IJNP (Indonesian Journal of clinical nutrition physician)
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EFFECTIVENESS OF PROBIOTIC SUPPLEMENT ON HELICOBACTER PYLORI INFECTION ERADICATION IN GASTRIC ULCERS
Full text linkBackground: Helicobacter pylori colonizes the gastric mucosa in 50% of the human population. H. pylori infection causes several upper gastrointestinal tract diseases such as chronic gastritis, peptic ulcer, duodenal ulcer, and gastric cancer. H. pylori is also associated with a high risk of developing gastric adenocarcinoma. The World Health Organization classifies H. pylori infection as a class 1 carcinogen. Giving probiotics may improve the immune system and suppress the effects of pathogens. However, mixed results were obtained from the use of various kinds of bacteria and fungi as probiotics.
Objective: To determine the effectiveness of probiotic supplementation against the eradication of Helicobacter pylori infection in gastric ulcers.
Conclusion: The effectiveness uses of probiotics to eradicate H. pylori has not been proven. It will take clinical trials with a sufficient number of subjects and certain probiotic strains to be able to determine the type of strain, dosage, duration of use, and side effects that can be caused
PROFIL ANTROPOMETRIK, VITAMIN D, B12, FOLAT, DAN FERITIN PASIEN OBES PRABEDAH BARIATRIK DI POLIKLINIK GIZI RUMAH SAKIT SUMBER WARAS
Full text linkObese patients, especially patients with severe obesity and requiring bariatric surgery, have a high prevalence of nutrient deficiencies. This study aims to determine some of the basic characteristics of patients undergoing bariatric surgery so that they can be used as supporting data for post-bariatric surgery nutrition medical therapy, particularly in the provision of food sources and micronutrient supplementation which can be deficient due to anatomic and physiological alterations after the surgery. The study was conducted on 55 preoperative bariatric patients by assessing age, gender, and degree of obesity based on body mass index (BMI), serum vitamin D and B12 levels, erythrocyte folic acid, and serum ferritin of subjects. The study is descriptive with a cross-sectional design. Subjects were taken by consecutive sampling. The results showed that the mean age of preoperative bariatric patients was 36 ± 7.1 years; most (85.5%) were women. Most subjects (34.5%) had BMI of 35–39.9 kg/m2. Vitamin D deficiency was present in most (75.6%) of the study subjects, but most had serum vitamin B12 levels, erythrocyte folic acid levels, and serum ferritin levels within normal limits. This study shows that the basic profile of patients undergoing bariatric surgery is primarily late adults, classified as severe obese and having vitamin D deficiency.
Keywords: Obesity, Prebariatric, Serum Vitamin D, Serum Vitamin B12, Erythrocyte Folic Acid, and Serum Ferritin
EFFECTIVENESS OF PREOPERATIVE CARBOHYDRATE LOADING WITH LENGTH OF HOSPITALIZATION IN NON-INVASIVE GYNECOLOGICAL SURGERY PATIENTS: AN EVIDENCE-BASED CASE REPORT
Full text linkBackground
Carbohydrate loading is one of the steps in the preoperative procedure of Enhanced Recovery after Surgery (ERAS). The advantages of the ERAS pathway have positive effects on postoperative outcomes, including a reduction in the length of stay/LOS in hospital.
Objective: This study aims to critically analyze the effectiveness of carbohydrate loading on the reduction in the length of hospital stay among patients undergoing non-invasive gynecologic surgical procedure.
Methods: A search was conducted to find several literatures from PubMed, Cochrane and Scopus. This study assesses the relevance and feasibility of the literatures. The search found three selected literatures to further conduct a critical assessment.
Results: A critical review was conducted towards three randomized controlled trial literatures. Two literatures showed a significant reduction in the length of stay with preoperative carbohydrate loading (p<0.001), while one literature showed an insignificant finding (p=0.684).
Conclusions: Carbohydrate loading as a part of the preoperative management of ERAS could reduce the length of hospital stay among patients undergoing non-invasive gynecologic surgery procedure. Differences in the results of several studies indicate the need for further studies using the similar intervention method.
