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Catheterization of the bladder involves introducing a latex or plastic tube through the urethra and into the bladder. The catheter provides a continuous flow of urine in patients unable to control micturition or those with obstructions. It also provides a means of assessing urine output in hemodynamically unstable patients. Because bladder catheterization carries the risk of UTI, blockage, and trauma to the urethra, it is preferable to rely on other measures for either specimen collection or management of incontinence. Types of Catheterization. Intermittent and indwelling retention catheterizations are the two forms of catheter insertion INTERMITTENT CATHETERIZATION introduce a straight single-use catheter long enough to drain the bladder (5 to 10 minutes When the bladder is empty, you immediately withdraw the catheter. COMPLICATION- increases risk of trauma and infection. INDICATION- It is common for people with spinal cord injury or other neurological problems such as multiple sclerosis to perform self– intermittent catheterization up to every 4 hours daily for months or years. UTI rate is lower than for patients with long-term indwelling catheters. INDWELLING CATHETERIZATION- remains in place for a longer period, until a patient is able to void voluntarily or continuous accurate urine measurements are no longer needed The straight single-use catheter has a single lumen with a small opening about 1.3 cm ( 1 2 inch) from the tip. . Urine drains from the tip, through the lumen, and to a receptacle. An indwelling Foley catheter has a small inflatable balloon that encircles the catheter just above the tip. When inflated the balloon rests against the bladder outlet to anchor the catheter in place. The indwelling retention catheter often has two or three lumens within the body of the catheter . One lumen drains urine through the catheter to a collecting tube. A second lumen carries sterile water to and from the balloon when it is inflated or deflated. A third (optional) lumen is sometimes used to instill fluids or medications into the bladder. It is easy to determine the number of lumens by the number of drainage and injection ports at the end of the catheter A second type of intermittent catheter has a curved tip A Coudé catheter is used on male patients who may have enlarged prostates that partly obstruct the urethra. It is less traumatic during insertion because it is stiffer and easier to control than the straight-tip catheter Plastic catheters are suitable only for intermittent use because of their inflexibility Latex catheters are recommended for use up to 3 weeks. Be aware of allergies. Pure silicon or Teflon catheters are best suited for long-term use (2 to 3 months) because of less encrustation at the urethral meatus Balloon sizes range from 3 mL (pediatric) to large postoperative volumes (75 mL). In adults the 5-mL and 30-mL sizes are the most common: The 5-mL size allows for optimal drainage, whereas the 30-mL size is used after pros

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A well-known hospital in Gwalior, Madhya Pradesh, ITM Hospital & Research Center has recently updated its super specialty and elevated the pre-existing facilities including critical care and minimal invasive surgery protocols. As per the hospital's management team, "The 300-bedded tertiary care hospital operates under the guidance of highly experienced medical and healthcare professionals and includes 20 ICU beds, 20 beds for Obs, Gynae, and NICU, three modern operating theaters, a well- equipped and 24x7 available ER department, dialysis center, a dedicated mother and child care unit, along with highly advanced technologies like CT scan, MRI, Bone DEXA along with ECHO, TMT, Physiotherapy and more. Our highly experienced doctors bring a multidisciplinary approach across 25+ super specialties, including oncology, cardiology, joint replacement, minimal access surgery and others. We aim to enhance health care in Gwalior, Madhya Pradesh by providing quality medical care with trust, transparency and empathy while meeting all safety standards," says Mr. Ramashankar Singh, Chairman of the hospital. The hospital has also been recognised as the best emerging hospital in the vicinity for several specialties for following the moral of “Sewa Samta aur Sammaan”. Dr. Ramashankar adds, "This recognition is a testament to our mission of serving people with the best critical care and minimal invasive surgery. We remain committed to delivering outcome-driven experiences and care to treat and heal people, based on the same values that the group has followed for the past three decades”

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Botulism has been used as a weapon of terror in the past. During World War II, the infamous Unit 731, the Japanese biological warfare group, fed cultures of Clostridium botulinum to prisoners during the Japanese occupation of Manchuria, killing them. It was suspected that Germany had weaponized botulism as well, and several other countries were suspected to have done research into the use of botulism as a weapon. More recently, between 1990 and 1995, aerosols were dispersed on at least three occasions by the Japanese cult Aum Shinrikyo, who would later go on to release sarin gas in the Tokyo subway, to disastrous effect. These releases of botulism failed for various reasons, but the ease with which Aum Shinrikyo was able to culture Clostridium botulinum from the soil is one reason that this toxin would make an excellent bioweapon.

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