High Prevalence Of Hearing Impairment Research Articles

Состояние слуховой функции у детей-воспитанников детских домов, эвакуированных из зоны военных действий

In this study, the structure and frequency of hearing impairment in children who lived at various times in the territories of military operations were studied. The high prevalence of otorhinolaryngological diseases, combined with low detectability, entails formidable complications, leads to a decrease in the quality of life of the child and the family as a whole, and negatively affects the general level of public health. In total, during the study, 398 children aged 5 to 16 years old were examined, who were in the temporary accommodation center of the Romashka children’s resting camp. The children are students of orphanages in the Donetsk People’s Republic (DPR) and the Luhansk People’s Republic (LPR) evacuated from the war zone in the first days of the Special Operation. There were 216 girls (54.3%) and 182 boys (45.7%) among them. The average age of children was 8.5 years. Hearing loss was detected in 33 children (8.3%). Two children (0.5%) had a severe form of sensorineural hearing loss of 3–4 degrees. Two children (0.5%) had a mild form of sensorineural hearing loss of 1–2 degrees. Four children (1%) had unilateral chronic sensorineural hearing loss. The diagnosis of otitis media with effusion was established in 20 children (5%), tubo-otitis, in three patients (0.8%). Suspicion of an anomaly in the development of the middle ear, in 2 children (0.5%). Examination of children in orphanages evacuated from the DPR and LPR did not reveal a high prevalence of hearing impairment. Sensoneural hearing loss: 2%, conductive hearing loss: 6.3%. The results of the work demonstrate a wide potential for improving hearing health in the examined children. Active diagnostics of hearing pathology is shown to all children in orphanages. After treatment of conductive hearing pathology, mandatory audiological monitoring is indicated, despite the subjective improvement in hearing.

Comparison of Hearing Impairment among Healthy and High-risk Neonates at a Tertiary Care Hospital, Rajasthan, India: A Cross-sectional Study

Introduction: Hearing impairment is caused by damage in the inner ear (can be even birth defect), ear infection, ruptured eardrum and so on. It can be prevented using early detection thus, helps in avoiding severe psychosocial, educational, and linguistic repercussions. Infants, who are not diagnosed of hearing impairment before six months of age, will have delays in speech and language development. Aim: To determine the prevalence of hearing impairment in highrisk neonates and to establish the fact that, these neonates have higher prevalence of hearing impairment as compared to normal population. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics at Jawaharlal Nehru Medical College and Hospital, Ajmer, Rajasthan, India. The duration of the study was six months, from December 2012 to May 2013. A total of 500 babies including 297 normal and 203 high-risk babies were enrolled into the study. All the neonates were screened using Behavioural Observation Audiometry (BOA) and Distortion Product Oto-acoustic Emission (DPOAE) preferably within three days of life. Those, who failed under this test, underwent for Brain stem Evoked Response Audiometry (BERA). Data was collected in the Microsoft Excel and analysis done by Statistical Package for Social Sciences (SPSS) version 23.0. Results: The mean age of the newborns on admission, was 3.86±4.25 days and the mean weight was 2560±510 g. Out of 500 newborns screened, 58 babies had abnormal results with the first screening test. When these 58 babies subjected to BERA, eight babies showed Hearing Loss (HL). Sepsis, Neonatal Intensive Care Unit (NICU) stay >5 days and use of aminoglycosides >7 days were the important risk factors associated with hearing impairment. Prevalence of hearing impairment in the present study was came out to be 16/1000. This finding was statistically significant with p-value<0.05. Conclusion: There was high prevalence of hearing impairment in high-risk newborns, majority of which were bilateral. The authors recommend multistage screening in all newborns at birth or within month’s time at all level of healthcare facility. Newborns with sepsis, NICU stay >5 days and use of aminoglycosides >7 days should have mandatory audiologic evaluation at discharge.

Functional Characterization of the MYO6 Variant p.E60Q in Non-Syndromic Hearing Loss Patients.

