Internship Report FYP

INTERNSHIP REPORT
FINAL YEAR INTERNSHIP REPORT
Faculty of Eastern Medicine

Program : BS HUMAN NUTRITION & DIETETICS
Name : Rehma Aqil

CMS ID : 472-2020
Supervisor : Mam Aqsa
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TABLE OF CONTENTS
ACKNOWLEDGEMENT 3
DEFINITIONS 4
CASE STUDIES 9
NAIMAT BEGUM HOSPITAL: 9
Case 1 (Gynea Ward)Post-op 9
Case 2 (Gynea Ward)Post-op 13
Case 3 (Gynea Ward) 15
Case 4 (General Ward) 17
Case 5 (Emergency) 20
Case 6 (General Ward) 22
Case 7 (Medicine Ward) 24
Case 1 (Medicine) 29
Case 2 (Surgical Ward) 32
Case 3 (ICU) 33
Case 4 (Gynae Ward) 35
Case 5 (Surgical Ward) Post-Op 37
Case 7 (Gynae Ward) 42
Case 8 (Private Ward) 44
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ACKNOWLEDGEMENT
All praise to Almighty who has given me an opportunity pertaining an internship program as a
part of BS (Human Nutrition & Dietetics). It is one kind of research work. We know very well
that research in any field of knowledge enriches the stock of knowledge. There may be two types
of research viz. theoretical research and applied research. First I would like to express my
profound gratitude to Miss Aqsa Shafeeq (department of Human Nutrition & Dietetics). She
helped me a lot by proper guidance, effective comments and with a good support. She had
always paved me the right way to conduct my internship program. She has passed a lot of time in
this respect. She was cordial to solve my problem. At last I am grateful to my respected teachers
and the head of the department Dr. Syed Rizwan. With deep sense of honor, I wish to extend my
sincere gratitude to Dr. Ahsana Dar Farooq (Dean – Faculty of Eastern Medicine) for her
insuring help and sympathetic guidance throughout the internship.
Regards
Name: RehmaAqil
Human Nutrition & Dietetics
Hamdard University
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DEFINITIONS
NUTRITION:
Nutrition is food intake, considering the body’s dietary needs. Adequate food is vital in
keeping people alive. Good nutrition is essential to good health and promotes the
growth and maintenance of your body.
NUTRIENTS:
A substance that provides nourishment essential for the maintenance of life and growth.
DIET:
The food and beverages you normally eat and drink.
FOOD GUIDE PYRAMID:
The Food Guide Pyramid is a tool designed to promote

variety, moderation, and balance in the diet. Variety means
eating foods from all food groups; moderation means limiting
the amount of high-sugar or high-fat foods, and balance
means eating the number of servings recommended
according to your individual calorie needs.
PRINCIPLES OF NUTRITION:
The following are 5 principles of nutrition.
- Water is essential for life.
- Avoid eating processed foods.
- At times, more can be less.
- Eat a well-balanced breakfast.
- Incorporate fruits or veggies into your meals
METHODS OF NUTRITIONAL ASSESSMENT:
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The purpose of nutritional assessment is to:
- Identify individuals who are at the risk of being malnourished.

- Identify individuals who are malnourished.
1. Anthropometric Methods:
Anthropomorphic measurements are human body attributes including size and
shape.
- Height, weight, and BMI

- Circumference (arm, abdomen, and thigh).
- Skinfold thickness (biceps, triceps).
- It is used to evaluate both over and under-nutrition.
2. Biochemical/Laboratory Methods:
Diagnostic tests are often performed to verify the patient’s clinical presentation.
- Routine lab tests such as serum electrolytes, blood urea nitrogen (BUN),
creatinine, blood glucose levels, lipid profile, liver enzymes, complete blood
count, and cholesterol can identify malnourishment.
- Proteins such as albumin, prealbumin, transferrin, and retinol-binding protein can
help evaluate nutritional status but should not be used alone.
- Micronutrient level of B vitamins (thiamine, riboflavin, niacin, pyridoxine, folic
acid, B12), vitamins A, C, D, E, and K, iron, zinc, selenium can be measured if
deficiencies are suspected.
3. Clinical Signs:
The patient’s nutritional status is often evident in the head-to-toe
physical assessment.
- Muscle wasting
- Poor dry skin , rashes, and lesions
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- Loss of subcutaneous fat tissue

- Thin arms and legs with edema in the abdomen and face
- Weakness, fatigue
- Irritability, apathy, or inattention
- Poor dental health
- Brittle hair, hair loss, or hair color loss
Conversely for over nutrition,
- Obesity
- High blood pressure
- Insulin resistance and hyperglycemia
4. Dietary Assessment:
- 24-hour dietary recall subjects were asked to recall all food and drinks taken in
the last 24 hours.
- A food frequency questionnaire list of around 100 food items is given to check for
frequency and quantity of foods taken by the individual per day, week, and
month.
- Dietary history subjects about usual intake, type, amount, frequency, and timings
to be obtained.
- In a food diary, food intake at the time of consumption should be recorded. The
length of collection period is between 7-10 days.
WEIGHT MANAGEMENT:
Weight management is the process of adopting long-term lifestyle modification to

maintain a healthy body weight based on a person's age, sex and height.
- BMI (Body Mass Index ): BMI is a person’s weight in kilograms divided by the
square of their height in meters. A fairly reliable indicator of the body fatness of
people.
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- IBW (Ideal Body Weight):

