of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT) and total bilirubin at all assessment points. Results showed a significant reduction in the serum levels of SGOT, SGPT and total bilirubin from baseline to 21 days, 42 days and 56 days. The total icterus symptom score was also significantly reduced from 5.17 ± 2.26 (baseline) to 2.6 ± 1.48, 1.37 ± 1.13 and 0.77 ± 0.73 at Days 21, 42 and 56, respectively. The Subjective Global Assessment (SGA) decreased significantly from 3.33 ± 1.16 (Day 21) to 2.33 ± 1.16 and 1.80 ± 0.76 at Days 42 and 56, respectively. The Physician Global Assessment (PGA) score was also significantly reduced from 3.0 ± 1.02 (Day 21) to 2.07 ± 0.83 and 1.70 ± 0.79 at Days 42 and 56, respectively. A significant reduction in serum creatinine level was observed at Day 56. No adverse effects or serious adverse effects were observed during the study period. The study concluded that Beliv tablet was highly effective for the treatment of liver disorders, as evidenced by the reduction in serum levels of SGOT, SGPT, total bilirubin, icterus symptoms and PGA and SGA scores. No treatment-related side effects were reported by any of the study participants suggesting that it was safe for clinical use in humans for the treatment of liver disorders.
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It is very crucial to know the physicochemical properties of drugs during the development of pharmaceutical products. Drugs are on compulsion to assess their compatibility of active substances, excipients and medicinal products with established standards by the pharmaceutical laws. Characterization of these active pharmaceutical ingredients (APIs) helps in improving the quality parameters of all raw materials used during the manufacturing process of pharmaceuticals and also in the final products. Maintaining quality standards of the drugs is the need of the hour in this era of increasing demand for indigenous medicines. Due to the absence of reference standards, standardisation of many of compound formulations is lagging behind. Ayurveda is one of the oldest medical science that has been serving the community since centuries. Arogyavardhini vati is one of the most important Ayurvedic formulation that is advised by the Ayurvedic scholars for liver disorders since centuries. Although, being administered by a vast community of Ayurvedic practitioners and from a very long period with multiple benefits, there were no many studies that are available on the physicochemical analysis and standardization of Arogyavardhini vati. Present study evaluated the physicochemical properties of Arogyavardhini vati and standardized. Arogyavardhini vati prepared by the Ayurvedic classical method complies with the standard parameters as mentioned in Ayurvedic Pharmacopeia of India. Present study observed that the analytical parameters and the pharmaceutical parameters for Arogyavardhini Vati were validated by HPTLC method and can be considered as the standard drug.
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Background: Pregnancy is a physiological condition in which various changes occur in pregnant women just to accommodate growing fetus. Pregnancy is a stress test for woman and may unmask certain underlying chronic diseases like, DM, hypertension which were silent or asymptomatic prior to pregnancy. This study was done to know the incidence, type and demographic profile of medical disorders in pregnancy among in patient at a tertiary care hospital.Methods: It was a retrospective study conducted on 578 patients of medical disorders in pregnancy admitted in a tertiary care hospital from January 2017 to December 2017. Data collected from record room and analysis done.Results: Total antenatal admissions were 4721. Incidence of medical disorders was 12.24%. Majority of women were in age group 20-30 years (65.5%). Low-parity (P0, P1). Hypertensive disorders in pregnancy was commonest reported disorder (42.3%), followed by hematological disorder (38.7%), liver disorder 5%, endocrine disorder 4.8%, epilepsy 3.8% and HIV 2.6% in present study.Conclusions: Hypertensive disorders were commonest medical disorder followed by hematological, liver, endocrine and epilepsy. All medical disorders in pregnancy to be managed by team approach.
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Introduction: Skin is the first barrier against any externalagent and a reflection of any deviation in the internal milieu.Any systemic disorder or organ dysfunction can leaveits imprints on the skin and so also the liver certainly hascutaneous manifestations in case of any disorder affecting it.Study objective was to investigate the spectrum of cutaneousmanifestations of various liver disorders and liver diseasespecific association.Material and methods: A total of 220 patients with primaryliver disorders were taken up for the study after proper ethicalclearance. A detailed clinical history was taken from thepatients regarding liver disorder and cutaneous symptoms. Athorough clinical examination was done and all specific andnonspecific cutaneous manifestations were recorded.Results: Out of 220 patients, 135(61.3%) were males and85(38.6%) were females with a male preponderance. Amongthe various liver disorders, most commonly seen was alcoholicliver disease seen in 84(38%) patients, nonalcoholic fatty liverdisease (NAFLD) and nonalcoholic steatohepatitis(NASH)in 51(23.2%) patients, cirrhosis in 35(16%) patients. Themost common cutaneous manifestation seen was icterus in190(86.3%) patients, pruritus in 178(80.9%) patients, xerosisin 112(51%) patients.Conclusion: The knowledge of the cutaneous manifestationsin liver disorders can be of great help as many liver disorderscan easily be detected at their incipient stage. This study wasdone to assess the spectrum of cutaneous manifestations inliver disorders and a significant observation made was liverdisease wise specific evaluation of cutaneous manifestationsthus providing better insight into the type of liver diseases.
