OBESITY

Accumulation of fat in fat cells (lipocytes) called obesity.

Fat cells increase in size up to maximum limit. After this more fats start to accumulate and
divide in to numbers.
Hyperplasty
Increase in number of fat cells called hyperplasty.
Hypertrophy
Increase in size of fat cell called hypertrophy.

Types of obesity
There are 2 types of obesity.
1. Gynoid obesity
2. Android obesity

Gynoid obesity
 Gynoid obese are known as “pear obese”.
 It is found in females.
 Thigh and hip have more fat accumulation

Android obesity

 Android obese are known as “apple obese”.

 It is found in males.
 Abdomen and chest have more fat accumulation

Causes of obesity

 Genetics

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  Physiological influences
 Food intake and eating disorders
 Junk foods
 Sedentary lifestyle
 Weight history
 Pregnancy
 Some medicine uses
 Underlying medical conditions
 Alcohol abuse
 Hormonal changes
 Overeating
 Diseases such as hyperthyroidism
 PCOs
 Cushing’s syndrome
 Cardiovascular diseases

Other diseases caused by obesity

 Cardiovascular diseases
 Diabetes
 Hypertension
 Fractures
 Kidney diseases
 Some types of cancer
 Breathing problem
 Back pain
 Infertility
 High Cholesterol level

MNT for obesity

Low fat, moderate protein, complex carbohydrates.

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 BMI CATEGORY PORTION CONTROL
25-29.9 Overweight 350Kcal
30-34.5 Obesity grade 1 400Kcal
35-39.5 Obesity grade 2 500Kcal
>40 Obesity grade 3 500Kcal
>50 Obesity grade 4 600Kcal

If a person is too much obese then give him low calories diet.
Recommend some exercise or walk.
Normal walk = 180 minutes per week
Brisk walk = 100 minutes per week
Give them lemon, mint, black seeds, green tea, black pepper, ginger tea, herbal things etc.

Precautions
 Avoid junk food
 Avoid spicy things
 Cook chicken, mutton and beef in less oil
 Avoid beverages
 Consume fruits and vegetables
 Do regular exercise
 Drink plenty of water

DIET PLAN

MEALS TIMINGS FOOD ITEMS

 1 glass water with 1tbsp of Basil seeds and half

Pre- 6;00 am
lemon
breakfast
 45 minutes brisk walk

 Take ½ roti, 3 tbsp salan ,7 Almonds

Breakfast 7:30-8:30am

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  1 cup tea

Mid- 10:00-  1 boil egg and 1 cup fat free milk

morning 11:00am

Lunch 1:00-2:00pm  Half Roti, 3tbsp vegetable salan with 1

 bowl of salad (any vegetables salad like cucumber,

onion, carrot, cabbage add 1 lemon juice)

 1 cup popcorn and half cup tea with pinch of carom

Snack 4:00pm
seeds ½ tsp tea and ½ inch ginger
time
 Exercise

 Black grains boil 1/3 cup, ½

Dinner 7:00-8:00pm
cucumber, 1 small onion, ½ cup cabbage1/2
tomato, Lettuce leaves and 1 lemon juice/2-3tbsp
yogurt (curd)

Snack 9:00pm
 1 glass of milk (fat free) + psyllium husk
time

DIABETES

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 Diabetes mellitus refers to a group of diseases that affect how your body uses blood glucose
(sugar). Actually, high level of sugar in blood is called diabetes. Glucose is vital to your
health because it's an important source of energy for the cells that make up your muscles and
tissues. 

During digestion, food is broken down into its basic components. Carbohydrates are
broken down into simple sugars, primarily glucose. Glucose is a critically important source of
energy for the body’s cells. To provide energy to the cells, glucose needs to leave the
bloodstream and get inside the cells.

An organ in the abdomen called the pancreas produces a hormone called insulin, which
helps the glucose get into your cells to give them energy. In a person without diabetes, the
pancreas produces more insulin whenever glucose level of blood rises and the insulin signals
the body's cells to take in the glucose. In diabetes, either the pancreas's ability to produce
insulin or the cells' response to insulin is altered.

