Development of Phonemically Balanced Word List in Tamil for Speech Audiometry and Evaluation of Its Effectiveness in Adults.

Speech audiometry has become an essential component of the audiological test battery. Various speech audiometry materials have been developed in different languages and also revised later to meet criteria such as familiarity of the words, phonetic/phonemic balance, number of test items, and dialectal variations. The current study focused on developing a PB word list in Tamil for adults. The study was carried out in two phases. Phase I involved the development of a PB word list in Tamil. Phase II included evaluating the effectiveness of the developed word lists on adults with normal hearing sensitivity and hearing impairment. A total of 500 bisyllabic words were used in creating a master list. The collected words were subjected to familiarity testing with 40 native Tamil speakers. From the master list of 500 words, 90% of the participants rated 320 words as most familiar, and those words were included in the study. The 320 words were validated by eight experts working in the fields of audiology, speech-language pathology, linguistics, and psychology. The disagreed-with words were excluded from the list, and only 270 words that were agreed upon by all the experts were included in the final list. The final lists comprised four-word lists with 25 phonetically balanced (PB) words per list. The final word lists were recorded and tested for goodness. These final words were then administered to find SIS scores for two groups. Group I consisted of adults with 120 normal hearing sensitivity, and Group II consisted of 130 adults with hearing impairment. The results were analysed using SPSS software. The mean SIS in adults with normal hearing sensitivity ranged from 99.4 to 99.8%. The SIS of adults with normal hearing sensitivity revealed no significant difference (p > .05) with respect to gender, ears, or across the four-word lists. All four-word lists provided similar scores, establishing the equivalency of word lists in individuals with normal hearing sensitivity as well as hearing impairment. A psychometric curve of performance intensity function in adults with normal hearing sensitivity revealed that the SIS score increased as the sensation level increased from 10 to 40 dB SL. There is a linear increase in SIS scores from 10 to 20 dB SL. A plateau was attained at 40 dB SL with 100% SIS scores. Thus, the present study recommends the use of 40 dB SL for SIS testing. Mean SIS scores for adults with mild, moderate, and severe hearing loss were found to be 90.1%, 65.4%, and 41.8%, respectively. A significant decrease in SIS was observed as the degree of hearing loss increased.

Comparison of Glycerol Test, ECochG and VEMP Findings in Patients with Meniere's Disease.

Present study aimed to find if multiple audio-vestibular tests can be used to improve in diagnosing Meniere's disease. The study compares the results of four test procedures of glycerol test, Electrocochleography (ECochG), cervical Vestibular Evoked Myogenic Potential (c-VEMP) and ocular Vestibular Evoked Myogenic Potential (o-VEMP) individually and also together to see whether the diagnosis of Meniere's disease can be improved. Experimental group consist of 16 participants (32 ears) diagnosed with Meniere's disease as per American Academy of Otolaryngology (AAO) -Head and Neck Foundation (2020) guidelines. Control group consist of 16 participants with compliant of only vertigo participated in the study. Participants in both group underwent glycerol test, Electrocochleography (ECochG), cervical Vestibular Evoked Myogenic Potential (c-VEMP) and ocular Vestibular Evoked Myogenic Potential (o-VEMP). Glycerol test showed a 38% positive rate for the presence of Meniere's disease. ECochG indicated the presence of endolymphatic hydrops in 62% of the participants. Abnormal finding in c-VEMP and o-VEMP was seen in 31% and 56% of the participants respectively. The combination of two tests such as ECochG and o-VEMP has increased the positive rate upto 87%. Adding one more test of c-VEMP or combining all four audiovestibular tests had a positive rate of 94% only. The present study indicated ECochG is a more sensitive tool in the diagnosis of Meniere disease followed by o-VEMP. Thus, the present study indicated that combination ECochG and o-VEMP could be used to find the presence of Meniere's disease successfully.

Effect of Glycerol Administration on ECochG and VEMP Findings in Individual with Meniere's Disease.

