scholarly journals Effect of prolonged starvation on the body preoperatively and the role of carbohydrate loading

Author(s):  
Abdulkarim Mohammad Alhassoun ◽  
Fahad Hussain Kammas ◽  
Mohammed Yousif Alaissawi ◽  
Walaa Mohamed Hasan ◽  
Nouf Mohammed Alrabiah ◽  
...  

Although recent reports discourage preoperative overnight fasting, many clinicians and surgeons still recommend 6-8 hours of overnight preoperative fasting before conducting elective surgeries. On the other hand, recent guidelines from worldwide multiple anesthesiology societies have suggested that overnight fasting should be approached with flexible durations and proper techniques. Many complications can result from prolonged fasting and preoperative starvation as the duration of fasting usually lasts for more than 12 hours secondary to intraoperative surgical delays. In this literature review, the aim was to discuss the current evidence from studies in the literature about the effect of preoperative starvation and the effect of carbohydrate (CHO) loading on the clinical outcomes of patients. We have noticed that gastric aspiration and respiratory damage can be prevented by preoperative fasting. However, this can lead to the development of other complications such as insulin resistance, a fierce immune response and exaggerated release of acute-phase reactants which might lead to severe organ damage and worsened patient’s prognosis. Accordingly, CHO loading should be carefully approached to properly intervene against these cases to enhance the prognosis of the prospective surgeries and the quality of care for patients. 

Author(s):  
Dr.Suraj Kumbar ◽  
Dr.Lohith BA ◽  
Dr.Ashvinikumar M ◽  
Dr. Amritha R ◽  
Dr. Shameem Banu

We are in technical era where there is more of sedentary life style and stress along with this urbanization is affecting our quality of food and health. This is leading to many lifestyle disorders and hormonal imbalances in our body. Hypothyroidism one among the endocrinal disorder. Thyroid is an endocrinal gland secrets T3 and T4 hormones regulated by TSH which is secreted by Pituitary gland. These hormones have two major effects on the body, 1) To increase the overall metabolic rate in the body 2) To stimulate growth in children. Hypothyroidism is common health issue in India. The highest prevalence of hypothyroidism (13.1%) is noted in people aged 46-54yrs old. With people aged 18-35 yrs being less affected (7.5%). To prevent these hazards Panchakarma is beneficiary to maintain metabolic rate. Here an attempt is made to diagnose hypothyroidism in the light of Ayurveda and management guidelines through Panchakarma.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 370
Author(s):  
Umair Iqbal ◽  
Ravirajsinh N. Jadeja ◽  
Harshit S. Khara ◽  
Sandeep Khurana

Hepatic encephalopathy (HE) is a common neurological consequence in patients with cirrhosis and has a healthcare burden of USD 5370 to 50,120 per patient annually. HE significantly hampers the quality of life and is a major cause of morbidity and mortality. Patients with cirrhosis are at a high risk for protein-calorie malnutrition due to altered metabolism. Current evidence has changed the old belief of protein restriction in patients with cirrhosis and now 1.2 to 1.5 g/kg/day protein intake is recommended. Case series and studies with small numbers of participants showed that a vegetarian protein diet decreases the symptoms of HE when compared to a meat-based diet, but the evidence is limited and requires further larger randomized controlled trials. However, vegetable or milk-based protein diets are good substitutes for patients averse to meat intake. Branch chain amino acids (BCAA) (leucine, isoleucine and valine) have also been shown to be effective in alleviating symptoms of HE and are recommended as an alternative therapy in patients with cirrhosis for the treatment of HE. In this review, we provide an overview of current literature evaluating the role of protein intake in the management of HE in cirrhosis.


2020 ◽  
Vol 26 (3) ◽  
pp. 78-82
Author(s):  
Т. F. Golubova ◽  
А. I. Kreslov

Climate is an active, powerful factor that can have a powerful therapeutic effect. Climatotherapy is prescribed for the purpose of General strengthening effects on the body, to stimulate its defenses, increase non-specific resistance, especially in chronic or sluggish pathological processes. The effect of climate therapy is manifested in the body's responses to environmental factors, the main condition of which is the use of physiologically based methods of dosing climate procedures. The bioclimatic station (BCS) of the resort of Yevpatoria carries out meteorological observations of medical orientation and their dosing. The creation of a modern center of climatotherapy, as a scientific-clinical Department of medical climatology on the basis of the BCS will allow to organize a single service on introduction of modern methods of climatotherapy in Evpatoria and the Republic of Crimea, improve the quality of the holiday of climateprotection and effectiveness of climatotherapy.


Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1417
Author(s):  
Maurillo ◽  
Bassan ◽  
Cascavilla ◽  
Ciceri

: In the acute myeloid leukemia (AML) setting, research has extensively investigated the existence and relevance of molecular biomarkers, in order to better tailor therapy with newly developed agents and hence improve outcomes and/or save the patient from poorly effective therapies. In particular, in patients with AML, residual disease after therapy does reflect the sum of the contributions of all factors associated with diagnosis and post-diagnosis resistance. The evaluation of minimal/measurable residual disease (MRD) can be considered as a key tool to guide patient’s management and a promising endpoint for clinical trials. In this narrative review, we discuss MRD evaluation as biomarker for tailored therapy in AML patients; we briefly report current evidence on the use of MRD in clinical practice, and comment on the potential ability of MRD in the assessment of the efficacy of new molecules.


2020 ◽  
Vol 10 (2) ◽  
pp. 103-115 ◽  
Author(s):  
Scott Rooney ◽  
Hani Albalawi ◽  
Lorna Paul

Relapses are a common feature of multiple sclerosis; however, recovery from relapses is often incomplete, with up to half of people experiencing residual disabilities postrelapse. Therefore, treatments are required to promote recovery of function and reduce the extent of residual disabilities postrelapse. Accordingly, this Perspective article explores the role of exercise in relapse management. Current evidence from two studies suggests that exercise in combination with steroid therapy improves disability and quality of life postrelapse, and may be more beneficial in promoting relapse recovery than steroid therapy alone. However, given the small number of studies and methodological limitations, further studies are required to understand the effects of exercise in relapse management and the mechanism through which exercise influences relapse recovery.


2019 ◽  
Vol 3 (4) ◽  
pp. 227-231
Author(s):  
Rihab Ksouri

Abstract Food is a vital need for everyone. Today, there is food for all, but the world still suffers from under- and over-nutrition and risk of cancer development and chronic diseases can follow both cases. Worldwide, cancer is a leading cause of mortality after cardiovascular disease; it is considered the second reason for death globally. Role of nutritional habits, the quality of food, the consumption of canned foods, genetically modified fruits and vegetables and exposed food to certain pesticides and carcinogens agents, and unhealthy lifestyle behaviours such as smoking, alcohol, obesity, and fast-foods consumption may be at risk to the development of some cancers. In recent decades, researchers have carried out attention in this field to improve the quality of life and to limit nutrition problems. Thus, this study aims to summarize current evidence on the relationship between nutritional factors and cancer expansion, how nutrition can be a heal and a source of fatal illness leading to death. In detail, this review will highlight the influence of specific foodstuffs on the threat of cancer incidence and recurrence by providing some examples of most carcinogenic compounds.


2020 ◽  
Vol 11 (5) ◽  
pp. 121-127
Author(s):  
Ajay Kushwaha ◽  
Nisha Kumari Ojha

Children are more susceptible to various infections because of underdeveloped immune system as compared to adults. Strengthening the immune system is a natural way to help the body fight against the disease-causing pathogens and immunomodulators can play a major role in this context. Various Ayurveda classics and studies published in journals related to Ayurveda drugs for improving immunity are reviewed and analysed. In Ayurveda, the objective of immune enhancement is achieved through the use of the Amalakyadi Rasayana (an Immunomodulators), as it increases longevity of life, memory, intellect, luxture, complexion, voice, strength of the body functions, strength of all senses and provides the resistance to disease, improves glow and power. Analysis of classical references and various experimental studies show that Amalakyadi Rasayana posse immuno-modulatory, Antioxidant, Anti-inflammatory, Antimicrobial, Anthelmintic activity. Present paper is a review to update knowledge on pharmacological properties, therapeutic actions and possible mode of action of the selected formulation, Amalakyadi rasayana from Yogaratnakara (Rasayanadhikara/17) to enhance the immunity in children. Rasayana is an important part of Ayurvedic therapeutics used to improve the quality of life by strengthening the tissue quality and by reducing the age-related tissue degeneration. This study reveals that Amalakyadi Rasayana have potential to improve or strengthen the immune system in children and thereby can lower down the morbidity rate in children.


2017 ◽  
Vol 30 (2) ◽  
pp. 247-264 ◽  
Author(s):  
Jacklyn Jackson ◽  
Amanda J. Patterson ◽  
Lesley MacDonald-Wicks ◽  
Mark McEvoy

AbstractCVD is the leading cause of death worldwide, a consequence of mostly poor lifestyle and dietary behaviours. Although whole fruit and vegetable consumption has been consistently shown to reduce CVD risk, the exact protective constituents of these foods are yet to be clearly identified. A recent and biologically plausible hypothesis supporting the cardioprotective effects of vegetables has been linked to their inorganic nitrate content. Approximately 60–80 % inorganic nitrate exposure in the human diet is contributed by vegetable consumption. Although inorganic nitrate is a relatively stable molecule, under specific conditions it can be metabolised in the body to produce NO via the newly discovered nitrate–nitrite–NO pathway. NO is a major signalling molecule in the human body, and has a key role in maintaining vascular tone, smooth muscle cell proliferation, platelet activity and inflammation. Currently, there is accumulating evidence demonstrating that inorganic nitrate can lead to lower blood pressure and improved vascular compliance in humans. The aim of this review is to present an informative, balanced and critical review of the current evidence investigating the role of inorganic nitrate and nitrite in the development, prevention and/or treatment of CVD. Although there is evidence supporting short-term inorganic nitrate intakes for reduced blood pressure, there is a severe lack of research examining the role of long-term nitrate intakes in the treatment and/or prevention of hard CVD outcomes, such as myocardial infarction and cardiovascular mortality. Epidemiological evidence is needed in this field to justify continued research efforts.


Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 974 ◽  
Author(s):  
Aileen Hill ◽  
Sebastian Wendt ◽  
Carina Benstoem ◽  
Christina Neubauer ◽  
Patrick Meybohm ◽  
...  

The pleiotropic biochemical and antioxidant functions of vitamin C have sparked recent interest in its application in intensive care. Vitamin C protects important organ systems (cardiovascular, neurologic and renal systems) during inflammation and oxidative stress. It also influences coagulation and inflammation; its application might prevent organ damage. The current evidence of vitamin C’s effect on pathophysiological reactions during various acute stress events (such as sepsis, shock, trauma, burn and ischemia-reperfusion injury) questions whether the application of vitamin C might be especially beneficial for cardiac surgery patients who are routinely exposed to ischemia/reperfusion and subsequent inflammation, systematically affecting different organ systems. This review covers current knowledge about the role of vitamin C in cardiac surgery patients with focus on its influence on organ dysfunctions. The relationships between vitamin C and clinical health outcomes are reviewed with special emphasis on its application in cardiac surgery. Additionally, this review pragmatically discusses evidence on the administration of vitamin C in every day clinical practice, tackling the issues of safety, monitoring, dosage, and appropriate application strategy.


2014 ◽  
Vol 20 (3) ◽  
pp. 184-192 ◽  
Author(s):  
Afia Ali ◽  
Jessica Blickwedel ◽  
Angela Hassiotis

SummaryChallenging behaviour is common in intellectual disability but it is difficult to diagnose and manage. It can adversely affect the quality of life of the individual and cause the breakdown of community placements, resulting in hospital admission. This article discusses the aetiology of challenging behaviour (including the complex relationship with mental illness), diagnostic problems, the current evidence base in relation to psychosocial and pharmacological treatments, and service delivery.LEARNING OBJECTIVES•Understand the aetiological basis of challenging behaviour.•Understand the role of functional analysis.•Appreciate the evidence base in relation to the psychological and pharmacological treatment of challenging behaviour.


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