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What Do The Following Test Reports Suggest?

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Posted on Thu, 27 Aug 2015
Question: Respected sir,
I was diagnoised with Scliding hiatus hernia and
Mild Hepatomegaly with grade II farry infiltration.     
My blood tests are as follows
I feel pain in left side of chest and upper back and continuous dizziness and drowsiness.
TMT, echo, ecg etc all are normal.
Dear sir/madam,


My name is XXXXXXX XXXXXXX M, AGE 30 Years, Working in Insurance company (administration). I don't smoke, I don't drink and I don't have any other bad habits. I eat Non Veg sometimes.
I am married and I have one baby girl (TWO years of age). I don't have any tensions and stress in office and House. My office work is normal and no Heavy work. I am very calm and smooth going person.
My BP is 130/100 Some times and Normally it will be 130/90.
My pulse rate some times it will go to 110 Normally it is above 80 Very few times it will be under 80.
I don't have sugar.

Two years back exactly 20th August 2013, first time I got left side chest and left side upper back pain. And also left side shoulder and left hand pain. From then onwards I feel the same pain up to Today. I feel this pain 24 hours in a day. Some times very high and some times manageable. I have taken many pain killers and tablets but still I am suffering from this pain.
The pain will be some times very heavy and tightness in the chest and left side of the shoulder and upper back..
Some times I feel that some pin is pinching me in the upper back side of the shoulder and left side of the chest. I feel very uncomfortable through out the day.
I feel drowsiness and unsteadiness through out the day.
When I am walking or sitting or sleeping I feel that I am pulling down to ground and I feel extreme tiredness in my legs and pain in legs, At the same time feel air hunger and not able to breath comfortably.
With all this pains and drowsiness I am doing my routine work.

I went to many doctors and clinics and underwent almost all tests. All tests showing normal. But I feel that I am going to die and some major problem occurred to me.

Yesterday I.e I 04/08/2015 i underwent health check up. While I am doing Stress test, I felt very uncomfortable. I have to do walking up to 12 mnts but I did only 8 mnts . I stoped walking because, I got extreme tired XXXXXXX and completely dried through and I got breathing problem, I mean that I felt very uncomfortable while breathing..
For that 8 mnts the stress test is normal. Echo is normal and ECG also normal.

I am getting pain in neck also, but in dec 2013 I underwent mri cervical spine and it showed normal.
Now also I feel neck pain alon with all this.

I was diagnosed with Sliding hiatus hernia last month and I am taking pantacid tablet.
I underwent Appendicitis operation in November 2014.

I got very high triglycerides and abnormal lipid profile.

I m trying to go for walking and to do exercises, but I feel extreme tiredness, drowsiness, and feel abnormal heart rate and neck pain and leg weakness and some times I feel that heart beat has stopped with air hunger.

Kindly tell me how to get out from this pain and drowsiness and to become healthy. Kindly suggest tests if I have to undergo.

I am attaching the medical reports with dates for your perusal.


RECENT REPORT

parameter     result values     normal values
creatine     0..9 mg/dl     0.5-1.4
          
electrolytes          
sodium     134 mmol/L     135.0-150
potassium     3..5 mmol/L     3.5-5.5
chloride     98 mmol/L     98-107
          
fasting blood glucose     101 mg/dl     70-110
post parandial blood glucose     122 mg/dl     70-140
          
liver function test          
          
Total bilirubin     1.1. mg/dl     0.2-1.0
Direct bilirubin     0.3 mg/dl     < 0.3
Indirect bilirubin     0.8 mg/dl     0.2-0.7
SGOT     145 IU/L     < 35
SGPT     75 IU/l     < 40
Alkaline phosphatase     287 IU/L     108-306
Total protein     7.7 gm/dl     6.5-8.0
Albumin     3.8 gm/dl     3.5-5.0
globulin     3.9 gm/dl     2.3-3.5
A/G Ratio     1     1.0-2.0
          
LIPID Profile          
          
Total Cholesterol     186 mg/dl     Boarder line High : 200-239
          High : > 240
          Desirable < 200
Triglycerides     565 mg/dl     Desirable < 200
          Boarder line High : 200-239
          High : > 240
HDL      39 mg/dl     Low (high risk) : < 40
          High (Low risk) : >= 60
LDL     121 (D) mg/dl     optimal : < 100
          Near Optimal : 100-129
          Boarder line High : 130-159
          high : 160-189
          very high : >= 190
Total cholesterol/HDL ratio     4.8     3.5-4.4
LDL/HDL Ratio     3.1     1.8-3.0
          
Thyroid Profile          
          
T3 Total     1.3 ng/ml     0.62-1.65
T4 Total     6.7 ug/dl     4.4-11.0
TSH     4.2 uIU/ml     1.25-5.25
          
