ADD   DIOVAN AND STOP CODIOVAN 
ADD   VITAMIX  K2
ADD  J  DEE  

She found to have vitb12  deficeincy   a

Today 27/2  she came with abdominal pain 
Abdominal ultrasound was requested 
Showed hepatomegally

Plan 
I have asked for lab  test  for the hepatomegally
Add  scobutyle co 
Acamol
Add  norvasc
Add   b12   injections 
26

HER BLOOD   IS  HIGH
ADD  NORVASC
DO LABS 
POSSIBLE  REFERRAL FOR   DR  HANI 

she is complaing from back pain  and generlzed weakness 

labs showed 
urine analysis  showed  no  proteinuria 
tsh  3
pth   149 
esr  20
creatinine  1
uric  acid  9.8 \na  141 \k   4.2 \cl   104 \fbs 86
ldl   145 \


blood  pressure  reading showed 
120/80 ---   135/90 


plan
normal e xmaintion
impression

plan
add  probiotics
affflatnex  250 mg  2  x1 
rtc after  2  months   with uric acid and   kidney function test 

thanknsn
omega
d
alloril 100 
diovan    160 mgonce

plan
consider adding  crestor   after   3  months 


C/O LEFT  FLANK PAIN , HEADACHE .
CNS  :     NUMBNESS ON THE  HANDS 
CHEST     NO CHEST PAIN  SOB   ON EXERTION 
ABDOMEN  NO ABDOMINAL PAIN  NO DIARRHEA   OR CONSTIPATION 
JOINT :