- IBW is an estimate of a person's ideal weight based on their height and frame
size.
- BMR (Basal Metabolic Rate):

BMR is the minimum amount of energy required by the body to maintain life at
complete physical and mental rest.
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- Total energy expenditure ( TEE ):
Total energy expenditure (TEE) is composed of the energy costs of the

processes essential for life expended in order to digest, absorb, and convert food
and the energy expended during physical activities.
TEE = BMR x Activity Factor
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CASE STUDIES
NAIMAT BEGUM HOSPITAL:
Case 1 (Gynea Ward)Post-op
Patient’s Name: Mrs. Baig
Age:33
Height: 5’3
Weight:
7 Weeks (59 kgs)
36 Weeks (65 Kgs)
BMI:
Presenting Complaint: 37+ Weeks of GA came for EL.LSCS, Backache
Medical Hx: UTI (4 Years)
Allergic Hx: Dust
Labs:
Hb: 13 g/dL
24 HOUR DIET RECALL:
Breakfast 2 Slices + 1 Cup Tea 240 Kcal
Lunch 1 Chapati + Chicken Salan 250 Kcal
Snack 1 Apple 45 Kcal
Dinner 1 Bowl Dhalia 200 Kcal
NUTRITIONAL REQUIREMENTS:
Caloric Requirement: 1925 Kcal
Protein Requirement: 65g (13%)
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Carbs Requirement: 264g (55%)

Fat Requirement: 67g (32%)
MEDICAL NUTRITION THERAPY:

- Iron-rich foods to help produce hemoglobin and reduce the risk of iron deficiency anemia
- Pair it with Vitamin C for better Iron absorption.
- Include Protein rich sources for faster wound healing
- Avoid Refined and processed foods are higher in salt, sugar, and fats.
- Have less spicy food to prevent wound infection.
- Avoid cruciferous vegetables to prevent gassy stomach.
- 20-25 Minuites walk per day.
DIET PLAN
MEAL SERVING Carbs (g) Protein Fats (g) TOTAL

(g) CALORIES
Breakfast: 2 Slice Bran Bread + 1 39.3 17.3 14.5 360 Kcal

Egg Omlette + 1 Cup
Chae
Snack 1 1 Orange and 1 Apple 27g 1g 0g 90 Kcal
Lunch 1 Bowl Chicken Dhalia 52g 12g 10g 335 Kcal

with Cucumber Slices
Snack 2 1 Fist Dry fruits with 1 32g 5g 4g 150 Kcal

Cup Tea
Dinner 1 Cup Mutton Yakhni + 32g 17g 11g 300 Kcal

1 serving Khichri
Pre- Bed 1 Cup warm Milk with 2 22g 9g 8g 200 Kcal
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Tbsp Panjeeri
Total 204g 61g 47.5 1435
GESTATIONAL DIABETES MELLITUS:

Gestational Diabetes Mellitus (GDM) is a form of diabetes that develops during pregnancy,
affecting glucose metabolism. It occurs when the body cannot produce enough insulin to meet
increased pregnancy-related demands, leading to elevated blood sugar levels.
GDM increases the risk of complications for both the mother and baby, including preeclampsia
and macrosomia.
Management involves lifestyle modifications, monitoring blood sugar levels, and, in some cases,
insulin therapy. Properly managed GDM reduces the risk of complications and typically resolves
after childbirth.
Glycemic Index:
The glycemic index is a scale from 0 to 100, with higher values indicating a more rapid increase
in blood sugar.
Individual responses to these foods can vary, and factors such as portion size and the
combination of different foods in a meal also influence blood sugar levels.
Here's a general list of foods and their glycemic index (GI) values.
Low GI Foods (55 or less):

- Legumes (e.g., lentils, chickpeas, kidney beans)
- Non-starchy vegetables (e.g., broccoli, cauliflower, spinach)
- Whole grains (e.g., quinoa, barley, bulgur)
- Fruits (e.g., cherries, grapefruit, apples)
Medium GI Foods (56-69):
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- Whole wheat products (e.g., whole wheat bread, whole wheat pasta)
- Basmati rice
- Sweet potatoes
- Oatmeal
High GI Foods (70 or more):

- White bread
- White rice
- Cornflakes and other breakfast cereals
- Sugary snacks and desserts
It's important to note that the glycemic index is just one factor in assessing the impact of food on
blood sugar levels.
Glycemic Load:
Glycemic Load (GL) is a measure that combines the glycemic index of a food with its
carbohydrate content, providing a more accurate assessment of its impact on blood sugar levels
per serving. It helps evaluate the overall effect of a specific quantity of food on blood glucose.
Case 2 (Gynea Ward)Post-op

