A Study of Papaya Extract in the Treatment of Low Platelet Count in Malaria and Dengue Children Below 18 Years

Abstract

BACKGROUNDThe normal blood platelet count is 1,50,000-4,50,000/μL. Thrombocytopenia results from decreased production, increased destruction and/or sequestration. Although, the bleeding risk varies somewhat by the reason for the thrombocytopenia, bleeding rarely occurs in isolated thrombocytopenia at counts <50,000/μL and usually not until <10,000-20,000/μL. Coexisting coagulopathies as is seen in liver failure or disseminated coagulation, infection, platelet-inhibitory drugs and underlying medical conditions can all increase the risk of bleeding in the thrombocytopenic patient. Most procedures can be performed in patients with a platelet count of 50,000/μL. The level needed for major procedures will depend on the type of surgery and the patient's underlying medical state, although a count of approximately 80,000/μL is likely sufficient. Thrombocytopenia results from one or more of three processes-(1) Decreased bone marrow production; (2) Sequestration, usually in an enlarged spleen; and/or (3) Increased platelet destruction. In our country, malaria and dengue is quiet prevalent and is known to cause the majority of morbidity and mortality, which is a direct result of thrombocytopenia. This study is done in order to check the efficacy of a papaya extract in these two diseases and thus in turn help save thousands of life, which are in the risk zone. Majority of the study on this topic was previously done in the adults, but none of the study came close to put an effort to what happens in the children or rather the paediatric group, which in our study is considered and studied. In the previous efforts, a plethora of diseases were considered, but in our study, it has been narrowed down to two diseases, which are rampant in this part of the world. MATERIALS AND METHODSThis study was done in the Department of Paediatrics, Travancore Medical College at Kollam. The study was done in the patients who belonged to the paediatric age groups (range 9 to 18 years). The study consisted of children (30 in number) who were admitted in the hospital and confirmed to have thrombocytopenia, which was secondary to confirmed dengue or malaria. Patients were promptly examined after taking a detailed history session. The blood samples was sent to the lab. The disease was once again confirmed and thrombocytopenia was considered when three consecutive platelet count was taken and when the count was lessened by at least 10,000 platelets. The study was conducted from October 2014 to September 2015. RESULTSAfter treatment, only dengue patients responded significantly on the first day, although on the fifth day, it lacked the same pace of prognosis. After five days of treatment in both diseases, they responded very well and crossed the one and half lakhs mark. CONCLUSIONThis study effectively proves the efficacy of the papaya extract in the subsidiary treatment of the two rampant diseases. The study also suggests that the use of papaya extract has to be initiated at a very early stage as there is a significant association of the rise in the pl...