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If You’re in Pain, Think UTI

Pain while passing urine, a desire to urinate every few minutes, an inability to pass urine despite the urge, high-coloured, cloudy urine, abdominal pain, high fever, shivering and vomiting — a few or all of these are symptoms of an infection somewhere along the urinary tract. In the elderly, the only symptom may be a change in mental status. In men, the pain may be felt in the rectal area. In children, after a period of dryness, bedwetting may recur. In babies, the temperature can fall instead of rise, and there may be jaundice. Almost 25 per cent of visits to a physician is due to this very common infection.
Urinary tract infection (UTI) affects all age groups and both sexes. It is much more common in women, because of the shorter urethra, its proximity to the anus, pregnancy (when the uterus obstructs the free flow of urine) and minor trauma during sexual intercourse. Thirty five per cent of women have one episode of UTI before the age of 30. Men tend to develop UTI if their prostrate gland is enlarged as this obstructs the flow of urine. In both sexes kidney stones, structural abnormalities of the urinary tract, diabetes or lack of immunity (HIV, cancer medication) can increase susceptibility to infection. Pregnant women can develop asymptomatic UTI with bacteria detected in their urine on routine examination. This condition, called “asymptomatic bactinuria” of pregnancy, needs to be treated.
Physicians suspect that UTI exists based on the symptoms. A routine urine examination shows abnormalities like pus cells or blood in the urine. A culture can be done to determine the organism responsible so that the appropriate antibiotic can be administered.

Untreated patients of UTI can sometimes recover spontaneously without treatment in a few months. But the infection can also enter the blood stream, causing potentially fatal septicaemia. The kidneys may become scarred, too. This leads to high blood pressure and kidney failure. During pregnancy, recurrent or chronic UTI or asymptomatic UTI compromises the placental blood supply. This affects the baby’s nutrition, leading to low birth weight and sometimes causing the mother to go into premature labour.

There are several regimens for treating UTI. Depending on the organism and antibiotic, in adult women a three-day course is usually sufficient for mild infection. In most cases and in the case of men, however, a 7-10 or 14-day course is required. Oral medication is usually sufficient. If the infection has affected the kidney, hospitalisation and intravenous medication may be required. It is important to follow the doctor’s instructions and complete the course of antibiotics even if you are symptomatically better. In women, if the symptoms do not respond and there is also white discharge, there may be an underlying pelvic infection. In men, non-responsiveness to treatment may be due to unrecognised prostatitis.

One of the ways to prevent UTI is to drink plenty of water. The urine becomes dilute and the bladder gets flushed regularly. An adult needs around 2.5 litres of water a day. In hot, humid climates and in people who exercise vigorously the requirement may go up to 4-6 litres a day. Also, drink a glass of water before going to bed. Empty the bladder before and after intercourse. Drink a glass of water after intercourse.

A few studies have shown that cranberry juice (available in India, Hindi name karaunda) and blueberry juice (not available) helps reduce the frequency and duration of UTI. This is because the juice contains vitamin C which acidifies the urine. It also contains natural chemicals that make the bladder wall slippery and prevent bacteria from sticking to it and initiating an infection. Other citrus juices and tablets of vitamin C are effective but not as efficient. A tablespoon of home-made curd taken on an empty stomach first thing in the morning naturally repopulates the intestines with “good lactobacillus”. This decreases the likelihood of the growth of disease-causing bacteria in the rectum, from where they can enter the urethra.

The pelvic muscles become lax after childbirth. This increases the possibility of the bladder and uterus descending downwards while straining. “Accidents” with leakage of urine and urgency can also occur.

All these increase the chances of infection. Keegles exercises should be done regularly soon after childbirth. Also while passing urine, consciously stop and start. This tones the pelvic muscles.

Women tend to lean forward while urinating. This position is inefficient as it increases the angle between the bladder and the urethra, creating an obstruction to the flow of urine. Women should consciously lean backwards. Also, when the area is being washed after urination or passing motion, wash from front to back. This decreases the likelihood of contamination of the urethra with rectal bacteria

Source: The Telegraph ( Kolkata, India)

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Endometrial Biopsy

Introduction:An endometrial biopsy is a way for your doctor to take a small sample of the lining of the uterus (endometrium). The sample is looked at under a microscope for abnormal cells. An endometrial biopsy helps your doctor find any problems in the endometrium. It also lets your doctor check to see if your body’s hormone levels that affect the endometrium are in balance.


The lining of the uterus changes throughout a woman’s menstrual cycle. Early in the menstrual cycle, the lining grows thicker until a mature egg is released from an ovary (ovulation). If the egg is not fertilized by a sperm, the lining is shed during normal menstrual bleeding.



*A soft, straw-like device (pipelle) to suction a small sample of lining from the uterus. This method is fast and is not very painful.

*A sharp-edged tool called a curette. Your doctor will scrape a small sample and collect it with a syringe or suction. This is called a dilation and curettage (D&C). A D&C may be done to control heavy uterine bleeding (hemorrhage) or to help find the cause of bleeding. This is done with general or regional anesthesia.

*An electronic suction device (Vabra aspiration). This method can be uncomfortable.


When a woman is having a hard time becoming pregnant, an endometrial biopsy may be done to see whether the lining of her uterus can support a pregnancy.



Why It Is Done
An endometrial biopsy is done to:

*Check for cancer. For example, an endometrial biopsy may be done to help determine the cause of some abnormal Pap test results.


How To Prepare
Tell your doctor if you:

*Are or might be pregnant. An endometrial biopsy is not done during pregnancy.

*Are taking any medicines.

*Are allergic to any medicines.


*Have been treated for a vaginal, cervical, or pelvic infection.

*Have any heart or lung problems.

If you are not bleeding heavily, you might want to take an NSAID medicine such as ibuprofen one to two hours before the test, to reduce the possibility of uterine cramps during the procedure. Ask your physician for a recommendation ahead of time.


If you are having a dilation and curettage (D&C) and will go to sleep (general anesthesia) for the test, do not eat or drink anything for 8 hours before the test. If you are taking any medicines, ask your doctor what medicines you can take the day of the test.

How It Is Done





An endometrial biopsy takes 5 to 15 minutes.

Dilation and curettage (D&C)
A D&C is usually done in a hospital or clinic. Most women do not need to stay overnight but can go home the same day.

Your doctor will put an instrument with smooth, curved blades (speculum) into your vagina. The speculum gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix. Your cervix will be gently spread open (dilated). Depending on the reason for the D&C, your doctor may use a tool called a hysteroscope to look inside the uterus. A small spoon-shaped instrument (curette) is then guided through the cervix and into the uterus. The top layer of the lining of the uterus is carefully scraped off and removed (along with any other tissue that looks abnormal) for biopsy.


You can do most of your normal activities in a few days. Do not lift anything heavy for a few days after the test. Do not douche or have sex for one week after the test.

How It Feels
If you have not had any pain medicine, you may feel a sharp cramp as the tool is guided through your cervix. You may feel more cramping when the biopsy sample is collected. Most women find that the cramping feels like a really bad menstrual cramp.



Dilation and curettage (D&C)
If general anesthesia is used during a D&C, you will be asleep and feel nothing. After the test, you will feel sleepy for a few hours. You may be tired for a few days after the test. You may also have a mild sore throat if a tube (endotracheal tube, or ET) was placed in your throat to help you breathe during the test. Using throat lozenges and gargling with warm salt water may help relieve your sore throat.

Risks Factors:
You might have pelvic cramps (sometimes intense) during the procedure and sometimes for a day or two afterward; you may also experience a small amount of vaginal bleeding. It is extremely rare to have heavy bleeding or to develop an infection that needs treatment.There is also a small risk of disturbing a very early pregnancy. To guard against this, your doctor might order a pregnancy test before performing the biopsy.

After the test:
You may feel some soreness in your vagina for a day or two. Some vaginal bleeding or discharge is normal for up to a week after a biopsy. You can use a sanitary pad for the bleeding. Do not do strenuous exercise or heavy lifting for one day after your biopsy. Do not douche. You may have to avoid sex or using tampons for several days. Ask your doctor when you can have sex or use tampons again.


*Heavy vaginal bleeding (more than a normal menstrual period).

*A fever.

*Belly pain.

*Bad-smelling vaginal discharge.

Time to know the results:

Endometrial biopsy  Normal

Endometrial biopsy  Abnormal:

*A noncancerous (benign) growth, called a polyp, is present.

*Overgrowth of the lining of the uterus (endometrial hyperplasia) is present.

*Cell changes that may lead to cancer are present.



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Childhood Obesity




A few extra pounds do not suggest obesity. However they may indicate a tendency to gain weight easily and a need for changes in diet and/or exercise. Generally, a child is not considered obese until the weight is at least 10 percent higher than what is recommended for the height and body type. Obesity most commonly begins in childhood between the ages of 5 and 6, and during adolescence. Studies have shown that a child who is obese between the ages of 10 and 13 has an 80 percent chance of becoming an obese adult.


* poor eating habits
* overeating or binging
* lack of exercise (i.e., couch potato kids)
* family history of obesity
* medical illness (endocrine, neurological problems)
* medications (steroids, some psychiatric medications)
* stressful life events or changes (separations, divorce, moves, deaths, abuse)
* family and peer problems
* low self-esteem
* depression or other emotional problems


* The Family

The risk of becoming obese is greatest among children who have two obese parents (Dietz, 1983). This may be due to powerful genetic factors or to parental modeling of both eating and exercise behaviors, indirectly affecting the child’s energy balance. One half of parents of elementary school children never exercise vigorously (Ross & Pate, 1987).

* Low-energy Expenditure


* Heredity



* increased risk of heart disease
* high blood pressure
* diabetes
* breathing problems
* trouble sleeping

Child and adolescent obesity is also associated with increased risk of emotional problems. Teens with weight problems tend to have much lower self-esteem and be less popular with peers. Depression, anxiety, and obsessive compulsive disorder can also occur.

Treatment :
Obese children need a thorough medical evaluation be a pediatrician or family physician to consider the possibility of a physical cause. In the absence of a physical disorder, the only way to lose weight is to reduce the number of calories being eaten to increase the child’s or adolescent’s level of physical activity. Lasting weight loss can only occur when there is self-motivation. Since obesity affects more than one family member, making healthy eating and regular exercise a family activity can improve the chances of successful weight control for the child or adolescent.



1. Physical Activity


2. Diet Management

Fasting or extreme caloric restriction is not advisable for children. Not only is this approach psychologically stressful, but it may adversely affect growth and the child’s perception of “normal” eating. Balanced diets with moderate caloric restriction, especially reduced dietary fat, have been used successfully in treating obesity (Dietz, 1983). Nutrition education may be necessary. Diet management coupled with exercise is an effective treatment for childhood obesity (Wolf et al., 1985).

3. Behavior Modification


Obesity frequently becomes a lifelong issue. The reason most obese adolescents gain back their pounds is that after they have reached their goal, they go back to their old habits of eating and exercising. An obese adolescent must therefore learn to eat and enjoy healthy foods in moderate amounts and to exercise regularly to maintain the desired weight. Parents of an obese child can improve their children’s self esteem by emphasizing the child’s strengths and positive qualities rather than just focusing on their weight problem.

When a child or adolescent with obesity also has emotional problems, a child and adolescent psychiatrist can work with the child’s family physician to develop a comprehensive treatment plan. Such a plan would include reasonable weight loss goals, dietary and physical activity management, behavior modification, and family involvement.


Little chocolate a day keeps heart attacks at bay

They were so addicted, they just could not give up their favourite daily snack  not even in the interest of science…..click & see


It turns out chocolate, like aspirin, affects the platelets that cause blood to clot, Diane Becker of the Johns Hopkins University’s School of Medicine and her colleagues discovered.



The study looked at the effects of aspirin on blood platelets. Before they got the aspirin, the volunteers were asked to stay on a strict regimen of exercise, refrain from smoking and avoid caffeinated drinks, wine, grapefruit juice and chocolate.

Source:The Times Of India