Lowe urinary tract infection ....

60 year diabetic male history of CAD , prostomegaly Complaint of hematuria for 4 days Similar type of problem occurred 1 year back On oral anti diabetic drug Metformin ,glimipride,Canagliflozin 100 Dytor plus ,met xl 25,carvidon Mr,, ecosprin gold ,flodart plus.... BP 136/76 Pulse 83 Please suggest management

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Primarily he looks to be a c/o LUTS Perusal of reports suggest Prostatomegaly with hematuria needs to adv PSA and r/o prostatitis or malignancy of prostate Secondaly glycosuria with raised sr creatinine suggest early Diabetic kidney disease as albuminurea is sugnificant Pt has multiple comorbidies Needs good control of diabetes Better to place on vildagliptin +canagliflizone TLC mild leucocytosis Rx tab Cefuroxime500mg bd Review continuation of ecosprin

Thank you doctor
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Better control of diabetes, do a bt,ct,pt,aptt.Stop ecospirin. Do a urine c/s, Can give him vitc 500mg aid Confirm the drugs for BEP. Better to start dutasteride 0.5mg od. Also do a Uroflowetry and a psa.

? DIABETES WITH.. PROSTATE PATHOLOGY.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. USG..ABDOMEN.. EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..

SUGGESTIVE. OF DIABETIC NEPHROPATHY WITH CHRONIC KIDNEY. DISEASE

Hematuria in this case can be due to ( though urinalysis does not show RBCs) 1) Diabetic with nephropathy ,CKD 2) On treatment for BPH 3 ) On double platelets for CAD 3) Stones in urinary tract . Suggest Withold antiplatelets temporarily . PSA estimation and check abdominal ultrasound and residual urine , stones

You should have to go for PSA with USG of KUB for Malignancy & cystoscopy if there is any urethral injury

See for usg pel abdo See for pt inr with aptt N treat accordingly

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