همایونیدکتر

Diet in liver disease

Nature & Severity of liver disease should be categorized

Child Pugh ScoreModel for end-stage liver disease ( MELD ) Compensated Versus decompensate Subjective Global assessment ( SGA )

Subjective Global Assessment

Historical Component Weight loss

Change in dietary intake

Presence of GI symptom

Functional Capacity

Metabolic demand

Physical examination ComponentEdema

Ascitis

Muscle Wasting

Subcutaneous fat loss

Micronutrient deficiency

DermatitisZinc

Vitamin A

Niacin

Night blindness

Photophobia

HyperkeratosisVitamin A

Burning of the mouth

Burning of the Tongue

Glossitis

Angular stomatitisVita B12

Folate

Easy Bruising Vitamin C

Vitamin K

ParesthesiaThiamin

Pyridoxin

Pallor ( Anemia )Iron deficiency

B12

DTRB12

B1

Laboratory investigationsAlbumin

Creatinin

INR

Vitamin A , D , E , Thiamin

Selenium , Zinc , Vitamin B12 , Folate

Delayed Hypersensitivity &

Total lymphocyte count

AntropometryChange in composition of body

compartment

MAMCMide Arm Muscle Circumference

( Lean tissue store )

SFT Skin Fold Thickness

Miscellaneous TestsDEXA Dual energy X-Ray absorptometry

Deutrium oxide dilution

In vivo neutron activation analysis

Bioelectrical impendence analysis

Energy ExpenditureResting Energy Expediture

Harris Benedict equation

Low Salt

Low Protein

High Carbohydrate

ProteinContent

Essential amino acids

Biologic Value