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Assimamaw NT, Kebede AK, Bazezew Genetu K. Effects of sex, toilet training, stress, and caffeine on nocturnal enuresis among school children in Gondar Town, the metropolitan city of Ethiopia: a community-based study in 2023. Front Pediatr 2024; 12:1366430. [PMID: 38915871 PMCID: PMC11194331 DOI: 10.3389/fped.2024.1366430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/29/2024] [Indexed: 06/26/2024] Open
Abstract
Background Nocturnal enuresis is associated with severe social and psychological problems that affect one's self-esteem, later in life, harmed adolescent and adult life, emotional stress on the family, and poor school performance. Moreover, enuresis children may cause panic attacks, mood disorders, and depression. This study aims to assess the prevalence and associated factors of nocturnal enuresis among children aged 5-14 years in Gondar city, Northwest Ethiopia, 2023. Methods A community-based, cross-sectional study was conducted from April 1, 2023, to May 30, 2023. A stratified multistage sampling technique was used to select study subject from kebeles in Gondar city. The data were collected by using a structured, interviewer-administer Questionnaire. The data were entered using EPI DATA version 4.6.02 software, and processed,and analyzed using the statistical package for the social sciences (SPSS) version 25. All variables with P ≤ 0.25 in the bivariate analysis were included in the final model of multivariate analysis. The multivariate binary logistic regression was used to assess the association between the independent and outcome variable. The direction and strength of statistical association were measured with an adjusted odds ratio along with 95% CI and a P-value <0.05 was considered statistically significant. Result The overall prevalence of nocturnal enuresis among children aged 5-14 years was 162 (22.2%). The findings showed that being boys [AOR = 0.54; 95% CI (0.31, 0.93)], child and no toilet training practices [AOR = 2.50; 95% CI (1.02, 6.15)], Having no caffeine [AOR = 0.16; 95% CI (0.09, 0.29)], and exposure to stressful events [AOR = 20; 95% CI (11.12, 33.34)] had a significant association with nocturnal enuresis, p-value <0.05. Conclusion In this study, the prevalence of nocturnal enuresis children age 5-14 years was higher than that in previous studies. Sex of child, toilet training practices, caffeine c before bed, and presences of stressful event were a significant predictor of nocturnal enuresis.
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Affiliation(s)
- Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- University of Gondar Comprehensive Specialized Hospital Gondar, Gondar, Ethiopia
| | | | - Kalkidan Bazezew Genetu
- Department of Surgical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alamri A, Singh VP, Alshyarba MH, Abdullah A, Ogran M, Alsuayri A, Al-Amri A, Ashraf TH, Alyami F, Alshahrani MS. Prevalence of nocturnal enuresis among children of Aseer region in Saudi Arabia. Urol Ann 2024; 16:81-86. [PMID: 38415232 PMCID: PMC10896321 DOI: 10.4103/ua.ua_90_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 02/29/2024] Open
Abstract
Introduction Nocturnal enuresis (NE) in children is a very common problem managed in pediatric urology. In this study, we present the prevalence of NE in children in Aseer region in Saudi Arabia. Methodology This study was conducted as a descriptive cross-sectional survey to estimate the prevalence of NE among 555 Saudi children aged 5-15 years in Aseer region in Saudi Arabia. Data collection was done through a questionnaire, which included questions on sociodemographic data, personal knowledge, enuresis-related characteristics, risk factors, and management modalities. Results This study identified a prevalence of enuresis of 24% of the study population, most of whom were boys. The majority of the parents had a high educational level. Clinical characteristics of the study population showed: 9% have a family history of NE, 2.2% have a history of neurological disorder, 10.0% have a history of urinary tract infections, 66.8% have associated daytime urgency, 67% have urine-holding behavior, and 19.5% have associated daytime enuresis of the study population. Conclusion Our study found that 24% of children in the Aseer region in Saudi Arabia have NE. Our study finding helps us to understand the prevalence of NE in Aseer region in Saudi Arabia, and this can be applied to other regions in the kingdom. Furthermore, this finding helps us to understand the need to raise awareness in the community about NE and the need to educate the nonpediatric urologist health-care provider about the best management practice for NE.
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Affiliation(s)
| | | | | | | | - Meshal Ogran
- Department of Surgery, College of Medicine, Abha, Saudi Arabia
| | | | - Amal Al-Amri
- Department of Surgery, College of Medicine, Abha, Saudi Arabia
| | | | - Fahad Alyami
- Department of Surgery, College of Medicine, Abha, Saudi Arabia
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Tang G, Liu H, Wu G, Ding G, Chu Y, Cui Y, Wu J. The pooled analysis evaluates the therapeutic efficacy of desmopressin combined with anticholinergic drugs in the treatment of pediatric nocturnal enuresis. Neurourol Urodyn 2024; 43:183-195. [PMID: 37787540 DOI: 10.1002/nau.25295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE This pooled analysis aims to demonstrate the clinical efficacy and safety of combined desmopressin and anticholinergic therapy in the treatment of pediatric nocturnal enuresis (NE). METHODS A systematic search was conducted through PubMed, MEDLINE, EMBASE, ResearchGate, and Cochrane Library to identify all randomized controlled trials (RCTs) comparing monotherapy with desmopressin versus combined therapy with desmopressin and anticholinergic agents for the treatment of NE. Data analysis was performed using RevMan version 5.4.1. RESULTS This study included 8 RCTs involving a total of 659 patients. The frequencies of complete response (CR), partial response (PR), and nonresponse (NR) were computed for both short-term treatment (1 month) and long-term treatment (3 months). Additionally, alterations in the mean number of NE episodes, adverse events, and relapse were assessed. Our analysis indicates that, in comparison to the monotherapy group, the combination therapy group plays a pivotal role in augmenting the CR odds and diminishing the NR ratios in both short-term and long-term treatments (1 month CR ratio [risk ratio (RR): 1.84; 95% confidence interval (CI): 1.22-2.76; p = 0.003, I2 = 72%]; 3 months CR ratio [RR: 1.48; 95% CI: 1.25-1.76; p < 0.00001, I2 = 0%]; 1 month NR ratio [RR: 0.67; 95% CI: 0.55-0.82; p = 0.0001, I2 = 0%]; 3 months CR ratio [RR: 0.37; 95% CI: 0.19-0.73; p = 0.004, I2 = 0%]). Furthermore, in both short-term and long-term treatment, the combined therapy group exhibits a greater magnitude of change in the average number of NE episodes compared to patients receiving monotherapy (1 month, mean difference [MD] = -2.97; 95% CI: -4.23 to -1.71, p < 0.0001; 3 months, MD = -4.30; 95% CI: -7.18 to -1.43, p = 0.003). Moreover, the combination therapy group exhibits a significant reduction in the recurrence rate (RR: 0.36; 95% CI: 0.15-0.86; p = 0.02). There is no significant difference in the incidence of adverse events between the two groups (RR: 1.16; 95% CI: 0.58-2.31; p = 0.67). CONCLUSION Combining desmopressin with anticholinergic medications is more effective for NE than desmopressin alone, with lower recurrence and minimal adverse effects.