Hereditary hearing loss (HHL) is a common genetic disorder accounting for at least 60% of pre-lingual deafness in children, of which 70% is inherited in an autosomal recessive pattern. The long tradition of consanguinity among the Qatari population has increased the prevalence of HHL, which negatively impacts the quality of life. Here, we functionally validated the pathogenicity of the c.178G>C, p.E60Q mutation in the MYO6 gene, which was detected previously in a Qatari HHL family, using cellular and animal models. In vitro analysis was conducted in HeLa cells transiently transfected with plasmids carrying MYO6WT or MYO6p.E60Q, and a zebrafish model was generated to characterize the in vivo phenotype. Cells transfected with MYO6WT showed higher expression of MYO6 in the plasma membrane and increased ATPase activity. Modeling the human MYO6 variants in zebrafish resulted in severe otic defects. At 72 h post-injection, MYO6p.E60Q embryos demonstrated alterations in the sizes of the saccule and utricle. Additionally, zebrafish with MYO6p.E60Q displayed super-coiled and bent hair bundles in otic hair cells when compared to control and MYO6WT embryos. In conclusion, our cellular and animal models add support to the in silico prediction that the p.E60Q missense variant is pathogenic and damaging to the protein. Since the c.178G>C MYO6 variant has a 0.5% allele frequency in the Qatari population, about 400 times higher than in other populations, it could contribute to explaining the high prevalence of hearing impairment in Qatar.

Deafness and Diabetes Mellitus: A Systematic Literature Review

Introduction Diabetes mellitus cases are increasing worldwide. It affects almost all systems of the body including audio-vestibular system. Diabetic otopathy (DO) is the presence of symptoms and signs of vestibular and auditory disorders in patients with diabetes mellitus after the exclusion of other causes. In this review we aimed to study the mechanism of development of hearing loss in diabetes, the relationship between duration and severity of diabetes, and association of other complications with hearing loss. Materials and Methods We searched the MEDLINE & PubMed database using terms ‘diabetic otopathy’ and ‘diabetes & hearing loss’ for the articles published since 1970. Twenty articles were selected and reviewed. Results The mechanism of development of DO is not yet clearly known. But it is suggested to be multifactorial. This review of literature suggested that hearing impairment is two times more prevalent in subjects with diabetes as compared to those without diabetes. The relationship between diabetic otopathy and diabetic kidney disease is most commonly noticed. Conclusion The higher prevalence of hearing impairment in diabetic patients compared with nondiabetic patients was consistent. It is necessary to establish a screening and monitoring strategy for patients with diabetes mellitus to prevent the development of hearing loss and its consequences on life quality.

Prevalence of hearing loss in India.

Background Despite abundant literature, a clear and coherent understanding of hearing loss (HL) in India is limited by the wide disparity in studies. Methods We did a review of published peer-reviewed journal articles. Studies reporting the prevalence and degree of HL in India from 1980 to 2020 were included. Information was gathered on the population characteristics, methodology applied and the prevalence of hearing impairment. The data were analysed to identify trends and at-risk sections of population in various categories. Results Four hundred and forty studies were identified after a database search; 29 full-length articles were selected for final analysis. Using a 3-step screening protocol, hearing impairment (abnormal auditory brainstem response/auditory steady state response) in neonates ranged between 1.59 and 8.8 per 1000 births. Among 'at risk' neonates, it ranged from 7 to 49.18 per 1000 births. In children the prevalence of HL was 6.6% to 16.47%. Otitis media was the most common cause of HL in children. Community-based studies (all ages) reported prevalence of HL between 6% and 26.9% and prevalence of disabling HL between 4.5% and 18.3%. Rural areas and elderly showed a higher prevalence of hearing impairment. Conclusion Despite India's improving health indices, hearing disability remains persistently high. It is a major contributor to the loss of personal potential and a financial strain for the individual and the country. A large-scale multicentric study to identify the degree and type of HL, social awareness campaigns, widespread neonatal screening, strengthening treatment facilities and well-funded rehabilitation programmes can counter the rising prevalence of hearing impairment.

Meniere's disease-like symptoms in 22q11.2 deletion syndrome

22q11.2 deletion syndrome (22q11.2DS) caused by a microdeletion on the long arm of chromosome 22, is characterized by congenital heart disease, hypoparathyroidism, immunodeficiency, developmental delay, and velopharyngeal insufficiency. Anatomic malformations of the middle and inner ears are frequently present, leading to high prevalence of hearing impairment. We present a first case of 22q11.2DS showing fluctuating hearing loss with recurrent vertigo attacks, resembling Ménière's disease.

