PENGELOLAAN DEFISIT NUTRISI PADA BAYI DENGAN MALNUTRISI DI DESA MRANGGEN KIDUL

Abstrak Latar Belakang: Malnutrisi merupakan kondisi seseorang mengalami kekurangan atau kelebihan nutrisi yang dapat menyebabkan pertumbuhan dan perkembangan orang tersebut terganggu. Malnutrisi banyak ditemukan pada bayi dengan usia diatas 6 bulan dikarenakan banyak keluarga yang belum memahami kebutuhan bayi secara khusus, belum mengerti cara membuat makanan pendamping yang bernutrisi sehingga menyebabkan bayi mengalami penurunan berat badan. Penurunan berat badan ini diakibatkan karena adanya gangguan dalam penyerapan makanan, sehingga terjadi defisit nutrisi Defisit nutrisi merupakan keadaan dimana asupan nutrisi tidak cukup untuk metabolisme tubuh. Tujuan: Penulisan ini bertujuan untuk memberikan deskripsi atau gambaran tentang pengelolaan defisit nutrisi pada bayi dengan malnutrisi di Desa Mranggen Kidul. Metode: Jenis penelitian deskriptif dengan pendekatan asuhan keperawatan berupa pengkajian, analisis data, merumuskan diagnosa keperawatan, perencanaan, pelaksanaan, dan evaluasi dalam penanganan malnutrisi. Hasil: Hasil pengelolaan yang dilakukan pada pasien dengan teknik pengumpulan data menggunakan wawancara, pemeriksaan fisik dan observasi. Kemudian dilakukan rencana keperawatan yaitu monitor berat badan dan identifikasi status nutrisi. Didapatkan hasil akhir berat badan pasien 5,1 kg dan status nutris pasien (BB/U: -4,3 SD (gizi buruk), PB/U: -4,1 SD (sangat pendek), BB/PB: -3,6 SD (sangat kurus), IMT/U: -3,7 SD (sangat kurus)). Kesimpulan: Berdasarkan tindakan keperawatan yang dilakukan, maka dapat disimpulkan malnutrisi pada pasien belum teratasi. Saran bagi keluarga agar lebih memperhatikan dan mengetahui bagaimana cara penanganan malnutrisi pada bayi. Kata kunci : Malnutrisi, Defisit Nutrisi, Bayi Abstract Background: Malnutrition is a condition of a person experiencing a lack or excess of nutrients that can cause the growth and development of the person to be disrupted. Malnutrition is often found in infants aged over 6 months because many families do not understand the baby's specific needs, do not understand how to make nutritious complementary foods, causing babies to lose weight. This weight loss is caused by a disturbance in the absorption of food, resulting in a nutritional deficit. A nutritional deficit is a condition where the intake of nutrients is not sufficient for the body's metabolism. Purpose: This paper aims to provide a description or description of the management of nutritional deficits in malnourished infants in Mranggen Kidul Village. Method: This type of descriptive research with nursing care approach in the form of assessment, data analysis, formulating nursing diagnoses, planning, implementation, and evaluation in the handling of malnutrition. Result: The results of the management carried out on patients with data collection techniques using interviews, physical examinations and observations. Then a nursing plan is carried out, namely weight monitoring and identification of nutritional status. The final results obtained were the patient’s weight was 5.1 kg and the nutritional status of the patient (BB/U: -4,3 SD (poor nutrition), PB/U: -4,1 SD (very short), BB/PB: -3,6 SD (very thin), BMI/U: -3,7 SD (Very thin)). Conclution: Based on the nursing acions taken, it can be concluded that malnutrition in the patient has not been resolved. Suggestions for families to pay more attention and know how to handle malnutrition in infants. Keywords : Malnutrition, Nutritional Deficit, Infant

EP.FRI.332 Impact of Nutritional Deficit in Emergency Surgery (INDIcatES): A cohort study

