#urinary retention treatment

[urosaketnarnoli]

Urinary retention is a condition characterized by the inability to empty the bladder completely. Common causes include an enlarged prostate, urinary tract obstructions, and neurological conditions. Symptoms may include weak urine flow and frequent urination. Treatment options vary but can include medications, catheterization, or surgical intervention, depending on the underlying cause.

[drmayurdalvi]

Urologic Emergencies Management and Treatment Strategies

Overview

Urologic emergencies refer to conditions that require immediate medical attention due to their potential for serious complications. These emergencies can range from life-threatening conditions such as urosepsis to painful conditions such as kidney stones.

In this blog post, we will discuss the management and treatment strategies for some common urologic emergencies.

Urinary Tract Infection (UTI)

UTIs are a very common urologic emergency, especially in women. Symptoms include burning pain during urination, increased frequency and urgency to urinate and fever. UTIs can cause major problems, like kidney infections if they are not addressed.

Management: The first step in managing a UTI is to obtain a urine culture to identify the bacteria causing the infection. Antibiotics are then prescribed based on the culture results. For intravenous antibiotics, hospitalization may be required in extreme cases.

Kidney Stones

Kidney stones are solid masses made of crystals that form in the kidneys. Severe side or back discomfort, nausea, vomiting, and blood in the urine are all symptoms. Kidney damage and urinary tract obstruction can both result from kidney stones in extreme circumstances.

Management: Treatment for kidney stones depends on the size and location of the stone. Pain management with analgesics is important to help patients cope with severe pain. Small stones can be treated with medication and hydration to help pass the stone. Large stones may require surgery or shock wave lithotripsy to break up the stone.

Testicular Torsion

Testicular torsion occurs when the spermatic cord twists, cutting off blood flow to the testicle. The scrotum will be extremely painful, swollen, and red. Testicular torsion is a medical emergency and requires immediate attention as the testicle can die within hours of torsion.

Management: Surgery is the primary treatment for testicular torsion. The goal of surgery is to untwist the cord and restore blood flow to the testicle. It might be necessary to remove the testicle if it is significantly injured.

Urosepsis

Urosepsis is a severe infection that occurs when a urinary tract infection spreads to the bloodstream. Symptoms include fever, chills, confusion and rapid breathing. Urosepsis is a life-threatening condition that requires immediate medical attention.

Management: Treatment for urosepsis includes hospitalization, intravenous antibiotics and supportive care. In severe cases, patients may require admission to the intensive care unit (ICU).

Acute Urinary Retention

When a person is unable to empty their bladder, acute urine retention develops, causing excruciating agony and discomfort. Causes include prostate enlargement, bladder stones, and neurological conditions.

Management: Using a urinary catheter to empty the bladder is part of the treatment for acute urine retention. In some circumstances, surgery can be required to address the retention's underlying cause.

Conclusion

 urologic emergencies require prompt medical attention to prevent serious complications. Early identification and treatment are key to successful management. If you are experiencing symptoms of a urologic emergency, seek medical attention immediately. If you are seeking such as urological condition please visit for better constancy

 drmayurdalvi.com

[cryptwrites]

Poisons

Hello! I'm gonna share how I go about writing poisons and the things I think are helpful to keep in mind. Now, I have never actually poisoned someone - shocker - but I have done extensive research on the topic, so I would say I know a decent amount about how to effectively poison someone. Disclaimer: This is for writing purposes only, don't poison people. Thanks.

Keep In Mind:

Poisoners need little to no physical strength although they do need a strong sense of self control & nerves of steel. Shooting or stabbing someone takes a mere moment of consideration and is frequently the result of  a split second decision, while position requires dedication. Many poisons require a certain amount of time to work and the poisoner usually must administer several doses of poison in order to work. The poisoner also usually must be within close proximity to their victim and often will have to look them in the eye and engage with the person while the person slowly dies.

Exotic poisons can be more trouble than they’re worth. Importing exotic poisons leaves a trail for authorities to follow, and they require more research to correctly use.

Smart poisoners work with what they’ve got. The clever killer looks for drugs that are already in the victim’s medicine cabinet and that could be deadly. Read medical warning labels to get an idea of how to use them.

Poison can be used in ways that aren’t deadly. If the goal isn’t death, you can render someone dizzy or dopey, making a character vulnerable to a bad influence. 

Common Poisons

Hemlock: Poison hemlock comes from a large fern-like plant that bears a dangerous resemblance to the carrot plant. It was readily available for treating muscle spasms, ulcers, and swelling, but in large doses will cause paralysis and ultimately respiratory failure. 

Mandrake: It was used as a sedative, hallucinogen and aphrodisiac. Superstition mediaeval denizens believes when the vaguely human-shaped root was pulled out that plant gave a piercing shriek that would drive anyone to madness or death - hence the harry potter scene.

Arsenic: Arsenic comes from a metalloid and not a plant, unlike the others but it’s easily the most famous and is still used today. instead of being distilled from a plant, chunks of arsenic and dug up or mined. It was once used as a treatment for STDs , and also for pest control and blacksmiths, which was how many poisoners got access to it. It was popular in the Renaissance since it looked similar to malaria death, due to acute symptoms including stomach cramps, confusion, convulsions, vomiting and death. Slow poisoning looked more like a heart attack.

Nightshade: A single leaf or a few berries could cause hallucinations - a few more was a lethal dose. Mediaeval women used the juice of the berries to colour their cheeks, they would even put a few drops on their eyes to cause the pupils to dilate for a lovestruck look which is why Nightshade is also called ‘Belladonna’ or “Beautiful woman.” The symptoms include dilated pupils, sensitivity to light, blurred vision, tachycardia, loss of balance, staggering, headache, rash, flushing, severely dry mouth and throat, slurred speech, urinary retention, constipation, confusion, hallucinations, delirium and convulsions.

Aconite: This toxic plant, also called Monkshood or Wolfsbane, was used by indigenous tribes around the world as arrow poison. The root is the most potent for distillation. Marked symptoms may appear almost immediately, usually not later than one hour, and with large doses death is near instantaneous. The initial signs are gastrointestinal including nausea, and vomiting. This is followed by a sensation of burning, tingling, and numbness in the mouth and face, and of burning in the abdomen. In severe poisonings pronounced motor weakness occurs and sensations of tingling and numbness spread to the limbs. The plant should be handled with gloves, as the poison can seep into the skin.

