Urinary Tract Infection UTI

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. The main etiologic agent is Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it does not usually have bacteria in it. When bacteria get into the bladder or kidney and multiply in the urine, they may cause a UTI.

The most common type of UTI is acute cystitis often referred to as a bladder infection. An infection of the upper urinary tract or kidney is known as pyelonephritis, and is potentially more serious. Although they cause discomfort, urinary tract infections can usually be easily treated with a short course of antibiotics. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine.

• Most common in females because of anatomy of the lower urinary tract: urethra is short and meatus  is close to the anus.
• Peak incidence occurs at 2 to 5 years of age.

Prevention

The following are measures that studies suggest may reduce the incidence of urinary tract infections.

• A prolonged course (six months to a year) of low-dose antibiotics (usually nitrofurantoin or TMP/SMX) is effective in reducing the frequency of UTIs in those with recurrent UTIs.
• Cranberry (juice or capsules) may decrease the incidence of UTI in those with frequent infections. Long term tolerance however is an issue.
• For post-menopausal women intra vaginal application of topical estrogen cream can prevent recurrent cystitis. This however is not as useful as low dose antibiotics.
• Studies have shown that breastfeeding can reduce the risk of UTIs in infants.

A number of measures have not been found to affect UTI frequency including: the use of birth control pills or condoms, voiding after sex, the type of underwear used, personal hygiene methods used after voiding or defecating, and whether one takes a bath or shower.

Therapeutic interventions.

• antibiotics to eliminate infection.
• Identiry and correct structural anomalies if present.
• Bland, high-protein, high carbohydrate diet.
• Prevent recurrence; preserve renal function. 

Principle of growth and development

Children may vary among each othe i their rate of growth and dvelopment. But stil all of them follow certain principles as follow.

• Growth and development is a continuos prcess from conception to adolescence. The rate of growth varie at different ags. During prnatal d infancy period the eate of growth is very rapid. This growth rat gradully declines during early childhood During te middle hilhood the growth rate is slo. the growth rate again becomes rapid durn puberly. Thus infancy and puberty ar two specific periods of rapid growth.
• The development takes place:

a.  In the cephalo-caudal directin.That means development proceeds from head to toe. For example the first step towards walking  is head control then sitting abilility.

b. Fom general to specific: That means general development takes place before special development. For example during skill development the gross motor skills will be developed before fine motor skills.

Developmental Tasks

In the process of physical growth and the development of abilities and skills the children are expected to carry out certain responsibilities or tasks at certain stages of dvelopment. These tasks are called developmental tasks. Havighurst, a psychologist, has defined the developmental task as "the task which arieses at certain periods in the life of an individual, the successful accomplishment of which leads to satisfaction and success with later tasks while the failure leads to dissatisfaction and difficulty with later life."  Some of these developmental tasks arise out of physical maturation e.g. learnng to sit, stand or walk. Wereas other developmental taks arise from social pressure e.g. learning to play , speak, read etc. and some developmental tasks arise out of personal values and desires e.g. preparing for a vocation.

Purposes of developmental tasks

•  Developmental taks serve as guidelines to know what the chiild is expected to do at different ages.
• Developmental tasks enable the parents to motivate children to do what is expected of them.

Developmental taks enable the parents to know what lie ahead and what the child is expected to do in the successive stages.