P-OGC93 Weight Loss and Complications in Oesophagectomy and Gastrectomy Patients

Background Oesophagectomy and gastrectomy are major surgeries which often involve patients fasting for prolonged periods of time post operatively thus requiring alternative nutrition regimens. In addition, patients often suffer dysphagia, anorexia, chemotherapy side effects and significant weight loss prior to surgery. Post-operative concerns include delayed gastric emptying, refeeding syndrome and dumping syndrome. Whilst placement of enteral feeding tubes aids the transition back to normal diet there are often still social, physical and dietary challenges that hinder nutrition. The aim of this study was to review weight loss in patients post operatively and to optimise post-operative nutrition. Methods The records of 113 patients who had undergone an oesophagectomy (43) or gastrectomy (64) between June 2018 and November 2019 at a single regional cancer centre were retrospectively examined. These patients’ contemporaneous weights had been recorded at set peri operative timelines and the greatest percentage weight loss calculated. The percentage weight loss was matched to the highest Clavien-Dindo post-operative complication. Results 89 patients had weights routinely reviewed post operatively, with the remainder not having regular post operative weights documented. The median weight loss was 7.53. For patients undergoing a total gastrectomy (27) weight loss ranged from 7.36-29.2%. Median weight loss was 11.45%. Patients who underwent subtotal gastrectomy (26) had between 0.37-18.5% with a median of 7.83% weight loss. Those who underwent an oesophagectomy (36) had between 0 - 28.67% weight loss with the median being 7.21%. 6 patients had their operations abandoned. Post-operative complications, inclusive of Grade II and above, occurred in 16.8% of cases. Majority of complications occurred in those undergoing an oesophagectomy (64%), however complications did not correlate with percentage weight loss. The most common complication was grade IIIb (Grade I: 8, Grade II: 1, Grade IIIa: 1, Grade IIIb: 14, Grade IVa: 2, Grade V: 2). Conclusions Significant post-operative weight loss is common after oesophagectomy or gastrectomy surgery. Postoperative weight loss did not correlate with complications. Furthermore, there did not appear to be a correlation with weight loss and type of procedure. Nutritional status plays an important prognostic role in patients undergoing oesophagectomy or gastrectomy. Optimising nutrition perioperatively and post operatively is important to enhance post-operative recovery and reduce post operative risk. Reviewing a larger cohort of patients would improve the robustness of this study.

Preoperative Nutrition Intervention in Patients Undergoing Resection for Upper Gastrointestinal Cancer: Results from the Multi-Centre NOURISH Point Prevalence Study

Background: Preoperative nutrition intervention is recommended prior to upper gastrointestinal (UGI) cancer resection; however, there is limited understanding of interventions received in current clinical practice. This study investigated type and frequency of preoperative dietetics intervention and nutrition support received and clinical and demographic factors associated with receipt of intervention. Associations between intervention and preoperative weight loss, surgical length of stay (LOS), and complications were also investigated. Methods: The NOURISH Point Prevalence Study was conducted between September 2019 and May 2020 across 27 Australian tertiary centres. Subjective global assessment and weight were performed within 7 days of admission. Patients reported on preoperative dietetics and nutrition intervention, and surgical LOS and complications were recorded. Results: Two-hundred patients participated (59% male, mean (standard deviation) age 67 (10)). Sixty percent had seen a dietitian preoperatively, whilst 50% were receiving nutrition support (92% oral nutrition support (ONS)). Patients undergoing pancreatic surgery were less likely to receive dietetics intervention and nutrition support than oesophageal or gastric surgeries (p < 0.001 and p = 0.029, respectively). Neoadjuvant therapy (p = 0.003) and malnutrition (p = 0.046) remained independently associated with receiving dietetics intervention; however, 31.3% of malnourished patients had not seen a dietitian. Patients who received ≥3 dietetics appointments had lower mean (SD) percentage weight loss at the 1-month preoperative timeframe compared with patients who received 0–2 appointments (1.2 (2.0) vs. 3.1 (3.3), p = 0.001). Patients who received ONS for >2 weeks had lower mean (SD) percentage weight loss than those who did not (1.2 (1.8) vs. 2.9 (3.4), p = 0.001). In malnourished patients, total dietetics appointments ≥3 was independently associated with reduced surgical complications (odds ratio 0.2, 95% confidence interval (CI) 0.1, 0.9, p = 0.04), and ONS >2 weeks was associated with reduced LOS (regression coefficient −7.3, 95% CI −14.3, −0.3, p = 0.04). Conclusions: Despite recommendations, there are low rates of preoperative dietetics consultation and nutrition support in this population, which are associated with increased preoperative weight loss and risk of increased LOS and complications in malnourished patients. The results of this study provide insights into evidence–practice gaps for improvement and data to support further research regarding optimal methods of preoperative nutrition support.

