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HEALRH ISSUE IS: My Daughter Age Is 11 Years. She

Posted on Sat, 8 Aug 2020

Question: HEALRH ISSUE IS: My daughter age is 11 years. She is having problem of burning sensation at entry area of urinary tract… it happens at end of the urination. She does feel to go urine again and again and burning sensation continues for some time after urine…

She get relief, when she stop to feel to go to urination… and burning sensation also comes down. There is no redness and swelling. There is no itching also;

EARLIER REVIEW BY DOCTOR: This problem started FIVE months back, we consulted gynaecologist… they examined and told… it may be fungal or bacterial infection only… urine test also done and results are normal; and they prescribed Triben B cream… and citralka syrup for one week… after using the same, she got some relief for one month… then again started… we used same medication… this problem is coming on and half…

Kindly suggest us for complete cure of this issue.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

HEALRH ISSUE IS: My daughter age is 11 years. She is having problem of burning sensation at entry area of urinary tract… it happens at end of the urination. She does feel to go urine again and again and burning sensation continues for some time after urine…

She get relief, when she stop to feel to go to urination… and burning sensation also comes down. There is no redness and swelling. There is no itching also;

EARLIER REVIEW BY DOCTOR: This problem started FIVE months back, we consulted gynaecologist… they examined and told… it may be fungal or bacterial infection only… urine test also done and results are normal; and they prescribed Triben B cream… and citralka syrup for one week… after using the same, she got some relief for one month… then again started… we used same medication… this problem is coming on and half…

Kindly suggest us for complete cure of this issue.

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Give oral antibiotic and antifungal

Detailed Answer:
Hi

Thanks for being at 'Ask A Doctor' service.

I have gone through the details and do understand your concern.
Urinary tract infection be it fungal or bacterial, is very notorious to recur. Recurrence is more common if proper treatment is not done or if hygiene is poor.

It is always better to send a urine examination before starting any antibiotic or antifungal.
Urine test tells us about the type of bacteria or fungus causing this problem and also the type of antibiotic most suitable to kill the bacteria.

I would suggest you send a urine routine examination and urine culture sensitivity test. Collect early morning samples for tests.

After sending the sample start some antibiotics like ofloxacin(fluoroquinolone) or cefixime (cephalosporin group) along with antifungal fluconazole. Most of the bacteria causing the urinary infection are sensitive to both these antibiotics. Once the urine report comes, the picture will be more clear. The total duration of antibiotics should be a minimum of 7-10 days. Similarly, fluconazole should be given minimum of 4 days.

Creams are not very effective in a complete cure.
Self-treatment and incomplete treatment worsen the situation.
Give alkalising agent like citralka or Alkasol for 5 days.

Maintaining good hygiene and taking plenty of water helps in early recovery and also prevents recurrence.

As there is a prolonged history of UTI, I would also suggest you get one USG done to rule out any urinary tract abnormality.

I hope this helps.
Please let me know if you have any more doubts.
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Pradeep Kumar Jain (12 hours later)

Thank you for your detailed response.

Ok sir, we will get done urine tests of routine examination and urine culture sensitivity test.

Please let me know HOW MANY TABLET PER DAY (one or two) AND WHAT MG (like 200mg or 400mg) of ofloxacin(fluoroquinolone) or cefixime (cephalosporin group) to be used ?

HOW MANY DAYS antifungal fluconazole tablet to be taken

I am waiting for your reply.

Thank you & regards

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Assuming a weight around 35 kgs for 11 yrs age

Detailed Answer:
Hi

Thanks for follow up

Average weight of 11 year old child is around 35 kg. Assuming the same weight the dose of ofloxacin is 200 mg twice a day for 7-10 days and fluconazole 150 mg once a day for 3 days.
If there is any allergy to fluoroquinolones, then cefixime instead of ofloxacin should not be given. Dose of cefixime again is 200 mg Bd for this age.
Please let me know about the culture report.

I hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (3 days later)

sir,

As per your advice, We got both the reports URINE CULTURE & SENSTIVE and URINE ROUTINE of our daughter... you are requested to go through report and guide us. We already started medicines as per your prescription

I uploaded report of URINE CULTURE & SENSTIVE and URINE ROUTINE.

thank you

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Need to change the antibiotic as per the report

Detailed Answer:
Hi

Thanks for follow up

I have seen the reports. Although urine routine examination is normal, the culture report shows enterobactor species.
This sensitivity report shows that organism is sensitive to ciprofloxacin, trimethoprim and nitrofurantoin. All other antibiotics to which organism is sensitive, can not be given orally(only iv/Im).
So I would like to change the antibiotic to ciprofloxacin(if not sensitive to fluoroquinolones) and nitrofurantoin.
The dose of ciprofloxacin for this age is 250 mg twice a day ans should be given minimum for 7 days. Similarly the dose of nitrofurantoin will be 100 mg twice a day for 7 days. Continue nitrofurantoin 100 mg once a day for another 7 days to prevent recurrence.
I hope this helps.
Please feel free to ask if you have any more doubts.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Pradeep Kumar Jain (41 minutes later)

Dear Sir,
Thanks for reply;

She started taking prescribed tablets after Urine Tests only; before urine test no tablets taken by my daughter. only she was using cream Triben-B cream;

She is taking ofloxacin (fluoroquinolone) 2 tablets from last two days and fluconazole 1 tablet per day from last three days.

Now My understanding is to stop above and start with ciprofloxacin 250 mg twice a day and nitrofurantoin 100 mg twice a day for 7 days + once a day for second week. is it right sir ?

Sir, what is meaning of: Conclusion of report is significant growth of enterobacter cloacae isolated in culture. PLEASE CORRELATE CLINICALLY;

it is mentioned report. It is infection ? is it treatable ?

thank you and waiting for your reply

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (43 minutes later)

Brief Answer:
Its urinary tract infection only

Detailed Answer:
Hi

Sometimes urine sample gets contaminated ( as close to anal area) and in that case also culture report shows growth of bacteria.
Clinically she is having symptoms of urinary infection and the culture report also shows significant growth of enterobactor. So it is bacterial urinary infection causing the symptoms.(Correlate clinically means the significance of report increases in presence of clinical symptoms).
Don't worry. As now the causative organism is detected,appropriate antibiotic therapy will help in treatment of infection.
You are right.. First 7 days give both antibiotics in twice daily dosage and there after nitrofurantoin only in once daily dose for 7 days.No need to give fluconazole further.
Give Alkasol or citralka syrup(urinary alkalinising agent) 5 ml two times a day for 7 days.
Maintain proper hydration with plenty of fluids.
Symptoms should subside after 3-4 days. But a repeat urine culture report will be needed after 7 days.
Ideally one USG KUB(kidney,ureter and bladder) should also be done after consulting a physician, to rule out any abnormality leading to repeated urinary infection.
I hope it helps.
I shall be glad to help further, if you need any.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (19 hours later)

Hai Sir
thanks for your reply.

she started both ciprofloxacin 250 mg and nitrofurantoin 100 mg; giving syrup also;

She is 42 kgs weight;
we will do USG KUB after one week or 10 days, if not urgency

is this infection common ? will be cured with medicine ? as we have no idea about this kind of infection.

with regards & thanks

waiting for your reply

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (6 hours later)

Brief Answer:
Most of the time UTI gets cured with medicines

Detailed Answer:
Hi

I can understand your concern. But you need not to worry as with appropriate treatment, UTI gets cured with medicines.
Although E coli infection is the commonest but Enterobactor UTI is also seen frequently.
I suggest you to continue the medicines and give plenty of fluids. Please get back to me once USG is done or if you have any more doubts.

Wishing for her early recovery.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (9 days later)

Dear Sir,

We have repeated URINE CULTURE AND SENSTIVE TEST again. Please go through the report and guide us. I am attaching report.

ciprofloxacin 250 mg was given for one week and stopped.
Citralke sirup also given for one week and stopped.

nitrofurantoin 100 mg one week over and second week on run one tablet per day.
Triben - B is being used for external area of urinary track daily two times.

