Characterization of commercial thermoelectric modules for precision heat flux measurement.

In this article, we present a cost-effective approach to the precision measurement of heat flux using commercial thermoelectric modules (TEMs). Two different methods of measuring heat flux with TEMs are investigated, namely, passive mode based on the Seebeck effect and active mode based on the Peltier effect. For both modes, a TEM as a heat flux meter is calibrated to show a linear relation between the voltage across the TEM and the heat flux from 0 to ∼450 W m-2. While both modes exhibit sufficiently high sensitivities suitable for low heat flux measurement, active mode is shown to be ∼7 times more sensitive than passive mode. From the speculation on the origin of the measurement uncertainty, we propose a dual TEM scheme by operating the top TEM in passive mode while its bottom temperature maintains constant by the feedback-controlled bottom TEM. The dual TEM scheme can suppress the sensitivity uncertainty up to 3 times when compared to the single-TEM passive mode by stabilizing the bottom temperature. The response time of a 15 × 15 mm2 TEM is measured to be 8.9 ± 1.0 s for heating and 10.8 ± 0.7 s for cooling, which is slower than commercial heat flux meters but still fast enough to measure heat flux with a time resolution on the order of 10 s. We believe that the obtained results can facilitate the use of a commercial TEM for heat flux measurement in various thermal experiments.

Isolation and molecular characterization of multidrug-resistant Escherichia coli from chicken meat.

Antibiotic-resistant Escherichia coli (E. coli) are common in retail poultry products. In this study, we aimed to isolate and characterize multidrug resistant (MDR) E. coli in raw chicken meat samples collected from poultry shops in Sylhet division, Bangladesh, as well as to determine correlation between resistance phenotype and genotype. A total of 600 chicken meat swabs (divided equally between broiler and layer farms, n = 300 each) were collected and the isolates identified as E. coli (n = 381) were selected. Disc diffusion antimicrobial susceptibility assay showed resistance of these isolates to ampicillin, erythromycin, tetracycline, streptomycin, trimethoprim-sulfamethoxazole, chloramphenicol, and gentamicin. Polymerase chain reaction (PCR) identified several antibiotic resistance genes (ARGs) in our isolates. Among these ARGs, the prevalence of tetA (for tetracycline) was the highest (72.58%) in broiler chicken isolates, followed by sul1 (for sulfonamide; 44.16%), aadA1 (for streptomycin; 33.50%), ereA (for erythromycin; 27.41%), aac-3-IV (for gentamicin; 25.38%), and the two genes cmlA (24.87%) and catA1 (8.63%) for chloramphenicol. On the other hand, the respective prevalence in layer chicken isolates were 82.06%, 47.83%, 35.87%, 35.33%, 23.91%, 19.02%, and 5.43%. Furthermore, 49.23% of the isolates from broiler chicken were MDR, with the presence of multiple antibiotic resistance genes, including 3 (40.11%) and 4 (9.13%) genes. On the other hand, 51.09% of layer chicken E. coli isolates were MDR, with 3, 4 or 5 ARGs detected in 36.41%, 14.13%, and 0.54% of the isolates, respectively. We also found that 12.8% of broiler chicken E. coli isolates and 7.61% of layer chicken isolates carried genes coding for extended-spectrum SHV beta-lactamases. Lastly, we report the presence of the AmpC beta-lactamase producing gene (CITM) in 4.56% and 3.26% of broiler and layer chicken E. coli isolates, respectively. We found significant correlations between most of the antimicrobial resistant phenotypes and genotypes observed among the investigated E. coli isolates. Our findings highlight the need for the prudent use of antimicrobials in chickens to minimize the development of antibiotic-resistant bacterial strains.

Antibacterial characteristics of thermal plasma spray system.

