Clinical Evaluation and safety of Liv.52 Drops in the management of loss of appetite in children: A subset analysis

Loss of appetite is a common complaint of mothers who bring their children for pediatric consultation. A number of pharmacological agents like cyproheptadine are used to correct this problem, but a number of adverse effects are known to occur with this medication. Liv.52 is a novel herbal formulation recommended for hepatic diseases and anorexia. Present study was carried out to evaluate the safety and efficacy of Liv.52 drops in the management of loss of appetite in children. Results indicated that Liv.52 drops improved appetite significantly in the children. It also led to general well being of the children. There were no adverse effects attributed to Liv.52 drops. INTRODUCTION Appetite is the internal driving force for the search, choice and ingestion of food. Subjective sensation of hunger, satiety, other appetite sensations and desire to eat specific type of food may be influenced by a number of different internal factors including physiological and psychological variables. Many reasons can cause a child to experience a loss of appetite during the first six years. Most of them are quite normal with no reason to alarm. When children do not feel well, they invariably have loss of appetite. Sometimes, it is difficult to distinguish a normal reduction in food needs from loss of appetite. If the child looses weight and exhibits other symptoms, it may be an appetite problem. External factors such as prior meals, physical activity, temperature, and weather may influence the subjective sensations. Feeding behavior is the result of the complex central nervous system, integration of central and peripheral neural hormonal and neurochemical signals relating to the brain and metabolic states. Seretonin plays an important role in regulation of appetite and the subsequent releases of growth hormone. Changes in circulating glucose concentrations appear to elicit meal initiation and termination by regulating activity of specific hypothalamic neurons that respond to glucose. Loss of appetite in children is a very common complaint of mothers. Medications like cyproheptadine are commonly used to improve appetite. But this may lead to untoward effects like decrease in growth hormone release and inhibition of steroid release. Hence there is a need of a safe and effective appetite stimulant. A number of herbal formulations are claimed to have appetite stimulation and Liv.52 drops is one such formulation. Present study was carried out to assess the efficacy and safety of Liv.52 drops in improvement of appetite in children. MATERIALS AND METHODS This open clinical evaluation was carried out in the out patient department of Paediatrics, Medical College, Kolkata in 2002. This protocol of this study was approved by local ethics committee and the parents of the children were free to withdraw from the study if they choose so. Seventy children of either sex entered into this study after informed consent obtained from one of the parents. Children with history of loss of appetite of at least one month duration