Malnutrition

ABSTRACT Nutritional status of pancreatitis patients varies among new cases and recurrent patients. Under nutrition is one of the major risk factors in the mortality and morbidity of patients with pancreatitis. Severe malnutrition will adversely affect outcomes, as occurs in other critical diseases. Malnutrition is known to occur in 50-80% of chronic alcoholics and alcohol is a major etiological factor. Excess body fat, lack of lean body mass, muscle wasting and poor immune status are some of the indicators of malnutrition associated with poor prognosis in patients. This study was an observational prospective study conducted on 22 subjects in two multi-specialty hospitals of Mysore city in the period of 2 months. Patients admitted to the hospital with diagnosis of pancreatitis and who were above 17 years of age were recruited for the study. Questionnaire was designed and data such as demographic profile, anthropometric, biochemical, clinical symptoms, medications, 24 hr dietary recall of hospital and home were collected. Results were expressed as Mean ± Standard deviation. Statistical analysis was conducted using student t test and chi square test by means of SPPS 16.0 software. Among 22 subjects, 17 were diagnosed with acute pancreatitis and 5 with chronic pancreatitis, 19 subjects had a history of chronic alcoholism. The serum protein levels was in the lower end of normal (6.73±0.93 g/dl) while liver enzymes and pancreatic enzymes were high(AST-75±81.28 U/L, ALT-47.11±48.44 U/L, P.lipase-485.18±431.65, P.amylase-667.45±824.53). The mean weight on admission was 62.2±9.59 kg, a weight loss of 2-4 kg was seen among majority of the patients at discharge, which could be attributed to the low-calorie intake (mean 367±488 kcal) during hospital stay. Even though the mean BMI was 23.41±4.17, the weight was attributed to empty calories acquired by daily alcohol consumption rather than diet. The mean intake of home recall was 1507 ±288 and that of hospital recall was 367±488. Malnutrition was found to be present among subjects and significant difference (p value-0.000) was seen in patients’ calorie intake. Nutritional status plays a major role in prognosis of patients and early nutrition support must be practiced for better recovery, reduction in length of stay and improvement in nutritional status of the patient. Keywords: Pancreatitis, Nutritional status, dietary recall, Malnutrition, Acute Pancreatitis, Chronic Pancreatitis

ABSTRACT The present study aimed to determine the prevalence of anaemia and malnutrition and some risk factors among hospitalized children attending Al-Nasser paediatric hospital. A cross-sectional study among hospitalized children attending Al-Nasser paediatrics hospital. The study included 522 children during the period May 2002 to May 2003. Data collection was through blood specimens, anthropometric indices and the questionnaire. The present study included 522 children attending AL-Nasser Paediatric Hospital with 334 males (64.0%) and 188 females (36.0%). Those children are distributed into three regions; the city 316 (60.5%), the camp 181 (34.7%) and village 25 (4.8%). The present study showed that 326 (62.5%) were anaemic, while 220/522 (42.1%) were underweight, stunting were 172/522 (32.9%) and wasting 140/522 (26.8%). The present study indicated that underweight and wasting were lower among males (38.6%), (20.0%) compared to females (48.4%), (38.8%) with a significance level (p=0.02, p=0.001). Palestinian children at high risk of anaemia and malnutrition. These two conditions should be considered by health authorities and urgent need for immediate intervention should be taken to minimize the consequences. Keywords: Anemia, Malnutrition, Prevalence, Gaza, Children

Chronic obstructive pulmonary disease (COPD) is a disease of the respiratory system characterised by extra pulmonary manifestations that includes nutritional depletion, which is known to have negative consequences on morbidity and mortality. Chronic malnutrition results in reduced lung and respiratory muscle function secondary to loss of lean body mass, multiple nutrient deficiencies and cachexia when chronic in nature. A literature review was performed on the prevalence and trend of malnutrition, reported in COPD patients. Increased resting energy expenditure, thermic response to food, early satiety, increased pro inflammatory cytokines are known to lead to loss of appetite, weight loss and cachexia on a long term. Under nutrition among various study populations is reported between 20-70% and cachexia in 27-33% of subjects with COPD. Malnourished individuals are exposed to higher risk of mortality, morbidity and poor prognosis by the reduced pulmonary function and risk of infections due to the loss of fat free mass, skeletal muscle strength, lower immune function secondary to malnutrition. Pre-existing oxidative stress can be further worsened by deficits in micronutrient intakes. Anthropometric assessment including fat free mass is important in evaluating nutritional depletion as some COPD patients may lose fat free mass without any alterations in fat mass. Thus, COPD patients can suffer from malnutrition, further aggravated by the severity of symptoms, biochemical alterations and severity of disease. Further, undernutrition can negatively affect the prognosis necessitating a thorough assessment of body composition along with somatic status among patients losing weight and those with a history of weight loss.