Review of Clinical Studies for Korean Medicine Treatment on Nocturnal Enuresis in Children

Objective To investigate the behavioral characteristics of preschool children aged 5-6 years with attention deficit hyperactivity disorder(ADHD) comorbid with enuresis. Methods Conner’s Parent Symptom Questionnaire and Digital Cancellation Test were used to investigate 42 children with ADHD(ADHD group), 36 children with ADHD comorbid with enuresis (ADHD+ NE group) and 48 normal controls. Results In the Conner’s Parent Symptom Questionnaire, the score of the conduct factors ((0.79±0.13), (0.83±0.50)), learning factors ((1.55±0.49), (1.92±0.62)), mind-body factors ((0.61±0.35), (0.67±0.22)), hyperactivity impulse factors ((1.96±0.48), (2.21±0.69)), anxiety factors((0.76±0.53), (1.02±0.58)) and hyperactivity indices ((1.57±0.14), (2.19±0.33)) in ADHD group and ADHD+ NE group were higher than those of the control group((0.59±0.39), (0.64±0.28), (0.35±0.74), (0.82±0.63), (0.51±0.40), (0.86±0.59), (all P<0.05)). The scores of learning factors, hyperactivity impulse factors, anxiety factors and hyperactivity indices in ADHD+ NE group were higher than those in ADHD group(P<0.05). In the digital cancellation test, the gross scores((52.37±1.48), (57.42±1.05))and net scores ((39.15±8.84), (38.99±5.72)) of ADHD group and ADHD+ NE group were lower than those in the control group ((89.40±7.82), (80.16±12.54))(均P<0.05). The error scores ((38.16±9.60), (40.59±9.28)) and error rate(0.40±0.27, 0.59±0.44)of ADHD group and ADHD+ NE group were higher than those of the control group ((14.01±5.32), (0.15±0.08))(all P<0.05). The error rate of ADHD+ NE group were higher than those of preschool ADHD group(P<0.05). Conclusion The behavioral problems of preschool children aged 5-6 years with ADHD comorbid with enuresis are more serious and anxiety is more obvious, which should be paid attention to. Key words: Preschool children; Attention deficit hyperactivity disorder; Enuresis; Behavioral characteristics

Objective To investigate the significance of blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) and ambulatory urodynamics monitoring (AUM) to find the cause of primary monosymptomatic nocturnal enuresis (PMNE) in children. Methods Thirty-seven children with PMNE (20 males and 17 females) were selected, with a mean age of (11.3±4.1) years old.A clinical management tool, 3-day urination record, daytime BOLD-fMRI scan, conventional urodynamics (CUD) and AUM were performed respectively.Thirty-seven gender-age matched children(19 males, 18 females) who would receive surgery treatment because of upper urinary tract disease and were confirmed to have no lower urinary tract dysfunction by CUD were enrolled as controls, with a mean age of (11.1±2.9) years old, and 13 cases underwent BOLD-fMRI scanning. Results It was found that the ALFF value of the left middle frontal gyrus of PMNE was decreased and the ReHo value of the left superior occipital gyrus was increased compared with the control group by the resting BOLD-fMRI.The maximum voiding volume of PNME children was (303.11±87.48) mL, the total urine volume at night was (568.65±208.48) mL, and the nighttime bladder volume was (217.43±81.53) mL.The incidence of maximum voiding volume reduction, nocturnal polyuria and decreased nocturnal bladder volume were 24.32% and 56.76%, and 64.86%, respectively.However, AUM results showed that maximum detrusor pressure in the PMNE group was (39.22±7.78) cmH2O(1 cmH2O=0.098 kPa), which was statistically significantly higher than that in CUD (32.22±9.00) cmH2O, and the difference was statistically significant (P 0.05). Conclusions The abnormal functions of the left middle frontal gyrus and left superior occipital gyrus, nighttime DO and the decrease of bladder capacity at night are considered to be key causes of enuresis in children with PMNE.AUM and resting state BOLD-fMRI evaluations are helpful in differentiating the pathogenesis of PMNE. Key words: Enuresis; Ambulatory urodynamics monitoring; Functional magnetic resonance imaging; Resting state

Objective To understand the experiences and feelings of major caregivers of children with nocturnal enuresis. Methods A semi-structured interview was conducted with major caregivers of children with nocturnal enuresis. Data were analyzed based on Colaizzi phenomenological research method. Results The major caregivers′experiences and feelings were classified into 4 themes, including overload care tasks, worry about the children with nocturnal enuresis, uncertain feeling of the prognosis, lack of family and medical support system. Conclusions Understanding the experiences and feelings of major caregivers of children with nocturnal enuresis can help medical workers realize their attending demands, provide professional services and promote the recovery of children. Key words: Nocturnal Enuresis; Children; Nursing; Qualitative Research