If someones poisoning another:

The character should analyse the daily life of the target well before attempting to poison them. Note what sort of medicines they take, at what moments they are most vulnerable, how attentive they are to their surroundings, and so on.

Choose a poison that suits your needs. You need to be as discreet as possible and not arouse suspicion. Too dramatic and people will know something is up. Choose poisons that are easy to slip into meals/don't have to be administered constantly, or you could simply frame it as an overdose by using the target's own medicines.

Think of how you want to administer the poison. Some take effect through touch while some require being swallowed. Based on that, come up with a plan to poison your target.

Make sure everything corresponds with the plot and characters, and nothing becomes a plot hole. Don't have a typically nervous character be perfectly calm when thinking of poisoning. Don't poison someone just for the sake of it. Have everything tie back to the plot, your characters rarely should be poisonings someone just for the "cool" effect. Trust me, it doesn't actually have that effect and just comes off like lazy writing. Have your characters act in accordance with their personalities.

Research time periods and history when choosing poisons. Not all poisons were popular during the same time periods, and not all of them are native to the same geographical areas.

[butchpeace]

Pelvic Floor Health for Detrans Women

A disclaimer before we start: I am not a doctor, a PT, or an expert of any kind, I just noticed there was a lack of information about pelvic floor health in the detrans (and trans) communities and I wanted to compile the information that I’ve gained. If there are any issues or you have any wisdom to share, please DM me! I plan to add to this post and edit it over time as I learn more.

95% of females who have been on testosterone report pelvic health issues, which can include urinary leakage or retention, bladder pain, difficulty emptying the bladder, general pelvic pain, pain with sex, vaginal dryness, vaginal atrophy, vaginismus, anal issues, and more. (Source)

If you’ve experienced any of these problems, you’re not alone, and there are things you can do!

Vaginal Atrophy

The vast majority of detransitioning women (and females who are transitioning) have vaginal atrophy, which is a thinning and weakening of the tissues that line the vaginal wall. Atrophy can lead to pain during sex, or with regular movement, bleeding due to small tears in the vaginal lining, narrowing of the vaginal canal, urinary issues, and more.

Because testosterone affects our ovaries, we can think of this issue as something similar to GSM (Genitourinary Syndrome of Menopause). Many of our symptoms mirror what happens to women as they age and their estrogen production decreases.

Treatments for Atrophy

1. Vaginal estrogen comes in the form of creams, suppositories, and insertable rings.

2. Vitamin E suppositories have been found to be as effective as vaginal estrogen in some studies. (Source)

3. Regular sexual activity can help by filling the vaginal wall tissues with blood, which can help to revitalize those tissues.

There are also many options for dryness, including vaginal moisturizers, aloe, coconut oil, and more. Sometimes the simplest natural options can be the most effective! Always talk to your gynecologist and do your own research on products you’re considering buying and make sure the ingredients are safe. Some people may experience yeast infections and other issues when using certain products.

Vaginal atrophy itself is to blame in many cases for the urinary symptoms that many of us report, and treating the atrophy may be all that’s needed in order to improve the urinary symptoms.

In other cases, we also need to look at overall pelvic floor health. I would argue that taking care of your pelvic floor is essential for any woman at any stage of life, since it can help with so many things!

Pelvic Floor Muscle Issues

Pelvic floor health issues can be divided into 2 types - Hypotonicity and Hypertonicity. Both types can lead to bladder issues, among other things.

Hypotonicity is the classic type many women experience after having children or during menopause. It’s also described as having a weak pelvic floor, and kegels are often the best treatment. The YouTube playlist at the end of this post includes videos for beginner and advanced kegel exercise methods and yoga.

Hypertonicity is the opposite type, where the pelvic muscles are chronically tight. For this, the treatment is to use muscle release methods to relax the pelvic floor. Remember - Relaxed muscles are the best at doing their job.

You wouldn’t think at first that Hypertonicity could lead to urinary symptoms like leakage, but when your muscles are overly tight, they just don’t work the way they should.

And when you have a urinary issue, or you’re dealing with the aftermath of childbirth, surgery, or any other medical trauma to the pelvic floor, there can be a tendency to reflexively tighten your muscles all the time, for fear of what might happen if you don’t. Some people with hypertonicity also experience their symptoms getting worse if they do a lot of kegel exercise. In these situations, kegels can become counterintuitive.

That said, using methods to address both types can be the best option for some people. As long as you listen to your body, keep track of how each method makes you feel, and talk with a doctor or pelvic floor PT if you have serious concerns or don’t understand how to do something, you should be able to figure out something that will help!

Vaginismus is also a very common condition that’s connected to hypertonicity and potential mental causes. You’ll know you have Vaginismus if you’ve always had trouble inserting things into your vagina, or if your partner has had trouble with it. Many women describe it as a sensation of the vagina closing up when faced with something trying to get in. You may find that at certain times or with certain objects, you have no problem, and at other times or with other objects, you do. Stretches and massages for hypertonicity can often help with Vaginismus.

Prolapse is a relatively common issue in women who have had kids and older women in menopause. This can also cause urinary symptoms. The incidence of pelvic floor prolapse in females on testosterone is not known, but due to atrophy weakening the walls of the vagina, it’s possible that testosterone will increase your risk. It’s also more common in people who have had a hysterectomy.

Tools

1. Vaginal dilators can be helpful for people who have trouble with Vaginismus or feel like their vagina is small. These are also helpful for people who have difficulty inserting fingers

2. A pelvic wand can help you to massage the internal muscles, if needed

3. Vibrators can be helpful for releasing tight muscles

4. Kegel trainers come in various types and can help you perform kegels more effectively if you know that your issue is hypotoniticy

5. Pessaries can help in cases where atrophy has led to pelvic floor prolapse. Make sure you get diagnosed before using one!

6. Your hands! Don’t underestimate the power of using your hands for external or internal massage

The biggest thing to take away from this post is this - Don’t be afraid of your vagina! Don’t be afraid to try things that may help you improve whatever issues you’re having.

Your vagina is a normal part of your body, and especially when you’re experiencing issues, that’s when it’s time to get to know it inside and out. If you’re anything like me, you’ve gone your whole life being too afraid to do certain things or explore your vagina in certain ways. We need to reduce the fear, stigma, and awkwardness of vaginal and pelvic floor issues, and the first step is to get to know your body. 💪

Exercises

I’ve put together a playlist of YouTube videos that have helped me in this process, which I will continue to add to. I hope they help you too!

