Submited on: 02 Jul 2012 05:46:09 AM GMT
Published on: 03 Jul 2012 04:43:24 PM GMT
 

  • What are the main claims of the paper and how important are they?

    1.Glutamine–enriched tube feed supplement produces positive biochemical and clinical effects  in severely-malnourished surgical G.I patients.

    2. It may also provide positive energy balance, and subsequent substrate enrichment with gln may benefit  the patients with malnutrition or nutritional depletion which indicated improvement.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Claims are novel


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    RCT but needs more details.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes, more details are need


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    No


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes


  • Other Comments:

    Thank you for asking me to review this article.

    Effect of soy and glutamine as substrate………

    1.This study is quite interesting but needs some modification.

    2. Use of too many abbreviation should avoided.

    3.English is very poor  which needs editing.

    4.Subjects and Methods.Please write the method of randomization, what is normal renal function-mention( Blood urea less than 40mg/dl)

    5.How many total subjects were assessed and how many excluded due to various reasons such as BUN >40mg/dl, ECH showing CAD or diabetes, or nonvolunteers.

    6.Some references from 2011 and 2012 should be given and discussed the present status on enteral nutrition.

    Table 1 should be more clear,how many groups are included.

    Table 1. Clinical data in the intervention and control groups.

    ………………………………………………………………………………………………………………………………

    Groups                                   Intervention group                         Control group

    ………………………………………………………………………………………………………………………………..

    Sex,male

    Mean age

    Mean body weight

    Mean BMI

    Clinical diagnosis

  • Competing interests:
    Dr Jayeeta is My Research Collaborator
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Singh RB, Rastogi SS, Niaz MA, Ghosh S, Singh R. Effect of fat-modified and fruits and vegetable enriched diets on blood lipids in the Indian Diet Heart Study. Amer J Cardiol 1992; 69:869-874.

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Singh R B.Effect of Soy and Glutamine as Substrate of Enteral Nutrition Compared to Standar Hospital Regimen Among Surgical Patients - A Randomized, Single Blind Controlled Trial[Review of the article 'Impact of Enteral Glutamine Enriched Polymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients ' by UV M].WebmedCentral 2012;3(7):WMCRW002096
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  • What are the main claims of the paper and how important are they?

    The Paper claims that Enteral Glutamine could induce overall improvement in the health status of severely malnourished post-operative GI patients. Glutamine is very good for enteral nutrition therefore the claim is a valid one.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    While Glutamine has already been proven to be excellent for enteral nutrition, the approach that the author has taken to prove its efficacy on malnourished, surgical patients is novel. 


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Detailed protocol is to be provided


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes. Use of NRI scores and BMI to categorise the nutritional status of subjects is appropriate.

     


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Authors should use proper language to ensure ease of readability and understanding. Using too many abbreviations should be avoided. Tables should be re-written using complete titles and stratified columns detailing group particulars (e.g. attributes, experimental group, control group)


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    As above


  • Other Comments:

    No

  • Competing interests:
    Dr Jayeeta was my Student in Undergraduate Programme in Food And Nutrition.
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
  • Experience and credentials in the specific area of science:

    Two decades of postgraduate teaching experience in the subject area

  • How to cite:  Baroova B .Impact of Enteral Glutamine Enriched Polymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients[Review of the article 'Impact of Enteral Glutamine Enriched Polymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients ' by UV M].WebmedCentral 2012;3(7):WMCRW002094
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  • What are the main claims of the paper and how important are they?

    The most timportant claim was to show how a kitche-based EN could improve GI patients and how it would help them.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Partially. The glutamine is well know as the best nutritional factor for this kind of patients.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    The protocol was well followed


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    The authors could compared their results with other works that have been published


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes


  • Other Comments:

    No

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
  • Experience and credentials in the specific area of science:

    I am a dermatoly professor and a nutrition doctor as well.

  • How to cite:  Bedin V .Impact of Enteral Glutamine Enriched Plymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients[Review of the article 'Impact of Enteral Glutamine Enriched Polymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients ' by UV M].WebmedCentral 2012;3(7):WMCRW002069
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  • What are the main claims of the paper and how important are they?

    This study investigates whether polymeric kitchen-based glutamine supplemented EN can improve nutritional, functional and quality of life (QOL) in terms of changes in body weight, early recovery from illness through decreasing hospital stay in severely malnourished G.I subjects.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    These claims are novel.