Comparison of prevalence of various ENT diseases and hearing impairment among children of government schools versus private schools of Mardan

Background: School children are frequently afflicted with ENT diseases. The diseases and their associated complications, especially hearing impairment, can be devastating to the children and families alike. Socioeconomic status of children can have strong effect on frequency of various ENT diseases. The objective of this study is to compare the frequency of various ENT diseases among children studying in government schools versus those in private schools of district Mardan.
 Subjects and methods: A cross-sectional descriptive study was carried out at Mardan from July to December 2019. The researchers visited four schools (two government and two private schools) in Mardan district. Relevant history was obtained and physical examination was done to find out the frequency of various ENT diseases. The data variables (age, gender, ENT diseases, hearing impairment) were noted in research Performa and data was entered and analysed in SPSS 21 software. Frequencies were determine for age, gender and ENT diseases. Independent t-test was used to analyze quantitative variables, while Chi-square was used to analyze qualitative variables. A p-value less than 0.05 was taken as significant.
 Results: Total 2986 children were examined in 4 schools. The mean age of the children was 11 years. There were 56% boys and 44% girls. Total 2106 children were examined in two government schools and 880 children were examined in two private schools. The frequency of impacted cerumen was 18.4% (21.2% of government school children versus 11.4% of private school children; p<0.05). Frequency of allergic rhinitis was 9.7% (9.5% of government school children versus 10.1% of private school children; p=0.635). The frequency of chronic suppurative otitis media (CSOM) in government school children was 4.9% versus 2.5% among those in private schools (p<0.05). In this study cumulative prevalence of hearing impairment was 26.8%, where prevalence in government school children was 30.9% versus 17.2% in private schools (p-value<0.001). The causes of hearing impairment were impacted ear cerumen (68.3%), CSOM (15.7%), otitis externa (6.2%), OME (4.1%), otitis media (2.8%), congenital ear deformities (1.6%) and foreign bodies in ear (1.2%). The main causes of hearing impairment in majority of children were impacted cerumen and CSOM in 84% children.
 Conclusion: Various ENT diseases like impacted cerumen, rhinosinusitis, allergic rhinitis, pharyngitis, tonsillitis and CSOM are common in school going children. Impacted cerumen and CSOM are significantly more prevalent in government school children as compared to private schools which are primary cause of hearing impairment in children leading to significantly high prevalence of hearing impairment in government school children

Audiological and otologic manifestations of glutaric aciduria type I

BackgroundGlutaric aciduria type 1 (GA-1) is a rare disease connected with speech delay and neurological deficits. However, the audiological and otologic profiles of GA-1 have not yet been fully characterized. To our knowledge, this is the largest study of comprehensive audiological and otologic evaluation in patients with GA-1 to date.MethodsThirteen patients diagnosed with GA-1 between January 1994 and December 2019 with audiological, radiological and genetic manifestations were retrospectively analyzed. Hearing tests were performed in all patients. MRI was performed for radiological evaluation.ResultsHearing loss was found in 76.9% (10/13) of GA-1 patients, including slight hearing loss in 46.1% (6/13) of patients, mild hearing loss in 15.4% (2/13) of patients, and moderate hearing loss in 7.7% (1/13) of patients. Normal hearing thresholds were seen in 23% (3/13) of patients. Patients with intensive care unit (ICU) admission history showed significantly worse hearing than those without (29.17 ± 12.47 vs 13.56 ± 3.93 dB HL, 95% CI 2.92–24.70, p = 0.0176). One patient had moderate sensorineural hearing loss and a past history of acute encephalopathic crisis. No usual causative gene mutations associated with hearing loss were found in these patients. MRI showed a normal vestibulocochlear apparatus and cochlear nerve. One patient with extensive injury of the basal ganglia on MRI after acute encephalopathic crisis was found to have moderate sensorineural hearing loss. Two patients with disability scores above 5 were found to have mild to moderate hearing impairment. No obvious correlation between macrocephaly and hearing loss was found.ConclusionA high prevalence of hearing impairment is found in GA-1 patients. Adequate audiological evaluation is essential for these patients, especially for those after encephalopathic crises or with ICU admission history.

Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

ObjectiveSensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. DesignCross-sectional study nested in the 2017 “Delirium Day” project. Setting and ParticipantsPatients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. MethodsDelirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). ResultsA total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2–2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1–1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6–1.2, P = .36; OR 1.1; CI 0.8–1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6–1.2, P = .27; OR 1.1, CI 0.8–1.4, P = .63). Conclusions and implicationsOur findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.