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Affiliation(s)
- Gonglin Tang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Hongquan Liu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Gang Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Guixin Ding
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Yongli Chu
- Department of Scientific Research, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
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Ahmad T, Minallah N. Comparative Analysis of Solifenacin Plus Desmopressin Versus Desmopressin Alone in the Treatment of Primary Mono Symptomatic Nocturnal Enuresis. J Pediatr Surg 2023; 58:2034-2037. [PMID: 37041092 DOI: 10.1016/j.jpedsurg.2023.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 04/13/2023]
Abstract
OBJECTIVES To compare the efficacy and tolerability of Solifenacin plus Desmopressin and Desmopressin alone in the treatment of primary monosymptomatic nocturnal enuresis (PMNE). METHODS A total of 88 children, 5-14 years old, diagnosed with PMNE were enrolled in this randomized control trial (RCT) from June 2017 to June 2020. After informed written consent patients were randomized to one of the two therapeutic groups. Group 1 received one puff of desmopressin nasal spray 1 h before bedtime every night. Group 2 received one pill of solifenacin 5 mg plus one puff of desmopressin nasal spray 1 h before bedtime every night. All patients were evaluated after three months for their response to treatment and drug side effects. RESULTS The mean age in desmopressin alone group and solifenacin plus desmopressin group was 8.1 ± 2.2 (5-14) and 7.9 ± 2.2 (5-14) years respectively (p-value >0.05). In group 2, 37/44 (84.09%) patients achieved complete response after three months of treatment in comparison to group 1 in which 27/44 (61.36%) patients showed complete response (p-value <0.05). In group 1, 8/44 (18.18%) patients developed treatment related side effects whereas in group 2, 12/44 (27.27%) patients developed side effects (p-value >0.05). No case of discontinuation of treatment due to side effects was observed in any of the two groups. The recurrence rate was also significantly lower in group 2 in comparison to group 1 (8.1% vs 33.3%, p-value <0.05). CONCLUSION Our study demonstrated that the combination of Solifenacin plus Desmopressin is more effective than desmopressin monotherapy in the treatment of PMNE with an acceptable tolerability profile. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Tariq Ahmad
- Institute of Kidney Diseases, Phase IV, Hayatabad, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Nasrum Minallah
- Institute of Kidney Diseases, Phase IV, Hayatabad, Peshawar, Khyber Pakhtunkhwa, Pakistan.
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Almaghlouth AK, Alquraini MA, Alsaleh NA, Almulhim MA, Alhabdan TK, Alsalman MA, Alburayh AA. Parental Beliefs About the Causes, Treatments, and Medical Assistance for Children With Nocturnal Enuresis in the Eastern Region of the Kingdom of Saudi Arabia. Cureus 2023; 15:e44557. [PMID: 37790064 PMCID: PMC10544793 DOI: 10.7759/cureus.44557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVE To assess parental beliefs about the causes, treatment, and necessity for medical assistance for children with nocturnal enuresis (NE). METHOD A self-administered survey questioned parents' beliefs about NE, including causes and at-home behavioral therapy. We evaluated the association between demographic characteristics and the tendency to seek medical advice for NE. RESULT The questionnaire received responses from 1232 individuals, 77.1% of whom were female and 82.9% of whom were 30 years of age or older. Psychological issues (53.5%) and laziness to get up (47.6%) were the most often believed causes of NE. Two frequent at-home behavioral therapies chosen by participants were voiding before bedtime and restricting fluid intake at night (73.4% and 70%, respectively). However, only 6.9% of respondents believe that a bedwetting alarm is an effective treatment. The two most frequently reported reasons for not seeking medical attention were parents' belief that their child will eventually outgrow bedwetting (34.1%) and "parents or children's embarrassment" (21.8%). The chi-squared test was used to evaluate the association between demographic characteristics and seeking medical advice. Participants with a single child were more likely than those with more than three children to take their child to the doctor (61.5% vs. 48.6%, respectively). Also, parents who don't have NE-afflicted children were more open to consider seeking medical advice for NE therapy (if their children developed it in the future) compared to parents who already have children with NE. CONCLUSION Parents in the Eastern region of Saudi Arabia hold various misconceptions about the causes and treatment of NE. Only 52.1% of parents would take their child to see a doctor if wetting the bed and only 48.1% of parents were aware of effective treatments for NE. These results emphasize that healthcare practitioners need to provide proper information to raise public awareness of NE.
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Affiliation(s)
| | | | - Noor A Alsaleh
- Pediatrics and Child Health, King Faisal University, Hofuf, SAU
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Sahoo A, Starr SL, Osadchiy V, Desai S, Iyer N, Luff M, Sollender GE, Sturm R. Identifying Targets for Innovation in Amazon Reviews of Bedwetting Alarms: Thematic Analysis. Interact J Med Res 2023; 12:e43194. [PMID: 37410523 PMCID: PMC10360013 DOI: 10.2196/43194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/06/2023] [Accepted: 05/26/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Nocturnal enuresis (NE) is a frequent diagnosis in pediatric and adolescent populations with an estimated prevalence of around 15% at the age of 6 years. NE can have a substantial impact on multiple health domains. Bedwetting alarms, which typically consist of a sensor and moisture-activated alarm, are a common treatment. OBJECTIVE This study aimed to determine areas of satisfaction versus dissatisfaction reported by the parents and caregivers of children using current bedwetting alarms. METHODS Using the search term "bedwetting alarms" on the Amazon marketplace, products with >300 reviews were included. For each product, the 5 reviews ranked the "most helpful" for each star category were selected for analysis. Meaning extraction method was applied to identify major themes and subthemes. A percent skew was calculated by summing the total number of mentions of each subtheme,+1 for a positive mention, 0 for a neutral mention, and -1 for a negative mention, and dividing this total by the number of reviews in which that particular subtheme was observed. Subanalyses were performed for age and gender. RESULTS Of 136 products identified, 10 were evaluated based on the selection criteria. The main themes identified across products were long-term concerns, marketing, alarm systems, and device mechanics and features. The subthemes identified as future targets for innovation included alarm accuracy, volume variability, durability, user-friendliness, and adaptability to girls. In general, durability, alarm accuracy, and comfort were the most negatively skewed subthemes (with a negative skew of -23.6%, -20.0%, and -12.4% respectively), which are indicative of potential areas for improvement. Effectiveness was the only substantially positively skewed subtheme (16.8%). Alarm sound and device features were positively skewed for older children, whereas ease of use had a negative skew for younger children. Girls and their caretakers reported negative experiences with devices that featured cords, arm bands, and sensor pads. CONCLUSIONS This analysis provides an innovation roadmap for future device design to improve patient and caregiver satisfaction and compliance with bedwetting alarms. Our results highlight the need for additional options in alarm sound features, as children of different ages have divergent preferences in this domain. Additionally, girls and their parents and caretakers provided more negative overall reviews regarding the range of current device features compared to boys, indicating a potential focus area for future development. The percent skew showed that subthemes were often more negatively skewed toward girls, with the ease of use being -10.7% skewed for boys versus -20.5% for girls, and comfort being -7.1% skewed for boys versus -29.4% for girls. Put together, this review highlights multiple device features that are targets for innovation to ensure translational efficacy regardless of age, gender, or specific family needs.
