Speech Difficulties Research Articles

Recreational music exposure and hearing health in young adults

ObjectiveThis study aimed to compare daily and total recreational music exposure levels and extended-spectrum audiogram results in young adults without pre-existing hearing problems.DesignThe study included healthy volunteers aged 18–25 with no known ear disease or hearing loss. Participants completed a questionnaire, underwent otoscopic and tympanometric examinations, and determined preferred music volumes in an audiometry booth using calibrated music samples of their preferred genres. Hearing thresholds up to 16 kiloHertz (kHz) were measured. Daily music exposure for each participant was normalized to 8 h to calculate a time-weighted average of 8 h (TWA8). Total exposure (TE) was calculated by multiplying TWA8 by the number of years of music listening.ResultsA total of 32.4% of participants had TWA8s above 65 dB. Their hearing thresholds at 125, 250, 500, and 16,000 Hz and the average of 125 Hz–8 kHz were significantly higher. Participants with TWA8s above 65 dB were also more prone to speaking loudly and experiencing communication difficulties on the phone. Those with a TE of more than 400 experienced significantly more speech discrimination difficulty in noisy environments and temporary hearing loss/tinnitus after exposure to loud music. Participants with a TE above 700 had worse thresholds at 4, 14, and 16 kHz frequencies, as well as 125–8000 Hz and 500–4000 Hz averages compared to those with a TE below 700.ConclusionsThis study provides evidence that recreational music with much lower exposure levels than the universally accepted TWA8 of 85 dB could negatively impact hearing in healthy young adults. Therefore, maintaining a maximum TWA8 of 65 dB is recommended.

Comparison of social skills and problem behaviours of children with different developmental disabilities

Objectives Difficulties in social skills, such as a lack of understanding of emotions and thoughts, deficiencies in problem-solving, and struggles in establishing peer correlations, can negatively impact both the social and academic dimensions of one’s life, resulting in the emergence of problematic behaviors. Studies have consistently shown a correlation between the social skills and problem behaviors of children with developmental disabilities. Therefore, it may be essential to compare the social skills and problem behaviors across various developmental disabilities and understand the correlation between them to design effective intervention programs. Methods In this study, the social skills and problem behaviors of 172 children and 18 teachers in inclusive classrooms, special education classrooms, and special education schools were analyzed. The Social Skills Rating System-Teacher Form assessed children’s social skills and problem behavior profiles with different developmental disabilities. Results The findings revealed that children with autism spectrum disorder exhibited the most significant social skill deficits and the most intense problem behaviors. Following autism spectrum disorder, those with intellectual disabilities, learning difficulties, and language and speech difficulties experienced elevated levels of social skill deficits. In terms of problem behaviors, after autism spectrum disorder, those with intellectual disabilities, language and speech difficulties, and learning difficulties exhibited the most intense problem behaviors. Gender differences were observed, with girls demonstrating higher social skills and lower problem behaviors than boys. Children with developmental disabilities receiving inclusive education showed higher social skills than those educated in special education schools. Additionally, a strong negative correlation between the social skills and problem behaviors of children with developmental disabilities was identified. Conclusions Our results show that social skills and problem behaviors of children with developmental disabilities vary according to the type of disability, age, gender, and educational settings. In addition, our results show that improving the social skills of children with developmental disabilities can effectively prevent and reduce problem behaviors.

Beta Spectral Power during Passive Listening in Preschool Children with Specific Language Impairment

Introduction: Children with specific language impairment (SLI) have difficulties in different speech and language domains. Electrophysiological studies have documented that auditory processing in children with SLI is atypical and probably caused by delayed and abnormal auditory maturation. During the resting state, or different auditory tasks, children with SLI show low or high beta spectral power, which could be a clinical correlate for investigating brain rhythms. Methods: The aim of this study was to examine the electrophysiological cortical activity of the beta rhythm while listening to words and nonwords in children with SLI in comparison to typical development (TD) children. The participants were 50 children with SLI, aged 4 and 5 years, and 50 age matched TD children. The children were divided into two subgroups according to age: (1) children 4 years of age; (2) children 5 years of age. Results: The older group differed from the younger group in beta auditory processing, with increased values of beta spectral power in the right frontal, temporal, and parietal regions. In addition, children with SLI have higher beta spectral power than TD children in the bilateral temporal regions. Conclusion: Complex beta auditory activation in TD and SLI children indicates the presence of early changes in functional brain connectivity.

