Bedwetting or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence. For infants and young children, urination is involuntary. Wetting is normal for them. Most children achieve some degree of bladder control by 4 years of age. Daytime control is usually achieved first, while nighttime control comes later.

The age at which bladder control is expected varies considerably. Some parents expect dryness at a very early age, while others not until much later. Such a time line may reflect the culture and attitudes of the parents and caregivers.

Factors that affect the age at which wetting is considered a problem include the following:

The child's gender: Bedwetting is more common in boys.
The child's development and maturity
The child's overall physical and emotional health. Chronic illness and/or emotional and physical abuse may predispose to bedwetting.
Causes

No one knows for sure what causes bed-wetting, but various factors may play a role:

A small bladder: Your child's bladder may not be developed enough to hold urine produced during the night.
Inability to recognize a full bladder: If the nerves that control the bladder are slow to mature, a full bladder may not wake your child, especially if your child is a deep sleeper.
A hormone imbalance: During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
Stress: Stressful events, such as becoming a big brother or sister, starting a new school, or sleeping away from home, may trigger bed-wetting.
Urinary tract infection: This infection can make it difficult for your child to control urination.
Sleep apnea: Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep.
Diabetes: For a child who's usually dry at night, bed-wetting may be the first sign of diabetes.
A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child's neurological system or urinary system.

Symptoms

Wetting during the day
Frequency, urgency, or burning on urination
Straining, dribbling, or other unusual symptoms with urination
Cloudy or pinkish urine, or blood stains on underpants or pajamas
Soiling, being unable to control bowel movements
Constipation
Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.

When to see a doctor: Most children outgrow bed-wetting on their own, but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.

Consult your child's doctor if: 

Your child still wets the bed after age 7
Your child starts to wet the bed after a few months or more of being dry at night
Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring
Self-Care at Home-
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful

Reduce evening fluid intake.
The child should urinate in the toilet before bedtime.
A system of sticker charts and rewards works for some children.
Make sure the child has safe and easy access to the toilet.
Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet.

Bedwetting - 7 Possible Reasons Behind It

Puberty is a time when a girl's body begins to define itself in more womanly terms. This is the start of a process that will usher in decades of sexual activeness and child bearing years. The changes that a girl goes through during this period can be quite challenging with a play of hormones as well as physical changes, such as growth of hair in private parts and the development of breasts, among various other changes. When these changes come at an early age, it can be all the more challenging to cope and comprehend the process. The onset of early puberty is something that is becoming more and more common with girls between the age bracket of 12 &amp; 13. How can you help deal with early puberty? Here's a list of tips!

1. Self-Image: One of the most important side effects of early puberty remains one's image of the self, as this phase in life is characterised by the most dramatic physical changes that can leave a lifelong effect on the girl's mind. The reinforcement of positive self-image to help the girl grow more comfortable in her skin despite the wide array of feedback she may be getting from sources outside the home, will help in creating a positive impact on a lifelong basis.

2. Doubts: This is a time when the child goes through a number of doubts regarding looks and appearance as well as how well she may be able to cope with the onset of the new process. As parents, the best thing to do is to let the child explore this terrain even as you remain firmly in the background for hand holding when the child asks for it. This will help the girl become even more confident to take life's decision more efficiently and seriously.

3. Talking About It: The best thing to do is to talk things out. Once you start seeing the changes in the girl's appearance by way of hair growth and sudden sprouting of breasts and height, it is important to understand that puberty may be close by. So have a talk about menstrual cycles and the changes that the child will be seeing soon. This will help in mentally preparing the child and giving her the leeway to ask questions that you can answer over a period of time.

4. Opposite Sex: It would also be beneficial to discuss the changes in the behaviour of boys towards her, as this will help her blossom into a more confident lady in the years to come.

Remember to love and support your child through this important milestone of her life, as the way you reach can have a lasting impact on her.

How to Deal with Early Puberty

Epilepsy is a neurological condition that leads to recurrent seizures. Seizures arise when electrical activity in the brain suddenly surges causing a temporary disturbance within the messaging systems located between the brain cells.

Epilepsy is more common in children below the age of two years and adults above the age of 65 years.

Seizure Types

Seizures are classified into two main categories depending on their area of impact. 

