Prevalence of Hearing Loss among Very Low Birth Weight (VLBW) Babies in Two Tertiary Hospitals in Malaysia.

OBJECTIVE: This study aimed to evaluate hearing loss among very low birth weight babies in two hospitals in Malaysia. MATERIAL AND METHODS: A total of 380 babies from Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur and Sarawak General Hospital (SGH) were recruited in this retrospective study. All babies with birthweight less than 1500grams nursed in the Neonatal Intensive Care Unit (NICU) between January 2014 till December 2019 was included in the study. Data was analysed on demography, interval taken for hearing intervention and defaulter rate. The data of patient parameters between both hospitals were analysed and association between various factors were evaluated. RESULTS: A total 187 Very Low Birth Weight (VLBW) Kuala Lumpur babies and 193 VLBW Sarawak babies met the inclusion and exclusion criteria, among which 10.1% and 10.9% had SNHL in Kuala Lumpur and Sarawak respectively. CHL was reported among 8.6% Kuala Lumpur and 14% of Sarawak babies. When studied on the different types and degrees of hearing loss, 2.6% of Kuala Lumpur babies born less than 28 Weeks Gestation Age (WGA) had moderate SNHL and 2.0% of Sarawak babies had profound SNHL. In this study only gestational age (week) (p=0.003) and dysmorphism (p<0.001) were statistically significant to be associated with hearing loss. CONCLUSION: The prevalence of hearing loss among VLBW babies in Kuala Lumpur was 20.3% and 24.8% in Sarawak. Gestational age (p=0.044) and presence of dysmorphism (p<0.001) were found to have statistically significant association with prevalence of hearing loss. The defaulter rate at Kuala Lumpur was 52.6% and 42.3% in Sarawak.

Challenges in Managing Intractable Epistaxis in a Post-nasal Surgery and Radiated Cancer Patient: A Case Report and Literature Review.

Recurrent epistaxis represents an alarming sign that may suggest a sinister aetiology, especially in patients with previous head and neck malignancy. The recognition of certain potentially life-threatening conditions, namely pseudoaneurysm or tumour recurrence, remains prudence to avoid disastrous repercussion. Nasal endoscopy has become an essential tool in otolaryngology. It can aid identify the underlying cause of epistasis and facilitate therapeutic management. On the other hand, radio imaging is highly sensitive in detecting vascular lesions, besides providing a pre-operative mapping if surgical intervention is planned. This paper reported a patient with sphenoidal sinus squamous cell carcinoma in remission presented with torrential epistaxis not relieved with nasal packing. Despite a repeated angiogram and magnetic resonance image, the identification of the source of bleeding remained futile, culminating in an examination under general anaesthesia. The diagnosis of carotid blowout syndrome was made intraoperatively, and the bleeding was temporarily secured with a muscular patch, preceded by the insertion of a vascular stent. The authors wish to highlight the importance of examination under general anaesthesia if radio imaging does not correlate to the clinical findings. Management options for carotid blowout should be tailored to the patients' medical conditions. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03625-4.