Obstructive Uropathy . . . Rectal Examination . . . Intravenous Pyelography . . . Flu.

July 18th

I had a middle-aged male yesterday, referred from his company clinic. His problem was difficulty in micturating. He would get to a convenience whenever he feels the urge to pass urine but then finds that he needs to wait for many seconds to lapse before the urine out-flow can actually begin. There usually is some straining on his part to achieve a good stream.

Obviously he has some degree of obstruction anywhere along the urinary out-let. Could be a Urethral Stricture or a disease pathology of the Prostate gland.

I had to do a full physical examination of the abdomen. This included a "digital" examination. This is a physical assessment per rectum (or a PR), in which the right index finger of the gloved hand, is inserted deeply into the rectum via the anus, in a certain deft maneouvre.

I went ahead, informed and prepared him on my couch and then executed this maneouvre, thus acertaining the nature of the rectal mucosa as well as the prostate gland, all in one sweep of that index finger.

My findings were normal. His rectal mucosa seemed free from any gross pathology and the prostate gland appeared the usual way.

Of course such an examination cannot in itself create a definite, informed opinion. And so I sent him off to do an intravenous pyelograghy - these are radiological studies - amongst other medical tests and investigations.

July 18th

A couple entered my consulting room with their ill toddler. The mum was visibly expectant of a new baby while the "sick" child didn't look so, at all.
As I made the inquiries as to what exactly the problem was, the child played around the room happily.

The dad looked well-groomed and quite the successful family man, all in his mannerisms.

As I examined his little girl, I engaged him conversationally, inquiring what line of business he was into. He was an Accountant in a well known firm.

We talked about the state of the Nigerian capital market. I wrote a prescription for the child while I informed them of this medical blog, writing down for them the web-site and joking that I just might make an entry about their visit if not for anything significant but to mention how healthy-looking I found their daughter to be.

She was indeed chubby and playful. I think it was a minor case of flu that she had.

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