80 years  old female pateint 
known to have dm for the last   20 years 
htn for the last       20 years 
dl d
pericardiatis    s/p pericardial effusion  at  7/10/2023 


  since   2011   1.6-  3 
she was  followed by dr naseem and  shoiki     1.6  -2.2 


today  she   dod the labs and shwoed  creatinien  3 

uric     4.5 trigleceride   136 
wbc   16     hgb  11  plt 107

medciation 
galvus   50 mg once daily   and  now  sitaglu 
liponil 40 mg once 
lasix  once daily 
alloril  100 mg once 
hba1c    6 
aspirin

plan 
add  calcium 
biosolve 
add   alfacal 

 one week   to repeat the creatinine   and then to send  it  to  me 
nifidelolg   30 mg   once daily