aDepartment of Surgical Gastroenterology, CSMMU, Lucknow, U.P., India. E-mail: induja.awasthi@gmail.com
bDepartment of Surgical Gastroenterology, CSMMU, Lucknow, U.P., India. E-mail: abhijitchandra@hotmail.com
cDepartment of Surgical Gastroenterology, CSMMU, Lucknow, U.P., India. E-mail: lavkacker@indiatimes.com
dDepartment of Surgical Gastroenterology, CSMMU, Lucknow, U.P., India. E-mail: anupkwahal@rediffmail.com
eDepartment of Plant Pathology, CSMMU, Lucknow, U.P., India. E-mail: natupatho@sify.com
Glutamine supplementation in critically ill and surgical adults may normalize intestinal permeability, attenuate nitrogen loss, improve survival, and lower the incidence of nosocomial infections. Aims were to examine the effect of glutamine on Nutritional status, functional status and mortality in Glutamine Supplemented (Gp.A)/Non-supplemented (Gp.B) Malignant Obstructive Jaundice (MOJ) patients managed with endoscopic drainage. Seventyeight patients were enrolled in the study: Gp.A=25, Gp.B=53. Glutamine supplementation was 50ml (20g)/day intravenously for 3 days and 30g/day orally for 4 days. On 42nd post-procedure day BMI, IL-2, TL-6, TNF- and Karnofsky Score were assessed. In Gp.A mean BMI was 21.54+3.13 on procedure day and 23.71+3.01 on 42nd day. In Gp.B it was 18.18+1.91 on procedure day which improved to 19.98+2.47 on 42nd day. In Gp.A mean Karnofsky score was 78.80+8.33 on procedure day and 49.20+39.15 on 42nd day; in Gp.B it was 67.74+13.39 which reduced to 35.47+36.03 on 42nd day.IL-2 Level in Gp.A was 81.98+75.62 pg/ml on procedure day and 27.14+31.91pg/ml after supplementation. In Gp.B it was 34.40+68.84pg/ml on procedure day which reduced to 3.26+9.39pg/ml on 42nd day.IL-6 Level in Gp.A was 163.35+169.36pg/ml on procedure day and 56.65+48.49pg/ml after Supplementation. In Gp.B it was 117.67+103.15pg/ml on procedure day which reduced to 41.08+43.47pg/ml on 42nd day. TNF-α Level in Gp.A was 44.65+37.07pg/ml on procedure day and 3.26+8.31pg/ml after Supplementation. In Gp.B it was 40.29+64.62pg/ml on procedure day and 39.01+50.49pg/ml on 42nd day. The mean survival of patients in Gp.A was 163.32±232.1 days and 82.30±114.9 days in Gp.B. It can be concluded from the study that Glutamine supplementation helps in improving the Nutritional status and reducing mortality of MO J patients.
Glutamine, malignant obstructive jaundice, edoscopic
