Categories
Diagnonistic Test

Urinalysis

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Definition :
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds that pass through the urine.

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It is a routine examination of the urine for cells, tiny structures, bacteria, and chemicals that suggest various illnesses. A urine culture attempts to grow large numbers of bacteria from a urine sample to diagnose a bacterial urine infection.


How the Test is Performed

A urine sample is needed. Your health care provider will tell you what type of urine sample is needed. For information on how to collect a urine sample, see:

*24-hour urine collection
*Clean catch urine specimen

There are three basic steps to a complete urinalysis:

1. Physical color and appearance:

*What does the urine look like to the naked eye?
*Is it clear or cloudy?
*Is it pale or dark yellow or another color?

The urine specific gravity test reveals how concentrated or dilute the urine is.

2.Microscopic appearance:

The urine sample is examined under a microscope. This is done to look at cells, urine crystals, mucus, and other substances, and to identify any bacteria or other microorganisms that might be present.

3,Chemical appearance:

A special stick (“dipstick”) tests for various substances in the urine. The stick contains little pads of chemicals that change color when they come in contact with the substances of interest.

Click to See : Urine chemistry

How to Prepare for the Test:
For a regular urinalysis, you are asked to urinate briefly into a plastic cup. When urine is collected for a urine culture, you must provide a “clean catch” sample – one that is not contaminated by skin cells and skin bacteria. This is so the doctor can obtain a sample of urine from inside your bladder, where normally there should be no bacteria. In contrast, there are many bacteria on the skin of a penis or in a vagina. The trick (harder for a woman than a man) is to pee directly into a sterile container without having the stream of urine first touch your skin or the nonsterile tissues of the vagina.

To collect a clean catch sample, you are given a sterile plastic container and asked to wipe off the area around your urethra (where urine exits) with an antiseptic cloth. For women, it’s also helpful to hold the two labia (outer walls) of the vagina apart with one hand when you urinate, so that the stream of urine passes directly into the sterile container. Since the first flow of urine is most likely to be contaminated by bacteria from around the opening of the urethra, first urinate for a moment into the toilet and then use the cup to collect the “middle” portion of your urine stream.

Certain medicines change the color of urine, but this is not a sign of disease. Your doctor may tell you to stop taking any medicines that can affect test results.

Medicines that can change your urine color include:

*Chloroquine
*Iron supplements
*Levodopa
*Nitrofurantoin
*Phenazopyridine
*Phenothiazines
*Phenytoin
*Riboflavin
*Triamterene

Why the Test is Performed :-

A urinalysis may be done:

As part of a routine medical exam to screen for early signs of disease
If you have signs of diabetes or kidney disease, or to monitor you if you are being treated for these conditions
To check for blood in the urine
To diagnose a urinary tract infection
Additional conditions under which the test may be performed:

*Acute bilateral obstructive uropathy
*Acute nephritic syndrome
*Acute tubular necrosis
*Acute unilateral obstructive uropathy
*Alkalosis
*Alport syndrome
*Analgesic nephropathy
*Anorexia nervosa
*Atheroembolic renal disease
*Atrial myxoma
*Bladder stones
*Chronic bilateral obstructive uropathy
*Chronic glomerulonephritis
*Chronic or recurrent urinary tract infection
*Chronic renal failure
*Chronic unilateral obstructive uropathy
*Chronic urethritis
*Complicated UTI (pyelonephritis)
*Congenital nephrotic syndrome
*Cystinuria
*Delirium
*Dementia
*Dementia due to metabolic causes
*Diabetes insipidus — central
*Diabetic nephropathy/sclerosis
*Enuresis
*Epididymitis
*Failure to thrive
*Focal segmental glomerulosclerosis
*Goodpasture’s syndrome
*Heart failure
*Hemolytic-uremic syndrome (HUS)
*Henoch-Schonlein purpura
*Insulin-dependent diabetes (IDD)
*IgA nephropathy (Berger’s disease)
*Injury of the kidney and ureter
*Interstitial nephritis
*Irritable bladder
*Left-sided heart failure
*Lupus nephritis
*Malignant hypertension (arteriolar nephrosclerosis)
*Medullary cystic kidney disease
*Membranoproliferative GN I
*Membranoproliferative GN II
*Membranous nephropathy
*Myelomeningocele (children)
*Necrotizing vasculitis
*Nephrotic syndrome
*Noninsulin-dependent diabetes (NIDD)
*Orchitis
*Ovarian cancer
*Paroxysmal nocturnal hemoglobinuria (PNH)
*Polycystic kidney disease
*Post-streptococcal GN
*Prerenal azotemia
*Primary amyloid
*Prostate cancer
*Prostatitis, acute
*Prostatitis, chronic
*Prostatitis, non-bacterial
*Pyelonephritis; acute
*Rapidly progressive (crescentic) glomerulonephritis
*Reflux nephropathy
*Renal papillary necrosis
*Renal tubular acidosis; distal
*Renal tubular acidosis; proximal
*Renal vein thrombosis
*Retrograde ejaculation
*Rhabdomyolysis
*Right-sided heart failure
*Secondary systemic amyloid
*Stress incontinence
*Systemic lupus erythematosus
*Systemic sclerosis (scleroderma)
*Thrombotic thrombocytopenic purpura
*Traumatic injury of the bladder and urethra
*Ureterocele
*Urethral stricture
*Urethritis
*Wegener’s granulomatosis
*Wilms’ tumor

