Sakuntala Putrevu 1 , Tirupati Reddy Chirra 2

BACKGROUND Thrombocytopenia is defined as platelet count less than one and half lakh per mm cube of blood. Thrombocytopenia has been documented in patients with infectious mononucleosis, cytomegalovirus, and varicella zoster infections. Hepatitis C, tuberculosis and human immunodeficiency virus also have been reported in the causes list. Thrombocytopenia is a well-known complication of chronic lymphocytic leukaemia, although it may not be encountered as easily as seen in autoimmune haemolytic anaemias in these patients. It has also been reported in patients with other lymphoproliferative disorders including Hodgkin’s disease. Thrombocytopenia in patients with a variety of solid tumours has also been thought to most likely be immune mediated. Thrombocytopenia may accompany Graves’ disease and Hashimoto’s thyroiditis, but it is not certain that it is immunologically mediated or not. In our country, Dengue and malaria remain the predominant cause for Thrombocytopenia. Chymopapain and papain are the two important compound that are present in papaya. Lipase, a hydrolase, which is tightly bonded to the waterinsoluble fraction of crude papain is also seen in papaya. The papaya seeds and fruits have excellent antibiotic properties. The consumption of unripe and semi-ripe papaya fruits could be dangerous during pregnancy as it contains papain which may cause natural uterine contraction and may lead to abortions. It is reported that the plant extracts of papaya have maximum activity against dengue virus. It also has been reported that the methyl gallate of plant origin interacts with herpes simplex virus and causes its destruction. Majority of the papaya plant parts is known to have antimicrobial property. This study puts in a sincere effort to check the effects of papaya extract in the treatment of low platelet count. This study is intended to help the practising physicians to understand the benefits of the use of papaya extract when using in the cases of thrombocytopenia. METHODS Sixty patients who had thrombocytopenia were considered for the study. The study was conducted in the Department of Internal Medicine, Osmania Medical College, Hyderabad, Telangana. The study was conducted from July 2014 to June 2015. Detailed history was taken. After taking aseptic precautions, the blood sample was collected and sent for the central lab for platelet count. The initial count was noted as first reading. Then, the patients were given 25 mL of C. Papaya extract three times a day in the morning, afternoon and in the evening. Subsequently, the test was repeated on day two, day three, day four and day five of the treatment. The readings were noted. The final reading on the day five was taken and measured for significance. RESULT In the present study, the mean age of the population was 26.06 years with a standard deviation of 3.12 years. Sex related statistics could not be done as the number of female patients was few. Out of the 60 confirmed patients having thrombocytopenia, 8 patients were confirmed to have dengue, 10 patients were found to be having malaria, 32 patients were undergoing chemotherapy, 4 patients were suffering from various thyroid diseases and 6 patients were found to have GIT diseases. Mean platelet count at the starting of the disease was found to be 50300 in dengue, 82900 in malaria, 49600 in chemotherapy, 85500 in thyroid diseases and 84100 in GIT diseases. After treatment, only chemotherapy patients responded significantly on the first day although on the fifth day it lacked the same pace of prognosis. All other diseases after five days responded very well and crossed the one and half lakh mark. CONCLUSION The papaya extract acts as a miracle drug in the treatment of thrombocytopenia. Although exact mechanism of its action is still unknown, if right research is done, it can be guaranteed as a potent drug of choice in the treatment for thrombocytopenia.