SYMPTOMS OF DIABETES:

Diabetes symptoms vary depending on how much your blood sugar is elevated. Some signs
and symptoms are following:

 Increased thirst
 Frequent urination
 Extreme hunger
 Unexplained weight loss
 Presence of ketones in urine
 Fatigue

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  Irritability
 Blurred vision
 Slow healing process
 Frequent infections such as gums or skin infection

Types of Diabetes:

There are mainly two types of diabetes.

1. Type 1 diabetes
2. Type 2 diabetes

Sometimes a third type of diabetes is also present, known as Gestational Diabetes.

TYPE 1 DIABETES:

It is a chronic disease. In people with diabetes type 1, cells in the pancreas that make
insulin are destroyed, and body is unable to make insulin.

Insulin allows the glucose to pass from your blood into your body’s cell. When cells have
enough, the extra glucose is stored in liver and muscles which is used during physical
activity. In type 1 diabetes, body is unable to process glucose due to lack of insulin. Glucose
from food can’t make its way into cells. This leaves too much sugar in blood. As a result, the
level of sugar in blood rises that can lead to both short-term and long-term problems.

DIAGNOSIS OF TYPE 1 DIABETES

Type 1 diabetes often develops quickly. People are diagnosed if they meet one of the
following criteria:

 Fasting blood sugar > 126 mg/dL on two separate tests

 Random blood sugar > 200 mg/dL, along with symptoms of diabetes

 Hemoglobin A1c > 6.5 on two separate tests

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TYPE 2 DIABETES:

It is lifelong disease that keeps your body from using insulin the way it should. Sometimes it
said to have insulin resistance.

People who are middle-aged or older are most likely to get this kind of diabetes. It used to be
called adult-onset diabetes. But type 2 diabetes also affects kids and teens, mainly because
of childhood obesity.

CAUSES OF TYPE 2 DIABETES:

pancreas makes a hormone called insulin. It helps your cells turn glucose, a type of sugar, from
the food you eat into energy. People with type 2 diabetes make insulin, but their cells don't use it
as well as they should.

At first, your pancreas makes more insulin to try to get glucose into your cells. But eventually, it
can't keep up, and the glucose builds up in your blood instead.

 Genes
 Extra weight
 Metabolic syndrome
 Too much glucose in liver
 Bad communication between cells
 Broken beta cells

RISK FACTORS

 Age 45 or older
 Family history
 Ethnicity: African, American etc

DIAGNOSIS:

To confirm the diagnosis of type 2 diabetes, your doctor will order a fasting plasma glucose
test or a casual plasma glucose.

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  Diabetes and the Fasting Plasma Glucose Test

The fasting plasma glucose test (FPG) is the preferred method for diagnosing
diabetes, because it is easy to do, convenient, and less expensive than other tests,
according to the American Diabetes Association.

MNT for Diabetes

Low carbohydrates (complex carbohydrates), moderate fats.

DIET PLAN

MEAL TIMING FOOD ITEMS

Early- 6:00am  Watermelon 1 cup

morning

Breakfast 8:00-9:00am  Two-egg veggie omelet (spinach, mushrooms, bell

pepper, avocado) with a half cup black beans, three-
quarters cup blueberries

Snack time 10:00-11:00am

 1 cup unsweetened kefir, 1 cup green tea

 Sandwich: two regular slices high-fiber whole grain

Lunch 1:00-2:00pm
bread, 1 tbsp plain, no-fat Greek yogurt
 1 tbsp mustard, 2 oz canned tuna in water mixed with
a quarter cup of shredded carrots, 1 tbsp dill relish, 1
cup sliced tomato

 Green tea 1 cup

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 Snack time 3:00-4:00pm

 1 corn tortilla, half medium baked potatoes, veggies

Dinner 7:00-8:00pm
salad 1 cup

HYPERTENSION

High blood pressure is called hypertension. It is a common condition in which the long-
term force of the blood against your artery walls is high enough that it may eventually cause
health problems, such as heart disease.

Blood pressure is determined both by the amount of blood your heart pumps and the
amount of resistance to blood flow in your arteries. The more blood your heart pumps and the
narrower your arteries, the higher your blood pressure. A blood pressure reading is given in
milli meters of mercury (mm Hg).

It has two numbers:

 Top number (systolic pressure): The first, or upper, number measures the
pressure in your arteries when your heart beats.

 Bottom number (diastolic pressure): The second, or lower, number measures

the pressure in your arteries between beats.