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Affiliation(s)
- Astha Sahoo
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Savannah Leah Starr
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Vadim Osadchiy
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Sophia Desai
- Department of Bioengineering, Samueli School of Engineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Neha Iyer
- Department of Bioengineering, Samueli School of Engineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Marie Luff
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Grace E Sollender
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Renea Sturm
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- University of California, Los Angeles Mattel Children's Hospital, Los Angeles, CA, United States
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Alshehri AA, Zaki MSH, Nour SO, Gadi WH, Zogel BA, Alfaifi SM, Masmali EM, Aburasain AB, Nour MO. Sleep-Disordered Breathing and Its Association with Nocturnal Enuresis at the Primary Schools in Saudi Arabia: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1074. [PMID: 37371305 DOI: 10.3390/children10061074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6-12 years in Saudi Arabia. A cross-sectional observational study was conducted among the caregivers of children aged 6-12 years in all Saudi Arabia regions. The data were gathered through a self-administered online questionnaire. It included demographic information, weight and height, and associated comorbidities, in addition to the weekly frequencies of snoring symptoms and of enuresis, as well as of unrefreshing sleep using Likert-type response scales. Counts and percentages, the mean ± standard deviation, chi-square test, independent samples t-test, and regression analysis were used in the statistical analysis using R v 3.6.3. The questionnaire was completed by 686 respondents. Most respondents did not report any comorbidities in their children (77.1%). Asthma and adenotonsillar hypertrophy were reported in 16.2% and 15.6% of children, respectively. Unrefreshing sleep, mouth breathing at night, snoring, chronic nasal obstruction, and difficulty breathing while asleep were reported once or twice per week in 38%, 34%, 28%, 18%, and 18% of children, respectively. The prevalence of NE was 22.3%, with about 36.6% of children having NE two or more times per week. Significantly, NE was reported in 26.6% of children who slept before 10 PM compared to 19% of children who slept after 10 PM; in 28.6% of children who snored or loudly snored (57.1%) three times or more per week; and in 51.2% and 27.5% of children with difficulty breathing while asleep and who breathed through their mouth at night for one or two nights per week, respectively. A multivariable regression analysis showed that male gender (OR = 1.52, p = 0.010), obesity (OR = 1.24, p = 0.028), early sleeping time (OR = 1.40, p = 0.048), loud snoring for three or more nights per week (OR = 1.54, p = 0.001), difficulty breathing for one or two nights per week (OR = 1.85, p = 0.010), and mouth breathing at night for one or two nights per week (OR = 1.55, p = 0.049) were associated with higher odds of NE. Our study revealed that 22.3% of primary school children reported suffering from NE. SDB is a common problem among children with NE. The exact mechanism that links SDB to the increase in the risk of NE is unknown. Male gender, obesity, early sleeping time, loud snoring, difficulty breathing, and mouth breathing at night are potential independent risk factors of NE in school-age children.
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Affiliation(s)
- Ali Abdullah Alshehri
- Department of Surgery, College of Medicine, Najran University, P.O. Box 1988, Najran 11001, Saudi Arabia
| | | | - Sameh Osama Nour
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt
| | - Wala H Gadi
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Basem A Zogel
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Samar M Alfaifi
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Enas M Masmali
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Amani B Aburasain
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Mohamed Osama Nour
- Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Damietta 34511, Egypt
- Faculty of Public Health and Health Informatics, Umm Al-Qura University, P.O. Box 715, Makkah 21955, Saudi Arabia
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Al-Asadi JN, Radhi AM, Jumaa DS, Hassan MK. The Role of Hyposthenuria in Enuresis Among Paediatric Patients With Sickle Cell Disease. Sultan Qaboos Univ Med J 2023; 23:206-211. [PMID: 37377834 PMCID: PMC10292602 DOI: 10.18295/squmj.9.2022.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/01/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Enuresis is common among children with sickle cell disease (SCD). Many risk factors have been postulated, but its relation to hyposthenuria is debatable. This study aimed to determine the prevalence of enuresis in children with SCD in Basrah, Iraq, and to examine its relation with hyposthenuria. Methods A cross-sectional epidemiological study was performed on children with SCD who met the inclusion criteria at the Basrah Center for Hereditary Blood Diseases from December 2020 to May 2021. A questionnaire was used to collect relevant data. Blood samples were tested for haemoglobin genotype, certain blood indices and serum haemoglobin. Urine was tested for albumin and creatinine, and the specific gravity was measured using urine dipsticks. The relationships between enuresis and various sociodemographic and clinical variables were assessed. Binary logistic regression analysis was done to examine the independent risk factors of enuresis. Results A total of 161 out of 200 eligible children were included in this study (response rate: 80.5%). The majority of participants (60.9%) were males. The mean age of the participants was 10.9 ± 2.9 years. Enuresis was reported in 50 (31.1%) patients. The independent risk factors for enuresis included family history of enuresis (adjusted odds ratio [OR] = 5.94, 95% confidence interval [CI]: 2.54-13.89; P <0.001), hyposthenuria (OR = 3.76, 95% CI: 1.25-11.30; P = 0.018) and sleep disorders (OR = 2.90, 95% CI: 1.19-7.06; P = 0.019. Conclusion Enuresis is common among children with SCD in Basrah, Iraq. Hyposthenuria was significantly associated with enuresis. Family history of enuresis and sleep disorders were also found to be significantly related to enuresis.
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Affiliation(s)
| | - Alyaa M. Radhi
- Pediatrics, College of Medicine, University of Basrah, Basrah, Iraq
| | - Dhuha S. Jumaa
- Pediatrics, College of Medicine, University of Basrah, Basrah, Iraq
| | - Meaad K. Hassan
- Pediatrics, College of Medicine, University of Basrah, Basrah, Iraq
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Ghobrial EE, Fawzi NM, Shiba MF, Tawfik MA. Abdomino-Pelvic Ultrasound Evaluation in Monosymptomatic Primary Nocturnal Enuresis. Clin Pediatr (Phila) 2023; 62:33-38. [PMID: 35854637 DOI: 10.1177/00099228221109998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Enuresis is one of the most common childhood problems. Our study aimed to evaluate children with enuresis by renal bladder ultrasound (RBUS) to detect urological abnormalities and to compare the sonographic findings with control group. METHODS Our study included 30 children with primary monosymptomatic nocturnal enuresis (PMNE). Another 30 matched children with normal continence to urine were assigned as controls. The 2 groups were subjected to urine analysis, serum creatinine, and RBUS. RESULTS Ultrasound showed abnormality in 10% of case group, which was not significantly different from controls (p = 1.000). CONCLUSION Abnormalities discovered by ultrasonography in PMNE are more than in control group but without statistical significance and do not require invasive diagnostic tests. Children with sonographic abnormalities appear to be more resistant to treatment. We concluded that ultrasound is not necessary in MPNE and should be done in patients resistant to treatment.
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Affiliation(s)
- Emad E Ghobrial
- Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.,Nephrology Clinic, Children's Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nevin M Fawzi
- Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Maha F Shiba
- Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Mary A Tawfik
- Department of Pediatrics, Ministry of Health, Cairo, Egypt
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10
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Mahr F, Brennan G, Billman M, Lane-Loney S. Sleep and Avoidant Restrictive Food Intake Disorder (ARFID): Correlation With Psychopathology, Gender, and Academic Performance. Cureus 2022; 14:e25628. [PMID: 35795524 PMCID: PMC9250759 DOI: 10.7759/cureus.25628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 12/01/2022] Open
Abstract
Objective No studies have investigated sleep disturbance in avoidant/restrictive food intake disorder (ARFID). We examined sleep disturbance in ARFID and its association with eating problems, body mass index (BMI), gender, internalizing and externalizing symptoms, cognitive performance, and academic difficulties. Methods Data from 71 ARFID patients from our partial hospitalization program (PHP) for children and adolescents were examined. Sleep data were extracted from measures administered at admission including Achenbach Child Behavior Checklist (CBCL), Children's Depression Inventory (CDI), and Revised Children's Manifest Anxiety Scale (RCMAS). Correlational analyses were conducted to evaluate the convergent validity of parent-reported and participant-reported sleep problems. Association with the severity of eating problems, BMI, percentage of median body weight (% MBW), age, gender, psychotropic medication, psychopathology, and academic difficulties was examined using analysis of variance (ANOVA) and Pearson’s correlation. Results Fifty-two percent of parents and 74% of participants reported two or more sleep symptoms. Trouble sleeping was reported by 46.48% and nightmares by 35.21% of parents. Parent-reported trouble sleeping highly correlated with internalizing disorders. Parent-reported trouble sleeping and participant-reported difficulty sleeping positively correlated with attention and attention-deficit/hyperactivity disorder (ADHD) problems. Parent-reported less sleep and feeling tired correlated with sluggish cognitive tempo, while walking/talking in sleep negatively correlated with school performance. Gender differences were noted in parent-reported sleep problems. Sleep disturbances were not associated with lower BMI or median body weight at intake. Parent-reported talking/walking in sleep and participant-reported bad dreams and bedtime worries positively correlated with Children's Eating Attitudes Test (ChEAT) scores at intake and discharge. Discussion Our results provide compelling evidence to screen for sleep disturbance in ARFID patients regardless of median body weight and BMI. Exploration of sleep disturbances in ARFID using objective measures is warranted.
