Assessment of nutritional status of the cirrhotic patients on enteral and parenteral feeding

2021 ◽  
pp. 026010602110209
Author(s):  
Mahwish Aslam ◽  
Sana Farooq ◽  
Bahisht Rizwan ◽  
Ayesha Asghar

Background: Cirrhosis is an irreversible disease that replaces healthy tissues with scar tissues. According to the Pakistan Medical Research Council’s national general population survey (2008–2014), the ratio of cirrhosis was 4.8% among the population. Objectives: To assess the nutritional status of cirrhotic patients on enteral and parenteral nutrition and to assess the degree of malnutrition among cirrhotic patients. Methods: A cross-sectional study was conducted at Shalamar and Shiekh Zayed Hospitals of Lahore from January–April 2017. The convenient sampling technique was used. Inclusion criteria were the patients with decompensated liver cirrhosis, whereas compensated patients were excluded from the study. Data were collected through the patient’s file, nurse’s, and dietitian’s notes. The nutritional status of participants was assessed based on socio-demographic characteristics, anthropometric measurements, biochemical assessment, clinical signs, and dietary recall. Variables were categorized and compared to observe the level of significance in enteral and parenteral nutrition. SPSS version 22 was used to analyze data. Results: Patients on parenteral nutrition had a higher ratio of malnutrition with a significant Child–Pugh score—61.8% of patients belonged to Class C and 35.3% Class B, while in enteral support, 7.3% belonged to Class C and 43.9% patients belonged to Class B ( p-value = 0.000). There was a definite relationship observed in the route of intake and malnutrition among cirrhotic patients. Conclusion: Enteral route of nutrition is an effective and the safest way to provide appropriate nutrients according to the patient’s demands.

2021 ◽  
Vol 15 (10) ◽  
pp. 2779-2782
Author(s):  
Saira Khalid ◽  
Nasir Shah ◽  
Yasir Abbas Zaidi ◽  
Muhammad Saleem Hasan ◽  
Saqib Jahangir ◽  
...  

Study Objectives: To determine the frequency of cirrhotic cardiomyopathy in patients with liver cirrhosis and to compare it across varying grades of cirrhosis on Child Turcotte Pugh classification. Study Design and Settings: It was a descriptive cross-sectional study carried at Department of Medicine, Lahore General Hospital Lahore over 1 year from Jan 2018 to Dec 2018. Patients and Methods: The present research involved 100 male and female patients aged between 16-70 years having liver cirrhosis diagnosed at least 6 months ago. These patients underwent echocardiographic screening of cardiomyopathy which was diagnosed by the presence of diastolic dysfunction (i.e. increased E/A ratio>1). An informed written consent was obtained from every patient. Results of the Study: There was a male predominance (M:F, 1.6:1) among cirrhotic patients with a mean age of 51.9±9.8 years. The mean BMI was 26.5±3.7 Kg/m2 while the mean duration of cirrhosis was 22.0±10.9 months. Majority (49.0%) of the patients belonged to CTP Class C followed by Class-B (39.0%) and Class-A (12.0%). Cirrhotic cardiomyopathy was observed in 41.0% patients with cirrhosis. There was statistically insignificant difference in the observed frequency of cirrhotic cardiomyopathy among various subgroups of cirrhotic patients depending upon patient’s age (p-value=0.928), gender (p-value=0.997), BMI (p-value=0.983) and duration of disease (p-value=0.782). However, it increased considerably with worsening of disease on CTP Classification; Class-A vs. Class-B vs. Class-C (8.3% vs. 35.9% vs. 53.1%; p-value=0.013). Conclusion: Cirrhotic cardiomyopathy was observed in a substantial proportion of cirrhotic patients and was more frequent in patients with more severe disease which warrants routine echocardiographic screening of cirrhotic patients so that timely recognition and anticipated treatment of this complication may improve the case outcome in future medical practice. Keywords: Cirrhosis, Cardiomyopathy, Child Turcotte Pugh Class


2020 ◽  
Vol 27 (01) ◽  
pp. 115-119
Author(s):  
Ehsan Rahim Memon ◽  
Prem Kumar Maheshwari ◽  
Shabana Lakho ◽  
Huma Mehmood

