BED WETTING--NOCTURNAL ENEURESIS

NOCTURNAL-NIGHT .ENEURESIS--PASSING URINE
NORMALLY A CHILD SHOULD  HAVE BLADDER CONTROL AT AGE 2--5.&SHOULD PASS URINE IN THE TOILET AT WILL VOLUNTARILY, WITH OR WITHOUT  HELP FROM FAMILY MEMBERS.THIS DOES NOT HAPPEN EVEN AT AGE 15 IN SO IT IS ALL DUE TO LACK OF INTEGRITY &COORDINATION BETWEEN THE BRAIN, BLADDER, BONES &NERVES IN THE SPINE.ESSENTIALLY IT IS LACK OF MATURITY OF CENTRAL NERVOUS SYSTEM.AT AGE 6 MONTHS. BABY ACHIEVES HEAD CONTROLAT AGE 6 M,&BLADDER CONTROL AT 2 YRS.DUE TO ADEQUATE MYELINATION OF SPINAL NERVES(DEVELOPMENT OF SHEATH LIKE COVERING &FINE NERVE ENDINGS)THE DEFECT IS DUE TO NON MYELINATION.

THIS IS A PSYCOPATHOLOGICAL STATE WHERE DOCTORS ASK FEW QUESTIONS TO PLAN TREATMENT.FOLLOWING QUESTIONS USUALLY ASKED:--
1)HOW MANY TIMES YOU PASS URINE IN A DAY (NORMAL--ONCE IN 3-4 HRS,& 6-8HRS AT NIGHT)2)IS IT A SMALL VOLUME OF URINE?-(-10-15 ML--OR 50-100  ML) EACH TIME.
3)IS THE ACT PAINFUL/BURNING?) 4)DOES IT PRODUCE STINKING SMELL?
5)DO YOU HAVE EXCESS THIRST, EXCESS EATING,EXCESS URINATION?(DIABETES)
6)DO YOU PASS EXCESS URINE VOLUME(ANTI-DIURETIC HORMONE DEFICIENCY)
7)HAVE YOU DONE URINE CULTURE STUDY FOR 3 DAYS?(URINE-INFECTION)
8) DO YOU DREAM AT NIGHTS?-IF YES ANALYSE? 9)DO YOU HAVE FEAR AT NIGHTS?(LACK OF SECURITY FEELING)
10)DOES ANY ONE(PARENTS/TEACHER /CLASSMATES)BULLY/RAG/BEAT YOU?

TREATMENT PLAN
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1)DO NOT BEAT /SCOLD / INSULT/CHILD.TELL CHILD IT IS TOTALLY CURABLE. IN 2WEEKS TO BOOST CONFIDENCE.
2)EMPIRICAL---!)NO FLUIDS BY MOUTH AFTER 6PM.2) GO TO BATH ROOM JUST BEFORE BED.3)WAKE UP AT 1AM &4AM(USE ALARM CLOCK) 4)BLADDER TRAINING BY DOCTOR
SPECIFIC
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TAB DEPSONIL(IMIPRAMINE HCL) ONCE AT NIGHT 9PM--15 DAYS
2) PSYCHOLOGICAL COUNSELLING REASSURANCE/COUNSELLING (TO INCREASE SENSE OF SECURITY)
3)URINARY INFECTION TREATMENT IF INDICATED.
4)BLADDER CONTROL TRAINING-USEFUL IN SMALL BLADDER SYNDROME.ANY OTHER TREATMENT AS PER CAUSE.

LITCHI VIRUS ENCEPHALOPATHY--AN ANALYSIS

Litchi fruit is harvested in all parts of asia.Ackee fruit is grown &eaten in Jamaica.Some children said to have developed A E S(Acute encephalitic syndrome) after consuming these fruits,which are said to be culprits by lay press& many states  in India &abroad  registered death of few children soon after consuming these fruits within a short period.
Points for discussion;
1)Is there any specific virus isolated/identified from these fruits?
2)Does it cause death of all children who ate these fruits?
3)Why does it not affect adults?
4)Any antiviral antibodies such as Ig G/Ig M,demonstrated from these children who ate these fruits?
5)Did all children,who died after fruit consumption,had full course of vaccination against J E&Hib?
6)Were all dead children,well nourished?
7)why all dead children were mal nourished?

Scients propose two theories:
1)A zoonotic virus theory

2)A chemical(toxicological) substance theory

VIRUS THEORY
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Bats thrive on fruits during latchi fruit harvest.They consume virus presnt in the fruit(so bats are vector no 1
These infected bats are bitten by culex/anophles mosquitos(vector no 2).when these infected mosquitos bite human they get the virus disease.
THE FOLLOWING DISEASES can  mimic A.E.S

1)west nile virus disease 2)chic-un-gunya virus disease3)herpes simplex virus disease 4)varicella zoster virus disease5)Rift valley fever virus6)Crimean cargo haemorrhagic fever virus 7)entero viruses8)Alpha virus
9)measles 10)Japanese B enchephalitis virus.11)DENGUE hemorrhagic fever/shock syndrome

When a child is clinically diagnosed as A E S  Clinicians  try to confirm by various lab studies to pin point the etiology Unfortunately it is a difficult job  to succedeoften.
According to Dr A T .John WHO consultant&professor of virology has travelled to many places where there were mystery fevers&children death reported.He is of openion that viruses dont play any part in this disease.
Chemical theory
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MCPA&MCPG ARE TWO CHEMICAL SUBSTANCES found in the alleged fruits.,which if consumed
can  bring down blood glucose(hypoglycaemia) by reducing liver glycogen storage,thus producing vomiting, fits altered sensorium &death specially in mal nourished children.Dr.A T John agrees with this theory, after extensive lab studies.
CONCLUSION
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Litchi fruit &Jamaican Ackee fruit, do not contain any virus,that could kill children at short intervel.
Extensive lab studies required to find out culprit virus by a process of exclusion of 12 culprit viruses
Is it possible?
drselvarajp@yahoo.com-------ph 9841354335


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