Differences in the Bacteriome of Smokeless Tobacco Products with Different Oral Carcinogenicity: Compositional and Predicted Functional Analysis.

Smokeless tobacco (ST) products vary significantly in their oral carcinogenicity. Much is known about the differences in the chemical, but not the bacterial, constituents of these products. In this study, we explored the composition and function of the bacteriome in ST products from four countries using quantitative polymerase chain reaction (qPCR) and 16S rRNA-based next generation sequencing. The bacterial load (16S rRNA copies/gram) was lowest in Swedish snus (3.4 × 106) and highest in Yemeni shammah (6.6 × 1011). A total of 491 species-level taxa, many of which are potentially novel, belonging to 178 genera and 11 phyla were identified. Species richness and diversity were highest for Swedish snus and lowest for Yemeni shammah. Bacillus, Paenibacillus, and Oceanobacillus spp. were the most abundant in American snuff; species of Pseudomonas, Massilia, Propionibacterium, Puniceispirillum, and Gloeothece predominated in Swedish snus. In Sudanese toombak, Facklamia, Desemzia, Atopostipes, and Lysinibacillus spp. accounted for the majority of the bacteriome. Yemeni shammah exclusively contained Bacillus spp. Functional prediction by phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) showed that genes encoding cadmium/zinc and nickel transport systems were enriched in the presumptively "high carcinogenicity" products. The bacteriome of ST products thus differed qualitatively, quantitatively, and functionally. The relevance of these differences, particularly with respect to nickel and cadmium, to oral carcinogenesis warrants further investigation.

Evaluation of hearing among kindergarten children in Jazan (Kingdom of Saudi Arabia).

INTRODUCTION: Hearing loss among kindergarten children is considered as a major health problem especially when there is a deficiency in routine hearing screening during the clinical examination. The aim of the study was to detect any pattern of hearing loss among kindergarten children in Jazan (Kingdom of Saudi Arabia). METHODS: A total of 1220 kindergarten students in Jazan (Kingdom of Saudi Arabia) were subjected to meticulous hearing evaluation using otological examination, Tuning fork tests, pure tone audiometry (PTA), speech audiometry, and tympanometry. RESULTS: We found that 18 kindergarten students had type C tympanogram (Eustachian tube dysfunction), 28 had type B tympanogram (secretory otitis media with conductive hearing loss), 4 had chronic otitis media with conductive hearing loss, and 6 had mild sensorineural hearing loss. CONCLUSIONS: Early detection and eradication of hearing loss improves quality of life outcomes of children which reduces the incidence of social burden from unrecognized hearing loss.

The relativity of integrity testing by telemetry in the diagnosis of cochlear implant defect: A case study and literature review.

OBJECTIVE: This paper report a rare case that showed the limitation of integrity testing by telemetry in detecting the cause of cochlear implant defect. METHOD: We are reporting the case of a 45-year-old female who received a cochlear implant 10 years ago, owing to a profound bilateral sensorineural hearing loss. Following the cochlear implant the patient's speech discrimination threshold improved dramatically. In March 2009, after a car accident, the patient was unable to hear. The clinical and radiological examination revealed no abnormality, nor did the telemetry test, with normal implant function and normal NRT. The proceeding medical treatment with a corticosteroid therapy and hearing rehabilitation brought no improvement. Thus we decided to revise both implantations. RESULT: The cochlear reimplantation was postoperatively found to have brought a marked improvement in the hearing and speech discrimination threshold. Conclusively we chose to perform a second cochlear reimplantation on the opposite side which after surgery revealed the same postoperative result. CONCLUSION: The telemetry test does not always enable one to discover the cause of the cochlear implant failure.

A case of unilateral hypoglossus nerve palsy associated with chordoma in the region of clivus.

We had a rare case of 50-year-old woman with a unilateral hypoglossus nerve palsy as a sign of clival chordoma. A computed tomography (CT) scan of the skull base showed bone destruction at the anterior part of the foramen magnum and CT scan of the neck reveals asymmetrical area at the base of the tongue. Magnetic resonance imaging showed a mass at the skull base in the region of the clivus with bone destruction in the middle and right side of the clivus. The tumor was biopsied through transnasal biopsy from the region of the clivus using a navigation system and microscopical surgical technique. Postoperatively, the patient received radiotherapy. Surgery is the most effective treatment of chordomas. An endoscopic approach provides easy, rapid and direct access to the clivus. A postoperative radiation therapy is recommended. A carbon ion radiotherapy is an effective treatment for chordomas of the skull base with minimal side effects. Close interdisciplinary collaboration between ORL, neuroradiology, pathology and oncology is desirable for effective therapy.