69    years old female patient   known to have  dm  for the last   15  years    hypertneison for the last   15  years    dld   for the alst  10 years    gout     for the last   5  years 
no ischemic  ehart disease 
hyperthyroidisim      then  hypothyrodisim  

medication 

lozar     50 mg  1x1 
insulin     mixtard   
carvidelol  12.5mg  1x1 
liponil  40 mg one 

she is planning   to fast   ramadan 
plan 
add  valsan  160 mg cone 
add  j  dee 
carivdelol 12,5  gm 1x2 
to do abdominal us  and    esr   calcium  urine  pcr 
cosnider adding  forxiga  after  ra madan 



labs showed   
hgb    12.4       wbc       7,2    plt      275
urine analysis showed     no rptoein and she has   plus  3 leucocyte snd a many  wbc 
a1c    8.6 
fs7bs   172 
creatinien  2.1 
bun  45
uric     acid 5.1
cholesterol  178  trigleceride    203
ast    17
na     143      k  5,2     tsh    15