Objectives: To determine the frequency of spontaneous bacterial empyema in cirrhotic patients with hepatic hydrothorax. Study Design: Descriptive cross sectional study. Setting: Conducted in gastroenterology unit at Isra University Hospital, Hyderabad. Periods: One year from April 2016 to March 2017. Material & Methods: Sample of 174 patients of Hepatic Hydrothorax was taken. Patients were of both gender and age ≥ 18 years, having diagnosed cirrhosis since last 5 years and currently having child class B & C severity were included. Hepatic hydrothorax was confirmed on ultrasound chest. After aseptic measures 50ml of pleural fluid was aspirated and sent to Isra University Hospital laboratory following the ultrasound guidelines. Spontaneous bacterial empyema was assessed as “polymorph nuclear cell count” more than 500 cells/mm3 or +ve culture with PMN cell count more than 250 cells/mm3 without parapneumonic effusion. All the data was recorded in the proforma. Results: The mean ± SD age of patients was 53.52 ± 5.52 years. Males were 60.92% while 39.08% were females. The frequency of spontaneous bacterial empyema was about 14.9%. Frequency of spontaneous bacterial empyema was little more in male gender than females (p value = 0.391), while it was significantly increased with increasing age as most common in age group of 61-65 years (p-value = 0.017). Conclusion: It was concluded that spontaneous bacterial empyema in cirrhosis patients was 14.9%.


Author(s):  
Dini Kesumah Dini Kesumah

ABSTRACT According to World Health Organization Health Organization (WHO) in 2005 showed 49% of deaths occur in children under five in developing countries. Nutritional problems can not be done with the medical and health care approach alone. Causes related to malnutrition that maternal education, socioeconomic families, poor environmental sanitation, and lack of food supplies. This study aims to determine the relationship between education and socioeconomic status of families with nutrition survey using a cross sectional analytic approach, with a population of all mothers of children under five who visited the health center in Palembang Keramasan Accidental sampling Sampling the number of samples obtained 35 respondents. Variables include the study independent and dependent variables and univariate analysis using Chi-Square test statistic with a significance level α = 0.05. The results from 35 respondents indicate that highly educated mothers earned as many as 16 people (45.7%), and middle and upper income families as many as 12 people (34.3%) and bivariate test results show that highly educated respondents toddler nutritional status good for 81.3% (13 people) is larger than the less educated respondents balitanya good nutritional status 26.3% (5 persons) as well as respondents who have middle and upper socioeconomic families with good nutritional status of children at 91.7% ( 11 people) is larger when compared to respondents who have family socioeconomic medium with good nutritional status of children at 30.4% (7 people). Statistical tests show that education has a significant relationship with nutritional status of children P value = 0.004 and socioeconomic families have a meaningful relationship with nutritional status of children P value = 0.002. Based on the results of the study suggested the health professionals in the health center should further improve the education, information about the importance of nutrition to the development of the child in the mothers through the selection and processing of good food and a good diet through health centers and integrated health.   ABSTRAK  Menurut badan kesehatan World Health Organization (WHO) tahun 2005 menunjukkan 49% kematian yang terjadi pada anak dibawah umur lima tahun di negara berkembang. Masalah gizi ini tidak dapat dilakukan dengan pendekatan medis dan pelayanan kesehatan saja. Penyebab yang berhubungan dengan kurang gizi yaitu pendidikan ibu, sosial ekonomi keluarga, sanitasi lingkungan yang kurang baik,dan kurangnya persediaan pangan. Penelitian ini bertujuan untuk mengetahui hubungan antara pendidikan dan sosial ekonomi keluarga dengan status gizi balita dengan menggunakan metode survei analitik pendekatan secara Cross Sectional, dengan populasi semua ibu yang memiliki anak balita yang berkunjung ke Puskesmas Keramasan Palembang dengan pengambilan sampel secara Accidental Sampling diperoleh jumlah sampel 35 responden. Variabel penelitian meliputi variabel independen dan dependen serta analisis univariat menggunakan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian ini menunjukkan dari 35 responden didapatkan ibu yang berpendidikan tinggi sebanyak 16 orang  (45,7%), dan keluarga yang berpenghasilan menengah keatas sebanyak 12 orang (34,3%) dan hasil uji bivariat menunjukkan bahwa responden yang berpendidikan tinggi status gizi balitanya baik sebesar 81,3% (13 orang) lebih besar bila dibanding responden yang berpendidikan rendah status gizi balitanya baik 26,3% (5 orang) serta responden yang mempunyai sosial ekonomi keluarga menengah keatas dengan status gizi balita baik sebesar 91,7% (11 orang) lebih besar bila dibanding responden yang mempunyai sosial ekonomi keluarga menengah kebawah dengan status gizi balita baik sebesar 30,4% (7 orang). Uji statistik menunjukkan bahwa pendidikan mempunyai hubungan yang bermakna dengan status gizi balita P value = 0,004 dan sosial ekonomi keluarga mempunyai hubungan yang bermakna dengan status gizi balita P value = 0,002. Berdasarkan hasil penelitian disarankan pada petugas kesehatan di Puskesmas hendaknya lebih meningkatkan penyuluhan-penyuluhan tentang pentingnya gizi terhadap tumbuh kembang anak pada ibu-ibu melalui cara pemilihan dan pengolahan bahan makanan yang baik serta pola makanan yang baik melalui kegiatan Puskesmas dan Posyandu.


