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TERAPI NUTRISI PADA PASIEN STENOSIS GASTROJEJUNOSTOMI Amelia Jessica; Audria Graciela; Yosua Yan Kristian; Yohannessa Wulandari
IJCNP : INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN Vol 4 No 1 (2021): IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN)
Publisher : Perhimpunan Dokter Gizi Klinik Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54773/ijcnp.v4i1.59

Abstract

Latar belakang Stenosis merupakan komplikasi yang dapat terjadi pada pembedahan gastrojejunostomi. Stenosis dapat menyebabkan gastric outlet obstruction (GOO), yaitu terhambatnya pengosongan lambung sehingga menimbulkan keluhan mual, muntah, intoleransi terhadap makanan, penurunan selera makan, dan nyeri perut. Gastic outlet obstruction berkepanjangan berisiko menyebabkan terjadinya dehidrasi, ketidakseimbangan elektrolit, serta malnutrisi. Penurunan berat badan ditemukan pada 65% pasien dengan GOO. Laporan Kasus Tn. B, 62 tahun, dengan diagnosis tumor ganas kolon asenden, pasca laparotomi hemikolektomi dekstra, eksklusi pilorus, dan gastrojejunostomi. Sejak satu tahun sebelum masuk rumah sakit, pasien mengeluhkan mual dan muntah disertai nyeri perut hilang timbul, terutama sebelah kanan. Pada pemeriksaan didapatkan tumor pada usus besar dan dilakukan operasi hemikolektomi kanan. Saat pembedahan, terdapat perlengketan tumor pada duodenum dan saat dibebaskan terjadi cedera pada duodenum, sehingga dilakukan eksklusi pilorus serta gastrojejunostomi. Sembilan hari pasca pembedahan dilakukan relaparotomi gastrojejunostomi Roux-en-Y serta adhesiolisis akibat adanya stenosis dan adhesi. Pasien mengalami penurunan berat badan sebanyak 19 kg dalam waktu 1 tahun terakhir. Terapi nutrisi berupa diet 1420 kkal, protein 1.1g/kgBB/hari, lemak 32%, dan karbohidrat 50% dalam bentuk nutrisi parenteral. Pemberian mikronutrien enteral untuk sementara ditunda. Pemantauan dilakukan setiap hari pada pasien berupa toleransi asupan, saluran cerna, tanda vital serta keseimbangan cairan. Kesimpulan Stenosis gastrojejunostomi merupakan komplikasi yang jarang terjadi, namun dapat mengakibatkan terjadinya GOO. Pemberian nutrisi parenteral perioperasi diberikan pada pasien yang tidak dapat mencukupi kebutuhan energi melalui oral atau enteral, serta kondisi malnutrisi berat pada pasien yang akan menjalani pembedahan. Nasogastrojejunal tube merupakan jalur pilihan pemberian nutrisi yang diutamakan pada GOO.
Body Mass Index And Survival Rate in Nasopharyngeal Cancer Patient: An Evidence-based Case Report Yohannessa Wulandari; Metta Satyani; Marvin Marino; Nurul Ratna Mutu Manikam
World Nutrition Journal Vol. 3 No. 2 (2020)
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V03.i2.0005

Abstract

Introduction: Nasopharyngeal cancer is the most common type of head and neck cancer with prevalence of 6.2/100000 population. Recently, study of prognostic factors for nasopharyngeal cancer still becomes one of research focuses. Several studies have tried to find the relationship between nutritional status (body mass index/BMI) and nasopharyngeal cancer patients’ survival rate, but the results are still inconsistent.                    Objective: To find the relationship between nutritional status represented by BMI and nasopharyngeal cancer patients’ survival rate.Methods: Electronic literature searches were performed in Cochrane®, Scopus®, and Pubmed®. Mesh term and title/abstracts were screened based on inclusion and exclusion criteria before relevant journals were reviewed.Results: Two articles were selected based on the eligibility criteria and relevancy to the clinical question. In the study of Huang et al., the subject was nasopharyngeal cancer patient stage III and IV was included as subject of the study. In the study of Lin et al., nasopharyngeal cancer patient with metastases was also included. Patient with higher BMI has better survival rate than underweight BMI category.Conclusion: Increasing BMI in underweight cancer patient simproves nasopharyngeal cancer patient’ survival rate.
The effect of dietary fiber on insulin resistance in obesity: A literature review Santri Dwizamzami Faridahanum; Fariz Nurwidya; Yohannessa Wulandari
World Nutrition Journal Vol. 4 No. 2 (2021): Volume 04 Issue 2, August 2021
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V04.i2.0009