RESULTS:

Normal Results
Normal urine may vary in color from almost colorless to dark yellow. Some foods (like beets and blackberries) may turn the urine a red color.

Usually, glucose, ketones, protein, bilirubin, are not detectable in urine. The following are not normally found in urine:

*Hemoglobin
*Nitrites
*Red blood cells
*White blood cells
Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean
For specific results, see the individual test article:

*Bilirubin – urine
*Glucose – urine
*Protein – urine
*Red blood cells in urine test
*Urine ketones
*Urine pH
*Urine protein
*Urine specific gravity

How long is it before the result of the test is known?
Your doctor might be able to do a urinalysis in his or her office and can give you the results within 10-15 minutes. If the urine is sent to a separate laboratory, it usually takes several hours to get results, so you may not hear from your doctor until the next day. A urine culture takes 24 to 72 hours to complete, so you may not hear results for several days.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/urinalysis.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm

http://www.hallvet.com.au/services/urinalysis.html

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Categories
Diagnonistic Test

Cystourethrogram

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Definition:
A cystourethrogram is an X-ray test that takes pictures of your bladder and urethra while your bladder is full and while you are urinating. A thin flexible tube (urinary catheter) is inserted through your urethra into your bladder. A liquid material that shows up well on an X-ray picture (contrast material) is injected into your bladder through the catheter, then X-rays are taken with the contrast material in your bladder. More X-rays may be taken while urine flows out of your bladder, in which case the test is called a voiding cystourethrogram (VCUG).

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By filling your bladder with a liquid dye that shows up on x-rays, your doctor can watch the motion of your bladder as it fills and empties and can see if your urine splashes backwards toward your kidneys as the bladder muscle squeezes. This kind of test can help your doctor to better understand problems with repeated urinary-tract infections or problems involving damage to the kidneys. It can also be useful for evaluating urine leakage problems.

If X-rays are taken while contrast material is being injected into the urethra, the test is called a retrograde cystourethrogram because the contrast material flows into the bladder opposite the usual direction of urine flow.

Why It Is Done
A cystourethrogram is done to:

*Find the cause of repeated urinary tract infections.
*Look for injuries to the bladder or urethra.
*Find the cause of urinary incontinence.
*Check for structural problems of the bladder and urethra.
*Look for enlargement (hypertrophy) of the prostate or narrowing (stricture) of the urethra in men.
*Find out if urinary reflux is present. See a picture of abnormal backflow of urine.
*Look more carefully at abnormalities first found by intravenous pyelography.

How To Prepare
Tell your doctor before the test if:.

*You are or might be pregnant.
*You have symptoms of a urinary tract infection.
*You are allergic to the iodine dye used in the contrast material or any other substance that contains iodine. Also tell your doctor if you have asthma, are allergic to any medicines, or have ever had a serious allergic reaction (anaphylaxis), such as after being stung by a bee or from eating shellfish.

*Within the past 4 days, you have had an X-ray test using barium contrast material, such as a barium enema, or have taken a medicine (such as Pepto-Bismol) that contains bismuth. Barium and bismuth can interfere with test results.

*You have an intrauterine device (IUD) in place.