Please guide us for further course of action.

thanks and regards

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Recent report shows, there is no UTI

Detailed Answer:
Hi
Thanks for follow up

I have seen the recent culture report. It shows there is no growth. That means, antibiotics worked well and now there is no urinary infection.
You can stop giving antibiotics as already 14 days of antibiotics course is completed.Also there is no need to apply cream further.
I suggest you to get an USG done at earliest to rule out any underlying abnormality.
Please get back to me with the USG report or if you have any doubts.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (14 hours later)

Dear Sir,

Thanks for your reply.

We have fear to go to hospital to get USG due to corona virus. If you feel it is very much required USG, then we need to plan for the same. Pls advice me.

This is additional question to our previous issue.

I am age of 42 years... can I take Vitamin D, Vitamin C, B12 and B complex tablets, as we are in lock down for long time... what dosage is recommended. B12 and D vitamin was deficient for me when got tested six months back...that time took some supplements

Thanks and with regards

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (58 minutes later)

Brief Answer:
You can wait for USG, please attach the report of vitamin d and b12

Detailed Answer:
Hi

I can understand your concern.
As she is asymptomatic now and recent urine culture report is also normal, you can wait for a week or two for USG.
Actually the dose of vitamin b12 and vitamin d depends upon the symptoms and the values in blood. I would request you to attach the reports and also please tell me about the symptoms in detail for which the investigations were done.
Waiting for your response.
Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Pradeep Kumar Jain (2 days later)

Dear Sir,

Please find USG as per your prescription.i uploaded the report of the same

Pls guide me.

thanks

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Dear Sir,

Please find USG as per your prescription.i uploaded the report of the same

Pls guide me.

thanks

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
No need to worry, no significant abnormality noted

Detailed Answer:
Hi
Thanks for follow up

I have seen the report and there is no significant abnormality.
Although the report is showing mild thickening of bladder s/o cystitis but in absence of symptoms and with normal urine report, it is of not much value.
So there is nothing to worry much. Just tell her to take plenty of fluids.
I hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Pradeep Kumar Jain (2 days later)

Hai
I am 43 years age. Male. I have one issue from long time...

After taking breakfast, lunch and dinner, I get one or two cough and some Phlegm (little mucus type) come out. Other time I don't get the same, only after eating only... this issue is there from two years time... I thought it will get cured automatically, but not cured... I also don't get quality breathing for some minutes after lunch or dinner...

I don't have any other health issues except sinusitis... this is there from more than 10 years...

I do regular walking and gym... some times after heavy gym workout... a little bit breathing issue will be there till night also.

So kindly guide me by considering above issue...

I have CHEST X RAY report and MRI THORAX... both are are attaching...

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (18 hours later)

Brief Answer:
Most likely due to regurgitation related

Detailed Answer:
Hi

I have gone through the details and do understand your concern.
I have seen the reports and there is nothing to worry about.
Symptoms after taking food is most likely due to reflux of GI content.
In some cases regurgitation of food content from stomach can be significant enough to cause reflux of food content in upper GI tract causing chest burn and in others it may present with mild discomfort like cough or irritation in upper airways.
Taking acid reducing agents like esomeprazole/lansopraole with antireflux medication like domperidone helps in most of the cases.
Change in diet pattern like avoiding spices,oily foods and taking water immediately after food helps.
If symptoms persists even after taking these measures, upper GI endoscopy should be done to see the changes in upper GI tract and more aggresive treatment will be needed.
Other possibilty can be post nasal drip. This is an allergic disorder and can present with mild cough or irritation in upper airway. Associated sinusitis can be seen in many of the patients with post nasal drip.Here antiallergic medication helps.
I suggest you to follow the antireflux measures first and check the outcome.

Please let me know if you have any more doubts.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (4 hours later)

Dear Sir

Thanks for you reply.

I have sinusitis issue from last 10 years....
I am attaching MRI of PNS also for your review.