Background Emergency laparotomy is associated with significant morbidity. Nutritional status is an important factor that can influence outcomes, particularly in this setting where temporary gastrointestinal failure can occur. This study aims to compare the performance of three nutrition risk tools in predicting time without enteral nutrition. Methods A prospective cohort study was conducted across two sites (NCT04696367). Patients undergoing NELA eligible procedures were invited to participate. Data collected included demographics, surgical diagnosis, surgical procedure, and surgical outcomes. Nutrition risk was assessed using three tools: MUST score, the Nutritional Risk Index (NRI), and Nutritional Risk Score 2002 (NRS). Results In total, 56 patients were recruited of whom 21 had small bowel obstruction. Median age was 69 years and 23 participants were female. Overall, 23 participants (41.8%) were identified as high risk using the MUST score, compared to 11 (20.0%) using NRS and 4 (8.9%) using NRI. Median time to return to normal enteral intake was 10 days (IQR 7-14). 91%, 90%, and 95% of those identified as low risk according to MUST, NRS, and NRI respectively were without enteral intake for 5 days or more. The median complication index score was 15 (IQR 0-34). There was no significant difference in duration of time without intake or complications seen in any of the nutritional risk groups. Discussion This study shows that patients undergoing emergency laparotomy spend a prolonged time without enteral intake. Current tools do not adequately stratify the likelihood of prolonged starvation at baseline, or in light of surgical findings.

Bilateral loss of taste from a unilateral thalamic infarct

Loss of sense of taste (hypogeusia) involving a part of the tongue can follow acute stroke. We describe a woman with a small right thalamic acute infarct causing bilateral (mainly left-sided) hypogeusia. Her problem remains sufficiently severe to cause distress and nutritional deficit. The anatomical distribution of her problem—cheiro-oral syndrome with concurrent hypogeusia—suggested involvement of adjacent relevant thalamic fibres. We address key considerations in examining taste in research and in practice and discuss issues to address in people with hypogeusia, including swallow deficits, psychological elements of the poststroke condition and nutrition. Dietetic management should include optimising taste stimuli and nutritional support. Introducing more detailed taste assessments into standard practice would likely improve stroke unit care.

Omega-3 fatty acids as component of nutritional and metabolic treatment of patients with COVID-19 and other viral diseases (literature review)

Nutritional deficit in patients with viral diseases, including COVID-19, can reduce the efficacy of specific treatment, decrease the survival rate, and increase medical expenses. According to international guidelines, timely correction of nutritional status with supplemental enteral and parenteral nutrition containing omega-3 polyunsaturated fatty acid from fish oil (omega-3 PUFAs: ЕРА and DHA) is able to improve clinical outcomes of specific antiviral treatment. The authors conducted an analytical review to assess the results from the study of clinical use of omega-3 PUFAs for the prevention and treatment of COVID-19 and other viral infections. Supplementation of clinical (enteral and parenteral) nutrition with omega-3 PUFAs allows for symptom reduction, shorter stay in hospital, and quicker recovery of patients infected with SARS-CoV-2 and other viruses. When used in combination with adequate macronutrient support, it can reverse nutritional deficit and improve clinical outcomes.

