male 34yrs age diabetic since 2yrs and report s are like this kindly evaluate Bilirubin is high

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Uncontrolled DM with Hyperbilirubinemia (may be drug induced or NASH). Stop secretagogues & start insulin. You can start UDCA & add some liver protective like RedlivDS or Liv52. Monitoring intermittently is of immense importance.

Uncontrolled DM with Hyperbilirubinemia (may be drug induced or NASH). Stop secretagogues & start insulin. You can start UDCA & add some liver protective like RedlivDS or Liv52. Monitoring intermittently is of immense importance.

Looking at reports i don't see any picture of uti as alb+and 4to6 pus cells are normal findings in a diabetic pt. If you are worried of alb+than do microalbuminurea or 24 hrs excretion of urinery alb. Hence i don't suggest any antibiotic. Next is serum bilirubin is high ie indirect is more than direct but urine is blank of BS /BP it looks to be hemolytic which may be due to malaria or any other reasons to be workout in detail. So far diabetes is concerned its uncontrolled and should be brought in controll with diet control change of life style and add insulin with desired oha which is to be decided after complete workout.

HE IS DIABETIC HE HAS RAISED INDIRECT BILIRUBIN MAY BE GILBIRT'S DISEASE ALT IS ALSO RAISED WHICH IS POSSIBLY DUE TO HEPATIC STEATOSIS COMMONLY ASSOCIATED WITH DIABETES H IS URINE PUS CELL IS HIGH ADV 1 USG UPPER A B D BLOOD HBs Ag HCV AB ASMA AMA FERRITIN CERULOPLASMIN 25 (OH ) D ,LIPIDS

Uncontrolled diabetes with uti First control sugar by giving insulin HAI then check grbs tid followed by tab metformin 500mg bed time.(od) Tab metformin 250 mg(before meal) Give diabetic diet to patient

1) Basant Kusumakar Ras 1 tab Suvarn Malini Basant Vrihat 1 tab Bahumutantak Ras 1 tab 2) Arogya vardhini vati 1 Yakrit Plihari Loh 1 tab 3) Jamun guthali, Gudmar patti, 100 gm each Kadujira, Guruvel, Chirayata, Kalonji, Asgandh, Kali tilli, Methi, Indrajo, Karela bij 50 gm. each Indrayan jad 25 gm Prepare the powder and take 1 tsf b.d.a.c. 4). Consult dietician.

Agree with Dr Nazia. Control DM first and inj ceftum 1gm bd. Pregabalin 75 od orally.

AND URINE C & S

You do a CH(complete hemogram), with RDW,AND RETICULOCYTE COUNT to see if some hemolysis is going or not...if not found most probably is a picture of liver function getting compromised due to NASH...add antidiabetis...(do not tell at curofy to advise on drugs as the dosage,amount and type of antidiabetics.will depend on the patient history and clinical conditions..)...you do one thing you add a basal insulin like glargine(0.1u/kg/bd.wt) alongwith the antidiabetic regimen that u should consult with some seniors on the dosage.. ...u better give him..FOSFOMYCIN (sachet monurol)-single dose...and than revevalute for UTI..DO A USG W/A to see NASH or possible ductal obstruction...if there is dilatation of cbd or some evidence of chronic/acute cholecystitis than add ursodiol.and take surgical advice(if needed)..meanwhile give him LIVERIL FORTE for his liver and focus mainly on control of his blood sugar...its not a one day picture...better educate him for a complete nutritional makeover...as the report itself tells that the person having this either is completely ignorant about his life or in the hands of a doctor who donot know his stuff....

It's indirect hyperbilirubinemia.since SGPT is raised find out whether he is alcoholic or has fatty liver.what is his Hb level.

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