The present study aimed to find the effect of glycerol administration on Electrocochleography (ECochG), cervical and ocular Vestibular Evoked Myogenic Potential (c-VEMP, o-VEMP) findings in individual with Meniere's disease. Sixteen participants (32 ears) diagnosed with Meniere's disease underwent ECochG, c-VEMP and o-VEMP for both pre and 1 h post-glycerol administration. Paired t-test indicated that the SP/AP ratio of ECochG measures was significantly improved with post-glycerol administration. There was no significant difference in the mean amplitude of o-VEMP and c-VEMP between pre and post-glycerol administration. However, while individual differences were compared, 75% of the participants reported either improvement in c-VEMP amplitude or newly emerging c-VEMP& o-VEMP. Based on the recommendation by Adams et al. (Otolaryngol Clin North Am 43(5):995-1009, 2010), the improvement on these tests results with post glycerol administration were considered as a significant indicator for the presence of Meniere's disease.With post glycerol administration, the present study found that 84%of participants were found to have an improvement in the amplitude for ECochG measures. There was an improvement in the amplitude measures of o-VEMP and c-VEMP, which were observed in 75% and 68%of participants respectively with post-glycerol administration. Improvement in the amplitude of test measures with post-glycerol administration were observed to be more for cochlear potentials of ECochG followed by vestibular potentials of c-VEMP and o-VEMP. Thus, improvement of ECochG amplitude with post-glycerol administration might serve as an additional indicator for the presence of Meniere's disease.

Synthesis, molecular docking, antimicrobial, antioxidant and toxicity assessment of quinoline peptides.

A series of quinoline based peptides were synthesized by a one-pot reaction through Ugi-four component condensation of lipoic acid, cyclohexyl isocyanide, aniline derivatives and 2-methoxy quinoline-3-carbaldehyde derivatives under microwave irradiation. The products were obtained in excellent yields and high purity. Solvent optimization and the effect of microwave irradiation with various powers were also observed. All the synthesized compounds were characterized by FTIR, NMR spectral data and elemental analysis. A total of eight peptides were subjected to antimicrobial, antioxidant and toxicity evaluation. Among them, four peptides showed potential towards antibacterial screening with Bacillus cereus, Staphylococcus aureus, Escherichia coli, Enterococcus faecalis and Candida albicans, Candida utilis and three peptides showed antioxidant test positive (DPPH). Besides, toxicity of all the peptides were evaluated by using brine shrimp and it was observed that four peptides showed mortality rate less than 50% up to 48h. Molecular docking studies revealed that the higher binding affinity of the two peptides toward DNA gyrase than ciprofloxacin based on Libdock score. The described chemistry represents a facile tool to synthesize complex heterocycles of pharmaceutical relevance in a highly efficient and one-pot fashion. The advantages of this method are its green approach, inexpensive solvent, shorter reaction times and excellent yields.

The outcome of Trabeculectomy with Mitomycin C at the Queen Elizabeth Hospital, Barbados

