ABSTRACT
Background: This study was conducted to assess the role of Partial Parenteral Nutrition (PPN) and a specially prepared 'mixed fluid formula' used as PPN in sick surgical neonates.Methods: This single institution based Randomised Control Trial was performed in Surgical NICU of a tertiary care Centre. Surgical neonates who required bowel rest for >3 days like Esophageal Atresia (22), Duodenal Atresia (38), Jejuno-Ileal Atresia (50), Necrotising Enterocolitis (29) and others (11), were chosen. As a CONTROL population half (75) neonates were allowed maintenance fluid only (Isolyte P) and rest (75) were given a combination of maintenance fluid (Isolyte P) and PPN (specially prepared mixed fluid). This mixed fluid each 100 ml was prepared with 65ml Isolyte P, 15 ml 25% Dextrose, 10 ml Normal Saline, 7 ml Astymin 3, 2 ml Multivitamin and 1 ml Injection KCl. Fluid was continued till enteral feeding was established.Results: Neonates according to their body weight were divided in three groups <1 kg (50), 1-2.5 kg (71) and >2.5 kg (29) and their post-operative outcome was assessed as Clinical Positive/Negative and Laboratory Positive/Negative. Results were separately assessed in 3 body weight groups under 'Control' and 'Study' which showed both Clinical and Biochemical improvement in 'Study group'.Conclusions: The composition of mixed fluid, its nutritional value, calorie supplementation, compatible osmolarity for peripheral venous administration and most importantly its easy and cost-effective preparation were assessed thoroughly and we recommend this 'mixed fluid' preparation as a very useful PPN for sick surgical neonates.
ABSTRACT
This study was designed to evaluate the effect of the individual nutrition education for type 2 diabetes who participate the diabetes buffet. The subjects were 66 patients and divided into education (n = 34) and control groups (n = 32). The mean age of education and control groups were 59.8 and 56.6 years old, respectively. There were no differences in age and body mass index (BMI) between two groups. Initial glycosylated hemoglobin (HbA1c), post prandial plasma glucose (PP2), total plasma cholesterol, and blood pressure were not different between two groups. But fasting blood sugar (FBS) was higher in education group than in control group. On completion of the study, the education group showed significant decreases in body weight, BMI, FBS and PP2, however, the control group showed no changes in body weight, BMI and PP2, and showed a significant increase in FBS. Initial calorie and protein intakes of the education group did not meet the prescribed amount, however, mineral and vitamin intakes were higher than estimated average requirement (EAR). By the end of study, calorie and protein intakes were significantly increased to meet the prescription. In order to evaluate the effect of diet education, awareness of calorie requirement was used as an index of understanding diet prescription. The degree of awareness of calorie requirement was dependent on age: younger patients showed higher awareness than older subjects. The subject who showed better understanding of diet prescription showed lower levels of HbA1c, FBS, and PP2 at the end of the experiment period. The results of this study clearly show that individual diabetes diet education is effective to make the patient understand their diet prescription, and is effective to control body weight and blood sugar level. Awareness of calorie requirement could be used as an index of understanding of prescribed diet. Since age is an important variable to determine the awareness of calorie requirement, different strategies of nutrition education should be developed for different age groups, especially patients over 70 years old.