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Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?

Yıl 2023, Cilt: 13 Sayı: 2, 343 - 347, 15.06.2023
https://doi.org/10.33808/clinexphealthsci.1109246

Öz

Introduction
Allergic rhinitis is the most common form of non-infectious rhinitis and is manifested with the symptoms of nasal congestion, sneezing, nasal discharge, and itching. Primary enuresis nocturna is involuntary urination while asleep after five years, at which bladder control usually begins. Our objective was to evaluate the relationship between allergic rhinitis and primary enuresis nocturna in childhood in this research.
Methods:
We included 300 children with allergic rhinitis and 300 control cases between the age of 5 and 17 years. With allergic rhinitis cases, age, gender, body mass index percentile, other allergic disorders, allergic rhinitis diagnosis age, allergic rhinitis severity and distribution, presence of primary enuresis nocturna, and presence of primary enuresis nocturna in the family were recorded. Subjects with disorders causing enuresis were excluded from the study.
Results:
The mean age in the allergic rhinitis and control groups was 9,6±3,4 vs. 10,0±3,1 years, respectively (p=0,15). There was no statistical difference between the two groups in terms of gender, age, body mass index percentile, and primary enuresis nocturna presence in the family (p=0.29, p=0.15, p=0.46, p=0.17; respectively). Primary enuresis nocturna was significantly higher in allergic rhinitis cases (p=0.02). Primary enuresis nocturna was significantly higher in boys than in girls (p=0.007). There is a significant difference in age and gender between those with and without primary enuresis nocturna in allergic rhinitis groups (p=0,001, p=0.01, respectively).
Conclusion:
We conclude that as allergic rhinitis increases the incidence of primary enuresis nocturna and worsens the quality of life, its treatment should not be neglected.

