Diet in liver disease

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Diet in liver disease

  1. 3. دکترهمایونی <ul><li>Diet in liver disease </li></ul>
  2. 4. <ul><li>Nature & Severity of liver disease should be categorized </li></ul><ul><li>Child Pugh Score </li></ul><ul><li>Model for end-stage liver disease ( MELD ) </li></ul><ul><li>Compensated Versus decompensate </li></ul><ul><li>Subjective Global assessment ( SGA ) </li></ul>
  3. 5. <ul><li>Subjective Global Assessment </li></ul>
  4. 6. <ul><li>Historical Component </li></ul><ul><li>Weight loss </li></ul><ul><li>Change in dietary intake </li></ul><ul><li>Presence of GI symptom </li></ul><ul><li>Functional Capacity </li></ul><ul><li>Metabolic demand </li></ul>
  5. 7. <ul><li>Physical examination Component </li></ul><ul><li>Edema </li></ul><ul><li>Ascitis </li></ul><ul><li>Muscle Wasting </li></ul><ul><li>Subcutaneous fat loss </li></ul>
  6. 8. <ul><li>Micronutrient deficiency </li></ul>
  7. 9. <ul><li>Dermatitis </li></ul><ul><li>Zinc </li></ul><ul><li>Vitamin A </li></ul><ul><li>Niacin </li></ul>
  8. 10. <ul><li>Night blindness </li></ul><ul><li>Photophobia </li></ul><ul><li>Hyperkeratosis </li></ul><ul><li>Vitamin A </li></ul>
  9. 11. <ul><li>Burning of the mouth </li></ul><ul><li>Burning of the Tongue </li></ul><ul><li>Glossitis </li></ul><ul><li>Angular stomatitis </li></ul><ul><li>Vita B12 </li></ul><ul><li>Folate </li></ul>
  10. 12. <ul><li>Easy Bruising </li></ul><ul><li>Vitamin C </li></ul><ul><li>Vitamin K </li></ul>
  11. 13. <ul><li>Paresthesia </li></ul><ul><li>Thiamin </li></ul><ul><li>Pyridoxin </li></ul>
  12. 14. <ul><li>Pallor ( Anemia ) </li></ul><ul><li>Iron deficiency </li></ul><ul><li>B12 </li></ul>
  13. 15. <ul><li>DTR </li></ul><ul><li>B12 </li></ul><ul><li>B1 </li></ul>
  14. 16. <ul><li>Laboratory investigations </li></ul><ul><li>Albumin </li></ul><ul><li>Creatinin </li></ul><ul><li>INR </li></ul><ul><li>Vitamin A , D , E , Thiamin </li></ul><ul><li>Selenium , Zinc , Vitamin B12 , Folate </li></ul>
  15. 17. <ul><li>Delayed Hypersensitivity & </li></ul><ul><li>Total lymphocyte count </li></ul>
  16. 18. <ul><li>Antropometry </li></ul><ul><li>Change in composition of body compartment </li></ul>
  17. 19. <ul><li>MAMC </li></ul><ul><li>Mide Arm Muscle Circumference </li></ul><ul><li>( Lean tissue store ) </li></ul>
  18. 20. <ul><li>SFT </li></ul><ul><li>Skin Fold Thickness </li></ul>
  19. 21. <ul><li>Miscellaneous Tests </li></ul><ul><li>DEXA Dual energy X-Ray absorptometry </li></ul><ul><li>Deutrium oxide dilution </li></ul><ul><li>In vivo neutron activation analysis </li></ul><ul><li>Bioelectrical impendence analysis </li></ul>
  20. 22. <ul><li>Energy Expenditure </li></ul><ul><li>Resting Energy Expediture </li></ul><ul><li>Harris Benedict equation </li></ul>
  21. 23. <ul><li>Low Salt </li></ul><ul><li>Low Protein </li></ul><ul><li>High Carbohydrate </li></ul>
  22. 24. <ul><li>Protein </li></ul><ul><li>Content </li></ul><ul><li>Essential amino acids </li></ul><ul><li>Biologic Value </li></ul>

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