I have no hurt burn.... regularly one cough after breakfast/lunch/dinner and some phlegm comes out.... very rare times breathing difficulty....

I am going to start to see PANTOPRAZOLE 40 mg for GRED / Acid Reflux
can I use this tablet ?

If Post Nasal Drip... what can I do ?

How to identify either Acid Reflux or Post Nasal Drip ?

Thanks and regards

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (30 minutes later)

Brief Answer:
You can start pantoprazole

Detailed Answer:
Hello

Have seen the pns mri scan.
As the most likely cause for your symptoms is reflux, it is OK to start Pantroprazole 40 mg empty stomach daily morning for 15-20 days. Observe for the symptoms if it gets better, this goes in favour of reflux. If symptoms persists you can start montelukast levocetrizine combination for one month and observe for the symptoms. This montelukast cetrizine combination works both in sinusitis and post nasal drip.
Do breathing exercise and change your dietary habits for better results.
Regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Pradeep Kumar Jain (45 hours later)

Hai Sir,
Thanks for reply.

Pantoprazole 40 gm... one is enough for day or two required ? before breakfast and before dinner ?

I used Montec LC tablet for 40 days course by 20th of May... I used it for chronic sinuties... doctor prescribed it as I have chronic sinusitis (little mucus formed in maxillary sinus) and I have eyes itching also.

Now also I have little mcuus inside my sinuses... as after taking steam daily very very little mucus comes out... I am using NASOWASH also from one week. can I use Mucolytic Ambroxol for relief from Mucus ?

I have not started any tablet for reflux or post nasal drip... so Please let me know which one first to start as per my all symptoms and issues.

thank you and with regards

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Can start Pantoprazole, continue steam inhalation

Detailed Answer:
Hi

Welcome again

Considering the most likely possibility of GERD,you can start pantoprazole. 40 mg tablet once a day before breakfast is the dose.
Combination of pantopraole with domperidone ( antiemetic) will work better. I suggest you to take the combination for initial two weeks and then switch to pantoprazole alone.
If it works then diagnosis goes in favour of GERD.
Continue steam inhalation and saline wash for sinusitis. I don't think mucolytic agent is needed.
Please get back to me if you have any more doubts.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (2 days later)

Dear Sir,

It is regarding my daughter XXXXXXX XXXXXXX UTI issue.

we completed medicines as per your prescription... like ciprofloxacin 250 mg twice a day and nitrofurantoin 100 mg twice a day for 7 days + once a day for second week. course completed by 27th May...

USG also reviewed by you.

Now she is having little burning sensation while doing urination... So I want to bring to your kind notice the same.

thanks and regards.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Please get one urine microscopy and culture test done

Detailed Answer:
Hi

Thanks for follow up

In view of reappearance of symptoms like burning micturition, we need to get repeat urine microscopy and culture test done to rule our recurrence of UTI.

Please get back to me with the reports.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (28 hours later)

Sir
Pls find report of urine culture and micro.

Pls advice me for further

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Sir
Pls find report of urine culture and micro.

Pls advice me for further

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Report shows recurrence of UTI

Detailed Answer:
Hello

I have gone through the urine routine and microscopy examination report and it shows RBCs, pus cells, proteins and nitrite; suggestive of recurrence of UTI.
This recurrence suggests that we have to treat UTI aggressively this time.
The plan of treatment would be
To send the urine culture sensitivity report.
Starting imperical antibiotic based on previous culture report like trimethoprim( please avoid if sensitive to sulfa drug)and nitrofurantoin.
To check the new culture report and manage antibiotic treatment based on that.
To give plenty of fluids with alkanising agent like alkacitral.
To continue small dose antibiotics and cranberry juice for at least 6 months to avoid recurrence.

So I suggest you to send the culture sample and to start Trimethoprim and sulfamethoxazole combination ( Septran tablet) 1 tab twice a day and nitrofurantoin 100 mg twice a day. Give plenty of fluids and Citralke syrup.
Please get back to me with the culture report.
With regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Pradeep Kumar Jain (10 hours later)

DEAR SIR,

THANKS FOR YOUR REPLY.

