Severe weakness

Male patient of age 45 Chief Complaints Weakness Not feeling energy in body Kabhi kabhi bohot gas banta hai Sidhi chadta hu to thakk jata hu Kuch kaam krne mei mnn nhi lagta History Suffering from this since months Occupation history painter Vitals Five days BP record Day1)Bp:90/60 Day2) Bp: 100/50 3) BP: 110/60 4)BP: 80/50 5)Bp:100;60 Pulse:70 Temp: Afebrile Spo२:97 Physical Examination Pallor+ Anemic+ App: Low Sleep: Normal Stool:Normal Bladder:Normal Investigations Cbc Hb11.8 Esr:20 Platelets:110 Lft and kft within normal limits Diagnosis General debility?? Management Current Treatment taking since two weeks Tab:Pan 40 one bbf Tab:Atoz one od Syrup ulgel sos

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From history i guess it is a c/o depression and nothing else So far low platelets are acceptable Hb is borderline Yes TFT and bsl f&pp should be done Overall treat psychologically Counseling Good nourishing diet Daily exercises Mild doses of tranquillisers Review after one month

Thanx dr Pushkar ji Bhomia
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? ANEMIA .. WITH .. THROMBOCYTOPENIA .. WITH .. ASSOCIATED .. SYMPTOMATIC T/T WITH CLINICAL CORRELATION .. MULTIVITAMINS ANTIOXIDANTS .. HORMONAL STUDY.. BSR..HBA1C..

Drugs history is most important... Alcohol, nicotine Other occupation history... painter so have chemical reactions. Low blood pressure... anemia... fatigue are connected to poor lifestyles with nutrition and also associated to cardiac problem, stroke related problems, vitamin B12, Liver function with echo , ECG, MRI are required. With spinal cord related problems rule out. Poor appetite to do relatives psychological impact. Poor absorption to do secondary infection as like tuberculosis, Typhoid, chronic gastritis.

Needs evaluation for Anaemia. Depression with Somatic symptoms can be one of the cause of fatiguability and lethargy. It is essential to rule out all possible causes for presenting Symptoms. Starting with antidepressants i.e Duloxetine Would help.

Anemia Thrombocytopenia ? Cardiac disease ad 2 DECHO R/O COVID By RT PCR

Anemia. Thrombocytopenia. Ad. Anemia profile. Hormonal study.

Adv bone marrow study Iron profile Hb electrophoresis

Do his FBSL, PPBSL, Lipids., Thyroid tests Inj. Neurobion 5 doses Tab calcium 500 mg od

Hypothyroidism

Adv HbA1c Iron profile Now start with Multivitamina and antioxidants

Hb1ac normal
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