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Introduction@#Khuumii (throat singing) is a unique form of art derived from the nomadic population of Central Asia, producing two or more “simultaneous” sounds and melodies through the organ of speech. @*Material and Methods@#The aim of the study is to identify the anatomical structures involved in the formation of khuumii and the features and patterns of their functions and compare each type of khuumii as performed by Mongolian people. A total of 60 participants aged 18-60 years (54 men and 6 women) were selected by non-random sampling method using cross-sectional study. Statistical analysis was performed using SPSS 23 software using questionnaires, X-ray, endoscopy, sound research method, and general blood tests. @*Results@#90.7% of the khuumii singers were male and 9.3% were female. The average height of the participants was 172.91±0.93 cm (arithmetic mean and mean error), average body weight was 77.53±2.46 kg, and body mass index was 25.93±5.31 respectively. Heart rate was 92.19±20.71 per minute prior to khuumii while 133.19±19.09 after performing khuumii and 85.81-98.56 at 95% confidence interval. In terms of ethnicity (ethnographically), the Khalkh were the largest ethnic group (72.1%), followed by Bayad, Buryatia, Darkhad, Torguud, and Oirat (2.3%), respectively. 60.5% of the participants were professional khuumii singers who graduated from relevant universities and colleges. The process of Khuumii was recorded by X-ray examination, and laryngeal endoscopy evaluated the movement of true and false vocal chords, interstitial volume, movements of epiglottis and arytenoid cartilage, and mucosa. Khuumii increases the workload of the cardiovascular system by 70-80%. Furthermore, the sound frequency is 2-4 times higher than that of normal speech, and sound volume is 0.5-1 times higher. 95.3% of throat singers did not have a sore throat, 88.4% did not experience heavy breathing, and 74.1% had no hoarseness. During the formation of khuumii sound, thoracic cavity, diaphragm, and lungs regulate the intensity of the air reaching the vocal folds, exert pressure on the airways and vibrate the sound waves through air flows passing through the larynx and vocal folds. Mouth-nose cavity as well as pharynx are responsible for echoing the sound.@*Conclusion@#It is appropriate to divide khuumii into two main types according to structural and functional changes in the organs involved; shakhaa and kharkhiraa. Khuumii, the “Human music” originating from the people of Altai Khangai basin by imitating the sounds of nature with their own voice in ancient times, spread all over the world from Mongolia and it is proposed to classify khuumii into two main types of shakhaa and kharkhiraa in terms of structural involvement and functionality.
ABSTRACT
@#BACKGROUND. Hearing loss is likely to be the most common congenital abnormality in newborns, with a reported prevalence of 1 to 2 per 1000 live births. It is vitally important to diagnose infant hearing loss or deafness at its early stages. Early detection and intervention is critical to prevent the adverse consequences of a delayed diagnosis on speech, language and cognitive development. Universal screening of hearing loss has been introduced in practice with distortion product of otoacoustic emission (DPOAE). The automated auditory brainstem response (AABR) screener is a dedicated hearing screening device which provides information not only about the outer and middle ear and cochlea but also about the auditory pathway up to the brainstem. METHODS. The study was descriptive and based on a retrospective analysis of the two year period databases (2014-2016) from the newborn hearing screening program. We have started the hearing screening from December 2012. Between 2014 to 2017 we have been screened total of 11218 newborns. We tested automated audiotory brainstem response of the newborns in their 1- 3 days of birth, using Maico MB11 Beraphone machine (German) according to the Joint Committee on Hearing Screening guidence. We assessed the test result of “pass” as “normal hearing, “refer” as to rescreen and tested again after 1 month. Infants referred again were gone to a specialist for further audio logic analysis (behavioral tests, auditory brainstem response, otoacoustic emissions and auditory steady state response). RESULTS. Our study was the first in Mongolia. Total of 10290 newborns passed bilaterally out of 11218 and 1323 referred in the first screening. For the rescreen test, 1088 out of 1134 infants resulted with “pass” and 46 infants with “refer”. For those infants, we did ABR test in their 3 and 6 months, and result of 9 children (18 ears) have bilateral profound hearing loss, 2 children (2 ears) have bilateral mixed profound hearing loss and 13 (26 ears) have bilateral profound conductive hearing loss. Coverage rate was 34,7%. First refer rate was 11,7%. Follow rate was 39,7%. We conducted the cochlear implantation surgery for 2 children out of 11. Currently, we are preparing other infants with bilateral profound hearing loss of 0-3 years old for the follow up CI surgery. CONCLUSION. In Mongolia, the data of infant hearing difficulties and prevalence of deafness is lacking. Although newborn hearing screening program has been approved in 2014 and brought opportunities to conduct universal neonatal hearing screening program. But at the moment, its only available at NCMCH which located in Ulaanbaatar city. 11 cases have a bilateral profound hearing loss out of 11218 newborns. Our study result shows similiar pattern (1.1 - 1.3 ear deafness in every 1000 birth. Lenarz et all.2008). Automated audiotory brainstem response was efficient in early identification of newborn hearing loss with high sensitivity and specification rates. Small population in the remote locations, high birth percentage, short period in the hospital after birth, lack of technology and human resources, and other factors result in higher level of referral rate newborn hearing screening and lower level of follow up and confirmation rate referals in Mongolia.
