NORMAL HAEMATOLOGICAL VALUES IN YOUNG PUNJABI FEMALES.

By MAN MOHAN SINGH

S. P. KAPOOR

and

GURBACHAN SINGH

(Department oj Pathology, Medical College, Amritsar.) This investigation 1ms been conducted to find

out the normal standards of blood picture in young helthy females in Punjab. This included liumoglobin; total red cell count, packed cell volume, erthyrocyte sedimentation rate, (E. S. i.) and total white cell count. In addition to lese, total serum proteins, serum albumin, serum

June, 1053] NORMAL HAEMATOLOGICAL VALUES : SINGH, KAPOOR & SINGH 317

globulin and serum calcium, were also estimated in a large number of subjects to find out the nomal standards.

Subjects.?Observations were made on 100 females of upper middle class Punjabi families. For this purpose, practically all the girl students of Medical College, Amaritsar and some mem- bers of the nursing staff of V. J. Hospital, Amritsar were selected. A usual routine clinical examination was done on all the subjects to rule out any disease so that only healthy females were included.

Total number .. .. 100

Medical College female Students .. 65

V. J. Hospital-Female Nurses .. 35

Diet of the.subjects.?The majority of the sub- jects were non-vegetarians and were having a

mixed diet consumed in an average upper middle class family in Punjab, which included meat and eggs on alternate days or at least twice a week, while the vegetarians took Paneer (cheese) etc. to supplement the protein part of their food. All of them consumed milk or milk products and fruits at least on alternate days.

Non vegetarians .. .. 65

Vegetarians ?. .. 35

The average diet consumed daily by a female medical student and a female nurse is given below:?

Female medical student.

Milk?seer.

Chapattis-5-6 (made from 3 chhataks of

wheat).

Vegetables?J seer.

Dal?\ chhatak. Curd?2 chhataks.

Meat or cheese twice a week?(2 ozs. of meat) Fruits (seasonal)?in moderate quantity

daily. Eggs?one egg on alternate days. Tea?daily.

Female nurse.

Milk?\ seer. Chatpattis?4-5 (made from 2.\ chhataks of

wheat.

Vegetables?{ seer. Hal?\ chhatak. Meat>?daily (1 chh.) N. V. Butter-1 oz.?daily (for Veg. only).

Eggs?one egg on alternate days (foi Non Veg. only). Fruits?seasonal in small quantity. Tea?daily.

Work and exercise.?The female medical stu- dent, on an average, has to attend the College for 7 hours and do 3-4 miles of cycling to cover the distance between the College and the hos- pital. The average female nurse has to be on duty for 7-8 hours, most of the time standing or walking about.

Age-growps.?All the '

subjects selected be-

longed to the age group 17-24 years.

Technique.?Studies were made with various blood samples collected in the morning and all the examinations were finished within 3 hours of taking of blood.

The following methods were employed in the determination of various values:?

(i) Haemoglobin determinations?were done by using Sahli-Haden hsemoglobino- meter.

(u) Total red cell (R. B- C.) count, packed cell volume, E. S. R. (Wintrobe's) and total white cell (W. B. C.) count were determined by the technique as described by Napier & Das Gupta (1945).

Deduction of the following were made from the above findings:?

(?) Mean corpuscular volume (M. C- V.):? Volume of packed cells in c. cm. per 1000 c. cm. of blood 4- red cells in million per c.mm.

(?) Average corpuscular hannoglobin (M. C. H.):

Haemoglobin in grammes per litre of

blood ? red cells in million per c. mm.

(c) Mean corpuscular haemoglobin concen-

Hamioglobin in grammes per 100 c. cm.

trattion per-centage (M. C. H. C.): x 100 -r Volume of packed cells in 100 c. cm.

(Hi) Total serum proteins, serum albumin and serum globulin were determined by Kjeldal's method.

(iv) Serum Calcium was determined by Clark and Collip's modification of

Tisdal's method.

Results : Average haemoglobin value.?It was 13.09 ? 0.86 grammes per 100 cc. The hsemo-

globin estimation in females has been reported in various provinces of India and out side

countries by the various authors. So a com-

parative statement of the results is given in

Table I. The average lucmoglobin value of the present investigation i.e., 13.09 ? 0.86 compares

, favourably with those of Khanna and Sachdev (1946) for Punjab 13.06 ? 1.15 and Benjamin (1939) for Delhi 13.11 ? 0.81.

318 THE INDIAN MEDICAL GAZETTE [Jdne, 1953

Table I.

Details of average hemoglobin values for females of different populations according to

various authorities.

jAge in yrs. Locality Economic status.

Htcmoglobin per 100 ccs.

(gms.)

Standard deviation

No. of cases.

Authority

I.

II.

III.

IV.

V.

VI.

VII.

VIII

18-30

14-38

17-22

17-30

Child bearing

18-22

18-22

17-24

Bombay

Calcutta

Madras

Delhi

Coonoor

(6000 ft)

Cachar

Assam

Britain

Britain

Norway

Mexico

America

Michigan

Punjab

Punjab

Coolies

Middle Class

students

Middle class

Coolies

Students

students

students and nurses.

