Impacto en la calidad de vida por la comprensión del tinnitus / The Quality of Life impaction by Tinnitus Comprehension

El tinnitus es la sensación de sonido en ausencia de cualquier fuente externa. Nuestro objetivo fue evaluar la repercusión del tinnitus en la calidad de vida. Se inscribieron 25 pacientes con tinnitus con una amplia gama de umbrales de pérdida auditiva (HLT) y estado de gravedad de tinnitus. La gravedad, la ansiedad y la depresión del tinnitus se evaluaron mediante el inventario de discapacidades por tinnitus (THI), el índice funcional de tinnitus (TFI) y la escala de ansiedad y depresión hospitalaria (HADS), respectivamente. Se realizó una audiometría de conducción aérea de tono puro. El impacto de la percepción del tinnitus en la calidad de vida se encontró más alto en el grupo de sufrimiento. La escala de ansiedad y depresión figuraba en 40% y 60%, respectivamente. El uso de la mano fue de 20 diestros y 5 zurdos. El tinnitus bilateral se está experimentando en el 76%. El LH se presentó en 17 (68%) de los pacientes con tinnitus. La descripción del sonido del tinnitus como silbido (40%), siseo (24%), pulsante (16%), timbre (8%) y ruidos de tono alto (12%). Con respecto al cuestionario THI, los sujetos con tinnitus se dividen en 60% (leve), 30% (moderado) y 10% (grave). Mientras que el cuestionario TFI, el 50% mostró un (leve), el 25% (moderado) y el 25% mostró (severo). Postulamos una fuerte asociación positiva significativa entre HADS y la gravedad del tinnitus: THI (P = 0,000) y TFI (P = 0,001). Esos datos revelaron que la percepción del tinnitus tiene impactos negativos en la calidad de vida mientras que la gravedad puede verse alterada por la lateralidad

Tinnitus is the sensation of sound in the absence of any external source, and the aim is to assess the impaction of tinnitus on QoL. 25-tinnitus sufferers were enrolled with a wide range of hearing loss thresholds (HLT) and tinnitus severity status. Tinnitus severity, anxiety and depression were assessed using tinnitus handicap inventory (THI), tinnitus functional index (TFI), and the hospital anxiety and depression scale (HADS), respectively. Pure tone air conduction audiometry was performed. The impaction of tinnitus perception on QoL was found higher in suffering group. The anxiety and depression scale figured in 40%, and 60%, respectively. The handed use was 20 rights handed and 5 left-handed. Bilateral tinnitus is experiencing in 76%. The HL occurred in 17(68%) of tinnitus patients. The description of tinnitus sound as whistling (40%), hissing (24%), pulsating (16%), ringing (8%), and high pitch noises (12%). Regarding THI questionnaire, tinnitus subjects are divided to 60% (mild), 30% (moderate), and 10% (severe). While TFI questionnaire, 50% showed a (mild), 25% (moderate), and 25% showed (severe). We postulated a strong significant positive association between HADS and tinnitus severity: THI (P=0.000) and TFI (P= 0.001). Those data revealed that tinnitus perception has negative impacts on QoL, and the severity may be altered by laterality.

Phenotypic and metabolic dichotomy in obesity: clinical, biochemical and immunological correlates of metabolically divergent obese phenotypes in healthy South Asian adults

<p><b>INTRODUCTION</b>Metabolic heterogeneity among obese individuals is thought to translate into variations in cardiovascular risk. Identifying obese people with an unfavourable metabolic profile may allow preventive strategies to be targeted at high-risk groups. This study aimed to identify clinical, biochemical and immunological differences between insulin-sensitive and insulin-resistant obese subgroups, to understand the population-specific pathophysiological basis of the adverse cardiovascular risk profile in the latter group.</p><p><b>METHODS</b>Cardiovascular risk indicators, including anthropometric parameters, blood pressure, acanthosis nigricans area, and related biochemical, endocrine and inflammatory markers, were determined in 255 healthy South Asian volunteers aged 18-45 years, with a 2:1 ratio of obese/overweight to normal-weight individuals. Lifetime atherosclerotic cardiovascular disease (ASCVD) risk was also calculated.</p><p><b>RESULTS</b>Body mass index (BMI) and insulin sensitivity-based tertiles independently showed incremental trends in waist-hip ratio, skinfold thickness, acanthosis nigricans area, blood pressure, serum lipids, hepatic enzymes, adipokines, inflammatory markers and ten-year ASCVD risk. The anthropometric, biochemical and inflammatory parameters of obese insulin-sensitive and obese insulin-resistant groups differed significantly. Extreme group analysis after excluding the middle tertiles of both insulin resistance and BMI also showed significant difference in anthropometric indicators of cardiovascular risk and estimated lifetime ASCVD risk between the two obese subgroups.</p><p><b>CONCLUSION</b>Obese insulin-sensitive individuals had a favourable metabolic profile compared to the obese insulin-resistant group. The most consistent discriminative factor between these phenotypic classes was anthropometric parameters, which underscores the importance of clinical parameters as cardiovascular risk indicators in obesity.</p>

