M.P.

BIRLA HOSPITAL

DEPARTMENT of HUMAN NUTRITION 2017

Submitted to………………….submitted by

Mis. Priya Gupta (dietician) Shivani Pandey

(M.P. Birla Hospital) (BHN second year)
ACKNOWLEDGEMENT
I express my sincere gratitude to the Director of the Hospital,
Dr.SanjayMaheswari sr, gave me the opportunity and resource to
undergo this internship program . I am also thankful to the Seniour
Advisor Dr.Rekha Maheswari the Medical Supritendent Dr.Sushil
shrivastava sr,and the HR Mr.Vinod singh,Department of the hospital for
their support .
This case study in Sahara hospital had been a very knowledgeable
experience for me .
There were many aspects on which I worked and this was possible due
to guidance and help from my chef Dietician guided me on every aspect
and gave me full freedom to work to bring out the best of me.
I would also like to thank all the DieticianMs.Priya gupta for their
valuable supports and suggestions.
Kitchen general manager , supervisors ,Chef , Stewards and everyone
else in the catering unit needs special mention for their supports.
The duty docters and entire nursing staff have been helpful enough to
provide me with all the details.
Iam especially thankful to all my patients and their attendants who have
patiently answard all my question and me all information needed to
complete my study.

THANKS
Shivani pandey
 INDEX

S.N. CONTENT

1) - Introduction of MP Birla hospital

2) - THREE WAY TO APPROACH

*Therapeutic approach

*Counselling approach

*Administrative approach

3) - Role of Dietician

4) - About Kitchen area

5) - Introduction of heart

6) - Introduction of hypertension

7) - Causes and Symptoms

8) - Dietary treatment
 9) - Case Study

INTRODUCTION OF M.P. BIRLA HOSPITAL

M.P. Birla Hospital is a 150 bedded hospital in the name
and style of "M.P. BIRLA HOSPITAL" at Satna under the
banner of M.P. Birla Institute of Fundamental Research
under West Bengal Registration Act. We are fully
equipped with the latest technologies and experienced
staff including paramedical staff. The following facilities
are available in our hospital We are a Service Provider as
Primary, Secondary & Tertiary (in some specialties) as
largest rural health care model since our establishment in
1991.
M.P. Birla Hospital has commitment towards delivering
this health care facilities in rural areas by adopting some
villages and various free mega camps, treatment to the
poorest of the poor with charity.
THREE WAYS
TO
APPROACH

*Therapeutic approach
*Counselling approach
*Administrative approach
 HEART DISEASE
INTRODUCTIONOFHEART DISEASE

The heart pumps blood with a rhythm determined by a group of pacemaking cells in
the sinoatrial node. These generate a current that causes contraction of the heart,
traveling through the atrioventricular node and along the conduction system of the
heart. The heart receives blood low in oxygen from the systemic circulation, which
enters the right atrium from the superior and inferior venae cavae and passes to the
right ventricle. From here it is pumped into the pulmonarycirculation, through
the lungs where it receives oxygen and gives off carbon dioxide. Oxygenated blood
then returns to the left atrium, passes through the left ventricle and is pumped out
through the aorta to the systemic circulation−where the oxygen is used
and metabolized to carbon dioxide. The heart beats at a resting rate close to 72
beats per minute. Exercise temporarily increases the rate, but lowers resting heart
rate in the long term, and is good for heart health.

HYPERTENSION
INTRODUCTIONOFHYPERTENSION-

Hypertension also known as high blood pressure is a long term medical condition
in which the blood pressure in the arteries is persistently elevated. High blood
pressure usually does not cause Symptoms. Long term high blood pressure,
however, is a major risk factor for coronary artery disease, stroke, heart failure,
peripheral vascular disease, vision loss and chronic kidney disease.

Normal range of hypertension:-

Types of hypertension
1.Primary hypertension
*Present in 90-95% of cases. Age of onset 35years.
*Usually no symptoms but person may experience
Frequent headaches, tiredness, dizzines or nose bleeds.
*Diagnosed after a doctor noties that your blood pressure is high on 3or more visits.
*Obesity, smoking, alcohol and genetics play on
important role in development of essential
Hypertension.
2.Secondery hypertension
*Present in 5-10% of couses age of onset 55 years.
*Secondery hypertension should be suspected when blood
pressure is resistant to treatment or increase rapidly over
weeks to months or to very high levels.
*An abdominal bruit over one or both of the renal arteries,
Especially in a patient with other manifestations of vascular
Disease suggests renal artery stenosis.