Management of Rigidity Dominant Parkinson’s Disease Through Ayurvedic Protocol

Parkinson's Disease (PD) is a disease with insidious onset and slow progression. It is a neurologic condition that causes motor manifestations namely, bradykinesia, rigidity, resting tremor, postural instability and non-motor symptoms such as depression and dementia. The modern treatment provides some symptomatic relief but any proven means for slowing the progression have not been found yet. This case is of a 64-year-old male patient who presented with complaints of slowness in daily activities, difficulty in raising left upper arm along with heaviness, tremors in both hands, difficulty in speech and movement for 3 years. Complaints were increasing progressively hindering his routine activities. He underwent our IP management for 60 days with follow-up after every 20 days. In every follow-up, the patient reported significant relief in his symptoms and after two months, he was able to perform his routine activities without any help.

Speech services by speech volunteers for children with cleft lip and palate in professional lacking area: Pilot study

Background: Cleft lip and cleft palate are the most common birth defects. Children with cleft lip with or without cleft palate (CP±L) face a vary of challenges, depending on the type and severity of the cleft including speech difficulty, dental problems, feeding difficulty, ear infections and hearing loss. Articulation error is the most common residual defect in children with cleft palate with or without cleft lip. Objective: To compare the numbers of pre- and post- articulation errors after using the Model of Speech Therapy by Volunteers (STV) for children with CP±L. Materials and methods: 9 children, aged range 6; 4-14; 2 years old, were included in this study and completely participated in the study. Pre- and post-articulation tests by Myanmar Articulation, Resonation, Nasal Emission and Nasal Turbulence Test were assessed at Mahamuni Monastery, and Thiriyadana Guha Pone Htoon Shan Monastery, Tachileik, Myanmar. STV is composed of a 3-day speech camp (1st month), 3 times 1-day site visits for complicated cases (2nd, 6th, and 10th months) and 3 times of 1-day follow-up speech camps (4th, 8th, and 12th months), Phonological approaches, traditional strategies, and specific techniques for speech correction in children with CP±L were taught to speech volunteers (SVs) and caregivers. Homework was assigned to SVs and caregivers. SVs provided a session of 45-minute speech correction every week. Caregivers practiced 5 sessions of 30 minutes in speech exercises /weeks at home. Results: STV revealed significant reductions in the numbers of articulation errors including articulation screening test [median difference: MD=6 (95% confident interval: CI=5.2-9.2)], and Myanmar articulation standard test at both word and sentence levels; [MD=8 (95% CI=6.5-10.8) and MD=5 (95% CI=4.2-8.3), respectively]. Conclusion: STV significantly decreased a number of articulation errors in children with CP±L of Myanmar, a professional lacking area, and could be applied in any area that has a similar situation. The result was a primary study, the further research should enroll more participants for generalization.