目的 采用功能连接法分析遗尿症(NE)患儿静息态下小脑与全脑功能连接的改变，探索NE患儿遗尿症状及认知功能障碍的神经生理机制。 方法 18例NE患儿及18例健康对照组患儿分别进行静息态下脑功能磁共振成像(fMRI)数据采集。经预处理后以小脑为种子点分别进行全脑的功能连接(FC)，获取2组的FC值后采用两样本t检验比较组间差异，并在Ch2模板上进行分析处理。 结果 与正常对照组比较，NE患儿小脑与左背外侧前额叶(t＝－4.03)、左顶下小叶(t＝－4.03)功能连接均减低(均P<0.05，校正后)，与其他脑区的功能连接未见明显差异。 结论 NE患儿小脑与左背外侧前额叶、左顶下小叶脑区存在功能连接异常，可能是NE患儿遗尿症状及认知功能障碍的神经机制之一。

Objective To survey the prevalence and distribution of sleep disorders in patients with Parkinson disease (PD) and to analyze the influencing factors. Methods The prevalence and distribution of sleep disorders were surveyed with Parkinson Disease Sleep Scale (PDSS) among 206 PD patients. The association of sleep disorders with age, course of disease, cognitive function, motor function, depression, and the equivalent dose of levodopa (LED) was analyzed. Results The overall PDSS score in 206 patients was (116.9±21.4). The three most frequent items of sleep disorders were the overall sleep quality(181/206, 87.9%), difficulty in maintaining sleep(160/206, 77.7%)and nocturnal enuresis(151/206, 73.3%); the three least frequent items were early awaking(87/206, 42.2%), urinary incontinence(56/206, 27.2%)and hallucination(44/206, 21.4%). The three items with the lowest average scores were nocturnal enuresis(6.9±3.1), difficulty in maintaining of sleep(7.1±2.7)and overall sleep quality(7.1±2.0); three items with the highest average scores were audiovisual illusion(9.3±1.8), incontinence caused by motion disability(9.0±2.1) and early awaking with upper and lower limb pain(8.7±2.1). PD patients were divided into group 1 [Hoehn-Yahr(HY F=3.27, P=0.04) between group 1 and group 3. The linear regression analysis showed that the HAMD and the LED scores had the greatest influence on PDSS score (R2=0.142, 0.196). Conclusion PD patients have a variety of sleep symptoms. The treatment of large doses of dopamine and depression contribute to the occurrence of PD sleep disorders. Key words: Parkinson disease; Sleep disorders; Depression; Questionnaires

Bruxism and enuresis: common entities but understood

Methylphenidate-Associated Onychotillomania, Myoclonus, and Enuresis Reversed by Switching to Atomoxetine

Bruxism and Enuresis: Common Entities But Understood

Background Children, elected to major surgeries under general anesthesia, experience tremendous stress during perioperative period, and the stress may be associated with negative postoperative behavioral changes(NPOBC), such as nightmares, enuresis, temper tantrum, etc, which may affect both emotional and cognitive development in these children. Objective To promote the awareness of NPOBC, meanwhile, to probe risk factors for its intervention to reduce the incidence of NPOBC and improve the prognosis of these children. Content Clinical trials reveal multiple potential risk factors for NPOBC, including young ages ( 4 d) in hospital, etc. These abnormal behaviors could relate to toxic effects of anesthetics on neuronal development, differentiation, connections, and apoptosis. Moreover, neuroinflammation initiated during surgery and the release of stress hormones in perioperative period could also contribute to these behaviors. Several strategies were implemented in several investigations, including administration of benzodiazepine antidepressant drugs or 2-adrenoceptor agonists, enhancement of support from family, and alteration of anesthetic procedure, etc. However, none of these interventions has convincing effectiveness. Trend There still lacks causal links between the risk factors mentioned above and the incidence of NPOBC. Additionally, the molecular, cellular, and circuit mechanisms underlying NPOBC require further multidisciplinary investigations, which may eventually provide avenues for the treatment and intervention of these behaviors. Key words: Children; Postoperative behavioral changes; Anesthesia, general

Childhood enuresis is treated successfully with desmopressin and alarm systems, although a high rate of relapse is often reported. In Australia,

Review of Clinical Researches for Herbal Medicine Treatment on Nocturnal Enuresis in Children

Nocturnal enuresis is a common pediatric condition that is likely multifactorial in etiology. Allergic disorders and asthma, as well as sleep

Objective To explore the neural mechanism of attention impairment in children with primary nocturnal enuresis. Methods ERPs elicited by performing the continuous operation test(CPT) were assessed in 20 children with primary nocturnal enuresis and 20 normal children. The Go/Nogo measurements of enuretic group at central scalp(Cz) were compared with the normal children and analyzed. Results 1.Behavior results: there was no significant difference in the reaction time, the correct number and the false number between primary nocturnal enuresis and control group(P>0.05). 2. ERP: (1)Go stimulate: the latency of Go-N2 and P3 of the children with primary nocturnal enuresis were longer than the normal control group(Go-N2: (326.80±46.40)ms vs (295.90±38.27)ms, P3: (438.80±62.60)ms vs (402.60±39.74)ms), and the difference had statistic significance(P 0.05). ②Latency: the latency of Nogo-P2 of the children with primary nocturnal enuresis was longer than that of the normal control group((214.10±27.85)ms vs (198.30±19.16)ms), and the difference had statistic significance(P 0.05). Conclusion Attention impairment in children with primary nocturnal enuresis might be caused by the information processing speed and conflict monitoring function obstacle, but it is not because the reactive inhibition dysfunction, thus result in the lack of arousal function and bedwetting. Key words: Primary nocturnal enuresis; Attention impairment; Event-related potential

