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- 1. Family visit DEPARTMENT OFCOMMUNITY MEDICINE RAHUL SAH 18066 KRISHNA KUMAR SAH 18071
- 2. Family visit Nameof the locality : Kalika chowk, Bharatpur-10 District : Chitwan
- 3.
- 4. GENERAL INFORMATIONS Household number: 24819 Name of the head of the family : Dil Bahadur Magar Type of the family :nuclear family Religion: Hindu Caste : Baisya Family members: 2 Respondent: Dil Bahadur Magar
- 5. GENERAL INFORMATIONS Name Relation withthe head of the family Age/Sex Marital status Literacy Occupatio n Addiction Dil Bahadur Magar Head of the family 55/M Married upto high school Ex policeman None Man Maya Magar Wife 54/F Married upto grade 6 Homemak er None
- 6. Remarks • Covid vaccineincluding booster doses received • Head of the family is hypertensive since 2 year • Family members not present: • 2 Sons , 2 daughter inlaws, 2 grandsons , 1grand daughter
- 8. Income and expenditure Source of income House Rent: Rs 40,000 per month Per capital Income: Rs 20,000 per month
- 9. Income and expenditure Monthlyexpenditure House hold Food: Rs 10,000 Clothing: Rs 2,000 Medical: Rs 1,000 Social and religious functions: Rs 1,000 Education: none Dept payment : 10,000 Miscellaneous: Rs 15,000
- 10. Income and expenditure Their income meets the expenditure Dept - For house loan Savings: No saving
- 11. Kuppuswamy scale Educationof head of the family: High School Certificate – score 4 Occupation of the head of the family: unemployed – score 1 Monthly income of the family: Rs 40,000/- score – 10 Total score: 4+1+10=15 Family is lower middle class
- 13. Housing House :Pucca No. Of Rooms: 2 Per capita space: 120 sq. feet Physical Crowding : absent Sex Crowding: absent Built up area (sq.ft) : 1093 sq feet(6 dhur) Set back (sq.ft):270 sq feet Floor : pucca Roof :Cemented (Pucca) Height of ceiling: 9 feet
- 14. Housing Ventilation :Adequate Cross ventilation : Absent. Lighting : Adequate Kitchen : Separate Smoke Out lets : Present Water Supply : Sources for Drinking: municipal water supply For other purpose : municipal water supply Water treatment before drinking : Filter Refuse disposal : Municipality garbage truck
- 16. Housing Excreta disposal:Sanitary latrine Live stock / poultry : absent. Drainage present around the house : YES If yes : Adequate Insects Flies : Present Mosquitoes : Absent Bugs : absent. Rodent: Absent
- 18.
- 19. Food stuff ItemQuantity (gm) Calories (kcal) Protein Vit-A (μmg) Iron (mg) Vit-B (mg) Calcium (mg) Vit-C (mg) Cereals Rice wheat 300 250 1035 852.5 20.4 30.25 0 72.5 2.1 12.25 6.6 10.5 30 120 0 0 Pulse Lentils 125 433.75 3.25 156.25 7.875 4.375 112.5 0 Milk products Milk 1000 750 35 1700 2 4 1700 10 Egg/Meat/Fish Meat 200 236 42.8 0 0 0 24 0 Oil and fats Oil 100 900 0 2000 0 0 0 0 Green leafy vegetables Mustard leaves 250 85 10 6555 40.75 0.75 387.5 82.5 Root and tubers Potato 150 145.5 2.4 36 0.6 2.025 15 25.5 Fruits Banana Apple 150 250 174 59 1.8 0.2 117 0 0.45 0.66 0.945 0 25.5 10 10.5 1 Total 4670.7 146.1 10636.7 66.68 29.195 2424.5 119.5
- 20. Diet survey Totalprotein consumption: 146.1gm Total calorie consumption: 4670.75kcal Total consumption unit in the family: 1 + 0.8 = 1.8 Protein consumption/unit/day: 81.167 gm (adequate) Calorie consumption/unit/day: 2594.86 kcal (adequate)
- 21. Social aspect ofnutrition
- 22. Food adequacy Doyou have cultivable land :No Facilities for food purchased : Shop in the community Quantity of food purchased (approx): Rice / week: 2 kg Vegetable / week: 3 kg Dal /week: 750 gm Oil / week: 750 ml .