You may be asked to sign a consent form authorizing this procedure. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?) .

If you are breast-feeding, give your baby formula for 1 to 2 days after the test.

How It Is Done

A cystourethrogram is done by a urologist or a radiologist. The doctor may be assisted by an X-ray technologist. You usually will not have to be admitted to the hospital.

You will need to take off all or most of your clothes, and you will be given a cloth or paper covering to use during the test. You will be asked to urinate just before the test begins.
You will be asked to wear a hospital gown and  lie on your back on an X-ray table. Your genital area will be cleaned and draped with sterile towels. Men may be given a lead shield that covers their genitals to protect them from radiation. But women’s ovaries cannot be shielded without blocking the view of the bladder.

A part of your genital area is cleaned with soap on a cotton swab. Then a soft, bendable rubber tube called a urinary catheter is inserted into your bladder, usually by a nurse. The tube is first coated with a slippery jelly and then pushed gently through the opening of the urethra (at the end of the penis for men and near the opening of the vagina for women).

CLICK & SEE

A sterile flexible cystoscope in an operating theatre

A catheter will be placed through your urethra and into your bladder. Contrast material will then slowly be injected through the catheter until your bladder is full.

You will feel some pressure while the tube slides into the urethra. Once it is in place, a tiny balloon on the end of the tube is filled with air to hold it in position. The other end (about 6 inches of tubing) hangs outside of your vagina or penis. The doctor uses this tube to fill your bladder with fluid containing a dye that shows up on x-rays. You will feel pressure in your bladder as it begins to expand.

To create a clear picture, your bladder needs to be filled with as much fluid as it can hold. You will probably feel a very strong urge to urinate. A few pictures are taken with the bladder completely full, and then the balloon is emptied and the tube is pulled out. You are given a urinal container or a bedpan and asked to urinate while you are still on the table under the x-ray camera. Several pictures are taken while your bladder is emptying. Many patients find this part of the test embarrassing, but it is routine and the doctor thinks nothing of it.

X-rays will be taken when you are standing up and sitting and lying down. The catheter is removed and more X-rays will be taken while you are urinating. You may be asked to stop urinating, change positions, and begin urinating again. If you are unable to urinate in one position, you may be asked to try it from another position.

After the test is over, drink lots of fluids to help wash the contrast material out of your bladder and to reduce any burning on urination.

This test usually takes 30 to 45 minutes.

How It Feels
You will feel no discomfort from the X-rays. The X-ray table may feel hard and the room may be cool. You may find that the positions you need to hold are uncomfortable or painful.

You will feel a strong urge to urinate at times during the test. You may also find it somewhat uncomfortable when the catheter is inserted and left in place. You will have a feeling of fullness in your bladder and an urge to urinate when the contrast material is injected. You may be sore afterward. If so, soaking in a warm tub bath may help.

You may feel embarrassed at having to urinate in front of other people. This procedure is quite routine for the X-ray staff. If you find yourself feeling embarrassed, take deep, slow breaths and try to relax.

During and after the test you may feel a burning sensation when you urinate. You may need to urinate frequently for several days after the test. You may also notice some burning during and after urination. Drink lots of fluids to help decrease the burning and to help prevent a urinary tract infection.

Risks Factors:
A cystourethrogram does not usually cause problems. Occasionally this test may lead to a urinary tract infection. If the contrast material is injected with too much pressure, there is some chance of damage to the bladder or urethra.

There is a small chance of having an allergic reaction to the x-ray dye used in the test. Some patients have some temporary irritation of their urethra after the tube has been in place, and this might result in some burning during urination for a few hours afterward. Let your doctor know if burning or pain with urinating lasts longer than a day; this could mean you have developed an infection.

As with all x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from x-ray tests is very small-too small to be likely to cause any harm. X-rays such as this kind in the pelvic area should be avoided in pregnant women, because the developing fetus is more sensitive to the risks from radiation.

There is always a slight chance of damage to cells or tissue from radiation, including the low levels of radiation used for this test. However, the chance of damage from the X-rays is usually very low compared with the benefits of the test.