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Aral A, Usta MB, Erguner Aral A. Factors associated with response to simple behavioral intervention in primary enuresis nocturna. Bull Menninger Clin 2022; 86:67-89. [PMID: 35258343 DOI: 10.1521/bumc.2022.86.1.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This 8-week longitudinal study examined predictors of response to simple behavioral intervention in primary enuresis nocturna (PEN). A total of 154 children, aged 8-18 years, diagnosed with PEN were evaluated. The results indicated that lack of constipation, milder enuresis severity, and higher bladder capacity are the primary predictors of good treatment response, and lower family dysfunction is the most robust familial predictor. Lack of constipation is the main predictor with unique variance in multiple regression. Specialists should be aware of conditions that hinder the success of simple behavioral intervention before implementing costly treatments. In treatment-refractory cases, it is important to examine each child for constipation. Family-centered approaches can be helpful if used in parallel with behavioral treatments.
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Affiliation(s)
- Armagan Aral
- Staff physician in the Department of Child and Adolescent Psychiatry, Mental Health Hospital, Samsun, Turkey
| | - Mirac Baris Usta
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
| | - Ayse Erguner Aral
- Psychiatry resident in the Department of Mental Health and Diseases, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
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12
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NAZARI H, SAFAVI P, HOOSHYARI Z, PARSAMEHR H, ABBASI MOTLAGH F, TAJIPOOR A, GOODARZI Z, MOGHADAM SS, KUMASI JODAKI S, SALEHI KIA H, VEYSKARAMI M, BEYRANVAND S. Mental disorders and their comorbidities among children and adolescents aged 6 to 18 years in Lorestan Province. IRANIAN JOURNAL OF CHILD NEUROLOGY 2022; 16:39-50. [PMID: 35222656 PMCID: PMC8752999 DOI: 10.22037/ijcn.v16i1.24465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 11/08/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The profile of mental disorders has been changing over time. The aim of this study was to investigate the prevalence of mental disorders in children and adolescents in the Lorestan province of Iran. MATERIALS & METHODS This community-based cross-sectional study was done on 1001 children and adolescents aged 6-18 years from Lorestan province randomly selected by multistage cluster sampling method. Children and their parents were interviewed using the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). Also, the comorbidities of psychiatric disorders were evaluated. RESULTS According to obtained results, 25.1% of participants were diagnosed to have at least one psychiatric disorder. The prevalence of psychiatric disorders was not significantly different between the two sexes (OR=0.876, P=0.378) and three age groups (P>0.05). this prevalence was significantly higher in rural areas than in urban areas (OR= 1.997, P=0) and was significantly lower in children of fathers with a high school diploma or higher education compared to children of less-educated fathers (P<0.05). On contrary, it was significantly more prevalent in children of mothers with high school and bachelor's degrees compared to illiterate mothers. (p<0.05). The most prevalent psychiatric disorders were oppositional defiant disorder (ODD) (5.9%), separation anxiety disorder (5.3%), and depressive disorders (5%). The most prevalent groups of psychiatric disorders included anxiety disorders (11.2%), behavioral disorders (9.4%), and mood disorders (5%). Behavioral disorders were highly comorbid with anxiety disorders (20.7%). CONCLUSION Mental disorders affect a high proportion of children and adolescents in Lorestan province. There is a need for psychiatric facilities to provide for the needs of families to child mental health services.
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Affiliation(s)
- Hedayat NAZARI
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Parvin SAFAVI
- Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Zahra HOOSHYARI
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran, Psychology and Educational science department, Allameh Tabataba’i University , Tehran, Iran
| | - Hosien PARSAMEHR
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Farzaneh ABBASI MOTLAGH
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Ameneh TAJIPOOR
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Zohreh GOODARZI
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Saba Shokri MOGHADAM
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Shirin KUMASI JODAKI
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Hamzeh SALEHI KIA
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Maryam VEYSKARAMI
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Samira BEYRANVAND
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
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13
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Heekes SL, Kruger CB, Lester SN, Ward CL. A Systematic Review of Corporal Punishment in Schools: Global Prevalence and Correlates. TRAUMA, VIOLENCE & ABUSE 2022; 23:52-72. [PMID: 32436472 DOI: 10.1177/1524838020925787] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Despite global shifts toward prevention of school corporal punishment, the practice remains widespread. This systematic review focused on (a) prevalence, (b) associated mental health and behavioral factors, and (c) correlates that may be risk or protective factors. Studies included in this review were peer-reviewed, published in English between 1980 and July 2017, and quantitative in design. Fifty-three papers met the inclusion criteria. All were cross-sectional surveys, predominantly of moderate quality and conducted in the United States (US) and on the African continent. Results indicated that school corporal punishment is prevalent across the globe (including where bans are in place) and does not appear to be decreasing over time, although measurement differences preclude firm conclusions. It is associated with physical, academic, mental health, and behavioral problems for children. Boys, Black students (in the US), and students exposed to violence at home were most at risk of corporal punishment. It is unclear whether disability puts a student at risk. Schools with high rates of other disciplinary practices were more likely to use corporal punishment, while those who employed a mental health professional and trained staff in safety procedures were less likely to use corporal punishment. Teacher attitudes favoring corporal punishment, and their use of violence in other contexts, increased risk. Low socioeconomic status (of the student or the school environment) increased risk, while high levels of state social capital reduced risk. Future research must include areas where corporal punishment is banned and focus on developing effective interventions to prevent school corporal punishment.
