XXXToday a mother and her ten year old daughter came to me. Even before taking her seat she started enquiring whether there was any medicine for stubbornness and laziness.
XXXThen she started narrating her story to me. She has two children, the elder one is a boy and goes to the college, the younger one is this girl. She herself is diabetic and physically weak. This girl doesn't help her mother at home, is very stubborn, don't take care of her things and urinates in the bed at night(Enuresis). She has dedicated all her time watching TV and doing nothing!
XXXEnuresis refers to the bed wetting after the age of three years. It is a psychosomatic problem.
Causes:(1)Psychological cause: When the parents are very strict, the child tends to be emotionally disturbed.
(2)Improper drainage of urine.
(3)Physical factors like thread worm infestations, genitourinary infections.
(4)Anatomical defects.
The diagnosis include a detailed interview with the parent as well as the child to find the aetiology and associated emotional factors. Here a complete physical examination and certain investigations like urine RE, are needed.
Treatment include psychotherapy and training. Too much water intake should be restricted at bedtime. Waking her up once or twice during night is also useful. The fact that she urinates in the bed should not be known to the others except the family. She should not be teased for this. Dry nights should be encouraged. This will help her regain the confidence and wet nights will be reduced.
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