The objective of this study is to investigate antibacterial characteristics of a thermal plasma spray system. For this purpose, copper powder was coated on a handmade atmospheric plasma spraying system made by the stainless steel 316 substrate, which is preheated at different temperatures before spraying. A number of deposition characteristics such as antibacterial characteristics, adhesion strength and hardness of coating, was investigated. All of the spray parameters are fixed except the substrate temperature. The chemical composition was analyzed by X-ray diffraction (XRD). A scanning electron microscopy (SEM) and back scattering electron microscopy (BSE) were used to show the coating microstructure, its thickness and also the powder micrograph. The energy dispersive X-ray spectroscopy (EDX) was used to analyze the coating particles. Hardness of the deposition was examined by Vickers tester (HV0.1). Its adhesion strength was declared by cross cut tester (TQC). In addition, the percentage of bactericidal coating was evidenced with Staphylococcus aurous and Escherichia coli bacteria. Study results show that as the substrates temperature increases, the number of splats in the shape of pancake increases, the greatness and percentage of the deposition porosity both decrease. The increment of the substrate temperature leads to more oxidation and makes thicker dendrites on the splat. The enhancement of the substrate temperature also enlarges thickness and efficiency of coating. The interesting results are that antibacterial properties of coatings against the Escherichia coli are more than Staphylococcus aurous bacteria. However the bactericidal percentage of the coatings against Staphylococcus aurous and Escherichia coli bacteria roughly does not change with increasing the substrate temperature. Furthermore, by increment of the substrate temperature, coatings with both high adhesion and hardness are obtained. Accordingly, the temperature of substrate can be an important parameter for progressing mechanical properties of the antiseptic deposition.

Design and fabrication of a new compound probe for plasma flux measurement in IR-T1 tokamak.

A new compound probe is designed, built, and installed on an IR-T1 tokamak to flow measurements in the plasma edge region. The first results of using this probe on the IR-T1 tokamak are presented. The plasma parameters such as plasma current, loop voltage, floating potential, ion and electron saturation currents, electron temperature, plasma potential, and plasma flow velocities are measured in this work. The results show that the electron temperature and the plasma potential in the edge area are 14 eV and 44 V, respectively. The results indicate that the mean value of a parallel Mach number is 0.5 while the mean value of a perpendicular Mach number is almost zero. The large parallel flow velocity (about 17 km/s) and the negligible perpendicular flow velocity are also seen in this work. The most important advantage of using this compound probe is that it can not only save space and vacuum ports but also measure more physical quantities at the same time, contributing to further physical analysis.

Surface protection from high energy electrons and X-ray radiation analysis in tokamak plasma.

Plasma cooling due to hard x-ray radiation from the Runaway electrons is an important issue in tokamaks. Thus, developing effective methods to reduce the Runaway electrons and the emitted hard x-ray is also important for optimal tokamak plasma operation. In this study, we investigated the effects of external fields on hard x-ray intensity and the Magnetohydrodynamic (MHD) activity. In other words, we presented the effects of positive biased limiter and Resonant Helical Field (RHF) on the MHD fluctuations and hard x-ray emission from the Runaway electrons. MHD activity and hard x-ray intensity were analyzed using Wavelet transform in the presence of external fields and without them. The experimental results showed that the MHD activity and therefore the hard x-ray intensity could be controlled by the external electric and magnetic fields.

Do paranoid delusions exist on a continuum with subclinical paranoia? A multi-method taxometric study.

BACKGROUND: There is widespread interest in whether psychosis exists on a continuum with healthy functioning. Previous research has implied that paranoia, a common symptom of psychosis, exists on a continuum but this has not been investigated using samples including both patients and non-patients and up-to-date taxometric methods. AIM: To assess the latent structure of paranoia in a diverse sample using taxometric methods. METHOD: We obtained data from 2836 participants, including the general population as well as at-risk mental state and psychotic patients using the P-scale of the Paranoia and Deservedness Scale. Data were analysed using three taxometric procedures, MAMBAC, MAXEIG and L-MODE (Ruscio, 2016), and two sets of paranoia indicators (subscales and selected items from the P scale), including and excluding the patient groups. RESULTS: Eleven of the twelve analyses supported a dimensional model. Using the full sample and subscales as indicators, the MAMBAC analysis was ambiguous. Overall, the findings converged on a dimensional latent structure. CONCLUSIONS: A dimensional latent structure of paranoia implies that the processes involved in sub-clinical paranoia may be similar to those in clinical paranoia.

Medical equipment antiseptic processes using the atmospheric plasma sprayed copper coatings.

Antibacterial surfaces such as copper coatings are able to reduce the growth of bacteria. In this study, copper coatings was deposited on the 316 stainless steel substrates by a handmade device operating as an atmospheric plasma spraying system. The chemical composition microstructure and morphology surface of the coatings are examined by x-ray diffraction (XRD) and scanning electron microscope (SEM) and back scattering electron microscope (BSE). Micro hardness as one of the key properties of the coating is characterized based on cross-section. We also evaluate the thickness and the adhesion strength of the coating. Dissection material of coating is performed by energy dispersive x-ray spectroscopy (EDX). Further, the antibacterial activity of our coatings is assessed by both gram negative Escherichia coli ATCC 10536 and gram positive Staphylococcus aureus PTCC 1112 bacteria. As the last step, the antibacterial performance of the coated stainless steel surface with copper are compared to uncoated one. Results confirm that the copper coatings improve the antibacterial property of substrates and owning fine antibacterial behavior compared to stainless steel.

