Desmopressin Plus Tolterodine vs Desmopressin Plus Indomethacin for Refractory Pediatric Enuresis: An Open-label Randomized Controlled Trial.

OBJECTIVE: To compare the efficacy of desmopressin plus tolterodine (D+T) with desmopressin plus indomethacin (D+I) for treating enuresis in children. DESIGN: Open-label randomized controlled trial. SETTING: Bandar Abbas Children's Hospital, a tertiary care children's hospital in Iran, from March 21, 2018, to March 21, 2019. PARTICIPANTS: 40 children older than five years with monosymp-tomatic and non-monosymptomatic primary enuresis resistant to desmopressin monotherapy. INTERVENTION: Patients were randomized to receive either D+T (60 µg sublingual desmopressin and 2 mg tolterodine) or D+I (60 µg sublingual desmopressin and 50 mg indomethacin) every night before bedtime for five months. OUTCOME: Reduction in the frequency of enuresis was evaluated at one, three, and five months, and response to treatment at five months. Drug reactions and complications were also noted. RESULTS: After adjustment for age, consistent incontinence from toilet training, and non-monosymptomatic enuresis, D+T was significantly more efficacious than D+I; mean (SD) percent in nocturnal enuresis reduction at 1 [58.86 (7.27)% vs 31.18 (3.85) %; P<0.001], 3 [69.78 (5.99) % vs 38.56 (3.31) %; P<0.000], and 5 [84.84(6.21) % vs 39.14 (3.63) %; P<0.001] months showing a large effect. At 5 months, complete response to treatment was only observed with D+T, while treatment failure was significantly higher with D+I (50% vs 20%; P=0.047). None of the patients in either group developed cutaneous drug reactions or central nervous system symptoms. CONCLUSION: Desmopressin plus tolterodine appears to be superior to desmopressin plus indomethacin for treating pediatric enuresis resistant to desmopressin.

A novel route to the synthesis of α-Fe2O3@C@SiO2/TiO2 nanocomposite from the metal-organic framework as a photocatalyst for water treatment.

In this study, an attempt was made to synthesize metal-organic frameworks (MOFs) based magnetic iron particles as photocatalysts for textile dye wastewater. Improvement strategy was a novel two-step dry method without using conventional methods to eliminate the consumption of chemical reagents. First, the heterogeneous photocatalyst of Fe-MOFs derived magnetic carbon nanocomposite with carboxylic acid surface functional groups (Fe@C-COOH) was achieved. Next, the α-Fe2O3@C@SiO2/TiO2 was successfully synthesized followed by a sol-gel method to coat the SiO2 shell and a solvothermal method to coat the surface of the intermediate TiO2 particles. The as-synthesized nanocomposite materials were characterized and physicochemical analytical equipment. Further, the investigation on magnetic photocatalytic nanocomposite α-Fe2O3@C@SiO2/TiO2 performance of dye degradation and photocatalytic activity on Reactive yellow 145 (RY145), using as an indicator was conducted. The as-synthesized nanocomposite particles were characterized using X-ray powder diffraction (XRD), thermogravimetric analysis (TGA), Fourier-transform infrared spectroscopy (FT-IR), vibrating sample magnetometer (VSM), X-ray energy dispersive spectroscopy (EDX), and scanning electron microscopy (SEM) techniques. The structural characterization of the as-synthesized materials proved that these methods generate oxygen-containing functional groups, such as, -OH, -CO, and -COOH, which increases the polarity and hydrophilicity of the photocatalyst. The photocatalytic oxidation of RY145 dye under UVc light was discussed by the apparent first-order reaction rate and the kinetic model of the Langmuir-Hinshelwood followed a better fitting. The optimal performance of the composite is at pH = 2, 15 mg/100 mL of photocatalyst dose, 150 mg/L concentration of the dye RY145 at 25 °C temperature under UVc lamp irradiation for 90 min, and with the apparent reaction rate constant was 0.0165 min-1. The thermodynamic analysis of activation parameters computed by the Eyring model and based on transition state theory (TST), an endothermic reaction with a positive value for Δ‡Ho (50.16 kJ mol-1) and a negative value for Δ‡So (-153 J/mol K) both contribute toward achieving positive values for Δ‡Go and a nonspontaneous process. The proposed α-Fe2O3@C@SiO2/TiO2 demonstrated a high capability of photocatalytic degradation up to 97% after five successive cycles at the optimal condition compared to that of Fe3O4@C (18.74%) and Fe@C-COOH (77.9%) without reusability.