High Prevalence of Hearing Impairment in Primary Congenital Hypothyroidism

Background: An association between hearing impairment (HI) and congenital hypothyroidism (CH) has been reported previously. However, in general, studies were retrospective and had small sample sizes, and the results were variable and inconclusive. The aim of our study was to assess the prevalence of HI among patients with CH and to examine factors potentially predictive of HI including severity of CH, etiology of CH, and timing of treatment initiation. Methods: Audiometry was undertaken prospectively in 66 patients aged 3–21 years diagnosed with primary CH and 49 healthy matched controls. All patients with HI underwent examination by an otolaryngologist, and in patients with sensorineural loss, brainstem evoked response audiometry was performed. A next-generation sequencing (NGS) panel for genes involved in deafness was performed in patients with sensorineural HI to exclude additional genetic etiologies. Results: HI was found in 19 patients (28.7%). Among them, 5 (7.6%) had moderate to severe bilateral sensorineural impairment and 14 (21.2%) had mild conductive HI. Conductive HI was bilateral in 5 of these patients (36%). None of the controls had HI. No specific etiology was found in patients with HI, and no differences were identified in age at diagnosis, age at initiation of levothyroxine (LT₄) therapy, gender, or ethnicity between patients with and without HI. A nonsignificant trend toward lower mean screening TT₄ levels was found in patients with HI (compared to those without HI) (3.42 vs. 5.34 μg/dL, p = 0.095). No pathogenic variants in genes attributed to HI were identified by NGS in the 5 patients with sensorineural deafness, indicating that HI in these patients was likely attributable to CH rather than other genetic etiologies. Conclusions: Our findings indicate a high prevalence of HI among patients with CH, predominantly of the conductive type. HI was not associated with the etiology of CH or with delayed initiation of LT₄ therapy. Audiometry is recommended for children diagnosed with CH and repeat monitoring may be warranted to identify acquired HI and to prevent long-term sequelae of undiagnosed deafness.

Hearing loss and hearing needs in an adult homeless population: a prospective cross-sectional study

Given that hearing loss is associated with increased social isolation, reduced earning potential and neurocognitive disease, findings of uncorrected hearing loss in the homeless population have important policy implications. We sought to estimate the prevalence of hearing impairment in an adult homeless population. We recruited adult (age ≥ 18 yr) homeless people across 10 homeless shelters in Toronto between April and June 2018 using a 2-stage sampling technique. Participants were interviewed by 1 interviewer using a modified survey that had been used in previous studies looking at other health needs in homeless populations. A comprehensive head and neck examination and audiometric evaluation were performed in each participant by an otolaryngologist and an audiologist. Descriptive statistics were estimated. Audiometric data were standardized directly for age and sex to facilitate direct comparisons with the general Canadian population. Of the 132 people invited, 100 (75.8%) agreed to participate. The median age was 46 (interquartile range [IQR] 37-58) years. The median duration of homelessness was 24 (IQR 6-72) months. Although most participants (78) had some form of extended health care benefits through social assistance, only 22/78 (28%) were aware that hearing tests and hearing aids were covered through these programs. After direct standardization for age and sex, the proportions of participants with a speech-frequency and high-frequency hearing loss were 39.5% (95% confidence interval [CI] 30.4%-49.3%) and 51.9% (95% CI 42.2%-61.4%), respectively. Nineteen participants were hearing aid candidates, only 1 of whom owned functional hearing aids. Rates of speech-frequency hearing loss (39.5%, 95% CI 30.4%-49.3% v. 19.2%, 95% CI 16.9%-21.7%) and high-frequency hearing loss (51.9%, 95% CI 42.2%-61.4% v. 35.5%, 95% CI 33.1%-37.7%) were substantially higher than in the general Canadian population. Our results suggest that homeless adults have a high prevalence of hearing impairment, even when living within a system of universal health insurance; awareness of health care benefits through social assistance programs was poor. Results from this study may prompt initiatives surrounding homeless outreach and health screening.

