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

There is an ongoing intense debate on what to eat, how to eat and when to eat during pregnancy. While quality eating is becoming crucial by the day for everyone, it becomes vital for a pregnant woman. It is a widely known and well-established fact that what a woman eats and drinks during pregnancy is the primary source of nourishment for the baby. So, the experts suggest that a would-be mother should choose a wide array of healthy foods and beverages in order to provide the required nutrients that the baby needs for optimal growth and development.

Foods to eat during pregnancy:
To improve prenatal nutrition, you should eat more fruits, lean protein, vegetables, whole grains and of course, dairy products. You must fill half of your plate with fruits and vegetables, 1/4th of it with lean protein and the remaining 1/4th with whole grains. It is also vital to include dairy products in each meal.

During pregnancy, you should eat more protein, which can be found in dairy products, particularly Greek yogurt. Also, increase your intake of soybean, peanuts, chickpeas, beans, and peas in your daily diet as they are excellent plant-based source of iron, folate, protein, and fiber. Sweet potatoes should always find a place in your diet since they contain copious amounts of beta-carotene, which is converted to Vitamin A in the body. Salmon contains Omega 3-fatty acids such as DHA and EPA, which are required for the development of the baby s brain and the eyes.

Foods to avoid during pregnancy:
To enhance the good effects of these helpful foods, you should also curb down those that can prove to be detrimental to your health. Some of these include:

Alcohol: Alcohol can directly pass to the baby through the umbilical cord, and heavy consumption of alcohol during pregnancy is linked with fetal alcohol spectrum disorders which may cause physical issues along with learning and behavioral problems in the unborn child.
Fishes with high mercury level: Fishes with high levels of methylmercury can prove to be detrimental to the baby. It is a toxic substance which may pass through the placenta and may prove to be harmful to the unborn baby's brain, nervous and renal system.
Raw meat: A mother may pass the Toxoplasma infection to her baby, which may lead to blindness and mental disability in later life of the child by consuming raw meat. So, it is essential to avoid sushi, uncooked poultry, raw cookie dough, homemade ice cream, tiramisu and raw and undercooked sprouts.
Note that even though pregnancy diet is referred to as eating for two, it doesn't mean that you will have to consume twice as much food as you used to consume. You are not eating for two until your second trimester, and the best thing you can do is to add 300 calories more along with the general dietary intake. So, consult with your doctor and frame a proper diet plan along these lines as suggested above to deliver a healthy baby.

Prenatal Care - Know What To Include In Your Diet!

Cochlear Implant is an electronic device replaced with the inner ear (cochlea) of the patients who are unable to send sound waves to the brain.

The surgery is performed on the patients who have the problem of hearing loss due to the damaged hair cells in the inner ears. The implant helps the patient to hear which are not responding to other hearing aids.

Conditions for Cochlear Implant:

Cochlear implants help people to hear with clarity. They are not like hearing aids, which make the sound louder, but it helps send sound waves to the brain and replaces the damaged hair cells in the inner ear. Following are cases where it is beneficial:

People who find it difficult to hear clearly with hearing aids.

Those with moderate hearing loss in both ears.

Patients with 50% or fewer score in the sentence recognition test.

Patients with 60% or less score in sentence recognition test with hearing aids on.

It is suggested to opt for cochlear implants in both ears. The reason is to give the patient a better perspective of sound direction and clarity in understanding the words.

How does the Cochlear Implant work?

Cochlear Implant is an electronic device with an embedded sound processor that has to be worn outside ears or on the body. Following steps are involved in cochlear implant:

The sound captured by the processor is converted digitally by the processor and sent to the coil inside the ears of the patient.

The implant converts digitally coded sound waves to electrical impulses.

The electric impulse simulates the hearing nerve of the patient.

Then sends these impulses to the brain.

Benefits of Cochlear Implants:

The cochlear implant is a blessing for people who have been suffering from hearing loss for a very long time. It provides aid to people who have not benefited from hearing devices. The benefits of the cochlear implant are:

Hear better.

Studies have shown that people with cochlear implants have better sentence recognition scores instead of hearing aids.

The patient can concentrate better in the crowd and can hear conversations across the table.

Reconnect with the missed sounds.

Enjoy music on the phone.