Objective To explore the effects of nurse-patient horizontal communication on medical compliance behavior and postoperative complications in patients with benign prostatic hyperplasia (BPH). Methods A total of 218 patients with BPH were recruited in the department of urology of Hunan Provincial People′s Hospital from March 2014 to December 2015. They were divided into control group (n=109, routine nursing) and experimental group (n=109, routine nursing+ personalized horizontal communication model) according to the order of admission. After intervention, patient compliance, the length of hospital stay, postoperative complications and patient satisfaction were evaluated between two groups. Results The patient compliance behavior on medication, reasonable diet and relaxation, giving up smoking and drinking of patients in experimental group were better than those in control group. Besides, the length of hospital stay and the number of patients with gross hematuria, enuresis or lower urinary tract symptoms in experimental group were less than those in control group. Moreover, the patient satisfaction of experimental group was better than that of control group. There were significant differences in those aspects between two groups (P<0.05). Conclusions The nurse-patient horizontal communication will be propitious to improve the patient compliance, reduce the length of hospital stay, decrease the incidence of complications and increase the patient satisfaction. Key words: Prostatic hyperplasia; Postoperative complications; Nurse-patient horizontal communication; Patient compliance; Patient satisfaction

In ayurveda, plants have been used for the treatment of so many diseases. Herbal drugs are easily available and have fewer side effects. So, many people are attracted towards the herbal drugs. Platycladus orientalis is one of the useful plant in Indian & Chinese medicine. It is used in treatment of so many diseases like diuretic, anticancer, anticonvulsant, stomachic, antipyretic, analgesic and anthelmintic etc. In Zimbabwe, Mozambique and South Africa Platycladus orientalis is grown as an ornamental. The essential oils extracted from leaves, cones and wood are important in body care products used in the Western world. Platycladus orientalis (Commonly- Morpankhi, Family- Cupressaceae) is an evergreen, monoecious trees or shrubs used in various forms of traditional medicines and homeopathy in various ways. In traditional practices Thuja is used for treatment of bronchial catarrh, enuresis, cystitis, psoriasis, uterine carcinomas, amenorrhea and rheumatism. Recent re-searches in different parts of the world have shown that p. orientalis and its active component thujone have the great potential against a various health problems The medicinal plants are widely used by the traditional medical practitioners for curing various diseases in their day to day practice. In traditional systems of medicine, different parts (leaves, stem, flower, root, seeds and even whole plant) of Ocimum canum Linn (known as kalaTulsi in Hindi), a small herb seen throughout India, have been recommended for the treatment of bronchitis, bronchial asthma, malaria, diarrhea, dysentery, skin diseases, arthritis, painful eye diseases, chronic fever, insect bite etc. The Ocimum canum L. has also been suggested to possess antifertility, anticancer, antidiabetic, antifungal, antimicrobial, hepatoprotective, cardioprotective, antiemetic, antispasmodic, analgesic,adaptogenic and diaphoretic actions.

Objectives The objective of this study was to determine the prevalence and risk factors of nocturnal enuresis (NE) among primary school children in Zarka district, Damietta governorate, Egypt. Background NE is a common medical and psychological problem worldwide among school-age children. Participants and methods The study was a nested case–control study that was conducted during the academic year 2013/2014 on 325 students aged 6–12 years in Damietta governorate. A questionnaire was designed and was filled in by the parents of randomly selected children attending two different primary schools. A comparative study was conducted in which the children having NE (n = 50) were considered as the case group, and a randomly selected group of nonenuretics with matched age, sex, and socioeconomic criteria (n = 100) was considered as the control group. Results The prevalence of NE was 15.4%. Logistic regression analysis showed that NE was associated with stressful family events and a history of urinary tract infection. In 60% of the enuretic children living in rural areas, working mothers were found to have less enuretic children than housewives. NE was significantly associated with low socioeconomic status of families. NE was associated with a positive family history: the history of enuresis in the father was 4%, the history of enuresis in the mother was 6%, and in brothers or sisters it was 20%. In addition, intake of diuretic drinks has a significant role. In addition, the analysis of data shows a positive association of lack of comfortable sleep. Conclusion The prevalence of NE in primary school children in Damietta governorate constitutes about 15.4%. The family history was seen to have had a markedly significant impact on the occurrence of NE in the studied children. Risk factors include living in rural area, nonworking mothers, psychological troubles, and intake of diuretic drinks.

Desmopressin is an effective treatment for childhood enuresis; however, the preferred method of discontinuation after successful therapy is

Review on Enuresis

Enuresis and sleep disordered breathing: An old and new link