Symptoms at stroke onset as described by patients: a qualitative study

BackgroundStroke is a common and severe disease that requires prompt care. Symptom expressions as one-sided weakness and speech difficulties are common and included in public stroke campaigns. For some patients stroke can present with subtle and less common symptoms, difficult to interpret. The symptom severity assessed by the National Institutes of Health Stroke Scale has decreased, and symptoms at onset may have changed. Therefore, we aimed to investigate how patients describe their symptoms at the onset of a first-time stroke.MethodsThe study used a qualitative descriptive design and conventional content analysis. Data were collected through recorded interviews with 27 patients aged 18 years and older hospitalised with a first-time stroke between October 2018 and April 2020. Data were analysed on a manifest level.ResultsSymptoms at stroke onset were presented in two themes: Altered Reality and Discomfort and Changed Body Functions and described in five categories. Various types of symptoms were found. All symptoms were perceived as sudden, persistent, and never experienced before and this appear as a “red thread” in the result. Regardless of symptom expressions, no specific symptom was described as more severe than another.ConclusionsStroke symptoms were described with a variety of expressions. Many described complex symptoms not typical of stroke, which can make it difficult to recognise the symptoms as a stroke and delay medical care. Public stroke campaigns should emphasize the importance of seeking medical care at the slightest suspicion of stroke and could be designed to help achieve this.

Evaluation of Complications Associated with Fixed Partial Denture: A Prospective Study.

To assess complications, survival rates, and patient-reported outcomes associated with fixed partial dentures (FPDs). A cohort of 146 subjects, aged 18 and above, requiring FPD were recruited. Following comprehensive dental examinations, FPDs were fabricated. Complications, survival rates, and patient-reported outcomes were evaluated at 3, 6, 12, and 24 months. Complications such as marginal discrepancies and framework fractures showed low frequencies over short-, mid-, and long-term intervals. Survival rates were high at 98.6%, 96.2%, 93.7%, and 91.1% at all intervals, respectively. Patient-reported outcomes indicated a mean comfort level of 8.2 with speech difficulties (8.2%) and hygiene challenges (4.8%). Overall satisfaction was high, with a mean score of 9.0. This study provided evidence of favorable outcomes with low complication rates, high survival rates, and positive patient-reported experiences associated with FPDs.

Abstract PO5-20-06: Paraneoplastic cerebellar degeneration in anti-Yo antibody and HER2-positive metastatic breast carcinoma

Abstract Paraneoplastic cerebellar degeneration (PCD) in the context of breast carcinoma affects less than 1% of patients. In most cases, breast cancer diagnosis follows several months or even years after the onset of neurological symptoms. The first association between PCD and occult gynecologic cancers (breast or ovarian) was identified in 1938 with the discovery of antibodies directed against cytoplasmic antigens of Purkinje cells (“anti-Yo antibodies”). Since then, evidence has grown significantly to support anti-Yo antibodies as excellent diagnostic markers of PCD with underlying gynecologic and breast carcinoma. This case study evaluates a 57-year-old female who initially presented with headache and subacute cerebellar ataxia. Her symptoms progressed over a period of three months with multiple falls, onset of speech difficulties, and diplopia. She also reported 30-pound weight loss, which she attributed to dieting and starting semaglutide. Magnetic resonance imaging (MRI) of the brain and spine were unremarkable and autoimmune workup was normal. Cerebral spinal fluid (CSF) and serum studies demonstrated positive anti-Yo antibodies. Computed tomography (CT) of the abdomen and pelvis showed an enlarged left axillary lymph node concerning for metastatic disease with a 1.2cm focus of asymmetric density in the central inferior left breast parenchyma. Diagnostic mammogram one year prior was reportedly normal. Ataxia symptoms improved after a course of empiric intravenous immunoglobulins and steroids. Ultrasound-guided biopsy of the left axillary lymph node revealed metastatic mammary carcinoma: estrogen and progesterone receptor negative and human epidermal growth factor receptor 2 (HER2)-positive, cT0N2aM0, ypTxN1aM0, stage IIIa (AJCC 8th edition). She underwent further metastatic workup, including repeat CSF studies and MRI. MRI of the spine was remarkable for multiple hemangiomas throughout the cervical, thoracic, and lumbar spine, with subsequent unremarkable bone scan. MRI of the abdomen was remarkable for right hepatic lobe hemangioma and a right adrenal nodule. CSF studies showed no sign of metastases. After multidisciplinary discussion, TCHP (docetaxel, carboplatin, trastuzumab, and pertuzumab) neoadjuvant therapy was initiated and repeat imaging demonstrated favorable treatment response with a shrinking axillary mass; no primary breast mass was identified. The patient underwent left sentinel lymph node biopsy with a positive frozen section intraoperative for invasive cancer, therefore proceeded with left axillary lymph node dissection. She was offered a mastectomy but elected for only axillary surgery. Pathology revealed 1 of 14 lymph nodes were positive for metastatic ductal carcinoma. She remains in a rehabilitation center and her ataxia is improving, but her functional status remains below baseline. She is undergoing radiation to whole breast and regional lymph nodes. With this case, we aim to continue to build upon the limited base of the exceedingly rare presentation of breast cancer-associated paraneoplastic syndrome. In addition, several studies and case reports have demonstrated a strong correlation between HER2 overexpression and anti-Yo associated PCD. As we continue to diagnose and monitor breast cancer patients, we could consider starting to screen for anti-Yo antibodies in HER2-positive patients to gain insight into a patient’s prognosis and development of PCD. Citation Format: You Kim, Alison Coogan, Andrea Madrigrano. Paraneoplastic cerebellar degeneration in anti-Yo antibody and HER2-positive metastatic breast carcinoma [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-20-06.

