Physicians’ Knowledge of Clinical Nutrition Discipline in Riyadh Saudi Arabia

Background: Nutrition plays a major role in the prevention and management of diet-related disease. With the absence of clinical nutrition dietitians, physicians are considered responsible for prescribing nutritional support. Identifying weaknesses in nutritional knowledge among Saudi physicians may provide guidance to improve their nutritional knowledge. Methods: A cross-sectional study that used an anonymous electronic questionnaire to investigate physicians’ knowledge of the clinical nutrition discipline. In addition to demographics, the questionnaire consisted of 15 questions covering six areas in the clinical nutrition discipline (macro- and micronutrients, nutrition and chronic diseases, nutrition and metabolic diseases, nutrition care process, nutrition support therapy, and research). For continuous variables, independent t-tests and one-way ANOVA were used. Results: A total of 332 had completed the questionnaire and were included in the study. Most of the physicians were Saudi (87%), male (73.5%), aged between 26 and 35 years (63.3%), and without health problems (56.3%). The mean score of the physicians’ knowledge was 5.3 ± 1.97 out of 15. Physicians who reported that they received some sort of nutritional training or course (M = 5.57, SD = 2.08) scored significantly more than physicians who did not (M = 5.10, SD = 1.86); t(330) = −2.174, p = 0.30. Conclusions: Nutrition should be reinforced as an important component of continuing medical education. There is a need for hiring more dietitians in health care settings in Saudi Arabia as an integral part of a multidisciplinary team delivering medical care services.

New coronavirus infection COVID-19: how do we feed the sick?

Повышение качества оказания помощи больным новой коронавирусной инфекцией COVID-19 возможно только на основе мультидисциплинарного подхода. Оценка пищевого статуса и при необходимости его коррекция являются важной составляющей комплексных программ лечения и реабилитации таких больных. Значительное число пациентов с COVID-19 составляют люди пожилого и старческого возраста, у которых уже есть признаки нутритивной недостаточности. Нарушения питания и сопутствующая им саркопения – факторы риска неблагоприятного течения COVID-19. Прогрессирование саркопении при COVID-19 объясняют возникновением вирусного миозита, миопатией, спровоцированной цитокинами, и иммобилизацией. Уменьшение мышечной массы ассоциировано с плохим прогнозом заболевания и снижением качества жизни. Коррекция нарушений пищевого статуса больных COVID-19 должна проводиться на всех этапах лечения. Важность проблемы нутритивной поддержки отражена во множестве публикаций, посвященных лечению больных COVID-19. Необходимо заметить, что Европейское общество клинического питания и метаболизма (European Society for Clinical Nutrition and Metabolism, ESPEN) в кратчайшие сроки выпустило рекомендации по нутритивной поддержке больных новой коронавирусной инфекцией, что лишний раз подчеркивает актуальность проблемы. Это стало логичным продолжением рекомендаций по коррекции пищевого статуса больных, находящихся на лечении в отделении реанимации и интенсивной терапии. Аналогичные клинические рекомендации были разработаны в Великобритании, Бразилии и целом ряде других стран. Использование препаратов для перорального дополнительного питания в большинстве случаев позволяет обеспечить потребности пациентов в необходимых нутриентах, уменьшить выраженность саркопении и повысить эффективность реабилитационных мероприятий. Improving the quality of care for patients with the new coronavirus infection COVID-19 is possible only on the basis of a multidisciplinary approach. Evaluation of nutritional status and, if necessary, its correction are an important component of comprehensive treatment and rehabilitation programs for such patients. A significant number of patients with COVID-19 are elderly and senile people who already have signs of nutritional deficiency. Eating disorders and accompanying sarcopenia are risk factors for the adverse course of COVID-19. The progression of sarcopenia in COVID-19 is explained by the occurrence of viral myositis, myopathy provoked by cytokines, and immobilization. Decreased muscle mass is associated with poor disease prognosis and reduced quality of life. Correction of nutritional disorders in patients with COVID-19 should be carried out at all stages of treatment. The importance of the problem of nutritional support is reflected in many publications devoted to the treatment of patients with COVID-19. It should be noted that the European Society for Clinical Nutrition and Metabolism (ESPEN) promptly issued recommendations on nutritional support for patients with new coronavirus infection, which once again emphasizes the urgency of the problem. This was a logical continuation of the recommendations for correcting the nutritional status of patients undergoing treatment in the intensive care unit. Similar clinical guidelines have been developed in the UK, Brazil and a number of other countries. The use of drugs for oral supplementary nutrition in most cases allows to meet the needs of patients for the necessary nutrients, to reduce the severity of sarcopenia and to increase the effectiveness of rehabilitation measures.

