10 | Himalaya Livline | Vol 6 | No. 4 | May–Aug 2023 expert comments Liv.52® (DROPS, SYRUP, TABLET, DS SYRUP, DS TABLET) Unparalleled in liver care Dosage Acute viral hepatitis Drops: 5 to 10 Drops TID (infants); 10 to 20 Drops TID (children) Syrup: 5 mL TID (children); 10 mL TID (adults) Tablet: 1 Tablet TID (children); 2 Tablets TID (adults) Syrup: 5 mL BID/TID (children); 10 mL BID/TID (adults) Tablet: 1 Tablet TID (children); 2 Tablets TID (adults) Drug-induced hepatitis DS Syrup/DS Tablet: 1 to 2 Teaspoonsful/Tablets BID with anti-TB/ Alcohol-induced liver damage Syrup: 10 to 15 mL TID Tablet: 2 to 3 Tablets TID Anorexia and suboptimal growth Drops: 5 to 10 Drops TID (infants); 10 to 20 Drops TID (children) Liv.52 is a hepatospecific formulation, designed for the treatment and management of liver disorders. An InterviewWith Dr Sarva Jeet Singh Doctor, how do lipids/fats accumulate in the liver? How does this lead to fatty liver? Fats can accumulate in the liver due to various reasons. Increased delivery of free fatty acids to the liver, increased synthesis of fatty acids in the liver, decreased oxidation of free fatty acids, or decreased assembly of very low-density lipoproteins leading to triglyceride accumulation are regarded as the primary factors that lead to fat accumulation in the liver. This impaired metabolism of lipids in the liver triggers oxidative stress, activation of stellate cells, and hepatocyte inflammation, resulting in fatty liver. Doctor, what are the most common signs and symptoms of fatty liver? Fatty liver is usually an incidental finding during other imaging analyses. Some patients with nonalcoholic fatty liver disease (NAFLD) present with thirst, bloating, fluctuations in body temperature, sleep disturbances, and anxiety. In progressed stages, a sharp or dull pain in the abdomen, in the right upper quadrant, is also reported. Doctor, what are the health complications associated with NAFLD? NAFLD is one of the most underdiagnosed liver conditions. Without timely diagnosis and management, NAFLD can result in long-term complications including hypertension, coronary artery disease, arrhythmia, chronic kidney disease, and extrahepatic malignancies. The chronic inflammatory state of NAFLD also contributes to the development and progression of cirrhosis and liver fibrosis. Doctor, what are the risk factors for NAFLD? NAFLD can stem from a wide range of factors. The most relevant factors include unhealthy dietary habits such as eating processed foods, nutrientdeficit foods, and high-sodium and high-fat foods, low physical activity and increased sitting time, presence of chronic metabolic abnormalities such as glycogen storage disorders and homocystinuria, and genetic polymorphisms that lead to impaired lipid metabolism. Doctor, how commonly does NAFLD progress further? NAFLD that coexists with other liver diseases such as hepatitis C, hemochromatosis, and alcoholic liver disease has shown to have more rapid disease progression. Approximately 10% to 30% of the patients with NAFLD could develop nonalcoholic
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