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SYMPTOMS

Most people with high blood pressure have no signs or symptoms, even if blood pressure
readings reach dangerously high levels.

A few people with high blood pressure may have headaches, shortness of breath or
nosebleeds, but these signs and symptoms aren't specific and usually don't occur until high
blood pressure has reached a severe or life-threatening stage.

Types of Hypertensions:

There are two types of high blood pressure.

PRIMARY (ESSENTIAL) HYPERTENSION

For most adults, there's no identifiable cause of high blood pressure. This type of high blood
pressure, called primary (essential) hypertension, tends to develop gradually over many years.

SECONDARY HYPERTENSION

Some people have high blood pressure caused by an underlying condition. This type of high
blood pressure, called secondary hypertension, tends to appear suddenly and cause higher
blood pressure than does primary hypertension.

CAUSES

 Various conditions and medications can lead to secondary hypertension, including:

 Obstructive sleep apnea

 Kidney disease

 Adrenal gland tumors

 Thyroid problems

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  Certain defects you're born with (congenital) in blood vessels

 Certain medications, such as birth control pills, cold remedies, decongestants,

over-the-counter pain relievers and some prescription drugs

 Illegal drugs, such as cocaine and amphetamines

RISK FACTORS

 Age
 Stress
 Excess of alcohol abuse
 Race
 Family history
 Overweight or obesity
 Inactivity
 Use of tobacco
 Too much salt (sodium) in diet
 Too little potassium in diet
 Certain chronic conditions such as kidney diseases, sleep apnea, diabetes etc
 Sometimes pregnancy contributes to high blood pressure

COMPLICATIONS

The excessive pressure on your artery walls caused by high blood pressure can
damage your blood vessels as well as your organs. The higher your blood pressure
and the longer it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to complications including:
 Stroke or heart attack
 Heart failure
 Aneurysm

 Weakened and narrowed blood vessels in your kidneys

 Thickened, torn or narrowed blood vessels in the eyes

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  Metabolic syndrome

 Dementia

 Trouble with understanding or memory

DIAGNOSIS

Because hypertension doesn't cause symptoms, it is important to have blood pressure checked 
regularly. Blood pressure is measured with an instrument called a sphygmomanometer
Blood pressure measurements are classified in stages, according to severity:

 Normal blood pressure: less than less than 120/80 mm Hg
 Pre-hypertension: 120-129/80-89 mm Hg
 Stage 1 hypertension: 140-159/90-99 mm Hg
 Stage 2 hypertension: at or greater than 160-179/100-109 mm Hg

PREVENTION
Reducing hypertension prevents heart attack, stroke, and kidney damage, as well as other
health problem.

 Reducing salt intake (to less than 5g daily)

 Eating more fruit and vegetables
 Being physically active on a regular basis
 Avoiding use of tobacco
 Reducing alcohol consumption
 Limiting the intake of foods high in saturated fats
 Eliminating/reducing trans fats in diet

MANAGEMENT

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  Reducing and managing stress
 Regularly checking blood pressure
 Treating high blood pressure
 Managing other medical conditions

DIET PLAN

Meals Timings Food Items

Early morning 06:00-07:00am  1 glass Drink (soaked psyllium husk and

basil seeds + bazoori syrup)

Breakfast 08:00-09:00am  1 cup Milk (fat free) and cornflakes + 3-4

walnuts

 1 cup watermelon
Snack time 10:00-11:00am

Lunch 01:00-02:00pm  2 Chapati + Baked Pumpkin (1/2 cup) +

Fried Lady's Finger (1/2 cup) + Salad (1
serve) + 1/4th Fresh Lime

04:00-05:00pm
 1 cup potatoes chat + 1 glass fresh juice
Snack time

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  2 Chapati + Drumstick n Potato Curry (1 cup)
Dinner 07:00-08:00pm + Salad (1 serve) + 1/4th Fresh Lime

Food items to be limit

 Frozen foods
 Sodium and salts
 Soft drinks
 Pastries
 Red meat
 Alcohol
 Whole milk
 Saturated and trans fats
o Smoking and sedentary lifestyle should give up.
o Sleep deprived

GASTROINTESTINAL DISORDERS

Sometimes tummy trouble is something serious. These are disorders of the digestive
system, an extensive and complex system that breaks down food in order to absorb water
and extract nutrients, minerals and vitamins for the body’s use, while then removing
unabsorbed waste.

