Lesson
Case presentationA 67-year-old Caucasian woman presented to the emergency department with a 3-day history of rapidly worsening dyspnoea on the background of a 3-month history of lethargy and exertional dyspnoea. Her medical history was significant for hypercholesterolaemia and diet-controlled type 2 diabetes mellitus. She was a current smoker. A myocardial perfusion scan performed 6 weeks before the current presentation had been unremarkable.
A feeding trial involving four Thoroughbred race horses was undertaken to establish whether inclusion of grape seed extract (GSE) in the diet of horses undergoing mild exercise had any effects on their general health, intake and digestion. Supplementation with GSE had no effect on either feed or water intake of the horses and the supplement was readily palatable to the horses at all levels of inclusion. Feeding GSE caused no adverse effects in terms of animal health (temperature, pulse and respirations rates), and there were some positive effects related to a presumed alteration in fermentation in the hindgut. Feeding GSE increased faecal pH, changing from acid faeces (pH 6.6) when no GSE was fed to neutral faeces (pH 7.0) when 150 mg GSE/kg body weight (BW) was fed. In addition, blood glucose concentrations were significantly ( P , 0.05) decreased when GSE was fed at 100 and 150 mg/kg BW (5.50 6 0.26 and 5.32 6 0.72 mmol/l, respectively) compared with the control diet (5.77 6 0.31 mmol/l). The actual mechanisms causing these alterations are yet to be elucidated, but could have important implications for the prevention of acidosis.
The study assessed the knowledge of mothers of the high income group of urban Baroda, related to breast feeding and weaning. Forty mothers with children aged 4 to 18 months were studied. Knowledge and practices regarding breast feeding and weaning were assessed using pretested questionnaires. Results indicated that only half the mothers breast fed their babies on the first day. Breast feeding was stopped when the child was 3-6 months; top feeding and solid supplements were initiated at 4-6 months. Mainly commercial baby foods were used for weaning. Most mothers avoided 'dals' for the child because these were believed to be difficult to digest and produced gas in the child's stomach. Fifty percent of the mothers were not in favour of feeding the sick child with small frequent meals.
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