A CASE REPORT ON THE MANAGEMENT OF SULCUS VOCALIS WITH REFER-ENCE TO SWARASADA

1Sulcus vocalis is a condition characterized by a groove or infolding of the mucosa along the surface of the vocal fold, disrupting the normal physiology of vocal fold vibration and impacting voice production. Common symptoms include hoarseness, vocal fatigue, voice weakness, and increased effort, particularly concerning working professionals who rely on speech for communication and quality of life. While treatment options like phono surgery and speech therapy exist, phono surgery often yields disappointing results, typically limited to increased voice loudness. In Ayurveda, this condition aligns with Swarasada, attributed to factors such as 2Athyucha bhasana(loud speaking) and abhighata(trauma), leading to dosha invasion in sabdhavahi siras and causing speech difficulties. Presented here is a case report involving a 33-year-old IT professional experiencing hoarseness, vocal fatigue, and weakness. Upon bronchoscopy, the diagnosis initially indicated muscle tension dysphonia, later revealing bilateral sulcus vocalis with GERD. The patient underwent Nasya, Gandusha, and Sneha Sweda procedures alongside internal medication. Following a one-month review, the patient exhibited marked improvement in voice clarity. Notably, modern treatments provided only temporary relief. This case report underscores the effective management of sulcus vocalis through Panchakarma treatments and internal medications, showcasing consistent relief over a three-month review period.

Unmasking Sturge-Weber syndrome in adulthood: A case with extrafacial port-wine stain and delayed neurological symptoms

Background: Sturge-Weber Syndrome (SWS) is a rare neurocutaneous disorder characterized by a facial port-wine birthmark, leptomeningeal angiomatosis, and glaucoma. This case report highlights the challenges of diagnosing SWS when presenting with atypical features. Here, we present a 55-year-old man with an extra facial port-wine stain and delayed-onset seizures, deviating from the classic triad. Case Presentation: A 55-year-old man presented with a recent seizure and a characteristic port-wine birthmark extending beyond the typical facial region. Neurological examination revealed no weakness, speech difficulties, or coordination problems. Ophthalmological examination didn’t reveal glaucoma. Limited resources restricted access to advanced imaging like MRI scans. However, based on the constellation of clinical findings, including the facial birthmark with angiomatosis and the new-onset seizure, the patient received a diagnosis of SWS. Treatment with Levetiracetam was initiated to prevent future seizures, and patient education on managing diabetes and hypertension was provided. Clinical Discussion: This case underscores the importance of considering SWS in diagnosing adult-onset seizures, especially with a characteristic facial birthmark. The delayed presentation and isolated seizure suggest potentially less severe brain involvement. Resource limitations necessitated a clinical diagnosis and treatment with readily available medications. Conclusion: This case highlights the challenges of diagnosing atypical SWS presentations. Early diagnosis is crucial for prompt management and improved patient outcomes. Future research should focus on developing robust diagnostic tools and exploring novel treatment options for atypical SWS presentations.

