الفهرس 
Nocturnal enuresisOnly 14 pages are availabe for public view
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Abstract
Nocturnal enuresis is the involuntary loss of urine that occurs only at night. It is normal voiding that happens at an inappropriate and socially unacceptable time and place. It may cause emotional and social problems for both, the child and the family. It can result in many psychological consequences and poor scholastic achievements. There is an observed association between enuresis and psychopathology in children which is evidenced by an increase of comorbid behavioral disorders in general and of ADHD in particular. We aimed to assess the prevalence of Nocturnal enuresis and its association with ADHD among primary school children in Berket Elsabaa distinct (Menoufia Governorate). So, we conducted a cross sectional study on 1573 primary school children, aged 6-12 years (mean age was 8.21±1.65 years) in four schools (2 urban and 2 rural areas) in Berket Elsabaa (Menoufia Governorate). The study was taken according to the questionnaire filled in by the parents and teachers under our supervision after explaining for them our questionnaire and aim of the study. The items of the questionnaire were designed to collect five sections of information about children and their families; the first section contained questions about the child identity, the workplace and educational level of parents and family history of nocturnal enuresis. The second section required information on the child past medical history, including history of chronic illness, congenital anomalies and drug history. The third section includes information concerning the frequency of nocturnal enuresis. The fourth section dealt with the negative impact of NE on the child; psychological, physical and educational. ADHD was diagnosed according to DSM-5 Criteria. The fifth section dealt with questions about varient sleeping disorders. Our results revealed that: 1. Nearly two thirds of the studied group was females and only one third was males. 62% of children were living in rural areas and 38% were urban residents. Nearly half of parents had middle educational level. 2. Nocturnal enuresis was reported in 22.2% of the studied children Primary type of enuresis had affected 92.5% of our children, while the secondary type was present in only 7.4%, with mean onset of occurrence at age of 4.77±0.91 years. None of the patient had diurnal enuresis all suffered from the nocturnal type. The majority of patients (92.3%) suffer from enuresis all over the year. 3. The physical exam was unremarkable in the affected children; none of the patients had physical problem, chronic diseases nor skeletal malformations, while constipation was present in 15.5% of them. 4. Sleep disorders have a high prevalence in children with nocturnal enuresis, it can be a result from enuresis or a risk factor for developing enuresis in children. 5. Urine analysis was done for the affected children, 12% of children had pus cells more than 10 and 0.60% had pus cells over one hundred. RBCS were present in a negligible amount. 22.6% had few epithelial cells in urine. Significant number of patients (72.2%) had phosphate and/or uriate crystals. 6. The mean of the CBC parameters was within normal values in the affected children only few numbers of patients had low hemoglobin levels, and some had elevated total leucocytes count.
7. On comparing the socio-demographic data between children with enuresis and those without enuresis we found that; enuresis was more prevalent in males than females. 8. Enuresis was more prevalent in the younger age group, the mean age of children with nocturnal enuresis was significantly lower than that in children without nocturnal enuresis. 9. No significant relationship was found between paternal educational level and frequency of enuresis. 10. Most enuresis children (54.2%) were urban residents. 11. On assessing the prevalence of ADHD among children with enuresis, we found that 0.90 of enuresis patients suffering from ADHD.