Patient’s Name: Areena Sheikh
Age:22
Height: 5’4
Weight:
Before Pregnancy: 42 kg
After Pregnancy: 50 kg
BMI: 18.9 kg/m2
Presenting Complaint: 40+ Weeks of GA with GDM, had oligohydramnios in 2nd Trimester
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Labs:
Hb: 10.6 g/dL
RBC: 3.35
Platelet: 224
RBS: 130-150
Breakfast 1 Boiled Egg + 1 Slice + 1 240 Kcal

Cup Tea
Lunch 1 Bowl of Chicken Corn Soup 200 Kcal
Snack 1 ABC Juice 60 Kcal
Dinner Half Plate Khichri with Raita 200 Kcal

- Have small, frequent meals to restore energy levels.
- Monitor sugar levels 4 times a day.
- Have less spicy food to prevent wound infection
- Add Fiber rich sources to manage blood glucose
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- Have food sources having low Glycemic Index (<50)

- A duration of 30 minutes of physical activity/day is recommended.
DIET PLAN
MEAL SERVING CARBS PROTEIN FAT TOTAL

(g) (g) (g) CALORIES
Breakfast 1 Bowl Oatmeal with 1 42g 9g 7g 250 Kcal

Date + ! Cup
unsweetened Tea +
Snack 1 1 Apple 15g 0g 0g 45 Kcal
Lunch 1 Whole Grain Roti + 42g 14g 12g 300 Kcal

Daal Palak
Snack 2 1 Bowl Red Bean Salad 21g 10g 4 150 Kcal

1 Cup Tea after half an
hour
Dinner Quarter Plate Rice with 40g 15g 10g 300 Kcal
Kofta Salan + Salad
Pre- Bed 1 Cup warm Milk 26g 13g 12g 250 Kcal
(Glucerna) with 2 Tbsp
Panjeeri
Total 186g 61g 45g 1295 Kcal
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Case 3 (Gynea Ward)

CHOLEOSTATIC JAUNDICE:
Cholestatic jaundice is a type of jaundice characterized by yellowing of the skin and eyes due to
impaired bile flow. It occurs when there is a disruption in the normal flow of bile from the liver
to the intestine, leading to the accumulation of bilirubin in the bloodstream.
Causes:
Causes include bile duct obstruction or liver diseases, and symptoms may include dark urine,
pale stools, and itching.
Patient’s Name: Saima Adnan

Age:26
Height: 5’3
Weight: 55kgs
BMI: 21.5
Presenting Complaint: Cholestatic Jaundice, Pregnant with 37+ GA (NPOL)
Labs:
Hb: 9.4 g/dL
RBC: 3.49


- HAve small frequent meals.
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- Iron-rich foods to help produce hemoglobin and reduce the risk of iron deficiency
anemia.
- Include omega-3 fatty acids for potential anti-inflammatory benefits.
- Low fat diet (<20g) due to fat malabsorption.
- Medium Chain Trigylcerides sources are recommended as they are water soluble.
- Supplementation of Fat Soluble Vitamin (A,D,E, K) should be added to the diet.
DIET PLAN
MEAL SERVING CARBS PROTEIN FATS TOTAL

Breakfast: 2 Slices Bran Bread with 34g 8g 8g 235 Kcal

1 TspButter + ½ Cup Tea
Snack 1 1 Banana 19g 1g 0g 90 kcal
Lunch 1 Bowl Dhalia with 1 tsp 37g 9g 7g 267 Kcal

added grounded Flax
seeds
Snack 2 1 Glass Lemonade 0g 19g 0g 80 Kcal
Dinner 1 Chapati + Chicken 17g 20g 5g 233 Kcal

Salan
Pre- Bed 1 Cup warm low fat 22g 9g 6g 200 Kcal

Milk 2 Tbsp Panjeeri
Total 129g 67g 26g 1100 Kcal
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Case 4 (General Ward)

Patient’s Name: Mr. Usman Haider
Age:39
Height: 5’10
Weight: 55 Kgs
BMI: 17.4
Presenting Complaint: Epigastric pain (5 days) after eating and dissolves after 2-3 hours
Occupation: Works in the Pepsi Company
Diet Hx: 2-3 bottles of Pepsi/day
He used to have frequent Dhaba meals with high spices.
Epigastric Pain:
Epigastric pain is discomfort or pain localized in the upper middle part of the abdomen, beneath
the ribcage. It is often associated with conditions affecting the stomach, pancreas, or gallbladder.
Labs:
Hb: 12.7 g/dL
Platelets: 12.4
Bilirubin: 0.8
Breakfast 1 Slices + 1 Cup Tea 180Kcal
Snack - -
Dinner - -
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- Avoid Heavy meals
- Avoid spicy and deep fried foods.
- Have probiotics added to the diet
- Eat fibre-rich foods.
- Add leafy green vegetables and fruits to the diet.
- Do not stay on an empty stomach for longer periods.
- Avoid caffeinated and carbonated drinks.
- Avoid the use of bubblegum.
- Do not lie down after having meals.
DIET PLAN
MEAL SERVING CARBS PROTEIN FAT TOTAL