Driving Towards Sustainable Future Through EV Health Monitoring System

Driving is a complex activity performed in a continually varying and stimulating environment. The coordination and execution of various skills like cognitive, sensory, psychomotor and physical are extremely necessary to drive safe. Most of the studies related to driving highlighted that 75% of traffic accidents occurs due to human factors including driver’s fatigue, deprived health condition, attention loss, bad emotional state, and lack of skills. Most of the developed country is ageing. Hence, the drivers above 60 years is also increasing. Ageing results are weakening in cognitive function and threaten driver safety. The aged drivers (age above 60 years) have a comparatively more significant risk of accident due to medical emergency than other factors like bad emotional state and lack of skills. The wellness of drivers’ is considered as a key factor of traffic accidents. Heart failure and non-traumatic disease (i.e., stroke) are the main risk factors for drivers’ death. Many of the victims have no prior knowledge of the presence of the condition. Stroke is a disease caused due to the disturbance in blood supply to the parts of the brain. After experiencing stroke, a driver’s ability to drive is generally affected by the visual, perceptual, motor, and cognitive deficits. Stroke leads to arm weakness, facing dropping, blurred vision, dizziness, coordination issue and speech difficulties of victims which are essential for driving. It is necessary to protect the driver’s those are possibly be the victims for stroke. Since, stroke onset during driving lead a serious threat to the other drivers and the general public. Now-a-days, there are lots of automotive industry competing not only to provide better performance in terms of the vehicle but also to provide the driver with better comfort even in long rides. Automakers are developing vehicle that could provide health monitoring service with Internet of Things (IoT). In IoT, an automobile or vehicle-treated as a “thing”. IoT plays an important role in connected vehicles development. It provide us cloud connectivity, health monitoring, safety and security. Automakers are developing vehicles with IoT enabled including healthcare, accident prevention, vehicle safety, driver safety, driver and passenger comfort, vehicle monitoring, etc. The paper aimed on summarizing the current developments in driver’s health and comfort monitoring through IoT.

Ankyloglossia-Related Speech Articulation Correction in Orthodontics: A Case Report

The ability of the tongue to protrude and elevate is the most crucial characteristic for activities like eating, speaking, nursing, and the development of dental arches. When the lingual frenum is short and tight, it can hinder the movement of the tongue, leading to malalignment of anterior teeth and Speech Articulation. This article discusses a case report of a 20-year-old male patient with a chief complaint of speech difficulty, maxillary anterior teeth spacing, and mandibular anterior teeth crowding. There was lingual frenum attachment suggestive of mild ankyloglossia. Patient underwent a lingual frenectomy pro- cedure under local anaesthesia which resulted in speech correction and relief of lower anterior crowding. Maxillary anterior spacing and midline diastema was corrected with orthodontic mechanotherapy and labial frenectomy, re- spectively. In cases where the frenulum anomaly is severe enough to result in both mechanical and functional limitations, surgery to reduce the frenulum (frenulectomy) is recommended. In consequence, it is fair to state that the chief complaint of inappropriate speech of the patient need to be resolved by an interdisciplinary approach.