A new perspective on synchrotron radiation applications: Runaway electrons studies using a hard x-ray detection in tokamaks.

The synchrotron radiation emitted by runaway electrons in fusion plasma provides information regarding the particle momentum and pitch-angles of the runaway electron population through the strong dependence of the synchrotron spectrum on these parameters. Information about the runaway density and its spatial distribution, as well as the time evolution of the above quantities, can also be deduced. On the other hand, control of radial electric filed and suggestion of the methods to reduce plasma turbulence are important issues in confinement process and particle transport in the tokamaks. In this work, the effects of positive limiter biasing on electrical fluctuations and hard x-ray have been investigated. For this purpose, the radial and poloidal electric fields have been measured using the Langmuir probe, and hard x-ray has been measured using the Scintillator detector. The biased electric voltage was +250 V. Also, electrical fluctuations are analyzed using wavelet transform technique in the presence of positive biasing and without it. The results show that time-frequency activity of radial electric field multiplies in the presence of positive biasing while poloidal electric filed frequency intensity decreases.

Clinical surface modification process using the nitrogen plasma and its anti-bacterial efficiency.

In this research, the cotton fabrics were treated with nitrogen plasma for the clinical and anti-bacterial purposes. Turmeric was used a as a natural dye. Some part of both untreated and plasma treated samples was immersed in silver nitrate as a mordant before dyeing. Effect of plasma and silver nitrate on dye ability of cotton samples was compared and studied. Samples were analyzed with different experimental methods, such as scanning electron microscopy (SEM), Reflection spectro-photometry and antibacterial test. Results showed that, turmeric dye have anti-bacterial efficiency and good antibacterial activity achieved by plasma treatment of fabrics. In case of AgNO3 treatment, samples showed 100% antibacterial activity. It also concluded that, nitrogen plasma has synergic effect on antibacterial activity of turmeric as natural dye on cotton fabrics.

A confident source of hard X-rays: radiation from a tokamak applicable for runaway electrons diagnosis.

In a tokamak with a toroidal electric field, electrons that exceed the critical velocity are freely accelerated and can reach very high energies. These so-called `runaway electrons' can cause severe damage to the vacuum vessel and are a dangerous source of hard X-rays. Here the effect of toroidal electric and magnetic field changes on the characteristics of runaway electrons is reported. A possible technique for runaways diagnosis is the detection of hard X-ray radiation; for this purpose, a scintillator (NaI) was used. Because of the high loop voltage at the beginning of a plasma, this investigation was carried out on toroidal electric field changes in the first 5 ms interval from the beginning of the plasma. In addition, the toroidal magnetic field was monitored for the whole discharge time. The results indicate that with increasing toroidal electric field the mean energy of runaway electrons rises, and also an increase in the toroidal magnetic field can result in a decrease in intensity of magnetohydrodynamic oscillations which means that for both conditions more of these high-energy electrons will be generated.

Energetic electrons, hard x-ray emission and MHD activity studies in the IR-T1 tokamak.

Determinations of plasma parameters as well as the Magnetohydrodynamics (MHD) activity, energetic electrons energy and energy confinement time are essential for future fusion reactors experiments and optimized operation. Also some of the plasma information can be deduced from these parameters, such as plasma equilibrium, stability, and MHD instabilities. In this contribution we investigated the relation between energetic electrons, hard x-ray emission and MHD activity in the IR-T1 Tokamak. For this purpose we used the magnetic diagnostics and a hard x-ray spectroscopy in IR-T1 tokamak. A hard x-ray emission is produced by collision of the runaway electrons with the plasma particles or limiters. The mean energy was calculated from the slope of the energy spectrum of hard x-ray photons.

x-ray irradiation analysis based on wavelet transform in tokamak plasma.

