The document discusses two cases of pediatric diarrhea and provides recommendations for treatment. It evaluates the patients' nutritional status and hydration, describes the metabolic changes that occur during diarrhea, and advises breastfeeding and oral rehydration solutions to prevent dehydration. Proper feeding practices and nutrition are emphasized to break the cycle of malnutrition and diarrhea.
Short bowel syndrome in infants... Dr Sunil DeshmukhSunil Deshmukh
Management of Short bowel syndrome in neonates & infants.........................by
Dr Sunil B Deshmukh, MBBS MD Paediatrics, Fellow in Neonatology(KEM Hospital ,Pune)
this is a chapter which comes under Nursing Foundations for First year BSc Nursing students. This ppt helps you to learn about the importance of nutrition, BMR, factors influencing dietary intake, factors affecting caloric needs, principles relevant to nutrition, assessment of nutritional status, dysphagia, acute care of patients with nutritional needs, feeding helpless patients, enteral tube feeding, insertion of NG tube, parenteral feeding, medical nutrition therapy, discussion on nursing process.
I presented a hyperemesis case for a Case Study Seminar where university faculty were invited to attend and RD\'s from the community could receive CPE\'s for attending.
constipation in children , pediatric constipation , management of constipation in children , understanding constipation , causes of constipation in children , functional constipation in children , treatment of constipation ,approach to constipation in children ,constipation in infants
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Short bowel syndrome in infants... Dr Sunil DeshmukhSunil Deshmukh
Management of Short bowel syndrome in neonates & infants.........................by
Dr Sunil B Deshmukh, MBBS MD Paediatrics, Fellow in Neonatology(KEM Hospital ,Pune)
this is a chapter which comes under Nursing Foundations for First year BSc Nursing students. This ppt helps you to learn about the importance of nutrition, BMR, factors influencing dietary intake, factors affecting caloric needs, principles relevant to nutrition, assessment of nutritional status, dysphagia, acute care of patients with nutritional needs, feeding helpless patients, enteral tube feeding, insertion of NG tube, parenteral feeding, medical nutrition therapy, discussion on nursing process.
I presented a hyperemesis case for a Case Study Seminar where university faculty were invited to attend and RD\'s from the community could receive CPE\'s for attending.
constipation in children , pediatric constipation , management of constipation in children , understanding constipation , causes of constipation in children , functional constipation in children , treatment of constipation ,approach to constipation in children ,constipation in infants
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. OBJECTIVES
At the end of the session, the students will be
able to:
● Describe the sequence of metabolic changes
occurring during diarrhea
● Evaluate nutritional status of patients
● Evaluate the adequacy of the diet before and
during diarrhea
● List the important things to consider in advising
the parents of pediatric patients with diarrhea
3. CASE #1
Age: 10 months old
Gender: Female
Weight: 8kg
Chief complaint: Diarrhea of 1 day duration (occurred 4x)
History of Present Illness:
- Breastfed since birth
- No accompanying vomiting
- Started eating congee with fish & vegetables @ 5mos.
- At onset of the diarrhea, the mother stopped breastfeeding & giving solid foods; instead
shifted to giving am with sugar
Physical examination:
- Child is alert with good skin turgor and adequate urine output
4. 1. Describe the sequence of the various metabolic
changes observed in diarrhea and correlate these
to the clinical manifestations observed in the
patient (e.g. gastrointestinal function and motility,
alteration in fluid volume, composition, acid-base
balance, etc.)
5. What is it?
● Increase in frequency of bowel evacuation and water content in stool
● More than 3 bowel movements per day
● Loose and watery stools
● Causes the body to lose electrolytes and water
Diarrhea
8. ● Metabolic Acidosis
○ Increase in bicarbonate loss
● Hypokalemia
○ Can cause muscle weakness, muscle
cramps and and cardiac arrhythmias
Acid-Base Balance
9. 2. Evaluate the nutritional status and state of
hydration of the patient (use growth chart and
assessment of hydration table). Compute for the
ideal weight for age of the patient.
10.
11. ● The Ideal Body weight for a 10 month old girl is 9.2 kg.
● According to Gomez Classification:
○ IBW = 8kg / 9.2 kg (100) = 86.9%
○ Interpretation: If the weight for age falls between 75-89%
then the patient would have First degree Malnutrition and
underweight.
Gomez Classification
12. 3. Determine the adequacy of the patient’s diet
before and during diarrhea; relate this to the cycle
of malnutrition and diarrhea.