Role of parental socio-educational factors on prevalence of paediatric otological disorders

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Parental socioeconomic status, often designated by education and occupation is likely to have significant implications in children’s otological health. Hence the present school screening study was formulated in an attempt to establish the role of these factors on the prevalence of various ear diseases and related hearing impairment in children.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 346 lower primary school children, in the age group of 5-10 years were included in this cross sectional study.&lt;strong&gt; &lt;/strong&gt;Details pertaining to the socioeconomic background of children were collected by questionnaire method. All children were initially evaluated by otoscopy and tuning fork testing and those having equivocal or abnormal tuning fork test results were subjected to pure tone audiometry and tympanometry. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; There was significantly higher prevalence of hearing impairment among children of mothers with lower maternal educational status (13.2% versus 6.3%, (p=0.04, Odds ratio (95% CI) 2.27 (1.004-5.13)). Normal ear findings were noticed significantly higher among children with higher paternal (62.3% versus 47.7%) and maternal (59.1% versus 45.7%) educational status.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Favourable parental socio-educational factors, especially maternal education have a significant positive impact on children’s otological health.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Communication Disorders among Children in a Developing Country, Nigeria

Background: Communication disorders in children are an invisible disability posing challenges to otorhinolaryngologist in developing countries. The aim of this study was to determine the prevalence, sociodemographic features, aetiology, types of communication disorders among under 18 years children attending our facility. Methods: This was a prospective study conducted in ear, nose and throat department in a Nigerian university teaching hospital, from June 2014 to May 2019. Data were obtained by using pretested interviewers assisted questionnaires from consented patients and analyzed using SPSS version 20.0. Results: Prevalence of communication disorder was 16.1%. Male was 68.2% with male to female ratio of 2.1:1. Communication disorder is commoner in first child 58.1% and detected by mother in 70.5% cases. Major cause was due to infection in 68.2%. Large percentage of communication disorder were language disorder in 60.8% and speech disorders which constitute 39.2% with associated varying degrees of hearing impairment in 78.8% of them. Sensorineural hearing impairment was noted in 69.6% cases. Language disorders were delayed speech &amp; language, mutism and specific language impairment in 22.6%, 16.6% and 14.7% respectively. Major speech disorder was articulation problem in 15.7%. Main sources of referral were 52.5% from paediatrician while 30.9% was from general practitioners. Conclusions: There was high prevalence of communication disorder which was associated with high prevalence of hearing impairment. The major causes were infection with inadequate obstetrics management.

Risk Indicators for Hearing Impairment in Neonates

To identify relation between prevalence of hearing impairment and risk factors at the time of birth in high risk neonates. A year-long study is performed at HBT Medical College and Dr. R. N. Cooper Municipal General Hospital, Vile Parle (west), Mumbai. The Study comprised of 478 high risk babies born between March 2016 and February 2017 and admitted in NICU of the hospital. Out of these 68 babies were either transferred to higher centre or took discharge against medical advice. A total of 410 babies completed the study. Additional 21 eligible babies died in NICU during the study. A Prospective Observational Study is used to analyse the findings of the study. Skew analysis of spread of prevalence across risk factors is used to establish higher prevalence of hearing impairment in high risk neonates. Cramer's Moment Coefficient of Skewness and Corresponding Test Statistics are used for studying the skewness. Out of 410 babies screened during the study 5 babies were diagnosed with profound SNHL. The risk factors associated with babies is plotted against frequency of babies with Profound SNHL. The plot is found to be un-uniformly distributed and shows inclination towards higher prevalence with high risk babies. Sample skewness (G1) value - 0.81 indicates moderately negative skewed sample. This means the number of babies with profound SNHL found by 3 stage screening is moderately concentrated at high risk weightage.

Screening of Hearing Impairment in High-Risk Neonates: A Study at Dr. R.N. Cooper Hospital and H.B.T. Medical College

Abstract Introduction The aim of this study was to find out the prevalence of hearing impairment in high-risk neonates born in Dr. R.N. Cooper Hospital and H.B.T Medical College and establish the fact that high-risk neonates have higher prevalence of hearing impairment compared with normal population. Materials and Methods A prospective observational study was conducted over a period of 1 year starting from March 2016 and involved three-stage screening of 410 neonates admitted to neonatal intensive care unit of Dr. R.N. Cooper Municipal General Hospital and H.B.T Medical College, Vile Parle (west), Mumbai. All enrolled neonateswere screened by a three-stage screening mechanism. First otoacoustic emission (OAE-1) screening was done within 24 to 72 hours of birth. Parents of neonates referred by OAE-1 were instructed to come back within 28 days for repeat OAE test (OAE-2). Those referred by OAE-2 were asked to come back after further 2 months for brainstem-evoked response audiometry. Data collected in the study were processed using Microsoft Excel. Results and Conclusion In the current study, out of 410 neonates who were screened by a three-stage screening mechanism, five including three girls and two boys were found to be suffering from profound sensorineural hearing loss. Observed prevalence of 12.20 (or 12 on rounding off to nearest digit) per 1000 in high-risk neonates is much higher compared with the prevalence of 1 to 6 per 1000 live births in overall population as reported by the American Speech-Language-Hearing Association.