The use of Facebook in a community pharmacist-led weight management programme – a London-based proof of concept study

Introduction In the United Kingdom (UK), 63% of adults are overweight,(1) costing the NHS £6.1 billion/year. With the public using digital technology over healthcare professionals (HCPs) for health advice, this warrants an investigation of technology use in community pharmacy, given its previous successful use.(2) Aim To determine the feasibility and perceptions of a community pharmacist (CP)-led weight management programme (WMP), enhanced by a Facebook support group (FSG). Methods A proof of concept study was conducted between January-March 2020. Recruitment was via a pharmacy, the university and a community Facebook group. Inclusion criteria: over 18 years; overweight; no medical conditions. Participants attended face-to-face meetings (ftf) with a CP and final year pharmacy student (PS) on two occasions (0 (baseline) and 4 weeks). At baseline, participants were given the NHS weight loss programme and set weight loss goals. During ftf, participants had height, weight, and waist circumference (WC) measurements by a CP/PS and discussed eating habits, exercise and alcohol. In between ftf, participants accessed the FSG (created (December 2019) and moderated by a CP). Here, they received posts about diet, exercise and motivation. Participants were to have their measurements taken ftf at 8-weeks, however, COVID-19 meant participants had to self-declare these via video call. Following the 8-week programme, participants completed a 4-section survey about their experience (signing up to the service; comparison to previous weight loss attempts; the FSG and overall perceptions). Question types included multiple choice, Likert scale and free text comments. Data were analysed in Excel (Microsoft Corporation 2016) with changes in height, weight, waist circumference, alcohol and exercise being calculated. Results Fifty-five participants were recruited. 18 were lost to follow-up, most (n=12/18) citing COVID-19. Of the 37 participants remaining (70.3% female, mean age=37 years), 22 were obese, the rest overweight. Mean weight loss, mean percentage weight loss and mean WC reduction at 4-weeks was 1.6 kg (SD+/- 1.7 kg), 1.8% (SD+/- 1.9%) and 2 cm (SD+/- 1.96 cm) respectively. At week 8 measurements were self-declared. Mean weight loss at 8-weeks from baseline was 2.7 kg (SD +/- 2.6 kg) and mean percentage weight loss was 3% (SD+/- 3%). Only five participants’ self-declared WC measurements at 8-weeks with mean reduction being 3.6 cm. Five participants moved to healthier BMI classifications by week 8. All participants accessed the FSG at least weekly with 13 accessing it daily. Diet posts were the most popular (n=20/37). Participants learned about portion control and increasing fruits/vegetables intake. All participants would recommend the programme to their friends/family. Conclusion An 8-week CPWMP, enhanced with FSG, supported participants to lose a mean of 3% body weight. Participants accessed the page regularly and were positive about its usefulness. One limitation was that the COVID-19 lockdown prevented the 8-week ftf, therefore, self-declared measurements were used. The pandemic has highlighted the importance of pharmacy embracing technology for service delivery, particularly when in-person contact is limited. The implication of this study is that it provides proof that the concept of digital service delivery could work in practice. References 1. GOV.UK. Tackling obesity: empowering adults and children to live healthier lives [Internet]. Department of Health and Social Care. 2020 [cited 2020 Aug 18]. Available from: https://www.gov.uk/government/publications/tackling-obesity-government-strategy/tackling-obesity-empowering-adults-and-children-to-live-healthier-lives 2. Crilly P, Kayyali R. A Systematic Review of Randomized Controlled Trials of Telehealth and Digital Technology Use by Community Pharmacists to Improve Public Health. Pharmacy 2020;8(3):137. Available from: https://www.mdpi.com/2226–4787/8/3/137