12.99

12.63

13.73

13.11

15.81

10.40

10.80

: 13.60

13.70

i 12.5 to ! 17.3

12.8 to

'

17.2

(kange) ! li.o to

16.8

(tlange)

13.76

13.06

i 13.09

+ 1.10

+ 1.01

+ 0.93

+ 0.81

+ 2.54

+ 1.74

+ 2.30

+ 1.15'

+ 0.86

101

128

62

100

100

25

20

60

100

601

50

25

100

Sokhey et al (1938,)

Napier, Neal Elwa- rds & Das (Jupta (1941)

Sankaran & Raja Gopal (1938)

Benjamin (1939)

Radha Krishna Rao

(1938)

Napier & Majumdar (1938)

Napier & Billimoria

(1937)

Price Jones (1931)

Whitby & Britton

(1939)

Lennberg & Schar- tim-Hensen (Whittby Britton P. ?4) Gil & Teran

Nelson.

Bethel (1926)

Khanna & Sachdev.

Present investing_ tion.

2. Total red blood cell count.?The mean

value for R. B. C. was found to be 4.55?0.04 millions per c.mm. The average figures obtained by other authors, Khanna and Sachdev (1946), Sokhey et al. (1938), Napier, Neal Edwards and Das Gupta (1941), Benjamin (1939), Napier and Majumdar (1938), Napier and Billimoria

(1937), in India vary between 4.45 and 4.615

millions per c.mm. as against the figures 4.8 and 5.012 millions per c.mm. obtained in Britain by Whitby and Britton (1950) and Price-Jones

(1931).

3. Packed cell volume.?The average packed cell volume was 41.6 ? 2.7 as compared to

41.8 ? 1.04 obtained by Khanna and Sachdev (1946) in 25 females of Punjab. The values

obtained by other authors in various parts of

india vary widely.

no If Mean corpuscular volume.?It was

92.23 ? 5.04 cu.u. The figures quoted by

various authors of other province of India

and outside show wide variations. This

value compares favourably with that obtained

by Benjamin (1939) in Delhi and Khanna and

nnrn ST j1946) *n Punjab, ?

re., 92.7 and

.

? cu-u. respectively. Comparison of

various values can be seen in Table II.

(6) Mean corpuscular hccmoglobin.?Its ave- rage value was 29.04 ? 1.78 y y This is ap-

^le saine fls that obtained by Sokhey

{ os) in Bombay which was 29.00 and is higher

Punjab ? anna anc* Sachdev (1946) in

tior^- ^CaU C0rPUscu^ar hccmoglobin concentra-

June, 1953] NORMAL HAEMATOLOGICAL VALUES : SINGH, KAPOOR & SINGH 319

The average value obtained was 31.47 ?0.511 per cent. This is practicaly the same as that of Khanna & Sachdev (1946) of female students

of Punjab. Other average values in various

provinces can be julged at a glance at

Table II.

Table II-

Results of M.C.V., M.C.H. and M.C.Ii.C. percentage and their standard deviation in various

populations (females only) according to different authorities.

Locality Number Mean standard Mean standard Mean Standard corpus- diviation corpus- deviation Hb. concen deviation. Authority. cular cular traton%

volume Haemo-

globin. eu.u rr.

f Calcutta.. 128 86.82 +7.28 27.42 +2.89 31.57 +1.76 Napier Nealedward & Das Gupta (41)

Bombay .. 101 88.53 .. 29.06 .. 32.86 .. Sokhev et el (1938) Delhi .. 100 92.7 .. 28.78 .. 33.58 .. Benjamin Q939) Assam .. 22 77.30 +7.70 24.42 +3.00 31.20 +1.77 Napier & Billimorida

(1937) ad

Cachar .. 25 82.49 +12.68 23.68 +3.10 28.67 +3.37 Napier & Maju'mder (1938)

Michigan. 50 86.30 ., ,. ,, .. +4.15

Punjab .. 25 90.60 +608 23.17 +3.3' 31.48 Khanna & Sachde.

(1946)

Punjab .. 100 92.23 +5.04 29.04 +1.78 31.47 +0.511 Present investiga- tion.

4. Erythrocyte Sedimentation rate.?(by Wintrobe technique). The average E.S.R. was 15.18 ? 8 40 mm. with a range of 1 to 35 mm.

In the table III the results are compared with those of other authors.

Table III.

Comparison of results of E.S.R. (Wintrobe method) with those of other workers.

Number Author \ alues. (in females only).

I. Wintrobe Lands berg (1935) (a) Rango 0-20nim.

(b) Average. 9.6mm.

II. Napier Range, 5.40 mm

III. Khantia Sachdey (1946) (a(Range 3-27mm. (b) Average 14.4mm.' (c) Standard deviation +9.74mm.

IV. Present investigation (No. of (a) Range. l-35mm. cases-98) (b) Average, 15.18mm.

(c) Standard deviation. +8.40

320 THE INDIAN MEDICAL GAZETTE [June, 1953

5. Total white blood cell count.?The average values of white blood cells were 7358 per c.mm. with a range of 4000 to 10700 per cmm.