Kaynakça

  • Schuler Iv CF, Montejo JM. Allergic rhinitis in children and adolescents. Pediatr Clin North Am. 2019;66:981-993. DOI: 10.1016/j.pcl.2019.06.004.
  • Yorgancıoğlu AA, Bilun Gemicioğlu B, Cingi C, Kalaycı O, Kalyoncu AF, Bachert C, Hellings P, Pfaar O, Schünemann HJ, Wallace D, Bedbrook A, Czarlewski W, Bousquet J. 2019 ARIA Care pathways for allergic rhinitis-Turkey. Turkish Thorac J. 2020;21:122-133. DOI: 10.5152/TurkThoracJ.2019.19084
  • Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M, Toskala. Natural course and comorbidities of allergic and nonallergic rhinitis in children. J Allergy Clin Immunol. 2012;129:403-408. DOI: 10.1016/j.jaci.2011.09.036.
  • Şimşek Y, Yılmaz Ö, Yüksel H. Allerjik rinit. Asthma Allergy Immunol. 2018;16.2:59- 69. DOI: 10.21911/aai.373
  • Nevéus T. Nocturnal enuresis - theoretic background and practical guidelines. Pediatr Nephrol. 2011;26:1207-1214. DOI: 10.1007/s00467-011-1762-8.
  • Alkan Özdemir S, Ertan P, Tekin G, Yılmaz Ö, Yüksel H, Yılmaz H. Relationship between sleep and life quality of children with monosemptomatic nocturnal enuresis by assessing actigraphy. J Turkish Sleep Med. 2017;4:48-53. DOI:10.4274/jtsm.65375.
  • Nascimento Fagundes S, Azevedo Soster L, Lebl AS, Rodrigues Pereira RP, Tanaka C, Pereira RF, Ferreira de Mattos Silvares E, Koch VH. Impact of a multidisciplinary evaluation in pediatric patients with nocturnal monosymptomatic enuresis. Pediatr Nephrol. 2016;31:1295-1303. DOI: 10.1007/s00467-016-3316-6.
  • Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, Brignardello-Petersen R, Canonica GW, Casale T, Chavannes NH, Correia de Sousa J, Cruz AA, Cuello-Garcia CA, Demoly P, Dykewicz M, Etxeandia-Ikobaltzeta I, Florez ID, Fokkens W, Fonseca J, Hellings PW, Klimek L, Kowalski S, Kuna P, Laisaar KT, Larenas-Linnemann DE, Lødrup Carlsen KC, Manning PJ, Meltzer E, Mullol J, Muraro A, O'Hehir R, Ohta K, Panzner P, Papadopoulos N, Park HS, Passalacqua G, Pawankar R, Price D, Riva JJ, Roldán Y, Ryan D, Sadeghirad B, Samolinski B, Schmid-Grendelmeier P, Sheikh A, Togias A, Valero A, Valiulis A, Valovirta E, Ventresca M, Wallace D, Waserman S, Wickman M, Wiercioch W, Yepes-Nuñez JJ, Zhang L, Zhang Y, Zidarn M, Zuberbier T, Schünemann HJ. Allergic rhinitis and its impact on asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017;140:950-958. DOI: 10.1016/j.jaci.2017.03.050.
  • Neyzi O, Bundak R, Gökçay G, Gunoz H, Furman A, Darendeliler F, Bas F. Reference values for weight, height, head circumference, and body mass index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015;7:280-293. DOI: 10.4274/jcrpe.2183.
  • Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG, Canonica GW, Carlsen KH, Cox L, Haahtela T, Lodrup Carlsen KC, Price D, Samolinski B, Simons FE, Wickman M, Annesi-Maesano I, Baena-Cagnani CE, Bergmann KC, Bindslev-Jensen C, Casale TB, Chiriac A, Cruz AA, Dubakiene R, Durham SR, Fokkens WJ, Gerth-van-Wijk R, Kalayci O, Kowalski ML, Mari A, Mullol J, Nazamova-Baranova L, O'Hehir RE, Ohta K, Panzner P, Passalacqua G, Ring J, Rogala B, Romano A, Ryan D, Schmid-Grendelmeier P, Todo-Bom A, Valenta R, Woehrl S, Yusuf OM, Zuberbier T, Demoly P. Global allergy and asthma European Network; allergic rhinitis and its impact on asthma. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67:18-24. DOI: 10.1111/j.1398-9995.2011.02728.x.
  • Strachan D, Sibbald B, Weiland S, Aït-Khaled N, Anabwani G, Anderson HR, Asher MI, Beasley R, Björkstén B, Burr M, Clayton T, Crane J, Ellwood P, Keil U, Lai C, Mallol J, Martinez F, Mitchell E, Montefort S, Pearce N, Robertson C, Shah J, Stewart A, von Mutius E, Williams H. Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC). Pediatr Allergy Immunol. 1997;8:161-168. DOI: 10.1111/j.1399-3038.1997.tb00156.x.