It comprises of these following vital organs:

 Mouth

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  Esophagus
 Stomach
 Small intestine
 Large intestine
 Rectum and anus
o GI tract also includes connected organ gallbladder, pancreas and the liver.

General symptoms of GI Disorders

Symptoms vary from person to person but common symptoms include:

 Abdominal discomfort (bloating, pain or cramps) 

 Unintentional weight loss

 Vomiting and nausea

 Acid reflux (heartburn) 

 Diarrhea, constipation (or sometimes both)

 Fecal incontinence

 Fatigue

 Loss of appetite

 Difficulty swallowing

Causes of GI disorders

Common causes of gastrointestinal disorders are included following:

 Low fiber diet

 Being stressed
 Not drinking enough water
 Eating a lot dairy product
 Inactive lifestyle
 Aging

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  Genetic factors

Most common gastrointestinal disorders

 Celiac Disease

 Irritable Bowel Syndrome (IBS)

 Lactose Intolerance

 Chronic Diarrhea

 Constipation

 Gastroesophageal Reflux Disease (GERD)

 Peptic Ulcer Disease

 Crohn’s Disease

 Gallstones

 Pancreatitis

CELIAC DISEASE

Celiac is caused by an autoimmune reaction to gluten - proteins found in grains such as

barley, rye, wheat, and their hybrids. When a person with celiac disease consumes gluten,
it triggers an immune reaction which destroys villi, small hair-like projections on the
lining of the small bowel.

When the villi are destroyed, the small intestine is unable to effectively absorb nutrients,
vitamins, and minerals from food. This results in malnutrition and can lead to many
serious health problems, including infertility, permanent damage to the small bowel, and
even the intestinal lymphoma.

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SYMPTOMS OF CELIAC DISEASE 

Symptoms in adults and children may vary. Common symptoms those are experienced by
adults as well as children are following:

 Aw-full smell in bowel

 Abdominal bloating
 Constipation
 Diarrhea
 Stomach pain
 Weight loss
 Vomiting

Celiac patients can have both digestive and non-intestinal  signs and symptoms. These are
symptoms that are outside of the intestines, symptoms like headaches, fatigue, joint pain,
iron-deficiency, skin rashes, hair loss, irregular menstruation, miscarriage, infertility, weak
bones, tooth discoloration and even seizures.

TREATMENT:

Celiac disease has no known cure. But the good news is that following a strict gluten-free
diet is in general very effective in reducing and often stopping these symptoms.
Multivitamin supplementation may help complement this lifelong gluten-free diet .

IRRITABLE BOWEL
SYNDROME (IBS)

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IBS is a group of gastrointestinal conditions in which one experiences a combination of
frequent abdominal pain, bloating and cramps associated with either diarrhea or
constipation. 

SYMPTOMS:

Its symptoms vary in duration and frequent from one person to another, can also occurs in
teenagers and even in children. Some people have mild symptoms while others have
substantial symptoms.

TREATMENT

Treatment options for IBS are included:

 Eating a diet with more fiber

 Avoiding stress, or learning ways to cope with stress

 Eliminating FODMAP from your diet. FODMAP stands for fermentable

oligosaccharides, disaccharides, monosaccharides, and polyols. FODMAPs are
carbohydrates found in many vegetables that are poorly absorbed in the intestine
and are prone to absorb water and ferment in the colon, causing symptoms. A low-
FODMAP diet should be undertaken with a dietitian or nutritionist. 

 Taking a probiotic for IBS

LACTOSE INTOLERANCE

Lactose intolerance is a disorder in which a person is unable to fully digest lactose, a

simple carbohydrate present in all mammals’ milk and in its derivatives. This is due to low
levels of an enzyme called lactase that is responsible for digesting lactose.

SYMPTOMS:

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Upon eating dairy, symptoms can range from mild to distressing. Symptoms of lactose
intolerance include diarrhea, gas, abdominal cramps and bloating .

TREATMENT:

Treatments for lactose intolerance include enzyme supplements to help break down
lactose, and replacing regular milk with lactose-free or dairy-free milk. It's important to
also identify the differences between lactose intolerance, milk allergy and dairy
sensitivity as part of your diagnosis and treatment.