Hypoplastic maxillary antra

Background: Maxillary sinus hypoplasia is an uncommon pathology of the paranasal sinuses, which might be encountered in the clinical practice. Computed tomography scan confirms its existence and any associated anatomical anomaly and variations that might coexist

Objective: To present three cases of maxillary sinus hypoplasia which were diagnosed and managed surgically

Design: A Retrospective Study

Setting: Otorhinolaryngology Department, Bahrain Defence Force Hospital, Bahrain

Method: Three cases of maxillary sinus hypoplasia were managed from January 2012 to December 2015. The clinical presentation, radiological findings and surgical management of these patients were documented and found to be distinct from other cases

Result: The first case was a fourteen-year-old male with long-standing nasal symptoms, which were not relieved by medical treatment. Sinus CT scan revealed an ill-defined infundibular passage and complete opacified small right maxillary sinus; CT was classified as hypoplasia type 2 according to Bolger et al and was successfully treated surgically

The second case was a twenty-seven-year-old male with persistent left sided facial heaviness and left-sided headache. Sinus CT scan revealed left side normal uncinate process with well-defined infundibular passage indicating type 1 maxillary sinus hypoplasia

The third case was a thirty-four-year-old pregnant female with diplopia and left-sided headache. MRI revealed left maxillary sinus and inferiorly displaced left orbital floor with non-homogenous fluid-like signal intensity suggesting marked left long-standing sinusitis

The patient was managed by an antral lavage under local anesthesia. After delivery, she was reassessed by CT scan of the sinuses, which revealed left side small sized partial opacified type 2 maxillary sinus hypoplasia

Conclusion: Symptomatic maxillary sinus hypoplasia patients with a diseased blocked ostiomeatal complex have special diagnostic considerations and therapeutic challenges

Phototherapy; comparison of new improvised versus conventional methods among neonates with jaundice

To compare mean duration of stay [in hours] of patients with new improvised versus conventional methods of phototherapy among neonates with jaundice. Randomized control trial. Six months. Neonatal ward, Department of Paediatric Medicine, Lahore General Hospital, Lahore. Subjects and Methods: 160 patients, with the help of random number table, all the patients were randomly divided into 2 groups A and B, after getting the informed consent from their parents. Group A patients received conventional phototherapy. Group B patients received phototherapy with reflecting mirrors placed beneath and at the side of the patient in baby's cot [new improvised method of phototherapy]. In this study the mean age of patients in group-A and group-B was 2.70 +/- 1.13 days and 2.12 +/- 1.98 days respectively. In group-A there were 47 [58.75%] male and 33 [41.25%] female patients while in group-B there were 51 [63.75%] male and 29 [36.25%] female patients. According to hospital stay, the mean hospital stay in group A was 39.76 +/- 11.80 hours and in group-B it was 44.90 +/- 14.21 hours, the mean hospital stay was statistically significant [p<0.001] Shorter mean duration of stay [in hours] was recorded in patients treated with new improvised as compared to conventional methods of phototherapy among neonates with jaundice, the data is primary in our country, this technique may be used further but after some more trials to confirm its efficacy regarding shorter duration of hospital stay

Imaging of neonatal vomiting in correlation with clinical and surgical findings

This study was conducted for-correlating the early radiological findings of different surgical causes of vomiting in the in neonates with surgical findings. From January 2009 to September 2012, 101 neonates presented with surgical cause of neonatal vomiting were referred to Diagnostic Radiology Department at Sohag University Hospitals and private sectors. Abdominal X-ray, abdominal ultrasound and Doppler and contrast imaging were done to identify the surgical causes of vomiting with clinical and surgical correlation. All cases were managed surgically by one pediatric surgeon in Pediatric Surgery Unit at Sohag University Hospitals. Patients with vomiting caused by non-surgical causes were excluded. Our study compromised 101 vomiting neonates [72 boys and 29 girls] with male sex predominance. Male to female ratio was 2.5:1. Sixty jour patients were found to have congenital hypertrophic pyloric stenosis [CHPS], 19 cases with jejuna-Heal atresia [JIA], 8 cases with duodenal atresia [DA], 2 cases with pyloric atresia, 2 cases with volvulus, 2 cases with complicated congenital inguinal hernias, 2 cases with congenital bands, 1 case with malrotation, and 1 case internal hernia. Radiological examinations were diagnostic in most of the cases and allied with surgical findings. Persistent vomiting in the neonatal period may the indicative of serious surgical conditions and requires neonatal and pediatric surgical involvement. Differentiating between all theses causes is difficult, it relies on good history taking and rumination and early appropriate radiological workup

Patient satisfaction with health services at medical ward in Al-Kindy teaching hospital