Hard x-ray emission from the Runaway electrons is an important issue in tokamaks. Suggesting methods to reduce the Runaway electrons and therefore the emitted hard x-ray is important for tokamak plasma operation. In this manuscript, we have investigated the effects of external fields on hard x-ray intensity and Magneto-Hydro-Dynamic (MHD) activity. In other words, we have presented the effects of positive biased limiter and Resonant Helical Field (RHF) on the MHD fluctuations and hard x-ray emission from the Runaway electrons. MHD activity and hard x-ray intensity were analyzed using Wavelet transform in the presence of external fields and without them. The results show that the MHD activity and therefore the hard x-ray intensity can be controlled by the external electric and magnetic fields.

miR-675 mediates downregulation of Twist1 and Rb in AFP-secreting hepatocellular carcinoma.

BACKGROUND: Alpha-fetoprotein (AFP)-secreting hepatocellular carcinomas (HCC) represent a genetically distinct subset of tumors often associated with a worse prognosis. However, the molecular mechanisms that underlie these phenotypic differences remain poorly understood. METHODS: HCC tumor samples from 27 patients were profiled using the Affymetrix 133 Plus 2.0 GeneChips. GeneGO Metacore software was used to identify altered biologic pathways. Expression validation was confirmed by RT-PCR. Manipulation of miR-675 by overexpression and antagomir-mediated knockdown was carried out with subsequent evaluation of effects on cell behavior by cell cycle, proliferation, invasion, and growth in soft agar assays. RESULTS: We identified a strong relationship between primary tumor H19 gene expression and elevated serum AFP. H19 has recently been identified to encode microRNA-675 (miR-675), and we confirmed the relationship in an independent sample of patients. Pathway analyses of the effect of miR-675 overexpression in hepatoma cells revealed a predominant upregulation of cell adhesion and cell cycle initiation pathways. We have demonstrated that miR-675 mediates increases in proliferation and an accumulation of cells with tetraploid DNA content associated with a repression of Rb. We also demonstrated that overexpression of miR-675 alters cellular morphology, reduces invasive potential, and increases anchorage-independent growth capacity. These findings are consistent with a mesenchymal-to-epithelial transition, associated with a reduction in the expression of the key EMT mediator, Twist1. CONCLUSIONS: Expression of the miR-675 in hepatocellular carcinoma links a dramatic upregulation of proliferative and growth capacity with inhibition of motility in HCC cells.

Identification of genes associated with ovarian cancer metastasis using microarray expression analysis.

Although the transition from early- to advanced-stage ovarian cancer is a critical determinant of survival, little is known about the molecular underpinnings of ovarian metastasis. We hypothesize that microarray analysis of global gene expression patterns in primary ovarian cancer and metastatic omental implants can identify genes that underlie the metastatic process in epithelial ovarian cancer. We utilized Affymetrix U95Av2 microarrays to characterize the molecular alterations that underlie omental metastasis from 47 epithelial ovarian cancer samples collected from multiple sites in 20 patients undergoing primary surgical cytoreduction for advanced-stage (IIIC/IV) serous ovarian cancer. Fifty-six genes demonstrated differential expression between ovarian and omental samples (P < 0.01), and twenty of these 56 differentially expressed genes have previously been implicated in metastasis, cell motility, or cytoskeletal function. Ten of the 56 genes are involved in p53 gene pathways. A Bayesian statistical tree analysis was used to identify a 27-gene expression pattern that could accurately predict the site of tumor (ovary versus omentum). This predictive model was evaluated using an external data set. Nine of the 27 predictive genes have previously been shown to be involved in oncogenesis and/or metastasis, and 10/27 genes have been implicated in p53 pathways. Microarray findings were validated by real-time quantitative PCR. We conclude that gene expression patterns that distinguish omental metastasis from primary epithelial ovarian cancer can be identified and that many of the genes have functions that are biologically consistent with a role in oncogenesis, metastasis, and p53 gene networks.

Genetic analysis of microsomal epoxide hydrolase gene and its association with lung cancer risk.

The human microsomal epoxide hydrolase (EH) gene contains polymorphic alleles, which may be linked to increased risk for tobacco-related lung cancer. The purpose of this study is to screen new polymorphisms and determine whether these polymorphisms can be used to predict individual susceptibility to lung cancer. The polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis was used to screen for polymorphisms in the coding region of the EH gene. Eleven polymorphisms, including previously reported polymorphisms, were identified and the prevalence of these variants was assessed in at least 50 healthy Caucasians and African-Americans. Among the 11 polymorphisms, the prevalence of the amino acid-changing EH polymorphisms in codons 43, 113 and 139 was examined in 182 Caucasian incident cases with primary lung cancer, as well as in 365 frequency-matched controls to examine the role of EH polymorphisms in lung cancer risk. A significant increase in lung cancer risk was observed for predicted high EH activity genotypes (odds ratio (OR) 2.3, 95% confidence interval (CI) 1.2-4.3) as compared with low EH activity genotypes. This association was more pronounced among patients with lung adenocarcinoma (OR 4.7, 95% CI 1.7-13.1). These results suggest that the EH polymorphism plays an important role in lung cancer risk and is linked to tobacco smoke exposure.

