Nutrition Management in COVID-19 Quarantine: Hospital-Based Study

ABSTRACT Background: This hospital-based study aimed to evaluate the nutritional status and dietary habits for COVID-19 patients, the amount of nutrients provided to the patients in the hospital and to detect the predictors of severity among COVID-19 patients in Jordan. Methods: A hospital-based study (N = 367, mean age 42.3, SD 15.4, 66.0% men) was conducted between March 17th and July 25th, 2020 in Prince Hamza Hospital. Data about socio-demographic, anthropometric, dietary habits, and macro-and micronutrient were collected from the patients’ medical files and some missing data were collected by phone directly from the patients. Results: The results of the linear regression only age was significantly and positively (ß=0.454, p-value=0.001) associated with severity of the disease among the study patients. Around 57% of the COVID-19 patients consumed three meals daily, while around 31-34% consumed one to two snacks daily. The majority (64%) of the patients drank more than five cups of water daily. About 24% of the patients complained of eating problems such as taste and/or smell loss, low appetite, and swallowing difficulty. The intakes of the vitamins B1, B2, B3, and B6 and vitamin C, as well as calcium, magnesium, phosphorus, selenium and sodium, were within the recommended dietary allowances (RDA). Conclusion: The servings of the five food groups as well as most of the macro-and micronutrient requirements were within the recommended intakes and RDA.

Graves’ Disease Following Subacute Thyroiditis

Subacute thyroiditis is an inflammatory thyroid disease caused by viral infection. Graves’ disease is an autoimmune thyroid disease caused by thyrotropin (TSH) receptor antibody (TRAb). Graves’ disease following subacute thyroiditis is rare, and only a few cases have been reported. A 58-year-old woman presented with anterior neck pain and swallowing difficulty. Laboratory tests showed elevated FT4, low TSH, normal TRAb, and elevated erythrocyte sedimentation rate. Thyroid ultrasonography (US) revealed focal, ill-defined hypoechoic areas in both thyroid lobes. The patient was treated with corticosteroid, and symptoms subsided after 1 month. Three months later, she complained of tremor and palpitation. Thyroid function testing showed hyperthyroidism with the positive conversion of TRAb, indicating Graves’ disease. Doppler US showed increased vascular flow in both thyroid lobes. She started treatment for hyperthyroidism with methimazole.

A Scoping Review of Research on Food Design Interventions to Improve Nutrition in Adults: A Focus on Food Shaping with Implications for Older Adults with Swallowing Disorders

The aim of this scoping review is to appraise and synthesise the scientific evidence on the use of food shaping interventions aimed at enhancing nutrition in adults. Specifically, the review aims to answer the following questions:1.What food shaping interventions have been examined as a means to increase access to nutrition for adults, across populations and settings?2.What food shaping interventions have been examined as a means to increase access to nutrition for older adults (a) with swallowing difficulty or with conditions with high prevalence of swallowing difficulty, or (b) in aged care settings?

Successful treatment of dysphagia in a COVID-19 survivor

<p class="abstract">This study was aimed<strong> </strong>document a successful case of dysphagia management after coronavirus disease 2019 (COVID-19) infection. COVID-19 is highly infectious disease and causes 75 million infection and 1.66 million deaths worldwide. Clinical features of COVID-19 including respiratory compromise, microvascular thrombosis and neurologic dysfunction as well as well as prolonged intensive care unit (ICU) care in severe cases yield patients particularly susceptible to mild to severe swallowing impairment which can persist for months or years after ICU discharge. A 52 years old female was diagnosed with severe pharyngo-oesophageal dysphagia after COVID-19 infection and was advised for swallowing therapy. The swallowing therapy was given thrice a week for 45 minutes including Masako, Shaker’s and modified Shaker’s exercise along with effortful swallow, Mendelsohn maneuvers and super-supraglottic swallow. After 2 weeks of swallowing therapy patient started taking semisolid food orally and maintain normal SpO₂level during feeding. This study concluded early intervention is the key to boost faster recovery and helped to improve patient’s quality of life.<strong> </strong>Swallowing manuvers and exercises were very effective for the management of dysphagia secondary to COVID-19 infection. This can be generalized and efficacy can be determined with large group of patients having swallowing difficulty after COVID-19 infection.</p>

