Case No.

: 7
Date: 18.05.24
1. Personal data:
• Name of the patient: CHANCHAL SARKAR

• Name of Consultant: Dr. A. LATIF

• Age: 44 Years
• Sex: Male
• Address: Rangamati, Paschim Medinipur.

Type of patient: Implant Removal (left knee)

• Patient’s ID No: 1134

• Bed No: 457-C
• Socioeconomic condition: Medium

2. Assessment of Nutritional Status:

A. Clinical assessment

(As per ICMR Score Card Method)

I. General
• Appearance: Good

II. Eyes
a) Conjunctiva
• Xerosis: Absent
• Pigmentation: Slight discoluration
b) Cornea
• Xerosis: Absent
• Vascularization: Absent
c) Lids
• Excoriation: Slight excoriation
 • Folliculosis: Absent

d) Functional
• Night blindness: Absent
III. Mouth
a) Lips
• Condition: Normal
b) Tongue
• Colour: Normal
• Surface: Normal
c) Gums
• Condition: Normal
d) Teeth
• Fluorosis: Absent
• Caries: Absent
IV. Hair
• Condition: Discolour and dry
V. Skin
a) General
• Appearance: Loss of lustre
• Elasticity: Wrinkled skin
b) Regional
• Face: Normal
VI. Adipose tissue
• Quantity: Deficient
VII. Oedema
• Distribution: Absent
VIII. Bones
• Condition: Normal
IX. Heart

• Size: Normal
X. Alimentary system
• Appetite: Normal
• Stool: Not normal evacuation

3. Assessment of Health status:

Pulse rate
Blood pressure (mm/Hg) Respiratory rate (per min)
(beats/min)
120/70 86 18

4. Assessment of Diet History:

4.1. 24 hours recall method (in hospital or home diet)

Time Food stuffs Amount

Tea 1 Cup
Morning
Biscuit 2 Pieces
Puffed rice 100 gm
Break fast
Alu-beans curry 100 gm
Rice 150 gm
Lunch Dal 25 gm
Alu-posto 130 gm
Fry sag 100gm
Chutni 10gm
Tea 1 Cup
Afternoon
Biscuit 2 Pieces
Ruti 100 gm
Dinner Dal 25 gm
Alu-potol curry 150 gm
 4.2. Analysis of nutrient intake

Amount Energy Carbohydr Protein Fat Vit-A Vit-C Fe Ca

Food stuff
(gm) (Kcal) ate(gm) (gm) (gm) (mcg) (mg) (mg) (mg)
Puffed rice 100 325 73.6 7.5 0.1 00 00 4.8 23
Wheat flour 100 341 69.4 12.1 1.7 29 00 4.0 48
(whole)
Biscuit 20 69.2 14.24 2.36 0.3 12.8 00 1.06 8.2
Rice 150 519 118.5 9.6 0.6 00 00 1.5 13.5
Bengal gram 50 180 30.45 8.55 2.65 94.5 1.5 2.3 101
(whole)
Lentil 50 171.5 29.5 12.55 0.35 135 00 3.79 34.5
Sushni sag 100 46 4.6 3.7 1.4 00 00 00 53
Parwar 100 20 2.2 2.0 0.3 153 29 1.7 30
Broad beans 50 24 3.6 2.25 0.05 4.5 6 0.7 25
Potato 200 194 45.2 3.2 0.2 48 34 0.96 20
Tomato, ripe 50 10 1.8 0.45 0.1 175.5 13.5 0.32 24
Onion, small 50 29.5 6.3 0.9 0.05 7.5 1 0.6 20
Poppy seeds 30 122.4 11.04 6.51 5.79 00 00 4.77 475.2
Oil 10 90 00 00 10 00 00 00 00
Total 2141.6 410.43 71.67 23.59 659.8 85 26.5 875.4