Couses of hypertension:-
*Smoking
*Lack of physical activity
*Too much alcohol consumption

*Stress
*Older age
*Genetics
*Chronic kidney disease
*Being overweight or obese
*Adrenal and thyroid disorders
 Symptoms of hypertension :-
*Headache
*Dizziness
*Impaired vision
*Failing memory
*Shortness of breeth
*Pain over the heart
*GIT disturbance
*Unexplained tiredness

Dietary treatment:-
Modrate calorie, low fat, low sodium diet normal protein
intake is prescribed.

Food rich in:-

Calcium-
1. Contacts & displayed heart muscle.
2. Make blood flow smoother.
*milk, tofu, yogurt
Potassium-
1. Lowers blood pressure.
2. Balances excess water in body.
*Coconut water,banana, orange,muskmelon, figs,
Potatoes, mangoes, beetroot.
Magnesium-
1. Relaxes muscles that controls blood vessels.
*Almonds, walnuts, barley, pumpkin seeds. Sunflower
Seeds
Omga3 rich good-
1. Improve blood circulation.
*Fish, flax seeds.
Avoid:-
*Salt in cooking or at the table.
*Highly salted food

CASE
STUDY
 Patient-1

Patient name- Chandrawati pathak

Dr. name- dr. S.k Maheshwari
IpD no.- 2488
D.o.A- 19/07/2017
Age/Sex- 52/f
Hight- 155c.m. weight- 60kg BMI-25
Normal calorie- 2230 Intake calorie-1700
NDA- 1800
History-
Past History- ovarian cyst+cancer+ HTN
Present History- HTN+ ovarian cyst
Biochemical Parametres:-
DATE Blood pressure
22/07/2017 130/90mmhg
23/07/2017 130/80mmhg
24/07/2017 120/80mmhg

DIETARY RECALL
22/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Juice 200ml
11:00Am
Lunch Dal water 200ml
2:00Pm
Evening Soup 200ml
 5:00Pm
Dinner Dal water 200ml
8:00Pm
Bedtime Milk 200ml
10:00Pm

23/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Juice 200ml
11:00Am
Lunch Dal water 200ml
2:00Pm
Evening Soup 200ml
5:00Pm
Dinner Dal water 200ml
8:00Pm
Bedtime Milk 200ml
10:00Pm
 24/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Veg.daliya 100gm
11:00Am
Lunch Khichdi 100gm
2:00Pm
Evening Soup 200gm
5:00Pm
Dinner Veg.daliya 100gm
8:00Pm
Bedtime Milk 200ml
10:00Pm

Patient-2
Patient name- sardavishwas
Dr. name- dr. S.k Shrivastava
IpD no.- 2488
D.o.A- 24/07/2017
Age/Sex- 72/f
Hight- 150c.m. weight- 55kg BMI-24
Normal calorie-1900 Intake calorie-1700
NDA- 1800
History-
Past History- HTN
Present History- HTN+ acute cheat pain

Biochemical Parametres:-
DATE Blood pressure
25/07/2017 150/100mmhg
26/07/2017 140/90mmhg
27/07/2017 130/90mmhg

DIETARY RECALL
25/07/2017

Time Meal Serving

Morning Tea 1 cup
8:00Am Biskut 2slice
B.fast Poha 100gm
11:00Am
Lunch Rice 70gm
2:00Pm Dal 50gm
Evening Soup 200ml
5:00Pm
Dinner Fulka 2slice
8:00Pm Dal 5
Bedtime Milk 200ml
10:00Pm

26/07/2017

Time Meal Serving

Morning Tea 1cup
8:00Am Biskut 2slice

B.fast Upma 100gm

11:00Am
Lunch Dal 50gm
2:00Pm Rice 80gm
Evening Soup 200ml
5:00Pm
 Dinner Dal 50gm
8:00Pm Fulka 2slice
Bedtime Milk 200ml
10:00Pm

27/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Poha 100gm
11:00Am
Lunch Khicdi 100gm
2:00Pm
Moning Soup 200ml
5:00Pm
Dinner Fulka 2slice
8:00Pm Lauki veg. 50gm
Bedtime Milk 200ml
10:00Pm
 Patient-3
Patient name- Rajesh p.d vishwakarma
Dr. name- dr. S.k Shrivastava
IpD no.- 2623
D.o.A- 24/07/2017
Age/Sex- 54/f
Hight- 158c.m. weight-75kg BMI- 28

Normal calorie- 2730 Intake calorie-2000

NDA- 1860
NDA- 170
History-
Past History- Acute HTN
Present History- Acute HTN+ pyroxial illness

Biochemical Parametres:-
DATE Blood pressure
25/07/2017 140/90mmhg
26/07/2017 130/90mmhg
27/07/2017 130/80mmhg
 DIETARY RECALL
25/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Juice 200ml
11:00Am
Lunch Dal water 200ml
2:00Pm
Evening Soup 200ml
5:00Pm
Dinner Dal water 200ml
8:00Pm
Bedtime Milk 200ml
10:00Pm

