Use Of Ototoxic Drugs Research Articles

Hearing Impairment in Babies Born to Mothers with Gestational Diabetes Mellitus

Introduction: The earlier the hearing loss in a child, the more difficult will it be for the child to achieve optimal development and lead a normal life. This study is directed toward early identification of deafness in neonates born to gestational diabetic mothers that help in the early rehabilitation of the child. Materials and Methods: Around 50 infants born to mothers with gestational diabetes were taken and screened after obtaining consent from parents and clearance from the ethics committee. Neonates born to gestational diabetic mothers in Father Muller Medical College were included. Critically ill neonates, neonates with hyperbilirubinemia, family history of deafness, use of ototoxic drugs, and low APGAR score babies (<6) were excluded. Detailed family history and information of the patients were obtained. The occupation of both parents, family income, and consanguinity was noted. It was also observed if the antenatal mother has attended ANC clinic regularly. Results: A longitudinal descriptive study was conducted on 50 infants born to gestational diabetic mothers. Hearing loss was assessed using distortion product otoacoustic emission. The majority of gestational diabetic mothers were homemakers followed by salesgirls. The other occupations also included Anganwadi workers, beedi workers, manual laborers, tailors, and farmers. The list also included cooks, hotel receptionist, office assistant, and floor manager. Most of the fathers were drivers ( n = 10) followed by farmers. The list also included fishermen, manual laborers, painters, salesmen, security personnel, waiters, tailors, teachers, office assistants as well as storekeepers. Conclusion: Our study assessed if there was a correlation between hearing loss in infants and gestational diabetes. Hence, in our study, we found that there may not be any relationship between hearing loss and diabetes in pregnancy.

Identification of Druggable Binding Sites and Small Molecules as Modulators of TMC1.

Our ability to hear and maintain balance relies on the proper functioning of inner ear sensory hair cells, which translate mechanical stimuli into electrical signals via mechano-electrical transducer (MET) channels, composed of TMC1/2 proteins. However, the therapeutic use of ototoxic drugs, such as aminoglycosides and cisplatin, which can enter hair cells through MET channels, often leads to profound auditory and vestibular dysfunction. Despite extensive research on otoprotective compounds targeting MET channels, our understanding of how small molecule modulators interact with these channels remains limited, hampering the discovery of novel compounds. Here, we propose a structure-based screening approach, integrating 3D-pharmacophore modeling, molecular simulations, and experimental validation. Our pipeline successfully identified several novel compounds and FDA-approved drugs that reduced dye uptake in cultured cochlear explants, indicating MET modulation activity. Molecular docking and free-energy estimations for binding allowed us to identify three potential drug binding sites within the channel pore, phospholipids, and key amino acids involved in modulator interactions. We also identified shared ligand-binding features between TMC and structurally related TMEM16 protein families, providing novel insights into their distinct inhibition, while potentially guiding the rational design of MET-channel-specific modulators. Our pipeline offers a broad application to discover small molecule modulators for a wide spectrum of mechanosensitive ion channels.

Evaluation of Subjective Tinnitus Severity and Distortion Product Otoacoustic Emissions and Extended High-Frequency Audiometry.

Tinnitus is a multifactorial phenomenon with quality-of-life detriments for those affected by it. We aim to establish a relationship between subjective tinnitus severity with objective audiometric data in the extended high frequency (EHF) from 9 to 16 khz and with distortion product otoacoustic emissions (DPOAE). We hypothesize that severe subjective tinnitus as measured by the Tinnitus Handicap Inventory (THI) does not correlate with increased hearing thresholds in the EHF range. Prospective. Single Tertiary Care Center. Patients identified with tinnitus and normal hearing thresholds within standard frequency range (250-8000 Hz) were consented for participation. Those with underlying otologic disease, trauma, radiotherapy, or ototoxic drug use were excluded. The THI questionnaire was given to eligible patients and audiometric test results were collected. THI scores were categorized by severity groups. An n = 20 to 30 was determined to have an effect size of 0.7 with a significance level of P = .05. THI and audiometric data were collected for 38 patients and categorized into mild (n = 18, 47.4%), moderate (n = 8, 21.1%), slight (n = 7, 18.4%), and severe (n = 5, 13.2%) tinnitus severity groups. Mean THI score was 32.3 ± 19.6 with a statistically significant difference in scores by assigned THI severity group (P < .01). There were no significant differences or linear relationship among hearing thresholds in EHF range or DPOAE stratified by subjective tinnitus group (P = .49, r2 = 0.10) CONCLUSION: Subjective tinnitus severity is not predictive of audiometric outcomes. This finding can be used as a counseling tool to help tinnitus patients manage symptoms, expectations, and overall treatment outcomes.