- 23. Cooking method Doyou clean rice and dal after purchasing ?: Yes Do you wash rice and dal ? : Yes Number of wash: 3 How do you wash vegetables – Before cutting . How do you cut vegetables ? Medium How do you cook vegetables ? Fry with oil Advice: - clean the rice only once or twice before cooking - Dont cut the vegetable into very small pieces -cook the vegetable by closing with the lid
- 25. Food storage Wheredo you store your food grains ? Kitchen What do you store it in? Plastic container Store of salt? Plastic container
- 26. Food safety Doyou keep the prepared foods covered ?: Yes Do you wash your hands before handing food ?: Yes Storage of cooked food : Safe Storage of uncooked food : Safe
- 27. Availability of Food Cereals: Produced as well as bought Pulses: Bought Vegetables: Bought Meat , Eggs: Bought Milk: Bought Is the milk available in adequate quantity : YES (Milk is available for drinking to all members)
- 28. Eating habits Frequencyper day: 4 Do you think some extra food during pregnancy / lactation is required ? YES If yes, why ? More nutrition is required for the pregnant and lactating women
- 29. Infant feeding andweaning knowledge How many hrs after delivery, breast feeding should be started? As soon as possible(1st hour) Do you think colostrum should be given ? Yes Do you know breastfeeding is important for child ? Yes Do you know about exclusive breastfeeding ? Yes How long should breast feeding be continued ? 2 years Frequency of breast feeding? 8-10 times per day
- 30. • Do youthink cleaning your breast before each feed is important? Yes • Do you think you should burp after each feed ? Yes • Do you know about weaning ? Yes • From which age weaning should be started ? 6 months What are the foods you consider suitable for weaning? Soft and mashed foods Whether breast feeding should be continued along with weaning ? Yes If Yes, how long ? 2 years Frequency of complimentary feeding? 1 time at beginning and increased gradually Do you know about the important of supplementary food ? Yes
- 31. Nutrition of pregnantand lactating women Do you know the important of increased food intake during pregnancy and lactation ? Yes What type of food do You Consider necessary? Nutritious food (Fruits, meat soups, eggs) Do you think that big size of the baby will create problem in delivery? Yes Did you think you should increase diet when became pregnant / after delivery ? Yes Do you have taboo for some food ?No Any particular social religious believes associated with eating practice? No
- 32. KNOWLEDGE ATTITUDE & PRACTICETOWARDS HEALTH
- 33. STUDY OF KNOWLEDGEATTITUDE & PRACTICE TOWARDS HEALTH Assessment of knowledge regarding causes of diseases. What do you think causes diseases? Unhygienic environment
- 34. ATTITUTE TOWARDS HEALTH Do you consider health as a valued asset : YES Do you believe that most of the diseases are preventable? YES Do you believe that most of the disease are curable ? YES Do you think any intervention required for recovery from diseases ? YES
- 35. HEALTH PRACTICES Do youpractice any preventive / promotive health care? Yes PERSONAL HYGIENE Do you take bath every day? Yes Do you keep your nails clean ? Yes Do you wash your hands with soap and water before taking food / after coming from toilet? Yes Do you brush your teeth every morning ? Yes
- 36. HEALTH PRACTICES IMMUNIZATION : Do you consider immunization is important for prevention of diseases? Yes Do you know the important of complete immunization ? Yes Are you children completely immunized? Yes
- 37. HEALTH PRACTICES ENVIRONMENTALSANITATION: Fromwhere do you collect drinking water? Municipal tap water Do you disinfect drinking water ? Yes Do you use sanitary latrine? Yes Where do you dispose off refuse? Yes (Municipal garbage truck)
- 38. HEALTH PRACTICES CARE DURINGILLNESSES : DIARRHOEA : Do you with draw food and water during diarrhea ? No Do you give more water during diarrhea ? Yes BREAST FEEDING / WEANING: Do you give colostrum? NO When do you start weaning? 6 months
- 39. HEALTH PRACTICES Wheredo you go for medical relief? Private hospitals Do you find any problem in seeking Medical Relief : No Attitude towards Govt. Health services : she was Not sure about govt. health services Have you ever met the local health worker : No.
- 40.