MY DAUGHTER GOT 103 F FEVER TODAY... HIGH FEVER

IS IT DUE TO UTI REOCCURING ???

She is not having much burning at the time of urination from last two days again... earlier two days she had... but from last two days she is not giving complaint of urinaiton...

But today high fever started.... what to do ?
we already given Crocin 500 tablet... can we give some antibiotic

immediately reply appreciated

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Follow up: Dr. Pradeep Kumar Jain (24 minutes later)

we have given Taxim-O 200mg.

Please advise me further

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

we have given Taxim-O 200mg.

Please advise me further

Answered by Dr. Pradeep Kumar Jain (3 hours later)

Brief Answer:
High fever is most likely due to UTI

Detailed Answer:
Hi

I am really very sorry for delayed reply.
The urine report is suggestive of UTI and this high fever is likely due to UTI only.
As previous culture report was sensitive to trimethoprim(septran) and nitrofurantoin, I would suggest you to start the same in the dosage mentioned earlier. Give paracetamol for fever.
Please send the urine culture (better before starting any antibiotics)

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (47 minutes later)

Dear Sir,

Thanks for reply.

We had already given CROCIN 500mg one tablet & TAXIM-O 200mg one tablet. My daughter Also told me medium stomach pain (more right side) and we have given HIFENAC - P tablet

After 3 hours fever came down to normal (99 F)... now it is 97 F (after 5 hours)... we are planning to give one more dosage of Crocin-500 mg after one hour... as want to give same after every six hours....

Tomorrow morning we are sending urine sample for culture sensate test... after urine sample we will also start -
Trimethoprim and sulfamethoxazole combination ( Septran tablet) 1 tab twice a day and nitrofurantoin 100 mg twice a day.

1. Are you sure is it because of UTI only ?

2. can we continue Crocin 500 mg after every six hours and Taxim-O 200 mg. can we continue Crocin if fever is below than 98.6 also

3. can we get your contact number if any urgency.

4. Please specify if any clarify is missing... so I will follow.

regards and urgent

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (25 minutes later)

Brief Answer:
You can give paracetamol at every 6 hours safely

Detailed Answer:
Hello again

I can understand your concern.
As fever is of high grade you can give paracetamol at an interval of 6 hours on the first day, by the time the antibiotic will start acting.
Fro next day give it 8 or 12 hourly and after that only when needed.
Paracetamol works by normalising raised temperature and does not decreases temperature further if it is in normal range. So no need to worry you can give safely at 6 hours.
Please don't give Hifenac P (Aceclofenac + paracetamol) when you are already give crocin as both contain paracetamol. Pain abdomen can be due to UTI. Here mefenemic acid(meftal spas) works well and can be given with crocin.
Please start septran and nitrofurantoin after sending the culture.
No need to give taxim o as already she will receive two antibiotics.
There is no reason to think for other cause of fever when we have positive report and fever is the most common presentation of UTI.
I am sorry but as per policy I can't provide my number here. I request you to contact customer care to get my number.
Please get back to me in case of any query.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (9 hours later)

good morning sir
thanks for reply

ok
we stop taxim-O and Hifenac P

we have not give Crocin further as fever came down to 96.8 and not came again from night to morning.

1. still Crocin is to be given ?

we are in our village... we are not able to get septrin tablet.... we got BACTRIM D.S DOUBLE STRENGTH...

2 can I use this tablet ? if

3. usable, half tablet or full tablet...?? as is combination of each tablet containing 800 mg sulfamethoxazole and 160 mg trimethoprim...

if this tablet is not good... we will try to get better option tablet

pls guide me.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Give half tablet of Bactrim DS tablet

Detailed Answer:
Hi

Give half tablet of Bactrim DS twice a day. That is equivalent to septran.
Give crocin only if needed.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Brief Answer:
Give half tablet of Bactrim DS tablet

Detailed Answer:
Hi

Give half tablet of Bactrim DS twice a day. That is equivalent to septran.
Give crocin only if needed.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Pradeep Kumar Jain (2 hours later)

DEAR SIR,
thanks for reply.