PROFILE OF RISK FACTORS FOR ACOUSTIC TRAUMA IN 105 HOWITZER CANNON SHOOTER STUDENTS AT THE PUSAT PENDIDIKAN ARTILERI MEDAN-CIMAHI

Acoustic Trauma is hearing loss caused by short period high frequency noise. Hearing loss can occur in military, because it uses the main tools of the weaponry system, such as guns, military vehicles, and explosions. This research aims to determine the description of risk factors for acoustic trauma, patterns of hearing protector use, and ear complaints among students of Pusdik Armed who perform 105 Howitzer Cannon shooting practice. This study used a descriptive method with a cross sectional design on the students of Pusdik Armed who perform 105 Howitzer Cannon shooting practice. The sampling technique used total sampling with 103 population. The research instrument was secondary data from the public dedication questionnaire of Dr Asti Kristianti, Sp.THT-BKL, M.Kes. The results showed a description of the risk factors for acoustic trauma in Pusdik Armed Students who perform Howitzer 105 Cannon shooting practice mostly due to high noise exposure (64.1%), smoking history (60.2%), using PLDs (59.2%), a minority do not wear hearing protectors (12.6%), and the use of ototoxic drugs (1.9%), and no one has hypertension and a family history of hearing loss. The pattern of using hearing protectors during 105 Howitzer Cannon shooting practice is from students who use ear protectors (87.4%), some use ear protectors during training (72.8%). The description of ear complaints before doing Howitzer 105 Cannon shooting practice mostly did not experience ear complaints either before (82.5%) or after (76.6%). Therefore, it is necessary to require the use of ear protective equipment for cannon shooters.

Development and validation of the screening tool for age-related hearing loss in the community based on the information platform

IntroductionCurrently, age-related hearing loss has become prevalent, awareness and screening rates remain dismally low. Duing to several barriers, as time, personnel training and equipment costs, available hearing screening tools do not adequately meet the need for large-scale hearing detection in community-dwelling older adults. Therefore, an accurate, convenient, and inexpensive hearing screening tool is needed to detect hearing loss, intervene early and reduce the negative consequences and burden of untreated hearing loss on individuals, families and society.ObjectivesThe study harnessed "medical big data" and "intelligent medical management" to develop a multi-dimensional screening tool of age-related hearing loss based on WeChat platform.MethodsThe assessment of risk factors was carried out by cross-sectional survey, logistic regression model and receiver operating characteristic (ROC) curve analysis. Combining risk factor assessment, Hearing handicap inventory for the elderly screening version and analog audiometry, the screening software was been developed by JavaScript language and been evaluated and verified.ResultsA total of 401 older adults were included in the cross-sectional study. Logistic regression model (univariate, multivariate) and reference to literature mention rate of risk factors, 18 variables (male, overweight/obesity, living alone, widowed/divorced, history of noise, family history of deafness, non-light diet, no exercising habit, smoking, drinking, headset wearer habit, hypertension, diabetes, hyperlipidemia, cardiovascular and cerebrovascular diseases, hyperuricemia, hypothyroidism, history of ototoxic drug use) were defined as risk factors. The area under the ROC curve (AUC) of the cumulative score of risk factors for early prediction of age-related hearing loss was 0.777 [95% CI (0.721, 0.833)]. The cumulative score threshold of risk factors was defined as 4, to classify the older adults into low-risk (< 4) and high-risk (≥ 4) hearing loss groups. The sensitivity, specificity, positive predictive value, and negative predictive value of the screen tool were 100%, 65.5%, 71.8%, and 100.0%, respectively. The Kappa index was 0.6.ConclusionsThe screening software enabled the closed loop management of real-time data transmission, early warning, management, whole process supervision of the hearing loss and improve self-health belief in it. The software has huge prospects for application as a screening approach for age-related hearing loss.

