Brief Answer:
Your urine analysis report is indicative of urinary tract infection

Detailed Answer:
Hello mam,
I did review your concern.

Your urinary analysis shows low normal pH and presence of deposits which on microscopy is significant for pus cells. It is most commonly seen in lower urinary tract infection but can also be seen with urinary tract stones, vaginal infection, interstitial nephritis,urethritis.

I would recommend the following steps-
1)The next best step would be urine dipstick test for leukocyte esterase and nitrites as well as urine culture for bacteria isolation, culture and sensitivity.

2)After the tests are done, you can start empirical antibiotic therapy, under your doctor guidance like trimethoprim-sulfa drug combination or norfloxacin for 7-14 days.

3)If you are having burning pain on urination, you can use phenazopyridine medication available over the counter 3 times a day to relieve you of your pain.
Once the test results are back we can modify your treatment and further management accordingly.

4)Also if you keep on having these problems and these urine findings for more than 2-3 times in a year then i would recommend a work up for diabetes and Intravenous pyelography/CT scan to visualise your lower urinary tract for any abnormality causing recurrent Urinary tract infection.

5) Also if you have vaginal or urethral discharge and itchiness I would recommend a gynecological examination for that and treatment for that in form of azithromycin/doxycyline but only under doctor guidance and only after proper examination.

Most likely its just an isolated case of lower urinary tract infection and will resolve with antibiotics and will be confirmed by the tests that I recommended. There are few other causes of pus cells but that need to be evaluated only if test results show us something else.
I hope this helps
Let me know if you have any more questions or concerns.i will try my best to help you. Also provide me feedback of your health and condition.
Wish you all the best mam.
Sincerely,
Dr Parth Desai

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Brief Answer:
I would recommend review of diabetes and lipidemia treatment and lifestyle

Detailed Answer:
Hello mam,
Thank you for your reply query.

Presence of uncontrolled diabetes makes it a complicated cystitis and I would recommend urine culture and senstivity followed by oral Levofloxacin 750mg OD for 10 days.

Also, Your HbA1c is elevated indicative of chronically raised sugar in your body so diabetic medications need to be evaluated. If needed insulin dose can be increased or glargine preparation can be added for a more sustained normoglycemia. The root cause of all problems you have explained may be due to diabetes not being controlled properly.

Along with diabetes cholesterol is high so a Atorvastatin is indicated and you can discuss that with your doctor. A renal test to detect microalbuminuria and if positive- starting ACE inhibitor medications will also help on long run.

Since there is swelling on both legs and feet I would recommend a echocardiography of heart and chest xray to rule out any chronic heart problem.

Also I would recommend following changes that may help control diabetes
1)Regular small quantity of meals, frequent intervals but small potions each time. They should be low in saturated fats,refined sugars and high in fibers and complex carbohydrates and natural sugars like fruits and vegetables.
2)Food rich in potassium like coconut water. It maintains potassium balance in diabetes and my personal experience as a doctor is good with this advice. many patients do benefit.
3)Once the feet pain goes away and heart investigations are normal i would recommend daily aerobic exercise to reduce weight and maintain sugar levels in body.
These changes are scientifically proven to help people along with medications in people with uncontrolled diabetes.
I know all these advices are easy to give but difficult to follow but with great determination and will power I am sure you will be able to bring back your sugar levels back to normal and all the problems will reduce.

As of now please review with your doctor and take the medications for urinary tract infection.
I hope this helps
wish you all the best
let me know if you have any more questions or concerns,
Also provide me feedback about your health and condition.


Sincerely,
Dr Parth Desai

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Brief Answer:
Resume olive oil and discuss following with your doctor for medications.

Detailed Answer:
Hello mam,
Thank you for your reply query.
You can upload your ECHO here for me to see. Most likely if it is reported normal heart is doing fine.
However, for the swelling in legs I would recommend you consult your doctor and get it evaluated. may be an abdominal ultrasound and total serum protein as well as urine albumin will help.

Olive oil is considered very healthy as it is rich in PUFA oil. polyunsaturated fatty acids are good for health as compared to saturated or trans fat which should be zero ideally in your oil. Also once you use the oil and it changes its color you should not use it again as heating converst PUFA into trans fat.

The tablets mentioned by you were good for your current health. however, i would recommend you to discuss these with your doctors-
1) Initiating a statin drug for lipid control.
2) reviewing diabetes medications esp insulin to bring HbA1c to less than 6.5(its 10 at this time).
3) Doing a urine for microalbumin test and if positive add an ACE inhibitor at low dose to prevent long term renal and heart injury by diabetes.

Please try to follow a healthy life style in form of diet and exercise as I mentioned previously. I am sure you will feel supergreat after few days of following that.

I hope this helps.
Let me know if you have any more questions or concerns mam. i will try my best to help you.
Wish you all the best.
Sincerely,
Dr Parth Desai

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