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Psychiatry and social medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
13.25. Which of the following is/are correct?Nocturnal enuresis is more frequent in boys than girls.Diurnal enuresis is more frequent in boys than girls.Nocturnal enuresis is more frequent in first-born children.Nocturnal enuresis is a familial disorder.Primary enuresis may present at the age of approximately 4 years.
Urinary
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
Bedwetting (nocturnal enuresis [NE]) may present in isolation (monosymptomatic enuresis [MSE]) or in association with daytime incontinence; urge, hesitancy, and straining symptoms; postvoid dribbling; or dysfunctional voiding (non-monosymptomatic enuresis [NMSE]). NE is defined as the involuntary voiding of urine during sleep at least three times a week for at least 3 months in a child 5 years or older. It is the most common chronic childhood complaint affecting over half a million children in the United Kingdom. The incidence of NE at the age of 5 years is about 10%; at the age of 10 years, it is around 5%; and 1%–2% of children continue with bedwetting after puberty. About 15% of children are spontaneously cured annually. NE is divided into primary nocturnal enuresis (PNE) (continue to wet beyond the age of 5 years), affecting 80% of children, and secondary nocturnal enuresis (SNE) (after a previous dry period greater than 6 months) in 20% of children. Causes of PNE include genetic (on chromosomes 12 and 13), delayed maturation, sleep disorders and antidiuretic hormone (ADH) deficiency. Causes of SNE include urinary tract infection (UTI), emotional stress, type 1 diabetes (T1D), child abuse, diabetes insipidus (DI), obstructive sleep apnoea (OSA) and seizure.
Paper 1 Answers
Published in Hayley Dawson, Anna Trigell, EMQs for the nMRCGP® Applied Knowledge Test, 2018
Enuresis alarms are the most effective treatment for nocturnal enuresis. Children are 13 times more likely to achieve 14 consecutive dry nights with alarm treatments than with placebo. The bell and pad technique is an example of an enuresis alarm, and is a form of behavioural therapy that is often used to treat nocturnal enuresis in children. Enuresis alarms are less likely to be successful if the parents are unenthusiastic or if there is a psychological or social instability.
Evaluation of boys with daytime incontinence by combined cystourethroscopy, voiding cystourethrography and urodynamics
Published in Scandinavian Journal of Urology, 2021
Lilia Winck-Flyvholm, Karen Damgaard Pedersen, Simone Hildorf, Jorgen Thorup
Between 2010 and 2018, we investigated 75 boys aged 5–14 (median age 9) years old according to a prospective set-up with cystourethroscopy including application of a suprapubic catheter in general anesthesia and within 24 h thereafter VCUG followed by urodynamic combined cystometry and pressure-flow study. All boys had daily problems with urinary incontinence, urgency and eventually frequency (more than seven times per day). The median number of daily voiding was 7 and 57% (43/75) of the boys had frequency. Nocturnal enuresis, defined as bedwetting at least once a month, was also noted in 46 boys. Prior to inclusion all boys had previously tried urotherapy for a period of 3 months to 5 years (median 1 year) and the minority (23%, 17/75) had additionally included periods of anticholinergic treatment with unsatisfactorily effect. The urotherapy regime included evaluation and regular monitoring with three days frequency volume charts, uroflowmetry and bladder emptying by ultrasonography. None of the boys had any previous episodes of urinary tract infection (UTI) recorded. None of the boys had neurological symptoms or abnormalities and none had obstructive flow pattern at repeated uroflowmetry. All the boys had normal upper urinary tract estimated by ultrasound examination. The boys had follow-up for 1 month to 9 years (median 2 years and 8 months).
Prevalence of psychiatric disorders and suicidality among children and adolescents with thalassemia major—A Turkish sample
Published in Children's Health Care, 2019
Abdurrahman Cahid Örengül, İlknur Ucuz, Nergiz Oner Battaloglu, Gulcihan Ozek, Vahdet Gormez
The high rates of nocturnal enuresis in the present study is an interesting one. Repeated voiding rates, but not enuresis, were 7.3% in the study of Ghanizadeh et al. (2006), however mean age of participants in their study was higher than the present study. Findings of the present study are in accordance with the findings in Ekinci et al. (2013) study, in which TM was reported to be a major risk factor for nocturnal enuresis. Besides, patients with enuresis were of younger age and had family history for enuresis and psychosocial family problems (Ekinci et al., 2013). In other studies, prevalence rate of enuresis was 12.2% in pre-adolescent children with TM (Beratis, 1993), and enuresis was more prevalent than healthy control group (33% vs 17%) in a case control study with 5–15 years old Indian children with TM (Saini et al., 2007). Thus, results of the present study supports higher prevalence of enuresis nocturna in children with TM.
Oxybutynin addiction: two case reports
Published in Journal of Substance Use, 2021
Harun Olcay Sonkurt, Ali Ercan Altınöz
After the urological examination, it was found that the patient showed no signs of nocturnal enuresis and referred to the psychiatry clinic with a primary diagnosis of substance use. With a detailed medical history it was found that he was using oxybutynin to facilitate communication with his inmates and to manage his temper more easily. He states that a friend of him told him that oxybutynin could calm the nerves, and because it is cheap, he has been using it to substitute heroin. Soon after, he needed to use it regularly. Subsequent to being in jail, he used it 8–10 times a day as long as he had access to the drug, yet as it was getting harder to obtain, he reduced the dosage by 4–5 times a day. He says he is not addicted, and the drug makes him feel good.