Treatment and Management of Nocturnal Enuresis: A Review

2017 ◽  
Vol 9 (5) ◽  
Author(s):  
Kandula Ravindra Reddy ◽  
Ramam Sripada
Keyword(s):  
Combination Therapy ◽  
Early Treatment ◽  
Pharmacological Treatment ◽  
Nocturnal Enuresis ◽  
Review Article ◽  
Treatment Modalities ◽  
Term Therapy ◽  
Short Term ◽  
Bladder Control ◽  
Relapse Rates

Nocturnal Enuresis (NE) is the involuntary passing of urine whileasleep after the age at which bladder control would normally be prevised. NE has hassled humans for hundreds of years. It has been recognized since the time of Papyrus Ebers, 1550 B.C. Various potions were prepared by using different plants, animals or organs in some of the early treatment modalities. A number of medications have been used to treat nocturnal enuresis where, Imipramine and Desmopressin acetate were found to be efficacious. Besides, some credit has also been given to Oxybutynin. Because of the high relapse rates recited after short-term therapy with pharmacotherapeutic agents, pharmacological treatment for NE is best considered as management therapy rather than a cure. In this review article, we have mainly focused on the treatment and management of nocturnal enuresis by reviewing various treatment modalities along with behavioural modifications, bladder retention training, hypnotherapy, psychotherapy and combination therapy.

Neurobehavioral Effects of β-Escin

2019 ◽  
Vol 8 (1) ◽  
pp. 79-86
Author(s):  
Huda J. Waheed ◽  
Saad B. Nashtar ◽  
Ali I. Al-Gareeb ◽  
Hayder M. Al-Kuraishy
Keyword(s):  
Healthy Volunteers ◽  
Term Therapy ◽  
Horse Chestnut ◽  
Cortical Arousal ◽  
Short Term ◽  
Fusion Frequency ◽  
Insignificant Effect ◽  
Sensorimotor Reaction ◽  
Critical Fusion Frequency ◽  
Neurobehavioral Effects

Background: Aescin or β-escin is the main and active constituent of horse chestnut seed (Aesculus hippocastanum) used for the treatment of inflammatory edema, venous insufficiency and ischemic ulcerations. Aescin has many actions due to induction of endothelial nitric oxide and prostaglandin F2-α production moreover; aescin antagonizes the effect of histamine and 5HT at receptor levels. </P><P> Objective: The aim of the present study was to evaluate the neurobehavioral effects of aescin on normal healthy volunteers. </P><P> Method: A total number of 65 healthy participants with mean age of 21+1.1 years were recruited to study the effects of aescin on the neurobehavioral effects of normal healthy volunteers compared to placebo. The neurobehavioral effects were assessed by psychomotor performances and sensorimotor reaction, cortical arousal and central integrity processes and assessment of memory capacity. Results: Placebo produced insignificant amelioration of TRT and RRT p>0.05, with mild significant effect on MRT p=0.03. Aescin produced a significant effect in the amelioration of psychomotor performances and sensorimotor reaction p=0.0001. Regarding the differential effect of placebo and aescin on the cortical arousal and central integrity processes, placebo illustrated insignificant effect at p>0.05 whereas; aescin showed mild significant effect on Critical Fusion Frequency (CFFA) p<0.05 and highly significant effect on the other parameters p<0.01 except for critical-fusion frequency threshold when aescin illustrated insignificant effect at p>0.05. Aescin illustrated significant acceleration of ІІ-back WMA, ІІІ-back WMA and Second trial Short-Term Memory (STM) at p<0.01 compared to the placebo effect. Conclusion: Short-term therapy with aescin improves the neurobehavioral effects on healthy volunteers.

A Holistic Approach to Phimosis in Children

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Rajendra Paliwal ◽  
Rashmi Pareek
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Medical Science ◽  
Holistic Approach ◽  
Review Article ◽  
Local Application ◽  
Treatment Modalities ◽  
Recurrent Attack ◽  
New Born ◽  
Tract Infections

Phimosis is described as condition in which prepuce or foreskin of glans penis is not retracted backwards resulting in poor narrowed stream of urine during micturition causing ballooning of prepuce along with recurrent attacks of balanoposthitis and Urinary Tract Infections (UTIs). Majority of new born boys do have non-retractile foreskin called as Physiological Phimosis. In Ayurveda phimosis is described as Nirudhaprakasha. Physiological phimosis usually does not require any kind of treatment as it resolve spontaneously within first couple of years mostly taking 3 to 6 years after which measures are considered to correct it surgically. Pathological phimosis is condition in which prepuce get adhered to glans secondary to adhesions or scarring made because of infection, inflammation or trauma. Pathological phimosis and physiological phimosis with recurrent attack of balanoposthitis and UTIs do require treatment. There are several treatment modalities are available according to severity of adhesions such as local application of steroid cream or oil, manual retraction, dilatation and Circumcision. In this review article we assess the various treatment modalities available in Ayurveda and contemporary medical science for better management of Phimosis.

