PURPOSE: We evaluated and compared the effectiveness of an enuresis alarm, desmopressin medication, and their combination in the treatment of Saudi children with primary monosymptomatic nocturnal enuresis (PMNE). MATERIALS AND METHODS: A total of 136 children with PMNE were randomly assigned to receive an enuresis alarm alone (EA group, n=45), desmopressin alone (D group, n=46), or a combination of both (EA/D group, n=45). Patients were followed weekly during treatment and for 12 weeks after treatment withdrawal. RESULTS: During treatment, wetting frequencies were significantly reduced in all groups and remained significantly lower than pretreatment values until the end of follow-up. In the D and EA/D groups, an immediate reduction in wetting frequencies was observed, whereas a longer time was required to reach a significant reduction in the EA group. The full and partial response rates were 13.3% and 37.8% in the EA group, 26.1% and 43.5% in the D group, and 40.0% and 33.3% in the EA/D group. A significant difference was observed only between the EA and EA/D groups (p=0.025). Relapse rates were higher in the D group (66.6%) than in the EA (16.6%) and EA/D (33.3%) groups. A significant difference was observed between the D and EA groups only (p=0.019). CONCLUSIONS: Desmopressin, an enuresis alarm, and combined therapy are effective in the treatment of Saudi children with PMNE. Desmopressin produced an immediate effect but relapses were common. The enuresis alarm provided gradual effects that persisted posttreatment. The combined therapy was superior to the alarm in achieving an immediate response; however, its effect was not better than that of the alarm long term.
Child* ; Combined Modality Therapy ; Deamino Arginine Vasopressin* ; Enuresis* ; Follow-Up Studies ; Humans ; Nocturnal Enuresis* ; Recurrence ; Treatment Outcome

OBJECTIVES: To compare the flexural cyclic fatigue resistance and the length of the fractured segments (FLs) of recently introduced M-Pro rotary files with that of RaCe rotary files in curved canals and to evaluate the fracture surface by scanning electron microscopy (SEM). MATERIALS AND METHODS: Thirty-six endodontic files with the same tip size and taper (size 25, 0.06 taper) were used. The samples were classified into 2 groups (n = 18): the M-Pro group (M-Pro IMD) and the RaCe group (FKG). A custom-made simulated canal model was fabricated to evaluate the total number of cycles to failure and the FL. SEM was used to examine the fracture surfaces of the fragmented segments. The data were statistically analyzed and comparisons between the 2 groups for normally distributed numerical variables were carried out using the independent Student's t-test. A p value less than 0.05 was considered to indicate statistical significance. RESULTS: The M-Pro group showed significantly higher resistance to flexural cyclic fatigue than the RaCe group (p < 0.05), but there was no significant difference in the FLs between the 2 groups (p ≥ 0.05). CONCLUSIONS: Thermal treatment of nickel-titanium instruments can improve the flexural cyclic fatigue resistance of rotary endodontic files, and the M-Pro rotary system seems to be a promising rotary endodontic file.
Continental Population Groups ; Fatigue ; Humans ; In Vitro Techniques ; Microscopy ; Microscopy, Electron, Scanning

Objective: To evaluate the in vitro cytotoxic activity of the fractionated extract as well as isolated compounds of Arum palaestinum Boiss. ( A. palaestinum) (black calla lily), and to identify the volatile components which may be responsible for the potential antitumor activity. Methods: A. palaestinum was collected from its natural habitats and subjected to phytochemical analysis for separation of pure compounds. In vitro cytotoxic activity was investigated against four human carcinoma cell lines Hep2, HeLa, HepG2 and MCF7 for the fractionated extract and isolated compounds. While, the diethyl ether fraction was subjected to GC-MS analysis as it exhibited the most potent cytotoxic effect to evaluate the active constituents responsible for the cytotoxic activities. Results: Four flavonoid compounds were isolated (luteolin, chrysoeriol, isoorientin, isovitexin) from the diethyl ether and ethyl acetate. The extracts and the pure isolated compounds showed a significant high antiproliferative activity against all investigated cell lines. The GC-MS analysis revealed the separation and identification of 15 compounds representing 95.01% of the extract and belonging to different groups of chemical compounds. Conclusions: The present study is considered to be the first report on the cytotoxic activities carried out on different selected fractions and pure compounds of A. palaestinum to provide evidences for its strong antitumor activities. In addition, chrysoeriol and isovitexin compounds were isolated for the first time from the studied taxa.