Keywords: enhanced recovery after surgery, gynecologic surgery, carbohydrate loading, length of stay
FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN DIARE DI UNIT STROKE RSUP DR. KARIADI: diare
Full text linkAbstrak
Latar belakang: Diare disebabkan oleh multifaktorial dan beberapa faktor diketahui berhubungan dengan diare selama pasien dirawat yaitu usia lanjut, lama rawat inap, kejadian infeksi, penggunaan antibiotik, dan status gizi malnutrisi. Di RSUP Dr. Kariadi Semarang belum pernah dilakukan penelitian faktor yang berhubungan dengan diare. Tujuan: Menghitung besar risiko usia lanjut, lama rawat inap, kejadian infeksi, penggunaan antibiotik, formula nutrisi enteral non pabrikasi, dan status gizi malnutrisi dengan kejadian diare. Metoda: Jenis penelitian case control dengan mengambil data restrospektif pasien stroke yang memenuhi kriteria inklusi dan eksklusi selama Januari – April 2020. Dilakukan pemeriksaan data berdasarkan variabel bebas, dilakukan pencatatan dan dianalisis hubungan dengan menggunakan uji statistik Chi Square. Hasil: Sebanyak 40 subyek penelitian yang di rawat di unit stroke RSUP Dr Kariadi mayoritas diagnosis stroke non hemoragik (55%) dan laki-laki (60%). Mayoritas subyek usia non geriatri yaitu kurang dari 60 tahun. Hasil penelitian menunjukkan adanya hubungan yang signifikan pada faktor usia lanjut, lama rawat inap dan penggunaan antibiotik terhadap diare. Usia lanjut subyek (p = 0,043) dengan risiko 10 kali lipat. Lama rawat inap > 5 hari (p = 0,031) dengan risiko 11,56 kali lipat. Penggunaan antibiotik dengan risiko 13,5 kali lipat. Sedangkan variabel lain tidak signifikan. Simpulan: Terdapat hubungan usia lanjut, lama rawat inap >5 hari dan penggunaan antibiotik terhadap kejadian diare pada pasien stroke yang di rawat di unit stroke RSUP Dr Kariadi
Kata kunci: diare, unit stroke, geriatri, antibiotik, lama rawat ina
AN EFFECTIVENESS OF OMEGA 3 SUPPLEMENTATION ON CLINICAL SYMPTOMS IMPROVEMENT AND CLINICAL PARAMETERS OF COVID-19
Full text linkAbstract
Background
Coronavirus disease 2019 (COVID-19) infection is a disease with high morbidity and mortality rates worldwide. This viral infection can cause metabolic and clinical changes that affect the patient's condition. Omega 3 polyunsaturated fatty acids (ω3-PUFAs) are important mediators of anti-inflammatory and immune response. Thus, it can reduce clinical symptoms of COVID-19 patients.
Objective: To know the effect of omega 3 supplementation in improving clinical symptoms and clinical parameters of COVID 19.
Methods: Article searches were conducted using advanced searching by combining MesH Terms and abstracts/titles in the Pubmed, Cochrane Library, and Scopus databases. The search found two selected literatures to further conduct a critical assessment.
Results:Two articles were selected based on the eligibility criteria and conformity with the Problem Intervention Comparison Outcome (PICO). Study conducted by Sedighiyan et al.,1 showed that there were significant changes in clinical symptoms of COVID-19 patients such as pain, fatigue (p< 0.001), increased appetite (p=0.003), decreased Erythrocyte Sedimentation Rate (ESR) values (p < 0.002), and decreased C-reactive protein (CRP) values (p<0.001). Study conducted by Doaei et al.,2 showed that there was significant decrease in pH (p=0.001), HCO3 (p = 0.001), Be (p = 0.001), and creatinine (p = 0.002), thereby improving clinical symptoms of COVID-19 patients.
