Brief Answer:
Please take precautions and get regular tests done to prevent complications

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. There are many causes of liver showing fatty changes and slight enlargement as follows
(i) Increased intake of fatty foods and alcohol
(ii) Over weight and obese patients.
(iii) Those who have fatty liver running in family members.
(iv) Any liver condition that is changing appearance of liver.
(v) Mild fatty liver can also be there in many normal people

2. If you have a family history of obesity and are over weight then get your liver function tests and lipid profile done to see if your liver enzymes and cholesterol level are normal. If cholesterol is high then you might have to take a well balanced diet that is good for diabetes and hypertension.

3. For gastritis, please avoid eating spicy food and please have your meals on time. If you want to take spicy food then curds also should be taken. Also you should drink good amount of water and fresh juices. Please do not do fasting and take small meals regularly. Alcohol and smoking if present then must be reduced. Mental stress should also be controlled at all times.

4. Medicines are the following
(i) SUPERMET-XL contains metoprolol succinate for control of hypertension
(ii) TELVAS contains telmisartan for control of hypertension
(iii) Starr f Gp1 might be antidiabetic agent as GP1 indicates glimepiride combination for control of diabetes. Please reply with exact name of medicine to know accurate composition detail.

Please take your medicines on time. If you are taking metformin as a combination with glimepiride for diabetes then please take vitamin B 12 capsules as metformin can cause deficiency of Vitamin B 12.

5. The prostate is a potato shaped gland located at the base of urinary bladder in males and has helps in secretion of prostatic fluid which is required for reproductive function. After the age of 60 years the prostate gets enlarged in most men and can cause difficulty in passing urine and increased frequency of urination. At 23 cc the prostate is minimally enlarged and does not require treatment unless you are having significant urinary symptoms.

6. As you have diabetes and hypertension therefore it is important to get your eyes, kidneys and nerves examined annually as these are the systems that are affected in both diabetes and hypertension and there any early signs are to be evaluated to prevent complication.

7. To have a check of your sugar level please do glycosylated hemoglobin HbA1C levels done as this is a more accurate value and shows 3 months average of blood glucose and is more reliable.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Please do weight control if possible and add Vitamin B 12 supplement

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. Your medicines are in order and you please continue taking them.

2. I would suggest that you take a Vitamin B 12 supplement. Since you are a vegetarian, you can try and have more green leafy vegetables.

3. One point to take note is your weight since your BMI is 29 which is over weight. Please try to have a regular fitness schedule, however if you have obesity in your family then losing weight might be difficult for you.

4. The HbA1C is normal and there is no need to worry for blood sugar and hypertension control.

5. Your diet seems to be adequate and well balanced and there is no need to modify at present blood sugar and lipid levels.

6. Getting heart check done including echocardiography every year or once in 2 years is recommended. Regarding gastritis please follow suggestions discussed in previous reply.

7. Once you reach 55 years age then please get prostate ultrasound done and also get blood PSA level test.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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