48 yrs female pt came with c/o spots on eyes since 8 months.. No past h/o medical sick ness. Kindly gives diagnosis n treatment

A male patient aged 63 years known case of T2DM with HTN with polyneuropathy has been under treatment from another GP reported to me for check up. He has been taking - TAB GLUCONORM G3 twice daily Tab Ajaduo 25 OD Tab. Telma 40mg OD His sugars are very much controlled. First visit on 23/05/2020 Complaints - paresthesia foot soles especially while sleeping and pain calf muscles,increased frequency of urine esp. at night and Vitals and RBS are normal too. I asked him to take same medicines gluconorm g3 and ajaduo as written above. I added tab Pregabid NT at bedtime + Tab Rejunex OD once daily + Vit D3 60K weekly + Tab Ultracet SOS and Tab Telma H OD. Ordered a panel of investigations and USG KUB. Second visit on 26/05/2020 His paresthesia on foot soles has been resolved almost 80%, but still has pain in calf muscles. Results of the panel investigations and USG KUB are - TFT -Normal Uric Acid - 8.5 HbA1C - 6.9 % VIt D3 - WNL VIT B12 - MARKEDLY ELEVATED (Also gives history of 12 injections of Vit B12 given I/M in the past) Lipid Profile is deranged as attached. GRADE 1 Prostatomegaly on USG KUB. My concerns are - 1) Paresthesia - We have to give pregabalin and Nortriptyline along with methylcobalamin 1500mcg once daily. Can I give pregabid NT and Rejunex OD at bedtime? 2) Uric Acid - As it is asymptomatic, and he has been taking empagliflozin for a long time, which actually aid in uric acid removal thru urine, but his uric acid levels are elevated instead. Is it necessary to burden this patient with a dose of furic 40 daily? 3)Regarding lipid profile, can I prescribe him cap maxepa OD afternoon along with a dose of Rosuvas F 15 mins before dinner. 4) Regarding prostatomegaly, Urimax D at bedtime? 5) As his Vit D3 are WNL, monthly once Vit D3 60k supplementation. 5) What to do regarding his elevated Vit B12 levels???

59 year old known CKD-ESRD on Hemodialysis, During dialysis she developed Chest pain, Apprehension and sweatings. O/E Regularly irregular pulse, BP-160/90, Chest-clear. What kind of arrhythmia is this???

58 yrs old female hypertensive 8 yrs duration taking amlodipine 5, hypothyroid of 5 yrs taking 75 microgm, Dyslipidaemia of 5 yrs taking statin.She has no complaints and nondiabetic . ECG on routine shows following. No previous ecg.Now line of treatment?

Good evening dear friends and colleagues, Obesity is defined as BMI of more than 30 kg/m2 . There are 3 grades in obesity. Grade 1 obesity is 30 to 34.9 kg/m2 Grade2 obesity is 35 to 39.9 kg/m2. Grade 3 obesity is known as morbidly obese BMI of more than 40kg/m2. Obesity is increasing all over the world ,becoming a good harbour of several diseases like Diabetes Hypertension Dyslipidemia CAD CVA OSA Cholelithiasis Osteoarthritis Sometypes of cancers. So ,let's fight against obesity and prevent diseases. With regards, Dr Sepuri Tirumala Devi