And again, please DM me with any information you think is helpful or stories about what worked for you.

And if you’re a medical professional, I would love for you to review this post and suggest edits or additions.

Please share this with all your friends! My intention is for this to be a community resource we can use to spread awareness✌🏼

[cedar-glade]

From last fall: One of the reddest reds on the landscape, associates with ericaceous heath belts with minimal light competition. So mainly dry sandstone with shallow nutrient poor soils and good drainage or sandstone barrens. Due to slow growth and an acidic weathering effect associated with the bark cortex and the water retention these species also tend to have incredible lichen diversity.

Citheronia regalis horn devil larva are associated as the primary moth that eats these leaves.

Oxydendrum arboreum

Sourwood, or some call it sour bark tree, chewing on the bark and active phloem was once common practice to alleviate the nerve pain associated with toothaches. The leaves themselves are an anti-gas, anti-inflammatory laxative(strong one at that). In some cases a tea can be made of the leaves that also aids in other issues and have been used to treat urinary infections by native people and early settlers to the Appalachian mountains and ilp.

Right now at llanfair permaculture we have an interesting soil dynamic that may be accessible for species like this due to good drainage and high organic comp as well as good lighting, the other thing is that these seeds don't seem to require any specialized treatment to germinate.

https://www.jstor.org/stable/3799771

[macgyvermedical]

What’s your most controversial hospital opinion?

Hoo boy.

I'd have to say it's a tie.

First, I'd say that the medicalization of nursing practice was a mistake.

See, medicine and nursing are two different sciences. Medicine treats disease (for example, asthma). Nursing treats reaction to disease (for example, the difficulty breathing related to asthma).

While an RN (Registered Nurse) is technically an independent license (as in, we are able to do our own assessments, create and implement our own care plans without direct oversight or orders), we still can't prescribe. Now that's fine- I'm definitely not saying an RN should have prescriptive privilege.

Because we can't prescribe, though, we need someone with prescriptive privilege to order things like pain medication, nausea medication, bronchodilators, and other things that drugs might do better than available nursing-based alternatives.

The problem is that hospitals tend to require orders from a doctor for things that should be entirely under a nurse's purview. Things like q2hr turns for pressure injury prevention, fall prevention interventions, patient education, and other things that by law don't require a doctor's order, and for which doctors are not well trained. This tends to end with a subpar set of orders related to the nursing care of that patient, and nurses don't really have the freedom to override these orders (or the time to educate our medical counterparts on nursing care to get those orders changed).

Now, there are nurses who can prescribe- Nurse Practitioners (NP or DNP, depending on their highest degree).

So if I ran the nursing world, I would de-medicalize nursing care. There would be a nurse practitioner on each floor whose job it was to manage pain, nausea, discomfort, urinary retention, wound care, constipation, and other things that are reactions to disease that require drugs or other orders to manage. This would free up doctors to focus on things they were trained for, and allow nurses to do what they were trained for, and, hopefully, result in better outcomes for the patient.

Second, and this one probably is more controversial, I think the trend towards single-occupancy rooms in hospitals was a mistake.

Not, of course, because I feel like privacy shouldn't be a thing or that single rooms are too cushy, I just genuinely think the care would be better in a ward-style setup.

Here's the thing. When a patient is in a room alone, we can't see them and they can't see us. They don't know if we're actively taking care of someone else, and we have to go all the way into a room (and all the customer service that goes into going into a room) just to check if a catheter bag needs emptied or if SCD pumps are on, or if one of our many confused patients is trying to get out of bed.

This tends to result in situations where patients feel like they've been forgotten or aren't getting the best care we can give them. It also results in things like food or needed medications being left in patient rooms for a long time because we didn't see it dropped off, and patients who go hours without an SCD pump being on because we might only see them once every 2 hours (instead of a quick check every time we're on the way to another patient).

And finally, while this sounds ridiculous, the size of the hospital floors that are needed to house single-occupancy rooms are a drain on time when time is at an absolute premium.

See, picture you're doing a 12-hour shift and you have 6 patients. That's 2 hours of care per patient spread over 12 hours. That's not direct care, either. Order needs changed or clarified? That's 10 minutes gone. Charting? That's another 45 minutes. Pretty soon you get down to less than an hour to give meds, do all necessary assessments, treatments, clean ups, education, etc... Spread over 12 hours. That amounts to about 20 minutes in a patient room spread over every 4-hour period. Say it takes 30 seconds to get from one room to another. Say it takes more than a minute to walk from the med machine to the room. That time all adds up, and eats into those 20 precious minutes.

Versus if I could have all 6 of those patients laying in beds right in front of me, maybe with walls between them and the option of a curtain facing the hall for privacy, I could provide considerably more nursing care with the same amount of time.

[weirdstrangeandawful]

Okay look. I really really love how much attention hEDS is getting because it is really hard for rare diseases to get treatment and diagnosis and hEDS is definitely underdiagnosed (still rare but also underdiagnosed). I also disagree strongly with the EDS society's gatekeeping of hEDS. Especially when their goal is to identify the genetic marker which means you need to rule more people in not out!!! If you end up with an extra group of people that's fine! I'm already convinced that hEDS is more than one subtype that have been erroneously combined.

But I will say that I've been finding a lot of people with joint hypermobility, and even generalised joint hypermobility, self-diagnosing makes it difficult to get treatment and diagnosis because the tone among doctors is shifting from 'devastating incurable illness that reduces quality of life to near zero and requires management as soon as possible' to 'just hypermobility'.

Yes, hypermobility is a pain. But I could deal with it.

I can't deal with (in no particular order) not being able to eat or drink, nausea, fainting, low blood volume, seizures, partial paralysis and ataxia, paresthesias, akathisia, extremely delayed wound healing and therefore infections, bruising from the lightest bump or blood draws, stretch marks, dermatographia, and other things that affect body image, thousands of dollars in dental work, constant cavities, ingrown nails, accessory toenails, extremely tight hamstrings (part of the reason I'm not diagnosed yet because they compensate for my lumbar spine), finger and thumb hyperextension, greatly reduced grip strength, dystonia, dislocations of both joints and tendons, trachea hypermobility causing me to stop breathing, severe TMJ issues, flat feet that have required mobility aids since I was 4 and continue to get worse, fragile and slightly hyperextensible skin, urinary retention, bladder and pelvic pain (including contraction-like symptoms without a uterus), severe headaches, tunnel vision, visual snow, tinnitus, insomnia, hypersomnia, joint pain, musculoskeletal pain, myofacial pain, nerve pain, nerve damage, extreme fatigue, hearing issues, vision issues, tremors, nutrient deficiencies, medication intolerances, and so many more symptoms and comorbidities.