  • Özdemir Ö, Elmas B. New developments in the diagnosis and therapy of allergic rhinitis. Asthma Allergy Immunology 2017;15:1-16. DOI: 10.21911/aai.5033.
  • Ertan P. Monosymptomatic nocturnal enuresis. Dicle Med J. 2012;39:145-152. DOI: 10.5798/diclemedj.0921.2012.01.0116.
  • Merhi BA, Hammoud A, Ziade F, Kamel R, Rajab M. Mono-symptomatic nocturnal enuresis in Lebanese children: Prevalence, relation with obesity, and psychological effect. Clin Med Insights Pediatr. 2014;8:13068. DOI: 10.4137/CMPed.S13068.
  • Choudhary B, Patil R, Bhatt GC, Pakhare AP, Goyal A, P A, Dhingra B, Tamaria KC. Association of sleep disordered breathing with mono-symptomatic nocturnal enuresis: A study among school children of central India. Aggarwal AN, ed. PLoS One 2016;11:e0155808. DOI:10.1371/journal.pone.0155808.
  • Shreeram S, He J-P, Kalaydjian A, Brothers S, Merikangas KR. Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: results from a nationally representative study. J Am Acad Child Adolesc Psychiatry 2009;48:35-41. DOI: 10.1097/CHI.0b013e318190045c.
  • Huang HM, Wei J, Sharma S, Bao Y, Li F, Song JW, Wu HB, Sun HL, Li ZJ, Liu HN, Wu Q, Jiang HL. Prevalence and risk factors of nocturnal enuresis among children ages 5-12 years in Xi'an, China: a cross-sectional study. BMC Pediatr. 2020;20:305. DOI: 10.1186/s12887-020-02202-w.
  • Gunes A, Gunes G, Acik Y, Akilli A. The epidemiology and factors associated with nocturnal enuresis among boarding and daytime school children in southeast of Turkey: a cross sectional study. BMC Public Health 2009;9:357. DOI: 10.1186/1471-2458-9-357.
  • Alexopoulos EI, Malakasioti G, Varlami V, Miligkos M, Gourgoulianis K, Kaditis AG. Nocturnal enuresis is associated with moderate-to-severe obstructive sleep apnea in children with snoring. Pediatr Res. 2014;76:555-559. DOI: 10.1038/pr.2014.137.
  • Jeyakumar A, Rahman SI, Armbrecht ES, Mitchell R. The association between sleep-disordered breathing and enuresis in children. Laryngoscope 2012;122:1873-1877. DOI: 10.1002/lary.23323.
  • Capdevila OS, Crabtree VM, Kheirandish-Gozal L, Gozal D. Increased morning brain natriuretic peptide levels in children with nocturnal enuresis and sleep - disordered breathing: a community-based study. Pediatrics 2008;121:e1208-e1214. DOI: 10.1542/peds.2007-2049.
  • Waleed FE, Samia AF, Samar MF. Impact of sleep-disordered breathing and its treatment on children with primary nocturnal enuresis. Swiss Med Wkly. 2011;141:w13216. DOI: 10.4414/smw.2011.13216.
  • Nevéus T, Leissner L, Rudblad S, Bazargani F. Respiration during sleep in children with therapy-resistant enuresis. Acta Paediatr. 2014;103:300-304. DOI: 10.1111/apa.12515.
  • Lai PH, Yang PS, Lai WY, Lin CL, Hsu CY, Wei CC. Allergic rhinitis and the associated risk of nocturnal enuresis in children: a population-based cohort study. Int Forum Allergy Rhinol. 2018;8:1260-1266. DOI: 10.1002/alr.22219.
  • Mungan NA, Seckiner I, Yesilli C, Akduman B, Tekin IO. Nocturnal enuresis and allergy. Scand J Urol Nephrol. 2005;39:237-241. DOI: 10.1080/00365590510007739.
  • Yılmaz-Durmuş S, Alaygut D, Soylu A, Alparslan C, Köse SŞ, Anal Ö. The association between monosymptomatic enuresis and allergic diseases in children. Turk J Pediatr. 2018;60:415-420. DOI: 10.24953/turkjped.2018.04.009.
  • Crespo JF, Rodríguez J, James JM, Daroca P, Reaño M, Vives R. Reactivity to potential cross-reactive foods in fruit-allergic patients: implications for prescribing food avoidance. Allergy 2002;57:946-949. DOI: 10.1034/j.1398-9995.2002.23626.x.
  • Yamada T, Murayama T, Mita H, Akiyama K. Bladder hypersensitivity of interstitial cystitis complicated by allergic diseases. Urology 2001;57:125. DOI: 10.1016/s0090-4295(01)01091-3.
Yıl 2023, Cilt: 13 Sayı: 2, 343 - 347, 15.06.2023
https://doi.org/10.33808/clinexphealthsci.1109246