13. - BREASTFEED AT BIRTH
- CONGEE WITH FISH AND VEGETABLES
BEFORE THE ONSET
OF DIARRHEA
*ADEQUATE
14. - STOPPED BREASTFEED AND SOLID
FOODS
- SHIFTED TO AM WITH SUGAR
DURING THE ONSET
OF DIARRHEA
*INADEQUATE
16. 4. What advice should be given to the patient’s
mother regarding breastfeeding, use of home
fluids or oral rehydration solutions, and other
nutritional support for the patient; describe their
advantages
17. BREASTFEEDING
● One of the most effective ways to ensure
child health and survival. However, nearly 2
out of 3 infants are not exclusively
breastfed for the recommended 6 months
● Studies in some developing nations have
shown that those who receive exclusive
breastfeeding during their first 6 months of
life are better protected against
infection with diarrheal diseases.
18. BREAST MILK
Ideal Food for Infants
safe, clean and contains
antibodies which help protect
against many common childhood
illnesses
Contains COLOSTRUM
Provides all the energy and
nutrients
19. ● Proper Breastfeeding Positioning and Attachment.
ADVICE TO MOTHER ABOUT BREASTFEEDING
GOOD FEEDING POSITIONING
● Baby’s head and body are in straight
line
● Baby is facing the breast, with nose
towards the nipple.
● Mother is holding the baby’s body
close to her body and supporting the
baby’s whole body.
20. ADVICE TO MOTHER ABOUT BREASTFEEDING
SIGN OF GOOD ATTACHMENT
● More areola is visible above the baby’s mouth than below
● Mouth is wide open with the lower lip turned outward
● Baby’s chin is touching the breast
● Baby’s sucking is slow and deep
21. ● Give more frequent, longer breastfeeds, day and night.
● If taking other milk, replace with increased breastfeeding
● Advise the mother on the benefits of Breastfeeding to her.
○ Associated with a natural method of birth control
○ Reduces risks of breast and ovarian cancer, type II diabetes, and
postpartum depression
● Advise the mother on the benefits of Breastfeeding to her baby.
○ Decreases the risks of being overweight or obesity
○ Decreases the development of type II diabetes
ADVICE TO MOTHER ABOUT BREASTFEEDING
22. ● Oral Rehydration Solution:
○ is a special combination of dry salts that is mixed with safe water.
It can help replace the fluids lost due to diarrhea.
● Where can it be obtained?
○ ORS packets are available from health centres and pharmacies
○ It can also be home made:
■ 6 level teaspoons of sugar and 1/2 level teaspoon of salt
dissolved in 1 liter of safe and clean water.
● A child under the age of 2 years needs at least 1/4 to 1/2 of a large
cup (250 mL) of the ORS drink after each watery stool.
USE OF HOME FLUIDS OR ORAL REHYDRATION SOLUTIONS
23. ● COMPLEMENTARY FOOD: Must be timely introduced at 6 months of
age
○ Feed 3 times a day if breastfed; feed 5 times a day if not breastfed
○ Introduced one at a time for a week
■ Start with lugaw, mashed vegetables or beans, steamed
tokwa, flaked fish giving one to two teaspoons a day.
NUTRITIONAL SUPPORT FOR THE PATIENT
24. 5. What biochemical significance if any, can be given
to the use of “am” with sugar in diarrheic patients?
25. ● suspension of starch obtained by draining boiled rice or by
boiling rice until it completely dissolves into the water
● recognized as a good preventive measure against diarrheal
diseases based on the same scientific principle, where
absorption of salt and water in the intestines is linked to
absorption of glucose
RICE WATER or “AM”
28. CASE #2
Name: Benjie
Age: 3 years old
Gender: Male
Weight: 11 kg
Chief complaint: Diarrhea & Vomiting of 3 days duration
History of Present Illness:
- Diarrhea occurred 6x a day and vomiting 3x a day. Past history revealed that the patient was
breastfed for 2 months then shifted to Bonna, 1:2 dilution. Solid food was started at 4 months old.
The patient is presently being given “lugaw” since the onset of diarrhea.
Physical Examination:
- Patient was irritable
- Temperature: 37 ͒C,
- Heart rate: 100 beats/min
- Respiratory rate: 20 cycles/min
- (+) sunken eyeballs
- Mouth and tongue were dry
- Poor skin turgor
- Decreased urine output
- Abdomen was slightly distended with hypoactive
bowel sounds
Laboratory:
- Serum electrolytes showed normal sodium and
decreased potassium levels.
29. 1. Assess the nutritional status, electrolyte status,
and state of hydration of the patient.
30. ● The Ideal body weight of a 3-year-old boy is 14 kg but the child is 10 kg
only.
○ For 1-5 y/o: Age in Years X 2 + 8
○ Assessment: Underweight
● Gomez Classification
○ (11/14) x 100%= 78.6%
○ Assessment: First degree Malnutrition
● His distended abdomen and hypoactive stomach lend visible evidence
of poor nutrition.
NUTRITIONAL STATUS
33. 2. Discuss the sequence of events in diarrhea that
will lead to alterations in volume, electrolyte,
osmolality, and acid-base balance as shown in this
case.