And yes, I recognise that it's not the patients' faults. They should absolutely be able to bring up concerns of hEDS without it negatively influencing other patients. But doctors suck a lot of the time.

[myhealthhospital]

Understanding Urethral Stricture: Causes, Symptoms, and Treatment

Urethral Stricture: Causes, Symptoms, and Treatment

Urethral stricture is a narrowing of the urethra, the tube that carries urine from the bladder out of the body. This condition can lead to various urinary problems and discomfort. Understanding the causes, symptoms, and treatment options for urethral stricture is essential for proper management.

Causes of Urethral Stricture

Urethral stricture can be caused by several factors, including:

Trauma: Trauma to the urethra, such as from a pelvic fracture or a straddle injury, can lead to the formation of scar tissue, which can narrow the urethra.

Infection: Infections, such as sexually transmitted infections (STIs) like gonorrhea or chlamydia, can cause inflammation and scarring of the urethra, leading to stricture formation.

Inflammation: Chronic inflammation of the urethra, often due to conditions like urethritis or balanitis, can result in the narrowing of the urethra over time.

Medical Procedures: Certain medical procedures, such as catheterization or surgery involving the urethra, can increase the risk of developing a urethral stricture.

Congenital Factors: Some individuals may be born with a narrow urethra, predisposing them to developing strictures later in life.

Symptoms of Urethral Stricture

The symptoms of urethral stricture can vary depending on the severity of the narrowing. Common symptoms include:

Difficulty Urinating: Narrowing of the urethra can make it difficult to start urination or maintain a steady stream.

Urinary Retention: In severe cases, urethral stricture can lead to the inability to urinate, which requires immediate medical attention.

Urinary Tract Infections (UTIs): Narrowing of the urethra can increase the risk of UTIs due to incomplete bladder emptying.

Urinary Frequency and Urgency: Strictures can cause the bladder to contract more frequently, leading to a constant urge to urinate.

Spraying or Dribbling of Urine: The narrowing of the urethra can cause the urine stream to spray or dribble instead of flowing in a steady stream.

Pain or Discomfort: Some individuals may experience pain or discomfort during urination, ejaculation, or while passing urine.

Treatment Options for Urethral Stricture

Treatment for urethral stricture depends on the severity of the condition and may include:

Dilation: This involves stretching the narrowed portion of the urethra using a series of dilators of increasing size. It is a common treatment option for less severe strictures.

Urethrotomy: This procedure involves using a special instrument to cut the stricture, widening the urethra. It is often used for short strictures.

Urethroplasty: In more severe cases, surgery may be required to remove the narrowed portion of the urethra and reconstruct it using tissue from other parts of the body.

Medication: In some cases, medications may be prescribed to help reduce inflammation and prevent further scarring of the urethra.

Self-Catheterization: Some individuals may need to perform self-catheterization regularly to help keep the urethra open and maintain urine flow.

Conclusion

Urethral stricture is a condition that can cause significant urinary problems and discomfort. Understanding the causes, symptoms, and treatment options for urethral stricture is crucial for effectively managing the condition. If you experience symptoms of urethral stricture, it is important to consult with a healthcare professional for proper evaluation and treatment.

[hiranandanihospitalpowai]

Kidney Diseases in Children - What Parents Need to Know

Kidney diseases are not just limited to adults; children can also be affected. As a parent or caregiver, it's essential to understand these conditions, recognize potential signs, and be prepared to navigate the challenges that come with pediatric kidney issues. In this article, we will shed light on kidney diseases in children, common pediatric kidney problems, early warning signs, and the necessary steps for parents and caregivers.

Understanding Pediatric Kidney Diseases

1. The Scope: Kidney diseases in children can encompass a wide range of conditions, from congenital anomalies to acquired diseases. These conditions may affect the structure or function of the kidneys, impacting their ability to filter waste and regulate fluids.

2. Congenital Kidney Conditions: Understanding congenital kidney issues in children is crucial for early detection and intervention. Some children are born with kidney issues, such as congenital anomalies like hydronephrosis, polycystic kidney disease, or renal agenesis. Hiranandani Hospital Kidney plays a significant role in providing specialized care and treatment for these conditions, ensuring that affected children receive the necessary medical attention and support for improved health outcomes.

3. Acquired Kidney Diseases: Children can also develop kidney diseases later in life due to infections, autoimmune disorders, or other underlying medical conditions. Early diagnosis and treatment are vital for managing these acquired conditions.

Early Warning Signs

1. Urinary Changes: Keep an eye out for changes in your child's urinary habits. Frequent urination, painful urination, or bedwetting beyond a certain age can be indicators of kidney issues.

2. Swelling: Noticeable swelling in the face, limbs, or abdomen may be a sign of kidney problems, as impaired kidney function can lead to fluid retention.

3. High Blood Pressure: Hypertension is not exclusive to adults. Elevated blood pressure in children can sometimes point to underlying kidney issues.

4. Growth and Development: Poor growth or delayed development could be attributed to chronic kidney disease, affecting the body's ability to absorb essential nutrients.

5. Fatigue and Anemia: Kidney problems may cause anemia and fatigue, as the kidneys play a role in producing erythropoietin, a hormone that stimulates red blood cell production.

.

Read For More Blog: Causes and Treatments for Acne and Prevention Tips

Navigating Pediatric Kidney Care

1. Timely Consultation: If you notice any warning signs, consult a pediatric nephrologist promptly. Early diagnosis and intervention can significantly improve outcomes.

2. Diagnostic Tests: Your child may undergo various tests, including blood work, urinalysis, imaging studies, and kidney biopsies, to determine the nature and extent of kidney disease.

3. Treatment Approaches: Treatment will depend on the specific kidney condition. It might involve medications, dietary changes, or even dialysis in severe cases. Some children may require a kidney transplant.

4. Emotional Support: Pediatric kidney diseases can be emotionally challenging for children and their families. Seek emotional support through counseling or support groups to help your child cope.

5. Monitoring and Follow-up: Regular follow-up appointments and ongoing monitoring are crucial to ensure the effectiveness of treatment and the overall well-being of the child.