Öz

Destekleyen Kurum

Yok

Kaynakça

  • Schuler Iv CF, Montejo JM. Allergic rhinitis in children and adolescents. Pediatr Clin North Am. 2019;66:981-993. DOI: 10.1016/j.pcl.2019.06.004.
  • Yorgancıoğlu AA, Bilun Gemicioğlu B, Cingi C, Kalaycı O, Kalyoncu AF, Bachert C, Hellings P, Pfaar O, Schünemann HJ, Wallace D, Bedbrook A, Czarlewski W, Bousquet J. 2019 ARIA Care pathways for allergic rhinitis-Turkey. Turkish Thorac J. 2020;21:122-133. DOI: 10.5152/TurkThoracJ.2019.19084
  • Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M, Toskala. Natural course and comorbidities of allergic and nonallergic rhinitis in children. J Allergy Clin Immunol. 2012;129:403-408. DOI: 10.1016/j.jaci.2011.09.036.
  • Şimşek Y, Yılmaz Ö, Yüksel H. Allerjik rinit. Asthma Allergy Immunol. 2018;16.2:59- 69. DOI: 10.21911/aai.373
  • Nevéus T. Nocturnal enuresis - theoretic background and practical guidelines. Pediatr Nephrol. 2011;26:1207-1214. DOI: 10.1007/s00467-011-1762-8.
  • Alkan Özdemir S, Ertan P, Tekin G, Yılmaz Ö, Yüksel H, Yılmaz H. Relationship between sleep and life quality of children with monosemptomatic nocturnal enuresis by assessing actigraphy. J Turkish Sleep Med. 2017;4:48-53. DOI:10.4274/jtsm.65375.
  • Nascimento Fagundes S, Azevedo Soster L, Lebl AS, Rodrigues Pereira RP, Tanaka C, Pereira RF, Ferreira de Mattos Silvares E, Koch VH. Impact of a multidisciplinary evaluation in pediatric patients with nocturnal monosymptomatic enuresis. Pediatr Nephrol. 2016;31:1295-1303. DOI: 10.1007/s00467-016-3316-6.
  • Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, Brignardello-Petersen R, Canonica GW, Casale T, Chavannes NH, Correia de Sousa J, Cruz AA, Cuello-Garcia CA, Demoly P, Dykewicz M, Etxeandia-Ikobaltzeta I, Florez ID, Fokkens W, Fonseca J, Hellings PW, Klimek L, Kowalski S, Kuna P, Laisaar KT, Larenas-Linnemann DE, Lødrup Carlsen KC, Manning PJ, Meltzer E, Mullol J, Muraro A, O'Hehir R, Ohta K, Panzner P, Papadopoulos N, Park HS, Passalacqua G, Pawankar R, Price D, Riva JJ, Roldán Y, Ryan D, Sadeghirad B, Samolinski B, Schmid-Grendelmeier P, Sheikh A, Togias A, Valero A, Valiulis A, Valovirta E, Ventresca M, Wallace D, Waserman S, Wickman M, Wiercioch W, Yepes-Nuñez JJ, Zhang L, Zhang Y, Zidarn M, Zuberbier T, Schünemann HJ. Allergic rhinitis and its impact on asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017;140:950-958. DOI: 10.1016/j.jaci.2017.03.050.
  • Neyzi O, Bundak R, Gökçay G, Gunoz H, Furman A, Darendeliler F, Bas F. Reference values for weight, height, head circumference, and body mass index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015;7:280-293. DOI: 10.4274/jcrpe.2183.
  • Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG, Canonica GW, Carlsen KH, Cox L, Haahtela T, Lodrup Carlsen KC, Price D, Samolinski B, Simons FE, Wickman M, Annesi-Maesano I, Baena-Cagnani CE, Bergmann KC, Bindslev-Jensen C, Casale TB, Chiriac A, Cruz AA, Dubakiene R, Durham SR, Fokkens WJ, Gerth-van-Wijk R, Kalayci O, Kowalski ML, Mari A, Mullol J, Nazamova-Baranova L, O'Hehir RE, Ohta K, Panzner P, Passalacqua G, Ring J, Rogala B, Romano A, Ryan D, Schmid-Grendelmeier P, Todo-Bom A, Valenta R, Woehrl S, Yusuf OM, Zuberbier T, Demoly P. Global allergy and asthma European Network; allergic rhinitis and its impact on asthma. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67:18-24. DOI: 10.1111/j.1398-9995.2011.02728.x.
  • Strachan D, Sibbald B, Weiland S, Aït-Khaled N, Anabwani G, Anderson HR, Asher MI, Beasley R, Björkstén B, Burr M, Clayton T, Crane J, Ellwood P, Keil U, Lai C, Mallol J, Martinez F, Mitchell E, Montefort S, Pearce N, Robertson C, Shah J, Stewart A, von Mutius E, Williams H. Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC). Pediatr Allergy Immunol. 1997;8:161-168. DOI: 10.1111/j.1399-3038.1997.tb00156.x.