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Affiliation(s)
| | - Chloe B Kruger
- Department of Psychology, University of Cape Town, South Africa
| | - Soraya N Lester
- Department of Psychology, University of Cape Town, South Africa
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14
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Sun H, You Y, Xue B, Xiao S, Lu Y, Ma H, Hou Y, Yu B, Pan X. Effect of DRD4 Receptor -616 C/G Polymorphism on Thalamic GABA Levels in Pediatric Patients With Primary Nocturnal Enuresis. J Magn Reson Imaging 2021; 54:1857-1864. [PMID: 34121249 DOI: 10.1002/jmri.27782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The single nucleotide polymorphism (SNP) of dopamine D4 receptor (DRD4) promoter (-616; rs747302) is associated with abnormalities of the thalamus in children suffering from primary nocturnal enuresis (PNE). PURPOSE To investigate the effect of DRD4 -616 C/G SNP on thalamic gamma-aminobutyric acid (GABA) levels in PNE children. STUDY TYPE Prospective, observational. SUBJECTS One hundred and seventy-six children with PNE and 161 healthy control children. FIELD STRENGTH/SEQUENCE 3 T, three-dimensional T1-weighted turbo field echo sequence and MEscher-Garwood Point RESolved Spectroscopy (MEGA-PRESS) MRS sequence. ASSESSMENT The MEGA-PRESS MRS sequence was used to measure thalamic GABA spectra. The thalamic GABA+ level was calculated using the Gannet 3.0 software package for each participant. A questionnaire was used to determine arousal from sleep (AS) scores. STATISTICAL TESTS Comparisons of the AS scores and thalamic GABA+ levels were performed using the Mann-Whitney U test between C-allele carriers and GG homozygotes in the PNE and control groups. Spearman correlation analysis was performed to determine the association between AS scores and thalamic GABA levels in PNE children. RESULTS Thalamic GABA levels in the PNE group were significantly higher than those in the healthy control group (0.178 (0.169-0.186) vs. 0.154 (0.146-0.164), Z = 8.526, Pcorrected < 0.001). The GABA levels in C-allele carriers were significantly higher than those in GG homozygotes in both the PNE and control groups (0.184 (0.181-0.193) vs. 0.170 (0.165-0.177), Z = 8.683, Pcorrected < 0.001; 0.166 (0.156-0.170) vs. 0.147 (0.141-0.152), Z = 9.445, Pcorrected < 0.001). GABA levels in the thalamus were also significantly and positively correlated with AS scores in C-allele carriers in the PNE group (r = 0.747, P < 0.05). DATA CONCLUSION DRD4 -616 C allele may be associated with increased thalamic GABA+ levels, especially in C-allele carrying PNE children. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Hongbin Sun
- Department of Radiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Yi You
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing Xue
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shanshan Xiao
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yao Lu
- Center of the Laboratory Technology and Experimental Medicine, China Medical University, Shenyang, China
| | - Hongwei Ma
- Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin Pan
- Department of Radiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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15
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Mohammadi MR, Hojjat SK, Ahmadi N, Alavi SS, Hooshyari Z, Khaleghi A, Ahmadi A, Hesari MJ, Shakiba A, Amiri S, Molavi P, Arman S, Mohammadzadeh S, Kousha M, Golbon A, Hosseini SH, Delpisheh A, Mojahed A, ArmaniKian A, Sarraf N, Safavi P, Moharari F, Dastjerdi R, Talepasand S, Jaberghaderi N, Ostovar R, Salmanian M, Zarafshan H, Nazari A, Haghbin A, Khalili MN. Prevalence of elimination disorders and comorbid psychiatric disorders in Iranian children and adolescents. J Pediatr Rehabil Med 2021; 14:19-29. [PMID: 33720855 DOI: 10.3233/prm-190628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Currently, there is a paucity of studies on the prevalence of Elimination Disorders among Iranian children and adolescents. Due to the ongoing need to monitor the health status of these children and adolescents, the present study aims to investigate the prevalence of Elimination Disorders and comorbid disorders in Iranian children and adolescents. METHODS In this cross-sectional study, 29,781 children and adolescents age 6 to 18 years old were selected and studied from all the provinces in Iran. The sampling was carried out by employing a multistage cluster sampling method, and several clinical psychologists using semi-structured interviews collected the data. Furthermore, clinical psychologists collected demographic information (including information about gender, age, place of residence, education level, and parental education level). The collected data were analyzed using SPSS version 20. RESULTS Generally, the prevalence of Elimination Disorders was found to be 5.4% covering both enuresis (p= 5.4, 95% CI = 5.1-5.7) and encopresis (p= 0.13, 95% CI = 0.09-0.2). The total prevalence of comorbid disorders was 38%, and among the comorbid disorders, Attention Deficit Hyperactivity Disorder (ADHD) (p= 11, 95% CI = 9.5-12.7) and Separation Anxiety (p= 10.6, 95% CI = 9.1-12.2) were the most prevalent. CONCLUSION The prevalence of Elimination Disorders in Iranian children and adolescents is moderate compared to similar studies elsewhere. As for comorbid disorders, ADHD and Separation Anxiety were found to be the most prevalent disorders. Since Elimination Disorders coexist with psychiatric disorders in children, further studies of these comorbidities may give better insight into the treatment and prognosis of Elimination Disorders.
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Affiliation(s)
- Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Seyed Kaveh Hojjat
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.,Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nastaran Ahmadi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Salman Alavi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Zahra Hooshyari
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ameneh Ahmadi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Mahsa Jafarzadeh Hesari
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Alia Shakiba
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Shahrokh Amiri
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parviz Molavi
- Department of Psychiatry, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Soroor Arman
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soleiman Mohammadzadeh
- Department of Psychiatry, Neuroscience Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maryam Kousha
- Department of Pediatric Psychiatry, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Atieh Golbon
- Department of Psychiatry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Seyed Hamzeh Hosseini
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Delpisheh
- Department of Clinical Epidemiology, Faculty of Medicine Psychosocial Injuries Research Center Ilam, University of Medical Sciences, Ilam, Iran
| | - Azizollah Mojahed
- Department of Clinical Psychology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza ArmaniKian
- Department of Psychiatry, Zanjan University of Medical Science, Zanjan, Iran
| | - Nasrin Sarraf
- Department of Child and Adolescent Psychiatry, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Parvin Safavi
- Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fatemeh Moharari
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rahim Ostovar
- Social Determinant of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Maryam Salmanian
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Hadi Zarafshan
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ali Nazari
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Ali Haghbin
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mina Norozi Khalili
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
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16
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Esmael A, Elsherief M, Abdelsalam M, Bendary L, Egila H. Sleep Architecture in Valproate-Induced Nocturnal Enuresis in Primary School and Preschool Children. J Child Neurol 2020; 35:975-982. [PMID: 32762394 DOI: 10.1177/0883073820944051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nocturnal enuresis is one of the side effects of valproic acid treatment, and generally underdiagnosed by clinicians. Studies reported that a variable incidence of valproic acid-induced nocturnal enuresis is 2.2% to 24% with unclear explanations of the reasons behind valproic acid-induced nocturnal enuresis. A retrospective study was carried out on 260 children (aged 5-12 years) diagnosed with idiopathic epilepsy, treated with valproic acid to evaluate the nocturnal enuresis secondary to valproic acid, and to discuss the characteristics of their sleep architecture. Nocturnal enuresis was reported in 28 (10.7%) patients after a mean exposure time to valproate of 18.78±8.4 days. Nocturnal enuresis was significantly associated with younger age and serum level of valproate (P = .05). The polysomnographic study suggested that the underlying mechanism may be related to impaired sleep efficiency, frequent arousals, prolonged sleep latency, snoring, or increased sleep depth which may impair a child's ability to awaken to the sense of bladder fullness or contractions.Clinical trial registration: ClinicalTrials.gov identifiers: NCT04191863.