Conclusion

Kidney diseases in children may present unique challenges, but with awareness, early detection, and timely intervention, the prognosis can be positive. As a parent or caregiver, your vigilance is key to safeguarding your child's kidney health. At Hiranandani Hospital Powai we are here to support you through this journey, providing expert care and guidance for pediatric kidney issues. Your child's health is our priority, and we are dedicated to helping them lead a healthy, kidney-empowered life.

[caresonomedicaldevices2009]

Clinical Application of Bladder Scanner in Diabetic Nephropathy

Clinical significance: Clinically, the vast majority of patients with diabetic nephropathy have changes in urination habits, increased bladder residual urine volume and increased bladder wall thickness. At the same time, patients with increased residual urine volume in the bladder are more prone to urinary tract infections, and excessive accumulation of residual urine volume can lead to vesicoureteral reflux. Patients with ureteral reflux have a higher incidence of abnormal kidney function due to long-term urinary retention caused by damage to their nerves or muscles. Therefore, it is extremely important to prevent vesicoureteral reflux caused by increased residual urine volume in the bladder and renal failure eventually caused by urinary tract infection.

Bladder scanner is widely used in the early detection of diabetic bladder and the auxiliary treatment of dysuria caused by diabetes. Bladder scanner can provide meaningful bladder volume and bladder residual urine volume data for clinical treatment of diabetic nephropathy and ureteral reflux ,etc.

Caresono bladder scanner has been widely used in the treatment of diabetic nephropathy, and has been well received by experts internationally.

For more information, pls visit:https://www.caresonomedical.com/news/clinical-application-of-bladder-scanner-in-diabetic-nephropathy

Email: spring.xu@caresono.com.cn

[medicallycomplexawareness2023]

What is Functional Neurological Disorder

What is Functional Neurological Disorder?? 

Functional Neurological Disorder (FND) describes a Problem with how the brain Receives and sends information to the rest of the body. 

It's often helpful to think of your brain as a computer. In someone who has FND, there's no damage to the hardware, or structure, of the brain. It's the software, or program running on the computer, that isn't working properly.

The problems in FND are going on in a level of the brain that you cannot control. It includes symptoms like arm and leg weakness and seizures. Other symptoms like fatigue or pain are not directly caused by FND but are often found alongside it.

Symptoms of FND

FND can have many symptoms that can vary from person to person. Some people may have few symptoms, and some people may have many. 

Functional Limb Weakness 

Functional Seizures 

Functional Tremor 

Functional Dystonia 

Functional Gait Disorder 

Functional Facial Spasm 

Functional Tics 

Functional Jerks and Twitches 

Functional Drop Attacks 

Functional Sensory Symptoms 

Functional Cognitive Symptoms 

Functional Speech and Swallowing Difficulties 

Persistent Postural Perceptual Dizziness (PPPD) 

Functional Visual Symptoms 

Dissociative Symptoms 

Common associated symptoms or conditions?? 

There are other symptoms or conditions that are commonly associated with FND. These include:

·      Chronic Pain, Including Fibromyalgia, Back and Neck Pain, And Complex Regional Pain Syndrome 

·      Persistent Fatigue 

·      Sleep Problems including Insomnia (Not sleeping Enough) and Hypersomnia (Sleeping too much) 

·      Migraines and other Types of Headaches and Facial Pain 

·      Irritable Bowel Syndrome and other Problems with the Function of your Stomach and Bowel 

·      Anxiety and Panic Attacks 

·      Depression 

·      Post-Traumatic Stress Disorder 

·      Chronic Urinary Retention 

·      Dysfunctional Breathing 

What causes FND?

·      We know that the symptoms of FND happen because there's a problem with how the brain is sending and receiving messages to itself and other parts of the body. Using research tools, scientists can see that certain circuits in the brain are not working properly in people with FND.

·      However, there's still a lot of research to be done to understand how and why FND happens.

Why does FND happen?

FND can happen for a wide range of reasons. There's often more than one reason, and the reasons can vary hugely from person to person.

Some of the reasons why the brain stops working properly in FND include:

the brain trying to get rid of a painful sensation.

a migraine or other neurological symptom

the brain shutting down a part or all of the body in response to a situation it thinks is threatening

In some people, stressful events in the past or present can be relevant to FND. In others, stress is not relevant.

The risk of developing FND increases if you have another neurological condition.

Diagnosing FND

When diagnosing FND, your healthcare provider will carry out an assessment to see if there are typical clinical features of FND.

Your healthcare provider may still choose to test for other diseases and conditions before diagnosing FND. This is because many conditions share the same symptoms and, in around a quarter of cases, FND is present alongside another neurological condition. Someone can have both FND and conditions like sciatica, carpal tunnel syndrome, epilepsy, or multiple sclerosis (MS).

The diagnosis of FND, however, should be given because you have the clinical features of FND. It shouldn't be given just because there's no evidence of other conditions or illnesses.

Because the symptoms of FND are not always there, your healthcare provider may ask you to video your symptoms when they are bad so they can see what's happening to you. 

Treatments

FND is a variable condition. Some people have quite short-lived symptoms. Others can have them for many years.

There are treatments available that can manage and improve FND. These treatments are all forms of rehabilitation therapy, which aims to improve your ability to carry out every day activities. Many of these treatments are designed to "retrain the brain". Some people with FND benefit a lot from treatment and may go into remission. Other people continue to have FND symptoms despite treatment.

Treatments are: 

·      Physiotherapy 

·      Occupational Therapy 

·      Psychological Therapy 

·      Speech, Language and Swallowing Therapy 

·      Medication (Antidepressants, Neuropathic Painkillers) 

Who is at risk of FND? 

No single process has been identified as being sufficient to explain the onset of FND. Several interacting factors biologically, psychologically, and socially can cause vulnerabilities, triggers and maintaining factors that contribute to FND. 

Why is this happening to me? 

There are usually several underlying biopsychosocial factors which play a role in the development of FND. Some of these factors contribute to making the brain vulnerable, trigger FND episodes and prevent people from getting better. Injury and pain can be a common trigger. Anxiety, depression, and traumatic life experiences can also contribute to making brains vulnerable to FND. 

[bharathomeopathy2]

Kidney Failure Treatment Without Dialysis: Alternative Medication for Chronic Kidney Disease Treatment

What is kidney disease? 