Breakfast 2 Slice French Toast + 1 53g 8g 12g 350 Kcal

Glass Apple Juice + 1
Pinch Kalonj
Snack 1 1 Cup Cabbage Soup 7g 2g 7g 80 Kcal
Lunch 1 Chapati + Bhindi Sabzi 20g 4g 12g 200 Kcal
Snack 2 1 Bowl Youghurt with 1 13g 12g 5g 110 Kcal

Probiotic Sachet
Dinnger 1 Chapati + Lauki Gosht 26g 17g 7g 250 Kcal
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Salan
119g 46g 43g 990 Kcal
URINARY TRACT INFECTION:

A Urinary Tract Infection (UTI) is a bacterial infection affecting any part of the urinary system,
including the bladder, urethra, ureters, and kidneys.
Symptoms:
Common symptoms include a frequent urge to urinate, pain or burning during urination, cloudy
or strong-smelling urine, and pelvic discomfort.
UTIs are more prevalent in women, and treatment typically involves antibiotics, with
complications possible if left untreated, such as kidney infections. Preventive measures include
staying hydrated, practising good hygiene, and urinating promptly after sexual activity.
Case 5 (Emergency)
Patient’s Name: Mrs Anum Salman
Age:29
Height: 5’4
Weight: 52 Kgs
BMI: 19.7 kg/m2
Presenting Complaint: Severe Urinary Tract Infection
Breakfast - -
Lunch - -
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Snack - -
Dinner - -

- Drink plenty of water.
- Avoid artificial sweeteners, spicy foods, alcohol, coffee, acidic fruits, citrus, or
caffeinated drinks as they irritate the bladder.
- Incorporate high fiber foods such as bananas, beans, lentils, nuts, oats, and other whole
grains that help remove harmful bacteria from your body. They also encourage regular
bowel movements, which can help relieve some bladder pressure.
- Berries as they contain proanthocyanidin, which has been shown to prevent infection-
causing bacteria from adhering to the lining of the urinary tract.
DIET PLAN
MEAL SERVING CARBS (g) PROTEIN FATS TOTAL

(g) (g) CALORIES
Breakfast: Oatmeal + 1 boil egg 29g 11g 8g 230kcal
Snack 1 1 Cup Grapes 23g 1g 0g 90 kcal
Lunch Lokey ka raita +Half 52g 11g 7g 300kcal
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plate matar pulao +

Achar
Snack 2 Cranberry supplement 4g 1g 3g 45kcal

+ 1 Cup popcorn
Dinner Mix sabzi + roti + 44g 15g 20g 410 kcal

Shami Kebab
Total 152g 39g 38g 1075kcal
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CHRONIC KIDNEY DISEASE

Chronic Kidney Disease (CKD) is a long-term condition characterized by the gradual loss of
kidney function over time
CKD is typically progressive and may advance through different stages, with symptoms often
becoming more pronounced as the disease worsens.
Causes:
Common causes of CKD include diabetes, high blood pressure, and other conditions that affect
kidney health.
Symptoms:
Chronic Kidney Disease (CKD) may manifest as fatigue, swelling, changes in urination, and
other symptoms, progressing with increased severity, potentially leading to complications such
as hypertension and cardiovascular issues. Early detection through routine screenings is crucial
for effective management
Intradialytic hypertension:
Intradialytic hypertension refers to an elevated blood pressure that occurs during hemodialysis,
potentially leading to complications; it is often observed during or immediately after the dialysis
procedure in individuals with end-stage renal disease. Managing intradialytic hypertension is
essential for minimizing cardiovascular risks in patients undergoing hemodialysis.
Case 6 (General Ward)

Patient’s Name: Mrs Nasreen Sheikh
Age:55
Height: 5’4
Weight: 63 Kgs
BMI: 23.7 kg/m2
Presenting Complaint: CKD on dialysis from 2.5 years, 2 time per week, Intra-dylitic
Hypotention, Constipation.
Surgical Hx: Hysterectomy
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Labs:
Hb: 8.9 g/dl
Pottasium: 4.5
BUN: 84
Calcium: 10.1
Phosphorus: 4.6
Albumin: 4.7
Creatinine: 7.9
Urine Output: 0
Breakfast 1 Roti + 1 Egg Omlette + 2 180Kcal

Sips Tea
Dinner Half Chapati with Salan 200 Kcal
Fluid Intake: 500 ml /day

- Have Small frequent meals.
- Have carbs cocnsisting of fibre rich sources.
- Do no have refined and processed foods.
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- Have low sodium, low phosphorus, low calcium, low magnesium diet.
- Replace animal rich protein sources with plant based protein sources.
- Add L- carnatine to the diet. It helps in hypotension.
- It is recommended to have 20-25 minutes of physical activity.
DIET PLAN
MEAL SERVING CARBS PROTEIN FATS TOTAL

Breakfast: 1 Whole Grain Roti + 1 16g 17g 17g 350

Whole Egg + 1 Egg white
Omlette + 2 Sips tea
Snack 1 1 Apple + ½ Tbsp Chia 17g 2g 2g 87