34.
35. ● Due to excessive gastrointestinal fluid losses.
● The body tries to maintain the fluid loss by decreasing the
urine output with low fractional sodium excretion as
manifested by patient.
VOLUME & OSMOLALITY: Isotonic dehydration
36. ● Large fecal losses → Potassium depletion
● Vomiting also contributes to potassium depletion
ELECTROLYTE: Hypokalemia
37. ● Diarrhea → direct loss of Bicarbonates → Metabolic
Acidosis
ACID- BASE BALANCE: Metabolic Acidosis
39. ● Most infectious diarrhea is self-limiting, medical care is primarily
supportive. Oral rehydration (OR) is the mainstay of treatment for all
Children affected by diarrhea; never neglect OR,even in the absence of
overt dehydration, because maintaining hydration is necessary.
Consider intravenous rehydration only in the unlikely event that OR is
unsuccessful
● OR therapy is the cornerstone of treatment, especially for small-bowel
infections that produce a large volume of watery stool output.
40. ● A 5-cc or 10-cc syringe without a needle is a very useful tool.
● OR is now universally recommended to be completed in an expedite way,
within 4 hours.
○ At completion of hydration, resumption of feeding is recommended
strongly. In fact, many studies convincingly demonstrate that early
refeeding hastens recovery.
41. 4. Explain the role of glucose in oral rehydration
solutions.
42. ● Due to large amounts of sodium secreted into the intestinal lumen so quickly
very little sodium is reabsorbed, which can lead severe hyponatremia
● Sodium absorption via the intestine occurs in two stages.
● The first is at the outermost cells (intestinal epithelial cells) at the surface of
the intestinal lumen. Sodium passes into these outermost cells by cotransport
facilitated diffusion (symport diffusion) via the SGLT1 protein. From there,
sodium is pumped out of the cells (basal side) and into the extracellular space
by active transport via the sodium potassium pump.
ROLE OF GLUCOSE IN ORS
45. ● To maintain electrolyte levels: Broth & Soup which contain Na+ Fruit
Juices, Soft Fruits & Vegetables which contain K+
● BRAT diet:
B – Bananas
R – Rice
A – Applesauce
T – Toast
● Avoid because they tend to aggregate diarrhea:
1) Milk products
2) Greasy foods
3) High fiber
4) Very sweet food
46. Case 1:
● Diarrhea is increase in frequency of bowel evacuation and water content in stool
● Assessment: First degree Malnutrition and underweight.
● Breastfeeding and solid foods SHOULD be given
● Breastfeeding is one of the most effective ways to ensure child health and survival.
● ORS is a special combination of dry salts that is mixed with safe water. It can help replace the fluids lost
due to diarrhea.
● Rice Water or “am” Biochemical Aspect: Addition of sugar → decrease osmotic pressure → increases the
salt and water absorption → decrease the stool volume.
Case 2:
● Assessment: First degree Malnutrition & Underweight; Hypokalemic & with Some Dehydration
● Alteration due to Diarrhea: Isotonic Dehydration (Volume & Osmolality), Hypokalemia (Electrolytes) and
Metabolic Acidosis (Acid- Base Balance)
● OR therapy is the cornerstone of treatment, especially for small-bowel infections that produce a large
volume of watery stool output.
● Nutritional Management: BRAT diet and Soft Fruit and Vegetables with high K+ content.
SUMMARY
47. ● Murray, R. K. (2003). Harper's illustrated biochemistry. New York: McGraw-Hill.
● D.M. Vasudevan, Sreekumari S., Kannan Vaidyanathan. (2011). Textbook of biochemistry for medical
students (ed.6). New Delhi: Jaypee Bros. Medical Publishers,
● Integrated Management of Childhood Illnesses (2016) by WHO and UNICEF
● WHO. https://www.who.int/health-topics/breastfeeding#tab=tab_1
● ORS. https://rehydrate.org/solutions/homemade.html
● Loo, D. D., Zeuthen, T., Chandy, G., & Wright, E. M. (1996). Cotransport of water by the Na+/glucose
cotransporter. Proceedings of the National Academy of Sciences of the United States of America,
93(23), 13367–13370. https://doi.org/10.1073/pnas.93.23.13367
● Islam MS, Nishiyama A, Sakaguchi E. Rice gruel and rice starch reduce sorbitol-induced diarrhoea in
cecectomized rats. Digestion. 2005;72(1):13-21. doi: 10.1159/000087398. Epub 2005 Aug 10. PMID:
16103671.
● https://rehydrate.org/diarrhoea/tmsdd/2med.htm
● https://www.lecturio.com/magazine/dehydration
● https://media.lanecc.edu/users/powellt/FN225OER/Carbohydrates/FN225Carbohydrates4.html
REFERENCES: