04 August 2004	Wednesday	17 Jamadi-us-Saani 1425

KARACHI, Aug 3: Health experts observed that the urinary tract infection was very common in the community and had reversible and modifiable risk factors in young male and female patients separately.

These views were expressed at continuation medical education programme on "Urinary Tract Infection: Myths, Mysteries and Realities", organized by the Department of Nephrology and Transplantation, Liaquat National Hospital at its convention centre on Tuesday.

The head of Nephrology and Transplantation Department, Dr Iffat Yazdani, discussed common clinical features of urinary tract infection and talked about tuberculosis involving the genitourinary tract beside cystitis, uretheritis and pyelonephritis.

She said that the incidence was higher in males as compared to females as only less than five per cent of females had genitourinary tuberculosis and 25 per cent of such patients might remain asymptomatic, so one had to have high index of suspicion to diagnose tuberculosis involving urinary tract.

She presented two cases with history of cystitis and uretheritis (lower urinary tract infection) and identified associated risk factors for cystitis in sexually active women, pregnancy, men indulging in prostitution, urinary tract obstruction, neurogenic bladder dysfunction and vesicoureteral reflux.

She explained that its most common symptom was dysuria along with urinary frequency, urinary urgency, suprapubic pain (specially after voiding) and 30 per cent hematuria.

"Acute uretheritis in men may present symptoms including urethral discharge in absence of suprapubic pain and urinary frequency and urgency," she said adding that women should clean perineum wiping front to back and empty bladder before and after intercourse while other measures beside treatment could be avoiding contraceptive diaphragm.

Dr Iffat Yazdani also presented one case of pyelonephritis and talked about its clinical features, including urinary urgency and frequency, fever more than 38 degrees Centigrade with chills, flank pain and tenderness, costo-vertebral angle tenderness and pyuria.

Senior Registrar of Liaquat National Hospital, Dr Farzana Adnan, discussed the urinary tract infection in children and said that its incidence at six years is higher in girls (i.e. 6.6 per cent) as compared to boys (1.8 per cent), while overall incidence of the Urinary Tract Infection in pre-pubertal age is three in girls and one per cent in boys.

She emphasised on earlier detection of the UTI in children, as in case of recurrent infections, it could lead to advanced kidney disease. "Vesicoureteric reflux is a major cause of the UTI in children and may lead to End Stage Renal Disease in 20 per cent of patients," she added.

"Unexplained fever among children aged two months to two years should be tested and checked for the UTI. Urine sample should be taken by suprapubic aspiration before impiric therapy," she said. Normal urinalysis in circumcised boys would rule out possibility of the UTI, she added.

The nephrology consultant of Liaquat National Hospital, Dr Absar Ali, gave presentation on "Asymptomatic bacteriuria" and explained that it was a bacterial urinary tract infection detected by the discovery of significant bacterial growth in a urine culture that occurred without any of the usual symptoms.

He said that the Urinary Tract Infection could become complicated in dwelling catheter use, VUR, obstruction, neutropenia, immune deficiency and asymptomatic bacteriuria in diabetic men.

All presentations were followed by short question and answer sessions. Later, the medical director of Liaquat National Hospital, Dr Salman Faridi, distributed certificates to the participants of the programme. - PPI