EVALUATION OF NUTRITIONAL KNOWLEDGE OF FEMALES MEDICAL STUDENTS AND NON-MEDICAL STUDENTS AT UNIVERSITY OF SCIENCE AND TECHNOLOGY IN SANAA CITY, YEMEN, 2018

Background:Nutritional knowledge plays a very important role in nutritional status. Evaluatenutritional knowledge among medical and non-medical female students at university of science and technology in Sanaa city, was the objective of present study. Methods: Cross-sectional study, was performed using a systematic random sampling technique. Data was collected by face-to-face interviews using pre-designed, semi-structured questionnaires on a period of two month from January to February 2019. Questionnaires was developed in two sections. The data was cleaned and coded then analyzed using SPSS version 21. Result: One hundred and twenty students were enrolled in this study. All of them were females. Their ages ranged between 18 years and 30 years. The most frequent age group (56.7%) was located between 21-23 years.Majority of students 100(83.3%) had good or excellent nutritional knowledge. Most of them 55(45.8%) were in clinical nutrition and dietetics department. In conclusion, students in clinical nutrition and dietetics department had better nutritional knowledge than students in English department. The difference was significant as indicated by Pearson Chi-Square (p value =.000),. There was also a significant correlation between nutritional knowledge with department, study year also attended nutritional courses(all p values < 0.05). Current findings suggest nutrition education curriculum is compulsory in every study field, and it is need for coordinated efforts to promote nutrition education programs among medical students in general and non-medical students in particularto improve nutritional knowledge of students.

Impact of an Expansion of a Clinical Nutrition Curriculum on Pre-Clerkship Medical Students’ Perception of Their Knowledge and Skills Related to Performing a Nutritional Assessment

Learning how to provide nutritional counseling to patients should start early in undergraduate medical education to improve the knowledge, comfort, and confidence of physicians. Two nutrition workshops were developed for first-year medical students. The first workshop, co-led by physicians and registered dieticians, focused on obtaining nutrition assessments. The second workshop focused on the appropriate dietary counseling of patients with chronic kidney disease and cardiovascular risk. We surveyed students before workshop 1, after workshop 1, and after workshop 2 to assess their perceptions of the value of physician nutrition knowledge and counseling skills as well as their own comfort in the area of nutritional knowledge, assessment, and counseling. We found a significant improvement in their self-assessed level of knowledge regarding counseling patients, in their comfort in completing a nutritional assessment, and in their confidence in advising a patient about nutrition by the end of the first workshop. By the time of the second workshop five months later, students continued to report a high level of knowledge, comfort, and confidence. The implementation of clinical nutrition workshops with a focus on assessment, management, and counseling was found to be effective in increasing student’s self-assessed level of knowledge as well as their confidence and comfort in advising patients on nutrition. Our findings further support the previous assertion that clinical nutrition education can be successfully integrated into the pre-clerkship medical school curriculum.

Professor Igor V. Prianikov (08.04.1959-12.03.2021)

On March 12, 2021 at the sixty-second year of life, a member of the editorial colleague of the journal "Clinical Nutrition and Metabolism", Professor, Doctor of Medical Sciences Igor Valentinovich Pryanikov suddenly passed away. Talented, intelligent, with an amazing sense of humor, Igor Valentinovich has always inspired his colleagues with his positive attitude, boiling energy and ability to work.