Glucocorticoid for Hearing Preservation After Cochlear Implantation: A Systemic Review and Meta-analysis of Animal Studies.

OBJECTIVES: To conduct systematic review and meta-analyses of preclinical studies describing the efficacy of glucocorticoids administered via different routes for hearing preservation after cochlear implantation. DATA SOURCES: A literature search was performed in PubMed to identify peer-reviewed articles published before December 31, 2017, with no language restrictions. Search components were "Cochlear implant," "Glucocorticoids," and "Hearing preservation." The results were specified for animal studies. STUDY SELECTION: Original studies in which glucocorticoids were administered before or during cochlear implantation in animal models and hearing threshold shifts were measured using auditory brainstem response. DATA EXTRACTION: Quality of included studies was assessed using the SYstematic Review Centre for Laboratory animal Experimentation protocol. Threshold Shift reduction between the "study" and "control" groups at 1-month postimplantation was the parameter used to evaluate hearing preservation. DATA SYNTHESIS: The random-effects models were used to combine the results of selected studies. Separate meta-analyses were performed for drug-eluting electrodes, systemic, and local administration. CONCLUSIONS: Administering either systemic or topical glucocorticosteroids had a significant effect on preserving low and high-frequency hearing. Topical administration was equally effective across a range of concentration levels and provided maximal hearing preservation when applied 120 minutes before implantation. The effect of systemic treatment was achieved with high doses, equivalent to 26 mg of dexamethasone per day in humans. No significant effect was found with the use of drug-eluting electrodes and more studies are needed to characterise the utility and efficacy of this administration method.

Electrical Impedance as a Biomarker for Inner Ear Pathology Following Lateral Wall and Peri-modiolar Cochlear Implantation.

OBJECTIVES/HYPOTHESIS: Spikes in cochlear implant impedance are associated with inner ear pathology after implantation. Here, we correlate these spikes with episodes of hearing loss and/or vertigo, with a comparison between lateral wall and peri-modiolar electrode arrays. METHODS: Seven hundred seventy recipients of Cochlear's slim-straight, lateral wall electrode (CI422), or peri-modiolar (CI512) electrode were investigated for impedance spikes. Impedance fluctuations were defined as a median rise of ≥ 4 kΩ across all intracochlear electrodes from baseline measurements taken 2 weeks after switch-on. Medical records were analyzed from 189 of the 770 patients. RESULTS: The slim straight, lateral wall electrode was found to spike in impedance at a significantly higher rate than the peri-modiolar array (17% vs 12%). The peri-modiolar electrode tended to spike in impedance earlier than the slim-straight electrode. Impedance spikes were found to significantly correlate with medical events (hearing loss, vertigo, or tinnitus). Overall, in the "spike" group, 42 of 75 patients (56%) demonstrated a clinical event during the impedance spike, whereas 26 of 114 patients (22%) of the "non-spike" group had a clinical event. This significant difference existed with both implant types. CONCLUSION: These results demonstrate a small, but significant increase in impedance spikes in lateral wall electrodes, and support the relationship between spikes in cochlear implant impedances and postoperative inner-ear events, including the loss of residual hearing and vertigo. Monitoring cochlear implant impedance may be a method for early detection, and so the prevention, of these events in the future.

Assessment of Immunomodulatory Activity of Euphorbia hirta L.

Immune system is the major target for development of treatment strategies to improve the management of infections. Many species of Indian medicinal plants have been reported to possess active principles with immunomodulating properties. Euphorbia hirta, a pantropic herb has been reported to be pharmacologically active. This study reports one another not widely reported property of the plant, immunomodulatory activity, which has been proved using simple techniques like the macrophage activity testing, carbon clearance test and mast cell de-granulation assay.

Efficacy of lincomycin against the strains of Staphylococcus aureus isolated from various types of pyodermas in children : in vitro and in vivo study.

Lincomycin is chemically distinct from all other available antibiotics except its semi-synthetic derivative clindamycin. Though it has been in the market for over three decades, there were not many clinical studies in India. This study has been undertaken to know its efficacy against Staphylococcus aureus, commonest organism of pyodermas in children. Material was taken from the lesions of 100 fresh cases of various types of pyodermas in children and studied by Gram stain and in 50% human blood agar and nutrient agar according to standard methods. The staphylococci thus isolated were tested for linocomycin susceptibility by using the disc diffusion technique. Lincomycin was given to all these children in a daily dose of 30 mg/kg 5 - 10 days. Treatment failure was defined as persistence of lesions after 10 days of treatment. 75% strains of staphylococci were susceptible to lincomycin in vitro and 95% of the patients responded to 5-10 days treatment. Five out of 100 children did not respond to treatment even after 10 days. No case of relapse was noticed among these 95 children for a period of 2 weeks. No side effects were observed and the drug was very well tolerated. Being highly effective and least toxic linomycin deserves a place in the antimicrobial arsenal of the modern dermatologists.

Porokeratosis - report of three unsusual cases.

Three unusual cases of porokeratosis - linear, punctate and warty porokeratoses are reported with histopathological features. These three types are rarely seen in clinical practice.