Pharmacological Treatment of Diabetic Peripheral Neuropathy: An Update

2021 ◽  
Vol 20 ◽  
Author(s):  
Mohamed Rafiullah ◽  
Khalid Siddiqui
Keyword(s):  
Peripheral Neuropathy ◽  
Pharmacological Treatment ◽  
Diabetic Peripheral Neuropathy ◽  
Pharmacological Therapy ◽  
Line Treatment ◽  
Pharmacological Treatments ◽  
First Line ◽  
Short Term ◽  
Disease Modifying Agents ◽  
Third Line

: Neuropathy is the most common complication of diabetes. 50% of adults with diabetes will develop neuropathy in their lifetime. Diabetic peripheral neuropathy (DPN) is the major form of neuropathy found in 75% of diabetic neuropathy incidences. Pharmacological treatments are recommended for pain management in DPN. Anticonvulsants like pregabalin and gabapentin are the preferred first-line treatment, followed by amitriptyline, duloxetine, and venlafaxine. Topical agents like capsaicin and isosorbide dinitrate are also useful in treating the DPN and may be considered for the second or third-line treatment. Opioids and related drugs are suggested for short-term use during the acute exacerbation of pain. Combination therapy may be beneficial in patients who do not respond to monotherapy. However, currently, there is no compelling evidence to suggest any specific combination of agents. Disease-modifying agents such as alpha-lipoic acid and epalrestat appear to improve the disease state but are not recommended by any guideline. This review discusses the available pharmacological therapy for treating DPN. Also, we highlight the recommendations from different guidelines about the pharmacological treatment of DPN.

Successful Combination Therapy for Amblyopia Secondary to Micro-Esotropia And Anisometropia

2021 ◽  
pp. 195-200
Keyword(s):  
Visual Acuity ◽  
Combination Therapy ◽  
Refractive Error ◽  
Combination Treatment ◽  
Current Treatment ◽  
Short Term ◽  
Eccentric Fixation ◽  
Case Summary ◽  
Vision Therapy ◽  
Spectacle Correction

Background: Micro-esotropia is a small-angle esodeviation typically less than nine prism diopters. Patients with this ocular condition often develop amblyopia due to the presence of a constant unilateral strabismus and an anisometropic refractive error in the deviated eye. Current treatment methods for strabismic and refractive amblyopia include spectacle correction, patching, and vision therapy (VT). Case Summary: A 9-year-old Asian female presented with a constant left primary micro-esotropia with unsteady eccentric fixation, contributing to mild amblyopia and frequent suppression in the left eye. She also had a hyperopic anisometropic refractive error. Combination treatment of in-office VT with short-term patching therapy (two hours per day) was administered, with the goal of improving her binocularity, fixation, and visual acuity. Conclusions: Amblyopia results from binocular dysfunction, therefore monocular patching therapy alone will not improve the underlying issue. VT is necessary to actively treat binocularity and subsequently improve visual acuity, while short-term patching can be used in combination to effectively target monocular accommodation and fixation.

Outcome of Short-Term and Long Term Antibiotic Prophylaxis in Colostomy Closure

2016 ◽  
Vol 4 (2) ◽  
pp. 43-48
Author(s):  
Md Jamal Saleh Uddin ◽  
Sukumar Chakrabarti ◽  
Md Shahidul Islam
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Anorectal Malformation ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Colostomy Closure ◽  
Term Therapy ◽  
Short Term ◽  
Sigmoid Colostomy

Background and Objectives: Antibiotic prophylaxis is a common practice in children undergoing colostomy closure for anorectal malformation, Hirschsprung's disease. Traditionally, antibiotics are given for unnecessarily longer period of time, which consumes scarce health resources having alternate efficient use. The present study was undertaken to compare the outcome between short-term and long-term antibiotic prophylaxis in colostomy closure. Materials & Methods: This randomized clinical trial was conducted in Dhaka Shishu Hospital, Dhaka over a period of 15 months from April 2001 to June 2002. Children admitted with anorectal malformation, Hirschsprung's disease for colostomy closures were the study population. However, immuno-compromised children or children already getting antibiotics were excluded from the study. A total of 46 such children were consecutively included and were randomly allocated to long-term group (n = 21) and short-term group (n = 25). The long-term group received antibiotic up to 5th postoperative day, while the short-term group received the same antibiotic up to 2nd postoperative day. Transverse colostomy was the main procedure employed in colostomy closure; however, a few patients required sigmoid colostomy. The outcome measures were incidence of wound infection, hospital stay and cost of treatment. Result: Majority of the children were between 1 - 5 years of age (75% in short-term and 50% in long-term group) followed by under 1 year (10% in short-term and 40% in long-term group) and > 5 years (15% in short-term and 10% in long-term group). The overall male to female ratio was 3:1. Majority (85%) of the patients in both long­term and short-term groups belonged to lower income group. Over half (52.2%) of the children had anorectal malformations (ARM) and the rest (47.8%) had Hirschsprung's disease (HD). Children were generally malnourished according to Gomez classification. Majority (91%) was operated on by transverse colostomy and few (9%) by sigmoid colostomy. Three patients in each group developed postoperative wound infection. Blood culture of none of these patients yielded growth of any organism, though wound swab culture did so in 5 cases out of 6 infected patients. In 2 cases, the organism was E.coli, in 2 cases, it was Pseudomonas and in one case Staph. aureus. Total cost of antibiotics in short-term therapy was less than 50% of that required in long-term therapy. The outcome in terms of recovery, complications and postoperative hospital stay was no different between groups. Conclusion: The study concluded that short-term antibiotic prophylaxis is as efficacious as long-term in preventing wound infection in patients with colostomy closure for anorectal malformation and Hirschsprung's disease. Short-term antibiotic prophylaxis is cost-effective Ibrahim Cardiac Med J 2014; 4(2): 43-48

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