CHRONIC DIARRHEA

Chronic diarrhea is a gastrointestinal condition in which the person passes watery, mushy
or loose stools that lasts more than 4 weeks.

TREATMENT

Best treatment option based on the underlying cause of diarrhea that has been identified. It
may include steroids, antibiotics, pain killers, immunosuppressants, antidiarrheal, and
other prescription medication. A specific diet and lifestyle changes may also help reduce
symptoms of chronic diarrhea.

CONSTIPATION

Constipation is a digestive condition in which the person experiences hard, dry and often
painful bowel movements, occurring less frequently than normal (generally fewer than
three bowel movements a week).

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TREATMENT:

constipation can be treated by:

 Increased fiber and water intake

 Frequent exercise (every day of the week is ideal)

 Not ignoring urges of bowel movements

If constipation persists, laxatives can be used as temporary relief.

MEALS FOOD ITEMS

Breakfast  2 slice brown bread + 1 boiled egg, 1 cup low fat
yogurt
(8:00-9:00am)
Mid-morning  1 medium cup fruit (berries, grapes, prunes)/ fresh
juice 1 glass
(10:00-11:00am)
Lunch  1.5 cup rice, chicken curry ½ cup, 1 cup salad

(1:00-2:00pm)
Snack time  2 wheat rusk, 1 cup tea

(4:00-5:00)
Dinner  2 tortillas, veg. curry ½ cup, 1 cup lentil soup

7:00-8:00
Bed-time  1 glass warm low-fat milk with psyllium husk

9:00pm

CROHN’S DISEASE

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 Crohn’s disease is a chronic inflammatory digestive disease that can affect any part of
the GI tract, from the mouth to the anus. It most commonly however involves the ileum
that becomes ulcerated and inflamed.

SYMPTOMS:

In the early stages of the condition, you may experience fever, weight loss, reduced
appetite, fatigue, bloody stools, abdominal cramps, and diarrhea. Potentially serious
symptoms appear much later. These can include: ulcers, skin inflammation, perianal
fistulas, and shortness of breath as a result of anemia.

TREATMENT:

Early screening and diagnosing can make a huge difference so you can start treatment. The
diagnostic process is run by gastroenterologists and involves endoscopies.

 Treatment can include:

 Medication: You may need to take medications such as antidiarrheal drugs, anti-
inflammatory drugs, immunomodulators, antibiotics, and biologics to block
inflammation.

 Change in diet: Although there aren’t generally any specific dietary restrictions
necessary, a diet with low impact on areas of the intestine that can be narrowed by
the inflammation is usually recommended. Also, other, more sophisticated changes
are likely to be advised by your doctor and dietician.

 Surgery: This is a last-resort treatment option if lifestyle changes and medications

don’t work. However, three-quarters of people with Crohn’s disease usually
undergo elective surgery at some point.

GERD 21
Gastroesophageal reflux disease (GERD) is defined as having symptoms of acid reflux
twice or more times a week. Acid reflux or heartburn occurs when stomach contents and
acids spill over into your Esophagus, causing a burning sensation and chest pain.

GERD usually manifests itself as a dry cough, discomfort in chest area, sore throat,
shallowing difficulties and sour taste in the back of mouth

TREATMENT

GERD can be treated by following

 Lifestyle changes: reduce obesity, avoid acid-stimulating foods (caffein, acidic

foods, red pepper, fried, tomato sauce), going to bed at least 2 hours after eating any
food.
 Taking over-the-counter antacids to treat heartburn
 Using H2 receptor blockers or proton pump inhibitors

If lifestyle changes and medication have not gotten rid of the symptoms, surgery to tighten
the stomach muscles may be necessary.

DIET PLAN

MEALS FOOD ITEMS

Breakfast  2 slice brown bread, 1 Slice low fat cheese, 1 boiled
egg, ½ cup low fat milk
(8:00-9:00am)

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 Mid-morning  Any fruit (avoid citrus fruit), 1 cup low fat yogurt

(11:00-
12:00pm)
Lunch  Tortilla, ½ cup salad (cabbage+ cucumber), fish
curry
(1:00-2:00pm)
Snack time  1 cup fresh juice, 1 cup boiled black grams

(4:00-5:00pm)
Dinner  1.5 cup brown rice, meat 5 oz, salad (1/2 cup), raita,
 And 1 glass low fat milk before bed time
(7:00-8:00pm)

PEPTIC ULCER DISEASE

Peptic Ulcer Disease (PUD) is a gastrointestinal condition, most commonly caused by an

infection by a microorganism called Helicobacter pylori, in which ulcers or open sores
develop in the inner lining of the stomach and duodenum.