  • Are the claims properly placed in the context of the previous literature?

    Yes, properly.


  • Do the results support the claims? If not, what other evidence is required?

    The results support the claims.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No, there are not important deviations from it.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    The paper has offer enough details of its methodology.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Other blood markers should be provided.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes, I would like to see this work presented in a seminar. I think it is important.


  • Other Comments:

    No.

  • Competing interests:
    No.
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    No.

  • How to cite:  Liu C .Impact of Enteral Glutamine Enriched Polymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients [Review of the article 'Impact of Enteral Glutamine Enriched Polymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients ' by UV M].WebmedCentral 2012;3(7):WMCRW002034
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  • What are the main claims of the paper and how important are they?

    The claims are responsively supported by the numerical data the author published. Recovery after gastrointestinal surgery is rapidly advanced by including glutamine in the nutrition of recovering patients by as much as 2-days per patient. The author shows this by reviewing similar calorie levels of carbohydrates, proteins, fats with one difference, glutamine intake versus none added except for food source. Those whose nutrition content added glutamine recovered quickly with modest weight gain with up to 2-days faster recovery (release).


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The claims made are supported in the wide body of responsible evidence.


  • Are the claims properly placed in the context of the previous literature?

    Yes the claims are placed close to those in the whole body of the literature, such as:

    Glutamine research supports that this nutrient:
    >Helps repair damage to the intestines in irritable bowel syndrome patients.  
    >Helps repair damage to the intestines in celiac disease patients.
    >Improves the condition of (acute) pancreatitis patients.   
    >Lowers lipopolysaccharides levels in ulcerative colitis patients.   
    >Is an essential for the health of the gallbladder.
    >Is an essential "fuel" for the villi and may help to repair damage to the villi cells of the intestinal wall.  
    >Is an essential for the health of the cells that line the colon wall and may increase blood circulation to the colon.  
    >Facilitates the growth of the tissues of the jejunum.   
    >Increases blood circulation to the small intestine, to the pancreas and to the stomach..  
    >Enhances the health and growth of the pancreas. 


  • Do the results support the claims? If not, what other evidence is required?

    The author's results support the claims.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No important deviations were reported.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    The methodolgy may have been improved by dietary analysis of the glutamine content from whole foods in the control group, i.e. how many grams glutamine were the control group patients receiving per day. The Glutamine group were receiving 0.35g/kg. Nutrition scientists ask what is the effect of total dose on outcome. This could be addressed, though it may be hindsite.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    A polymeric kitchen-based EN containing protein from skimmed milk source(control), the most
    commonly used protein source contains 1.67 g/glutamine/glutamate per cup. How many cups skimmed milk did each patient consume-average and what was the amount of glutamine in other whole foods g/glutamine/glutamate?

     

    We can compare the answer to the above control group to a polymeric kitchen-based EN with substrate enriched with enteral glutamine, 0.35g kg-1day-1 (study group). This glutamine study group averaged 18.55g Glutamine/day plus what ever they received from other whole foods.

     

    A dietary analysis with whole foods survey could be instructional, valuable information.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes, especially if all the nutrition is analyzed by actual gram weights as indicated above.


  • Other Comments:

    The author is commended for his brilliant informative contribution regarding the effects of nutrition upon patient's post-operative recovery.

  • Competing interests:
    None.
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Misner, B. Food alone may not provide sufficient micronutrients for preventing deficiency. Journal of the International Society of Sports Nutrition. 3(1):51-55, 2006. Misner Bill. Fifty Nutrient Associations That Influence Health State, The Townsend Letter for Doctors and Patients, Jan 2008 Misner Bill. "Is Milk Associated with Obesity?" The Townsend Letter for Doctors and Patients. May 2010.

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Misner B .Glutamine Nutrition Advances Post-Operative Recovery Gastrointestinal Patients [Review of the article 'Impact of Enteral Glutamine Enriched Polymeric Kitchen-Based EN on Nutritional, Functional and Quality of Life in Severely-Malnourished Postoperative Gastrointestinal Patients ' by UV M].WebmedCentral 2012;3(7):WMCRW002027
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Thanks for reviewing and spending ur valuable time.
Responded by Dr. Jayeeta Choudhury, PhD, FICN, FACN (USA) on 04 Jul 2012 04:58:19 PM