Himalaya Livline | Vol 6 | No. 4 | May–Aug 2023 | 5 such as Capparis spinosa, Terminalia arjuna, Cichorium intybus, Cassia occidentalis, Achillea millefolium, Solanum nigrum, and Tamarix gallica. In NAFLD, the herbal constituents of Liv.52 DS decrease the uptake of free fatty acids by hepatocytes, leading to a reduction of fat deposition in the hepatocytes; decrease DNA fragmentation through antioxidant activity, leading to lesser cell death; downregulate inflammatory mediators like tumor necrosis factor-α and interluekin-8 and upregulate cytoprotective peroxisome proliferator activated receptors-γ, leading to a decrease in hepatic inflammation; increase urea and albumin secretion, suggesting cell proliferation; and decrease SGOT and SGPT levels, indicating normalization of biochemical parameters. Conclusion This cumulative analysis demonstrated that oral administration of Liv.52 DS tablets in patients with NAFLD, for 2 to 3 months, can cause significant symptomatic improvements, reduction in SGPT and SGOT levels, reduction in hepatomegaly, and a fibrosis-free state. Thus, it can be concluded that Liv.52 DS tablets are effective in the management of NAFLD. Table. Effect of Liv.52 DS Tablets on Signs and Symptoms of Nonalcoholic Fatty Liver Disease Abdominal Discomfort Due To Hepatomegaly Screening (n = 76) End of Study (n = 76) P Value Absent 0 (0%) 47 (62%) < .0001 Present 76 (100%) 29 (38%) Fatigue Screening (n = 53) End of Study (n = 53) Absent 0 (0%) 40 (75%) < .0001 Present 53 (100%) 13 (25%) Weakness Screening (n = 54) End of Study (n = 54) Absent 0 (0%) 34 (63%) < .0001 Present 54 (100%) 20 (37%) Fisher’s exact test. Significance < .05. Figure 1. Effect of Liv.52 DS Tablets on SGOT and SGPT Levels ALT, alanine transaminase; AST, aspartate transaminase; SGOT, serum glutamic oxaloacetic transaminase; SGPT, serum glutamic pyruvic transaminase. Figure 2. Effect of Liv.52 DS Tablets on Fatty Liver Grades in abdominal discomfort due to hepatomegaly, fatigue, and weakness was also observed (Table). As per the cumulative data, by the end of the study, the NAFLD fibrosis score suggested no further progression to fibrosis. Some patients with an indeterminate NAFLD score at baseline also showed slight improvement toward normalcy by the end of the study. Further, the APRI score by the end of the study was 0.34, indicating no fibrosis progression in the liver. No clinically significant adverse events were either observed or reported in these studies. Discussion Liv.52 DS has a wide spectrum of therapeutic applications to correct hepatic dysfunction. The hepatoprotective, antioxidant, antimicrobial, antiviral, and antiinflammatory properties of Liv.52 DS tablets can be attributed to its constituents that primarily include herbs 500 0 1000 U/L Baseline P < .0001 P < .0001 End of Study End of Study Baseline SGOT (AST) SGPT (ALT) 55.56% 40% 4.44% 38% 60% 2% Grade 0 Grade 1 Grade 2 Grade 3 At Entry At the End of Study
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