A 62-year-old man has bleeding from the nose, most of the time blood is noted in the morning while sneezing nose or clearing throat. Past History:- has type 2 diabetes for the last 23 years. Hypertension for the last 18 years. Non Alcoholic cirrhosis for the last 10 years. Has undergone CABG with femoral vein grafting 3 years earlier. Lab tests:- Hb 8.8 gms, red cell count decreased, platelets 82,000/ microlitre, ESR 58 mm in the first hour.
LFT, KFT, Thyroid profile, AFP from blood, Prostatic antigen in the normal range. Lipid profile deranged. Past treatment: Cauterization was done in the left nostril, as the raw area was there which was bleeding. Drug Therapy :- Metformin 2.7 gms, glimepiride 8mg, vildagliptin 100mg, Telmisartan 80 mg, metoprolol 100SR, isosorbide dinitrate DR 30, Aspirin dose reduced by a cardiac surgeon from 150 to 75 mg. Kindly advise management.