Patient satisfaction is generally considered as extend to which the patient feel that their needs and expectations are being met by services provided. Satisfied patient are more likely to maintain consistent relationship with their care provider leading to improved compliance and better health outcomes. To evaluate the patient satisfaction to hospital services and identify factors that influences this satisfaction. Cross sectional study of 60 patients who were interviewed using a questionnaire that includes information under six main heading; 1] Patient general information; 2] Satisfaction about physician; 3] Satisfaction about nurses; 4] Satisfaction about pharmacy; 5] Satisfaction about laboratory services ;6] Satisfaction about ventilation and cleanliness. More than half of satisfied patients were among those of >/= 50 years old, female, and the majority of satisfied patients were among un-employed and those with single reason for admission. Statistical analysis showed a significant association between the reason for admission and patients satisfaction. The satisfaction of elderly was high and more in female, un- employed and less with those who admitted for more than one reason

Composite 3 layers tympanoplasty - promising and reliable technique for management of dry central tympanic membrane perforation

Numerous graft materials and methods of placement have been described to reconstruct the tympanic membrane. Cartilage was shown both experimentally and clinically to be well tolerated by the middle ear and has long-term survival. A twelve-year-old female presented with history of recurrent episodes of right ear pain and discharge. She experienced slight hearing impairment in the right ear. On examination, she was found to have perforation in antero-inferior quadrant of tympanic membrane of the right ear which was operated successfully with a new technique utilizing a composite 3 layers graft [Perichondrium-Cartilage-Perichondrium] via transcanal approach.

[Impacts of emotional catharsis by writing on depression in multiple sclerosis patients]

Multiple sclerosis [MS] is an acquired chronic neurological disease whose prevalence is more in some areas of Iran. Of its significant features are that most patients are young adults and also it's disabling nature. Psychiatric disorders such as depression are seen in MS patients considerably. Expression of emotions or emotional Catharsis by writing is one of the cost-effective self-helping methods whose efficacy has been studied on mental and physical health and survival in chronic patients. This method has not been studied on MS patients yet. This research has been conducted to evaluate the effects of Journaling on depression in MS patients. This study has been done in ''Interventional and Quazi experiment'' before and after method, on patients with [MS] coming to MS ASSOSIATION, in TEHRAN, IRAN within [2010]. After getting patients' written consents, candidates were asked to complete first DASS-21 questionnaire and then write negative feelings and emotions about a traumatic event, 30 minutes a day for four continuous weeks. After 1 month they were asked to complete another DASS-21 questionnaire. Finally Data of questionnaire were analyzed by SPSS version 16. Depression score are higher than normal in MS patients. Mean of depression score of intervention group was significantly better than before Journaling [P=0.008]. Journaling efficacy was not dependent on sex and patients age. Journaling and writing emotional expression is effective on depression score in patients with MS

study of antibacterial activity of plantago major and ceratonia siliqua

Antibiotics are generally beneficial in treating susceptible microbial infections but such beneficial effects are counter balanced by rampant irrational use. In fact, the misuse of antibiotics leads to the emergence of antibiotic-resistant bacteria. On the other hand, the consumption of foods contaminated with some pathogenic microorganisms represents a serious health risk to humans. Therefore the present study describes the comparison of antibacterial activity between two plants which are known traditionally by their biological activities and used in Iraqi folk medicine as antidiarrheal. Agar-well diffusion method tested antibacterial activities of methanolic crud extracts with different concentrations of the two plants on six types of bacteria strains which are: Lactobacillus sp., Staphylococcus aureus, Proteus sp. Pseudomonas aeruginosa, Escherichia coli, and Enterococcus sp. Two plants extract had antibacterial activity, methanolic extract of Plantago major was more active than methanolic extract of Ceratonia siliqua against the same tested bacteria. The biological activity was determined by measuring the inhibition zone in millimeters, results were expressed as means +/- standard deviation of triplicate experiments. These results suggest that extract of two plants possesses antimicrobial and properties, and therefore they can be used as a potential source of active ingredients for food, pharmaceutical industry or preservatives

Mesothelioma evaluation of treatment adopted, control rate and morbidity

This is a retrospective study included all patients with malignant mesothelioma presented to NEMRCOK from 1993 - 1995, 38 patients were included. 20 patients were treated with combination chemotherapy, 13 patients were treated with mixed external beam radiation therapy, 4 patients received combined radiotherapy and chemotherapy and only one patient had palliative radical surgery. The over all median survival of all patients was 8.6 months. A multivariate analysis was done to identify the significant predictors influencing survival concluded that localized disease, epithelial pathology and female patients who = or < 50 years are significant predictors of survival. Treatment complication encountered in the study included; recurrent pleural effusion empyema, continuous chest pain, repeated chest infections, local recurrence following either needle aspiration or diagnostic biopsy. Reversible renal affection related to platinol use had been also included