After the procedure
It is normal for your urine to have a pinkish tinge for 1 to 2 days after the test. Contact your doctor immediately if you have:

*Blood in your urine after 2 days.
*Lower belly pain.
*Signs of a urinary tract infection. These signs include:
*Pain or burning upon urination.
*An urge to urinate frequently, but usually passing only small amounts of urine.
*Dribbling or leaking of urine.
*Urine that is reddish or pinkish, foul-smelling, or cloudy.
*Pain in the back just below the rib cage on one side of the body (flank pain).
*Fever or chills.
*Nausea or vomiting.

Results
A cystourethrogram is an X-ray test that takes pictures of your bladder and urethra while you are urinating. Some results may be available immediately after the cystourethrogram. Final results are usually available within 1 to 2 days.

Cystourethrogram  Normal:

*The bladder appears normal.

*Urine flows normally from the bladder.

*The bladder empties all the way.

*The contrast material flows evenly out of the bladder through a smooth-walled urethra.

Cystourethrogram  Abnormal:

*Bladder stones,
*tumors,
*narrowing or pouches in the wall (diverticula) of the urethra or bladder are seen in the bladder.

*If the test was done because of possible injury to the bladder, a tear is found in the bladder wall or urethra.

*Urine flows backward from the bladder into the ureters (vesicoureteral reflux).

*Contrast material leaks from the bladder.

*The bladder does not empty all the way.

*The prostate gland is enlarged.

What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
*Having barium (from a previous barium enema test), gas, or stool in the bowel.
*Being unable to urinate on command because of embarrassment at having to urinate in front of other people.
*Pain caused by having the catheter into the urethra. This may also cause problems with your urinary stream. You may have a muscle spasm or not be able to fully relax the muscles that control your bladder.
*A cystourethrogram is not usually done during pregnancy because the X-rays could harm an unborn baby.
Resources:
https://www.health.harvard.edu/fhg/diagnostics/cystourethrogram.shtml
http://www.webmd.com/a-to-z-guides/cystourethrogram-16691

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Categories
Ailmemts & Remedies

Bilateral Hydronephrosis

Alternative Names: Hydronephrosis – bilateral

Definition
Bilateral hydronephrosis is the enlargement (distention) of the urine collecting structures and pelvis of both kidneys. Bilateral means both sides.

CLICK & SEE THE PICTURES

Click to See : Unilateral hydronephrosis

Causes
Bilateral hydronephrosis occurs when urine is unable to drain from the kidney down the ureters into the bladder. Hydronephrosis is not itself a disease, but rather a physical result of whatever disease is keeping urine from draining out of the kidneys, ureters, and bladder.

Disorders associated with bilateral hydronephrosis include:
*Acute bilateral obstructive uropathy
*Bladder outlet obstruction
*Chronic bilateral obstructive uropathy
*Neurogenic bladder
*Posterior ureteral valves
*Prune belly syndrome

*Uteropelvic junction obstruction

*Vesicoureteric reflux

Symptoms
Signs of hydronephrosis are generally seen during pregnancy ultrasound studies. There are no symptoms in the fetus.In the newborn, any urinary tract infection is reason to suspect some type of obstructive problem in the kidney. An older child who gets repeat urinary tract infections should be evaluated for possible obstruction.

Urinary tract obstruction usually has no other symptoms beyond an increased number of urinary tract infections.

Diagnosis:

Exams and Tests
Bilateral hydronephrosis may be seen on:

*CT scan of the abdomen or kidneys
*IVP
*Pregnancy (fetal) ultrasound
*Renal scan
*Ultrasound of the abdomen or kidneys

Treatment
Placing a Foley catheter may relieve the obstruction. Other treatment options include draining the bladder or relieving pressure with nephrostomy tubes placed through the skin (percutaneous) or stents placed in the ureters to allow urine to flow from the kidney to the bladder.

Once the blockage is treated, the underlying cause (such as an enlarged prostate) must be identified and treated.

Prognosis:
Advances in fetal ultrasound have given specialists the ability to diagnose problems caused by bilateral obstruction of the urinary tract in the developing fetus. If an obstruction is detected in a fetus, intrauterine surgery (performed while the fetus is still inside the mother’s uterus), or shortly after birth, will improve kidney function.

Newborns diagnosed with obstruction while still in the uterus can receive prompt surgical correction of the defects, often with good results.

Possible Complications :-
Renal insufficiency or failure may develop as a complication of many of the disorders associated with hydronephrosis.

When to Contact a Medical Professional
This disorder is usually discovered by the health care provider.