Abstract

Introduction Obesity has become a significant public health problem in developing countries such as Indonesia. According to WHO, 13% of adults aged 18 years and over were obese in 2016. In Indonesia, 21.8% of adults were obese. In obesity, the body's resistance to insulin will develop. Some studies showed a probable link between dietary fiber and insulin resistance. This research aims to investigate the role of the dietary fiber on insulin resistance in obesity. Methods: This study is a literature study to determine the effect of dietary fiber on insulin resistance in obesity with sources from scientific publications 10 years back. The databases were PubMed and Google Scholar. The search term used was using the explode function for subgroup terms with operators (“and,” or) for “dietary fiber”, “obesity”, “insulin resistance”. Hand-searching was used to identify further potential eligible studies. There were no language restrictions, however only publications with full texts available were included. Total 138 publications titles and abstract were screened for their relevance to this literature review. Results: A total of 25 publications were finally included. There are cross-sectional studies, randomized clinical trial, cohort studies, and article review. Some studies showed that dietary fiber had an effect on improve insulin resistance, but other studies did not find this effect. Conclusion: The studies of dietary fiber effect on insulin resistance have inconsistent results. In the future, further studies are required for better understanding about the effect of dietary fiber on insulin resistance in obesity
Medical nutrition therapy and vitamin D supplementation improved nutritional status and quality of life in relapse systemic lupus erythematosus patient : A case report Ayu Diandra Sari; Yohannessa Wulandari; Diyah Eka Andayani
World Nutrition Journal Vol. 5 No. S3 (2022): Selected conference proceedings of the Nutri Virtual Symposium 2021
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V05.S3.0025

Abstract

Medical nutrition therapy (MNT) plays pivotal role in comprehensive management of autoimmune disease, includes systemic lupus erythematosus (SLE). Meanwhile, MNT for SLE is still not a concern in many international clinical practice guidelines. Many studies reported about nutritional declines and metabolic complications related to long term corticosteroid use in SLE patients, i.e. malnutrition, sarcopenia, hypovitaminosis D, hypertension and etc. Besides, obesity is more expected become important risk factor in SLE.
Medical nutrition therapy and home monitoring in type 2 diabetes mellitus patient with metabolic syndrome and history of diabetic ketoacidosis Anak Agung Eka Widya Saraswati; Yohannessa Wulandari; Lily Indriani Octovia
World Nutrition Journal Vol. 5 No. S3 (2022): Selected conference proceedings of the Nutri Virtual Symposium 2021
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V05.S3.0024

Abstract

Obesity, one of the risk factors for mtype 2 diabetes mellitus (T2DM), is known to cause low-grade inflammation and increase T2DM morbidity. Obesity and T2DM also lead to other comorbidities, such as metabolic syndrome. The provision of medical nutrition therapy accompanied with routine home monitoring could improve glycemic control and achieve therapeutic targets, simultaneously.
High-Protein Dietary Supplementation and Nutritional Status Improvement of Malnourished Patients in Hospital Care Marcellus Simadibrata; Fiastuti Witjaksono; Yohannessa Wulandari; Raja Mangatur Haloho; Rabbinu Rangga Pribadi; Murdani Abdullah; Aditya Rachman; Anthony Eka Wijaya; Batara Bisuk; Daniel Martin Simadibrata; Rizka Mutiara; Kaka Renaldi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 2 (2021): VOLUME 22, NUMBER 2, August 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (736.079 KB) | DOI: 10.24871/2222021147-153

Abstract

Hospital malnutrition is common in Indonesia and other developing countries. In Asia, the prevalence of hospital malnutrition ranges between 27-39%. The causes of malnutrition in hospital care include insufficient food intake and increased catabolic processes due to underlying causes such as metabolic disease, infection, and malignancy. Several studies have demonstrated that malnutrition increases the morbidity and mortality of hospitalized patients, prolongs hospital stay, and delays recovery. Therefore, healthcare providers must recognize malnutrition early by conducting nutritional screening and assessment to prevent worsening of malnutrition and administer the optimal nutritional therapy to patients. Apart from giving a standard diet, high-protein food supplementation in liquid form remains a suitable alternative for patients, especially since it is easily digestible. A high protein diet is associated with a better mortality rate, better weight gain, and improved SGA score in patients.
The role of nutritional medical therapy on nutritional status, functional capacity and quality of life of pulmonary tuberculosis patients with difficulty Nugrahayu Widyawardani; Tjandraningrum -; Yohannessa Wulandari
World Nutrition Journal Vol. 6 No. 1 (2022): Volume 06 Issue 1, August 2022
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V06.i1.0007

Abstract

Pulmonary tuberculosis (pulmonary TB) is a chronic infectious disease with high levels of morbidity and mortality. Metabolic changes due to tuberculosis Mycobacterium infection and activation of the neurohormonal system contribute to the occurrence of malnutrition, which can have a negative effect on the prognosis of patients with pulmonary TB, as well as decreased functional capacity and quality of life. The provision of medical nutrition therapy from the beginning of diagnosis is upheld, supporting the recovery process of TB patients. In this series of cases, there were four cases of Pulmonary TB patients with difficulty, namely TB billion, chronic obstructive pulmonary disease (COPD), and meningitis TB. At the beginning of the examination, there was a deficiency of macronutrients and micronutrients, hypoalbuminemia, anemia, and decreased functional capacity and quality of life. Medical nutrition therapy is administered individually, according to clinical conditions such as TB with mild, moderate and severe malnutrition, those are gradually weight loss and muscle wasting when the symptoms start until treated in intensive care unit (ICU) and hospital ward. According to laboratory parameters such as anemia, hypoalbuminemia, and a history of food intake analysis such as hypocaloric and starvation.
Vitamin D serum level as a prognostic factor in 1 predicting mortality severe COVID-19 patients: An evidence based case report Heny Puspita; Marcia Kumala; Yohannessa Wulandari
World Nutrition Journal Vol. 6 No. 1 (2022): Volume 06 Issue 1, August 2022
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V06.i1.0002

