60  years old male pateint 
knonw to have    dm  for the last 20  years 
congestive heart failure 
open heart surgery    CABG   2017     at ramaallah 

medication 
insulin 
lantus    30  pm 
a[idra 20   and  10  before  each meal
sitaglu  50 mg 
lasix   40 mg ocne
spironm  100 mg once
betastin  16 mg 1x3
asa 100 mg ocne
famodinn
metformin  1x1
conconr  5 mg ocne
simavastatin 



presented for labs  check 
he  found to have   creatinine  0/4
urine analysis shwoed   plus  2  protein 
uric acid    4.3 
urea    28 
cholesteriol n  1 60 
wbc    7.4   hgb      15   plt     188

