<s>[INST] my grand mas report is as per follow:phalets low , swollen is found in temparal part of brain , in urine - urea is fluctuatin in between in 72 to 103 , creatinine is 2.8.are doctor says pencreas is nt workin and kidney is infected .blood sugar : 214.case history :she caried by-pass surgery in the year 2008.she is a patient of high blood pressure and  daibetes.please, advice what should done next? [/INST] Hi and welcome to Chat Doctor. As a specialist, i can understand your anxiety. Your grandmas condition is quite critical. She has multi organ involvement, with brain, kidneys,pancreas and heart being affected. Each of these organs function, has to be monitored closely.She'll need to be in an intensive care, with a ventilator facility and an intensivist ideally. Her blood routine, LFT,and electrolytes will need to be monitored closely. Along with mannitol infusion, shell need insulin and a broad spectrum antibiotic. Hemodialysis may be needed, if deterioration occurs. So, you can understand that treatment should be in a tertiary center. Chat Doctor.  Manga. </s>