ALG1-CDG: A Patient with a Mild Phenotype and Literature Review

ALG1-congenital disorder of glycosylation (ALG1-CDG) is an autosomal recessive multisystem disease. We here present a patient with a mild phenotype of ALG1-CDG. A 15-month-old female was referred with hypotonia, failure to thrive, and developmental delay. At 8 months of age, failure to thrive, feeding difficulties and developmental delay became apparent, and an epileptic seizure was observed at 11 months of age. Progressive deterioration and swallowing difficulty were observed. A brain MRI revealed a widening of the cerebrospinal fluid spaces and ventricular system, and decreased protein C, protein S and antithrombin III levels were identified. The isoelectric focusing showed a type 1 pattern. A homozygous c.1076C&#x3e;T (p.Ser359Leu) variant was found in the <i>ALG1</i> gene. CDG should be taken into consideration in patients presenting with unexplained multisystem involvement.

Prevalence of Dysphagia in Children with Cerebral Palsy”: A Multicenter Study in Lahore

Objective: The objective of the study was to determine the prevalence of dysphagia in children with cerebral palsy. Materials and Methods: A sample of 105 children with cerebral palsy age between four and sixteen years, were selected from cerebral palsy centers in Lahore. Out of these children almost all were with spastic cerebral palsy. Data was collected by using a questionnaire filled by the caregivers of children with cerebral palsy. This questionnaire constitutes questions regarding swallowing difficulty of CP child and their eating & feeding patterns to determine the prevalence of dysphagia. Results: Result indicated that out of 105 children’s caregiver with cerebral palsy 36(34.3%) responded affirmatively that their children have swallowing difficulty and 69(65.7%) responded negatively that their children have no swallowing difficulty. Conclusion: The findings suggested that prevalence of dysphagia in children with cerebral palsy is 34.3% in Lahore city.

Development of a Multidisciplinary Aerodigestive Program: An Institutional Experience

We share our experience on the implementation of a multidisciplinary aerodigestive program comprising an aerodigestive team (ADT) so as to evaluate its feasibility. We performed a retrospective chart review of the patients discussed at the monthly ADT meetings and analyzed the data. A total of 98 children were referred to the ADT during the study period. The number of cases increased steadily from 3.5 cases per month in 2019 to 8.5 cases per month in 2020. The median age of patients was 34.5 months, and 55% were male. Among the chronic comorbidities, neurologic disease was the most common (85%), followed by respiratory (36%) and cardiac (13%) disorders. The common reasons for consultation were suspected aspiration (56%), respiratory difficulty (44%), drooling/stertor (30%), regurgitation/vomiting (18%), and feeding/swallowing difficulty (17%). Following discussions, 58 patients received active interventions, including fundoplication, gastrostomy, laryngomicrosurgery, tracheostomy, and primary dilatation of the airway. According to the questionnaire of the caregiver, the majority agreed that the main symptoms and quality of life of patients had improved (88%), reducing the burden on caregivers (77%). Aerodigestive programs may provide comprehensive and multidisciplinary management for children with complex airway and digestive tract disorders.

A Systematic Review of Oropharyngeal Dysphagia Models in Rodents

Oropharyngeal dysphagia is a condition characterized by swallowing difficulty in the mouth and pharynx, which can be due to various factors. Animal models of oropharyngeal dysphagia are essential to confirm the cause-specific symptoms, pathological findings, and the effect of treatment. Recently, various animal models of dysphagia have been reported. The purpose of this review is to organize the rodent models of oropharyngeal dysphagia reported to date. The articles were obtained from Medline, Embase, and the Cochrane library, and selected following the PRISMA guideline. The animal models in which oropharyngeal dysphagia was induced in rats or mice were selected and classified based on the diseases causing oropharyngeal dysphagia. The animal used, method of inducing dysphagia, and screening methods and results were collected from the selected 37 articles. Various rodent models of oropharyngeal dysphagia provide distinctive information on atypical swallowing. Applying and analyzing the treatment in rodent models of dysphagia induced from various causes is an essential process to develop symptom-specific treatments. Therefore, the results of this study provide fundamental and important data for selecting appropriate animal models to study dysphagia.