2018 ◽  
Vol 9 (02) ◽  
pp. 192
Author(s):  
Wiwid Wahyuningsih ◽  
Atik Setiyaningsih

ABSTRAKLatar Belakang : Keberadaan kader di posyandu sebagai salah satu sistem penyelenggarakan pelayanan sangat dibutuhkan. Mereka adalah ujung tombak  pelayanan kesehatan yang merupakan kepanjangtanganan puskesmas Jawa Tengah tahun 2011 jumlah gizi kurang 5,35% dan gizi buruk 0,10%. Untuk Kabupaten Semarang dari 23.562 balita yang ditimbang pada tahun 2011 gizi lebih 1,13%, gizi baik 93,51%, gizi kurang 4,86% dan gizi buruk 0,49% (DepKes Prov Jateng, 2011). Tujuan Penelitian : Penelitian ini bertujuan untuk mengetahui hubungan peran kader posyandu dengan status gizi balita. Metode Penelitian : Desain penelitian ini adalah survey analitik dengan menggunakan pendekatan cross sectional. Populasi dalam penelitian ini adalah seluruh balita di Posyandu Mawar di Desa Gedangan sejumlah 40 responden, dengan teknik total sampling dan analisa data chi square. Hasil Penelitian : Hasil perhitungan chi square di peroleh X² hitung 10.644 pada df=4, P.value 0.031 dimana probabilitas lebih kecil dari level of significant 5 % (0,001 < 0,05) berarti Ha diterima dan Ho ditolak. Kesimpulan : ada hubungan antara peran kader posyandu dengan status gizi pada balita.Kata Kunci : peran kader , status gizi balitaCADERE ROLE RELATIONSHIP WITH NUTRITIONAL STATUS OF CHILDREN POSYANDUABSTRACTBackground : posyandu cadre in Existence as one of the 56th's service system is urgently needed. They are the tip of the Spear is a kepanjangtanganan health services clinics in Central Java in 2011 the amount of nutrition less 5.35% 0.10% and malnutrition. To Semarang from 23.562 toddler who weighed in 2011 more nutritional 1.13%, 93,51%, good nutrition nutrition less 4.86% and 0.49% poor nutrition (Department of Health Central Java Prov., 2011). Objective : the research aims to find out the relationship role of posyandu cadre with the nutritional status of children. Methods : the design of this research is a survey using the analytic approach of cross sectional. The population in this study are all the toddlers at the Rose in the village of Posyandu Gedangan some 38 respondents, with total sample techniques and data analysis a chi square. The results :. The chi square calculation results in getting X ² count 10.644 on df = 4, P. value 0.031 where probability is smaller than the level of significant 5% (0.001 < 0.05) mean Ha Ho accepted and rejected. Conclusion : there is a connection between the role of cadres of posyandu with nutritional status on toddlers.Keywords : the role of cadres, toddler nutrition status


