Edwina Raj

Abstract

Meningoencephalitis is an inflammation of the brain and its surrounding protective membranes. Meningitis is a life-threatening disease and can lead to significant sequelae.We were presented with a 6 year 5 months old female child on ventilation, retrieved by referral hospital on examination revealed human herpesvirus 6 through cerebrospinal fluid analysis and diagnosed with meningoencephalitis on Magnetic Resonance Imaging(MRI) with three repeated failed extubation and hence planned tracheostomy. Child presented no movements with suspected motor or sensory (vision, hearing) disability, generalized tonic-clonic seizure (GTCS), altered sensorium requiring a long term rehabilitation and nutrition support. On close monitoring, a continuous effort of three months and with a multidisciplinary clinical approach from different disciplines including neurologist, intensivist, clinical dietitian and physiotherapy, the child successfully completed the long term rehabilitation treatment with remarkable improvement observed within 12 weeks both neurologically and nutritionally with a better clinical outcome. Keywords: Pediatric Meningoencephalitis, Viral Encephalitis, Nasogastric feeding, Human herpesvirus, Medical Nutrition Therapy  in Meningoencephalitis.

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Abstract

Steven Johnson syndrome also known as Toxic Epidermal Necrolysis (Ten) is a severe hypersensitivity reaction which not only involves the skin but the mucosal membrane as well. This disease is caused due to sulpha drugs, antiepileptics, and antibiotics. This case report of a 5 year old boy who was admitted with general symptoms like cough, fever, rash and redness of the eyes with worsening of the symptoms. The medical treatment or procedures done at the hospital were (1) Amniotic Membrane Graft/ Amniotic Membrane Transplantation and (2) Collagen Dressing for the skin. Nutrition plays an important role for the growth, development, mucosal healing and faster recovery of the patient. The Purpose of effective nutrition management in SJS is to promote wound healing, positive nitrogen balance, weight preservation, immune function, and host defense mechanisms which is necessary for survival and prevent malnutrition. SJS is a highly catabolic state which requires an increase in dietary calorie and protein intake, in SJS only oral intake is not sufficient due to the damage of the oral mucosal membrane hence enteral nutrition is mandatory where supplements are given to meet the daily dietary requirements, the supplement provided to the patient was semi elemental to meet the requirements, for faster growth, repair and recovery. Keywords: Stevens johnson syndrome, Nutrition in toxic epidermal necrolysis, Enteral nutrition, Partially hydrolysed semielemental formula

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Abstract

The study aims at evaluating patients visiting for regular health check up presented with hypertriglyceridemia and positively influenced abdominal obesity. Hypertriglyceridaemia, a condition in which TG levels are elevated, is a common type of dyslipidaemia. It is believed to be a risk for coronary artery disease, diabetes and etiology for acute pancreatitis. Study was conducted on 30 patients who had high triglycerides and waist circumference were checked on their visit. Other anthropometry details were also recorded. As per the study the results showed a significant association between the Triglyceride levels and the waist circumference. The standard WHO cut off value for waist circumference were referred to compare the recorded values. A complete diet and lifestyle modification with patient education was reinforced to prevent triglyceride induced pancreatitis, insulin resistance and to reduce the risk for coronary heart disease among our health check patients. Keywords: Triglycerides, Hypertriglyceridemia, Waist circumference, Dyslipidemia, Pancreatitis.

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