We have actually given URINE SENSTIVE test also earlier ayongwith urine microscopy... we got result after three days. i.e today... URINE SENSITIVE TEST is in third page.

CONCLUSION OF REPORT IS: Significant growth of Escherichia coli isolated in culture. Please correlate clinically.

Please find detailed report I am uploading....

can we continue septran and nitrofurantoin only ?

Please guide me...

thanks

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Give cefuroxime and nitrofurantoin

Detailed Answer:
Hello

I have seen the culture report and here the organism e coli is resistant to septran(trimethoprim sulfamethoxazole) and sensitive to nitrofurantoin and cefuroxime.
I would suggest you to start cefuroxime 250 mg twice a day for 10 days and nitrofurantoin for 7 days. After 7 days of nitrofurantoin we will give 50 mg of nitrofurantoin for 2-3 months to prevent recurrence.
Please let me know if you have any more doubts.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (42 minutes later)

Dear Sir,

Thanks for reply.

My understanding is: we need to stop Septran as it is resistant to E coli... today we have given one complete tablet.... so we stop it.

We need to start Cefuroxime 250mg twice a day along with Nitrofurantoin 100mg. this is for next ten days...

Is E coli is result of enterobacter cloacae ?

Is high shows in RBCs, pus cells, proteins and nitrite are linked with E Coli ?

will E coli be cured with above medication. ?

We are little worried as she got 103 F yesterday... today fever is around 100F only.... will give relief of fever with this medicaid ?

Please clarify me sir

thanks and regards

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (36 minutes later)

Brief Answer:
You are right, septran needs to be stopped

Detailed Answer:
Hi
Welcome again
You are absolutely right. The new report shows growth of E Coli bacteria. This bacteria is different from enterobactor. This e coli is resistant to septran and sensitive to nitrofurantoin and cefuroxime so we need to start these two.
Urinary RBC, pus cells, protein and nitrite all suggests urinary infection and these can be seen in any bacterial infection be it e coli or enterobactor. The total duration of initial treatment will be 10 days. Also give supportive treatment like fluids and citralka. After 9 days plan is to repeat urine test and to continue low dose nitrofurantoin 50 mg once a day for next 2-3 months in view of repaeted infection to prevent recurrence. As culture report shows sensitivity to nitrofurantoin and cefuroxime. The treatment should cure the uti. No need to worry as fever is due to UTI and once infection subsides, fever will not recur.
I hope this clears your doubt.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (18 hours later)

Dear Sir

we have started from today morning Cefuroxime 250mg twice a day along with Nitrofurantoin 100mg.. also giving Crocin 500.... but fever is not coming down easily... it is standing between 101F - 102F...

How to handle high fever... ?
She is also saying chills also there...

Please suggest me.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (2 hours later)

Brief Answer:
Give plenty of fluids & paracetamol 6 hourly, Do tepid sponging

Detailed Answer:
Hi

I can understand your concern.
You can give crocin at an interval of 6 hours. Also do full body tepid sponging (not with cold water but with slightly warm water) under high speed fan.
Fever with chill is characteristic of UTI. Please don't use blanket to cover the body in case of shivering or chill as it decreases the heat loss.
If fever persists even after giving paracetamol and sponging, you can give mefenemic acid (meftal p) 250 mg. Mefenemic acid can be given three times a day.
I expect, fever to come down within next two days. If fever persists we may need to investigate further.
Continue giving cefuroxime and nitrofurantoin in the mentioned dosage.
Give plenty of fluids to maintain the hydration and also to flush out the bacteria from urinary tract.

I hope these measures will provide her relief.
Wishing for her early recovery.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (24 hours later)

Dear Sir,
Thanks for reply..

Yesterday night we had given Meftal-P 250mg to My daughter... then fever started coming down from 103F to normal... today we have given Crocin 500 once in day time... fever is maintained in normal only... today no high fever...

