Karnail Singh

Effect of Wheat Grass Tablets on the Frequency of Blood Transfusions in Thalassemia Major

Forty patients of Thalassemia Major children were treated with wheat grass tablets (WGT). The mean hemoglobin in the pre WGT was 8.54 +/− 0.33 g% whereas in WGT period was 9.13 +/− 0.14 g% (p < 0.001). The mean blood transfused as packed cells in pre WGT period was 326.82 +/− 74.10ml/kg/year whereas during WGT period it was 256.39 +/− 45.47 ml/kg/year. The percentage difference in the amount of packed cells transfused in pre WGT and WGT period was 18.02 +/− 22.96 (p < 0.001). The decrease in the blood transfusion requirements was by 25% or more in 20 (60.6%) cases. The mean interval between the consecutive blood transfusions in Pre WGT period was 18.78 +− 4.48 days whereas in WGT period was 24.16 +− 4.78 days (p < 0.001). Wheat grass has the potential to increase the Hb levels, increase the interval between blood transfusions and decrease the amount of total blood transfused in Thalassemia Major patients.

The Effect of Exclusive Breastfeeding on Hospital Stay and Morbidity due to Various Diseases in Infants under 6 Months of Age: A Prospective Observational Study

Background. Mothers milk is the best for the babies. Protective and preventive role of breast milk was evaluated in this study by assessing the relation of type of feeding and duration of hospital stay or morbidity. Methods. This prospective study was conducted in a tertiary care hospital and 232 infants in the age group of 14 weeks to 6 months formed the sample. There are two groups of infants, that is, one for breastfed and one for top fed infants. Statistical analysis was done and results were calculated up to 95% to 99% level of significance to find effect of feeding pattern on hospital stay due to various diseases and morbidity. Results. Prolonged hospital stay, that is, >7 days, was lesser in breastfed infants and results were statistically significant in case of gastroenteritis (p value < 0.001), bronchopneumonia (p value = 0.0012), bronchiolitis (p value = 0.005), otitis media (p value = 0.003), and skin diseases (p value = 0.047). Lesser morbidity was seen in breastfed infants with gastroenteritis (p value 0.0414), bronchopneumonia (p value 0.03705), bronchiolitis (p value 0.036706), meningitis (p value 0.043), and septicemia (p value 0.04). Conclusions. Breastfed infants have shorter hospital stay and lesser morbidity in regard to various diseases as compared to top fed infants.

Centchroman as First-line Treatment for Mastalgia: Results of an Open-label, Single-arm Trial.

Mastalgia is a distressing symptom and may be severe enough to interfere with usual daily activities. Breast pain is either cyclical or noncyclical. Currently; multiple options are available for the treatment of mastalgia including hormonal and nonhormonal agents. This study was conducted to evaluate the role of centchroman as a nonhormonal first‐line treatment for moderate to severe mastalgia. To accomplish this; a prospective open‐label, single‐arm study was done using the Pretest–Posttest Design. A total of 100 women suffering from mastalgia were grouped according to the characteristic pattern of breast pain (cyclic and noncyclic) and received centchroman 30 mg/day for 12 weeks followed by observation for 12 weeks. The efficacy analysis of centchroman was done by comparing median Visual Analog Scale score, median pain duration and side effects over time among the two groups. Centchroman significantly alleviates mastalgia with minimal side effects. The median pain score was significantly reduced over successive visits (1, 4, 12, and 24 weeks). The median pain duration decreased remarkably over time in comparison to the baseline (p = 0.001). Overall the response rate was 88% at the end of 12 weeks and 85% at the end of 24 weeks. The drug was found more effective with a quicker response in cyclic pattern of matalgia. Complete response was observed in 66% of cyclic mastalgia and 40% of noncyclic mastalgia patients at 1 week of therapy. The response was improved over time in both groups and at completion of treatment (12 weeks) 92% patients in cyclic group and 80% patients in noncyclic group were pain free. The effect of the drug persisted till the completion (24 weeks) of the study (p = 0.001). These results imply that centchroman is very effective in treating breast pain and can be prescribed as drug of first choice for mastalgia.

The relationship between feeding and nutritional status: a prospective and observational study conducted in northern region of India

According to the Prime Minister of Norway, GroBruntland, a physician and Director General of WHO, real development of a nation is possible only with healthy population. For the sustenance of freedom, democracy and economic growth as well as human dignity, health requires to be treated as a basic human right. With an objective of health as a basic right the infant health should be assigned a topmost priority. Emphasis on infant health through better nutrition as well as medical care is being laid by WHO and targets were fixed by United Nation through the Millennium Development Goals.

Factors predicting the risk of intra-abdominal sepsis and burst abdomen in patients with abdominal trauma undergoing laparotomy

AIM: This study aims to study the factors which predict the risk of intra-abdominal sepsis (IAS) and burst abdomen in patients with abdominal trauma undergoing laparotomy. MATERIALS AND METHODS: Seventy-five patients with abdominal trauma undergoing laparotomy were evaluated in pre-, intra-, post-operative period for factors such as injury severity score (ISS), abdominal trauma index (ATI), operative severity score (OSS), and intra-abdominal pressure (IAP). The correlation was found among these factors and risk of IAS and burst abdomen following laparotomy. RESULTS: Mean ATI, ISS, and OSS in IAS present and absent group were (35 ± 10 and 21 ± 7), (47 ± 16 and 22 ± 9), and (30 ± 6 and 18 ± 6), respectively. Mean ATI, ISS, and OSS in burst abdomen present and absent group were (35 ± 10 and 22 ± 8), (43 ± 14 and 23 ± 12), and (30 ± 6 and 19 ± 6) respectively. Mean IAP on D0, D1, and D2 in IAS present and absent group were (23 ± 7 mmHg and 16 ± 3 mmHg), (14 ± 4 mmHg and 7 ± 3 mmHg), and (11 ± 5 mmHg and 5 ± 2 mmHg), respectively. Mean IAP on D0, D1, and D2 in burst abdomen present and absent group were (23 ± 7 mmHg and 16 ± 3 mmHg), (13 ± 4 mmHg and 7 ± 4 mmHg), and (11 ± 5 mmHg and 5 ± 2 mmHg), respectively. Out of the 15 patients who had IAS, 13 also had burst abdomen. Significant correlation was found between ATI, ISS, and OSS with IAS and burst abdomen, and between IAS and burst abdomen. CONCLUSIONS: Higher scores of ATI, ISS, OSS, and IAP are associated with higher chance of developing IAS and burst abdomen in the postoperative period. The presence of one complication in the postoperative period increases the risk for the other. Therefore, we can have risk-based approach in managing the patients having above-mentioned risk factors.

Hydatid disease involving pectoralis minor muscle alone

Hydatid cysts are rarely found in muscles. Reports have shown the presence of hydatid cysts in the pectoralis major muscle alone or together with the pectoralis minor muscle. Herein, we present a rare case of a hydatid cyst found in the pectoralis minor muscle alone without the involvement of the pectoralis major or any other muscle or organ.