Dysuria among adult men attending a primary health care center in Kuwait

The purpose of this study was to explore common causes of dysuria in men attending primary health care centers in Kuwait and to describe general practitioners' diagnosis for dysuria and to compare them with diagnosis reported by hospital urologists. The study design is a descriptive study conducted in Dasman primary health care center in the Capital region of Kuwait during October - December 2006. All men aged 20 years and over presenting with pain, burning sensation or discomfort on urination attending the center during the study period which no antibiotics had been prescribed during the preceding four weeks were included in the study. For the purpose of comparison, individuals were classified into negative and positive according to the urine culture results. The mean age of the participants was 40.4 +/- 11.7 years; 22.4% were single. 51.1% were working outdoor. Only 28.9% of patients reported associated symptoms with their dysuria. Patients with negative urine culture had significantly higher proportion of associated symptoms than those with positive urine culture [P = 0.003]. Two thirds of patients received septrin as an antiseptic therapy, with a significance higher proportion of patients with positive culture received treatment from outside the clinics [P < 0.001]. More than half of cases [56.6%] were diagnosed as urinary tract infection, 18.4% as prostatitis, 10.5% as sexually transmitted diseases, 13.2% as genitourinary calculi and 1.3% as other urologic problem. Urine culture was positive in 92.6% of urinary tract infection and 7.4% of genitourinary calculi cases, while negative cases were more encountered among cases of prostatitis and sexually transmitted diseases. There was no hospital feedback among 56.6% of the studied patients. This negative attitude was encountered among 58.1%, 42.9%, 75.0%, and 60% of patients diagnosed as urinary tract infection, prostatitis, sexually transmitted diseases and genitourinary calculi. Primary health care diagnosis went in consistent with hospital ones in 73.7%, 62.5%, 50.0%, 75.0% of patients provisionally diagnosed as urinary tract infection, prostatitis, sexually transmitted diseases and genitourinary calculi respectively. Dysuria data collected in general practices will never provide a complete picture of dysuria

Otitis media: a review for the family physician

Otitis media [OM] is a serious healthcare concern worldwide. Acute otitis media is over-diagnosed. Symptoms are neither sensitive nor specific for the diagnosis of otitis media. Four characteristics of the tympanic membrane - position, mobility, color and degree of translucency should be evaluated and described in every examination. The most notable trends in the bacteriology of AOM during the past decade have been a rise in the proportion of patients infected with drug-resistant S. pneumoniae and an overall increase in beta-lactamase-producing H. influenza and M. catarrhalis. Antibiotic resistance to otogenic organisms occurs more frequently nowadays. Surgical management of otitis media is also discussed in this review