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Nutrition in ICU Calorie Count
Nutritional status in critically ill patients can be difficult to assess. Anthropometric measurements (eg. skin fold thickness and mid-arm circumference) are commonly used to assess populations but are not particularly useful in individuals. Biochemical tests also have their limitations: albumin levels fall rapidly as part of the acute phase response and hemoglobin is affected by hemorrhage, haemolysis, transfusion and bone marrow suppression. Transferrin, prealbumin and lymphocyte counts can be useful however they are dependent on the patient being well hydrated. Body Mass Index (mass [kg] / height [m] 2) is a frequently used tool (with a BMI < 18.5 classed as underweight) and has been shown to be an independent predictor of mortality in seriously ill patients. Nevertheless it does not reflect the acute changes in nutritional status important in critical illness and is used most for the assessment of long term health risks of obesity. Probably the most useful measure of nutritional status is a targeted history and examination. One such method which is widely accepted is known as the Subjective Global Assessment which includes Weight change – both chronic (over 6 months) and acute (over 2 weeks ), Changes in food intake, Gastrointestinal symptoms – nausea, vomiting, diarrhea and anorexia, Functional impairment and is combined with a physical examination
About the Speaker
Dr. Adel Mohamed Yasin Al Sisi
MBBS, MD(Critical Care Medicine) , Ph. D (Critical Care Medicine)
Upcoming Case Discussions
Pediatric and Adult Veneers: Case Studies
Pediatric dental veneers can be transformative in restoring smiles and dental function in children with various dental issues. Case studies illustrate the efficacy and benefits of veneers in pediatric dentistry. They might showcase how veneers can improve the appearance of discolored or malformed teeth, enhancing a child's self-esteem. They might also demonstrate how veneers can correct dental imperfections caused by injury or developmental abnormalities. These studies highlight the importance of personalized treatment plans tailored to each child's unique dental needs. Veneers in pediatric dentistry offer durable and aesthetic solutions, often with minimal tooth preparation, making them suitable for young patients. Through case studies, dental professionals can showcase successful outcomes and educate parents about the potential advantages of veneers in enhancing their child's dental health and confidence.
Importance of Holistic Care in Cancer: Oncologist’s Perspective
Holistic care in cancer emphasizes treating the whole person, not just the disease, by considering physical, emotional, social, and spiritual aspects. It recognizes that cancer affects every aspect of a person's life and aims to improve overall well-being alongside medical treatments. Holistic care focuses on managing symptoms, reducing treatment side effects, and enhancing quality of life. It incorporates complementary therapies such as acupuncture, massage, meditation, and nutritional counseling to support conventional treatments. Psychological support is integral to holistic care, addressing anxiety, depression, and coping strategies during diagnosis, treatment, and survivorship. Holistic care encourages open communication between patients, caregivers, and healthcare providers to ensure personalized and patient-centered treatment plans. It fosters a sense of empowerment and control for patients, helping them actively participate in decision-making and self-care.
Diabetes Care: Insulin Management Techniques
There are various types of insulin, including rapid-acting, short-acting, intermediate-acting, and long-acting, each with different onset and duration of action. Basal-Bolus Regimen technique involves using both basal (long-acting) and bolus (rapid-acting) insulin to mimic the body's natural insulin release pattern, providing continuous background insulin and mealtime coverage. Insulin pens are convenient and portable devices for administering insulin. They allow for precise dosage adjustments and discreet insulin delivery. Insulin pumps deliver a continuous infusion of rapid-acting insulin, offering flexibility in insulin dosing and mealtime boluses, particularly beneficial for type 1 diabetes management. Patients on insulin learn to estimate and match their insulin dose to the amount of carbohydrates consumed in meals and snacks, improving glycemic control.Rotating injection sites (abdomen, thighs, buttocks, arms) helps prevent lipohypertrophy and ensures optimal insulin absorption. Individualized glycemic targets are set based on age, diabetes type, and overall health, with the aim of achieving optimal blood glucose control while minimizing hypoglycemia.
Postpartum Haemorrhage (PPH)
Postpartum hemorrhage (PPH) is a significant complication following childbirth, characterized by excessive bleeding within 24 hours of delivery. It's a leading cause of maternal mortality globally. PPH can occur due to various factors, including uterine atony (failure of the uterus to contract), trauma during childbirth, retained placental tissue, or coagulation disorders. Prompt recognition and intervention are crucial to prevent severe consequences. Management typically involve uterine massage, administration of uterotonic medications, uterine artery embolization, or, in severe cases, surgical interventions like hysterectomy. Timely and effective management strategies are essential to reduce maternal morbidity and mortality associated with PPH.
Inflammatory Bowel Disorders: Types
Crohn's disease is a type of IBD that can affect any part of the digestive tract, causing inflammation and ulcers. It commonly involves the end of the small intestine (ileum) and the beginning of the large intestine (colon). Ulcerative colitis is characterized by inflammation and ulcers in the lining of the large intestine (colon) and rectum. It typically starts in the rectum and can extend continuously into the colon. Some cases of IBD cannot be clearly classified as Crohn's disease or ulcerative colitis due to overlapping features or atypical presentations. This is referred to as indeterminate colitis.Microscopic colitis includes two subtypes: collagenous colitis and lymphocytic colitis. These conditions are characterized by chronic inflammation of the colon lining visible only under a microscope. While primarily known for causing mouth sores and skin lesions, Behçet's disease can also involve the gastrointestinal tract, leading to ulcers and inflammation resembling Crohn's disease.
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Dr. Adel Mohamed Yasin Al Sisi's Talks on Assimilate
- 27th-September-2022,TIME : 4PM to 5:30PM
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Nutritional status in critically ill patients can be difficult to assess. Anthropometric measurements (eg. skin fold thickness and mid-arm circumference) are commonly used to assess populations but are not particularly useful in individuals. Biochemical tests also have their limitations: albumin levels fall rapidly as part of the acute phase response and hemoglobin is affected by hemorrhage, haemolysis, transfusion and bone marrow suppression. Transferrin, prealbumin and lymphocyte counts can be useful however they are dependent on the patient being well hydrated. Body Mass Index (mass [kg] / height [m] 2) is a frequently used tool (with a BMI < 18.5 classed as underweight) and has been shown to be an independent predictor of mortality in seriously ill patients. Nevertheless it does not reflect the acute changes in nutritional status important in critical illness and is used most for the assessment of long term health risks of obesity. Probably the most useful measure of nutritional status is a targeted history and examination. One such method which is widely accepted is known as the Subjective Global Assessment which includes Weight change – both chronic (over 6 months) and acute (over 2 weeks ), Changes in food intake, Gastrointestinal symptoms – nausea, vomiting, diarrhea and anorexia, Functional impairment and is combined with a physical examination