Microalbuminuria          
          
Specimen     spot urine     
urine albumin     NIL     
Urine volume     15     
micro albumin     07 mg/l     Normal < 30
          Microalbuminuria : 30-299
          Clinical albuminuria > 300
          
Haemogram          
          
Haemoglobin      13.9 g/dl     13.5 to 16.5
PCV     39%     37-53
MCV     81 fl     80-96
MCH     28 pg     27-32
MCHC     35%     30.-3.6
Total RBC count     4.88 Millions/cumm     40-60
          
Total & Differential count          
          
Total WBC count     6100 cells/cumm     4500-11000
Polymorphs     53%     40-75
Lymphocyteds     39%     22-45
Eosinophils     4%     1.0-6
Monocytes     4%     2.0-10
Basophils     0%     0-1
Platelet Count     2.25 Lakhs/cumm     1.5 -4
ESR     10 mm/hour     1-10.0
          
peripheral smear          
          
RBC     Normocytic Normochromic     
WBC     with in normal limits     
Platelet     Adequate     
          
HIV (TRI-DOT)          
HIV      Non Reactive     
HIV - I     Non Reactive     
HIV - II     Non Reactive     
          
HBSAG (Rapid)     Non Reactive     
Hepatitis C Virus (HCV Rapid)     Non Reactive     
          
Urine Complete Examination          
          
Colour     Pale yellow     
Appearance     Clear     
Volume     15.0 ml     
PH     6     <6.0
Reaction     Acidic     
Specific Gravity     1.01     1.01 - 1.025
          
Biochemical Examination          
          
Urine Albumin     Nil     
urine sugar     Nil     
Phosphates     Absent     
Nitrates     Negative     
bile salts     Negative     
bile pigments     Negative     
urine ketone bodies     Negative mmol/l     <0.5
urobilinogen     negative mg/dl     0.2 - 1.0
blood     Absent     
leukocytes Esterase     Negative     
          
Microscopic Examination          
          
RBC     NIL /hpf     
Pus cells     1-2 /hpf     
Epithelial Cells     1-2 /hpf     
casts     NIL     
crystals     NIL     
Bacteria     NIL     
Others     NIL     
          
*****************End of Report*******************          
          
          
          
USG ABDOMEN          
          
Liver is mild enlarged in size (16 Cm) andshows diffuse increased echotexture.          
There is no evidence of any focal lesion/IHBD          
          
Gall bladder distended. No e/o calculi/ wall thickening/ pericholecystic fluid collection seen.          
No e/o focal lesion          
          
CBU is not dilated. Portal Vein is normal          
          
Pancreas is normal in size and texture          
no obivious paraaortic lymphadenopathy          
          
spleen is normal in size (9.4) and echotexture          
          
right kidney measures 12.5 * 4.5 CM          
left kidney measures 11.8 * 5.4 cm          
both kidneys are normal in size and echotexture          
no e/o hydronephrosis there is no focal lesion seen          
CMD maimtained          
          
Urinary bladder is distended. No e/o calculi/diverticula/ wall thickening seen          
          
Prostate is normal in size (vol ; 19 cc and echotexture          
          
no evidence of dilated bowel loops          
there is no evidence of ascites          
no pleural effusion bilaterally          
          
IMPRESSION:          
          
Mild Hepatomegaly with grade II farry infiltration.          
          
          
*****************End of Report*******************          
doctor
Answered by Dr. Mukund Savaskar (1 hour later)
Brief Answer:
Left Chest pain with Hepatomegaly and Sliding Hernia.

Detailed Answer:
Provisional Diagnosis-Left Chest pain with Hepatomegaly and Sliding Hernia.
Hi,Dear.Thanks for the query to HCM virtual Clinic.
I studied your marathon and complex query for 30 mts almost.I understood your health concerns about the chest pain /sliding hernia etc.
In brief your main concerns are-
Left Chest Pain with back pain
Drowsiness and dizziness.
Dear, In my opinion you are a complex case with multiple issues and would need good long term treatment plan to be executed seriously.
You have obesity with Fatty liver and disturbed lipid profile along with it,which is causing all the problems you have in chest/back and the drowsy feeling.
Your case needs better management and treatment as soon as possible,as the things are definitely serious from the late medical examination reports.
Please update more info on the following-
Give detailed days schedule /
and daily food /eating plan
Office work and daily work hours.
Don't be nervous and don't ever think of death,as you are quiet young.
You have consulted many doctors with no relief to your problem.
Don't take painkillers on your own as it would complicate the matter.
I would review your case after I get your information soon.
I would help you out if you take it up seriously and start executing the protocols.
Welcome with further query in this regard to HCM by direct questions,as the subject is very laborious and would take many sessions for you to get the results.