- 41. Name :Dil Bahadur Magar Age : 55 Sex : Male Locality : Urban District : Chitwan Zone : Bagmati Name of the Head of the Family :Dil Bahadur Magar Religion : Hindu Type of the Family : Nuclear Caste : Baisya
- 42. Economic aspectof the family i) Total income of the family : 40,000 ii) Per capita income of the family : 20,000 iii)Expenditure per month : a. Food : 10,000 b. Clothing : 2,000 c. Education : None d. Housing : None e. Medical care : 1,000 iv) Debt : Taken for house laon
- 43. Dietary habitof the family : Non–vegetarian Environmental Sanitation a. Housing : Pukka house b. Refuse disposal : Municipality vehicle c. Water supply: Municipality supply d. Drainage : Adequate e. Excreta disposal : Sanitary latrine f. Livestock & poultry: None
- 44. Chief complaints No anyfresh chief complains History of Present illness According to the patient he had no complaints right now but He was diagnosed with Hypertension 2 years back with the history of headache, blurring of vision for which he was given medicine but he took it for few months and left after having no any symptoms. 1 year back he had epigastric abdominal pain which was acute in onset , burning in character,non-radiating generally after few hours of eating and was not so severe to hamper his activities.He was daignosed with gastritis and is on medication .He had no history of nose bleeds, chest pain, fatigue, unusual sensation of heart beat, shortness of breath, facial flushing, dizziness, difficulty breathing during sleep, irregular heart beat, blood in urine, sweating and trouble sleeping.
- 45. History ofpast illness a. Illness in the childhood: None b. Other illness : Gastritis c. Chronic Illness : Hypertension d. Treatment availed: Antihypertensive drugs ( Not on medication since 1.5 years) Proton pump inhibitor ( Rabeprazole 20 mg once daily ) No history of Tuberculosis, COPD, Thyroid disorders and blood transfusion
- 46. Personal History : a)Non-smoker b) Non-drinker c) Bowel and bladder frequency are normal d) Appetite is normal e) Sleep is normal f) Diet is mixed
- 47. Patient’s brothersuffer from hypertension and diabetes. No family members has COPD, tuberculosis and thyroid disorders FAMILY HISTORY
- 48. Socio economichistory Lives in pukka house Education up to High school Home life is harmonious without disputes Relationship among family members is good There is good community support Education : High School Certificate – score 4 Occupation : Unemployed– score 1 Monthly income of the family: Rs 40,000/- score – 10 Total score: 4+1+10=15 Family is lower middle class
- 49. Drug andallergy history Drug Dose Indication Side effects Rabeprazole 20 mg Gastritis None • No history of allergic reaction
- 50. General Examination Vitals BP– 150/110 mm Hg Pulse- 80/minute RR – 18 times/minute Temp: 98.4 F (Right axilla) ̊
- 51. BMI Weight - 85kg Height - 5ft 6 inches ( 1.676 mt ) BMI - 85 = 30.35kg/m² (1.676)² The patient is OBESE
- 52. On examination Pallor: absent Icterus: absent Lymphadenopathy: absent Clubbing: absent Cyanosis: absent Oedema: absent Dehydration: absent
- 53. Cvs examination Pulse: 1. Rate: 80 2. Rhythm: Regular 3. Volume: Normal volume 4. Condition of the arterial wall: Normal 5. Comparison between two radial pulses: No radio radial delay 6. Other peripheral pulses: palpable
- 54. Examination of theheart precordium 1. Inspection Chest is symmetrical, Apical impulse not visible, No any visible scars, No engorged veins, No scar present, No peripheral impulse present 2. Palpation Apical impulse palpable 3. Auscultation S1, S2 heard No extra heart sound heard
- 55. ABDOMINAL EXAMINATION 1. Inspection Slightly distended abdomen, Globular in shape, umbilicus Central in position , no engorged veins vissible, no vissible scars, No vissible pulsations 2. Palpation Warm on palpation, No tenderness, No palpable mass, No hepatomegaly, Spleen not palpable 3. Percussion Tympanic percussion sound 4. Auscultation Bowel sound normal
- 56. Case summary 55 yearsold male with no apparent symptoms and no chief complaints has been suffering from chronic hypertension since 2 years and Gastritis since 1 year and is under medicationof only Gastritis. His vitals were as BP=150/110 mmHg, RR = 18/min , pulse rate= 80/min. On examination there was no specific findings.
- 57. Advice tothe patient Reduce the salt intake Reduce fatty food Have small and frequent meals Reduce weight Do regular exercise Go for regular health checkups Reduce stress
- 58.
Editor's Notes
- #1 Nabin kr mahato (18047) Deva sai ananth(18048)