Hi XXXXXXX,

Thanks for sending me the report.

I am glad that the liver function test report is normal. All the findings are within the normal range. It is a sign of relief.

Now, my further suggestions for your brother:

1. Get his serum alpha feto protein levels checked.

2. He needs to be vaccinated against Hepatitis B and A, if it is not done until now.

3. You might probably get an MRI of the liver done to look at the actual architecture of the liver.

4. An upper gastrointestinal endoscopy will help in identifying any esophageal varices.

5. Get him operated at the earliest for the ureteric stone to prevent damage to the kidneys.

Dietary and lifestyle changes:

1. Complete abstinence from alcohol of all types.

2. Avoid high fat content foods.

3. Avoid any herbal medicines or drugs that can damage the liver like NSAIDs (Paracetamol).

4. Plenty of fluids orally up to 5 L per day. Limejuice will help in prevention of further stone formation.

Although his liver is contracted, the functioning capacity of the kidney is absolutely normal as suggested by the liver function test values.

He should gradually improve with the above measures.

Do let me know if you have more concerns.

Regards,

---