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Affiliation(s)
- Ahmed Esmael
- Department of Neurology, 68780Faculty of Medicine, Mansoura University, Egypt
| | - Mohammed Elsherief
- Department of Neurology, 68780Faculty of Medicine, Mansoura University, Egypt
| | - Mohamed Abdelsalam
- Department of Neurology, 68780Faculty of Medicine, Mansoura University, Egypt
| | - Lotfy Bendary
- Department of Urology, Faculty of Medicine, 68865Zagazig University, Egypt
| | - Hossam Egila
- Department of Neurology, 68780Faculty of Medicine, Mansoura University, Egypt
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17
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Huang HM, Wei J, Sharma S, Bao Y, Li F, Song JW, Wu HB, Sun HL, Li ZJ, Liu HN, Wu Q, Jiang HL. Prevalence and risk factors of nocturnal enuresis among children ages 5-12 years in Xi'an, China: a cross-sectional study. BMC Pediatr 2020; 20:305. [PMID: 32571248 PMCID: PMC7310244 DOI: 10.1186/s12887-020-02202-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/12/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Nocturnal enuresis (NE) has a negative impact on children's health and imposes a long-term burden on families. With economic development and cultural improvements, parents and medical professionals pay more attention to NE. The aim of this study was to investigate the prevalence and risk factors of NE among children ages 5-12 years in Xi'an, China. METHODS A stratified cluster sampling method was used to conduct a cross-sectional study of NE in 10 kindergartens and 20 primary schools in Xi'an. We used univariate analysis to compare the prevalences of characteristics such as gender, duration of disposable diaper (DD) use, toilet training onset time, daily living habits, academic performance, and family history of NE. Logistic regression analysis was used to calculate odds ratio and to determine risk factors of NE. RESULTS The study included 6568 children ages 5-12 years, of which 262 (3.99%) had NE. The prevalence rates of NE decreased with age, with the highest prevalence at age 5 (9.09% for boys; 6.03% for girls). However, the prevalence increased with duration of DD use. Children experienced more NE if they never accepted toilet training (7.83%) or if they drank sugary beverages during the day (5.36%). Sleep disorders, sweets intake, drinking low amounts of plain water during the day, and family history of NE, were statistically associated with NE. CONCLUSION NE was closely associated with a family history of NE, being male, long-term use of DD, delayed toilet training, drinking sugary beverages and/or consuming little plain water, and sleep disorders. A supportive parental attitude towards NE and timely medical treatment can improve the quality of life of enuretic children.
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Affiliation(s)
- Hui-Mei Huang
- Department of Epidemiology and Biostatistics, School of Public Heath, Xi'an Jiaotong University, No.76 West Yanta Road, Xi'an, 710061, Shaanxi, China.,Department of Renal Dialysis, The First Affiliated Hospital of Xi'an Jiaotong University, No.277 West Yanta Road, Xi'an, 710061, Shaanxi, China.,Department of Nephrology, The Affiliated Children Hospital of Xi'an Jiaotong University, No.69 Xijuyuan Lane, Xi'an, 710002, Shaanxi, China
| | - Jing Wei
- Department of Epidemiology and Biostatistics, School of Public Heath, Xi'an Jiaotong University, No.76 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Shristi Sharma
- Department of Epidemiology and Biostatistics, School of Public Heath, Xi'an Jiaotong University, No.76 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Ying Bao
- Department of Nephrology, The Affiliated Children Hospital of Xi'an Jiaotong University, No.69 Xijuyuan Lane, Xi'an, 710002, Shaanxi, China
| | - Fei Li
- Department of Breast Cancer, Shaanxi Tumor Hospital, No.309 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Jian-Wen Song
- Department of Dermatology, The Affiliated Children Hospital of Xi'an Jiaotong University, No.69 Xijuyuan Lane, Xi'an, 710002, Shaanxi, China
| | - Hai-Bin Wu
- Department of Pediatric intensive care unit, The Affiliated Children Hospital of Xi'an Jiaotong University, No.69 Xijuyuan Lane, Xi'an, 710002, Shaanxi, China
| | - Hong-Li Sun
- Shaanxi Institute of Pediatric Diseases, The Affiliated Children Hospital of Xi'an Jiaotong University, No.69 Xijuyuan Lane, Xi'an, 710002, Shaanxi, China
| | - Zhi-Juan Li
- Department of Nephrology, The Affiliated Children Hospital of Xi'an Jiaotong University, No.69 Xijuyuan Lane, Xi'an, 710002, Shaanxi, China
| | - Huan-Nan Liu
- Department of Epidemiology and Biostatistics, School of Public Heath, Xi'an Jiaotong University, No.76 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Qian Wu
- Department of Epidemiology and Biostatistics, School of Public Heath, Xi'an Jiaotong University, No.76 West Yanta Road, Xi'an, 710061, Shaanxi, China.
| | - Hong-Li Jiang
- Department of Renal Dialysis, The First Affiliated Hospital of Xi'an Jiaotong University, No.277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
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18
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Alhifthy EH, Habib L, Abu Al-Makarem A, AlGhamdi M, Alsultan D, Aldhamer F, Buhlagah R, Almubarak FM, Almufadhi E, Bukhamsin GM, Zadah MH. Prevalence of Nocturnal Enuresis among Saudi Children Population. Cureus 2020; 12:e6662. [PMID: 31966951 PMCID: PMC6964794 DOI: 10.7759/cureus.6662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Nocturnal enuresis (NE) is the involuntary urination that occurs while asleep after an age when bladder control at night is expected. It has a global incidence of 1.4%-28% among 6-12 years old children. The aim of this study is to show the prevalence, risk factors, types of provided treatment of enuresis among studied children in Kingdom of Saudi Arabia (KSA). Methods A cross-sectional descriptive study was carried out among Saudi children, 3-12 years of age, from different cities in Saudi Arabia, during the period from 20 October to 20 November 2019. Data was collected by using a pre-designed questionnaire that was distributed online and included questions designed to fulfill the study objectives. Results This study reported that 31.2% of Saudi children of the chosen ages are suffered from enuresis, the majority occurred at day and night by 55.1% while 43.9% occurred only at night. Participants described types of provided treatment as follows: behavioral modification was the most commonly used by 31.6% followed by pharmacological intervention (29.6%), bed-wetting alarm (6.8%), exercises to strengthen the bladder muscles (6.2%) and surgical intervention reported by 1.5% only. It was found that the improvement of enuresis on treatment occurred in 43.6% of cases. There was a significant reduction of the prevalence of NE with age (peak is 63.6% in 5-7 years old) but no significant correlation was found with gender (p = 0.104). However, there was a significant correlation with parent having history of NE (p = 0.001). Conclusion The study reported that 31.2% of children found to have nocturnal enuresis; 43.9% of those had nocturnal enuresis alone. There were no significant correlations between nocturnal enuresis and child gender while it significantly correlated with child's age and having a family history of NE. Behavioral modification therapy was the most commonly provided treatment followed by pharmacological intervention; improvement occurred in less than half of the cases with treatment.
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Affiliation(s)
- Elham H Alhifthy
- Clinical Sciences, Pediatrics, Developmental and Behavioural Pediatrics, Princess Nourah Bint Abdulrahman University, College of Medicine, Riyadh, SAU
| | | | | | | | | | | | | | | | | | | | - Maria H Zadah
- Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
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19
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Su MS, Xu L, Pan WF, Li CC. Current perspectives on the correlation of nocturnal enuresis with obstructive sleep apnea in children. World J Pediatr 2019; 15:109-116. [PMID: 30446975 DOI: 10.1007/s12519-018-0199-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/09/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) and nocturnal enuresis (NE) are common clinical problems in children. OSA and NE are thought to be interrelated, but the exact pathophysiological mechanisms are not yet clear. This review aims to explain the possible pathogenesis of NE in children with OSA. DATE SOURCES We have retrieved all relevant original articles from Database that have been published so far, including the prevalence studies of NE and OSA in children, sleep characteristic studies that use polysomnography (PSG) to focus on children with NE, and studies on the relationship between OSA and NE. RESULTS Clinical studies have revealed that the risk of NE in children with OSA was increased compared with that of their healthy peers. This increased risk may be associated with sleep disorders, bladder instability, detrusor overactivity, nocturnal polyuria, endocrine and metabolic disorders, and inflammation. CONCLUSIONS Cardiopulmonary and renal reflex-induced neuroendocrine disorder may play an important role in the mechanism of NE in children with OSA, but this remains to be confirmed by animal studies. Other causes such as oxidative stress and inflammatory responses need to be further researched.