26/07/2017
Time Meal Serving
Morning Tea 150ml
8:00Am
B.fast Poha 100gm
11:00Am
Rice 80gm
Dal 50gm
Lunch Kadhi 50gm
2:00Pm Fulka 2slice
Selad 25gm
Evening Soup 200ml
5:00Pm
Rice 80gm
Dal 50gm
Dinner Luaki veg. 50gm
8:00Pm Fulka 2slice
Selad 25gm

Bedtime Milk 200ml

10:00Pm

27/07/2017
Time Meal Serving
Morning Tea 150ml
8:00Am
B.fast Veg.daliya 100gm
11:00Am
 Rice 80gm
Lunch Dal 50gm
2:00Pm Chole veg. 50gm
Fulka 2slice
Selad 25gm
Evening Soup 200ml
5:00Pm
Rice 80gm
Dal 50gm
Dinner Kadhi veg. 50gm
8:00Pm Fulka 2slice
Selad 25gm

Bedtime Milk 200ml

10:00Pm

Patient-4

Patient name- Santi gupta

Dr. name- dr. S.k Shrivastava
IpD no.- 2636
D.o.A- 24/07/2017
Age/Sex- 55/f
Hight- 155c.m. weight- 52kg BMI- 21

Normal calorie-2230Intake calorie-2000

NDA- 1800

History-
Past History- Normal
Present History- Acute HTN

Biochemical Parametres:-
DATE Blood pressure
25/07/2017 130/70mmhg
26/07/2017 130/80mmhg
27/07/2017 120/80mmhg

DIETARY RECALL
25/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Daliyaporrage 100gm
11:00Am
Lunch Dal 50gm
2:00Pm Daliya 70gm
Evening Soup 200ml
5:00Pm
Dinner Dal 50gm
8:00Pm Daliya 70gm
Bedtime Milk 200ml
10:00Pm
 26/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Veg.Daliya 100gm
11:00Am
Lunch Dal 50gm
2:00Pm Daliya 70gm
Evening Soup 200ml
5:00Pm
Rice 80gm
Dinner Dal 50gm
8:00Pm Kaddu veg. 50gm
Fulka 2slice
Bedtime Milk 200ml
10:00Pm

27/07/2017

Time Meal Serving

Morning Tea 150ml
 8:00Am
B.fast Veg. Upma 100gm
11:00Am
Dal 50gm
Lunch Daliya 70gm
2:00Pm Soya Badi veg. 50gm

Evening Soup 200ml

5:00Pm
Dinner Dal 50gm
8:00Pm Rice 70gm
Bedtime Milk 200ml
10:00Pm

Patient-5

Patient name- MOhni devi

Dr. name- dr. S.k Shrivastava
IpD no.- 2790
D.o.A- 31/07/2017
Age/Sex- 55/f
Hight- 155c.m. weight- 52kg BMI- 21

Normal calorie-2230Intake calorie-2000

NDA- 1800
History-
Past History- Normal
Present History- Acute HTN +vartigo

Biochemical Parametres:-
DATE Blood pressure
31/07/2017 160/90mmhg
1/08/2017 170/90mmhg
2/08/2017 130/90mmhg

DIETARY RECALL
31/07/2017

Time Meal Serving

Morning Tea 150ml
8:00Am
B.fast Daliyaporrage 100gm
11:00Am
Lunch Dal 50gm
2:00Pm Daliya 70gm
Evening Soup 200ml
5:00Pm
Dinner Dal 50gm
8:00Pm Daliya 70gm
Bedtime Milk 200ml
10:00Pm
 01/08/2017

Time Meal Serving

Morning Tea 150ml
8:00Am Biskut 2pice
B.fast Veg.daliye 100gm
11:00Am
Dal 50gm
Lunch Rice 70gm
2:00Pm Fulka 2slice
Chole veg. 50gm
Evening Soup 200ml
5:00Pm
Dal 50gm
Dinner Rice 70gm
8:00Pm Fulka 2slice
Kaddu veg. 50gm
Bedtime Milk 200ml
10:00Pm

02/08/2017
 Time Meal Serving
Morning Tea 150ml
8:00Am Biskut 2pice
B.fast Veg.upma 100gm
11:00Am
Dal 50gm
Lunch Rice 70gm
2:00Pm Fulka 2slice
Soyabadi veg. 50gm
Evening Soup 200ml
5:00Pm
Dinner Dal 50gm
8:00Pm Rice 70gm
Fulks 2slice
Parwal veg. 50gm
Bedtime Milk 200ml
10:00Pm