BIOSOFT HELP FILES

1)      Malignant ulcer

1)      Ecthyma -

2)      Tropical ulcer

3)      Atopic eczema

4)      Drug dermatitis

5)      PVD

6)      Diabetic ulcers

7)      Neuropathic ulcers

1)      Intertrigo

2)      Fungal infections

3)      Cellulitis

1)      Umbilical infection – Mx with Penicillin or Erythromycin

2)      Umbilical granuloma – 1 mm- 1 cm pink, friable, nodule at the base of the umbilicus, persistent discharge. Mx – Silver nitrate application

1)      Stools containing discharge (fistula, urachal remnants)

2)      Umbilical cellulitis (precursor of sepsis)

3)      Bright res umbilical nodule (umbilical polyp)

4)      Prolapse of intestines through the umbilicus (omphalomesenteric remnants)

5)      Painful swelling of the umbilicus (omphalomesenteric remnants infections)

6)      Painful mass between the umbilicus and the suprapubic area (urachal remnants)

7)      Clear umbilical discharge containing urine (urachal remnants)

8)      Pain and discharge during urination (urachal anomalies)

1)      Stress incontinence – 50% of cases, stress incontinence +++, urge incontinence +, urgency, frequency, normal cystometry, Mx – In all cases except mild sx, medical unfitness for surgery and patient’s unwillingness, surgery is indicated, non-surgical methods include pelvic floor exercises, vaignal continent devices,  other general measures for incontinent include – incontinent pads, fluid restriction, avoidance of caffeine-containing products, medial management of cough and  constipation

2)      Detrusor instability – 40% cases, urgency, urge incontinence, stress incontinence, enuresis, frequency, nocturia, incontinence during sexual intercourse, Ix – urodynamic demonstration of failure to inhibit detrusor contractions during cystometry, Mx – general measures for incontinence as mentioned under stress incontinence, bladder drilling – passing urine every 1.5 hrs, not passing urine in between even if incontinent, continue until patient remain continent for 1.5 hrs, then increasing the voiding intervals half hourly and repeating the above steps until desired goals achieved, oxybutynin 2.5-5 mg tid, Tolterodine 1-2 mg daily (?),  imipramine  50 mg nocte, propantheline 30-60 mg qid, DDVAP 40 mcg nocte, finally surgery on failure of medical therapy,

3)      Lower urinary tract infections

4)      Functional incontinence

5)      Autonomic Dysfunction Syndromes – See under MMSSCs

1)      UTI – Upper

2)      UTI - Lower

3)      Detrusor instability -

4)      asdfasf

1)      UMN lesion of lower limbs

2)      LMN lesions of lower limbs

3)      Urinary dribbling, frequent small voids, recurrent UTI, palpable bladder abdominally, residual urine volume in bladder more than 50% of bladder capacity, weak urinary stream, pelvic mass, cystocele (chronic retention with overflow)

4)      Recent AH, obstructed labor, continuous dribbling of urine diurnal and nocturnal (urinary fistulas)

5)      Spina bifida occulta, the bifid clitoris (congenital abnormalities of the urinary tract)

6)      Postmicturition pain, postmicturition dribbling, dyspareunia (urethral diverticulum)

(Cardozo 1999)

Irritative voiding syndrome - Frequency of micturition, Urgency, Nocturia, Dysuria,

Obstructive voiding syndrome - Hesitant, interrupted, weak stream, urgency, leaking, dribbling, nocturia, significant postvoid residual urine, ineffective straining, poor stream, postvoid fullness, double voiding,