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On medication for BP and depression. Health check up done. Suggest some best medical treatment ?

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Practicing since : 1981
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my mother has got the annual health checkup and in the skiagram chest view its shown clacified opacity in the right mid zone.PP Blood sugar=182 and S.CHOLESTROL=201 and LDL Chloestrol=138and in microscopic stool examination it shows Entamoebic hystolitica -cyst(Few) and ESR is also high.2 months back she had the uterus operation and she also has blood pressure so she is eating medicines for blood pressure and depression..i want to make my mother fully fit so please suggest me best medical treatment for her..thank you
Posted Tue, 7 Aug 2012 in Depression
Answered by Dr. Anil Grover 32 minutes later
Thanks for writing in.
I am qualified and certified cardiologist, I read your question with diligence.
She has following problems (provisional list):
1. Hypertension (how much, what medicines)
2. High Cholesterol (other lipid fractions like HDL and triglycerides)
3. Pulmonary Tuberculosis to be excluded for activity (Mountoux, History?)
4. Cysts for Entamoeba Histolytica (no ova seen)
5. Secondary Depression (symptoms, treatment)
6. Mild Microcytic Anemia (Her menstrual history, nutritional history, vegetarian?)
7. Abnormal Liver Function Tests and fatty liver on ultrasound
8. High PP sugar (Fasting Blood Sugar not known)

WWW.WWWW.WW is not permitted to prescribe prescription medicines but we can suggest changes in medication for the local doctor for medicines. Therefore, please let us know her height and weight, fasting blood sugar, HbA1C (if you are going to get done Fasting Blood Sugar tomorrow morning then get this done) your question shall remain active and in followup you can provide the information which is necessary. And the list of medications she is taking if not taking we will suggest but prescription you will have to get from the local doctor. Do not worry she is having normal life style illnesses which are easily treatable with medicines and life style changes. If you can get an EKG done and send us the report. A radiological report of x-ray about presence or cavities or such lesions will be useful. Are you sure you have not missed in describing her symptoms what she complains of (apart from indigestion and depression like does she have fever or cough or both). We have seen your attachments and so please do not repeat what you have already sent as you can see a provisional list of diagnoses has already been made.
Looking forward to hear from you.
With Best Wishes

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
Follow-up: On medication for BP and depression. Health check up done. Suggest some best medical treatment ? 43 hours later
Yea her weight is 69kg and her height is 5 feet 3 inch..she does not have any cough problem and neither fever..fasting blood sugar=78 as in reports..she is currently eating biduret for blood pressure(changed from aginal AT by doctor) and mirnite 7.5 for depression..we had also consulted a general plhysician and he had seen the reports and told her to add three medicines namely..amiciline,liv 52,and udiliv tablets..he also told for pentab D in case of more gastic problem..we haven't yet got the EKG or ECG beacuse the doctor told its normal nothin to worry seeing the reports...he told her for diet control and nothin more..But if u still think we shuld have her ECG or EKG we would have it done..and also told for getting blood sugar tested after 15 days again to check it..she is taking sugar free tablets...she was also eating calcium tablet as it was told by gynacologist after she had uterus plzz tell me whether she should continue eating calcium tablet or not..and also sugesst changes in medicines if needed and also what diet she should follow after dis..
Answered by Dr. Anil Grover 39 minutes later
I expected answers to all my questions. But no positive answers to some of my questions excludes amoebiasis, pulmonary tuberculosis, anemai from the list but cholesterol value I still do not know. I am not sure diabetes has been excluded as conclusively as needed, a repeat fasting blood sugar and glycalated hemoglobin HbA1C which I had mentioned in my first mail will do that.

Well her problem is one and in fact only problem with long term consequences is she is overweight and sedentary (She has Body Mass Index of 26.9 with the height and weight provided by you ideally it should be less than 24), this is the cause of hypertension and depression. It is good to know that her EKG is normal for it may lead to coronary artery disease.

At any age, following is the list of risk factors for future development of Coronary Artery Disease. Let me enumerate and you can place yourself the risk you are carrying ('*' means you have the risk factor, '+/-' means I do not know and about others you know better):-

Diabetes -
Obesity and Sedentary Life Style*
High Bad Cholesterol and Lipid Component +/-
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*

From the list, above you have some risk factors. Smoking, Obesity and possible sedentary life style you have identified. Therefore, I will strongly recommend consulting your doctor; he may complete the list as well do the EKG which may tell us the cause of pain.
It is never too late to change. With your weight everything you do will have to be under supervision. It need not be cardiologist but your primary doctor can guide your way back to health - I am happy to read that. You may need drugs and he/she (or ask the dietitian) to advise you about diet low in calories and cholesterol, advise you on quantum of exercise. You ought to keep your weight under control for you do not want other attack. If you like non vegetarian you cannot take red meat but there is no bar (in taking certainly quantity had to be less) on egg white, roasted chicken and roasted fish.
I do not see any rationale of antidepressive drugs request her doctor to wean her off this drug (I could not find in Allopathic drugs available in India), neither I find the need for Liv 52. She can take calcium because of her age. Usually a balanced diet contains all the nutrients one needs and she does not have liver disease. Secondly, she ought to go for long brisk walks to start with she can walk at her normal speed level walk for 40 minutes a day every day of the week. The ultimate aim is to increase it to at the speed of 5/km per hour level walk for forty minutes a day. That will take care of her depression.

Hope you found something useful in this answer. If you have any follow-up query I shall be happy to answer.


Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
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