Assessment of the risk of hearing loss in children with cystic fibrosis

Cystic fibrosis (CF) is a severe hereditary disease with a multisystem lesion. Manifestations of CF include severe infectious purulent lesions of all parts of the respiratory tract, including purulent rhinosinusitis with nasal polyps. The involvement of the sinonasal region and the need for systemic use of ototoxic drugs (primarily aminoglycosides to treat resistant bacterial infection) potentially create a risk of both conductive and sensorineural hearing loss (SNHL). The available data on the epidemiology of hearing disorders in CF is contradictory. Currently, genetic determinants of the development of aminoglycoside SNHL have been identified. For 136 CF patients (75 girls, 61 boys) aged 3 to 17 (9.4±3.9) years were performed audiological examination: tympanometry, transient-evoked otoacoustic emission and the pure tone threshold audiometry (standard frequency range) (n=126). History of systemic therapy with aminoglycosides was evaluated for each patient. Sequencing of c.35delG mutations in the GJB2 gene (nuclear DNA) and A1555G in the 12S rRNA gene (mitochondrial DNA) was performed in 215 patients with cystic fibrosis (the group partially overlaps with the audiological group), and as a control - 106 children with bronchial asthma and 103 healthy children, their age ranged from 3 to 17 (8.8±3.8) years. Audiological examination of CF children reveled a prevalence of conductive hearing loss comparable to the general population (2.4%). The frequency of SNHL was 1.6%, wich exceeds that of non-CF children. A genetic study revealed one case of heterozygous carriage of the c.35delG mutation in the GJB2 gene in a patient with bronchial asthma. In the group of patients with CF (n=215), mutations in the connexin 26 gene were not detected. No A1555G mutation was detected either in the group of patients with CF or in the control groups. Children with CF are at risk for the development of sensorineural, but not conductive hearing loss. Routine total screening for A1555G and c.35delG mutations probably seems not to be recommended.

Peripheral and brainstem auditory evaluation in post-COVID-19 individuals

PurposeThe purpose of this study was to investigate the peripheral and central auditory pathways in adult individuals after COVID-19 infection. MethodA total of 44 individuals aged between 19 and 58 years, of both genders, post-COVID-19 infection, confirmed by serological tests, with no previous hearing complaints and no risk factors for hearing loss, were assessed. All the participants underwent the following procedures: pure tone audiometry, logoaudiometry, immitanciometry, and Brainstem Auditory Evoked Potentials (BAEP), in addition to answering a questionnaire about auditory symptoms. ResultsThirteen individuals (29.5 %) had some hearing threshold impairment, mainly sensorineural hearing loss. In the BAEP, 18 individuals (40.9 %) presented longer latencies, mainly in waves III and V. According to the questionnaire answers, 3 individuals (9.1 %) reported worsened hearing and 7 (15.9 %) tinnitus that emerged after the infection. As for the use of ototoxic drugs during treatment, 7 individuals (15.9 %) reported their use, of which 5 showed abnormalities in peripheral and/or central auditory assessments. ConclusionConsidering the self-reported hearing complaints after COVID-19 infection and the high rate of abnormalities found in both peripheral and central audiological assessments, it is suggested that the new COVID-19 may compromise the auditory system. Due to the many variables involved in this study, the results should be considered with caution. However, it is essential that audiological evaluations are carried out on post-COVID-19 patients in order to assess the effects of the infection in the short, medium, and long term. Future longitudinal investigations are important for a better understanding of the auditory consequences of COVID-19.

Sensorineural hearing loss among children at risk: A 16-year audiological records review in a tertiary referral center

