Evecare • Vol 11 • No. 2 • Sep–Dec 2023 6 At baseline, 75% of the patients had hepatomegaly (liver size > 16 cm), and 25% of the patients did not have hepatomegaly (liver size < 16 cm). After 2 months of treatment with Liv.52 DS, only 42% of the patients had hepatomegaly, and 58% of the patients did not have hepatomegaly (Table 2). After the treatment with Liv.52 DS, the liver size significantly reduced from 17.44 ± 1.9 cm at baseline to 17.29 ± 1.77 cm at the end of month 1 (P < .0001) and further reduced to 15.87 cm at the end of month 2 (Figure). After the treatment with Liv.52 DS, the AST level reduced from 60.33 ± 13.04 IU/L at baseline to 56.43 ± 15.47 IU/L at month 1 and further reduced to 54.12 ± 17.26 IU/L at month 2, with a significance of P < .0339. The ALT level was 70.68 ± 18.49 IU/L at baseline, and it reduced to 64.13 ± 22.07 IU/L at month 1 (P < .0215) and further reduced to 61.9 ± 22.7 IU/L at month 2 (P < .0022). Hematology and biochemical investigations showed that Liv.52 DS is a safe formulation. Though high-density lipoprotein and low-density lipoprotein levels were within the normal range, the total serum cholesterol and serum triglyceride levels were borderline high at screening, and they remained the same at the end of the study. There were no clinically significant adverse events reported during the entire study period. The overall compliance to the treatment was good, with no treatment discontinuation. Discussion The hepatoprotective activity observed in this study can be attributed to the synergistic action of the bioactive ingredients of Liv.52 DS—Capparis Table 2. The Effect of Liv.52 DS on Hepatomegaly Liver Size on Ultrasonographic Screening Baseline Month 1 Month 2 No. of Subjects, n (%) No. of Subjects, n (%) No. of Subjects, n (%) Hepatomegaly, > 16 cm 45 (75) 43 (72) 25 (42) No Hepatomegaly, < 16 cm 15 (25) 17 (28) 35 (58) Figure. Effect of Liv.52 DS on Liver Size, Determined Using Ultrasonography spinosa, Cichorium intybus, Solanum nigrum, Terminalia arjuna, Cassia occidentalis, Achillea millefolium, and Tamarix gallica. C spinosa prevents elevation in the levels of malondialdehyde (plasma and hepatic) and liver enzymes (AST and ALT). C intybus suppresses the oxidative degradation of DNA in tissue debris. S nigrum protects the DNA against oxidative damage and also acts as a potent scavenger of hydroxyl and diphenyl picrylhydrazyl radicals. T arjuna reduces cholesterol levels and is also useful in liver disorders. C occidentalis modulates hepatic enzyme levels. T gallica has a beneficial effect on liver glycogen and serum proteins. Conclusion The results of this study reveal that treatment with Liv.52 DS causes a significant improvement in hepatomegaly and liver function parameters such as AST and ALT. During the study period, there was no progression of liver fibrosis due to NAFLD. The hematological and biochemical findings of this study suggest that Liv.52 DS is effective and safe in the management of NAFLD. 20 25 5 10 15 0 Liver Size, cm Baseline Month 1 Month 2 Safety and Efficacy of Liv.52 DS in Nonalcoholic Fatty Liver Disease
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