ABSTRACT
Hearing loss is likely to be the most common congenital abnormality in newborns, with a reported prevalence of 3 per 1000 live births. It is vitally important to diagnose infant hearing loss or deafness at its early stages. The automated auditory brainstem response (AABR) screener is a dedicated hearing screening device which provides information not only about the outer and middle ear and cochlea but also about the auditory pathway up to the brainstem.The data presented were collected in the well-baby nursery. Overall, data from 5857 neonates screened from December 2012 to July 2015 were analyzed in this study. During 1-3 days after birth, they were analyzed with automated auditory brainstem response (AABR). Neonates referred the screening were scheduled for repeated diagnostic evaluation within a month. And newborns referredagain were sent to a specialist for further audiology analysis.Out of the 5857 babies screened, 5050 passed bilaterally and 807 referred. The number of infantsreferred for 2nd stage, post-discharge re-screening was 319. Of this group, 287 passed bilaterally and 32 failed the re-screening in one or both ears. Diagnostic testing was performed on all of the 32 infants who were referred. The resulting referral rate was 13.7% for first stage and 1,4% for second stage. The follow-up rate was 37%. The confirm rate was 0,13%. Profound bilateral sensor neural hearing loss was identified in 3 infants. Profound bilateral mixed hearing loss was identified in 1 infant.Automated auditory brainstem response (AABR) was efficient in the early identification of newborn and infant hearing loss with high sensitivity and specificity rates. Due to the results of the study, 3 out of 5857 infants were diagnosed with a profound hearing loss and it’s approximately close to the results of other studies and statistics.
ABSTRACT
Hearing loss is likely to be the most common congenital abnormality in newborns, with a reported prevalence of 3 per 1000 live births. It is vitally important to diagnose infant hearing loss or deafness at its early stages. The automated auditory brainstem response (AABR) screener is a dedicated hearing screening device which provides information not only about the outer and middle ear and cochlea but also about the auditory pathway up to the brainstem. The data presented were collected in the well-baby nursery. Overall, data from 5857 neonates screened from December 2012 to July 2015 were analyzed in this study. During 1-3 days after birth, they were analyzed with automated auditory brainstem response (AABR). Neonates referred the screening were scheduled for repeated diagnostic evaluation within a month. And newborns referred again were sent to a specialist for further audiology analysis. Out of the 5857 babies screened, 5050 passed bilaterally and 807 referred. The number of infants referred for 2nd stage, post-discharge re-screening was 319. Of this group, 287 passed bilaterally and 32 failed the re-screening in one or both ears. Diagnostic testing was performed on all of the 32 infants who were referred. The resulting referral rate was 13.7% for first stage and 1,4% for second stage. The follow-up rate was 37%. The confirm rate was 0,13%. Profound bilateral sensor neural hearing loss was identified in 3 infants. Profound bilateral mixed hearing loss was identified in 1 infant. Automated auditory brainstem response (AABR) was efficient in the early identification of newborn and infant hearing loss with high sensitivity and specificity rates. Due to the results of the study, 3 out of 5857 infants were diagnosed with a profound hearing loss and it’s approximately close to the results of other studies and statistics.
ABSTRACT
Лабиринтит нь сонсгол-тэнцвэрийн анализаторын захын хэсэг бүтнээрээ ба хэсэгчлэн гэмтэх үйл явцаар тодорхойлогдох эмгэг юм. Дунд чихний идээт үрэвслийн үед контактын замаар буюу остеомиелит болсон ясаар дамжин, ястай хүртэлцэж байгаа тархины хальсыг шууд гэмтээн гавал тархи руу халдвар дамжина. Мөн цусны судсаар болон дотор чихээр халдвар дамжин идээт лабиринтит үүсгэж гавал тархи руу хүндэрнэ. Ихэнх тохиолдолд дунд чихний архаг үрэвслийн хурцдалтын улмаас үүсдэг ба энэ нь цочмог үрэвслийн үеийн хүндрэлтэй харьцуулахад хэд дахин элбэг тохиолдоно. Идээт лабиринтит нь дунд чихний идээт үрэвсэл ба гавал тархины хүндрэлийн завсарт, эмгэг жамын гинжин хэлхээний нэгэн хэсэг болж байдаг. Бага тархины буглаа, идээт лабиринтит нь эмнэлзүйн олон шинжээрээ хоорондоо төстэй тул ялган оношлох шаардлага үүсдэг бөгөөд цочмог үрэвслийн үе шатыг эхлэж байгаа гавал тархины хүндрэлээс цаг тухайд нь ялгаж оношлож чадвал эмчилгээний тактикийг цаг алдалгүй өөрчлөх боломжтой. Олон судалгаануудын үр дүнг харьцуулахад бага тархины буглаа нь голдуу тахир ангалын бөлөнтэй хавсран тохиолддог байна.