Clinical and neuroimaging characterization of the first frontotemporal dementia family carrying the MAPT p.K298E mutation

We present an in-depth clinical and neuroimaging analysis of a family carrying the MAPT K298E mutation associated with frontotemporal dementia (FTD). Initial identification of this mutation in a single clinical case led to a comprehensive investigation involving four affected siblings allowing to elucidate the mutation's phenotypic expression.A 60-year-old male presented with significant behavioral changes and progressed rapidly, exhibiting speech difficulties and cognitive decline. Neuroimaging via FDG-PET revealed asymmetrical frontotemporal hypometabolism. Three siblings subsequently showed varied but consistent clinical manifestations, including abnormal behavior, speech impairments, memory deficits, and motor symptoms correlating with asymmetric frontotemporal atrophy observed in MRI scans.Based on the genotype–phenotype correlation, we propose that the p.K298E mutation results in early-onset behavioral variant FTD, accompanied by a various constellation of speech and motor impairment.This detailed characterization expands the understanding of the p.K298E mutation's clinical and neuroimaging features, underlining its role in the pathogenesis of FTD. Further research is crucial to comprehensively delineate the clinical and epidemiological implications of the MAPT p.K298E mutation.

Impact of a novel pre-hospital stroke notification programme on acute stroke care key performance indicators in Hong Kong: a multicentre prospective cohort study with historical controls.

Early identification and initiation of reperfusion therapy is essential for suspected acute ischaemic stroke. A pre-hospital stroke notification (PSN) protocol using FASE (facial drooping, arm weakness, speech difficulties, and eye palsy) was implemented to improve key performance indicators (KPIs) in acute stroke care delivery. We assessed KPIs and clinical outcomes before and after PSN implementation in Hong Kong. This prospective cohort study with historical controls was conducted in the Accident and Emergency Departments of four public hospitals in Hong Kong. Patients were screened using the PSN protocol between August 2021 and February 2022. Suspected stroke patients between August 2020 and February 2021 were included as historical controls. Door-to-needle (DTN) and door-to-computed tomography (DTC) times before and after PSN implementation were compared. Clinical outcomes including National Institutes of Health Stroke Scale score at 24 hours and modified Rankin Scale score at 3 months after intravenous recombinant tissue-type plasminogen activator (IV-rtPA) were also assessed. Among the 715 patients (266 PSN and 449 non-PSN) included, 50.8% of PSN patients and 37.7% of non-PSN patients had a DTC time within 25 minutes (P<0.001). For the 58 PSN and 134 non-PSN patients given IV-rtPA, median DTN times were 67 and 75.5 minutes, respectively (P=0.007). The percentage of patients with a DTN time within 60 minutes was higher in the PSN group than in the non-PSN group (37.9% vs 21.6%; P=0.019). No statistically significant differences in clinical outcomes were observed. Although the PSN protocol shortened DTC and DTN times, clinical outcomes did not significantly differ.

Bipolar disorder, Deafness and Culturality in Psychiatric Home Hospitalization: A Clinical Case

IntroductionMental health in the deaf community is a complex issue. Challenges in diagnosis and treatment arise from a lack of experienced interpreters and difficulties in translating Sign Language to spoken language. Deaf individuals, due to auditory limitations, are more vulnerable to abuse, increasing their risk of mental health disorders, including bipolar affective disorder (BPAD). BPAD is a prevalent, debilitating condition with varied prevalence estimates. Managing it is tough due to its lifelong, unpredictable nature. A new approach called Psychiatric Home Hospitalization Unit aims to provide acute mental health care at home as an alternative to hospitalization.ObjectivesTo show the management of severe bipolar disorder with comorbidity from a Psychiatric Home Hospitalization UnitMethodsA clinical case of bipolar disorder with deafness attended at the Psychiatric Home Hospitalization Unit of our hospital is presented.ResultsA 24-year-old deaf woman borned in Pakistan and later moving to Catalonia, she faced educational challenges but ultimately completed her studies with sign language support. Afterward, she struggled to find suitable employment, and her family had a history of bipolar disorder.She exhibited a sudden change in behavior, characterized by irritability, paranoia, and distrust. Communication was challenging due to her speech difficulties, but assessments using sign language and observation were conducted. Her physical examination was normal, but her speech was disorganized and pressured, suggesting possible auditory hallucinations and thought disturbances. She was hospitalized and diagnosed with bipolar disorder with psychotic features.During her initial hospitalization, she received lithium, olanzapine, clotiapine and benzodiacepines. After discharge, she continued treatment through a home hospitalization service during almost 4 month. During follow-up she presented a course with high affective instability, rapid cycling alternating brief periods of stability with other presenting manic and mixed features with high disorganization.Due to the rapid cycling pattern Valproic acid was considered. Valproic acid was introduced up to 700 mg/d (97.1 mcg/mL). Treatment with lithium carbonate 800 mg/d (0.91 mEq/L) was maintained. Previous antipsychotic regimen was changed to quetiapine 400mg/d, olanzapine 5mg/d. Her condition improved significantly with the adjusted treatment regimen. She was discharged to an outpatient service.ConclusionsDiagnosing and treating bipolar affective disorder (BPAD) in a deaf and mute patient posed unique challenges. The rapid mood cycling pattern and complexity of her case made treatment challenging. Family information and interpreter support were vital. Cultural factors were considered, and home hospitalization was crucial in managing symptoms that lasted over four months.Disclosure of InterestNone Declared