Conclusion:
Omega 3 supplementation can improve clinical symptoms and clinical parameters of COVID 19. However, further research is needed with a larger sample, a longer duration, and with dose adjustment of omega 3 supplementation.
Keywords:COVID-19, omega 3 fatty acids, clinical symptoms and clinical parameters improvemen
EFFICACY OF IMMUNONUTRITION CONTAINING OMEGA-3 FATTY ACIDS TO REDUCE MORTALITY IN ACUTE RESPIRATORY DISTRESS SYNDROME: AN EVIDENCED-BASED CASE REPORT
Full text linkBackground: Acute respiratory distress syndrome (ARDS) remains one among the most reasons for ICU admission. It is related to high rates of mortality despite many recent advances in overall support. A relative increase in oxidative stress in patients with ARDS results in increased alveolar injury. Immunonutrion containing omega 3 fatty acids is one among the strategies that currently receiving attention within the management of ARDS since they are known to have anti-inflammatory effects, but the results are still inconsistent.
Objective: This study aimed to find out the efficacy of immunonutrition containing omega 3 fatty acids in reducing mortality in patients with ARDS.
Methodology: Electronic literature researches were performed in PubMed, Cochrane, and Scopus. MeSH term and title/abstracts were screened based on inclusion and exclusion criteria before relevant journals were reviewed.
Results: Two articles were selected based on the eligibility criteria and relevance to the clinical questions. The study of Langlois P. et al. found significantly reduced mortality in patients receiving continuous enteral infusion route of immunonutrition containing omega 3 fatty acids. While Dushianthan A. et al. found little or no mortality benefit with the administration of immunonutrition containing omega 3 fatty acids.
Conclusions: There is little or no mortality reduction within the administration of immunonutrition containing omega 3 fatty acids.
Keywords: acute respiratory distress syndrome, ARDS, immunonutrition, omega 3 fatty acids, mortality
PERAN ORAL NUTRITION SUPPLEMENT (ONS) TERHADAP MALNUTRISI PADA PASIEN GANGGUAN JIWA
Full text linkLatar Belakang: Terapi gizi berperan sebagai bagian dari terapi medis untuk membantu pengobatan dan meningkatkan kualitas hidup pasien dengan gangguan jiwa. Tujuan: untuk mengetahui peran ONS terhadap malnutrisi pada pasien gangguan jiwa. Penelitian pre-post test group design. Pasien rawat inap sejak bulan September – Februari yang dilakukan asessmen gizi. Kriteria inklusi: malnutrisi berat dan mendapat ONS. Kriteria eksklusi: pulang paksa kurang dari 3 hari, mendapat terapi nutrisi parenteral dan diagnosa penggunaan NAPZA multipel. Data dianalisis dengan paired samples t-test. Hasil: Pasien malnutrisi sebanyak 153 (27.7%). Jumlah responden 56 dengan laki-laki 30 (53.6%) dan wanita 26 (46.4%). Mayoritas menderita skizofrenia 37 (66.1%). Peningkatan berat badan rerata 1.32 kg dengan pemberian rerata ONS 500 ml/hari selama rerata 8.7 hari. Uji statistik menunjukkan hasil signifikan antara berat badan sebelum dan setelah terapi (p-value = 0.000). Kesimpulan: Didapatkan hasil signifikan antara berat badan sebelum dan setelah pemberian terapi gizi dengan ONS pada pasien malnutrisi dengan gangguan jiwa
TERAPI NUTRISI PADA GAGAL JANTUNG KONGESTIF NYHA FC - II DENGAN SEVERE PROTEIN ENERGY MALNUTRITION
