Determination of calorie and protein intake among acute and sub-acute traumatic brain injury patients

Purpose:Malnutrition is a common problem among hospitalized patients,especially among traumatic brain injury(TBI)patients.It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management.However,the data of nutrient intake especially calorie and protein among TBI patients were scarce.Hence,this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah,Terengganu.Methods:This observational study involved 50 patients recruited from the neurosurgical ward.Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2-8 days.Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO™(Woodinville,USA)and manual calculation based on the Malaysian food composition database(2015).Results:Patients consisted of 56%males and 44%females with the median age of 28.0(IQR=22.8-36.5)years,of which 92%were diagnosed as mild TBI and the remaining(8%)as moderate TBI.The Glasgow coma scale(GCS)was adopted to classify TBI severity with the score 13-15 being mild and 9-12 being moderate.The median length of hospital stay was 2(IQR=2.0e3.3)days.Calorie and protein intake improved significantly from day 1 to discharge day.However,the intake during discharge day was still considered as suboptimal,i.e.75%of calorie requirement,whilst the median protein intake was only 61.3%relative to protein requirement.Moreover,the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower,i.e.52.2%and 41.0%,respectively.Conclusion:Although the calorie and protein intakes had increased from baseline,hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements.Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.

Hypnotherapy for overweight and obese patients:A narrative review

Obesity and overweight problems are serious global health issues today and despite many efforts,the prevalence has continued to rise for decades.Interestingly,hypnotherapy has been gaining recognition as an effective treatment for obesity and overweight problems.This review compiles contemporary scientific research on the effectiveness of hypnotherapy for weight reduction.Scopus,Pub Med and EBSCO Host databases were applied in the study.The search identified 119 articles,of which seven met the inclusion criteria.A total of 539 respondents(82.7%women and 17.3%men)between the ages of 17 and 67 years were represented in the seven studies.Most studies incorporated lifestyle changes,such as changes of dietary habit and behavioral recommendations in the hypnotic procedure.Their results suggested that the use of hypnotherapy not only promoted weight reduction during the treatment period but also after treatment cessation,and in some cases,one to ten kilograms were lost during follow-up periods.In addition,one study even showed increased physical activity among the hypnotised individuals.This use of hypnotherapy also improved respondents'eating behavior and quality of life.However,a definitive conclusion could not be drawn due to several methodological flaws and the limited number of published studies in this area.Therefore,further well-designed studies are needed to substantiate the effectiveness of hypnotherapy for this modern-day health problem.