MODELS FOR THE PREDICTION OF QUALITY PARAMETERS OF TABLE EGGS STORED UNDER DIFFERENT CONDITIONS

A total of 144 newly - laid eggs obtained from Lohmann Brown layers were distributed and stored under three storage conditions: room temperature, polythene bag/room temperature and refrigeration. Changes in Haugh unit, yolk ), index and percentage weight loss were evaluated between 0 and 14 days at intervals of two days each, Haugh unit, yolk index, and albumen have significantly (P>0.001), while percentage weight loss increased (P<0.001) with storage duration, Generally, quality on the parameters of refrigerated eggs were significantly (P<0.05) higher than those stored used in polythene bag or those stored open in the room o. Polythene-bagged eggs had the least percentage weight loss. Significant (P<0.001) storage method x storage duration interactions were obtained. Regressing the internal egg quality measurement (Y) over storage period (X) in simple linear Y = a +bx) or the exponential (Y = ab ). regression functions showed that the predictive ability measured as also the r2 - values was generally higher with the. exponential than the simple linear model. The predictive ability of each egg quality parameter was higher with the polythene - bagged eggs than with other storage conditions. Using the simple linear prediction model, table eggs purchased randomly from retail egg shops had quality values of eggs that were about 4 - 11 days after lay prior to purchase.

Effects of wood resource size and decomposition on hyphal outgrowth of a cord-forming basidiomycete, Phanerochaete velutina

To assess the relationship between resource use and hyphal growth in a cord-forming basidiomycete, Phanerochaete velutina, soil microcosm experiments were conducted using wood blocks of three different sizes in three different soil quantities, thereby simulating the different amounts of available nutrients. The highest percentage weight loss was observed in the smallest wood blocks after a 27-d incubation period in soil microcosms, although the percentage weight loss over the 2-month pure culture colonization prior to inoculation was not significantly different among various block sizes. The greatest hyphal outgrowth was also observed in the smallest wood blocks and was positively associated with wood decay. The slopes of the regression lines between hyphal coverage and percentage wood mass loss were identical among different wood sizes, but the slopes between hyphal coverage and absolute wood mass loss were steeper in the smaller wood blocks than that in largest one. These results suggest that the level of intensity of mycelial foraging for new resources in the soil depends on the percentage of the amount of wood resource utilized, and not on the absolute amount of carbon obtained from the wood.

ANTI-TERMITE EFFECT OF ANADELPHIA AFZELIANA (RENDLE) STAPF EXTRACTS ON SELECTED WOOD SPECIES IN MAKURDI, BENUE STATE, NIGERIA

This study examined anti-termite effect of Anadelphia afzeliana extracts on Daniellia oliveri, Gmelina arborea and Terminalia ivorensis wood species in Makurdi, Nigeria. A. afzeliana was collected, dried under shade, pulverized and the phytochemical constituents of screened. Weight of 100 g was respectively dissolved in 200 mL of methanol and hot water and mixtures left to macerate within 24 hours and thereafter filtered to obtain extracts. Concentrations of 20 %, 30 % and 50 % were constituted from methanol and aqueous extracts.Test woods were weighed and impregnated in treatments for 72 hours, after which absorption and retention were calculated. Treated woods were laid out in a timber grave yard in a Completely Randomized Design with seven treatments and solignum as control. Grand total of 360 test wood were used. Percentage weight loss was calculated on test wood. Anthraquinones, balsams, flavonoids, phlobatannins, tannins, terpens, resins, phenols and saponins phytochemicals were present in A. afzeliana. Mean absorption of G. arborea, T. ivorensis and D. oliveri test wood were 93.04 -130.55 kg/m3, 100.54 - 142.04 kg/m3 and 96.94 - 175.01 kg/m3, respectively. The values were lowest in solignum and highest in 20 % A. afzeliana aqueous extract. Mean retention in G. arborea, T. ivorensis and D. oliveri were 9.29 - 62.51 kg/m3, 11.29 - 90.78 kg/m3 and 10.79 - 55.69 kg/m3; lowest in solignum and highest in 50 % A. afzeliana aqueous extract. Mean percentage weight loss was 13.81 - 30.65 % (G. arborea), 13.37 - 23.31 % (D. oliveri) and