A focal seizure is one that affects only one part or area of the brain whereas a generalised seizure affects the whole brain. Further, both focal and generalised seizures have various sub-categories which are as follows-

Previous nomenclature- 

Partial Seizure

  Simple Partial Seizure
  Complex Partial Seizure
  Partial Seizure with Secondary Generalization

Generalized Seizure

  Absence Seizures
  Myoclonic Seizure
  Atonic Seizure
  Tonic Seizure
  Tonic-clonic Seizure
  Mixed Seizure
  Status Epilepticus

Latest nomenclature of seizure types:

Focal seizures-

  Focal aware seizures
  Focal impaired awareness seizures (previously called complex partial seizures)
. Bilateral tonic clonic seizures

Generalised onset seizures-

  Tonic clonic seizures.
  Atonic seizures (sometimes called drop attacks) and tonic seizure.
  Myoclonic seizures.
  Absence seizures.

Symptoms

The well know symptom of epilepsy is a convulsion/ fit, a few other symptoms include-

  Intermittent spells of fainting. When this happens the patient is likely to lose control of his/her bladder or bowel movements. Following this, the person is likely to suffer from extreme tiredness.
  Spells of a blackout with difficulty in remembering
  Becoming unresponsive to any instructions or questions asked during brief periods of time
  Bouts of continuous blinking without any known reason
  Inappropriate movements that keep on occurring
  Changes in sensory perceptions
  Sudden stiffness in the body

Reasons for Epilepsy

Messaging systems within the brain are responsible for every function that goes about in your body. A disruption to this system caused by defective electrical activity leads to epilepsy in a person. Many people inherit epilepsy while others may develop this condition as a result of-

  Head trauma sustained during an accident
  A stroke or a tumour that has affected the brain impairing its normal capabilities
  An injury to the brain before or during birth
  Associated with developmental issues
  Infections of the brain

Treatment for Epilepsy

Epilepsy in childhood can be treated by using medications and by adopting dietary changes in some cases. Medications for epilepsy mainly include-

  Anticonvulsants - Helps control seizures and manages the symptoms of epilepsy
  Medications for nerve pain - Reduce pain that is caused by the damaged nerves

These medications should be consumed as and when prescribed by the doctor. You must consult a paediatrician for this, as he/she will take your child s physical and mental in consideration before starting the treatment.

Seizures that occur in childhood may be benign. This means that it will not continue into one s adult life. Further, those children who have suffered from epilepsy in their childhood have been seen to have normal mental and intellectual development in their adulthood. However, some epilepsy syndromes in children can have a devastating effect on the child.

Seizure threshold is a term that is used to refer to the conditions that are important for the production of seizures. The threshold is lower for people who are more prone to having seizures whereas the threshold is higher for those who do not have a tendency to suffer from seizures.

A Complete Guide To Childhood Epilepsy!

Parental Depression is an aspect which affects the innocent child, right from the time it is in the mother's womb.

Maternal depression could be due to various reasons ranging from familial disharmony to poor health. Unfortunately, a depressed mother's pessimistic thoughts could pass on to the pure soul inside her. So the effect starts in utero. After birth, she may be careless and negligent towards a child whose most important requirement is love. And children of these mothers become victims of behavioral and cognitive problems and poor school performers. They may also acquire the illness of depression eventually.

A depressed father will display stress and agitation instead of engaging the young minds in interesting learning or other activities.

Hence, before stepping into parenthood, it's important to be mentally fit and not just physically healthy. Exercise and meditation is of great help and of course a happy home environment.

Supporting each other is the key to getting things on track again.

Talk to your spouse: Chat with your spouse, showing affection, doing things with them and encouraging them to get out of the house are important.
Appreciate her but respect your family: Help her see that the family needs her and appreciates that she is expecting. While doing the same ensure that you respect the feelings of your family members.
Opt for specialist care: Offer to see a therapist and encourage her to take medications. Getting the help of an expert helps get guidance to handle difficult situations.
Be emotionally present with her: Go with her to as many antenatal checkups as you can, and make sure you are there for the ultrasound scans. This encourages a woman and gives her the satisfaction that her partner is involved.
Compliment her and pay attention to her: Many women find it difficult to cope with the changes in their body during pregnancy. She may be worried about stretch marks, concerned about weight gain or just be feeling not much like her old self. Make sure to compliment her and let her know how much you love her.
Be a shoulder for her to cry on: Listen to all of her concerns, and offer her the reassurance and support she really needs.
Be there to help: After the birth, your partner will need time to recover. She will be exhausted, sore and hormonal, and will be relying on you for support. Help with the baby, and do as much as you can.

What Is Parental Depression? How to Support Each Other?

Valvar aortic stenosis, commonly called aortic stenosis, is a disorder which occurs when the aortic valve of the heart becomes narrow. The narrowing of the valve prevents its full opening, and hence, blood flow from the heart to the aorta is restricted. When the aortic valve gets obstructed, the heart has to exert much more effort to pump the blood. The heart muscles get weakened as a result. This condition is more common in children.