SAT-216 Prevalence of Endocrine, Gynecological and Other Medical Conditions Among Adult Women with Turner Syndrome

Background: In addition to short stature and ovarian insufficiency, women with Turner syndrome (TS) are at increased risk for multiple chronic health conditions, especially as they age. Reports describing the presence of comorbidities in older adult women with TS are limited. The objective of this study was to examine the prevalence of endocrine, gynecological, and other chronic medical conditions in a large cohort of adult TS patients. Methods: We performed a retrospective chart review of women with TS attending our adult TS clinic jointly run by gynecology and endocrinology at a university-based ambulatory hospital in Toronto, Canada. All patients had a diagnosis of TS based on karyotype testing and attended at least one clinic visit between February 1, 2015 and July 1, 2018. Data were collected from electronic medical records and included information on patients’ medical conditions, results of screening and blood tests and clinical measurements. Prevalence of diseases was determined for the whole cohort and stratified by age, <40 and ≥40 years. Statistical comparison between older and younger woman was done using the chi-square test. Results: We identified 122 adult women with TS. The mean age was 37.7 years (range: 19-68), and 40.2% were > 40 years of age at clinic visit. The mean age at diagnosis was 11.4 years. The mean height of was 146.8cm (+/-8.06) and the mean BMI was 27.1 (+/-6.24). The majority of patients (84.4%) were on hormone therapy, with the most common type being the oral contraceptive pill (47.6%). Regarding endocrine conditions, 24.5% had hypothyroidism, 16% had dysglycemia (either diabetes or pre-diabetes), and 27.9% had decreased bone mass (either osteoporosis, osteopenia or low bone density). The prevalence of hypothyroidism and dysglycemia were significantly higher among older women (hypothyroidism 36.7% age ≥ 40 vs. 17.8% age < 40, p=0.018; dysglycemia 24.5% age ≥ 40 vs. 5.5% age <40, p= 0.023). Gynecological conditions were identified in 35% of overall patients and were significantly higher among older women (42.8% age ≥ 40 vs. 13.7% age < 40, p=0.0028). With regards to other medical conditions, 41% had hearing impairment, 36.1% had cardiac abnormalities, 18.8% had renal abnormalities and 9% had celiac disease. Women > 40 years had a higher prevalence of hearing impairment (59.1% age > 40 years vs. 28.8% age < 40 years, p=0.0008), while the prevalence of cardiac, renal abnormalities and celiac disease was similar between age groups. Conclusions: The results of this study indicate a high prevalence of medical and gynecological conditions in women with TS, especially those > 40 years of age. This cohort is unique given the older age of our patients as well as the high burden of comorbid disease that we identified. Our study further underscores the importance of multidisciplinary adult TS clinics for monitoring and screening women with TS for comorbidities throughout adulthood.

Contributing factors to high prevalence of hearing impairment in the Elias Motsoaledi Local Municipal area, South Africa: A rural perspective.

BackgroundThere is evidence that the factors contributing to the prevalence and aetiology of hearing impairment vary widely from one country to another. In South Africa, as in other low-income and middle-income countries, more context-specific information on the estimated prevalence of hearing impairment and the factors that contribute to its onset is required.AimThe aim of this study was to provide decision-makers and hearing health professionals with local and accurate information on the prevalence of ear and hearing disorders in the Elias Motsoaledi Local Municipal (EMLM) area of the Limpopo province, South Africa.MethodsThe World Health Organization (WHO) protocol for population-based surveys of prevalence and causes of deafness, hearing impairment and other ear diseases was utilised. A random multi-stage cluster sampling strategy, two-stage sampling, was utilised to select the seven municipal wards and 357 households through the probability proportional to size method. A total of 850 participants were included in the study.ResultsThe overall prevalence of hearing impairment was 19.88% (95% confidence interval [CI]: 0.15–0.2) and 8.94 (95% CI: 0.08–0.12) for disabling hearing impairment. The prevalence of ear disease was 13.19% (95% CI: 0.10–0.15), with impacted cerumen and otitis media reported most often. Associations with hearing impairment were established for age, gender and hypertension.ConclusionThe study has shown a higher prevalence of disabling hearing impairment in the rural EMLM area of the Limpopo province compared to global prevalence rates. In addition, known factors associated with hearing impairment were confirmed.

