RESUMO
A sixteen year old male presented with progressive dysphagia, dysphonia and haemoptysis over eight months. Radionuclide studies and computed tomographic scans confirmed an only functional thyroid gland at the base of tongue which was excised wholly via mandibular split transoral route and patient put on thyroxin replacement therapy.
Assuntos
Tireoide Lingual/diagnóstico , Adolescente , Transtornos de Deglutição/etiologia , Disfonia/etiologia , Hemoptise/etiologia , Humanos , Tireoide Lingual/cirurgia , Masculino , Faringite/etiologia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To determine the prevalence and type of hearing disorders in HIV positive patients not on anti - retroviral drugs (ARVs) and correlate this with the world health Organization (WHO) stage of HIV disease and CD4 positive cell counts. DESIGN: Case control study. SETTING: Comprehensive Care Clinic (CCC) and Voluntary Counseling and testing centre at Kenyatta National Hospital. SUBJECTS: One hundread and ninety four HIV positive patients attending CCC and 124 HIV negative subjects recruited from voluntary counseling and testing (VCT) centre. RESULTS: Hearing loss (HL) was present in 33.5% of HIV positive compared to 8.1% in negative subjects. No gender bias in HL Sensorineural hearing loss (SNHL) was the most common and the frequencies most 'affected were four-anti eight kHz CONCLUSION: Hearing loss is more prevalent in HIV positive individuals not on anti-retroviral drugs than negative normal subjects. Low CD4 cell count and advanced HIV diseases were associated with increased chance of having a hearing loss. Otological care should be part of the comprehensive care of HIV positive patients.
Assuntos
Soropositividade para HIV/complicações , Perda Auditiva/complicações , Adolescente , Adulto , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Estudos de Casos e Controles , Feminino , Soropositividade para HIV/tratamento farmacológico , Soropositividade para HIV/imunologia , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVES: To determine if patients on Anti-retroviral drugs (ARVs) develop hearing impairment. DESIGN: The comprehensive care clinic (CCC), Kenyatta National Hospital (KNH), Nairobi. SETTING: Case controlled study. SUBJECTS: Two hundred and seventy one human immunodeficiency virus (HIV) positive patients on ARVs were matched for age and sex with 273 HIV positive patients who were not on ARVs. RESULTS: Thirty four percent of HIV positive patients not on ARVs had a hearing loss compared to only 28% in patients who were on ARVs. sensorineural hearing loss was the most frequent hearing disorder in both groups. Majority of the patients had mild hearing loss and the higher frequencies were the most affected. There was a notable worsening of hearing loss with increase in age, but this was not statistically significant. It was noted that HIV positive patients hearing level worsened on starting ARVs but this improved after six months of ARV treatment. CONCLUSION: Prolonged usage of ARVs is not associated with decreased hearing function. The most common hearing loss found in patients on ARVs is sensorineural hearing loss (SNHL).
Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Perda Auditiva/epidemiologia , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Perda Auditiva/diagnóstico , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Background: This study was aimed at determining the prevalence and type of hearing disorders in HIV positive patients and any correlationship with the CD4 counts/stage of HIV/AIDS in patients attending the omprehensive care clinic (CCC). Methods: Case control study of 194 HIV positive patients attending CCC recruited into the study after informed consent. A thorough clinical examination and otoscopy done followed by tuning fork tests; Pure Tone Audiometry and tympanometric tests. This was compared with 124 HIV negative subjects matched for age and sex who were recruited from the voluntary counseling and testing centre. The world health organization staging of the HIV/AIDS disease and the CD4 positive lymphocyte cell count were carried out and correlated with any hearing disorder. Results were analyzed using statistical package for social sciences version 10.0. Results: Hearing loss (HL) was present in 33.5of HIV positive compared to 8.1in negative subjects. No gender bias in HL but HL worsened with advancement of age. SNHL was the most common and the higher frequencies were the most affected. Low CD4 cell count and advanced HIV disease were associated with increased chance of having a hearing loss. Conclusion: Hearing loss is more prevalent in HIV positive individuals than negative normal subjects and tends to worsen with the advancement of the HIV disease. This may negatively impact on the overall care and standard of living of HIV positive patients; hence otological care should be part of the comprehensive care