  • Özdemir Ö, Elmas B. New developments in the diagnosis and therapy of allergic rhinitis. Asthma Allergy Immunology 2017;15:1-16. DOI: 10.21911/aai.5033.
  • Ertan P. Monosymptomatic nocturnal enuresis. Dicle Med J. 2012;39:145-152. DOI: 10.5798/diclemedj.0921.2012.01.0116.
  • Merhi BA, Hammoud A, Ziade F, Kamel R, Rajab M. Mono-symptomatic nocturnal enuresis in Lebanese children: Prevalence, relation with obesity, and psychological effect. Clin Med Insights Pediatr. 2014;8:13068. DOI: 10.4137/CMPed.S13068.
  • Choudhary B, Patil R, Bhatt GC, Pakhare AP, Goyal A, P A, Dhingra B, Tamaria KC. Association of sleep disordered breathing with mono-symptomatic nocturnal enuresis: A study among school children of central India. Aggarwal AN, ed. PLoS One 2016;11:e0155808. DOI:10.1371/journal.pone.0155808.
  • Shreeram S, He J-P, Kalaydjian A, Brothers S, Merikangas KR. Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: results from a nationally representative study. J Am Acad Child Adolesc Psychiatry 2009;48:35-41. DOI: 10.1097/CHI.0b013e318190045c.
  • Huang HM, Wei J, Sharma S, Bao Y, Li F, Song JW, Wu HB, Sun HL, Li ZJ, Liu HN, Wu Q, Jiang HL. Prevalence and risk factors of nocturnal enuresis among children ages 5-12 years in Xi'an, China: a cross-sectional study. BMC Pediatr. 2020;20:305. DOI: 10.1186/s12887-020-02202-w.
  • Gunes A, Gunes G, Acik Y, Akilli A. The epidemiology and factors associated with nocturnal enuresis among boarding and daytime school children in southeast of Turkey: a cross sectional study. BMC Public Health 2009;9:357. DOI: 10.1186/1471-2458-9-357.
  • Alexopoulos EI, Malakasioti G, Varlami V, Miligkos M, Gourgoulianis K, Kaditis AG. Nocturnal enuresis is associated with moderate-to-severe obstructive sleep apnea in children with snoring. Pediatr Res. 2014;76:555-559. DOI: 10.1038/pr.2014.137.
  • Jeyakumar A, Rahman SI, Armbrecht ES, Mitchell R. The association between sleep-disordered breathing and enuresis in children. Laryngoscope 2012;122:1873-1877. DOI: 10.1002/lary.23323.
  • Capdevila OS, Crabtree VM, Kheirandish-Gozal L, Gozal D. Increased morning brain natriuretic peptide levels in children with nocturnal enuresis and sleep - disordered breathing: a community-based study. Pediatrics 2008;121:e1208-e1214. DOI: 10.1542/peds.2007-2049.
  • Waleed FE, Samia AF, Samar MF. Impact of sleep-disordered breathing and its treatment on children with primary nocturnal enuresis. Swiss Med Wkly. 2011;141:w13216. DOI: 10.4414/smw.2011.13216.
  • Nevéus T, Leissner L, Rudblad S, Bazargani F. Respiration during sleep in children with therapy-resistant enuresis. Acta Paediatr. 2014;103:300-304. DOI: 10.1111/apa.12515.
  • Lai PH, Yang PS, Lai WY, Lin CL, Hsu CY, Wei CC. Allergic rhinitis and the associated risk of nocturnal enuresis in children: a population-based cohort study. Int Forum Allergy Rhinol. 2018;8:1260-1266. DOI: 10.1002/alr.22219.
  • Mungan NA, Seckiner I, Yesilli C, Akduman B, Tekin IO. Nocturnal enuresis and allergy. Scand J Urol Nephrol. 2005;39:237-241. DOI: 10.1080/00365590510007739.
  • Yılmaz-Durmuş S, Alaygut D, Soylu A, Alparslan C, Köse SŞ, Anal Ö. The association between monosymptomatic enuresis and allergic diseases in children. Turk J Pediatr. 2018;60:415-420. DOI: 10.24953/turkjped.2018.04.009.
  • Crespo JF, Rodríguez J, James JM, Daroca P, Reaño M, Vives R. Reactivity to potential cross-reactive foods in fruit-allergic patients: implications for prescribing food avoidance. Allergy 2002;57:946-949. DOI: 10.1034/j.1398-9995.2002.23626.x.
  • Yamada T, Murayama T, Mita H, Akiyama K. Bladder hypersensitivity of interstitial cystitis complicated by allergic diseases. Urology 2001;57:125. DOI: 10.1016/s0090-4295(01)01091-3.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Articles
Yazarlar