CARDIOVASCULAR INJURY IN ANOREXIA NERVOSA

Objective. Demonstrating cardiovascular injury amoung a group of female patients suffering from anorexia, compared to a similarly-aged group of women with body mass within the normal range. Materials and methods. Clinical, biological and paraclinical parameters were determined in the two patient groups: Group A, consisting of 39 patients suffering from anorexia, and Group B, consisting of 40 patients of similar ages, but having a normal body-mass index (BMI). Results. Compared to the normal-BMI cohort, the female patients diagnosed with anorexia are more bradycardic, have lower blood pressure, biologically were found to suffer from various degrees of anemia (hypochromic, microcytic, caused by iron deficiency), leucocytosis, thrombocytosis, hypoglicemia, slight nitrogen compounds retention, hyponatremia, hypokalemia, hypochloremia, hypomagnesemia, hypocalcemia, hypophosphatemia, low levels of triglycerides and of all cholesterol fractions, hypoproteinemia with hypoalbuminemia, mild hepatic cytolysis, increased levels of creatine kinase and cortisol. In terms of echocardiographic findings, the patients with anorexia have decreased dimensions of all cardiac chambers and of the inferior vena cava, lower cardiac output and index, diminished A-wave velocity, with an increase in E/A ratio, lower E', A' and S' velocities for the lateral ventricular wall, along with lower E' and A' velocities for the interventricular septum, and a decrease in both tricuspid annular and mitral annular systolic excursions. Discussions. There is an obvious link between the magnitude of clinical, biological and paraclinical abnormalities and low BMI. Further studies are needed in order to establish the degree of reversibility of said abnormalities following the total or partial correction of the patients' nutritional deficit. Conclusions. The patients suffering from anorexia present with multiple abnormal findings, both biological and clinical in nature, alongside a subclinical negative impact on the cardiovascular system. Early detection of these negative changes could impose the adoption of a realimentation plan, possibly accompanied by the use of specific pharmacological agents, that would bring about improvements in these patients' overall status.

First trimester pregnant woman's complaint during COVID-19 pandemic

First trimester pregnant women will adapt to various things of discomfort, one of which is morning sickness. If not given a virginity intervention, then this pregnant woman could experience nutritional deficit. The aim of this case study is to provide an overview of how pregnant women in their first trimester cope with their complications during the COVID-19 pandemic. This research method uses in-depth interviews and observations of pregnant women in their first trimester at home. The results obtained were that there were three problems described by Mrs. L, namely; physical discomfort such as dizziness, nausea and fatigue, which can be dealt by taking a warm bath, or smelling some aromatherapy oil such as mint, disturbance of nutritional fulfilment which can be overcome by consuming fresh food, ginger water in a small portion yet frequently and the risk of stress which can be overcome by praying five times a day and gardening, cleaning up the house, discussing with other pregnant friends in whatsapp group. This study can serve as a guide for nurses in providing nursing interventions to pregnant women in the first trimester during the COVID-19 pandemic.

The palm tree: A cropscape of monoculture and devouring carbon sinks

India accounts for 17 per cent of world palm oil consumption. Palm oil was initially considered a potential nutrition and environment solution that would replace fossil fuel and trans-fats in the nutrition chain. That promise of replacing fossil fuels and trans-fats is far from met; palm tree monoculture has led to devastation of rainforests in Indonesia and Malaysia, which together account for 85 of global palm oil production. Symmetrical rows of palm trees have replaced once-dense irreplaceable habitats of trees and plants. The initial deforestation was induced by European innovation and consumption. India and China have now outstripped European buyers as the main buyers of palm oil.The global cropscape of the palm is reviewed in this paper in the Indian context. Policy appears to encourage palm oil imports in the face of India’s dire agricultural landscape, with negative returns for farmers, a growing nutritionally bereft food chain and exponential deforestation of tropical forests in Indonesia and Malaysia. The paper explores the inherently economically and the socially destructive substitution of ethnically produced and consumed seed oils such as mustard, sesame and coconut. Small farm holdings comprise nearly 85 per cent of India’s total cultivated area. Of about 138 million agricultural farm holdings, 117 million are small and marginal holdings (The Agriculture Census of 2010-11). This paper studies the global supply chain of the palm seed oil that potentially has multi-pronged externalities of destruction of farm income in the importing nation, disruption of nutrition needs and augmenting global emissions through deforestation .Commerce ideally fulfills the needs of communities. Institutional Analysis and Development (IAD theory) by Ostrom (1999) suggests that the social group that has embedded equitable relationships will set policy that requires equal participation and cooperation of all actors involved. Satisfying the consumer with cheaper goods at the cost of the environment and the destruction of incomes of farmers with small land holdings goes against this theory. The author will explore the dynamics of the locally grown seed oils with substitution by palm oil imports, and Indian institutional incentives that foster destruction of forests in SE Asia. The destruction of farm incomes and nutritional deficit will also be discussed.