Abstract

Introduction: The mortality rate of COVID-19 is still high. Many prognostic factors have been studied to decrease the mortality rate. One of the many factors is vitamin D status, known for years as an immunomodulator and anti-inflammatory agent. Vitamin D deficiency could worsen the symptoms of COVID-19 and ultimately lead to mortality. However, some literature shows controversial results. Methods: Literature research was conducted by advanced searching in Pubmed, Cochrane Library, Scopus, and ProQuest, using a combination of both MeSH Terms and Title/Abstract. After removing duplicates, these literature were screened according to the eligibility criteria. Appraisal and level of evidence of the final literature were determined based on Oxford Centre for Evidence-Based Medicine. Results: Two selected literature were relevant to answer our clinical question. The former is a retrospective cohort study by Radujkovic et al. (2020), while the latter is a prospective cohort study by Bennouar et al. (2020). Both show similar results that low vitamin D serum levels in severe COVID-19 patients can increase the in-hospital mortality risk. Conclusion: Vitamin D is one of the prognostic factors that can predict the mortality rate of severe COVID-19 patients. We suggest that vitamin D serum level can be measured regularly in COVID-19 patients and administered to patients with such deficiencies. Adequate vitamin D deficiency management is expected to lower the COVID-19 mortality rate.
Correlation of frequency of visits to clinical nutrition outpatient clinic with body weight and handgrip strength of head and neck cancer patients undergoing chemoradiation Luana Lidwina Latief; Diyah Eka Andayani; Yohannessa Wulandari
World Nutrition Journal Vol. 6 No. S1 (2022): Selected conference proceedings of the Nutri Virtual Symposium 2022
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V06.S1.0023

Abstract

Background : Head and neck cancer patients who get chemoradiated are at risk of malnutrition and an increase in malnutrition of up to 88% at the end of chemoradiation. Side effects of chemoradiation in the form of xerostomia, mucositis, nausea or vomiting add to the decrease in nutritional status and functional capacity. Monitoring nutritional status, one of which is carried out by assessing body weight (BW) and hand-holding strength (HGS). BW and HGS assessments are a simple and minimally invasive way for people with head and neck cancer (HNC) compared to other examination tools such as body composition measuring devices, Dual Energy X-Ray Absorptiometry (DEXA), and require high costs. It is not yet known the frequency of optimal visits of HNC patients to the nutrition poly during the moradiation period. This study aims to see a correlation between the frequency of visits by HNC patients undergoing morbidity to BW and HGS.
Enteral nutrition with medium-chain triglyceride compared to total parenteral nutrition in patient with chylothorax: an evidence based case report Chintya Tedjaatmadja; Yohannessa Wulandari
World Nutrition Journal Vol. 7 No. 2 (2024): WNJ. Volume 07 Issue 2, February 2024
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V07.i2.0005

Abstract

Introduction: Chylothorax is associated with longer length of stay, higher morbidity, mortality, and hospitalization cost. The main principle of chylothorax therapy is to reduce the chylous flow. The current nutritional management of patients with chylothorax are a low fat diet with long chain triglyceride (LCT) restriction, enteral nutrition with high medium chain triglyceride (MCT), and total parenteral nutrition. However, low fat diet with LCT restriction takes quite a long time (around 3 weeks) and requires close monitoring due to risk for malnutrition, essential fatty acid, and micronutrient deficiencies. The nutritional management determines the success of conservative therapy in chylothorax patients. The aim of this study was to determine whether a high MCT enteral diet is more superior than total parenteral nutrition regarding the resolution of chylothorax. Method: Literature searching was conducted using advanced searching in three large databases: Pubmed, Science Direct, and ProQuest using eligibility criteria determined by the authors. Quality of evidences were assessed based on GRADE Guidelines. Level evidence was determined based on Oxford Center of Evidence-based Medicine (CEBM). Result: Three systematic reviews and one cohort met the PICO and eligibility criteria that had been set. Two studies concluded that enteral nutrition was better than parenteral nutrition. One study concluded that parenteral nutrition could be considered first and one study could not conclude which kind of nutrition was better. Conclusion: Administration of high MCT enteral nutrition can be the first line therapy in patients with chylothorax and still need close monitoring during the administration. One of the factors that need to be monitored is the daily production of chylothorax volume. The results shown by these studies are inconsistent and warrant further research of high-quality studies regarding the treatment of chylothorax.