Effect of fluid supplementation with phototherapy in reducing the serum bilirubin levels in severe hyperbilirubinemia

Hyperbilirubinemia otherwise called ”jaundice” is yellowish-green pigmentation of the sclera and skin brought about by an expansion in bilirubin creation or an imperfection in bilirubin elimination. Prospective randomized comparative correlational study carried out on babies admitted to NICU in Krishna Hospital. All healthy term babies (= 37 weeks) with non haemolytic hyperbilirubinemia with absolute serum bilirubin =20 mg/dl - = 25 mg/dl from second day of life to fourteenth day of life. Out of 811 babies admitted in NICU during the study period, 52 babies were admitted for severe hyperbilirubinemia in NICU. Thus, the incidence rate was 6.4%.out of these 28 (53.84%) were male and 24 (46.15%) were female. The frequency of extreme hyperbilirubinemia was more in inborn babies (78.88%) than out born babies (21.15%). The frequency of extreme hyperbilirubinemia with respect to birth weight were, Weights between 2000 gms-3000gms were 40 (76.9%) and weight above 3000 gms were 12 (23.07%). The percentage weight loss from the time of birth till admission between enhanced and non enhanced gatherings was comparable. In the study, 28 (53.84%) were delivered per vaginally, 24 (46.15%) were born by LSCS. Most neonates in our study, 31 (59.61%) cases presented with in 2-5 days, 20 cases presented between 6-10 days and only one case between 11-14 days. The mean gestational age of presentation in both groups was not significant. By unpaired T test both supplemental and non supplemental groups are comparable i.e., the levels of bilirubin, rate of reduction of bilirubin between 2 groups is not significant. By ANOVA test i.e., the levels of bilirubin, rate of reduction of bilirubin in both the groups is highly significant. The complete length of phototherapy required between2 groups is not significant. This information show that organization of extra intravenous liquid in embittered sound, term, breastfed neonates have no useful impact on the pace of serum bilirubin decrease during phototherapy.

PENGARUH JARAK PENGANGKUTAN TERHADAP PENYUSUTAN DAN PERSENTASE PENYUSUTAN BOBOT BADAN AYAM KAMPUNG SUPER (The Effect of Transport Distance on Depreciation and Percentage Weight Loss of Super Native Chicken)