The stomach lining is normally protected from corrosion by digestive juices by a thick
mucus layer. Peptic ulcers may occur when this protective layer is reduced.

RISK FACTORS

 Aging
 H.pylori
 Alcoholism
 Long term use of certain medication

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SYMPTOMS

Mild symptoms of PUD included:

 Acid reflux
 Vomiting or nausea
 Bloating
 Burning sensations in the upper abdomen

In a serious case of peptic ulcer disease, someone may experience

 Heavy vomiting
 Occasionally blood-tinged
 Severe pain in the upper abdomen
 Tarry-black stool (indicative of a bleeding ulcer)
 Weight loss

TREATMENT:

In addition to a healthful diet, prescription drugs are mandatory and can help treat most
peptic ulcers. 

GALLSTONES

These are small stone-like solids that form in the bile-storing gallbladder when there is a
high concentration of bilirubin and cholesterol. While they can cause no symptoms at all.

Gallstones may also cause pain in the

 Upper abdomen
 burping
 Dark urine

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  Nausea
 Clay-like stool.

TREATMENT

Depending on symptoms, surgery may be recommended to get rid of the gallstones.

Without the gallbladder, bile is not stored anymore in the gallbladder and thus it flows
straight from the liver into the small intestine. This won’t affect a normal digestive
function.

PANCREATITIS

 Inflammation of the pancreas is called pancreatitis. Pancreas is an organ that produces

digestive juices as well as hormones. It is the most common pancreatic disorder and a cause
of considerable morbidity.

CAUSES:

The main preventable causes of pancreatitis in adults are:

 Alcoholism

 Smoking cigarettes

 Obesity

 Abdominal injury

  Gallstones

 Cystic fibrosis

25
  Other rare genetic disorders

 Hypertriglyceridemia (very high triglycerides)

 Infections

SYMPTOMS:

Symptoms typically start suddenly. Mostly characterized by

 Abdominal pain
 Nausea
 Vomiting

It can cause some serious complications such as

 Diabetes
 Kidney failure
 necrotizing pancreatitis i.e., pancreatic cells dying
 Pseudocyst i.e., pockets of fluid in pancreas, that rapture

TREATMENT

Treatment must be carried out in hospital, and includes fasting, infusion of IV fluids, pain
medication and additional measures depending on the cause that has been identified.  

DIET PLAN

MEAL FOOD ITEMS

Breakfast  Tortilla 2 + veg. curry (1 small bowl) + 1 cup
curd

26
 (8:00-9:00am)
Mid-morning  1 medium size apple (unskinned)

(11:00-12:00pm)
Lunch  Khichdi- moong daal (1cup) + fried fish 1 piece
+ fresh salad ½ bowl
(1:00-2:00pm)
Snack time  Veg. sandwich 1 piece + 2 biscuits +1 cup tea/
fresh juice
(4:00-5:00pm)
Dinner  2 tortillas + carrot and beetroot curry +steamed
fish 1 piece + soup 1 cup
(7:00-8:00pm)

RENAL FAILURE

The kidneys are two bean-shaped organs, each about the

size of a fist. They are located just below the rib cage, one
on each side of the spine. Every day, the two kidneys filter
about 120 to 150 quarts of blood to produce about 1 to 2
quarts of urine, composed of wastes and extra fluid.
FUNCTION
 Extract waste from blood, balance body fluids, form urine,
and aid in other important functions of the body.

Some kidney diseases are following:

1) Nephrotic syndrome (due to gene)
2) Acute and chronic renal failure
(due to hypertension)
3) Hemodialysis (long term)
4) Peritoneal dialysis (short term)
5) Kidney stones

1) NEPHROTIC SYNDROME

“Nephrotic syndrome is a collection of symptoms due to kidney damage. This includes

protein in the urine, low blood albumin levels, high blood lipids, and significant swelling.”

