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Suggest Treatment For Weakness And Stomach Issues

Posted on Wed, 26 Oct 2016

Question: Since 2 weeks I had .Weakness, stomach upset but not loose motion, intense nausea. Headache. Fever only two days 1o2 then low grade. Today randomly tested blood for various tests. cbc esr is normal and platelets too. Other tests are Sgot 74, Sgpt 90. Typhii o is 1:80 and typhii H is 1:160. Should I test for Mantoux or Ultrasound. What is suggestive. At present it's only fatigue and nausea.

Answered by Dr. Tushar Kanti Biswas (5 hours later)

Brief Answer:
Fever (investigation)

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

You had high fever to start with-subsequently low grade along with nausea and fatigue. Your SGOT (74 iu/L) and SGPT (90 iu/L) levels are elevated . Go for MP (Malaria parasite),RMA(Rapid Malaria Antigen) and Dengue NS1 Antigen,IgM & IgG. Widal test can be false positive.

Alternatively it could also be acute viral hepatitis. You have not mentioned serum bilirubin level. In view of elevated SGOT & SGPT levels ultrasonography(USG) of Abdomen is indicated. Platelet and PCV(hematocrit) can be repeated after 3 days.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Tushar Kanti Biswas (25 minutes later)

Sir my serum bilirubin is 0.8 and bilirubin direct is 0.1. last night also I went twice to bathroom. Bulky slight loose stool. After motion for few mins infeel buring sensation then normal. But after toilet sever calf Cramp and leg pain so couldn't lie down n sleep. Due to nausea I had to sit upright and sleep

Answered by Dr. Tushar Kanti Biswas (8 minutes later)

Brief Answer:
Fever (investigation)

Detailed Answer:
Symptoms of leg pain and calf cramp are non-specific. Calf cramps may be due to electrolyte imbalance. Take 2 spoonfuls of Oral re-hydration solution(ORS) in a glass of water every 6 hourly if you continue to have loose stool , till it normalizes. Monsoon related illness needs to be ruled out first and go through the investigation as already advised and let me know.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Tushar Kanti Biswas (5 hours later)

I just return from physician. She found its difficult to correlate my cbc with sgot and sgot.and widal. She thinks its viral.hepatia or food infection. Asked me to get blood culture, Weil XXXXXXX tc, dc, lft, urine culture and Usg abd. Usg report came on spot I have a fibroid in utreus rest all spleenliver normal. Rest culture report will come on three days.

Answered by Dr. Tushar Kanti Biswas (4 hours later)

Brief Answer:
Fever (investigation)

Detailed Answer:
It is better to follow the advise of your treating physician as she has examined you also.Acute viral hepatitis would have increased your serum bilirubin also and Urine will show bile salt and bile pigment positive.Urine routine examination might have been done as you are female patient.Typhoid fever can be associated with moderately
elevated values in liver function tests.Rest of the investigation reports as available may clinch the diagnosis.
Most likely you are already on some antibiotic advised by your physician.
Regards

Dr. T.K. Biswas M.D. XXXXXXX

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Above answer was peer-reviewed by : Dr. Nagamani Ng