Seeds
Lunch Quarter plate rice with ½ 40g 8g 2g 250

cup Daal
Snack 2 5-6 Pista Unsalted 1g 1g 2g 24
Dinner ½ Roti + Cholay Salan + 44g 14g 13g 350

½ Bowl Red Bean Salad
Total 118g 42g 36g
Case 7 (Medicine Ward)

Patient’s Name: Mr Ahmed
Age:60
Height: 5’5
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Weight: 50 Kgs
BMI: 18.3 kg/m2
Presenting Complaint: Hematuria , inability to walk , bedsore grade III , weakness.
Breakfast 1 Cup Tea + 3 Rusk 200 Kcal
Lunch ½ Chapati + Chicken Salan 200 Kcal
Snack - -
Dinner ½ Bowl Dhalia 100 Kcal
Protein Requirement: 53g
Carbs Requirement: 187g
Fat Requirement: 32g

- Increased needs for protein for wound healing and repair of body tissues.
- Zinc for membrane repair, inflammation and immune defense , tissue re-epithelialization
, scar formation.
- Vitamin A stimulates epithelial growth collagen synthesis, epithelialization.
- Vitamin C that acts as an antioxidant , aids in wound healing, and vitamin E( anti-
inflammatory ).
- Avoid spicy foods to prevent inflammation.
- Cranberry that will work as a diuretic and treat any urinary infection and prevent
hematuria.
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DIET PLAN
FOOD SERVING CHO PRO FAT TOTAL

CALORIES
Breakfast: 1 bowl of 39gm 16gm 13gm 336kcal

oatmeal + 1
boil egg + 1
cup tea + 1
Pinch Kalongi
Snack 1 1 Tbsp 2gm 1gm 1gm 20kcal

Pumpkin
Seeds
Lunch ½ Khichri + 39gm 33gm 21gm 450kcal

Raita + 1
Servings
steamed fish
Snack 2 1 Orange + 18gm - 69kcal

black tea
Dinner 1 roti + ½ 79gm 30gm 11gm 350kcal

Cup daal + 1
Carrot Sliced
177gm 80gm 46gm 1225kcal
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Patient’s Name: Sariya Ahmed
Age:61
Height: 5’6
Weight: 65 Kgs
BMI: 23.1 kg/m2
Presenting Complaint: Abdominal pain , tremors in hand , epigastric pain , SOB , nausea.
Breakfast 1 Roti + 1 Egg Fried 250 Kcal
Lunch 1 Plate Rice + 1 Cup Daal + 450 Kcal

Papar
Snack 1 Cup Tea 90
Dinner ¾ Plate Yakhi Pulao 550 Kcal
Fat Requirement: 46.9g
- Ensure adequate fluid intake to prevent dehydration, especially if nausea is present.

- Sip on water or electrolyte solutions throughout the day.
- Eating smaller, more frequent meals rather than large meals may help manage symptoms
of nausea and abdominal pain
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- Identify and avoid foods that may trigger symptoms. Common triggers include spicy,
greasy, or acidic foods
- Reduce or eliminate caffeine intake, as it can contribute to tremors and may exacerbate
other symptoms
DIET PLAN

CALORIES
Breakfast: 1 Cup Tea + 25gm 7gm 6gm 174Kcal

2 Rusk
Snack 1 Boiled Peas 9gm 3gm - 50Kcal
Lunch ½ Matar 56gm 9gm 12gm 431Kcal

Chawal +
Timatar
Chutney +
Raita
Snack 2 Ginger Tea 9gm 30Kcal
Dinner 1 Chapati + 53gm 12gm 14gm 400Kcal

Aalu Bhurta
+ Raita +
Cumcumber
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..
TAJ MEDICAL CENTRE:
CHRONIC RENAL FAILURE:

Chronic Renal Failure, also known as Chronic Kidney Disease (CKD), is a progressive and
irreversible condition where the kidneys gradually lose their ability to function over time.
Causes:
Common causes include diabetes, hypertension, and glomerulonephritis.
Symptoms:
Symptoms may include fatigue, swelling, changes in urination, and hypertension.
Management:
Management involves lifestyle changes, medications, and, in advanced stages, may require
dialysis or kidney transplantation for renal replacement therapy. Early detection and intervention
are crucial to slow progression and mitigate complications.
Case 1 (Medicine)
Patient’s Name: Mr. Shahid Mohabbat
Age:45
Height: 5’9
Weight: 81 Kgs
BMI: 26.4 kg/m2
Presenting Complaint: Chronic Renal Failture, RTI, Anemia Of Chronic Disease
Medical Hx: HTN, TB (20 years back), Hemoptysis, Weightloss Fever
Hemoptysis: Coughing up blood
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Labs:
Hb: 8.7 g/dL
Urea: 128 mg/dl
Creatinine: 7.7 mg/dl
Breakfast 2 Slices Bread with 1 Egg 260Kcal