Kidney disease, especially chronic kidney disease (CKD) can be a very serious health condition in which the kidneys slowly cease to remove the excess fluids and waste from the blood. The condition can cause an unintentional accumulation of wastes within the body, which can cause numerous health problems. Kidney diseases can lead to kidney failure, called end-stage renal disease in which the kidneys can no longer function as they should. If you don't get timely and effective Treatment for kidney failure, kidney disease could cause life-threatening complications.

Understanding Kidney Disease 

The kidneys are vital organs for filtering fluids, maintaining electrolytes in balance and ensuring overall fluid balance. Kidney diseases can be classified into two major kinds:

Acute Kidney Injury (AKI): This is an abrupt decrease in kidney function that may be reversed with the right treatment.

Chronic Kidney Disease (CKD): A gradual decline in kidney function with time, usually leading to kidney disease.

CKD is more prevalent and is usually caused by conditions like diabetes or high blood pressure as well as glomerulonephritis (inflammation of the kidney's filtering unit). Other causes include genetic diseases, long-term incontinence of the urinary tract and chronic kidney infections.

Complications of Kidney Disease

The High Blood Pressure Kidneys damaged are less capable of regulating blood pressure, resulting in hypertension. This is then able to further harm the kidneys, resulting in an unending cycle.

Anemia: Kidneys that are healthy make the hormone erythropoietin that stimulates the production of red blood cells. The damage to kidneys can lower the amount of erythropoietin in the body, causing anaemia.

Bone Disease: Kidneys assist to regulate phosphate and calcium levels. In CKD the balance is disturbed, resulting in bones that are weak and an increased possibility of fractures.

Fluid Retention: Kidneys that are failing cannot eliminate excess fluid from the body, which causes swelling of the ankles, legs, and hands, and shortness of breath as a result of accumulation of liquid in the lungs.

The high Creatinine Levels: it's a waste product that is removed through the kidneys. Creatinine levels that are high in the blood signify decreased kidney function. They are also utilized as a way to determine the degree in kidney diseases.

Kidney Failure: One of the most serious consequences that can occur with CKD is kidney dysfunction, in which the kidneys lose their capacity to function. The stage of kidney failure is a need for immediate treatment, usually with dialysis or a kidney transplant.

Homeopathy for Kidney Disease

Homeopathy cure for chronic kidney disease is a holistic and natural type of medicine that is an alternative or an alternative strategy to treat kidney disease. The treatment aims to increase the body's ability to heal itself and restore balance without harsh medications or harmful procedures.

Homeopathic Approach to Kidney Disease:

A Personalized Treatment Approach: Homeopathy emphasises personalised treatment based upon the patient's specific symptoms, medical history and general health. A doctor of homeopathy will take into consideration the emotional, physical and mental health of the patient prior to making a recommendation for a remedy.

Natural Remedies Homeopathic remedies originate from natural substances, such as minerals, plants, as well as animals. The remedies are prepared in highly dilute forms, which makes them safe and free of adverse side effects.

The root cause of the problem instead of merely treating symptoms, homeopathy seeks to treat the underlying cause that causes kidney problems. For instance, in the case of CKD caused by diabetes or high blood pressure, homeopathic treatment focuses on controlling these conditions to avoid further damage to the kidneys.

Enhancing Kidney Function Improve Kidney Function: Homeopathic remedies are commonly utilised to improve kidney function and lessen inflammation. These remedies aid in eliminating toxic substances, ease pain and enhance urinary function.

Lowering the Creatinine Levels of High-Creatinine Patients: Homeopathic remedies that are specific to the patient are believed to lower the levels of high creatinine by improving kidney function and aiding in detoxification.

Preventing Kidney Failure with Homeopathy is a method to slow the development of CKD and to prevent kidney damage by helping to support the kidneys' capacity to regenerate and heal. 

The Role of Homeopathy in Chronic Kidney Disease Treatment

Homeopathy can be extremely beneficial as a complement to chronic kidney disease treatment in conjunction with conventional therapies. It may help alleviate symptoms, lessen the need for dialysis, and improve patients' quality of life.

Advantages of Homeopathy in CKD Treatment:

Safe and non-invasive Homeopathic medicines are not invasive and are free of negative side effects, which makes them an ideal choice for long-term usage.

Holistic Methodology: Homeopathy treats the patient in a holistic way, taking care of the physical, emotional and psychological aspects that are essential in chronic diseases such as CKD.

Preventing Kidney Failure By controlling the underlying factors that cause kidney problems homeopathy may be able to stop or delay the development of kidney failure.

Kidney failure treatment without dialysis for patients looking for alternatives to dialysis homeopathy may be the best option, as it aims to enhance renal function in a natural way.

Conclusion

Kidney problems are a serious issue that requires careful treatment to avoid complications, such as high levels of creatinine as well as cardiovascular diseases, as well as kidney disease. While conventional treatment is essential, homeopathy provides a holistic natural method for high creatinine treatment, which focuses on addressing the root of the issue and assisting your body's process of healing. Through the integration of homeopathy into a treatment regimen, patients can benefit from an improvement in kidney function, better treatment of their symptoms, and even be able to avoid dialysis.

[urolifehealthcare-blog]

Urethral Stricture Treatment in Pune

Are you suffering from urethral stricture? Urolife Clinic in Pune offers advanced and effective treatments to alleviate this condition. Our experienced urologists, led by Dr. Irfan Shaikh, specialize in diagnosing and treating urethral strictures using the latest techniques.

What is Urethral Stricture?

Urethral stricture is a condition where the urethra, the tube that carries urine from the bladder out of the body, becomes narrowed or blocked. This can cause difficulty urinating, urinary frequency, painful urination, and even urinary retention.

Causes of Urethral Stricture

Urethral strictures can be caused by various factors, including:

Injury or trauma: Accidents, surgeries, or infections can damage the urethra.

Infections: Sexually transmitted infections (STIs) or urinary tract infections (UTIs) can lead to inflammation and scarring.

Radiation therapy: Radiation treatment for prostate cancer or other pelvic cancers can damage the urethra.

Congenital defects: Some people are born with a narrow urethra.

Treatment Options for Urethral Stricture

If looking for Urethral Stricture treatment in Pune, Consult Dr. Irfan Shaikh at Urolife Clinic — Urethral Stricture Treatment Doctor in Pune.The treatment for urethral stricture depends on the severity of the condition and the underlying cause. Our urologists at Urolife Clinic offer a variety of effective treatment options, including:

Dr. Irfan Shaikh and his team at Urolife Clinic are committed to providing compassionate and effective care for patients with urethral stricture. If you are experiencing symptoms of this condition, please contact us to schedule a consultation.

