RESUMO
Background: Due to the increasing global use of nutritional supplements, dietitians play a key role in raising consumer awareness and reducing supplementary side effects. Hence, determination of the states of knowledge, attitudes and practices of this group as to common dietary supplements is important
Methods: A list of all the dietitians employed in the health centers, nutrition clinics and private offices of Shiraz city was prepared; then, all the 36 qualified dietitians were referred to and the information of 25 dietitians was collected. To gather the data, we employed a 4-part questionnaire including demographic data and questions related to their knowledge, attitudes, and practices about prescribed dietary supplements. The knowledge scores of less than 50%, 50-75%, and over 75% were considered as low, medium, and good knowledge, respectively. And the classification of attitudes was determined based on quartile ranking. The data were statistically analyzed through SPSS, version19, using Chi-square and t-test statistical methods
Results: Most of the dietitians had moderate [80%] and low [20%] level of knowledge, while 100% of them had a positive attitude [3[rd] quartile] about the role of dietary supplements in health, side effects, and food interactions. The most common supplements recommended were those for anemia and growth of children. In this study, the dietitians who had higher level of knowledge significantly used nutritional journals to increase their awareness
Conclusion: Considering the key roles of dietitians and their knowledge, attitudes, and practices in the field of supplements and the results of the study, it appears that necessary measures should be taken to enhance the dietitians' knowledge
RESUMO
The evidence saying that the rate of Systemic Inflammatory Response Syndrome [SIRS] is high in patients with advanced cirrhosis and portal hypertension, this could have negative outcome on patients prognosis. This prospective study included 109 cirrhotic patients who were admitted to Imam Khomeini Hospital, affiliated with Orumieh University of Medical Sciences, during 2011-2012. The presence of SIRS and the model for end stage liver disease [MELD] were assessed on admission and during the hospital stay. SIRS was considered positive if patients had two or more of the following: temperature of >38°C or <36°C; heart rate >90 beats/min; respiratory rate >20/min or PaCO2 <32 mmHg or the use of mechanical ventilation; WBC >12000/mm[3] or <4000/mm[3] or more than 10% immature neutrophil count. MELD was calculated as: MELD = 3.8 [Ln serum bilirubin [mg/dl]] +11.2 [Ln INR] +9.6 [Ln serum creatinine [mg/dl]] +6.4. Hospital outcome was defined as death or hospital discharge. A total of 109 cirrhotic patients between the ages of 14 to 84 [mean: 54.6 +/- 18.4] years were included. There were 65 [59%] male patients. Of the 109 patients, 76 [69.8%] were SIRS-negative and 33 [30.2%] were SIRS-positive. The mean calculated MELD score for all patients was 15.5. There was a cor-relation noted between SIRS and high serum creatinine levels [p=0.01] and between SIRS and a high MELD score [p=0.00]. During follow-up 19 [17.4%] patients died. SIRS was correlated with death [p<0.00] on multivariate analysis, SIRS was independently associated with hospital death. SIRS is a relatively frequent event in cirrhotic patients admitted to referral centers. It is closely related to the severity of liver disease as shown by the MELD score. SIRS independently and adversely affects the in-hospital outcome in patients with liver cirrhosis