Association between self-reported hearing impairment and diabetes: a Brazilian population-based study

BackgroundSome studies have already explored the relationship between diabetes and hearing loss; however, this relationship has still not been well established, especially due to methodological limitations related to lack of control for confounders. The aim of this study was to analyze the association between self-reported hearing impairment and diabetes among adults in Brazil, controlling for sociodemographic and occupational exposure to ototoxic agents.MethodsThis is a cross-sectional study based on data collected by the National Health Survey of 2013 in Brazil. A total of 60,202 individuals aged≥18 years were interviewed. Crude and adjusted prevalence ratios were calculated using the Poisson regression model with robust estimation of the variance. All analyzes were performed considering the appropriated weights imposed by the complex sample design.ResultsHearing loss prevalence was 2.56% (95%CI: 2.34–2.79). It was higher in males, older age groups, white and individuals with lower levels of schooling. Diabetes was positively and significantly associated with hearing loss in the crude analysis (PRcrude = 2.92; 95%CI: 2.75–3.11) and also in the analysis adjusted for gender, age, skin color, schooling, smoking, alcohol consumption and occupational exposure (PRadj = 1.46; 95%CI: 1.32–1.61).ConclusionsThe present results suggest that individuals with diabetes have higher prevalence of hearing impairment. There is the need of longitudinal studies to investigate if diabetes is a risk factor to hearing impairment.

Prevalence of hearing impairment in Aligarh: a community based study

Background: Hearing impairment is avery complex phenomenon, which has many and serious consequencesfor people and involves many factors and issues that should becarefully examined. The objective of the study were to estimate the prevalence of hearing impairment in the study population.Methods: Study design was a community based cross sectional study. Setting was on field practice areas of the urban and rural health training centers, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh. No. of Participants was 422 study subjects age 18 and above 18 years; Systematic random sampling and proportionate to population size method (PPS). Statistical analysis was carried out using SPSS version 13; Chi-square.Results: Overall prevalence in present study population was found to be 23.1%. The prevalence in the rural areas (24.8%) was found to be higher than that of the urban areas (20.5%). The age specific prevalence showed that the maximum prevalence was in the age group of more than 70 years (66.6%). In the rural areas the prevalence was highest in the &gt;70 year age group(75%) while in the urban areas it was maximum in the 61-70 year age group(61.5%). The prevalence was least in the 31-40 year age group in both urban (5.4%) as well as rural areas (14.5%). The association of hearing loss with age was found to be highly significant.Conclusions:A high prevalence of hearing impairment was found in the study. Increasing prevalence of hearing impairment was observed with advancing age.

Psychosocial hearing disadvantage and associated factors among construction workers in Mato Grosso, Brazil.

To estimate the prevalence and to analyze the factors associated with self-reported hearing handicap by construction workers in the state of Mato Grosso, Brazil. A cross-sectional study was conducted with 866 construction and heavy construction workers. Participants responded to an epidemiological survey subdivided in: identification data, sociodemographic data; lifestyle; work environment characteristics; occupational exposure factors; hearing protection measures; and hearing handicap inventory to quantify the psychosocial consequences of work-related hearing loss. The prevalence of hearing impairment among workers in the construction sector was 14.43% (n = 125). There were 311 emotional and social complaints related to hearing problems. Hearing handicap was associated with: 60 or over age group (PR = 1.94, 95%CI 1.01 - 3.71); alcohol consumption (PR = 1.94, 95%CI 1.38 - 2.73); direct exposure to noise (PR = 1.75; 95%CI 1.03 - 2.97); exposure to dust (PR = 1.59, 95%CI 1.13 - 2.24); non-use of earplugs (PR = 1.39, 95%CI 1.00 - 1.93); and non-use of neck flap cap (PR = 1.52, 95%CI 1.09 - 2.13). We observed a high prevalence of hearing impairment among workers in the construction sector associated with: individuals aged 60 years or older; alcoholism; exposure to noise and dust; non-use of earplugs; and non-use of neck flap cap. Therefore, it is necessary to implement policies aimed at preserving the hearing health of construction and heavy construction workers.