The assessment and management of hypergranulation

Wound healing follows a process of four distinct phases: haemostasis, inflammation, proliferation and maturation. Problems can arise in any of these phases, delaying the wound process. Hypergranulation (also known as overgranulation) during the proliferation phase occurs when granulation tissue over grows beyond the wound surface. Such wounds have a discoloured, raised or swollen appearance and bleed easily. The cause may be infection, the effects of friction on the wound area, nutritional deficit or stress. Treatments will depend on the cause. There is a lack of studies on treatments for hypergranulaton and more research is required.

Relationships between inappropriate eating habits and problematic alcohol use, cigarette and waterpipe dependence among male adolescents in Lebanon

Background it is important to investigate the relationship between disordered eating in male adolescents and smoking and alcohol consumption as they are risk factors to other diseases as well. For example, high levels of alcohol accompanied by the acidic damage and nutritional deficit exhibited in people with disordered eating habits - due to induced vomiting - has been shown to increase risk of esophageal cancer. Considering the very few studies done on disordered eating prevailing in males and the prevalence of smoking and drinking habits, our study aims to investigate the correlation between inappropriate eating habits and one’s dependence on cigarettes, waterpipes, and alcohol all the while focusing on male adolescents. Methods This was a cross-sectional observational study that enrolled 389 male students (13–17 years of age) drawn from five Lebanese schools between October and December 2019. Results The MANCOVA analysis was performed taking the addiction scales as the dependent variables and the EAT-26 score as an independent variable, adjusting for the covariates (age, BMI and household crowding index). Higher EAT-26 scores (more inappropriate eating attitudes) were significantly associated with higher waterpipe dependence (B = 0.11; CI 0.06–0.17) and more problematic alcohol use (B = 0.08; CI 0.04–0.12), but not cigarette dependence. Conclusions This study revealed an association between inappropriate eating and increased drinking and smoking the waterpipe, but not cigarettes. The manifestation of inappropriate eating habits was found to be significant among male adolescents; in the literature, this is also true for female adolescents. In Lebanon, the engagement of adolescents in alcohol drinking and waterpipe smoking is frequent as they are accessible due to the lack of law enforcement and supervision in the country. In addition, while this study found an association between inappropriate eating habits and dependency on smoking and drinking, further investigation should be done on the role of one’s psychology in their exhibition of disordered eating as means to prevent the manifestation of these habits.

COMPARATIVE ANALYSIS OF MACRO- AND MICRONUTRIENT PROFILE OF YOUNG MALES IN THE RUSSIAN NORTHEAST

Significance. According to WHO, unbalanced diet is one of the leading causes of chronic diseases. Adolescence should be considered a person’s life most important period in terms of developing eating habits that define the body macro- and micronutrient intake. The purpose of the study was to assess diet type and balance and specify region-related macro- and micronutrient diet profiles among young Caucasian and Aborigine males in the North-East of Russia. Material and method. ASPON-nutrition software program was used to analyze the availability of proteins, fats, carbohydrates, fiber, vitamins, as well as macro- and microelements in diets of young males residing in the Magadan Region and Chukotka Autonomous District (mean age equals to 17-21 years, n = 278). Results. The study has identified a clear imbalance in the diet characterized by a low intake of the protein-lipid component, a shortage of polyunsaturated fatty acids, and a complete lack of fiber intake against the background of the increased share of mono- and disaccharides as well a deficiency of macro-, microelements and vitamins in the diet. The deviations have proved to be typical of people residing in the city of Magadan, primarily of the young indigenous population who experience a 100 percent nutritional deficit for a number of components.