Treatment of Dengue Infection; A Clinical Trial Focusing on the Effect of Silymarin on Clinical Features

Background: Dengue annually affects almost 100 million people globally while 2.5 billion people are at risk of developing dengue fever. The treatment of the infection is decided on the basis of the clinical features and level of fluids in the body. Liver is the main organ susceptible in dengue infection. Silymarin is a flavonoid which is known to play an important role in normalization of enzyme alanine amino transferase as well as aspartate amino transferase levels in hepatic disorders. Objective: To assess the improvement in clinical features in dengue patients having silymarin treatment as compared to the placebo, along with conservative therapy. Methods: A randomized controlled trial was conducted Ziauddin hospital, Clifton, Karachi. 92 dengue patients, aged 18 to 70 years, were included in the study and were equally divided into two groups, A and B, which received silymarin and placebo respectively, along with the symptomatic dengue treatment. The clinical features assessed included nausea, vomiting, bodyache, headache, retro-orbital pain, rashes, petechial haemorrhoids, facial flushing, conjunctivitis and hepato splenomegaly. The data were analyzed using SPSS version 20.0. Chi-square test and independent samples t-test were used for inferential analysis whereas the significance level was set at 0.05. Results: The study results revealed that 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 (p>0.05 for all). Moreover, none of the clinical features studied were found to be significantly different in both study groups (p>0.05 for all). Conclusion: The study results revealed that none of the clinical features studied significantly improved in the treatment group as compared to the placebo group after Silymarin treatment. Further evaluation of the potential benefits of Silymarin therapy in the treatment of dengue infection is recommended. Key words: Treatment; Dengue Infection; Clinical Trial; Silymarin; Clinical Feature