Hearing thresholds in sickle cell anemia patients: emerging new trends?

PURPOSE OF STUDY: Advances in medicine resulting in better understanding of sickle cell disease and general improvement of the well-being of the sufferers even in the developing countries have positively affected the dreadful outlook of this disease with resultant increase in the population of sickle cell disease patients reaching adulthood, and less severe complications. We therefore set out to evaluate the presence and severity of sensorineural hearing loss in sickle cell anemia (SCA) patients in the light of the overall improvement in the morbidity and mortality. METHODS: A prospective case control study of SCA patients attending our adult SCA clinic and control subjects from homozygous hemoglobin AA patients attending the staff clinic of the hospital for routine medical tests. Tympanometry and diagnostic audiometry were performed on each patient. MAIN FINDINGS: Forty-six SCA patients (21 males, 45.7%) aged 16-48 years with a mean age of 22.9 years +/- 6.45 and 42 controls (24 males, 57.1%) aged 15-39 years with a mean age of 23.7 years +/- 5.69 were included in this study. The average hearing thresholds of SCA patients were consistently higher than controls in all frequencies tested in both right and left ears. Of the 92 ears of SCA patients tested, 95.7% exhibited hearing thresholds within normal limits, and 4.3% had mild hearing loss. The controls had thresholds within normal limits. CONCLUSION: The incidence of significant sensorineural hearing loss in SCA seems to have reduced in line with the general improvement and survival of SCA patients. The hearing loss is worse in the right ear and has a female preponderance. We hope that more aggressive primary and secondary prevention and adequate treatment of sickle cell crisis would reduce if not eliminate the hearing loss found in SCA.

Hearing function in Nigerian children with a family history of type 2 diabetes.

OBJECTIVE: Consequent on our previous observations [F.E. Ologe, E.O. Okoro, Type 2 diabetes and hearing loss in black Africans, Diabetic Med. (in press).], we investigated whether abnormality in auditory function can precede overt diabetes in individuals with a genetic predisposition to type 2 diabetes. METHOD: Frequency specific pure tone audiograms (125, 250, 500, 1000, 2000, 3000, 4000, 8000 Hz) and fasting blood glucose (FBG) and 2h post prandial blood glucose (2hrPBG) levels were measured in Nigerian children aged 9-19 years with at least a biologic parent with type 2 diabetes and compared with controls (contemporaries with non-diabetic parents). RESULTS: : Both groups were similar in gender mix, age, body sizes, FBS, 2PPhr BG, SBP; the values being (chi(2) = 0.04, d.f. = 1, p = 0.84); 14.32 +/- 2.29 years versus 14.77 +/- 3.10 years, 19.47 +/- 1.82 kg/m(2) versus 18.66 +/- 3.12 kg/m(2); 4.26 +/- 0.68 mmol versus 4.04 +/- 0.61 mmol; 5.07 +/- 0.95 mmol versus 5.16 +/- 1.04 mmol; 103.73 +/- 9.62 mmHg versus 100.07 +/- 13.77 mmHg for control and offspring of diabetic individuals, respectively. Similarly, pure-tone air-conduction audiograms were comparable (p > 0.5) in both groups. CONCLUSION: The data shows normal glucose metabolism in teenage offspring of type 2 diabetes and a pattern of audiogram not different from those observed in their counterparts without a genetic predisposition to type 2 diabetes.

Sonographic assessment of postvoid residual urine volumes in patients with benign prostatic hyperplasia.

OBJECTIVE: To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in patients with prostatic gland enlargement. DESIGN: Prospective. SETTING: Department of Radiology, University of Ilorin Teaching Hospital, Ilorin. SUBJECT: Fifty-two consecutive patients with benign prostatic hyperplasia. The mean age was 64.98+/-9.57 years. METHOD: PVR urine was evaluated by ultrasonography. Each patient had two examinations, the first of which was with a full bladder and the second of which was immediately after voiding. Two orthogonal diameters were measured on each bladder section (longitudinal and transverse) in the supine position. Fifty-two paired sets of ultrasonic measurements were thus obtained. Catheterized postvoid urine residue was regarded as the gold standard. RESULTS: Using these measurements, an equation--[PVR(CUBIC)=374.057+(-196.94+V1)+(32.5539+V1(2))+(-1.1480+V1(3)) where V1=average of the length (L), width (T), and the anteroposterior distance on transverse section (Dt) of the postvoid urinary bladder]--more accurate than previously existing ones was obtained by cubic regression analysis. Mean ultrasound estimated volume was 220.51 ml as against 220.76 ml after catheterization. The mean difference was 0.25 ml (not significant, p<0.01) with 95% confidence interval of +/-10 ml. With this equation, the ultrasonographic residual urine volume showed a higher correlation coefficient with the catheterized volume at p<0.01 (Pearson r=0.982, r2=0.96) than previously defined formulas. The standard error of the mean was 5.11 ml (mean=220.5+/-190.4 ml). CONCLUSION: With the above equation, we consider conventional transabdominal ultrasonography a reliable method for assessing the residual urine volume in patients with benign prostatic hyperplasia. This equation, though complex when compared to some of the pre-existing formulas, can be integrated into the memory of modern ultrasound machines for easy and faster computation.