Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain as follows:

1. His cholesterol levels are above the normal ranges. The total cholesterol/HDL cholesterol ratio is above 5 in this case, which means that he has a slightly elevated cardiovascular risk related to dyslipidemia. This risk factor coupled with obezity, imposes a higher risk for possible cardio-vascular events (like stroke or myocardial infarction).

I would recommend performing some other tests :

- a resting ECG
- a Doppler ultrasound of the cervical vessels to examine the blood flow to the brain and investigate for possible athero-sclerotic plaques.
- some other blood lab tests (blood fasting glucose and HbA1C to investigate for diabetes, kidney and liver function tests, blood electrolytes).

I would recommend some lifestyle modifications :

- avoid saturated fatty acids (present in red meat and butter, etc.) and eat more food rich in omega 3 fatty acids like fish, fish oil, olive oil, wallnuts, etc.
- perform a lot of physical activity (walking, recreational sports, etc.)
- try to lose some pounds. You can consult his with a dietitian. Physical activity is also helpful for this purpose.

If his Total cholesterol /HDL ratio does not decrease below 4.5 after a month (with these lifestyle modifications), I would recommend starting a statin like simvastatin, etc..

Based on his cervical Doppler ultrasound (the possible vessel narrowing), he may need to start on anti platelet agents like aspirin 80mg.

2. Regarding his TIBS, it is slightly below the normal ranges, but it does not indicate any disorder, unless his Hemoglobin and red blood cells are within his normal ranges (above 11.5mg/dl for Hb and 4 million for RBC).

3. I would also recommend avoid smoking as it is a known risk factor for cardio-vascular disorders.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri

---

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again XXXX!

Regarding acidum acetylsalicylicum, it is called otherwise aspirin. When used in low doses (80-150mg daily), it has an anti-platelet effect, thus leading to possible prevention of cardiovascular events (stroke or myocardial infarction).

I suggested its use above. I would recommend continuing it if he can tolerate it (no gastritis or duodenal ulcer and no allergy reaction).

Regarding the wound on his lower leg, I would recommend consulting with a dermatologist or a infectious disease specialist. It is necessary a careful examination of the wound and some blood lab tests to find out the possible cause and choose the best treatment options. It may be a chronic infection.

Hope to have been helpful!

Feel free to ask any other questions whenever you need!

You can ask me directly at any time at my personal link:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Best wishes,

Dr. lliri

p.s.: You can rate my answer if you wish to.

---