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Abstract Introduction Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was wellstructured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices.
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Background: In most of the obstetric patients undergoing caesarean section, spinal anaesthesia is the most accepted approach. It provides a rapid, intense, definite and better sensory and motor blockade. In spite of this, eighty per cent of patients experience hypotension after spinal anaesthesia. The use of vasopressors (Phenylephrine and Ephedrine) is the mainstay of treatment for hypotension. Methods: This is a prospective, randomized and comparative study conducted on 100 obstetric patients undergoing caesarean section in spinal anaesthesia. The patients were divided into two groups (group P and group E) each containing 50 members. When hypotension occurred in patients undergoing surgery, group P was given 40mcg of phenylephrine and group E received 6 mg bolus dose intravenously. The comparison in between the two groups was done by using Student’s t test. Results: Phenylephrine has proved to be better in raising as well as maintaining the arterial pressure after the block as compared to ephedrine. The administration of phenylephrine showed reduction in heart rate. Neonatal APGAR scores were comparable in both Phenylephrine and Ephedrine groups. Conclusion: Intravenous phenylephrine plays a major role in controlling the post-spinal anaesthesia hypotension, without jeopardizing the maternal physiology and foetal outcomes.
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Propofol is a widely used intravenous agent for general anesthesia and sedation. Propofol is associated with a variety of neuroexcitatory events including: opisthotonus, muscle rigidity, myoclonus, and seizures collectively termed as seizure-like phenomenon (SLP). We report a rare case of propofol induced severe neuroexcitatory symptoms at the time of induction in a young male presenting for emergency laparotomy. He developed generalized tonic- clonic seizures which resulted in dislodgement of intravenous cannula. Immediately a new intravenous cannula was inserted with difficulty during convulsions and injection thiopentone 200 mg bolus was given. Convulsions subsided within a minute. Patient remained hemodynamically stable and surgery was uneventful. He developed emergence agitation which was treated with injection midazolam. Patient recovered with no neurologic sequelae.
ABSTRACT
Background: Music therapy is a new approach being used for the management of metabolic abnormalities and stress related illness. Objective: To study the effect of Music therapy on various clinical and biochemical parameters of Metabolic Syndrome. Methods: This cross sectional study was carried out on 100 patients of metabolic syndrome selected randomly. These patients were divided into two equal groups after age, sex adjustment. In control group (group I) 50 patients underwent the conventional treatment. 50 patients in study group were treated with supervised music protocol along with conventional treatment. The Body Mass Index, ;Waist-Hip ratio, Blood pressure, Fasting blood sugar were monitored weekly while HbA1c and lipid profile were determined at the baseline and after three months of exposure to music therapy. Statistical analysis was performed by employing student t- test. Results: In the study group there was a significant decrease in BMI (27.18±5.02 to 25.44±3.49 kg/m2, p<0.05), waist hip ratio (0.95±0.05 to 0.93±0.05 cm, p<0.05), Fasting blood sugar (196.00±47.80mg/ dl to152.00±16.19mg/dl , p<0.001), HbA1c (8.41±1.31% to 7.08±0.78 % p<0.001), Systolic Blood Pressure (151.00±12.10 to 136±9.04 mmHg p<0.001), Diastolic Blood Pressure (94±4.80 to 86.44±3.16 mmHg, p<0.01), Mean serum cholesterol (257.80±18.92 to 229.12±17.82mg/dl, p<0.001) and triglycerides (180.86±14.04 to 136.50±8.92mg/dl, p<0.001), LDL (167.97±14.40 to 140.20±15.41mg/dl, p<0.001), and VLDL (33.60±2.88 to 28.04±3.08mg/dl, p<0.001) and increase in HDL (33.32±3.38 to 39.71±3.41mg/dl, p<0.001), when compared with those of control group not receiving the music therapy along with the conventional treatment. Conclusion: The promising outcomes of Music therapy showed that it may be considered as a useful adjunct to conventional treatment in management of the metabolic syndrome. This study advocates music therapy to establish it from a general well being concepts to a neuroscience guided model.