No full textGagal jantung kongestif adalah sindrom klinis kompleks di mana jantung tidak dapat memompa cukup darah untuk memenuhi kebutuhan tubuh. Gagal jantung merupakan epidemik pada sekitar 1% sampai 2% dari populasi di seluruh dunia. Cachexia dan malnutrisi merupakan komplikasi serius dari berbagai penyakit, salah satunya gagal jantung. Malnutrisi pada pasien gagal jantung, merupakan salah satu prediktor dari mortalitas dan dapat menyebabkan kualitas hidup yang kurang baik. Tujuan utama terapi nutrisi pada penderita gagal jantung kongestif adalah untuk mempertahankan dan meningkatkan status gizi sehingga dapat menurunkan morbiditas dan mortalitas penderita. Pria usia 77 tahun dikonsulkan dengan diagnosis gagal jantung kongestif NYHA FC-II, Hipertensi dan Atrial Fibrilasi dan malnutrisi berat (Subjective Global Assesment Skor C). Pasien memiliki riwayat asupan yang kurang dan perubahan konsistensi asupan selama 1 tahun dan memberat sejak 1 bulan yang lalu karena sesak nafas. Terapi nutrisi melalui diberikan dengan target 1300 kkal secara bertahap melalui oral dan parenteral dengan protein 1-1,2 gram/kgBB ideal/hari. Suplementasi yang diberikan adalah Zinc, Vitamin B Kompleks, Vitamin A, Vitamin C, Vitamin D dan Curcuma. Pada akhir masa perawatan terdapat perbaikan metabolik seperti deplesi sistem imun, magnesium,albumin,enzim transaminase dan kalium
TERAPI NUTRISI PADA PASIEN ABSES HEPAR LOBUS SINISTRA DENGAN PLEUROPNEUMONIA DAN SEVERE PROTEIN ENERGY MALNUTRITION
No full textAbses hepar adalah bentuk infeksi pada hati yang disebabkan karena infeksi bakteri, parasit, jamur, yang ditandai dengan adanya proses supurasi dengan pembentukan pus di dalam parenkim hati. Abses hati dapat berdampak buruk pada status gizi melalui asupan makanan yang berkurang, malabsorpsi, peningkatan katabolisme dan penyerapan nutrisi yang diperlukan untuk sintesis dan pertumbuhan jaringan. Wanita usia 73 tahun dikonsulkan dengan diagnosis abses hepar lobus sinistra dan adhesi ileum grade IV dengan Pleuropneumonia dan malnutrisi berat (Subjective Global Assesment Skor C dan Skor MNA 7). Pasien memiliki riwayat asupan yang kurang sejak 3 minggu terakhir karena nyeri perut. Terapi nutrisi diberikan 1200 kkal, ditingkatkan bertahap menjadi 1600 kkal sesuai kemampuan dan kondisi pasien, dengan komposisi protein 1.2-1.5 g/kg BB ideal/hari, karbohidrat 50% dan lemak 30-34.1 % diikuti dengan suplementasi zinc, Vitamin B kompleks, Vitamin C, Vitamin D, curcuma dan kapsul ekstrak ikan gabus. Terapi nutrisi pada abses hepar dengan pemenuhan makronutrien dan mikronutrien yang memadai dan imunonutrisi sangat penting untuk mencegah perburukan penyakit dan luaran pada pasien ini membaik
EFFECT OF L-ARGININE SUPPLEMENTATION WITH ENDOTHELIAL FUNCTION IN DIABETES MELLITUS AND CARDIOVASCULAR DISEASE: AN EVIDENCE BASED CASE REPORT
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Abstract
Background: Cardiovascular disease is the main complication that induces morbidity in diabetes mellitus patients. Endothelial function plays a role in these complications. Nitric oxide is a nitrogen-free radical produced from L-arginine, involved in several mechanisms for maintaining endothelial function to prevent cardiovascular disease and diabetes mellitus.
Methods: A search for relevant literature in PubMed, Cochrane, and ProQuest was conducted. After assessing the relevancy and eligibility of the literature, two pieces of literature were selected and critically appraised.
Results: There are two works of literature from systematic review and meta-analysis were found. The studies suggest pro and contra L-arginine supplementation with endothelial function in diabetes mellitus and cardiovascular disease.
Conclusions: L-arginine might be the alternative supplement for cardiovascular disease and diabetes mellitus, but further analysis in improved studies is needed to confirm.
Keywords: l-arginine, diabetes mellitus, cardiovascular disease, endothelia