Fried
Lunch 1 plate Daal Chawal 370 Kcal
Dinner 1 Roti with Aalu Palak 250 Kcal

- Have Small frequent meals.
- Have carbs consisting of fibre rich sources.
- Do no have refined and processed foods.
- Have low sodium, low phosphorus, low calcium, low magnesium diet.
- Replace animal rich protein sources with plant based protein sources.
- Add L- carnatine to the diet. It helps in hypotension.
- It is recommended to have 20-25 minutes of physical activity
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DIET PLAN
FOOD SERVING CHO PROTEIN FATS TOTAL

CALORIES
Breakfast: 1 + ½ Whole 26gm 18gm 19gm 350kcal

Grain Roti +
1 Whole Egg
+ 1 Egg white
Omlette + 2
Sips tea
Snack 1 1 Apple + ½ 29gm 3gm 4gm 60kcal

Tbsp Chia
Seeds
Lunch Half plate 62gm 17gm 4gm 350kcal

rice with ½
cup Daal
Snack 2 5-6 Pista 2gm 2gm 4gm 40kcal

Unsalted
Dinner 1 Roti + 65gm 14gm 19gm 477kcal

Phalli Salan +
½ Bowl
Chickpea
Salad
184gm 54gm 50gm 1277kcl
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Case 2 (Surgical Ward)

Patient’s Name: Ghazi Mustafa
Age:61
Height: 5’5
Weight: 57
BMI: 17.6 kg/m2
Presenting Complaint: Abdominal pain, nausea.
Diagnosis : Mass in epigastrium.
Breakfast - -
Lunch - -
Snack - -
Dinner - -

- Consuming soft and easily digestible foods because it is easier on the digestive system
- Eating smaller, more frequent meals throughout the day instead of large, heavy meals
may help manage symptoms and reduce the strain on the digestive system.
- Drinking water can help with digestion and prevent dehydration.
- Avoid spicy, greasy, or acidic foods
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- Avoid caffeine and alcohol because it can irritate the digestive tract.
DIET PLAN

CALORIES
Breakfast: 1 Bowl Oat 50gm 7gm 4gm 250Kcal

meal with dry
fruits
Snack 1 1 Glass 9gm 2gm 45 Kcal

Coconut
water
Lunch Half Plate 72gm 19gm 5gm 300 Kcal

Rice + ½ Cup
Daal + Salad
Snack 2 2 Banana 46gm 2gm 1gm 180Kcal
Dinner 1 Chapati + 27gm 36gm 2gm 440Kcal

Anday Aalu
Salan
Case 3 (ICU)
Patient’s Name: Alia Shamsi
Age:88
Height: 5 Feet
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Weight: 60
BMI: 25.8 kg/m2
Presenting Complaint: Stroke , bedsore grade I
Medical Hx: DM
DIET PLAN (NG):

NG PLAN : Plan is to give 5 scoops of glucerna in 200 ml of water every 4 hourly.
( 1 scoop of glucerna gives 2 gms of protein and 225 kcal )
Breakfast :
( 6:00 am )
5 scoops of glucerna in 200 ml of water gives 10 gms of protein and 225 calories.
Snack 1 :
( 10 am )
Lunch :
( 2 pm )
Snack 2 :
(6 pm )
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Dinner
( 10 pm )
CALCULATIONS :
225 x 5 = 1125 kcal
10 x 5 = 50 gms of proteins
Case 4 (Gynae Ward)

Patient’s Name: Ms.Kainat
Age: 30
Height: 5’3
Weight: 70
BMI: 27.3 kg/m2
Presenting Complaint: 36+ Weeks came for EL.LSCS and BTL ( Bilateral Tubal Ligation)
Past medical Hx: 2 miscarriages
Bilateral Tube Ligiation:

Bilateral tubal ligation is a surgical procedure for permanent female sterilization, involving the
closure or blocking of both fallopian tubes to prevent the egg from reaching the uterus and
meeting sperm.
Bilateral tubal ligation is a surgical procedure for permanent female sterilization, involving the
closure or blocking of both fallopian tubes to prevent the egg from reaching the uterus and
meeting sperm.
Labs:
Hb: 11 g/dL
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Breakfast 1 Paratha + Omlette 350
Lunch Half Plate Matar Chawal + 550

Timatar Chutney + Raita +
Shami Kabab + Achar
Snack ! Cup Tea + Dry Fruits 150
Dinner 1+ ½ Roti + Palak Gosht + 250

Cucumber Slices
Protein Requirement: 73.31g

- Avoid cruciferous vegetables to prevent gassy stomach.
- 20-25 Minuites walk per day.
DIET PLAN
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CALORIES
Breakfast: 2 Slice Bran 45gm 23gm 21gm 462Kcal

Bread + 1
Egg Omlette
+ 1 Cup
Chae
Snack 1 1 Orange 43gm 2gm 1gm 163Kcal

and 1 Apple
Lunch 1 Bowl 5ack 2 1 Fist Dry 32gm 5gm 4 1

Chicken fruits with 1 g 7
Dhalia with Cup Tea m5
Cucumber K
Slices c
a
l
Dinner 1 Cup 41gm 32gm 21gm 488Kcal