27
Focal segmental glomerulosclerosis (FSGS) is the most common cause of Nephrotic
syndrome in adults. FSGS causes collapse and scarring of some glomeruli.
Symptoms:
 Severe swelling (edema), particularly around your eyes and in your ankles and feet.
 Foamy urine, which may be caused by excess protein in your urine.
 Weight gain due to excess fluid retention.
 Fatigue.
 Loss of appetite.

2) ACUTE & CHRONIC RENAL FAILURE

Kidney failure occurs when the kidneys lose their ability to function. To treat kidney failure
effectively, it is important to know whether kidney disease has developed suddenly (acute) or
over the long term (chronic). Many conditions, diseases, and medicines can create situations that
lead to acute and chronic kidney disease. Acute kidney injury, also called acute renal failure, is
more commonly reversible than chronic kidney failure.
Symptoms:
 Decreased urine output, although occasionally urine output remains normal
 Fluid retention, causing swelling in your legs, ankles or feet
 Drowsiness
 Shortness of breath
 Fatigue
 Confusion
 Nausea
 Seizures or coma in severe cases

3) HEMODIALYSIS

“Dialysis, is a process of purifying the blood of a person whose kidneys are not working
normally.”
“Hemodialysis is a process that uses a man-made membrane (dialyzer) to: Remove wastes,
such as urea, from the blood.”
Our blood is put through a filter outside your body, cleaned, and then returned to you. This is
done either at a dialysis facility or at home.
4) PERITONEAL DIALYSIS

 “In peritoneal dialysis, the patient's abdomen is filled with a special solution called dialysate
that helps remove waste and extra fluids from the blood.”
 Your blood is cleaned inside your body. A special fluid is put into your abdomen to absorb
waste from the blood that passes through small vessels in your abdominal cavity. The fluid is
then drained away.

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 5) KIDNEY STONES

“Kidney stones are hard deposits made of minerals and salts that form inside your
kidneys. Kidney stones have many causes and can affect any part of your urinary tract —
from your kidneys to your bladder.”
Symptoms:
 Severe pain in the side and back, below the ribs
 Pain that radiates to the lower abdomen and groin
 Pain that comes in waves and fluctuates in intensity
 Pain on urination
 Pink, red or brown urine
 Cloudy or foul-smelling urine
 Nausea and vomiting

Types of kidney stones are following:

i. Uric acid stones
ii. Oxalic acid stones
iii. Mixed stones

REQUIREMENTS

DISEASE PROTEIN POTASSIU PHOSPHAT SODIUM KCAL

M E
Nephrotic 1.2-1.5 g 4500mg 800mg 2900mg High
syndrome per Kg
Acute renal 0.6 g per Kg 4000mg 500mg 2500mg High
failure
Chronic renal 0.8 g per Kg 500mg 600mg 2000mg As per

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 failure Req
Hemodialysis 1.2-1.5 g 4500mg 800mg 2900mg High
per Kg
Peritoneal 1.0-1.2 g 4500mg 800mg 2900mg High
dialysis per Kg
Kidney stones 0.8 g per Kg ------- ------ ------ As per
Req

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 Diet Plan
Breakfast:
1 piece of bread, 2 eggs, 04 oz fluid
Snack Time:
2 banana

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Lunch:
Sandwich with 2 slices white bread, 1 cup grapes, 1 glass water
Snack time:
1 glass fresh juice
Dinner:
1 plate rice, 2 oz meat gravy, vegetable salad

Burn Injuries

Burn injuries are an under-appreciated trauma that can affect anyone, anytime and anywhere.

The injuries can be caused by friction, cold, heat, radiation, chemical or electric sources, but
the majority of burn injuries are caused by heat from hot liquids, solids or fire. Burn injury is
a complex traumatic event with various local and systemic
effects, affecting several organ systems beyond the skin. Burn trauma
represents a type of injury that can be caused by heat, freezing,
electricity, chemicals, radiation or friction. Burn injuries are highly variable
in terms of tissues affected, the severity and resultant complications.

Classification of burn:
Burns are classified as first-, second-, third-degree, or fourth-degree depending on how
deeply and severely they penetrate the skin’s surface.