2017 ◽  
Vol 2 (1) ◽  
pp. 20-28
Author(s):  
Fitriani ◽  
Tenriwati

At present, the incidence of injuries in Indonesia is quite high, as seen from data on traffic accidents in the general public. There are several factors that affect wound healing, one of which is nutritional status. Based on the preliminary data retrieval conducted by researchers in the seruni surgery room in the last 1 month namely in March, it was found that the number of wounded patients was 109 patients, where the number of men was 78 (71.56%) while the number of women was 31 ( 28.44%) The purpose of this study was to determine the relationship between nutritional status and the wound healing process in RSUD. H. Andi. Sulthan Daeng Radja Kab. Bulukumba. This research uses the type of design of this research is quantitative research. This type of research uses analytic observational research with cross sectional approach. The sample of this study were 41 respondents taken by purposive sampling method. Data analysis in this study used the chi-square test (chi square test). The results of the analysis used the chi-square statistical test with a confidence level (α = 0.05). Based on the results of this test, the p value is 0.001, thus p <α (0.001 <0.05), then Ho is rejected and Ha is accepted. The conclusion of this study is that there is a relationship between nutritional status and the process of wound healing in RSUD. H. Andi. Sulthan Daeng Radja Kab. Bulukumba. Researchers suggest that this study be used as a material consideration in the fulfillment of nutrition in wound care patients in RSUD.H.A. Sulthan Daeng Radja Kab. Bulukumba and this research can be continued by conducting research related to the wound healing process and linking it with other variables.


2022 ◽  
Vol 71 (12) ◽  
pp. 2761-2765
Author(s):  
Lubna Ghazi ◽  
Murtaza Dhrolia ◽  
Aamna Hamid ◽  
Ruqaya Qureshi ◽  
Kiran Nasir ◽  
...  

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment.  Continuous...


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saleh Alshaibi ◽  
Tala AlBassri ◽  
Suliman AlQeuflie ◽  
Winnie Philip ◽  
Nesrin Alharthy

Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Method This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). Result A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.


2020 ◽  
Vol 9 (1) ◽  
pp. 111-118
Author(s):  
Lumastari Ajeng Wijayanti ◽  
Eny Sendra ◽  
Ratih Novitasari ◽  
Tanti Dwi Pujaningsih

This research used cross sectional design. The population was 194 respondents and the sample was 54 respondents which are taken by using simple random sampling technique. Independent variable in this research was demographic status that was measured by questionnaire and nutritional status that was measured based on Body Mass Index (BMI). Meanwhile, dependent variable in this research was the occurrence of anemia that was measured by using spectrophotometry. Data analysis used Fisher's Exact test and Two-Sample Kolmogorov-Smirnov test (α = 0,05). Result of Fisher's Exact test was obtained that p value = 1,000 > 0,05, which meant that there was no significant correlation between demographic status and the occurrence of anemia. Meanwhile, result of Two-Sample Kolmogorov-Smirnov test was obtained that p value = 0,017 < 0,05, which meant that there was a significant correlation between nutritional status and the occurrence of anemia.


2021 ◽  
Vol 21 (1) ◽  
pp. 331
Author(s):  
Yeni Indrawatiningsih ◽  
ST Aisjah Hamid ◽  
Erma Puspita Sari ◽  
Heru Listiono

Anemia is a major health problem for people in the world, especially in developing countries, about 50-80% of anemia is caused by iron deficiency. The purpose of this study was to determine the factors that influence the occurrence of young women. This research is an analytical survey with a cross sectional research design, the study was conducted in May - June 2020 in the village of Sidomakmur, Gumawang Community Health Center, East OKU Regency, the population in this study were all young women recorded by village midwives in Sidomakmur Village, totaling 212 people. and the sample is some of the young women who take part in the Posyandu Youth in Sidomakmur Village, amounting to 98 people, through Proportional Random Sampling, univariate (proportion), bivariate (chi square test) and multivariate (logistic regression) analysis. The results of the analysis showed that adolescent education (p value: 0,000), parents' income (p value: 0.012) and adolescent nutritional status (p vaue: 0,000) had a significant relationship with the incidence of anemia in adolescent girls, while adolescent age (p value: 0.224). ) does not have a significant relationship with the incidence of anemia in adolescent girls, while the age of adolescents. Based on the final model of multivariate analysis, the variable that had the greatest influence on anemia status was the variable nutritional status. It is necessary to provide counseling to young women and improve the way of delivering information when young women conduct examinations on how to prevent anemia, both in the form of a good healthy lifestyle and how to maintain health for the growth and development of young women themselves. 