Mutton
Yakhni + 1
serving
Khichri
Case 5 (Surgical Ward) Post-Op

Patient’s Name: Ms Rabia Bashir
Age: 55
Height: 5’6
37
INTERNSHIP REPORT
Weight: 58
BMI: 20.6
Presenting Complaint: Hip Fracture
Breakfast - -
Lunch - -
Snack - -
Dinner - -

- Intake of protein to heal the injury and prevent infections like Meat, fish, milk, cheese,
cottage cheese, yogurt, nuts, seeds, beans, soy products, and fortified cereals.
- Calcium build strong bones, so foods and drinks rich in it can help your bone fracture
heal.
- Vitamin C helps your body make collagen, which helps your bone fracture heal.
- Salt must be reduced to the maximum extent possible from our diet because it reduces the
calcium content in bones and weakens them further.
- Caffeine, alcohol, sugar and processed food must also be kept away from the diet.
38
INTERNSHIP REPORT
DIET PLAN

CALORIES
Breakfast: 2 bread slices 57gm 20gm 17gm 452kcal

+ omelet + 1
handful of
dry fruits
Snack 1 Coconut 9gm 2gm 45kcal

water
Lunch fish salan + 34gm 38gm 15gm 436kcal

chawal
Snack 2 pumpkin 2gm 1gm 1gm 18kcal

seeds 1 tbsp
Dinner 1+½ roti + 66gm 19gm 16gm 476kcal

palak gosht
Patient’s Name: Ms Nasreen
Age: 60
Height: 5’3
39
INTERNSHIP REPORT
Weight: 69 kgs
BMI: 26.9 kg/m2
Presenting Complaint: Gall bladder stones.
Surgery Procedure: Laparoscopic Cholecystectomy
Dinner 1 Bowl Dhalia 200 Kcal
Caloric Requirement: 1725 kcal/day
Protein Requirement: 86.25 gms
Carbs Requirement: 258 gms
Fat Requirement: 38 gms
MEDICAL NUTRITION THERAPY :
● Avoid fatty, greasy, or spicy foods.

● Consume lean meat, low fat dairy, and leafy green vegetables.
● Consume fruits and fruit juices.
40
INTERNSHIP REPORT
● Addition of fat-solubletamins in diet to prevent deficiency of fats.

● Incorporate proteins in diet to help in healing of surgical
wound.
DIET PLAN
FOOD SERVING CHO PRO FATS TOTAL

CALORIES
Breakfast: 1 boil egg + 1 26gm 13gm 11gm 251kcal

cup tea + 2
rusks
Snack 1 Fruit juice 31 gm - - 128 kcal
Lunch Khichri + 73gm 24gm 7gm 448 kcal

dahi +timatar
chutney
Snack 2 Bean salad 27gm 3gm 8gm 185 kcal
Dinner Daliya + 54gm 34gm 24gm 569 kcal

yakhni + ½
roti
41
INTERNSHIP REPORT
Case 7 (Gynae Ward)

Endometrial cyst :
An endometrial cyst, also known as an endometrioma, is a type of ovarian cyst formed when
endometrial tissue grows within the ovary. It is commonly associated with endometriosis, a
condition where tissue similar to the lining of the uterus develops outside the uterus.
Symptoms :
● pelvic pain
● irregular menstrual cycles
● fertility issues
Patient’s Name: Ms Kiran
Age: 22
Height: 5’1
Weight: 65 kgs
BMI: 27.1 kg/m2
Presenting Complaints : abdominal pain , painful heavy periods , increased urination.
Diagnosis : Endometrial cyst.
Labs:
Hb: 10 g/dL
42
INTERNSHIP REPORT
Dinner 1 plate haleem + ½ tandoori 500 Kcal

roti
Protein Requirement: 76 gms
Carbs Requirement: 152 gms
Fat Requirement: 34 gms
MEDICAL MUTRITION THERAPY :
● Avoid or limit foods that may promote inflammation in the body and lead to further pain
or progression of the disorder. These foods include : Alcohol ,caffeine , gluten ,red meat ,
saturated and trans fat.
● Antioxidant-rich foods found in colorful fruits and vegetables, such as oranges, berries,
dark chocolate, spinach, and beets
● Fruits, vegetables, and whole grains are packed with dietary fiber, which may help lower
estrogen levels. They also provide vitamins, minerals, and antioxidants, which may help
ease pain and oxidative stress.
● Processed foods are low in important nutrients and fiber. They have also been linked to
increased inflammation, which could contribute to symptoms of endometriosis.
● Omega-3 fats have anti-inflammatory properties, and they have been shown to help
decrease menstrual pain. What’s more, a high omega-3 fat intake has been associated
with a reduced risk of endometriosis.
43
INTERNSHIP REPORT
DIET PLAN

CALORIES
Breakfast: 2 wheat bread 29gm 13gm 7gm 226kcal

+ 1 boil egg
Snack 1 Fruit chat 50gm 4gm 1gm 290kcal
Lunch mutton curry 39gm 35gm 13gm 410kcal

+ salad + roti
Snack 2 Wheatable 15gm 8gm 5gm 175kcal

biscuits
Dinner Mix sabzi + 39gm 13gm 9gm 442kcal

roti
Case 8 (Private Ward)

