Management of Dengue Infection; a Prospective Study Highlighting the Effect of Silymarin on Liver Functions Test

Background: Dengue is a viral illness that globally affects around 50 million people annually and approximately 3.9 billion people are at risk to contract the infection. Liver is the major organ involved during the disease process. Silymarin is being used to cure liver problems for hundreds of years and have been proved to be a hepatoprotactive agent in many studies. Objectives: 1) To evaluate the effect of Silymarin in dengue infection induced liver problems, primarily liver enzymes and, 2) to assess symptomatological improvement with the treatment of Silymarin in dengue patients. Methods: A randomized controlled trial was conducted Ziauddin hospital, Clifton, Karachi.92 dengue patients were included in the study who were equally divided into two groups, A and B, which received silymarin and placebo respectively, along with the symptomatic dengue treatment. The laboratory parameters utilized to measure liver function were serum levels of direct and indirect billirubin, alanine amino transferase, gamma glutamyl transferase and alkaline phosphatase. The data were analyzed using SPSS version 20.0. Chi-square and independent samples t-test were used for inferential analysis whereas the significance level was set at 0.05. Results: The study results revealed a significant difference only in the mean serum levels of sodium and indirect bilirubin in both study groups (p< 0.05 for both). Moreover, none of the clinical features studied were found to be significantly different in both study groups (p>0.05 for all). Furthermore, none of the liver enzymes were found to significantly decrease after the use of Silymarin in the treatment group as compared to the placebo group. Conclusion: The study showed no positivity in improvising liver function in the treatment group, as determined by the serum levels of liver enzymes. Furthermore, symptomatological improvement with the treatment of Silymarin in dengue patients could not be established definitely. Key words: Management, Dengue, Silymarin, Liver Function Test