6. Total serum 'proteins.?Out of the total of 100, 59 subjects were investigated for total serum proteins, serum albumin and serum glo- bulin. The average values obtained were:?

Total serum proteins: 7.20 ? 0.26 gms. per 100 ccs., Serum albumin: 5.05 ? 0.26 gms. per

100 ccs., Serum globin: 2.19 ? 0.206 gms. per 100 c.cs. We could not find in the literature

any values worked out in Indians especially for females in this country, so we have been obliged to give a compartive statement with values ob- tained by Barkat and Smith (1948) in W.

Africa, along with haemoglobin values in the two countries. These compartive values can be seen in Table IV.

Table IV*

Serum Protein and Hemoglobin levels in various population (Females only).

Locality Age No. of. Total Albumin Globulm Ilaemoglo- Authority. cases. Proteins bin Gms/

100 cc.

W. Africa. Above 90 7.69 Gms. .. .. 9.87 Barkat & Smith 16 yrs. (1949)

S.D. + 0.76

do Above 40 7.94 Gms. .. .. 10.4 Barakat & Smith 16 yrs. S.D. + 0.6S

(1949)

Punjab 17-24 59 7.20 Gms. 5.05 2.19 13.09 Present

S.D.+0.29 S.D.-0.26 S.D.-0.206 investigation.

7. Serum calcium.?Observations were made on 46 out of the total of 100, for serum calcium. The average value was 10.75?0.44 mgm. per cent with a range of 9.5?11.4 mgm. per cent. As no other figures were available for serum calcium of females in other parts of the country, so no comparative statement could be given. Conclusions.?The various haematological

values that have been worked out, represent the averages in a young female of an average upper middle class family of this province. Although the general health of the population in the coun- try has gone down,* female students and the female nurses are maintaining good hematologi- cal standards due to good and nourishing diet that is consumed in this province and the amount of work and exercise that is done by them.

Summary.?Investigation has been carried out on blood samples of 100 upper middle class

young healthy females in Punjab (65 medical students and 35 nurses) to determine the normal values of haemoglobin, total RB.C. count, packed cell volume: (M.C.V., M.C.H., M.C.H.C.), E.S.R. and total W.B.C. count. In

addition to those 59 subjects were investigated for total serum proteins, serum albumin and serum globulin, while serum calcium was deter- mined in 46 out of 100 subjects.

Although the average figures for various

hematological values are less than those of other * On the justification for jeremiads, by our country-

men and our aiders' we entertain very serious doubts.?

Editor, I.M.G.

countries, they compare favourably with those of previous workers in Punjab and Delhi, while they are mostly higher than those of other parts of India. Comparative statements of all these values are given in Tables I to IV. The average values of total proteins, serum albumin, serum globulin and serum calcium arc nearly as good as those in any other country. Acknowledgement.?\Ve are very grateful to

Shri S. K. Das Gupta, Asst. Professor of Bio- chemistry, Medical College, Amritsar for under- taking the various bio-chemical tests of blood.

REFERENCES

Barxkat, M. R., and Ijancct, ii, 12. Smith, D. A. (1949).

Benjamin, A. (1939) .. Rep. Sci. Advisory Board, Indian Res. Fund. Assoc., p. 108. Now Delhi.

Betiiell, F. H. (1936) .. J. Amcr. Med. Assoc., 107, 564.

I^0Enna, L. C., and Indian Med. Ga%., 81, 296. Sachdev, J. C. (19-16).

Napier, L. E., and Indian J. Med. Res., 25, 529. Bilimoria, H. S. (1937). ;

Napier, L. E., and Das Ilwmatoloqical Technique. Gupta, C. R. (1915). U. N. Dhur and Sons Ltd.,

Calcutta.

Napier, L. E? and Indian J. Med. Res., 28, 541. Majumdar, D. N. (1938).

June, 1953] CASES OF MYIASIS IN MAN : BASU, MENON AND GUPTA 321

Napier, L. E., N5(. Ibid., 29, 375.

Edwards, M. I., and Das Gupta, C. R. (1941).

Price-Jones, C. (1931). J. Path, and Bad., 34, 779.

Radhakrishna Rao, Indian J. Med. Res., 25, 957. M. V. (1938).

Sankaran, G., and Raja- Ibid., 25, 741.

gopal, K. (1938).

Sokhey, S. S., ct al. Ibid., 26, 723.

(1938).

Whitby, L. E. H., and Disorders o/ the Blood.

Britton, C. J. C. J. and A. Churchill Ltd., (1950). London. /

BIBLIOGRAPHY

Das Gupta, C. R. (1952). Indian Med. Gaz., 87, 95.

Lehmann, H. (1947) .. Brit. J. Exper. Path., 27, 377.

Idem (1949) .. Nature, 164, 954.

Wright, S. (1948) .. Applied Physiology? Oxford University Press, London.