You may need a second opinion in some cases where my experience will be helpful to deal with complex paediatric problems. Dr Tewary is willing to discuss these issues/queries any time and help you with further information/clarification where needed.
He has fixed as well as flexible attachment with various private hospitals. This allows him to help patients who want to be seen privately according to earliest mutual convenience. Having worked at senior positions in India and UK, he has developed expertise in advanced & tropical diseases. His sub-specialist interest is in paediatric nephrology and he is one of the few paediatricians providing this unique service in the West Midland.
He provides a detail feedback to you after his consultation, explaining the management plan and next course of action. Where relevant he can perform the follow-up sessions in his NHS Clinic.
Date of Implementation: October,2016.
Authors Title: Tewary K
Method of collecting a clean catch sample-
Boys Retract the prepuce (as possible) and wash the glans with lukewarm water, either directly or through cotton balls soaked in water..
Girls Spread the labia in frog leg position and wash with lukewarm water, directly or through cotton balls.
For the very young child a sterile container with provided funnel (available in children’s ward) can be used to collect the sample into the container.
If toilet trained it may be easy to place a sterile bowl into a pot and collect the urine in this. Urine can then be poured from the bowl into the sterile container.
An older child may be able to urinate directly into the container.
A “mid-stream” sample of urine is best for the sample collection, as the initial stream may be contaminated with the bacteria from skin.
Only a small amount of urine is required for the test.
What if it is difficult to collect urine directly into the pot/container?
Reference: NICE guideline, CG54; Urinary Tract infections in under 16s: Diagnosis and Management.