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Affiliation(s)
- Miao-Shang Su
- Department of Pediatric Respiratory Medicine and Sleep Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Li Xu
- Department of Pediatric Respiratory Medicine and Sleep Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Wen-Feng Pan
- Department of Pediatric Respiratory Medicine and Sleep Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Chang-Chong Li
- Department of Pediatric Respiratory Medicine and Sleep Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
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Aliyu I, Lawal T, Michael G. Toilet training and parental help-seeking behavior toward elimination disorders: Our experience in a semi-urban setting. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2019. [DOI: 10.4103/mjdrdypu.mjdrdypu_43_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Shah S, Jafri RZ, Mobin K, Mirza R, Nanji K, Jahangir F, Patel SJ, Ejaz MS, Qaiser I, Iftikhar H, Aziz K, Khan W, Maqbool HS, Ahmed H. Frequency and features of nocturnal enuresis in Pakistani children aged 5 to 16 years based on ICCS criteria: a multi-center cross-sectional study from Karachi, Pakistan. BMC FAMILY PRACTICE 2018; 19:198. [PMID: 30547752 PMCID: PMC6293541 DOI: 10.1186/s12875-018-0876-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 11/19/2018] [Indexed: 11/24/2022]
Abstract
Background Nocturnal enuresis (NE) is a common symptom in children worldwide. International Children’s Continence Society (ICCS) defines enuresis as either mono-symptomatic, NE with lower urinary tract symptoms and NE with co-morbid conditions. The objectives of this study were to determine the frequencies and types of NE and associated symptoms and conditions in children aged 5 to 16 years based on ICCS criteria. Methods A multi-center cross sectional study was conducted between November 2012 and December 2013 in the primary care clinics of four hospitals in Karachi. Children aged five to fifteen years were included through consecutive sampling. Informed consent was obtained from the parents and a pre-coded semi-structured questionnaire was used to obtain the information. Data was entered on SPSS version 20.0 and multivariable logistic regression analysis was used for data analysis. Results Out of 429 children aged between five and sixteen years, 243(56.9%) were boys and the remaining 186(43.1%) were girls. One hundred and eighty three children (43%) had nocturnal enuresis (NE). Forty four (10.3%), had mono-symptomatic NE, 57(31.1%) had associated lower urinary tract symptoms (NE-LUTS), whereas 30 (16.3%) had NE with a co-morbid condition. Fifty two (28.4%) NE’s had at least one of both LUTS and a co-morbid condition. Out of the 246(57%) non-enuretic’s, 31(12.6%) had a LUTS, 95(38.6%) had a co-morbid condition and 57(23.2%) had at least one of both LUTS and a co-morbid condition. The remaining 63 (25.6%) were symptom free. Increased voiding frequency, urgency, dysuria, suprapubic pain and daytime incontinence were the LUTS significantly associated with NE. Co-morbid conditions significantly associated with NE included constipation, congenital defects, developmental delay, and learning and sleep problems. Conclusion Although NE can be an only symptom, it is often associated with lower urinary tract symptoms like dysuria, urgency, suprapubic pain, and daytime incontinence. Children presenting with NE often have co-morbid conditions like constipation, urinary tract infection, sleep disorders, and developmental delay. Many children presenting with these conditions as the primary complaint may also have NE. It should be addressed as unrecognized and untreated NE can cause additional morbidity and distress.
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Affiliation(s)
- Sameena Shah
- Department of Family Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Rabab Zehra Jafri
- Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, USA
| | - Khalil Mobin
- Community Health Sciences, Karachi Medical and Dental College, Karachi Metropolitan Corporation, Karachi, Pakistan
| | | | - Kashmira Nanji
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Fatima Jahangir
- Department of Family Medicine, Ziauddin University Hospital, Karachi, Pakistan
| | | | - Muzamil Shabana Ejaz
- Dow Medical College, DOW University of Health Sciences, Baba-e-Urdu Road, Karachi, Pakistan
| | | | | | - Komal Aziz
- Saint Louis University, St Louis, MO, USA
| | - Wajiha Khan
- Department of Pediatrics, Aga Khan University, Karachi., Pakistan
| | - Humza S Maqbool
- UC, San Francisco - Fresno medical education program, California, USA
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Rahmani E, Eftekhari MH, Fallahzadeh MH, Fararouei M, Massoumi SJ. Effect of vitamin D and omega-3 on nocturnal enuresis of 7-15-year-old children. J Pediatr Urol 2018; 14:257.e1-257.e6. [PMID: 29598883 DOI: 10.1016/j.jpurol.2018.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 01/02/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Nocturnal enuresis is known to be a common urinary bladder complication in children. Recent studies have associated vitamin D and omega-3 insufficiency with nocturnal enuresis. AIM This was a 2-month randomized, placebo-controlled, double-blind trial to measure the effects of vitamin D, omega-3 supplements, and their combination on nocturnal enuresis among 7-15-year-old children. MATERIALS AND METHODS Participants (180 children with nocturnal enuresis) were selected from children referred to the Pediatric ward of Imam Reza Clinic in Shiraz, Iran. Demographic information and anthropometric measures were taken. Fasting blood and urine samples were also collected, and serum vitamin D and urine prostaglandin E2 were measured before and after intervention. Enuretic children were randomly assigned to four groups: Group A, vitamin D (1000 IU/day); Group B, omega-3 (1000 mg/day); Group C, both omega-3 (1000 mg/day) and vitamin D (1000 IU/day); and Group D, placebo. RESULTS The results suggested that the study groups were not significantly different regarding demographic and anthropometric measures at baseline. Comparison of different groups revealed that 44.4% of participants in Group A, 28.2% of Group B and 45% of Group C were cured from enuresis (P = 0.03). Serum 25(OH) D was significantly increased in Group A, but urine prostaglandin E2 was not significantly decreased in response to supplementation. Although supplementation with both Group A and Group B were found to be effective, the combined intervention did not increase the effect of each intervention solely. CONCLUSIONS The results showed that supplementation with vitamin D and omega-3 could reduce the number of wet nights among 7-15-year-old children with nocturnal enuresis.
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Affiliation(s)
- E Rahmani
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M H Eftekhari
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - M H Fallahzadeh
- Nemazi Hospital, Nephrology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Fararouei
- HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S J Massoumi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Arena S, Patricolo M. Primary nocturnal enuresis: Assessment and treatment at a single referral center. Pediatr Int 2017; 59:812-815. [PMID: 28415139 DOI: 10.1111/ped.13298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 03/14/2017] [Accepted: 04/10/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to investigate the prevalence of primary monosymptomatic and non-monosymptomatic nocturnal enuresis (PMNE and PNMNE) and associated factors in a major referral center for NE in Abu Dhabi. METHODS Children referred to the Paediatric Continence Clinic, between 2014 and 2016, for PNE were included in the study. Exclusion criteria were neuropathic bladder, abnormality of the bladder and bowel, urethral stenosis, neurological and psychiatric problems, non-completion of the diagnostic protocol, and follow up <6 months. RESULTS A total of 128 patients were included in the study: 82 boys (64.1%) and 46 girls (35.9%). A total of 42.7% of boys and 8.7% of girls had PMNE, and 57.3% of boys and 91.3% of girls had PNMNE. Constipation was present in 46% of patients. In the male PNMNE group, 74.5% had overactive bladder (OAB), 10.6%, dysfunctional voiding (DV); and 14.9%, OAB + DV. In the female PNMNE group, 35.7% had OAB; 21.4%, DV; 40.5%, OAB + DV; and 2.4%, underactive bladder. A total of 97% and 86 of children with PMNE and PNMNE, respectively, had resolution of NE. Boys had a significantly higher incidence of PMNE, and girls, of DV. CONCLUSION In Abu Dhabi, NE is often associated with bladder dysfunction or DV, mostly in girls, and with constipation. High intake of dry, low fiber foods, along with hot weather and the stress of city living negatively affect the incidence of fecal retention and of NE. A multimodal approach, including the treatment of constipation, led to a satisfactory resolution of PNE in almost 90% of cases.