[macgyvermedical]

Is there an illness or injury that one can't improvise their way out of? Say you're on a camping trip. Which illness or injury would be the worst news?

For illness I'd say a stroke or heart attack. For injury I'd say an abdominal injury that results in torn or punctured bowel.

You can break bones, even big bones, and improvise splints/use tourniquets to stop internal bleeding long enough to carry someone out of the backcountry.

You can get some really nasty wounds, even like bear attack bad, and pack them.

You can get serious skin infections and use hot compresses to bring blood to the area and kill the pathogens.

You can get a systemic infectious disease and keep other people away from it and keep the person as well fed/rested/hydrated as possible.

But unless you happen to be a trauma surgeon well trained in low-resource surgery, an abdominal wound more than a day from help would screw you. And unless you happen to carry TPA in your first aid kit and everything else lines up perfectly, you're not going to be able to treat a clot.

The closest you could get with the abdominal wound is hope it was mild. If you carried a foley catheter (not unheard of in backcountry first aid kits due to their usefulness in emergencies like urinary retention and severe nosebleeds), certain antibiotics and and some way to boil water, you could repeatedly rinse the abdominal cavity, which might buy some time. You would also need the person to refrain from eating or drinking, which might be difficult considering they're probably going to have to hike out themselves.

As far as the stroke, you *might* be able to make a decent guess as to whether it was a hemorrhagic stroke or an ischemic stroke through physical diagnosis. But only really if someone is really good at physical diagnosis (they were trained sometime between the 1950's and the 1980's), and you might be able to give aspirin if you could tell that it was probably ischemic. This wouldn't necessarily make anything better but it might stop it from getting worse.

Same with a heart attack. You could figure out that it was probably a heart attack with physical diagnosis, give aspirin, keep the person resting, and keep that up until you were out of the backcountry. But unlike our friend with the abdominal injury, you'd have to carry this person out, and that means it's going to be much, much slower going.

Today our successes with heart attack treatment is that we can quickly give clot-dissolving drugs and place stents, restoring bloodflow to the heart muscle and limiting the amount of that muscle that dies. A stent might get someone out of the hospital in 3 days and back to normal life within weeks. 70 years ago, people almost always went into some level of heart failure after heart attacks, because the only treatment was bed rest for 6 weeks, wait and see what the damage was, and treat the repercussions.

It would be similar having a heart attack in the backcountry. You'd basically just give aspirin and prevent the person from using too much oxygen (strict rest).

[drneerajgoyal]

Common Kidney Problems: When to Seek Help

Introduction

Kidneys are vital organs that play a crucial role in filtering waste products from the blood, regulating blood pressure, balancing fluids, and producing hormones necessary for the body’s functioning. However, like any other organ, the kidneys are susceptible to various problems that can impact their performance.

Understanding the common kidney problems, their symptoms, and when to seek medical help is essential to maintain overall health. For those experiencing kidney issues, consulting the Best Kidney Doctor is imperative to receive the right diagnosis and treatment.

In this article, we will explore common kidney problems and guide you on when it’s necessary to seek help from a professional, such as Dr. Neeraj, a renowned kidney specialist.

Understanding the Role of the Kidneys

Before diving into common kidney problems, it’s important to understand the role of the kidneys in the body. The kidneys are two bean-shaped organs located on either side of the spine, just below the rib cage. They perform several vital functions, including:

Filtering Waste: The kidneys filter out waste products and excess substances from the blood, excreting them through urine.

Regulating Blood Pressure: They help regulate blood pressure by balancing salt and water levels in the body.

Electrolyte Balance: The kidneys maintain the balance of electrolytes like sodium, potassium, and calcium, which are essential for nerve and muscle function.

Producing Hormones: They produce hormones such as erythropoietin, which stimulates red blood cell production, and renin, which helps regulate blood pressure.

When the kidneys are compromised, these functions can be disrupted, leading to serious health issues. Recognizing the signs of kidney problems early and consulting the Best Kidney Doctor, such as Dr. Neeraj, can prevent further complications.

Common Kidney Problems

Several kidney problems can affect the kidneys’ ability to function properly. Some of the most common include:

Chronic Kidney Disease (CKD)

Chronic Kidney Disease is a long-term condition where the kidneys gradually lose function over time. CKD is often a result of other underlying health conditions like diabetes or high blood pressure. Early stages of CKD may not present noticeable symptoms, but as the disease progresses, symptoms may include:

Fatigue and weakness

Swelling in the legs, ankles, and feet due to fluid retention

Shortness of breath

Difficulty concentrating

Persistent itching

Changes in urine output or color

When to Seek Help: If you have risk factors like diabetes, high blood pressure, or a family history of kidney disease, it’s crucial to regularly monitor your kidney function. Consult the Best Kidney Doctor, such as Dr. Neeraj, if you notice any of the above symptoms or if you’re diagnosed with early-stage CKD.

Acute Kidney Injury (AKI)

Acute Kidney Injury is a sudden loss of kidney function, often occurring due to severe dehydration, infection, or the use of certain medications. AKI can be life-threatening if not treated promptly, but it is often reversible with timely intervention. Symptoms of AKI include:

Decreased urine output

Swelling in the legs, ankles, or around the eyes

Fatigue

Confusion or difficulty concentrating

Shortness of breath

Nausea and vomiting

When to Seek Help: AKI is a medical emergency. If you experience a sudden drop in urine output or any of the other symptoms mentioned, seek immediate medical attention. Early diagnosis and treatment by the Best Kidney Doctor, like Dr. Neeraj, can prevent permanent kidney damage.

Kidney Stones

Kidney stones are hard deposits of minerals and salts that form in the kidneys. They can vary in size and may cause intense pain when passing through the urinary tract. Common symptoms of kidney stones include:

Severe pain in the back, side, or lower abdomen

Pain during urination

Blood in the urine

Frequent urge to urinate

Nausea and vomiting

When to Seek Help: If you suspect you have a kidney stone, it’s important to seek medical attention. Small stones may pass on their own with increased fluid intake, but larger stones may require medical intervention, such as lithotripsy or surgery. Consulting the Best Kidney Doctor, such as Dr. Neeraj, can help you determine the best course of treatment.