Estimating the relative risk of developing melanoma in INK4A carriers.

Estimation of the relative risk of cancer due to rare germline mutations using population-based epidemiological techniques is challenging, since studies with very large numbers of subjects are required. In this pilot study using a novel study design, we evaluated the role of INK4A mutations in melanoma by comparing patients with multiple primary melanomas to those with single primaries. Patients were ascertained from the Surgery and Dermatology Clinics at Memorial Sloan-Kettering Cancer Center and at the Yale University Pigmented Lesion Clinic. Subjects completed a questionnaire covering risk factors for melanoma and were tested for INK4A mutations. Five (8%) of 65 patients with multiple primaries had a mutation, compared with none of 88 patients with single primaries (P=0.03). Examination of other factors, such as number of nevi on the arms of the patients, fair skin, hair and eye colour, and other phenotypic characteristics associated with the risk of melanoma, demonstrates that these factors exhibit higher prevalence in the multiple primary cases than in the single primaries. These results provide evidence of the utility of the new study design in evaluating the impact of rare but highly penetrant cancer risk factors.

Interplay of antibody and T cell responses in acute myocardial infarction.

This study sought to investigate the interplay between antibody and T cell responses triggered by an acute myocardial infarction (MI) and their possible role in the progress of this disease. Serum samples were collected from two groups of patients, group A (n = 26) within the first week of MI, and group B (n = 28) at 2 weeks and 2 months after MI. Patients in group A were older and had higher prevalence of hypertension and previous attack of MI than patients in group B. The levels of anti-myosin immunoglobulin M and immunoglobulin G antibodies in the serum samples from group A were significantly higher than those in normal control subjects. In group B, the levels of both antibodies were lower than those in group A but remained significantly higher than those in normal control subjects at both 2 weeks and 2 months. The levels of intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) in the serum samples from group A patients were significantly higher than those in normal control subjects. At 2 weeks after MI (group B), only the level of sVCAM-1, but not that of sICAM-1, was significantly higher than that in normal control subjects, and there were no significant changes in the levels of these two molecules from 2 weeks to 2 months after MI. We conclude that the higher levels of anti-myosin antibodies and adhesion molecules in group A patients as compared with group B patients may be due to higher or more frequent exposures of their immune systems to heart antigens. Furthermore, the immunoglobulin M antibody response during the first week of MI had an inverse relationship with the level of interleukin-2R (sIL-2R), which suggested a possible suppressive or regulatory role of this antibody on the cellular immune response during this time.

Monoclonality of multifocal myxoid liposarcoma: confirmation by analysis of TLS-CHOP or EWS-CHOP rearrangements.

Multifocal presentation, defined as the presence of tumor at two or more anatomically separate sites, before the manifestation of disease in sites where sarcomas usually metastasize (e.g., lungs) occurs in about 1% of extremity soft tissue sarcomas (STSs). Debate still persists whether multifocal STSs represent an unusual pattern of metastasis or multiple separate primary tumors. Among STSs with multifocal presentation, myxoid liposarcoma is the predominant histological type. This subtype of liposarcoma contains the specific t(12;16) chromosomal translocation, which results in rearrangement of the TLS and CHOP genes that is clone specific at the DNA level. We, therefore, sought to address the question of clonality by molecular analysis in six patients who presented with either synchronous or metachronous multifocal myxoid liposarcoma. In all six cases, adequate frozen tumor was available for DNA extraction from at least two distinct anatomical sites. Southern blot analysis using CHOP, TLS, and EWS cDNA probes was performed on genomic DNA. Five cases contained a TLS-CHOP rearrangement, and one case had the variant EWS-CHOP fusion (seen in <5% of cases). The size of the rearranged CHOP fragment differed among the six patients, as expected, but was identical in all anatomically separate tumor samples from each patient. Likewise, the sizes of the rearranged bands observed with either the TLS or EWS probes supported the monoclonality of all cases. Our results confirm the monoclonal origin of multifocal myxoid liposarcoma, establishing the metastatic nature of distant soft tissue lesions in these cases. It remains unclear whether this unusual pattern of metastasis represents an intrinsic property of this subset of myxoid liposarcoma or merely a rare chance occurrence. The clinical outcomes observed in this small series suggest that the prognosis of multifocal myxoid liposarcoma is poor, regardless of its often bland or "low-grade" histological appearance.

