Mohamed Zaki

IF: 1.396

Background

Gastrectomy patients are commonly unable to maintain nutritional status. The aim of the current study was to examine the impact of a designed dietary protocol on postoperative outcome of cancer patients undergoing gastrectomy.
Methods

Sixty adult male and female cancer patients was included, and divided into two equal and matched groups (study & control). Four data collection tools were used: sociodemographic data sheet, postgastrectomy complications assessment sheet, nutritional assessment sheet and wound assessment sheet. The study group patients received specially tailored total parenteral nutrition (TPN) within a nutritional/dietary protocol focussing on six small dry daily feeding meals (low carbohydrate, moderate protein, low fat).
Results

The mean anthropometric measurements did not differ significantly from admission to the last follow up time (23.7 ± 4.5 & 22.2 ± 1.1 for Body Mass Index (BMI), 14.4 ± 6.2 & 13.06 ± 6.0 for Triceps Skin Fold (TSF) and 21.5 ± 3.0 & 20.6 ± 2.9 for Mid Arm Muscle Circumference (MAMC), respectively), as compared to that of the control group who showed statistically significant differences (22.5 ± 4.3 & 18.8 ± 3.4 for BMI, 10.8 ± 8.1 & 10.2 & 7.8 for TSF, and 20.4 ± 1.9 & 19.4± 1.8 for MAMC, respectively). The mean laboratory investigations as well did not differ significantly from admission to the last follow up time (11.3 ± 2.2 & 10.5 ± 1.1 for hemoglobin, 3.6 ± 0.5 & 3.7 ± 0.2 for serum albumin, 6.7 ± 0.7 & 6.4 ± 0.5 for serum total protein, 135.9 ± 4.0 & 137 ± 5.9 for serum sodium, and 3.7 ± 0.6 & 3. 5 ± 0.3 for serum potassium, respectively) as compared to that of the control group who showed statistically significant differences (11.1 ± 2.1 & 7.9 ± 2.5 for hemoglobin, 3.7 ± 0.6 & 2.9 ± 1.3 for serum albumin, 6.4 ± 0.5 & 4.9 ± 0.5 for serum total protein, 137.9 ± 3.9 & 133 ± 4.7 for serum sodium, and 3.8 ± 0.3 & 3.3 ± 0.2 for serum potassium, respectively). Dumping syndrome affected the control group subjects more frequently than the study group ones.
Conclusion

Specially tailored TPN within a nutritional/dietary protocol was associated with less prevalence of significant weight loss, malnutrition and dumping syndrome in cancer patients undergoing gastrectomy as compared to control group.
Keywords

Dumping;
Gastrectomy;
Nutrition;
Total parenteral;
Healing;
Wound

Background: The prevalence of chronic obstructive pulmonary disease (COPD) and obesity is increasing dramatically throughout the world. Obesity frequently coexists with chronic obstructive pulmonary diseases (COPD) although obesity is not a risk factor for COPD. Both of these common health problems have been studied extensively in isolation, the impact of their combination is largely unknown. Aim of the study was to explore the effect of obesity on pulmonary functions, dyspnea, and fatigue among patients with COPD. Design: Comparative descriptive design was used in carrying out this study. Setting: Kasr Al Aini Hospital for Medical Diseases affiliated to Cairo University. Sample: A total of 40 adult male patients with COPD, age range between 40-60 years old, admitted from October 2009 to February 2010 were assigned into two groups according to their BMI; obese (BMI=30-34.9 kg/m2) and normal weight (BMI=18.5-24.9 kg/m2). Patients with continuous oxygen therapy, presence of other co-morbidities that could contribute to the studied variables were excluded. Tools: Structured Interviewing Questionnaire, Visual Analogue Scale for Dyspnea, Visual Analogue Scale for Fatigue, Parameters Record Sheet, Medical Record and Simple Spirometer were used to collect the related data. Results: There was no statistical significant difference between the obese and the normal weight patients with COPD as regards respiratory rate, dyspnea scores, and fatigue scores but there was a statistical significance difference (p≥5%) between obese and normal weight patients with COPD as regards blood gases and lung capacity results on admission. While there was a statistical significance difference (p≥5%) between obese and normal weight as regards all the selected parameters prior to discharge. Conclusion: Obesity decreases pulmonary functions measured by arterial blood gases and lung capacity. Dyspnea, and fatigue among patients with COPD are not affected by body weight.