Nutritional adequacy in patients of the intensive care unit in Suez Canal University Hospital who are tube fed enterally

To assess the actual energy received by the patients of the intensive care unit in Suez Canal University hospital who are enterally fed compared to their estimated daily caloric requirement and to find out the causes of interruption of tube feeding. A descriptive study, to assess the adequacy of enteral tube nutrition intake and the factors that affect its delivery in the critically ill patients in Suez Canal university hospital, by monitoring the patients nutrition by Harris benedict equation [HBE] and laboratory investigations. The study was carried out in the general intensive care unit. All the patients receiving enteral nutrition were included with a target sample size of 92 patients. A date sheet was used to collect informations about the daily nutritional intake along with daily laboratory investigations including baseline values of blood glucose, potassium, phosphorus and blood gases, Urine analysis, CBC, triglycerides, creatinine, BUN, sodium, chloride, calcium, magnesium, coagulation, liver enzymes, billirubin, amylase, total protein, transferrin and transthyretin, twice weekly measurement of blood glucose, potassium, phosphorus and blood gases and once weekly measurement of CBC, triglycerides, creatinine, BUN, sodium, calcium, magnesium, coagulation, liver enzymes, billirubin, amylase, total protein, transferrin, transthyretin and urine analysis. Patients were followed up until enteral feeding withheld or death. Through following up the patients by measuring the daily caloric intake and laboratory investigations, the study showed that 67.4% of the patients were underfed and only 29.3% were adequately fed. The mean cause of feeding interruption was gastrointestinal factors [65.2%], such as vomiting and diarrhea, followed by intensive care unit factors [10.9%], such as surgical procedures and diagnostic procedures. Significant decrease in the values of BUN, total billirubin, total protein [T.protein], magnesium, PH and bicarbonate was found one week after starting enteral feeding. The majority of the included patients were found to be underfed. Gastrointestinal problems as diarrhea and vomiting played a major rule in unsuccessful delivery of adequate energy requirements to the patients

Correlation between leptin hormone levels and bone mineral density in hepatitis C patients with chronic liver disease

There is accumulating evidence that leptin has a pleiotropic role in hematopoiesis, immune response, fibro-genesis, and hepatocarcinogenesis. The aim of this study was to determine the correlation between leptin levels and bone mineral density in HCV chronic liver disease patients. A medical history to retrieve information about health status, current medications and history of viral or toxic hepatitis; a physical examinations including height and weight; a fasting blood draw for the determination of liver profile and leptin. BMD values were measured by dual-energy X-ray absorptiometry [DEXA] at the L2-L4 lumbar spine and femoral neck. Fasting leptin was highly increased in HCV CLD patients with osteopenia than HCV CLD patients with normal hone mineral density [p<0.05]. Leptin showed a significant negative correlation with bone mineral density [BMD] in HCV CLD patients [r=-0.191, p=0.039] and significant positive correlation with age [r=0.331, p=0.041]. Serum concentrations of leptin is positively correlated in chronic liver disease patients with age and negatively correlated with BMD especially in patients with hepatitis C infection