Nocturnal Enuresis: A Review and Focus on The Treatment Modalities of Monosymptomatic Nocturnal EnuresisN octurnal Enuresis (Bedwetting) significantly impacts children and families, especially emotional well-being, self-esteem, interpersonal relationships, and socialization. 1,2 However, both domestic and international studies have found only a minority of caregivers have brought this problem to consult a physician. 3 Therefore, physicians play a key role in finding the problem to provide advice and help children receive appropriate treatment at an early stage, resulting in a better quality of life for children and families. 4 DefinitionsThe definition of enuresis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) refers to repeated voiding of urine into bed or clothes, occurring at least twice a week for at least 3 consecutive months in children older than 5 years of age (or the developmental equivalent). Enuresis is divided into nocturnal enuresis (wetting while asleep at night) and diurnal enuresis (daytime wetting while awake). 5 The International Children's Continence Society (ICCS), 6 however, uses the term intermittent urinary incontinence, which refers to involuntary wetting, and classifies it into two categories. First, enuresis, also known as nocturnal enuresis, is defined as nighttime wetting at least once a week for at least 3 consecutive months in a child 5 years of age or older. Another is daytime urinary incontinence, which includes daytime wetting at least once every 2 weeks. Furthermore, enuresis is classified as monosymptomatic (MNE) or non-monosymptomatic (NMNE), with the latter correlating with lower urinary tract symptoms such as severe frequency, urgency, urine leaking, abnormalities of urine stream, or daytime incontinence. 7 In addition, enuresis can be categorized into primary and secondary forms. Primary enuresis is defined as the child who has never obtained continence, whereas secondary enuresis is the one that has been continent for at least 6 months and become incontinent. 5
This preliminary study aims to evaluate health literacy among bisexual men living with HIV. MATERIALS AND METHODS: A cross-sectional survey was conducted among 26 adult bisexual male HIV-infected patients in the HIV Clinic from October 2021 to May 2022. We applied the Thai version of the HIV-HLT to investigate health literacy among bisexual men living with HIV. RESULTS:The average age of the participants was 41.34 ± 12.41 years. 61.5% were single and 34.6% had divorced marital status. 50% had finished their bachelor degrees. Approximately half of the participants had been diagnosed with HIV infection for more than 5 years. 57.7% had adequate HIV health literacy and 26.9% had inadequate HIV health literacy, respectively. The laboratory outcome showed that 96.2% had a CD4 count of more than 200 cells/cm 3 and 76.9% had a viral load of less than 20 copies/ ml. CD4 and viral load were not associated with the level of health literacy. However, all participants had no previous history of opportunistic infections within the past 6 months. CONCLUSION: Most bisexual men living with HIV have adequate health literacy. The level of health literacy is not associated with CD4 and viral load. However, opportunistic infections within the past 6 months are not reported. Therefore, a Thai version of HIV-HLT may be applied to measure health literacy among bisexual men living with HIV and could be a potential for clinical use.
Depressive symptoms are frequent clinical features in schizophrenia patients, which can be found in all stages of the disease, from the initial phase of symptoms to the period of exacerbation and after the psychosis has calmed down. Post-psychotic depression is depression that occurs after the psychotic symptoms have subsided. These depressions are the main symptoms of schizophrenia affecting mental and functional impairments. Patients are also more likely to have suicidal thoughts and successful suicide. 1 Psychosocial therapy is an alternative treatment of depression in people with schizophrenia. The author reviews depression in schizophrenic patients and psychosocial treatments. Depression in schizophrenic patientsDepression refers to a persisting clinical condition that features low mood, anhedonia, and characteristics such as low energy, selfreproach, impaired concentration, pessimism, guilt, lack of confidence, sleep, or appetite disturbances. In contrast, depression in schizophrenia is defined as schizophrenic patients with distorted negative thoughts for themselves, their surroundings, and their future. It refers to a state of negative emotions, such as sadness, loneliness, regret, negative thoughts about oneself such as self-reproach, discouragement, boredom, feelings of self-worth, anorexia, and decreased sexual performance. There are various differences from depression in patients without schizophrenia. 2 People with schizophrenia who feel sad for more than 2 weeks are characterized by depressed mood, unhappy mood, and appetite disturbances. Energy levels and sleep patterns change. Patients experience feelings of guilt, worthlessness, and despair, all of which are leading causes of suicide attempts. 3 Depression is a significant mental and psychiatric problem encountered in every country worldwide. The incidence of depression in schizophrenic patients is expected in a psychotic episode. Moreover, it was found that 81% of schizophrenic patients presenting their first psychotic symptoms had had depression during the 4 years before treatment. Among schizophrenic patients with first psychotic symptoms, the prevalence of depression was 4-20 % 5 , and the prevalence after remission was 20 %. 6
Health Literacy Among Individuals Living with HIV H ealth literacy refers to the knowledge, understanding, and social skills that determine individual motivations and abilities to reach an understanding and to use medical information to achieve good health, including developing knowledge and competence in health care changes in attitudes and motivations to create healthy behaviors for oneself. 1,2 Health literacy first appeared in the literature of a seminar on health education in 1974. 3 The World Health Organization launched a campaign for member states to develop and promote people's health literacy in 1998. As a result, health literacy has been accepted and pushed into public policy in many countries. In Thailand, the term health literacy was first used in academic papers in 1998 by the Public Health Research Institute. However, the data on HIV health literacy in Thailand has been limited. The review's objective was to describe HIV health literacy, factors associated with health literacy, and factors related to an improved health outcome. Health literacy among people living with HIV/AIDSHIV is a human immunodeficiency virus. HIV is an RNA virus in Retroviridae and its subfamily Lentiviridae. HIV was discovered and reported Dr. Luc Montagnier, a French scientist, and Dr. Robert Gallo, an American scientist. When HIV enters the physical body, it destroys T lymphocyte CD4 (CD4), B cells, dendritic cells, macrophage, etc. 4 When CD4 is lower than 200 cells/mm 3 , the patient is likely to have an opportunistic infection (OIs) and acquired immunodeficiency syndrome (AIDS), the final stage of an HIV infection. AIDS was reported as a new disease in 1981 and increasing among young homosexual men who succumbed to unusual opportunistic infections and rare malignancies. 5 In 2017 the number of people infected with HIV globally was 36.7 million people, or 0.8 percent of the world's population. This includes about 17 million children under 15 years of age, of whom around 1.5 million live in Sub-Saharan Africa. 6 Out of the total number of people infected with HIV, only about 17 million people, or 46.32%, have received ART (antiretroviral therapy). In Thailand, the first HIV infection was reported in 1984. 7 In 2016, there were approximately 423,800 people or 1.1% of Thailand's population,
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