الفهرس 
LIVER DISEASES AND MALNUTRITIONOnly 14 pages are availabe for public view
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Abstract
Malnutrition is highly prevalent among patients with chronic liver disease and is nearly universal among patients awaiting liver transplantation.
Malnutrition in patients with cirrhosis leads to increased morbidity and mortality rates.
Furthermore, patients who are severely malnourished before transplant surgeries have a higher rate of complications and a decreased overall survival rate after liver transplantation.
In light of the high incidence of malnutrition among patients with chronic liver disease and the complications that result from malnutrition in these patients, it is essential to assess the nutritional status of all patients with liver disease, and to initiate treatment as indicated.
In this prospective study we tray to find out a suitable program (individualized) for nutritional rehabilitation in infants and children with chronic liver diseases and evaluate it’s impact on the anthropometric measures of these patients.
The study sample was classified into 2 groups: group Ι 22 cholestatic patients & group ΙΙ 18 non cholestatic ones with age ranging from 6 months to 10 years with mean of 5.2±4.02 years.
All patients who undergo the nutritional rehabilitation program were subjected to Full history taking, laying stress on {dietary history,developmental history, symptoms of liver disease},anthropometrics{Weight & Height Head circumference Mid upper arm circumference} and laboratory investigations{serum(albumin,iron,transferrin,potassium,PT,PTTand liver function tests SGPT,SGOT,Total &Direct bilirubin ).at the start of the study.
All patients had individualized nutritional rehabilitation program according to Sokal et al (1996) for 6 months period and they were reevaluated for anthropometrics and biochemical profile at the end of the study.
Our study found that in the pre-interventional phase in the present study, all anthropometric measurements as percent of mean height for age, percent of mean weight for age, TSF and MAC were lower in all of the patients,the patients with cholestatic liver disease exhibited more severe nutritional deficit than did those with non cholestatic liver disease.
According to the laboratory results before the nutritional program ,the liver function test were invariably abnormal where the patients exhibited higher values for total and direct bilirubin (for cholestatic liver disease) , ALT and AST for all patients fifty percent of patients had an increase PT and seventy five percent had decrease serum albumin
After 6 month of the implementation of the nutritional rehabilitation program, there was significant improvement in percentage of means for weight and height, TSF, MAC, increase in serum albumin, serum transferring and significant decrease in total, direct bilirubin and AST
In conclusion we observed that nutritional support of children with chronic liver disease is extremely rewarding and resulting in an improvement in nutritional status and Liver function.