Actually, We have given urine sample for senstive test on 8th XXXXXXX in our village local lab... today we got reports of the same... I am uploading same report also.... There are some variations in Lalpath lab report (dated 06/06/20) and this local lab report (dated 10/06/20)...

I am not able to understand why these variations are there... Please go through the same and guide me.

with regards and waiting for your reply.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (4 hours later)

Brief Answer:
No need to worry, Continue advised medications

Detailed Answer:
Hi

I have seen the new culture report. This report is almost same as previous one.The only difference is that here the organism is resistant to ciprofloxacin.
Briefing you about culture sensitivity report for better understanding. Actually different labs check sensitivity pattern for different group of antibiotics and there is always some difference between the antibiotic selection among different labs. The new lab has not tested for cefuroxime and showing resistance to cipro.
As we have already given ciprofloxacin last time and the new report showing resistance to same. It is better to continue cefuroxime and nitrofurantoin.
As fever is showing declining trend, you can continue paracetamol three times a day for next one day and meftal P only if needed. From day after tomorrow you can give paracetamol only when there is rise in temperature.
Declining fever is a positive sign that antibiotics are working well.
As she has this UTI problem since long it would be better to continue with same dose for total 14 days initially and then with low dose nitrofurantoin for next 6-8 weeks.
I can understand the reason of your anxiety but being a pediatrician and with my past experience I hope with this treatment she will be cured
completely.
Wishing for good health of your daughter.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (12 days later)

Hai Sir

It is regarding My daughter XXXXXXX XXXXXXX .. UTI infection.

we have completed 14 days Cefuroxime 250mg twice a day along with Nitrofurantoin 100mg... after first three days of this medication, high fever came down.. Now no fever... no burning sensation after urine and no symptoms.

Now we are giving Nitrofurantoin 50mg... how many days to be given ?

Do we need to get any test now ?

Please guide me

Thanks

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Continue nitrofurantoin for next 2-3 months

Detailed Answer:
Hi

Welcome again

It's good to know that your child is doing well.
As she is suffering from chronic/recurrent UTI ,it would be better to continue low prophylactic dose for next 2-3 months. In such case long term treatment is needed to avoid recurrence.
Maintain all hygiene and continue giving plenty of fluids.

I shall be glad to help further if you need any.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Pradeep Kumar Jain (23 hours later)

Hai Sir,

Thanks for your reply....

1. Please confirm any Urine tests are to be done ? & when to be done ?

In addition to above...
2. My left hand thumb middle joint pain is there from last one month... what is to be done to get relief sir ? I don't when it started... I usually do gym...

waiting for your replay sir....

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (28 minutes later)

Brief Answer:
No need to repeat the urine test

Detailed Answer:
Hi

There is no need to repeat the urine test if she is asymptomatic.
That joint pain can be transient. If it worsens or there is associated swelling please let me know. You can apply some gel like diclofenac gel if the pain is significant.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (16 days later)

Hai sir

How are you

PAST HISTORY:
I am having Allergic rhinitis/sinusitis from long time... it was converted as chronic sinusitis... daily little white mucus... then eye ( corner area of nose) itching also started.. I am using Montek LC tablet from last three months once on every alternative day and nasal wash once or twice daily. sinusitis and eye itching under control only... no running nose... no sneezing; when I stop the tablet... eye itching getting started..

but I have VERY SMALL WHITE PIMPLES/BLISTER type inside nose (entrance area) from last four days; very small area of nose inside entrance area. I have no pain and itching. I have little tingle sensation and uneasiness...

Is WHITE PIMPLES/BLISTER because of Nasal spray ? how can I get it cured ?

As I am taking Montek LC tablet from long time... can I stop.. If I stop... how to handle eyes itching... ? now white mucus is also not there... but eye itching is there.