Case report: Young onset stroke from familial hypercholesterolemia

Introduction. Familial hypercholesterolemia (FH) is a medical condition that leads to extremely high levels of low-density lipoprotein (LDL) cholesterol, increasing the risk of ischemic heart disease, including myocardial infarction. However, the link between FH and ischemic stroke is still debatable. In this case, we report a young adult female who had FH and high levels of LDL and suffered from an early-onset ischemic stroke. Case presentation. A 38-year-old female presented with acute numbness and weakness in her right limb, as well as speech difficulty. She had no history of hypertension, migraine, or diabetes, but did have a history of eyelid xanthoma. The results of the neurological examination confirmed a slightly gradual response, a mild weakness in her right limb, and a slightly reduced response to touch and pain. Laboratory tests showed very high cholesterol and LDL levels, as well as an increased CRP level. Radiological examination via a CT scan revealed lesions within the left frontotemporal region. The patient was prescribed dual antiplatelet therapy and vascular risk factor medication, and after 6 days of treatment, was discharged to go home. Conclusion. We present a case of ischemic stroke in a young patient with clinically diagnosed FH, highlighting the possibility of FH in those with early-onset cerebrovascular disease.

Reference Data for a Quick Speech-in-Noise Hearing Test in the French Language

Introduction: Difficulty in understanding speech in noise is the most common complaint of people with hearing impairment. Thus, there is a need for tests of speech-in-noise ability in clinical settings, which have to be evaluated for each language. Here, a reference dataset is presented for a quick speech-in-noise test in the French language (Vocale Rapide dans le Bruit, VRB; Leclercq, Renard, & Vincent, 2018). Methods: A large cohort (N = 641) was tested in a nationwide multicentric study. The cohort comprised normal-hearing individuals and individuals with a broad range of symmetrical hearing losses. Short everyday sentences embedded in babble noise were presented over a spatial array of loudspeakers. Speech level was kept constant, while noise level was progressively increased over a range of signal-to-noise ratios. The signal-to-noise ratio for which 50% of keywords could be correctly reported (speech reception threshold, SRT) was derived from psychometric functions. Other audiometric measures were collected for the cohort, such as audiograms and speech-in-quiet performance. Results: The VRB test was both sensitive and reliable, as shown by the steep slope of the psychometric functions and by the high test-retest consistency across sentence lists. Correlation analyses showed that pure tone averages derived from the audiograms explained 74% of the SRT variance over the whole cohort, but only 29% for individuals with clinically normal audiograms. SRTs were then compared to recent guidelines from the French Society of Audiology [Eur Ann Otorhinolaryngol Head Neck Dis. 2022;139(1):21–7]. Among individuals who would not have qualified for hearing aid prescription based on their audiogram or speech intelligibility in quiet, 18.4% were now eligible as they displayed SRTs in noise impaired by 3 dB or more. For individuals with borderline audiograms, between 20 dB HL and 30 dB HL, the prevalence of impaired SRTs increased to 71.4%. Finally, even though five lists are recommended for clinical use, a minute-long screening using only one VRB list detected 98.6% of impaired SRTs. Conclusion: The reference data suggest that VRB testing can be used to identify individuals with speech-in-noise impairment.