Abstrak Penelitian ini bertujuan untuk mengetahui dan mempelajari pengaruh jarak pengangkutan terhadap penyusutan dan persentase penyusutan bobot badan ayam kampung super. Penelitian ini dilakukan selama satu hari dari kandang yang berlokasi dari Kampung Patrol, Desa Sirna Galih, Kecamatan Cigalontang, Kabupaten Tasikmalaya ke Kampung Cigangsa, Desa Bojongloa, Keacamatan Cilawu, Kabupaten Garut. Rancangan yang digunakan dalam penelitian ini adalah Rancangan Acak Lengkap (RAL), dengan empat perlakuan dan lima ulangan, yaitu : P1 (Jarak Pengangkutan 10 Km), P2 (Jarak Pengangkutan 20 Km), P3 (Jarak Pengangkutan 30 Km), dan P4 (Jarak Pengangkutan 40 Km), dengan menggunakan 100 ekor ayam kampung super yang dibagi secara acak ke dalam 5 unit keramba yang diisi 20 ekor tiap unit keramba, dan tiap unit keramba dibagi 4 kelompok perlakuan dengan 5 ulangan. Hasil penelitian menunjukkan bahwa semakin jauh jarak pengangkutan, maka semakin besar penyusutan dan persentase penyusutan bobot badan ayam kampung super. Sampai jarak pengangkutan 40 km tidak berpengaruh signifikan terhadap penysutan dan persentase penyusutan bobot badan ayam kampung super. Penyusutan dan persentase penyusutan paling tinggi diperoleh pada jarak pengangkutan 40 km yaitu rata-rata sebesar 35,2 gram/ekor dan 4 persen. Kata Kunci : Pengangkutan, Penyusutan, Ayam Kampung Super. Abstract This research aim ti study the effect of transport distance on depreciation and percentage weight loss of super native chicken, was conducted on 1 day located from Patrol of Sirna Galih Village, Cigalontang District, Tasikmalaya Regency to Cigangsa of Bojongloa Village, Cilawu District, Garut Regency. The method on this research was experimental method with design conducted Complete Randomized Design, on four treatments and five replications, which as follows; P1 (Transport Distance 10 Km), P2 (Transport Distance 20 Km), P3 (Transport Distance 30 Km), dan P4 (Transport Distance 40 Km), by using 100 super native chickens which were randomly divided into 5 cage units filled with 20 chickens per cage unit, and each cage unit is divided into 4 treatment groups with 5 replications. The results showed that the longer distance of transportation, the greater the lost weight and percentage of lost body weight of super native chicken. Until the transport distance of 40 km does not have a significant effect on lost weight and percentage of lost body weight of super native chicken. Depreciation and the highest percentage of depreciation were obtained at 40 km transport distance, which was an average of 35.2 grams / head and 4 percent. Keywords : Transport Distance, depreciation, Super Native Chicken

Chemical modification of Petersianthus macrocarpus (essia), to determine whether durability depends on bulking or hydroxyl substitution

Wood is a biodegradable material. Decay resistance of wood is improved when the wood is chemically modified. The decayresistance of a chemically modified wood is improved as the modification stabilizes the cell wall polymers against enzyme attackdue to the blocking of accessible hydroxyl groups of the cell wall polymers which reduces the amount of water for hydrolysis. Theimproved durability of the modified wood as a result of reducing the amount of water molecules into the cell wall for hydrolysiswill depend on either bulking or percentage hydroxyl substitution (%OH). Petersianthus macrocarpus (essia), a tropical hardwoodspecies was chemically modified with acetic anhydride (AA) and pentanoic anhydride (PA) in dry pyridine to improve its decayresistance. Graveyard test was used to analyze the effect of the modification on the decay resistance of the wood in twelve weeksin-ground contact. Percentage weight loss and visual decay grades were used to evaluate whether the decay resistance dependson weight percentage gain or percentage hydroxyl substitution. The decay resistance of the modified samples were found to bedependent on bulking.

The Impact of Insect Infestation on Stored Purpled Cocoa Beans

Under-fermentation of cocoa beans produces purple beans. The fermentation period is 6 to 7 days but some cocoa farmersunder-ferment their cocoa beans leading to the development of purple cocoa beans. This study determined the impact of insectinfestation on stored purple cocoa beans. Wet cocoa beans were fermented for 1, 2, 3, 4 and 5 days to produce the purple beans.Ephestia cautella and Tribolium castaneum, both singly and in combination, were introduced into the cocoa beans and storedfor different (30, 60, 90 and 120 days) period. Insect population, percentage weight loss and the contaminants produced bythese insects were determined. Cocoa beans infested with E. cautella alone had the highest population of 297.0 ± 22.7. Beansfermented for 3 days had the lowest insect population both singly and in combination after 120 days of storage. The highestpercentage weight loss was recorded in cocoa beans fermented for one day (10.1 ± 1.87%) and 4 days (10.1 ± 8.74%). T.castaneum did not cause much damage to the cocoa beans but E. cautella alone caused significant damage to stored cocoabeans. Insect infestation and poor fermentation contribute significantly to the reduction in quality of cocoa beans.