AIM: To evaluate the efficacy of trabeculectomy with mitomycin-c in a predominantly black population. METHOD: The records of 43 eyes with 34 patients (males 15, females 19; age range 22-87 years), who underwent trabeculectomies with mitomycin-c for uncontrolled glaucoma at the Queen Elizabeth Hospital were reviewed. Forty-three eyes (rt eyes 22, Lt eyes 21, unilateral 25, bilateral 9, combined procedure 4) had trabeculectomies. All surgeries were performed by six surgeons between July 1995 and October 1998. The concentration of mitomycin-c varied from 0.2 to 0.5 mg/ml and was applied over 2 to 5 minutes. RESULTS: We evaluated treatment outcome based on the following categories of surgical results for patients with a pre-operative IOP>21mmHg. 1. The operation was considered successful when the IOP was <21mmHg without any anti-glaucoma medications. 2. The operation was a failure when the IOP was raised >21mmHg and required anti-glaucoma medications to control the IOP. The mean preoperative IOP was 26mmHg and the mean postoperative IOP was reduced to 14mmHG. There was failure in 19 eyes where the IOP was raised over >21mmHg and required anti-glaucoma medications or control. Twenty-four eyes were still functional at 18 months with IOPs less than 21mmHg without any anti-glaucoma medications. Visual acuity (VA) in the functional 24 eyes: the VA remained the same in 9 patients and the VA progressively deteriorated in the remaining 15 patients in spite of reduced IOP after mitomycin trabeculectomies. CONCLUSION: The most common cause of failure after trabeculectomy is scarring at the filtration site due to fibrosis or more appropriately normal healing by fibrosis - mitomycin simply delayed the normal healing. Eyes with pseudopakia are at higher risk for failure. Most of the studies in the past were done in the predominantly white population with a short follow-up period. In contrast, all the patients in this study were of African origin and had at least 18 months follow-up, with mean follow-up of 39 months. To our knowledge, this is one of the longest follow-up studies in a predominantly Black population and is the first in the Caribbean. (AU)

Diabetic retinopathy in Barbados: the Barbados eye study

OBJECTIVE: Diabetic retinopathy is an important cause of visual loss in Barbados and the Caribbean region. The Barbados Eye Study (BES) provides the largest source of population based data on diabetic retinopathy in black adults. METHODS: This is a prevalence study of 4,631 participants based on a random sample of the Barbados population aged 40-84 years (84 percent participation). Diabetes was defined as self-reported history of physician diagnosed diabetes and/or glycosylated haemoglobin > 10 percent (2 standard deviations above the population mean of persons without a diabetes history). Retinopathy was assessed by independent gradings of 30 degrees colour stereo fundus photographs of the disk and macula. RESULTS: Diabetes was present in 19.4 percent of blacks (n=4,313), 15.2 percent of mixed black and white; n=184), and 7.5 percent of white/other (n=133) self reported racial groups. Type 1 diabetes was infrequent. In the overall black/mixed study population regardless of diabetes status, the prevalence of retinopathy was 5.9 percent. In the 636 black and mixed participants with diabetes and gradable fundus photographs, the prevalence of retinopathy was 28.5 percent; 19.8 percent had minimum background changes, 7.7 percent had moderate changes and 0.9 percent had severe retinopathy. Clinically significant macular oedema (CSME) was found in 8.6 percent of those with diabetes. CONCLUSION: In the Afro-Caribbean population over 40 years of age, about 1 in 17 persons had retinopathy. Among those with diabetes, 28.5 percent had retinopathy and 8.6 percent had CSME. These results highlight the clinical and public health relevance of diabetic retinopathy in the region (AU)

Treatment of traumatic hyphaema - abstract

Fifty-three (53) patients who sustained hyphaema after blunt trauma were admitted, treated and followed up in the Eye Department, at the Queen Elizabeth Hospital, Barbados. Many forms of treatment are used for patients with traumatic hyphaema. These range from no medication to mydriatics, miotics, tropical and systemic corticosteroids and systemic aminocaproic acid. Several studies in the past suggest that both aminocaproic acid and systemic steroids were successful in reducing the incidence of rebleeding. However, the rate of rebleeding is so variable that controversy exists about the necessity of treatment. In this study, all patients were treated with topical corticosteroids, no mydriatics and strict bed rest. Seven per cent (7.5 percent) of the patients experienced rebleeding; however, rebleeding was not a determining factor related to the final outcome of visual acuity. The adverse reactions of aminocaproic acid and systemic steroids greatly outweigh the benefits of their usefulness in reducing the incidence of rebleeding in our situation. The treatment regime consists of strict bed rest, topical corticosteroids (to treat the masked Iritis) and no mydriatics (to prevent further aggravation of sphincter damage). Raised intraocular pressure is a major concern following traumatic hyphaema and requires early recognition and prompt management (AU)