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Affiliation(s)
- Salvatore Arena
- Unit of Paediatric Surgery, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Mario Patricolo
- Department of Paediatric Surgery, Mediclinic and Al Noor Hospital Group, Abu Dhabi, United Arab Emirates
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Thurber S. Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities. Arch Psychiatr Nurs 2017; 31:319-323. [PMID: 28499575 DOI: 10.1016/j.apnu.2016.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 11/11/2016] [Accepted: 11/12/2016] [Indexed: 10/20/2022]
Abstract
Enuresis constitutes a frequently encountered problem area for children that may adversely affect social and emotional adjustment. This type of incontinence has been of concern to the human family for centuries. A brief history of enuresis is presented followed by current conceptualizations, diagnostic criteria, prevalence rates and psychiatric comorbidities. Historic notions of causation together with ineffective, sometimes barbaric treatments are then discussed, ending with a presentation of evidence-based treatment modalities, with the urine alarm being an essential element of effective treatment. An intervention termed dry bed training combines the urine alarm with a series of procedures designed in part to reduce relapse potential and should be a primary consideration for implementation by treatment professionals. Finally, a brief case study is presented illustrating special etiological and treatment considerations with juvenile psychiatric patients.
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Affiliation(s)
- Steven Thurber
- Child and Adolescent Behavioral Health Services, 1701 Technology Drive, Willmar, MN 56201, United States.
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Ferrara P, Di Giuseppe M, Fabrizio GC, Sbordone A, Amato M, Cutrona C, Verrotti A. Enuresis and Punishment: The Adverse Effects on Child Development and on Treatment. Urol Int 2016; 97:410-415. [PMID: 27376868 DOI: 10.1159/000447496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/06/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the role of punishment in enuretic children and how the punishments can influence therapy response. METHODS We enrolled 218 enuretic children. The children and their families were asked to participate in the study at the end of the clinical evaluation. RESULTS The analysis of the questionnaires shows that at least one punishment because of nocturnal enuresis (NE) had been applied to 27 out of 218 (12.4%) children. Punishment methods were reprimanding in 19 out of 27 (70.4%), depriving of sleep in 11 out of 27 (40.7%), mildly beating in 3 out of 27 (11.1%), leaving the child wet in 1 out of 27 (3.7%) and other methods in 2 out of 27 (7.4%). In the group of punished children, a full or partial response in terms of a decreased number of wet nights was achieved in 40.7 vs. 59.2% in children who had not been punished. CONCLUSIONS Parents should be sensitized on the adverse effects of punishment on child development. It is important in childcare to explain the definitions of the disorder and find the best treatment (behavioural and/or medicinal) depending on the single patient, his/her family and compliance of both. Successful management of NE has benefits to both the child and the family.
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Affiliation(s)
- Pietro Ferrara
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy
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Prevalence of nocturnal enuresis and related risk factors in school-age children in Egypt: an epidemiological study. World J Urol 2016; 35:459-465. [PMID: 27306687 DOI: 10.1007/s00345-016-1879-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 06/08/2016] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To determine the prevalence of mono-symptomatic nocturnal enuresis (MNE) and its risk factors among school-age children in our community. METHODS A cross-sectional study included school-age children from two governorates in south of Egypt. A questionnaire was presented to randomly selected students. It consisted of 3 domains: Domain 1 included questions about MNE, domain 2 was about risk factors for MNE, and domain 3 was about management of MNE. RESULTS The study included 4652 students (9 ± 2 years) from 12 primary schools (51 % males and 49 % females). Of 4652 students, 834 (18 %) had NE, with no significant difference between rural and urban areas (17.5 vs. 18.4 %, p = 0.4). Younger age categories showed higher prevalence of MNE than in older children. MNE caused moderate-to-severe bother for 44.5 and 87.8 % of students and parents, respectively. Urinary tract infection, pinworm infestation, constipation, and caffeine over-consumption significantly associated with MNE. Family history of MNE was positive in 84.7 %. Daytime incontinence coexisted in 16 % of cases. Children with ≥4 siblings and birth order ≥3 had more prevalent MNE. Deep sleepers and exposure to problems/violence correlated positively with occurrence of MNE. Father's level of education and work status, mother education, number of children per room, and socioeconomic status significantly associated with occurrence of MNE. There was no significant correlation between gender and prevalence of MNE. No treatment was used in 53.2 % of cases. CONCLUSION In the Egyptian community, pinworm infestation, UTI, constipation, and overconsumption of caffeine-containing beverages are potential reversible risk factors for MNE in school-age children.
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Ozkaya E, Aydın SC, Yazıcı M, Dundaröz R. Enuresis Nocturna in children with asthma: prevalence and associated risk factors. Ital J Pediatr 2016; 42:59. [PMID: 27287763 PMCID: PMC4901497 DOI: 10.1186/s13052-016-0266-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 05/30/2016] [Indexed: 02/06/2023] Open
Abstract
Background Enuresis Nocturna (EN) is a common disorders in childhood. Although many different underlying pathophysiological mechanisms have been proposed to explain EN, its etiology is multifactorial. Some reports demonstrate that there is an association between EN and allergic diseases. To study (1) the prevalence of EN in children with asthma, (2) to determine the possible risk factors for EN in asthmatic children. Methods Five hundreds and six children aged 6–14 years-old diagnosed with asthma and 380 age-matched non-asthmatic controls were enrolled into this cross-sectional case–control study. We studied an allergy panel that included skin prick tests with (8 inhalant allergens), total IgE, and blood eosinophil count for both groups. Semi-structured interviews were conducted with the parents of children presenting EN. Factors associated with EN in children with asthma were analyzed using a logistic regression model. Results The prevalence of EN was significantly higher in children with asthma as compared to the controls: 132 (26 %), 43 (11.5 %) respectively (p = 0.001). Emergency visits frequency, and family history of enuresis were higher in the asthmatic children with EN than in asthmatic children without EN. According to the logistic regression analysis, positive pollen sensitization (p = 0.027, OR = 1.94), allergic rhinitis (p = 0.032, OR = 2.36), and high eosinophil count (p = 0.004, OR = 1.40) were independent risk factors for EN in children with asthma. Conclusion This study showed that the prevalence of EN in children with asthma was higher than in same age controls. Sensitization to pollens, allergic rhinitis and high blood eosinophil count associate to the EN in children with asthma.
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Affiliation(s)
- Emin Ozkaya
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Bezmialem Vakif University Medical Faculty, Adnan Menderes Bulvari Vatan Caddesi, 34093, Fatih/Istanbul, Turkey.
| | - Seren Calıs Aydın
- Department of Pediatrics, Giresun University Medical Faculty, Giresun, Turkey
| | - Mebrure Yazıcı
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Bezmialem Vakif University Medical Faculty, Adnan Menderes Bulvari Vatan Caddesi, 34093, Fatih/Istanbul, Turkey
| | - Rusen Dundaröz
- Department of Pediatrics, Bezmialem Vakif University Medical Faculty, Adnan Menderes Bulvari Vatan Caddesi, 34093, Fatih/Istanbul, Turkey
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