MANAGEMENT OF BELL’S PALSY - A CASE REPORT

Bell’s palsy is a disease affecting one side of the facial muscles abruptly due to compression or inflammation of the facial nerve. This case study explores the clinical presentation and Ayurvedic management of a 52-year-old female patient presenting with symptoms consistent with Bell's palsy, termed as Sopha/Kapha Anubanda Arddita in Ayurveda. The patient exhibited sudden onset facial deviation, speech difficulty, and other associated symptoms. The diagnosis was primarily clinical, supported by classical symptoms of Ardita and Bell's palsy. Treatment involved a combination of Kaphahara/Sophahara medications followed by Vatahara medicines, alongside specific therapeutic procedures tailored to address the underlying doshic imbalances. Critical interventions included the administration of Amrutotharam Kashayam, topical applications of Lepana, and Nasya with Ksheerabala Taila 101 Avartti, among others. The patient showed significant improvement in symptoms and motor functions over a 14-day inpatient treatment period, demonstrating the efficacy of Ayurvedic interventions in managing acute onset LMN Facial palsy. This case underscores the importance of individualised treatment approaches and the potential of Ayurveda in addressing complex neurological conditions.

The Impact of Non-Seizure Symptoms in Dravet Syndrome and Lennox–Gastaut Syndrome

Dravet syndrome (DS) and Lennox–Gastaut syndrome (LGS) are developmental and epileptic encephalopathies (DEE) that onset in childhood, and persist lifelong. In both, non-seizure symptoms (NSS) include intellectual disability, psychiatric symptoms, speech and communication difficulties, motor and gait difficulties, appetite and eating difficulties, autism spectrum characteristics, attention deficit hyperactivity disorder, and sleep disorders. The NSS impact health-related quality of life (HRQoL) for the affected individual and the caregiver, considering personal time, sleep, finances, energy, and family and social relationship. In this industry-sponsored symposium, three leading ex-perts in DEEs discussed NSS, and how properly assessing and tracking these can lead to more informed understanding of an individual’s needs. This can help to guide treat-ment for NSS and, subsequently, increase HRQoL for both the individual and their caregivers.

The Effectiveness of Neuro-Linguistic Programming Techniques in Reducing Students’ EFL Oral Disfluencies

This study aimed to investigate the effectiveness of Neuro-Linguistic Programming techniques (NLP) in reducing EFL oral disfluencies among second-level students in the Department of English, Faculty of Education-Tooralbaha, University of Lahej. A sample of 40 students from the second level of the second semester in the academic year 2021-2022 was selected with a focus on ensuring homogeneity based on their previous grade sheet of speaking skills. The sample was then divided into two groups: an experimental group consisting of 20 students and a control group of the other 20 students. To achieve the study’s objectives, a pre-test was conducted to measure the oral disfluencies of both the experimental and control groups. Following that, a training program based on NLP techniques was administered to the experimental group over sixteen training sessions during eight weeks. Subsequently, a post-test was conducted to measure the oral disfluencies of both groups to collect the data needed. After conducting appropriate statistical analysis, the findings emphasized the effectiveness of the NLP techniques in reducing instances of students’ oral disfluencies such as pauses and repetitions. These findings emphasize the value of integrating NLP techniques into language teaching and learning providing a practical means to address speech difficulties and cultivate greater fluency and confidence among EFL students. Based on these findings, the researcher has formulated a series of recommendations to leverage NLP in various educational domains.