Prevention
A fetal ultrasound can reveal an obstruction of the urinary tract and allow for early surgery with better outcomes in the newborn. Other causes of obstruction, such as kidney stones, can be diagnosed early if individuals recognize early warning signs of obstruction and kidney disease.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000474.htm

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Categories
Ailmemts & Remedies

Acute Bilateral Obstructive Uropathy

Urinary system
Image via Wikipedia

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Alternative Names: Urethral obstruction; Acute urethral obstruction; Obstructive uropathy – bilateral – acute

Definition:Acute bilateral obstructive uropathy is a sudden blockage of the flow of urine from both kidneys. The kidneys continue to produce urine in the normal manner, but because urine does not drain properly, the kidneys start to swell. You may click to See also:

*Cronic unilateral obstructive uropathy

*Acute unilateral obstructive uropathy

CLICK & SEE

Causes: In men, acute bilateral obstructive uropathy is most often a result of an enlarged prostate. Other causes in men include: *Bladder cancer *Kidney stones *Prostate cancer Acute bilateral obstructive uropathy is much less common in women, but may be due to: *Bladder cystocele *Cervical cancer *Injury from surgery involving the reproductive organs *Pregnancy Other causes in men and women include: *Blood clots *Neurogenic bladder *Other rare retroperitoneal processes *Papillary necrosis *Posterior urethral valves in infant boys Acute bilateral obstructive uropathy occurs in about 5 out of 10,000 people. You may click to enlarge the pictures and see:-> *Female Bladder Catheterization..…..>. *Male Bladder catheterization…..……> *Female Urinary Tract…………………………..> *Male Urinary Tract………………………………>

 

Symptoms: *Abnormal urine flow — dribbling at the end of urination *Blood in the urine *Burning or stinging with urination *Decrease in the force of the urinary stream, stream small and weak *Decreased urine output (may be less than 10 mL per day) *Feeling of incomplete emptying of the bladder *Fever *Frequent strong urge to urinate *Recent increase in blood pressure *Leakage of urine (incontinence) *Nausea and vomiting *Need to urinate at night *Sudden flank pain or pain on both sides *Urinary hesitancy *Urine, abnormal color

 

.Diagnosis: Physical Exams : The doctor will perform a physical exam. The exam may show: *Large and full bladder *Swollen or tender kidneys *Enlarged prostate (men) *There may be signs of chronic kidney failure, high blood pressure, and infection. Fever is common with an infection. Tests that may be done include: *Arterial blood gas and blood chemistries *Basic metabolic panel — will reveal kidney function and electrolyte balance *Blood BUN *Creatinine clearance *Complete blood count *Potassium test *Serum creatinine test *Urinalysis and a urine culture (clean catch) *Ultrasound of the bladder *Uroflowmetry The following tests may show hydronephrosis (swelling of kidneys): *IVP *Renal scan *Ultrasound of the kidneys *Abdominal CT scan This disease may also alter the results of the following tests: *Creatinine – urine *Radionuclide cystogram Treatment: The goal of treatment is to relieve the blockage, which will allow urine to drain from the urinary tract. You may need to stay in a hospital for a short while. Short-term treatment may include: *Antibiotics and other medications to treat symptoms *Catheterization– the placement of a tube into the body to drain urine (See: Urinary catheters) Long-term treatment involves correcting the cause of the blockage and this may involve: *Surgery such as transurethral resection of the prostate (TURP) *Laser or heat therapy to shrink the prostate if the problem is due to an enlarged prostate Surgery may also be needed for other disorders that cause blockage of the urethra or bladder neck.

 

Prognosis: If the acute obstruction is quickly relieved, symptoms usually go away within hours to days. If untreated, the disorder causes progressive damage to the kidneys. It may eventually lead to high blood pressure or kidney failure.

Possible Complications : *Acute kidney failure *Chronic bilateral obstructive uropathy *High blood pressure *Reflux nephropathy *Urinary tract infection *Urinary retention or incontinence

When to Contact a Medical Professional : Call your health care provider if you have decreased urine output, difficulty urinating, flank pain, or other symptoms of acute bilateral obstructive uropathy.

