Introduction Obesity is a nutritional disease which is still a health burden particularly in Jakarta. The main treatment for obesity is nutritional intervention. Nowadays, several dietary approaches have been developed, including ketogenic diet, which is still controversial. Methods Literature search had been done within 4 databases including PubMed®, Cochrane®, Google® Scholar, and Science Direct®, using keywords: obesity, ketogenic diet, low-fat diet, and weight loss. Then, Medical Sub Heading (MeSH) was used. The search resulted in two articles which were appraised according to aspects of validity, importance, and applicability Results A randomized-controlled trial study showed similar effect of weight loss with ketogenic diet compared to low-fat diet. On the other hand, a meta-analysis study showed ketogenic diet caused more weight loss than low-fat diet. Both studies showed an increased risk of cardiovascular disease from the ketogenic diet group, which were shown by a decrease of flow-mediated dilatation and an increase of LDL-C. Conclusion Ketogenic diet shows a better long-term effect for weight loss in obese patients than low-fat diet. However, ketogenic diet may increase the cardiovascular event risk significantly.
Sepsis has been accounted for various burdens worldwide, especially in critically ill patients. This could eventually lead to inflammatory response, provocation ischemia and lactic acidosis. On the other hand, thiamine was suggested as a coenzyme which could improve the outcome of those patients. Thus, we conducted an evidence-based case study with research on PubMed, ProQuest, and Scopus using a search strategy focusing on RCT or cohort study on thiamine supplementation/level towards the outcome of critically ill patients with sepsis. We found three articles eligible for review after full-text assessment. Articles were appraised using the University of Oxford’s tools for critical appraisal. It was known that all studies were good in terms of validity and applicability. This study showed that thiamine supplementation could improve lactate clearance and reduce mortality risk, moreover, thiamine deficiency could increase the risk of lactate acidosis. However, a high level of thiamine was associated with a high level of lactate in patients with liver failure. Therefore, thiamine supplementation could be recommended for critically ill patients with sepsis and normal liver function. Further research, such as RCT or systematic review on thiamine supplementation for age groups to make this study more applicable.
IntroductionColorectal cancer patients may be treated with several modalities and one of them is surgical treatment. Surgery in cancer patients is a risky procedure and may not always result in prolonged survival. Therefore, before receiving any recommended treatment, the patient's prognosis has to be assessed and defined properly. Several methods are available to assess the prognosis of cancer patients; one of them is the prognostic nutritional index (PNI). Objective This study aimed to predict the survival of a colorectal cancer patient postoperatively by calculating the preoperative PNI score. Method Literature searching was done using inclusion and exclusion criteria on two databases, i.e. the PubMed and the Cochrane Library. The outcome was survival (disease-free survival, relapse-free survival, or overall survival). Results Five articles that address the clinical question were retrieved. All indicated that a patient with low PNI score (<44.5) had a shorter overall survival (HR between 1.92 and 3.98 with all p values were <0.05). Conclusion Pre-operative PNI score can be used to assess the overall survival of a colorectal cancer patient who underwent surgical resection. Patients with a PNI score > 44.5 had better survival than lower PNI score.World.Nutr.Journal | 26 family suggested him to find another doctor for another opinion. Therefore, Mr. MR came to this clinic to find a second opinion for the recommended surgical treatment. He asked how long his chance to live if he takes the procedure.
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