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Background: Liver plays an important role in regulation of blood glucose in fed state as well as in fasting. Diabetes mellitus can result as a consequence of liver disorder and vice versa. Objective of the present study is to compare the liver enzymes in type 2 diabetic patients as compared to non-diabetic patients.Methods: A case- control study was conducted in Clinical Biochemistry Laboratory, Adarsha Super speciality Hospital, Udupi from April 2018 to August 2018. The data of 174 diabetic patients and 118 healthy people as controls was collected. Fasting blood glucose, aspartate aminotransferase (AST), alanine amino transferase (ALT) and alkaline phosphatase (ALP) were estimated in the study subjects.Results: It was found that AST levels (47.55±4.69U/L) in diabetics extremely significantly high as compared to controls (33.51±2.33U/L). ALT levels were insignificantly high in diabetics compared to controls. ALP was significantly elevated (p=0.0002) in diabetics. Correlation study showed a weak positive correlation between AST, ALT and blood glucose. Odds ratio showed a higher risk of liver enzyme elevation in diabetics. Risk of elevation of AST was found to be 1.65 times high and ALT was 1.25 times high in diabetics compared to non-diabetics.Conclusions: Diabetics had high liver enzymes as compared to non-diabetics. An association was found between type 2 diabetes mellitus and liver enzymes. For better characterization of cause and effect, further studies need to be done on alterations in liver function tests along with the histopathological analysis of liver biopsy samples.
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Background: Non-alcoholic steatohepatitis (NASH) is commonly associated with type 2 diabetes mellitus (DM). Prevalence of NASH in type 2 DM has not been well studied and there is an epidemic rise in type 2 DM in Asian and Western populations. Its association with chronic liver disease in the form of NASH makes it an important health problem. Hence, we have studied its prevalence and correlation of biochemical parameters with histological grades of non-alcoholic fatty liver disease (NAFLD) in otherwise asymptomatic type 2 DM patients. Materials & Methods: One hundred and twenty-five individuals were screened. N=30 individuals were excluded due to history of alcohol intake or liver disease as a result of other causes. N=95 non-alcoholic individuals with type 2 DM underwent abdominal ultrasonography (US abdomen). N=28 patients had evidence of fatty liver on US abdomen, and 16 of these 28 patients underwent liver biopsy. Results: Out of 125 patients enrolled with the suspicion of Nonalcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic steatohepatitis in patients of Type 2 Diabetes Mellitus, female patients were 70 (56%) and male patients 55 (44%). The prevalence of NAFLD was found to be more in females n=40 than males n=30. N=16 patients were undergone liver biopsy for the suspicion NASH. Out of 22 patients suspected, only 9 patients were found to be having NASH. Conclusion: We conclude that the prevalence of NASH is high in type 2 DM patients and liver biopsy is the only investigation to differentiate between non-alcoholic fatty liver and steatohepatitis.
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Background: HBV is exceptionally irresistible that even moment hints of tainted blood as meager as 0.0001 ml can transmit disease. A few of the standard remedial, demonstrative, prophylactic intrusive techniques can spread HBV disease. Therefore, this study was conducted to know the prevalence of hepatitis B surface antigen in voluntary blood donors, health care workers (medical and paramedical personnel) and patients with liver disorders. Methods: Present study was hospital based cross sectional study carried out among 60 subjects during a period of one year in Geetanjali Medical College & Hospital, Udaipur, Rajasthan. These 60 subjects consisted of 20 patients with liver disorder, 20 health care workers and 20 voluntary blood donors. Subjects were selected randomly. After obtaining informed consent, detailed history and examination was carried out. The blood samples were collected and sent for detection of HBsAg by ELISA. Results: Maximum subjects 31 (51.7%) belonged to the age group of 21-30 years overall as well as among the voluntary blood donors i.e. 60%. Among voluntary blood donors, 96% were males. 60% belonged to urban areas. Among rural subjects, maximum (54.2%) were having liver disorders. Liver disorder was more common (66.7%) among heterosexual high risk behavior subjects compared to only 22.8% with no high risk behavior. Seropositivity was found highest among patients with liver disorder (65%) followed by among health care workers (15%). Seropositivity was nil among voluntary blood donors. Overall the seropositivity was 26.7%. Conclusions: Patients with liver disorders especially chronic hepatitis were mostly seropositive. Among health care workers, being a doctor was an important risk factor for acquiring hepatitis B infection. Hence all health care workers should be immunized for hepatitis B.
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Background & objectives: There are only a few studies on aetiology of portal hypertension among adults presenting to tertiary care centres in India; hence we conducted this study to assess the aetiological reasons for portal hypertension in adult patients attending a tertiary care centre in southern India. Methods: Causes of portal hypertension were studied in consecutive new adult patients with portal hypertension attending department of Hepatatology at a tertiary care centre in south India during July 2009 to July 2010. Results: A total of 583 adult patients (>18 yr old) were enrolled in the study. After non-invasive testing, commonest causes of portal hypertension were cryptogenic chronic liver disease (35%), chronic liver disease due to alcohol (29%), hepatitis B (17%) or hepatitis C (9%). Of the 203 patients with cryptogenic chronic liver disease, 39 had liver biopsy - amongst the latter, idiopathic non cirrhotic intrahepatic portal hypertension (NCIPH) was seen in 16 patients (41%), while five patients had cirrhosis due to non alcoholic fatty liver disease. Fifty six (10%) adult patients with portal hypertension had vascular liver disorders. Predominant causes of portal hypertension in elderly (>60 yrs; n=83) were cryptogenic chronic liver disease (54%) and alcohol related chronic liver disease (16%). Interpretation & conclusions: Cryptogenic chronic liver disease was the commonest cause of portal hypertension in adults, followed by alcohol or hepatitis B related chronic liver disease. Of patients with cryptogenic chronic liver disease who had liver biopsy, NCIPH was the commonest cause identified. Vascular liver disorders caused portal hypertension in 10 per cent of adult patients. Cryptogenic chronic liver disease was also the commonest cause in elderly patients.