Prevention You may not be able to prevent this condition. Routine annual physicals with a primary care doctor are recommended. If your doctor finds you have acute obstructive uropathy, you should be referred to the nearest emergency room and seen by a urologist.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources: http://www.umm.edu/ency/article/000485.htm http://www.nlm.nih.gov/medlineplus/ency/article/000485.htm

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Health Quaries

Some Health Quaries & Answers

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help?………

Q: Whenever I take any antibiotics or painkillers I develop severe gastric irritation, with belching, burning and pain. Can I take antacids to prevent this?

A: Painkillers usually belong to the “aspirin” family, or are paracetamol or are NSAIDs (non-steroidal anti-inflammatory agents). All of them can cause gastric irritation to varying degrees. The same is true of some antibiotics also. Using an antacid decreases the availability of the medication as many of them interact with the antacid in the stomach. Instead, you can add omeprazole, pantoprazole or ranitidine to the prescription. You can speak to your physician for specific advice and dosage schedules.

Try smiling :-

Q: At 50 years of age I find I have a sad and depressed look as I have bags on the cheek and my whole face sags. It affects my mood when I look in the mirror.

CLICK & SEE

A: Sagging of the skin (jowls) occurs owing to the loss of subcutaneous elastic tissue with age. The skin is not held taut. Gravity then causes the cheeks to sag. You have to be very conscious of this.

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Instead of developing a grumpy expression, try smiling. This will pull up your cheek muscles and the skin overlying them.

You can also apply oil every morning and massage your cheeks upwards. This will give you slow improvement. If nothing works, and you are really mentally affected by this, several plastic surgery techniques are available. Alternatively, you can always try Botox.

Grandma’s bladder :-

 

Q: My 82-year-old grandmother suffers from recurrent urinary tract infections. Cultures of the urine repeatedly grow significant numbers of bacteria. The doctors advised an ultrasound (USG) and it indicated significant residual urine — around 190cc. What can we do?

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A: Residual urine means that her bladder is not emptying properly. Urine is left behind in significant amounts after she has passed urine. This occurs because of a weakness of the pelvic muscles as a result of previous childbirth, age and the loss of protective female hormones after menopause. Urine is a good culture medium for bacteria to gain a foothold and thrive. As long as this problem persists and urine remains in the bladder, infections will recur. You also need to check if she has any additional risk factors like diabetes.

Appropriate antibiotic treatment has to be given in the correct dosage for the recommended schedule for the infection to clear. Sometimes a small night dose of antibiotic has to be continued prophylactically for a few months. Ask your grandmother to lean backwards instead of forwards while passing urine. That will help to empty the bladder more. In addition, yoga or Keegle’s exercises can be done to strengthen the pelvic muscles.

Exercise, please:-

Q: I have been a naturopath and yoga teacher for 30 years. Many diseases, infirmities, injuries and the effects of ageing can be delayed or prevented by practising this scientific ancient exercise form. Recovery from illness is also faster. I find most of my patients very resistant to the idea of exercise. They have a thousand irrelevant excuses to put off to “tomorrow” a schedule to start being physically active. Needless to say, tomorrow never comes!

A: People are looking for a “quick fix ”, an instant solution or a miracle drug that’ll cure all their ailments with the least effort. Unfortunately the body has to be maintained and nurtured like any other piece of functioning ageing machinery.

Studies show that 60 minutes of aerobic activity and 10 minutes of stretching will go a long way in maintaining health. For those who cannot spare that amount of time at one stretch, it can be split into 10 or 20 minute segments. The eventual benefits are immeasurable.

On the pill for 15 years :-

Q: I am 45 years old and have been on an oral contraceptive pill (OCP) for 15 years. How will I know if I have reached menopause? After all, the pill produces withdrawal bleeding every month.

A: When you actually reach menopause there will be no withdrawal bleeding after the tablets are stopped. If this occurs for three months you have probably reached menopause. It is safer to continue the pills for a year more. If you stop the pill you should use some other form of contraception like condoms for a year.

Excruciating pain :-

Q: I was pregnant a year ago. On scan the baby was found to have Down’s syndrome. I underwent a termination of the pregnancy. Now I have lower abdominal pain all the time. Sometimes it is so severe that I have to double up. What can I do?

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A: Since this pain has appeared after the abortion, you could take an ultrasound of the pelvis and do a urine examination. This will help to determine if there is an infection or any other reason for the pain. Armed with these reports you could go to a gynaecologist for specific advice and treatment.

Sources: The Telegraph (Kolkata, India)

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