Cochlear Implant improves the quality of life of people with hearing loss. It gives them an aid to understand and engage themselves in a conversation. However, it takes time to learn the interpretation of the sound signals that are received from cochlear implants. But, the patient can learn and lead a normal life with the implant. The factors which affect the benefits of Cochlear implants are:

The extent of hearing loss

The duration of the hearing loss and the condition before implantation

Damage to inner hair cells

Other health issues

The practice and rehabilitation time have been done in practice after implantation

The cochlear implant is performed in the patients after taking extensive tests determining the condition of the patients. It is activated after 2-6 weeks of surgery to give the surgery site a time to heal. Most people are discharged from the hospital after surgery and are prepared for the use of an implant. There are training sessions and classes for patients who have just gone for cochlear implants.

Cochlear Implant - How Do They Help?

Typhoid is an infectious bacterial fever with an eruption of red spots on the chest and abdomen and severe intestinal irritation, brought about by the Salmonella typhi bacteria. It can also be brought about by Salmonella paratyphi, a related bacterium that generally causes a less extreme sickness. The bacteria are stored in water or in the food by a human carrier and are then spread to other individuals around them.

Multiple Ways to Prevent Typhoid Fever

Vaccination: Take one dose of the vaccine one week before travelling. The other is given orally in four cases, with one container to be taken every alternate day. Neither one of the vaccines is 100% effective. Both require repetitive immunisation since the effect of vaccines diminishes over time.
Washing your hands: Frequently washing your hands in hot, soapy water is the most ideal approach to control contamination. Wash before eating or cooking food and after using the toilet. Use a hand sanitiser in cases where water isn't accessible.
Drinking clean water: There are a few ways in which you can avoid getting typhoid fever spread by contaminated water.
Abstain from drinking untreated water.
Contaminated drinking water is a specific issue in areas where typhoid fever is endemic. Thus, drink only boiled or filtered water, or canned or packaged carbonated drinks.
Carbonated filtered water is more secure than non-carbonated filtered water.
Request drinks without ice.
Use filtered water to brush your teeth and try not to swallow water in the shower.
Clean water can get contaminated again in case it is not put away securely.
Store the clean drinking water in a container with a little opening and use it within four hours.
Staying away from raw fruits and vegetables: Maintain a strategic distance from crude foods grown in the ground. Since crude produce may have been washed away in water, maintain distance from products of the soil that you cannot peel, particularly lettuce. To be totally protected, you might need to stay away from street food completely.
Cooking: Pick hot foods. Keep away from food that is put away or served at room temperature. Steaming hot nourishments are ideal. Also, in spite of all precautions, there is no assurance that the food served at the finest restaurants is safe for your health. It is best to stay away from foods served by street side vendors. Completely cook all meats, fish and vegetables. Eat them while they are still hot.
Washing: Wash your dishes and utensils with proper dish washing soap and water. Wash your cutting board particularly well with a cleanser and water.
Peeling: Peeling fruits and vegetables protects you from typhoid. Eat natural products that have been freshly washed and peeled, for example, oranges and bananas.

Typhoid Fever - Follow These Steps and Prevent It!

Sometimes, during consumption of certain food items many children get itchy throat, eyes, ears, asthma, sneezing, rashes, diarrhea and eczema. This can be due to food intolerance in children. It is a form of allergic disease in children. Every 1 out of 10 children suffer from food intolerance. These days, food allergies are becoming more and more common in children who are allergic to nuts, milk and eggs. In some cases it can also be life threatening. This condition is known as anaphylaxis. Milk and egg allergies are more common throughout the world.

Symptoms of food intolerance:

Bloating

Your bowels start becoming irritable.

Stomach starts to ache.

Cough and cold is a common symptom.

Itchy skin rash

Causes of food intolerance in children:

There are enzymes in your body, which help you to digest the food you consume. Some enzymes in your body are insufficient; which further causes food intolerance in children. For instance, lactose intolerance causes spasms, stomach aches, diarrhea and so on so forth.

Food intolerance can also be caused due to chemicals, such as chemicals present in coffee, tea, cheese and chocolates.

Some food products can also cause food intolerance such as undercooked beans containing aflatoxins can cause extreme stomach infections in children.

Some children are also intolerant to certain food products which have salicylates such as majority of fruits, vegetables, herbs and also additives. Processed food contains a high amount of salicylates.

Children can be allergic to antioxidants like artificial food coloring, artificial flavouring and preservatives.

What to do if you think your child has food intolerance?

Take your child for a skin prick test. In this test, the skin is pricked with a thin needle and when the blood oozes out, supplements of different food products are put in that area. If that particular area becomes reddish and begins to itch, your child has allergy to that certain food product

A blood test should be done. It verifies the level of lgE present in your blood and finds out if your child is suffering from food intolerance or not. If you wish to discuss about any specific problem, you can consult a doctor.

Food Intolerance in Children - 5 Reasons Behind it

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

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