Urinary Tract Infections (UTIs)

Urinary Tract Infections are common, particularly in women, and occur when bacteria enter the urinary tract. If left untreated, a UTI can spread to the kidneys, leading to a more serious condition known as pyelonephritis. Symptoms of a kidney infection include:

Fever and chills

Back or side pain

Frequent and painful urination

Cloudy or foul-smelling urine

Nausea and vomiting

When to Seek Help: While mild UTIs can often be treated with antibiotics, a kidney infection requires prompt medical attention. If you experience symptoms of a UTI along with fever and back pain, seek help from the Best Kidney Doctor, such as Dr. Neeraj, to prevent complications.

Glomerulonephritis

Glomerulonephritis is a condition where the tiny filters in the kidneys, known as glomeruli, become inflamed. This inflammation can lead to kidney damage and affect the kidneys’ ability to filter waste. Symptoms may include:

Blood or protein in the urine

High blood pressure

Swelling in the face, hands, feet, and abdomen

Fatigue

Reduced urine output

When to Seek Help: If you notice blood in your urine or experience unexplained swelling, it’s essential to seek medical advice. Early diagnosis and treatment by the Best Kidney Doctor, like Dr. Neeraj, can prevent the condition from progressing to more severe kidney damage.

Polycystic Kidney Disease (PKD)

Polycystic Kidney Disease is a genetic disorder characterized by the growth of numerous cysts in the kidneys. These cysts can lead to enlarged kidneys and impair their function over time. Symptoms of PKD include:

High blood pressure

Pain or tenderness in the abdomen

Blood in the urine

Frequent urination

Kidney stones

Urinary tract infections

When to Seek Help: PKD can lead to chronic kidney disease and other complications if not managed properly. If you have a family history of PKD or experience any of the symptoms listed, consult the Best Kidney Doctor, such as Dr. Neeraj, for a thorough evaluation and appropriate treatment plan.

Nephrotic Syndrome

Nephrotic Syndrome is a kidney disorder that causes the body to excrete too much protein in the urine. It can result from damage to the glomeruli and is associated with other conditions like diabetes or lupus. Symptoms include:

Severe swelling, especially in the legs and around the eyes

Foamy urine due to high protein levels

Weight gain from fluid retention

Fatigue

Loss of appetite

When to Seek Help: If you notice significant swelling or changes in your urine, it’s important to consult a healthcare provider. Nephrotic Syndrome requires specialized care, and seeing the Best Kidney Doctor, like Dr. Neeraj, can help manage the condition and prevent further complications.

When Should You Seek Help?

Knowing when to seek help for kidney problems can make a significant difference in the outcome. Here are some general guidelines:

Persistent Symptoms: If you experience persistent symptoms such as swelling, changes in urine, or unexplained fatigue, it’s important to seek medical advice.

Sudden Onset of Symptoms: A sudden decrease in urine output, severe pain, or symptoms of infection require immediate medical attention.

Family History: If you have a family history of kidney disease or conditions like PKD, regular check-ups with the Best Kidney Doctor are essential for early detection and management.

High-Risk Factors: Individuals with diabetes, high blood pressure, or autoimmune disorders should be particularly vigilant about their kidney health and consult a specialist if they notice any changes.

Routine Check-ups: Even in the absence of symptoms, routine check-ups with a kidney specialist, such as Dr. Neeraj, can help monitor your kidney function and catch any potential issues early.

Preventing Kidney Problems

While some kidney problems are unavoidable, others can be prevented through lifestyle changes and proactive health management. Here are some tips for maintaining healthy kidneys:

Stay Hydrated: Drinking plenty of water helps the kidneys filter waste and prevents kidney stones.

Control Blood Sugar: If you have diabetes, keeping your blood sugar levels in check can prevent kidney damage.

Monitor Blood Pressure: High blood pressure is a leading cause of kidney disease, so it’s important to manage it through diet, exercise, and medication if necessary.

Limit Salt Intake: Excess salt can lead to high blood pressure and strain the kidneys.

Avoid Overuse of Painkillers: Over-the-counter pain medications can cause kidney damage if used excessively. Always follow the recommended dosage and consult a doctor if you need long-term pain management.

Maintain a Healthy Diet: A balanced diet rich in fruits, vegetables, and whole grains can support kidney health and prevent obesity, a risk factor for kidney disease.

Avoid Smoking and Excessive Alcohol Consumption: Both smoking and excessive alcohol intake can damage the kidneys over time.

Conclusion

Kidney problems can have a profound impact on your overall health and quality of life. By understanding the common kidney issues and knowing when to seek help, you can take proactive steps to protect your kidney function. Regular check-ups, especially if you have risk factors like diabetes or high blood pressure, are crucial for early detection and management of kidney problems.

[pace-hospitals]

List of Urologist in Hyderabad at PACE Hospitals

A urologist is a medical doctor who specializes in the diagnosis, treatment, and management of conditions related to the urinary tract and the male reproductive system.

The urology department at PACE Hospitals comprises a team of the renowned and top urologist in Hyderabad, Telangana, who are specialists in kidney transplantation (live and cadaver kidney transplant), dialysis, Uro-oncology, endourology, geriatric, pediatric urology and postoperative care with expertise in diagnosing, treating, and preventing various types of rare, serious urological related conditions and hospital-acquired infections. The team of experienced and skilled urologists, urology surgeon has vast expertise in managing all kind of critical urology disease and disorder, including:

Urinary tract infections

Urinary incontinence & retention

Urinary bladder disease

Kidney stone diseases

Bladder, Kidney and Prostate cancer

Hydronephrosis

Benign prostatic hyperplasia (BPH)

Ureteral stones­

Kidney transplantation

List of urologist in Hyderabad at PACE Hospitals:

Dr. Vishwambhar Nath — MBBS, MS (General Surgery), DNB (Urology), M.Ch (Urology) — 40+ years of experience - Senior Consultant Urologist & Renal Transplant Surgeon

Dr. Abhik Debnath — MBBS, MS (General Surgery — IMS, BHU), MCh (Urology — CMC Vellore), DNB (Urology) — 10+ years of experience — Consultant Laparoscopic Urologist, Endourologist, Andrologist & Kidney Transplant Surgeon

Dr. K Ravichandra — MBBS, MS (General Surgery), MCh (Urology) — Consultant Laparoscopic Urologist, Andrologist & Kidney Transplant Surgeon

For appointment, kindly call 04048486868