[Public health customers' experiences of health accessibility: a phenomenological study]

Custom-orienting is a critical issue for public health service. Peoples with a variety of developmental health care needs and perspectives are health care clients. Health accessibility through "Primary health care" has been approved and emphasized in Alma Ata in 1978. It is important to have a clear and transparent understanding of clients' health needs and problems that would enable us to address such needs and prevent the negative consequences that might otherwise ensue. The aim of this study was to understand and gain deeper insight into health service customers' lived experience of public health accessibility. This study has been conducted with a phenomenological approach. Max van Manen six steps method of hermeneutic-phenomenology has been used. Nine health care clients were selected purposefully and interviewed semi-structured. The results of this experiment revealed the following six themes: to encounter with holistic learning chance, custom-oriented communications, qualified health care service, appropriate time-place health services, equality- orienting, and individual participation. The participants believed that health accessibility is something more than just to have health services. Therefore, health education and social equality will bring about optimum health services. To develop multi-dimensional learning and to promote individual participation will be useful for more community empowerment

[ comparison between the bacteria flora in tonsils' surface and center in patients undergone tonsillectomy]

Chronic adenotonsillar hypertrophy is known as subclinical infection of the tonsil's parenchyma and has various clinical presentations. The absolute cure is tonsillectomy. Since the microorganisms indwelling the central part of tonsils play an important role in chronic tonsillitis, getting to know these germs is of essential importance. This study was performed on fifty four [29 boys and 25 girls, 3-15 years old] candidates for tonsillectomy or adenotonsillectomy, referring to Ghaem Hospital through 2007-2008. The aerobes and anaerobes of the tonsils' surface and center were analyzed by smears and appropriate cultures. The most common aerobe on either the surface or centre of tonsils was Streptococus. viridans, and the next common one was Staphilococus aureous. No significant difference was observed between cultured organisms in tonsils' surface and center. Among the anaerobes gram negative cocci, [Villonella] and gram positive cocci, [Peptostreptococcus] were respectively the most common. Using appropriate techniques, we can specify much more easily the microorganisms of tonsils' center by surface sampling

[Diagnosing voice disorders in children with cochlear implantation and hearing aids using artificial intelligence systems]

The purpose of this study is to quantify the voice disorders in children with cochlear implantation and hearing aids. Until now, quantifying voice disorders has been done subjectively by speech experts and it is for the first time that the preset study tends to run an objective experiment using signal processing features. 4 levels were considered to be qualify speech. Linear and nonlinear features were extracted from 5 Farsi words: "mashin', "mar', "moosh', "gav" and "mowz" uttered by 30 subjects and then put into hidden Markov classifiers. Classifier outputs then were fused together to have better accuracy. The main hypothesis of the study is to answer this question: Can we separate children into 4 levels based on their voice features? Voice features including "fundamental frequency, first formant, second formant, third formant, first to second formant ratio, third to second formant ratio, Rational Intensity, nasality, approximate entropy and fractal dimension were extracted from speech segments and then are were given to artificial decision making system [classifiers]. The results show that classifiers can separate 4 levels of voice disorders with the accuracy of 93.1%. Among the introduced features, first to second formant ratio and third to second formant ratio can be used directly to track voice recovery after using cochlear implantation or hearing aid. The output of this research study can act as a speaker independent system to help speech specialists with evaluating voice disorder recovery in children who fall in the same range of age

Sudden sensorineural hearing loss due to metastasis to the temporal bone in endolymphatic sac region: a case report

Metastatic carcinoma of the temporal bone is rare and its clinical presentation depends on the site of bone involvement. The most significant symptom is hearing loss, but facial paralysis, vertigo and tinnitus have also been reported. Metastasis to the Endolymphatic sac presenting as a sudden hearing loss accompanied by meniere-like symptoms has not yet been reported. Herein we report a case of sudden SNHL due to metastasis from breast carcinoma

[Sudden idiopathic sensorineural hearing loss in Ghaem hospital. Mashhad]

Objective: determining the epidemiologic pattern of sudden idiopathic sensorineural hearing loss in hospitalized patients

Material and Method: patients to the hospital due to sudden sensorineural hearing loss were evaluated thoroughly [history, physical examination, lab tests, imaging]. Those with a certain diagnosis were excluded, and in the unknown etiology group the preferred information was obtained. All patients were treated with prednisone, acyclovir, and low salt diet. Daily audio logic tests were performed

Results: the peak incidence was the fourth decade, with women being affected more than men. The onset was more common in the early morning and in the fall. The accompanying signs were tinnitus [90%] and vertigo [50%]. Hearing loss was profound [>90dB] in 80% of the patients. Hearing enhancement in 75% of hospitalized patients was negligible [none or less than 20dB], and only in 15% was there a dramatic response [improvement more than 50dB]

Conclusion: hearing enhancement [prognosis] in severely affected patients is not prominent despite using widely accepted therapy