Adem Yasar 0000-0002-1045-0211

Özge Yılmaz 0000-0001-6051-5020

H Yuksel 0000-0001-9577-8445

Yayımlanma Tarihi 15 Haziran 2023
Gönderilme Tarihi 26 Nisan 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 13 Sayı: 2

Kaynak Göster

APA Yasar, A., Yılmaz, Ö., & Yuksel, H. (2023). Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?. Clinical and Experimental Health Sciences, 13(2), 343-347. https://doi.org/10.33808/clinexphealthsci.1109246
AMA Yasar A, Yılmaz Ö, Yuksel H. Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?. Clinical and Experimental Health Sciences. Haziran 2023;13(2):343-347. doi:10.33808/clinexphealthsci.1109246
Chicago Yasar, Adem, Özge Yılmaz, ve H Yuksel. “Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?”. Clinical and Experimental Health Sciences 13, sy. 2 (Haziran 2023): 343-47. https://doi.org/10.33808/clinexphealthsci.1109246.
EndNote Yasar A, Yılmaz Ö, Yuksel H (01 Haziran 2023) Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?. Clinical and Experimental Health Sciences 13 2 343–347.
IEEE A. Yasar, Ö. Yılmaz, ve H. Yuksel, “Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?”, Clinical and Experimental Health Sciences, c. 13, sy. 2, ss. 343–347, 2023, doi: 10.33808/clinexphealthsci.1109246.
ISNAD Yasar, Adem vd. “Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?”. Clinical and Experimental Health Sciences 13/2 (Haziran 2023), 343-347. https://doi.org/10.33808/clinexphealthsci.1109246.
JAMA Yasar A, Yılmaz Ö, Yuksel H. Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?. Clinical and Experimental Health Sciences. 2023;13:343–347.
MLA Yasar, Adem vd. “Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?”. Clinical and Experimental Health Sciences, c. 13, sy. 2, 2023, ss. 343-7, doi:10.33808/clinexphealthsci.1109246.
Vancouver Yasar A, Yılmaz Ö, Yuksel H. Is Allergic Rhinitis Associated With Enuresis Nocturna In Childhood ?. Clinical and Experimental Health Sciences. 2023;13(2):343-7.

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