ABSTRACT
Hemodialysis as a treatment modality for Stage V chronic kidney disease (CKD) has significantly decreased mortality. However, there have been several studies reporting sensorineural hearing loss (SNHL) in these patients which affects their quality of life. The role of hemodialysis in its etiology has been widely debated and the strength of available evidence has not yet been evaluated. A systematic literature review was conducted to identify a possible association of hemodialysis to hearing loss and guide in making informed decisions in the management of CKD patients. Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified using Preferred Reporting Items for Systematic Review and Meta-Analyses framework. Studies that were published since the inception of the database to May 2020 and written in the English language were analyzed. A total of 36 articles on hemodialysis and sudden or SNHL were retrieved. Many were observational (13 cohorts, 10 case-control, seven case series, and six cross-sectional) studies involving 99,020 participants with ages ranging from 1 to 80 years. This review elucidates the occurrence of SNHL in CKD patients on hemodialysis. Yet, the available literature fails to provide conclusive evidence on hemodialysis as a causative agent for SNHL. Audiological assessment of all CKD patients before hemodialysis and regular follow-up may help in early diagnosis and better management of hearing loss
ABSTRACT
Background: Congenital hearing loss is estimated to be 1–6/1000 live births. In India, it is reported to be 5.6/1000 live births. The Joint Committee on Infant Screening 2007 recommends that all newborns be screened for hearing loss by 1 month of age, have diagnostic follow-up by 3 months, and receive appropriate intervention by 6 months of age. Objective: This descriptive study was conducted to determine the age at diagnosis of hearing impairment in deaf children and determine the factors affecting it in South India.Materials and Methods: A cross-sectional questionnaire-based study was conductedon children with hearing impairment (bilateral profound hearing loss) attending 10special schools in Southern India.The cluster sampling technique was used to collect the data. Result: Our study involved 273 children in the age group of 3–22years.We found that the mean age at diagnosis of hearing impairment was 23.03(±3.696 SD) months while the mean age at suspicion of hearing impairment in these children was 13.70(±2.13 SD)months.The various factors responsible for the delay in diagnosis were financial constraints, influenced by friends and family, fear, and anxiety. The treatment-seeking behavior among the parents, lack of awareness of clear guidelines among the medical fraternity,and absence of awarenessof this problem among the general public also contributed to the delay
ABSTRACT
Background: Oxidative stress markers are increased in type 2 diabetes mellitus and its estimation helps in predicting the long term complications. In present study comparison and correlation of the levels of serum adenosine deaminase, serum malondialdehyde, and serum total antioxidant capacity in type 2 diabetes mellitus and in age and sex matched healthy controls. Methods: Study group consisted of 100 individuals between the age group of 35-65 years of age. Of which 50 individuals with type 2 diabetes mellitus were considered as cases. The control group consisted of 50 age and sex matched healthy individuals. Study was approved by institutional ethical committee. By aseptic precautions 2 ml of venous blood was collected in a plain vacutainer tube, after 8-12 hours of fasting. Serum adenosine deaminase, serum malondialdehyde, and serum total antioxidant capacity were estimated in all groups. Results: The study observed an increased level of serum adenosine deaminase, malondialdehyde and decreased levels of total antioxidant capacity in type 2 diabetes mellitus compared to controls. Serum adenosine deaminase levels in type 2 diabetics were 50.77 ± 6.95 and in controls was 17.86 ± 4.04. Serum Malondialdehyde levels in type 2 diabetics was 512.13 ± 70.15 and in controls was 239.32 ± 23.97. Serum total antioxidant levels in type 2 diabetics was 0.39±0.15 and in controls was 1.66±0.25. Positive correlation was seen between serum adenosine deaminase and malondialdehyde and it was statistically significant. Statistically significant negative correlation was seen between serum adenosine deaminase and total antioxidant capacity. Conclusion: Adenosine deaminase can be used as oxidative stress marker. Their increased levels indicate oxidative stress in type 2 diabetes mellitus. Therefore, estimation of serum adenosine deaminase levels help in early prediction and prevention of long term complications occurring due to oxidative stress in diabetics, thereby decreasing the mortality and morbidity in them.