4.3. Current medication:

Medication name
Inj. Ondem (6) – IV stat
Inj. PAN 40 – IV stat
IVF RL – 6 hourly
Inj. TT (0.5) – IV stat
NPM
5. Preparation of Diet Chart according to patient’s condition:
5.1. Diet chart preparation
Amount Energy Carbohydr Protein Fat Vit-A Fe Ca
Food stuff
(gm) (Kcal) ate (gm) (gm) (gm) (mcg) (mg) (mg)

Rice 100 346 79 6.4 0.4 00 1.0 9

Puffed rice 200 650 147.2 15 0.01 00 13.6 46
Wheat flour 100 341 69.4 12.1 1.7 29 4.0 48
(whole)
Lentil 50 171.5 29.5 12.55 0.35 135 3.79 34.5

Bengal 50 180 30.45 8.55 2.65 94.5 2.3 101

gram(whole)
Soyabean 75 324 15.67 32.4 14.62 319.5 7.8 180
Coriander 10 4.4 0.63 0.33 0.06 691.8 0.14 18.4
leaves
Papaya 100 27 5.7 0.7 0.2 00 0.9 28
Parwar
100 20 2.2 2.0 0.3 153 1.7 30
Cucumber 100 13 2.5 0.4 0.1 00 0.60 10
Potato
100 97 22.6 1.6 0.1 24 0.48 10
Onion, small 50 29.5 6.3 0.9 0.05 7.5 0.6 20
Carrot 100 48 10.6 0.9 0.2 1890 1.03 80

Coconut 200 48 8.8 2.8 0.2 00 0.1 48

water
Banana, ripe 100 116 27.2 1.2 0.3 78 0.36 17

Lime, sweet 100 43 9.3 0.8 0.3 00 0.7 40

musambi
Rohu 100 97 4.4 16.6 1.4 00 1.0 650
Egg, hen’s 50 86.5 00 6.65 6.65 210 1.05 30
Fowl 50 54.5 00 12.95 0.3 00 00 12.5
Chana, cow’s 50 132.5 0.6 9.15 10.4 55 00 104
Oil 10 90 00 00 10 00 00 00
Sugar 5 19.9 4.97 0.005 00 00 00 0.6
1517
Total 2938.8 477.02 143.98 50.29 3687.3 41.15
 5.2. Menu planning

Time Menu Food stuff Amount(g) Household

measurement
Early morning 250ml 1 full glass
(6:00am) Warm water Water
Puffed rice 100
Breakfast 1 bowl
(8:00am) Muri ghugni, Bengal gram (whole) 50
boiled egg and Egg, hen’s 50
banana
Coriander leaves 10
Banana, ripe 100 1 piece
Midmorning
(11:30am) Nuts Coconut water 200 1 full glass

Cucumber 100 1 piece

Rice, Parboiled rice 100 1 serving
Dhal,
Lunch Fish curry Lentil 50 1 bowl
(1:30pm) Rohu 100
1 bowl
Potato 50
Carrot 100

Parwar 100
Oil 5
Mid after noon Sweet lemon 100 1 piece
(3:30pm) Fruits
Evening Puffed rice 50
(6:30pm) Channa, muri 1 bowl
Channa, cow’s 50
Sugar 5
Wheat flour(whole) 100 1 serving
Dinner Ruti, mixed
(9:00pm) chicken soup Fowl 50
Soyabean 75
Potato 50
1 full bowl
Papaya 100
Onion, small 50
Oil 5
PROVIDE PROPER GUIDELINES

1. The intake of dietary fiber

should be increased by eating
whole cereals & increasing
consumption of fruits &
vegetables.
2. Drink adequate amount of water.
3. Rich foods should be avoided.
4. High fat foods should be avoided.
5. Food should be eaten slowly &
chewed well. How one eat is
more important then what one
eats because fast eating
provokes gastric feeding reflex.

6. Do some free hand exercises.

7. Take proper rest.

8. Should intake minerals and

vitamins as per the given diet
chart.