Specificity of TLS-CHOP rearrangement for classic myxoid/round cell liposarcoma: absence in predominantly myxoid well-differentiated liposarcomas.

Myxoid liposarcoma (LS), the most common subtype of LS, is known to be characterized by the specific t(12;16) resulting in a TLS-CHOP fusion in almost all cases. We wished to address the following questions: (i) Is this genetic hallmark also present in other types of LS with predominant myxoid change? (ii) What is the proportion of cases with the variant EWS-CHOP fusion? (iii) What is the optimal approach for Southern blot detection of TLS breakpoints? We identified 59 LS characterized histologically by >90% myxoid component, in which frozen tissue tumor was available for DNA extraction. These 59 LS with myxoid features were divided into 2 groups: 42 LS with classic myxoid/round cell appearance (myxoid LS) and 17 well-differentiated LS (WDLS) with a predominant (>90%) myxoid component. Within the myxoid LS group, 29 tumors were low grade and 13 high grade (>20% round cell component). Among the 17 predominantly myxoid WDLS, there were 15 low grade and 2 focally high grade tumors. In addition, we selected as control group, 20 LS of other histological types with minimal or no myxoid change (17 WDLS and 3 pleomorphic LS) and 13 myxofibrosarcomas. Southern blot analysis was performed in all cases using a CHOP cDNA probe, and in all CHOP rearranged cases using a TLS cDNA probe. Probe/enzyme combinations for Southern blot analysis were CHOP exon 3-4 cDNA probe with BamHI or SacI, TLS exon 3-6 cDNA probe with BclI. All 42 cases of myxoid LS showed a CHOP rearrangement and 38 of them also had a TLS rearrangement. Among the 4 myxoid LS without Southern blot evidence of TLS rearrangement, 1 showed an EWS-CHOP fusion by Southern blotting and reverse transcriptase-polymerase chain reaction and in another case, reverse transcriptase-polymerase chain reaction detected a TLS-CHOP fusion transcript. None of the predominantly myxoid WDLS and none of the tumors included in the control group showed rearranegements with CHOP probe. In addition, 12 predominantly myxoid WDLS, 10 other LS, and 5 myxofibrosarcoma from the control group were also tested for TLS rearrangement; all were negative. The TLS-CHOP fusion is highly sensitive and specific for the entity of classic myxoid/round cell LS. Other types of LS, even with a predominant myxoid component, lack the TLS-CHOP rearrangement, confirming that they represent a genetically distinct group of LS. The prevalence of the EWS-CHOP variant fusion was approximately 2% in this series. The optimal enzyme for TLS genomic breakpoint detection is BclI.

Paediatric hearing loss in rural Pakistan.

OBJECTIVE: The present study was designed to generate population-based data on the prevalence and causes of hearing loss in rural Pakistani children. A community screening programme was utilized to identify and evaluate the hearing impaired. METHODS: The study was performed in conjunction with the Ministry of Population Welfare in Sialkot District, Punjab Province. School-aged children between the ages of 5 and 15 years were screened and examined for hearing impairment according to World Health Organization (WHO) protocols. Case-control analysis of audiometric, physical examination, and risk factors for hearing loss were performed, followed by chi-square analyses. RESULTS: A total of 607 children comprised the study population, with an overall point prevalence of hearing impairment of 7.9%. Fifty percent of all hearing loss was conductive in nature, amenable to either medical or surgical therapy. The risk factors most associated with conductive hearing loss were otorrhea and multiple ear infections greater than 5. In cases of severe hearing loss, 70% were the result of consanguinous marriages. Almost no cases of hearing loss were attributable to measles, mumps, rubella, and the TORCH infections. CONCLUSION: This study has generated some badly needed population-based data on the magnitude of the problem of hearing loss in rural Pakistan. It is hoped that the results of this work will stress the importance of hearing health in Pakistan and to encourage other professionals to pursue similar projects.