Author(s):  
M Zamzani ◽  
Hamam Hadi ◽  
Dewi Astiti

<p><strong>ABSTRACT</strong></p><p><strong><em>Background</em></strong><strong><em>s</em></strong><strong><em>:</em></strong><em> The increasing prevalence of obesity is caused by imbalance between energy input to energy output. Physical activity in children both at school and at home plays an important role in determining the nutritional status of children, including the risk of obesity. </em></p><p><strong><em>Objectives:</em></strong><em> To determine the relationship between children physical activity with obesity in Ngebel Elementary School, Tamantirto Kasihan Bantul. </em></p><p><strong><em>Methods:</em></strong><em> This study was an observational study with cross sectional design. The study population is all children grades 3, 4, and 5 Ngebel Elementary School, Tamantirto Kasihan Bantul. These samples included 96 children who met the inclusion and exclusion criteria obtained with less total sampling technique. Weight children measured using digital bathroom scales to the nearest 0.1 kg and height was measured using the nearest 0.1 cm microtoice assisted by trained enumerators. Physical activity data were obtained using a physical activity questionnaire was adopted from previous studies. Nutritional status data is calculated using the WHO software Anthro 2005. Univariate analysis using frequency distribution and bivariate analysis using </em><em>Fisher’s Exact Test</em><em>. Data were analyzed using software statistic.</em></p><p><strong><em>Results:</em></strong><em> Results analisis showed physical activity had a significant relationship with the incidence of obesity in children, with p Value 0.015 (&lt;0,05) with OR of 4.78 (95% CI: 1.36 to 16.82), </em><em>in other words children who do moderate to severe activity ≤1 hour/day had 5 times higher chance to be obese than children with moderate to severe activity &gt;1 hour/day.</em></p><p><strong><em>Conclusions:</em></strong><em> Physical activity has a significant association with obesity.</em><em> </em></p><p><strong>KEYWORDS<em>:</em></strong><em> physical activity, obesity, elementary school children</em><em></em></p><p> </p><p><strong>ABSTRAK</strong></p><p><strong><em>Latar belakang: </em></strong><em>Peningkatan prevalensi obesitas disebabkan oleh adanya ketidakseimbangan antara masukan energi dengan keluaran energi. Aktivitas fisik pada anak-anak baik di sekolah maupun di rumah berperan penting dalam penentuan status gizi anak, termasuk risiko terjadinya obesitas.<strong></strong></em></p><p><strong><em>Tujuan: </em></strong><em>Untuk mengetahui </em><em>hubungan antara aktivitas fisik dengan kejadian obesitas pada anak Sekolah Dasar Negeri Ngebel, Tamantirto Kasihan Bantul.</em></p><p><strong><em>Metode: </em></strong><em>Penelitian ini merupakan penelitian observasional dengan rancangan cross sectional. Populasi penelitian adalah semua anak kelas 3, 4, dan 5 SDN Ngebel, Tamantirto Kasihan Bantul. Sampel penelitian berjumlah </em><em>96 </em><em>anak yang memenuhi kriteria inklusi dan eksklusi diperoleh dengn teknik total sampling. Berat anak-anak diukur dengan menggunakan timbangan injak digital dengan ketelitian 0,1 kg, sedangkan tinggi badan diukur menggunakan microtoise dengan ketelitian 0,1 cm dibantu oleh enumerator terlatih. Data aktivitas fisik diperoleh menggunakan kuesioner aktivitas fisik yang diadopsi dari</em><em> penelitian sebelumnya</em><em>. Data status gizi dihitung dengan menggunakan software WHO Anthro 2005. Analisis univariat menggunakan distribusi frekuensi dan analisis bivariat menggunakan</em><em> Fisher’s Exact Test</em><em>. Data dianalisis dengan menggunakan program software statistic.</em></p><p><strong><em>Hasil: </em></strong><em>Hasil a</em><em>nalisis </em><em>menunjukkan aktivitas fisik memiliki hubungan yang signifikan dengan kejadian obesitas pada anak dengan </em><em>nilai p value 0,009 (&lt;0,05) dengan nilai OR 5,69 (95% CI: 1,42-22,65), dengan kata lain anak yang melakukan aktivitas sedang-berat ≤1 jam/hari berpeluang 5 kali lebih besar untuk mengalami obesitas daripada anak dengan aktivitas sedang-berat &gt;1 jam/hari.</em></p><p><strong><em>Kesimpulan: </em></strong><em>Aktivitas fisik memiliki hubungan secara bermakna dengan obesitas.</em><strong><em></em></strong></p><p><strong>KATA KUNCI: </strong><em>aktivitas fisik, obesitas, anak SD</em></p>


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