Name Noor Fatima

Class HND-7
Roll no. Bs hnd f17038

Internship
Lahore General Hospital

Anemia
Anemia is defined as the low number of red blood cells or the amount of hemoglobin they
encompass. This reverberates by limiting the O2 and CO2 exchanging between the blood
and tissues. Anemia caused due the nutritional aspects is attributed to the deficiency of
Iron, Folic acid (Megaloblastic anemia) and Vitamin B12 (Pernicious anemia).

Risk Factors

• Poor socio-economic class

• Teenage Pregnancy
• Family History
• Menstrual Problem
• Eating disorders (Anorexia Nervosa)

Calculations
BMI = W(kg)/H(m)2
= 65/2.64
= 24 normal
REE = 655.1 + (9.56* W) + (1.85*H) – (4.7*age)
REE = 655.1 + (9.56* 65) + (1.85*162) – (4.7*age)
= 1435.2 kcal
PAF = 1.1
1.1*1435kcal
TEE= 1578kcal
Carbohydrates = 55/100*1578 = 867/4 = 216g
Proteins = 25/100*1578 = 394/4 = 98g
Fat = 20/100*1578 = 315/9 = 35g
Fluid requirements = 1500+45*25
= 1500+1125 = 2625/250 = 10glasses

Diet Plan
Pre Breakfast 2 dates
½ Apple
2 bread slices
Breakfast
1 boiled egg
1 cup low fat milk
Mid-morning 1 cup fresh juice of any seasonal fruit
1 chapatti (whole wheat)
2 oz. meat
Lunch
1 cup fresh salad
1/2 cup raita
1 cup tea
Snack
2 biscuits
2/3 cup rice
Dinner 1 cup cooked vegetables 2tsp
yogurt
Bedtime 1 cup milk

MNT
• Non enteric-coated oral iron supplements are the first line of therapy. Ferrous
sulphate is most commonly used and has the greatest bioavailability.
• Dairy products should be avoided because they interfere with the absorption of
oral iron
• Medications that alter gastric pH can also decrease iron absorption. These include
antacids, proton pump inhibitors and H2 blockers.
• Supplements should be taken on an empty stomach, if tolerated, and at least 2
hours before, or 4 hours after, these classes of medications.
• Simultaneous intake of ascorbic acid increases absorption of iron. For example, a
glass of orange juice contains sufficient vitamin C to significantly increase iron
absorption from foods.
 • Tea, coffee, and cocoa should not be consumed with meals if poor iron status is
suspected. Polyphenols in these beverages inhibit the absorption of non-heme
iron.

Height = 5’4= 64/39.37 = 1.62m

BMI = W(kg)/H(m)2
= 92/ (1.62)2

= 35 Obese
IBW = 106 + 6*4
= 106 + 24 == 130/2.2 = 59kg
REE = 66.5 + (13.7*W) + (5*H) – (6.8*Age)
REE = 66.5 + (13.7*59) + (5*162) – (6.8*65)
= 1242kcal
PAF = 1.1
= 1.1*1242
=1366kcal
TEE = 1366*1.2
=1639kcal

AMDR
Carbohydrates = 60/100*1639 =983/4 =245g
Proteins = 20/100*1639 = 327/4 = 81g
Fats = 20/100*1639 = 327/9 = 36g
Exchanges
Serving
Food Proteins Carbohydrates Fats Calories
size
Fruits 5 - 75 - 300
Vegetables 5 10 25 - 125
Milk 2 16 24 10 240
Grains 8 24 120 8 640
Meat 2 14 - 6 90
Fat 1 - - 5 45
Diet Plan
Early Morning 1 Apple
2 slices bran bread
Morning 1 boiled egg + 1oz lean meat ½
cup fat free milk
Mid-Morning 1 cup fresh apple juice
1 chapatti (whole flour)
Lunch 1 cup cooked spinach with 1oz lean meat
1 cup tea after an hour of lunch
2 veg cutlets (1/2 cup boiled vegetables +
Snack 1 boiled potato)
1 cup green tea
2/3 cup boiled rice
Dinner 1 cup broccoli
1 cup raita

Hypertension
Foods Allowed Foods Not Allowed

 Fresh and frozen vegetables  Butter and margarine

without sauces, Greens, Broccoli,  Regular salad dressings
Cauliflowers, peppers, etc. Fatty meats

 Fresh frozen or dried fruits: 
Whole milk dairy products
berries, apples, bananas, pears, Fried foods

 etc. Dried beans, brown rice, faro, Salted foods
quinoa, whole-wheat pasta Fresh  Canned soups
 or frozen meat or poultry  Fast foods
(Lean meats)  Deli meats
Fresh or Frozen fish: Cod, sea 

bass, tuna etc.
Eggs

Olive oil, avocadoes and its oil

 Low-sodium canned or homemade
soups
 Milk, yogurt, unsalted butter and
low-sodium cheeses
 Whole wheat breads, low sodium
tortillas and crackers
 Pumpkin seeds, unsalted peanuts
and other nuts

MNT
• Even if you are taking medications for your blood pressure, you should still limit
how much sodium you consume.
• In general, people with high blood pressure should get between 1,500 milligrams
(mg) and 2,400 mg sodium per day.
• If you need to lose weight, the DASH plan can help you because it limits high-fat
foods and refined carbohydrates. These foods can be high in calories but don’t
contain many healthy nutrients.
• Eating the right types of fat and avoiding the unhealthy ones helps to reduce the
buildup of plaque in your blood vessels. This lowers your risk for strokes or heart
attacks. DASH diet includes MUFAs and PUFAs. However, it limits saturated
and trans fats.
• Potassium is an electrolyte that reduces blood pressure and stroke risk through
improved vasodilation.
• A randomized controlled study with healthy individuals found that 3 servings of
whole grains reduced systolic and diastolic pressure by 6 mm Hg and 3 mm Hg,
respectively.
• Large prospective studies support the evidence that whole grain consumption
reduces blood pressure and hypertension risk.
• Magnesium helps moderate blood pressure, competes with sodium for binding
sites on vascular smooth muscles cells, and reduces endothelial dysfunction in
hypertensive patients.