Patient’s Name: Fatima Shamsi
Age: 25
Height: 5’4
Weight: 65
BMI: 24.6 kg/m2
Presenting Complaint: Abdominal Pain, Severe Constipation , bleeding while defecation.
44
INTERNSHIP REPORT
Breakfast 1 Boiled Egg with 1 Cup Tea 170
Lunch 1 Club Sandwhich 400
Snack Fresh Orange Juice with 450

Salted Peanuts
Dinner Alfredo Pasta 450
Protein Requirement: 82.5 gms
Carbs Requirement: 226.5 gms
Fat Requirement:45.8 gms

- Avoid Cruciferous Vegetables which cause bloating
- Avoid Spicy and deep fried foods.
- Have fibre-rich foods.
- Add Probiotics to populate good bacteria in the gut.
- Avoid Carbonated and sugary drinks.
- Add Fat to the diet.
DIET PLAN
45
INTERNSHIP REPORT
CALORIES
Pre Breakfast Warm water 10gn 2gm 5gm 74 Kcal

+ 1 tsp Olive
Oil + 1 Tbsp
Ispaghol
Breakfast: 2 Slice Bran 45gm 18gm 20gm 495Kcal

Bread + 1 egg
Omlette + 1
Tsp Butter +
1 Cup Tea
Snack 1 Half Papaya 17gm 1gm - 68Kcal
Lunch Half Plate 64gm 30gm 10gm 500Kcal

Rice + 1/2
Cup daal +
Karela Sabzi
+ Salad
Snack 2 1 Cup 16gm 10gm 3gm 140Kcal

Youghurt
with
Probiotic
Dinner 1 Roti + 33gm 22gm 15gm 454Kcal

Shimla Mirch
Chicken
46
INTERNSHIP REPORT
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INTERNSHIP REPORT

FINAL YEAR INTERNSHIP REPORT

Faculty of Eastern Medicine

Name : Rehma Aqil

Human Nutrition & Dietetics

The food and beverages you normally eat and drink.

FOOD GUIDE PYRAMID:

The Food Guide Pyramid is a tool designed to promote

METHODS OF NUTRITIONAL ASSESSMENT:

The purpose of nutritional assessment is to:

- Identify individuals who are at the risk of being malnourished.

- Height, weight, and BMI

deficiencies are suspected.

- Loss of subcutaneous fat tissue

Conversely for over nutrition,

Weight management is the process of adopting long-term lifestyle modification to

- IBW (Ideal Body Weight):

- BMR (Basal Metabolic Rate):

- Total energy expenditure ( TEE ):

Total energy expenditure (TEE) is composed of the energy costs of the

24 HOUR DIET RECALL:

Breakfast 2 Slices + 1 Cup Tea 240 Kcal

Lunch 1 Chapati + Chicken Salan 250 Kcal

Snack 1 Apple 45 Kcal

Dinner 1 Bowl Dhalia 200 Kcal

Carbs Requirement: 264g (55%)

MEDICAL NUTRITION THERAPY:

MEAL SERVING Carbs (g) Protein Fats (g) TOTAL

Breakfast: 2 Slice Bran Bread + 1 39.3 17.3 14.5 360 Kcal

Snack 1 1 Orange and 1 Apple 27g 1g 0g 90 Kcal

Lunch 1 Bowl Chicken Dhalia 52g 12g 10g 335 Kcal

Snack 2 1 Fist Dry fruits with 1 32g 5g 4g 150 Kcal

Dinner 1 Cup Mutton Yakhni + 32g 17g 11g 300 Kcal

Pre- Bed 1 Cup warm Milk with 2 22g 9g 8g 200 Kcal

Total 204g 61g 47.5 1435

GESTATIONAL DIABETES MELLITUS:

Low GI Foods (55 or less):

Medium GI Foods (56-69):

High GI Foods (70 or more):

Case 2 (Gynea Ward)Post-op

24 HOUR DIET RECALL:

Breakfast 1 Boiled Egg + 1 Slice + 1 240 Kcal

Lunch 1 Bowl of Chicken Corn Soup 200 Kcal

Snack 1 ABC Juice 60 Kcal

Dinner Half Plate Khichri with Raita 200 Kcal

MEDICAL NUTRITION THERAPY:

- Have food sources having low Glycemic Index (<50)

MEAL SERVING CARBS PROTEIN FAT TOTAL

Breakfast 1 Bowl Oatmeal with 1 42g 9g 7g 250 Kcal

Snack 1 1 Apple 15g 0g 0g 45 Kcal

Lunch 1 Whole Grain Roti + 42g 14g 12g 300 Kcal

Snack 2 1 Bowl Red Bean Salad 21g 10g 4 150 Kcal

Total 186g 61g 45g 1295 Kcal

Case 3 (Gynea Ward)

Patient’s Name: Saima Adnan

Protein Requirement: 65g (13%)

MEDICAL NUTRITION THERAPY:

MEAL SERVING CARBS PROTEIN FATS TOTAL

Breakfast: 2 Slices Bran Bread with 34g 8g 8g 235 Kcal