Consequences of traffic noise in residents of Karachi, Pakistan

To find out effect of road traffic noise on human beings in busy places of Karachi, working at these places and to compare its results with the previously done studies on this subject. This prospective epidemiological study was designed to evaluate effects of Noise induced hearing Loss due to road traffic at different places [Gurumander, Tibet Centre, Marry Weather Tower] of Karachi. A sample of 125 cases were randomly selected who had noise exposure of 90 dB or above of their surroundings for more than 6 months. The study was conducted from October 1[st] 2013 to January 1[st] 2013. The minimum age was 18 years while maximum age was 47 years. The age group found most affected was from 23 years to 27 years. The males were 84% and females 16%. Subjects exposed to noise for more than 12 hours per day were 36.8%. Varying degree of hearing loss was evaluated in subjects where 17.6% were normal, 33.6% had mild hearing loss, 45.6% had moderate and 3.2% had moderately severe hearing loss. Traffic noise was found to bother 55.2% of subjects. Analysis of data indicates an enormous increase in noise levels as compared to previous studies. This study establishes that there exists a concrete direct link between NIHL and duration of exposure to noise above permissible levels. Traffic authorities should initiate measures to reduce the noise levels in the city particularly at more noisy places

Epidemiology of vestibular neurinitis in vertigo presenting at tertiary care health care facility in Pakistan

To determine the frequency of vestibular neuronitis in vertigo patients at a tertiary public health care facility in Karachi Pakistan. It is an epidemiological study conducted at Ear Nose Throat, Head and Neck Surgery Department Jinnah Postgraduate Medical Centre [JPMC], a tertiary care hospital in Karachi, Pakistan. The study duration was from Jan 2007 to Dec 2009. The exclusion criteria included hypertension, diabetes mellitus, hearing loss, other cranial nerves deficits, multidirectional non fatiguing nystagmus, long term medication, Truncal ataxia, inflamed tympanic membrane, mastoid tenderness, high grade fever, and nuchal rigidity. Diagnosis of Vestibular Neuronitis [VN] was made on clinical findings. Patients with sudden onset of vertigo with nausea or vomiting, Clinical signs of unsteadiness, Spontaneous and horizontal nystagmus, Absence of other neurological signs and normal otoscopy and normal hearing were included in the study. Four hundred fifty seven patients reported with vertigo. One hundred sixty five were diagnosed as VN and were enrolled for the study. It was found that patients of VN were increasing yearly; younger male population was found to suffer more than others. Highest incidence was between the age group 16 to 30 years. More patients reported during the months of July - August and March - April every year during the change of season i.e. summer to winter or winter to summer. Vestibular Neuronitis was found more in males than females. Younger population was found to suffer more. Peak incidence was noted during the months of July - August every year. Incidence of VN in younger males and during July - August needs more investigation

effect of excessive noise exposure on the hearing thresholds of aviation workers in Karachi

The purposes of this study on Aviation Workers were to [a] determine the prevalence of Noise induced hearing loss [NIHL] in aviation workers [b] suggest measures for its prevention. This cross sectional epidemiological study was conducted with noise exposed and non noise exposed matching variables of adult age group, full time [24 hours], male workers at a large metropolitan airport of Karachi, Pakistan [Noise exposed group], villagers living in the outskirts of Karachi who had their work place and residence within the village [non noise exposed group]. The three measures used were Hearing Questionnaire, Audiological assessment and a record review of base line hearing test [pure tone audiogram] and noise levels at locations of work and residence lived i.e. round the clock noise exposure. Subjects with other causes of hearing impairment like, otitis media, post high grade fever, metabolic disorders and history of ototoxicity were excluded from the study. A significant difference in prevalence of hearing loss [more than 30db] between the noise exposed and non noise exposed group [P<0.5] was noted. Aggressive hearing conservation measures are required for these aviation workers; they are like [a] Availability of HPD's [b] Ban on "Non Certified" aircraft operations as specified by ICAO Chapter 3, Annex-16

Role of toluidine blue in early detection of oral cancer

Oral cancer is one of the ten most common cancers in the world with marked geographic incidences in occurrence. The range of frequency of this dreadful cancer varies form negligible in Japan to 45% in Sir Lanka, Nepal, India and Pakistan when compared with the over all incidence of all bodily cancers. In Pakistan oral cancer constitute 10% of all malignant tumors standing second to bronchogenic carcinoma in males and breast carcinoma in females. The more early it is diagnosed the better is the prognosis. This prospective study was planned to use Toluidine Blue as a diagnostic material for early diagnosis of oral cancer. Patients with oral lesions having no clinical evidence of oral cancer, but presenting as non-healing oral ulcers more than 6 months or raised margins were selected. They belonged to both sexes and all age groups. Toluidine Blue [ORA SCAN] was used to stain the lesion and biopsy was taken from stained area, 30 patients which in some cases was more than one place. These patients were randomly selected. Histopathology revealed squamous cell carcinoma in twelve patients and dysplasea in five patients. Tuluidine Blue can be used as early diagnostic aid in cancer of oral mucosa