 First-degree (superficial) burns. First-degree burns affect only the outer layer of
skin, the epidermis. The burn site is red, painful, dry, and with no blisters. Mild
sunburn is an example. Long-term tissue damage is rare and often consists of an
increase or decrease in the skin color.
 Second-degree (partial thickness) burns. Second-degree burns involve the
epidermis and part of the lower layer of skin, the dermis. The burn site looks red,
blistered, and may be swollen and painful.
 Third-degree (full thickness) burns. Third-degree burns destroy the epidermis and
dermis. They may go into the innermost layer of skin, the subcutaneous tissue. The
burn site may look white or blackened and charred.
 Fourth-degree burns. Fourth-degree burns go through both layers of the skin and
underlying tissue as well as deeper tissue, possibly involving muscle and bone. There
is no feeling in the area since the nerve endings are des

Causes

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Burns are caused by:
• Fire
• Hot liquid or steam
• Hot metal, glass or other objects
• Electrical currents
• Radiation, such as that from X-rays
• Sunlight or other sources of ultraviolet radiation, such as a tanning bed
• Chemicals such as strong acids, lye, paint thinner or gasoline
• Abuse

Complications

Complications of deep or widespread burns can include:

• Bacterial infection, which may lead to a bloodstream infection (sepsis)
• Fluid loss, including low blood volume (hypovolemia)
• Dangerously low body temperature (hypothermia)
• Breathing problems from the intake of hot air or smoke
• Scars or ridged areas caused by an overgrowth of scar tissue (keloids)
• Bone and joint problems, such as when scar tissue causes the shortening and
tightening of skin, muscles or tendons (contractures)

Stages of Recovery:

1- Shock period
2- Recovery period
3- Reconstruct period

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 Diet Plan
Breakfast:
1 slice of bread, 1 full eggs, 1 cup juice, 1 apple
Snack time:
2 glass of protein shake
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Lunch:
2 kabab, 1 rooti, 1 egg, 2 bananas, 1 glass mango juice
Snack time:
Tea, 2 piece steam fish
Dinner:
1 plate rice, 1 egg, half cup black cheery, 1 glass peach juice
Bed time:
1 glass of full cream milk

PCOS
“Ovaries not work properly and not secrete hormones in female’s due to which androgen
work increases as compared to estrogen.”
Due to PCOs after the age of 30-35 years fertility rate is zero in females.

Polycystic ovary syndrome

(PCOS) is a condition in which
the overies produce
an abnormal amount of androgen,
male sex hormone that usually
present in
women in small amount.
The name polycystic ovary syndrome describes the numerous small cuts ( fluid
filled sacs) that form in the ovaries. Polycystic ovary syndrome is the most
common cause of chronic an ovulation and an ovulatory infertility.
Clinical manifestations of PCOS
Menstural irregularities
Excess endrogen
Obesity
Hirsutisms
Oligomenorrhea
SIDE EFFECTS

 Loss of ability to carry baby

 Menstrual cycle disturb
 Acne issues
 Hair loss increases

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 Weight gain

Common Symptoms of PCOS

The most common PCOS symptoms are:
Irregular periods
Acne
Weight gain
Male pattern baldness
Darking of skin
Headaches
SOLUTION

 Increase physical activity

 Use foods that are high in Estrogen and low in Androgen
activity (Soyabean, plants based food have more estrogen while
animal based foods have high androgen)
 Lower the cholesterol level
 Restrict or less intake of junk food

PREVENTION

 Good dietary habits

 6-7 hours sleeping time
 Stop munching between meals
 Don’t eat in night
 Increase water intake
 Reduce smoking

Diet Plan:

PreBreakfast:
Ginger turmeric tea with lemon in it
Breakfast:
Muesli with 1 glass milk soaked in it/ corn flakes in 1 glass milk
Snack Time:
1 glass of lassi, 1 hand full of peanuts
Lunch:

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1 glass of water with 2 table spoon of apple sider vinegar in it, 1 plate
meat curry/ daal, 1 wheat flour rooti, 1 cup raw vegetable salad
Snack time:
1 cup tea/coffee, 2-3 low fat biscuits
Dinner:
1 plate vegetable pulao, 1 cup raita/ 1 plate khichdi (mix daal with rice
and chicken in it), raw vegetable salad
Bed time:
1 glass skim milk with 1 sachet psyllium husk in it.
NOTE: Drink at least 2.5-3 litre water with this diet plan.

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