All the patients recruited in this study were of uncomplicated acute viral hepatitis. Both groups were comparable in age, sex and duration of illness. Mean age of patients in Livwin group was 29.93 ± 2.70 and that of placebo group was 33.37 ± 2.43. There were 22 male and 7 female patients in Livwin group and that in placebo group were 25 and 4, respectively .
The polyherbal formulations like Liv.52,[5
] Kamalahar forte,[5
] and Valiliv[5
] have got two or more similar contents as that of Livwin such as Kutki, Arjuna, Daruharidra, Punarnava, Guduchi
and Bhumyamalaki, Ashvagandha
. Therefore, the efficacy of these previous formulations was reviewed in the light of observation of present study. These polyherbal formulations have more components ranging from 9 to 19 and contain components other than herbal.[5
] Livwin has seven components and all are herbal.
In the present study, there was significant earlier recovery of weakness in Livwin group as compared to placebo group 
Baijal et al
] also observed that there was significant improvement of weakness in Liv.52 DS group over a period of 1 month.
Livwin contains Ashwagandha
which is used as general tonic, useful in debility, fatigue, inability to concentrate specially due to the liver disease or other problems as stress.[11
] Antioxidant action of Livwin probably can explain the mechanism for improvement of weakness. Mohanty et al
] found that Ashwagandha
has optimum protective effect against selenite-induced oxidative damage lenses. Singh et al
] found antioxidant action of Kutki (Picrorhiza kurroa
) in rats. Stanely et al
] observed that Guduchi (Tinospora cordifolia
) root extract exhibited antioxidant action in rats.
Levels of serum bilirubin, AST and ALT were observed in normal range in significantly more number of patients earlier with Livwin treatment as compared to placebo . Dange et al
] observed that biochemical recovery (serum bilirubin, AST, ALT) occurred in significantly less days with Arogyawardhini
, Hepax and Valiliv as compared to placebo. The results of present study are comparable with these studies.
Recovery of raised serum bilirubin with Livwin treatment is due to ingredients like Kutki
, which helps in recovery of icterus and raised serum bilirubin by virtue of their choleretic action. Shukla et al
] observed choleretic action of Kutki in animal studies. Chandan et al
] in animal study observed choleretic action to Punarnava
. Raised serum bilirubin in acute viral hepatitis presumably results from intrahepatic obstruction of biliary canaliculi; the obstruction is direct consequence of cellular inflammation. Begum et al
] observed anti-inflammatory action of Ashwagandha
. Pandey et al
observed anti-inflammatory action of Kutki
Livwin contains Bhuiamla
, which has activity against hepatitis B virus. In present study, number of hepatitis B positive patients were less (Livwin-1, placebo-1). Venkateswaren et al
] observed that Bhuiamla (Phyllanthus niruri)
had antiviral action against Hepatitis B virus (HBV) in vitro
. To prove the efficacy of Livwin in hepatitis B virus positive patients, further evaluation is needed.
Adverse events such as epigastric pain and diarrhea were reported by 10.37% patients in this study. Adverse events such as epigastric pain, diarrhea and skin rash were observed with Arogyawardhini in 10% patients, with Valiliv in 17.39% patients and with Liv.52 in 8.82% patients.[16
] Adverse events observed with Livwin are comparable to adverse events with these polyherbal formulations.
The limitations of this study include the fact that viral markers for Hepatitis other than “B” was not done due to high cost of investigations.