Conversation: The conversation between human and AI assistant.
[|Human|] Case of ACLF (HEV + ? NASH), decompensated, mild to moderate ascites, renal dysfunction, no HE, T.BIl is 36.9, D. BIL is 22.4, SGOT is 283, SGPT is 139, HB is 6.7. Operated for prostae cancer around 7 years back and chemotheraphy done around 6 months back, Mild heart attack around 4 months back. please advice treatment
[|AI|]  Hi, You have mentioned three main issues, we will discuss it one by one. 1. For decompensated cirrhosis, I need to know regarding signs and symptoms of portal hypertension and whether the patient is already taking some treatment or not. If he ever experienced SBP or Hepatic encephalopathy? 2. What is the current status of his prostate cancer? Whether it is metastasized or not? What current treatment is he taking along with prior chemotherapy. 3. what do you mean by mild heart attack? I need to know the findings on his ECHO, whether he was advised coronary angiography or not? What sort of treatment is he taking? We need to adjust the treatment on priority basis according to the need of the patient. This has to be discussed with cardiology department for anti-platelets therapy. Beta-blockers are going to be beneficial for heart as well as to reduce his portal pressure. We have to consider treatment for his ascites with low sodium day and diuretics. If a high risk for SBP / HE we can give prophylaxis for SBP/HE as well. Hope I have answered your query. Let me know if I can assist you further.