manage how to stop child kid children
Guys in this video let us look at aneurysis so passage of urine in the clothes ah the child is having no bladder control um that is beyond five years only if it happens okay then only you will call it as uh enuresis so below five years you don’t expect the baby to actually have any uh so much of bladder control so remember it is beyond five years usually beyond
Five years okay so for this there can be some psychological stressors or some physiological dysfunction that can happen because these people may have a hypo uh hypo secretion of vasopressin so those could be the causes of aneurysis so you can understand that can actually be a cause or there can be just a stress okay and this can be primary or secondary that
Means primary means it as baby a child has never established control and secondly means it had established control which has lost now okay so based on this you would have to treat now um how will how will you treat this patient guys you have to first take the history and find out if there’s anything wrong with this patient else what you can do is you’ll try
Non-pharmacotherapy like behavior modification like you can try uh motivational therapy making the child void its bladder before it goes to sleep reducing the intake of liquids before bedtime right just giving a sip of water sips just small sips okay not that you have to dehydrate its tongue etc then you should maintain a diary which will increase the child you
Should not school the child right then you should make sure that uh it is sleeping comfortably sometimes they are not sleeping comfortably there might be mosquitoes which are biting them they are just tossing and turning the whole night because of some issue with the bed maybe there are ants on it etc which makes them make a lot of more urine so you have to check
All that and when the child tosses and turns in the bed you should make it get up and void its bladder in the night okay all that you should do okay and then um dry day dry night everything you have to check you have to increase your child to water avoid its bladder frequently there are some alarm therapy that is uh you know to tell it that there is a full bladder
When it when it senses that there is a small little wetness in the diaper or underwear it will start giving an alarm and then you make the child go to the bathroom okay this type of things are available a lot in amazon okay just check that then uh anyways you have to rule out the cause like as a doctor you should check that there are no worms or constipation or
Uti right all this you have to rule out so for worms you have to give deworming for the child alberta’s all etc constipation you have to treat and uti if it is there basically urinary tract infection will cause urgency right so a lot of problems will be there frequency urgency so basically uti urinary tract infection urine analysis you should do check if there
Are any bacterial growths and you should also check if there is any congenital anomaly in the child which is causing frequent utis okay now let us come to pharmacotherapy we are getting started with pharmacotherapy where this is where you will get some marks as very specific points anticholinergic drugs remember anticholinergics do what they will retain they help
In urine retention etc so these are they can reduce um uninhibited bladder contractions for children who are having daytime urge incontinence and even if they have nocturnal aneurysms all that it will help okay so um the what are they giving here oxi but wine and oxy but vinin ah phi mg okay phi mg oxybutynin or 2mg they are talking about and at bedtime they are
Getting all this okay at big time they are talking about this anticholinergics and this is given only uh for six year above okay greater than six year child okay then you have desmopressin decimal present let’s remove this one decimal pressure that is bda vp dda vp ddavp sounds like ddavp okay decimal present so what will it do it works by reducing the volume
Of the urine so basically this move this reduces volume of urine see the content of urine can still be seen at least so the water level can be reduced so the volume of urine will be less right so if you stop this medication they can again start relapsing okay so if you stop this medication can cause relapse stopping this medication can cause relapse okay so
This is something bad about it this one they are saying they don’t use it anymore because it causes side effect cardiac arrhythmia okay so anticholinergics oxybutynin is what you have to remember oxybutyline and oxygen you have to remember guys occipitaline and you say okay you will get marks oxybutyline and oxidized vitamin for nocturnal aneurysms any resistant
Member pediatrics do you remember from your pharmacology classification uh classification of anticoagulant cholinergic drugs go down here synthetic compounds here we are using oxy but vinyl this is a vasico selective it says what is this vasico selective makes you feel like oxybutywinding toiletries taller than so all these are things that you have learnt in
Your pharmacology already okay remember this oxybeauty vinyl makes you pee less hope you have understood the treatment for a neurosis bed betting that’s it for now guys from our side bye bye you
Transcribed from video
Pediatrics Enuresis Bet wetting trea child nocturnal Oxybutynin Tolterodine desmopressin DDAVP By MBBS VPASS