Pls guide me sir

Pls guide me.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (20 hours later)

Brief Answer:
Continue montelukast cetirizine and consult an ENT specialist

Detailed Answer:
Hi

I can understand your concern

Allergic conditions recur or persist if exposure to allergen is continuing.
In such cases where we don't know the culprit allergen or where avoidance of allergen is not possible, we should continue the anti allergic medications.
The white colored lesion can be small polyp( can't say exactly) as polyps are common with allergic rhinitis and sinusitis.
I would request you to continue the antiallergic medication and to consult an ENT specialist for clinical examination. You may also undergo allergen sensitivity test to find out the causative allergen.
I hope this helps.
please get back to me if you have any more doubts.
regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Pradeep Kumar Jain (36 hours later)

Hai Sir,
Thanks for your reply.

Not in a position to get allergen sensitivity test due to coronavirus domestic problems.

Mostly these are not polyps... I think it is kind of fungal or some other infection... very small white cluster type is there. DO I NEED TO APPLY ANY CREAM OR TABLET ?

I am using Montek LC tablet from three months... took daily for first month... took once on every alternative day for two months... IS IT SAFE TO TAKE Montek LC tablet for MORE TIME ?

Please advise me sir.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (15 hours later)

Brief Answer:
You can continue montelukast cetirizine tablet for long run

Detailed Answer:
Hi

Welcome again
I can understand your concern about delaying investigation considering corona infection.
You can use montelukast and cetirizine for long term without any significant side effects.
Regarding nasal mass I would request you to consult an ENT specialist as clinical evaluation is needed to diagnose the condition.

Wishing you good health.
Regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Pradeep Kumar Jain (3 days later)

Hai Sir,

It is related to my daughter skin allergy issue. she is 11 years old.

Basically my daughter skin allergic whenever she play in soil and plats... some patches comes on legs... we shown to doctor also... they told these will come down by age....

But now 20 days back came to our native village from XXXXXXX
today my daughter got patches on her skin... not sure reasons...is it some allergy or some mosquito bites kind.. or what... she is not having any other symptoms.

Can you sought me some medication for these.
I am uploading photos of the same

with regards

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (20 hours later)

Brief Answer:
Long term Oral antiallergic with local application of steroid will help

Detailed Answer:
Hi
I have gone through the details and most likely it is some kind of allergy.
The best way to get rid of these type of lesions is to avoid the allergen. But most of the time the allergen is not known.
Allergic disorders run in families. You can give monteleukast cetrizine combination to her also. The dose will be 5 mg once a day. This needs to be given for long term.Local application of hydrocortisone 1% cream for 3-4 days helps in early resolution of skin lesions.

I hope this helps.
Please let me know if you have any more queries.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Pradeep Kumar Jain (17 hours later)

Hai Sir
How are you.

We would like to know about vitamin supplements.

We have not reports of any vitamin test... but in general as per present situation of Corona virus... we would like to take Vitamin C, D and B Complex for our whole family.

my family is Me, my wife, my mother, and my kids.

Mother age is 62 years.
Kids age is 12 year one and 14 years.. weight is around 40 to 44 kgs each.

Please suggest us what dosage and how frequent these supplements to be taken .... based on present scenario... we want to enhance immunity...

Please suggest us in this regard. Please also suggest us if any other supplements, if you want to recommend.

regards and thanks

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Vitamin v and b complex daily and vitamin d weekly

Detailed Answer:
Hi sir

Nice to hear from you once again.
I am great. Hope you and your family members are doing fine.
Vitamin B complex and vitamin c are water soluble and there is no such toxicity with overdosing as being water soluble the excess amount get excreted from kidney.
So all of you can take any multivitamin formula like A to Z syrup or Becon syrup 5-10 ML twice a day.
Similarly vitamin C (Limcee)can be taken 500 mg one a day.
Vitamin D is a fat soluble vitamin and the dose is 60000 units once a week for 8 weeks irrespective of age and gender.
You can also use ashwagandha,giloy wati, aamla juice, lemon juice or tulsi leaves to enhance your immunity. Drinking lukewarm water and steam inhalation also helps.

Wishing for good health of your family.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Pradeep Kumar Jain (0 minute later)