This is only rarely done in the hospital to exclude a rare benign condition of “postural albuminuria“. Any random fresh urine sample is good enough. For detecting diabetes, it will be better to give a urine sample one or two hours after breakfast or lunch. If a patient having high fever (but not consuming vitamin B complex tablets) starts passing high colored urine like light black tea, it indicates that after about a week or so, this patient will develop jaundice.
Routine urine examination gives enough information worth the money. In a male person, presence of pus cells or blood cells is definitely abnormal. Not so in a female patient. This examination is enough to make a diagnosis of “acute “urinary tract infection in a female patient having swelling of the face or legs, presence of albumin will point towards kidney disease as the cause of swelling. Even in absence of any symptom in the body, presence of albumin and casts means the patient has silent kidney disease.
Urine culture test:
Is often asked by doctors to diagnose “acute” urinary tract infections. This test is very useful in hospitalized patients, especially those who have been operated upon or had a catheter passed in the bladder. Most of the laboratories are not well equipped and thus the results are often wrong or misguiding.
For a doctor the better method to adopt is to suspect E.Coli germs in all the patients and treat them. Only if the patient does not respond within a week, should the tests be asked for with the following precautions:
1. Urine must be sent to a big laboratory or a big hospital, who can afford to maintain media and machines required to grow such germs.
2. The patient must be given a five minute lecture on how to collect and send the urine sample.
Thus just a growth of bacteria is not a fool proof result, therefore one can also ask for additional test of “colony count”. Even in normal urine, up to 50,000 colonies of germs can be grown easily. In fact, only if these colonies are more than 100,000 in numbers, the test is considered to be positive.
Also if the usual drugs have not worked for a week, an additional test worth asking would be that of “antibiotic sensitivity”. This report guides the doctor to choose the drug with maximum sensitivity.