role of dyslipidemia in sensorineural hearing loss in children

The relationship between dyslipidemia and hearing is controversial, especially in children as data are scarce and limited to case reports. We sought to determine whether dyslipidemia is associated with sensorineural hearing loss [SNHL] in a group of 5-18 year old children and adolescents. Records of all 5 to 18 year old children who attended the pediatric endocrinology clinic of Loghman Hospital in Tehran, Iran, between April 2007 and April 2009, were reviewed. Records with a lipid profile were obtaimed and following confirmation of their; lipid profiles, they were enrolled if the results were the same as before [normal or dyslipidemic]. Pure tone thresholds, speech discrimination score and lipid profiles were analyzed. When controlled for age and sex, no associations between dyslipidemia and SNHL were found. There was also no statistically significant relationship between dyslipidemia and SNHL in different age groups. No association was found between dyslipidemia and SNHL in children and adolescents aged 5 to 18 years

cardiovascular changes induced by inspired oxygen fraction in patients undergoing on-pump coronay artery surgery

The inspiratory gas during open heart surgery with on-pump technique usually consists of 100% oxygen without any N2O because the risks of bubble embolism during these procedures. We sought to establish whether the cardiovascular effects of increased FiO2 are also present in cardiac surgery patients. The present study was a randomized double- blind clinical trial on sixty adult patients [40-70 years] with the cardiac ejection fraction [EF] of more than 40% and ASA II or III undergoing elective on pump coronary artery bypass. They received either a mixture of 50% O2 with 50% air [case group=30] or 100% oxygen [control group=30] throughout the anesthesia. Data were analyzed by SPSS software using t-test and Q-square as well as non parametric tests wherever appropriate. The mean values of systolic, diastolic and mean blood pressure as well as HR and CI were similar in the case and control groups [p>0.05] at all times of measurement. The mean PaO2 was significantly higher in the control group [p<0.05]. The mean pH was statistically higher in the control group but not clinically noticeable. The control group required more inotropic drug support than the case group [16 vs. 8 patients respectively]. Likewise, the mean venous pressure was higher in the control group compared with the case group. Exposing patients during and after coronary artery surgery to hyperoxia induced significant hemodynamic changes which required more extensive studies with invasive CI measurements and larger groups

Impact of anti-tuberculosis therapy on plasma zinc status in childhood tuberculosis

This study compared plasma zinc levels in 15 children with active pulmonary tuberculosis, 15 malnourished children and 15 healthy children. Mean plasma zinc concentrations in children with tuberculosis [71.7 microg/dL] were not significantly different than the other 2 groups [72.5 and 76.9 microg/dL]. The zinc status of the children with tuberculosis was evaluated after 2 months and 4 months of DOTS therapy. The serum zinc level during anti-tuberculosis therapy decreased after 1 month and then recovered to the initial level after 4 months of treatment

Primary and acquired drug resistance in childhood tuberculosis

This study determined the resistance pattern of Mycobacterium tuberculosis to 4 first-line anti-tuberculosis drugs in children with pulmonary tuberculosis at the Iranian National Research Institute of Tuberculosis and Lung Diseases from 1999 to 2004. There were 350 children with positive cultures over the study period: 7 [2%] were resistant to at least one of the 4 anti-tuberculosis drugs. Primary resistance was detected in 4 cases and secondary resistance in 3 cases. Most cases [6] were among Afghan refugees. Resistance to rifampicin both in primary and secondary resistances was high, showing that children in the Islamic Republic of Iran face the threat of drug-resistant tuberculosis transmission

[Efficacy and safety of inhaled steroid in children with asthma: a comparison of fluticasone propionate with beclomethasone]

Inhaled corticosteroids are indicated in children who have more than mild persistent asthma. Fluticasone propionate is a newer corticosteroid agent with more potency compared with previous generations. However, still few dose ranging studies have investigated optimal dosing of inhaled corticosteroids particularly in children regarding the tolerability and safety of the drug. The primary purpose of this study is to compare and evaluate the efficacy and safety of Fluticasone to Beclomethosone in the treatment of childhood asthma that is unresponsive to non-steroidal medications and also in persistent, moderate and severe asthma. 70 children, aged 6 to 14 years, were enrolled in the open randomized trial of parallel group design. 52 children with moderate, severe or persistent asthma received Fluticasone 100microg twice daily for 12 weeks compared with 18 asthmatic children on Beclomethasone 200microg daily. The outcome was assessed by data on questionnaires, changes in clinical symptoms, results of peak flowmetery [PEFR]. More over safety was assessed by 24 hour urinary cortisol measuring at the beginning of the study and comparison of the data with urinary cortisol at the end of 12 weeks. Of 70 children, 13 [18.6%] had a history of contact with pets during their life. At the beginning of the study in Beclomethasone group the following signs and symptoms were found: cough 88.9%, post exercise cough 88.9%, dyspnea 66.7% and wheeze 72.2%; however, these figures were as follow in Fluticasone group: 75%, 76.9%, 46.2%, and 59.6%, respectively. After 3 months of therapy they have been changed as follow 16.7%, 11.1%, 11.1% and 16.7%, respectively, in Beclomethasone group and 15.4%, 11.1%, 1.9% and 3.8%, respectively, in Fluticasone group. Data showed a better improvement in clinical signs of patients with Fluticasone [p<0.05]. Pulmonary function test revealed a better lung function in Fluticasone group [p<0.05]. In addition 24 hour urinary cortisol level were measured at the beginning and after 12 weeks of therapy and it was within normal range for both drugs. Fluticasone was associated with better improvement in lung function and controlled asthma symptoms much better than Beclomethasone, therefore, it is efficient in the treatment of persistent, moderate and severe asthma in children

[Knowledge of general practitioners about acute otitis media]

Acute otitis media [AOM] is one of the most common disease during childhood, therefore, every physician must be oriented about its diagnosis and treatment. This study was conducted to assess efficiency and performance of our medical educational system. This descriptive study was performed on 100 general practitioners requesting them to fill a questionnaire composed of questions dealing with diagnosis, treatment and follow up of AOM. Totally, 100 general practitioners with the mean age of 28.6+/-2 years wee enrolled. Averagely, 30.5% of questions had been answered correctly. Our general practitioners' knowledge about AOM was poor, thus, we should revise our medical educational system

[Association between playing musical instruments and hearing loss]

Sound pollution has unwarranted effects on hearing loss. Despite numerous prior studies on sound pollution and its effects in industrial environments, scanty studies are available among musicians. The aim of the present study is to evaluate the association between musical instruments noise and hearing loss. For this prospective study, 50 professional players of string, windy, and percussion instruments as well as 30 matched controls were selected. All subjects were programmed for pure tone audiometery [PTA] and classic tempanometery. The study population included 19 females and 31 males aged 20 to 55 years and history of playing musical instruments of 3-44 years. Hearing threshold of 88% players was within the normal range, however, 6% revealed to have slight and the remaining 6% had mild hearing loss. In frequency of 8000Hz, 30% of players had hearing loss of 25.3db in their left and 24% had hearing loss of 28db in their right ear. Meanwhile, in frequency of 4000Hz, 16%of players had hearing loss of 25.5db in their left and 10% had hearing loss of 27db in their right ear. Those who had a history of at least 15 years of playing musical instruments were shown to have a sensorineural hearing loss in all frequencies. Since hearing loss is a major health concern among musicians, periodic audiometric examinations and use of protective means are strictly recommended for professional musicians