Diagnosis of valvar aortic stenosis-
Before diagnosis, we should know about the symptoms of valvar aortic stenosis in children. They include:

 Feeling breathless
 Angina or chest pain with a feeling of pressure or tightness
 Syncope of fainting
 Palpitations and enhanced heartbeats
 A steady decline in regular activities and energy levels
 Fatigue due to little exertion
 Not gaining weight
 Poor eating patterns
 Problems in breathing

The wall of the left ventricle also thickens muscularly, and the thick wall occupies more space in the lower chamber of the heart and hence, the room for adequate blood supply is reduced. This may lead to heart failure.

Echocardiogram-
The initial test that is recommended for patients with symptoms of valvar aortic stenosis is doppler echocardiography. This test enables the doctor to estimate the aortic valve region, peak or mean transvalvular gradients and the maximum aortic velocity. These primary measures are required to assess the severity of the disease. Echocardiography provides important information on the valve function, left ventricular filling pressure and disruptions in other valves.

Other major tests which help in the diagnosis of valvar aortic stenosis include:
 Mri or magnetic resonance imaging, which provides images of internal body structures with great detail.
 Ct scan or computed tomography where three-dimensional images are extracted.
 Chest x ray
 Cardiac catheterization where a dye is used to highlight blockages, if any, in the heart.

Treatment-
Usually, there are no medicines for fixing valvar aortic stenosis as the disease is not reversible. Medicines can be used to treat the problems, which are caused by the condition.

Replacement of the damaged valve by surgery is the best treatment for valvar aortic stenosis. The surgery performed is called valvuloplasty. This is a cardioscopic surgery where a tube with a small balloon is inserted into a vein. The tube is guided into the heart, and the balloon is inflated. The balloon and tube are removed after the valve is opened. The damaged valve is replaced by mechanical valve or the valve of a cow or pig by an open-heart surgery.

Valvar aortic stenosis is a severe heart condition in children, and the only permanent remedy for this disease is a valve replacement surgery.

Diagnosis and Treatment of Valvar Aortic Stenosis in Children

Coughing is a common problem of the respiratory tract and often indicates a deeper problem. It can be very irritating and can affect eating habits and socialization. A cough which persists for more than 4 weeks is believed to be chronic in nature. Tuberculosis (TB) is the most common cause of chronic cough in India. TB is an airborne bacterial infection caused by the organism - 'Mycobacterium tuberculosis', that primarily affects the lungs, although other organs and tissues may be involved. Cardinal features are: 

Chronic cough with or without sputum.
Fever more in the night time. 
Poor appetite. 
Unintentional weight loss. 
Read on to know about other common causes of chronic cough and how to manage them.

Allergies: People with allergies usually have a chronic cough, which gets aggravated when exposed to the allergens such as pollen or environmental dust. Staying away from allergen provides relief. Antihistamines are also useful, which most people detected with allergies keep in handy. Inhalers might be required, if there is associated congestion or shortness of breath.
Asthma: This is a very common chronic condition, caused by inflammation and swelling of the lungs, in addition to wheezing and shortness of breath. Asthma patients often suffer from a chronic cough. An asthma attack usually happens during the night or early morning, and is triggered by colds, cigarette smoke, air pollutants or allergens, which can even include certain foods. Most asthmatics usually carry their steroids, inhalers, and bronchodilators, as the onset of attack can be unpredictable.
Bronchitis: This condition of inflammation of the bronchial region is very common among smokers and among the elderly. There is excessive mucus accumulation, which the body tries to clear via coughing. The lungs are weakened and therefore, the coughing is painful.
Gastroesophageal reflux disease (GERD): This is a problem of the digestive system, but regurgitation of food into the airway induces cough. GERD is a chronic issue and so most people also end up with a chronic cough. It is worse with sitting up than with sitting down. Treatment includes H2 blockers to suppress acid production and dietary changes including small, frequent meals and avoiding spicy food items.
Upper airway cough syndrome: There could be multiple problems in the upper airway, which leads to a constant postnasal drip. Here, there is constant dripping of the sputum into the air passage, which can lead to a chronic cough whenever there is impaired air flow. This can be caused by various forms of chronic sinusitis and rhinitis. People diagnosed with this condition usually resort to antihistamines and decongestants for relief.
Other causes: There are a number of other causes as noted below. Smoking, tuberculosis, congestive heart failure, pertussis or whooping cough, foreign body in the airway, cancer in the airway passage, chronic aspiration of foods, etc. can all lead to chronic cough.
The key is to identify the reason that is causing the chronic cough. Most people who are diagnosed are educated to handle it and carry the required medications including steroids, bronchodilators, and inhalers.

Suffering from Chronic Cough - How to Manage it?

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