Brief Answer:
Follow the Advises as below..

Detailed Answer:
Dear XXXXXXX Welcome Back to HCM..

Thanks for following up, yes I've reviewed all these reports..I'm listing all the advises as per the gravity of findings following :

1. Cardiac - this is indicative of the most important finding among all, i.e. Positive Stress test for Myocardial ischemia, means there is some element of blockage somewhere in the coronaries(the coronary arteries supplying oxygenated blood to your heart), most likely in the vessels supplying the Lateral and the inferior wall of the heart..

I'd advice you to schedule an appointment with an Interventional Cardiologist to plan and execution of coronary intervention(Coronary Angiography and proceed) to find out the culprit vessel/s, the percentage of blockage and management (interventional vs conservative, in your case most likely it'll be conservative only) accordingly..


2. Endocrine & Gastro- your BMI is suggestive of overweight along with prediabetes (with a high PPBS and HBA1C 5.8 in prediabetes range also), along with these, there's an element of Gr-II Fatty liver with elevated LDL in lipid profile..

So there's a need to consult with a Gastroenterologist along with an Endocrinologist for appropriate management and need for starting lipid lowering medications(statin group of drugs)

3. Lifestyle Modification- Complete abstinence from alcohol is immediately advised.. no occasional consumption also..in your health check-up it was mentioned that you consume ~100 units at a go, which is quite heavy causing enough damage to your liver(I'd rather contradict with the other fellow endocrinologist who diagnosed you as non-alcoholic fatty liver disease, because most probably he didn't see this check-up reports actually)..

The good news is this stage is still reversible so start a life free with alcohol and smoking..

Consult a dietitian at the same time for a comprehensive diet chart preparation which will not only help you to stay healthy but also will help to reduce weight also in the long run..

Swimming is not allowed now, no long duration running also..you can do simple free hand exercises at home till all the cardiac issue gets settled..

4. ENT - this was your actual complaint previously which led to all these investigations, however it's the least important one in the lot now..even though as rightly pointed out , the cause of your congestion,cough,shortness of breath is due to the Deviated nasal septum(DNS) along with the maxillary polyp only..

So after all those major issues get sorted out, just schedule an ENT visit to discuss with the ENT specialist regarding need for the corrective surgery (septoplasty vs SMR) for the DNS..

Seems like a lot of work for now, so my advice would be, just get admitted in the hospital(since you've got corporate check-ups in Apollo, so that's the first choice for convenience)..all these consultations as well as complete management will be taken care of within a matter of few days(2-3 days only), needless to say the management for future well-being also..

I hope I made myself clear explaining all the current health issues, let me know how you stay in the due course..

My Best Wishes..

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

Take Care
Kind Regards

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Brief Answer:
follow as already advised

Detailed Answer:
Dear XXXXXXX Welcome Back..

Now I've already gone through all of your other queries before answering this one, so I'd request you not to copy paste your other queries as the findings are quite apparent in this regard..YES REGARDLESS TO SAY THAT I'VE REVIEWED ALL OF YOUR HEALTH CHECK-UPs..

In other word, when you're seeking my guidance, stop copy pasting other replies and tell me clearly what is your doubt in your own language so that I can clarify them..

By the way, all you need to know is already mentioned in my previous reply, so I'd request you to kindly go back and read carefully and then only reply back for further guidance..

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

Take Care
Kind Regards

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Brief Answer:
100 ml is entirely different compared to 100 units of alcohol..

Detailed Answer:
Hello XXXXXXX Welcome Back,

No , 100 ml of alcohol 4 to 5 times a year, is hardly any amount , so if that's what you've consumed then definitely that's not the cause for your fatty liver..

But 100 ml and 100 units - entirely different calculation, get your data clarified first of all and know what is one unit per alcohol, I'd suggest you to go through this portal for further clarifications in this regards : http://drinkresponsibly.in/

However it's also been mentioned that your mother's also a diabetic, so genetical predisposition for diabetes, overweight, junk foods, alcohol abuse , smoking - all are the contributing factors for the fatty liver ..

However this is certainly not the most important factor now , so please concentrate on the most important & relevant features now and get well soon..

Let Me know how you stay in the due course..

My Best Wishes..

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

Take Care
Kind Regards

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