All your problems could be sorted out in 3 mths time.
So take care and update me your information to me soon.
Hope this would calm you down and would help you to take care in time to come.
Write good review and hit thanks after reading this reply.
Have a Good day.Take Care.
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Specialist and Consultant in Non-Curable Diseases by Rejuvenation therapies.


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Mukund Savaskar (27 minutes later)
Respected sir,

I use to wake up at 6.30 or 7. I will play with my daughter up to 8 and I will take bath and break fast at 9.00 AM . Afternoon 1.30 pm I will take my lunch.
and evening 7.30 or 8 my dinner . and I will go to sleep round 10 pm.
My office hours is 10 AM to 6.00 PM . with half an hour break 1.30 to 2.00 PM.
food I use to take idly or dosa with chetney in the morning.
After noon I will take rice with curry and curd.
Night some times rice and some times chapathi. oil less.
at present I am taking leafy vegitables and fruits. once in a week I am taking nonveg like chicken.

I feel very uncomfortable in the middle of the chest and stomach sir.... with air hunger. some times sweating also ...
doctor
Answered by Dr. Mukund Savaskar (9 hours later)
Brief Answer:
Hypertension with Chest pain with Obesity induced Sliding hernia

Detailed Answer:
Diagnosis-1-Hypertension with Chest pain with Obesity induced Sliding hernia
2- with secondary Hepatomegaly from Fatty liver
Hi,Dear.Good Evening.Sorry for the late reply as I was busy in critical case.
Thanks for the updates on your daily Schedule.
In my opinion you should consult a Physician and plan your treatment for Hypertension induced Chest pain and air hunger
with simultaneous treatment for Obesity which has induced Sliding hernia in your case.
In the mean while contact me for further definitive treatment for 3 mths protocol to control chest discomfort and stomach discomfort.
I would suggest-
Diet Restrictions in volume and quantity , and restrictions strictly for oil/ and excess caloric intake x for 1 mth to start with.
Daily Brisk walk for 30 minutes.
Change your 3 times intake to 1 afternoon meal(1 Pm) with supports by liquid intake not after 7 pm.
Take anti-hypertensive medicines under instructions from Physician.
Reduce salt and tea intake for next 3 weeks.
Keep watch on BP records with your Physicians advise.
These important suggestions would reduce your weight and would reduce your sliding hernia over a time.
But this would need strict follow up by direct question to ME on HCM platform,every 2 weeks.
I would help you to guide and help you to come out of this complicated health issues.
Impression-
You are quite young with Normal TMT and reversible bio-chemical status of your body.
If you feel still worried about the chest pain and sweating, I would advise you to have ER Cardiologist,in case of any emergency of chest discomfort.
So don't worry for fear of death due to something serious in your body.
AS your case needs controlled medications I avoided to give specific drug plan for you.I tried to impress on you that Holistic approach would bring solution to your intricate problem ,as diagnosed here in above.
Welcome for any further query in this regard by direct query to Me.
Feel free to update more details to my mail id- YYYY@YYYY
Write good review and hit thanks after reading this reply.
Wishing you fast recovery.
With Regards,
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Consultant and Expert in Non-Curable -Diseases by Rejuvenative therapies.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3606 Questions

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What Do The Following Test Reports Suggest?

Brief Answer: Left Chest pain with Hepatomegaly and Sliding Hernia. Detailed Answer: Provisional Diagnosis-Left Chest pain with Hepatomegaly and Sliding Hernia. Hi,Dear.Thanks for the query to HCM virtual Clinic. I studied your marathon and complex query for 30 mts almost.I understood your health concerns about the chest pain /sliding hernia etc. In brief your main concerns are- Left Chest Pain with back pain Drowsiness and dizziness. Dear, In my opinion you are a complex case with multiple issues and would need good long term treatment plan to be executed seriously. You have obesity with Fatty liver and disturbed lipid profile along with it,which is causing all the problems you have in chest/back and the drowsy feeling. Your case needs better management and treatment as soon as possible,as the things are definitely serious from the late medical examination reports. Please update more info on the following- Give detailed days schedule / and daily food /eating plan Office work and daily work hours. Don't be nervous and don't ever think of death,as you are quiet young. You have consulted many doctors with no relief to your problem. Don't take painkillers on your own as it would complicate the matter. I would review your case after I get your information soon. I would help you out if you take it up seriously and start executing the protocols. Welcome with further query in this regard to HCM by direct questions,as the subject is very laborious and would take many sessions for you to get the results. All your problems could be sorted out in 3 mths time. So take care and update me your information to me soon. Hope this would calm you down and would help you to take care in time to come. Write good review and hit thanks after reading this reply. Have a Good day.Take Care. Dr.Savaskar M.N. M.S.Genl-CVTS XXXXXXX Specialist and Consultant in Non-Curable Diseases by Rejuvenation therapies.