ObjectivesHearing loss (HL) constitutes an increasing worldwide health problem. Neonatal hearing screening improved early detection and management to alleviate HL detriments on the person and society. Still, HL in childhood, beyond infancy, is under-investigated, especially in developing countries. This study aimed to explore the prevalence of HL in childhood amongst Jordanian children with HL risk factors and investigate the associated risk factors. MethodsRetrospective cross-sectional review of audiological records in a tertiary public and teaching hospital. The data of 1307 children aged 0–15 years who underwent audiological assessment from 2000 to 2016 were included. A review of diagnostic audiological and medical records was conducted to investigate the prevalence of sensorineural HL in high-risk (HR) children and the most contributing risk factors. ResultsDescriptive statistical analysis showed that the prevalence of sensorineural HL was 29.2% in the study sample. The HL was bilateral in 95% and mild to moderate HL in 73%. The mean age at the diagnosis was around 4.5 years. The most common risk factors were parental concern about their child's hearing, ototoxic drug use, and developmental and speech delay. The Chi-squared test showed that parental concern and ototoxic drug use were associated with an increased probability of having HL. ConclusionThe prevalence of HL amongst at-risk children in Jordan is relatively high, and the diagnosis is delayed. The results highlight the importance of implementing a hearing screening program in at-risk children. This needs to start from birth and include a serial follow-up to detect cases of delayed-onset HL.

Maternal, Perinatal, and Postnatal Predisposing Factors of Hearing Loss in Full-Term Children: A Matched Case-Control Study

Introduction: Studies on risk factors for childhood hearing loss (HL) are usually based on questionnaires or small sample sizes. We conducted a nationwide population-based case-control study to comprehensively analyze the maternal, perinatal, and postnatal risk factors for HL in full-term children. Methods: We retrieved data from three nationwide databases related to maternal characteristics, perinatal comorbidities, and postnatal characteristics and adverse events. We used 1:5 propensity score matching to include 12,873 full-term children with HL and 64,365 age-, sex-, and enrolled year-matched controls. Conditional logistic regression was used to evaluate the risk factors for HL. Results: Among the various maternal factors, maternal HL (adjusted odds ratio [aOR]: 8.09, 95% confidence interval [95% CI]: 7.16–9.16) and type 1 diabetes (aOR: 3.79, 95% CI: 1.98–7.24) had the highest odds of childhood hearing impairment. The major perinatal risk factors for childhood hearing impairment included ear malformations (aOR: 58.78, 95% CI: 37.5–92.0) and chromosomal anomalies (aOR: 6.70, 95% CI: 5.25–8.55), and the major postnatal risk factors included meningitis (aOR: 2.08, 95% CI: 1.18–3.67) and seizure (aOR: 3.71, 95% CI: 2.88–4.77). Other factors included acute otitis media, postnatal ototoxic drug use, and congenital infections. Conclusions: Many risk factors for childhood HL identified in our study are preventable, such as congenital infection, meningitis, ototoxic drug use, and some maternal comorbidities. Accordingly, more effort is required to prevent and control the severity of maternal comorbidities during pregnancy, initiate genetic diagnostic evaluation for high-risk children, and aggressive screening for neonatal infections.

Regenerative Therapy Approaches and Encountered Problems in Sensorineural Hearing Loss.

Hearing loss is one of the most important public health matters worldwide, severely affecting people's social, psychological, and cognitive development. The perception of sound, movement, and balance in vertebrates depends on a special sensory organ called the cochlea, which contains hair cells and supporting cells in the inner ear. Genetic factors, epigenetics, the use of ototoxic drugs (some antibiotics and chemotherapeutics), noise, infections, or even aging can cause loss of hair cells and their related primary neurons, leading to sensorineural hearing loss. Although a sensorineural hearing loss, also known as permanent hearing loss, is treated with hearing aids and cochlear implants, treatment methods are limited. Since even the best implant cannot exhibit the characteristics of the original ear, the permanent sensory deficit will be permanent. For this reason, it has become important to develop regenerative treatment methods to regenerate and replace lost or damaged hair cells and neurons. Developments in stem cell technology have led to promising studies in regenerating damaged/lost hair cells or neurons with endogenous or exogenous cell-based therapies. Epigenetic mechanisms can turn hearing-related genes on and off and determine which proteins to copy. In addition, due to gene silencing, gene replacement, and CRISPR/CAS9 technology, gene therapy methods have accelerated, and studies have been carried out to treat dominant and recessive mutations that cause genetic-induced hearing loss or increase hair cell regeneration. In this paper, potential gene therapy and stem cell applications in the acquisition of cochlear function, which causes sensorineural hearing loss, and the difficulties encountered in these applications are compiled from a bioengineering perspective.

Neonatal hearing screening in Soba University Hospital, Khartoum, Sudan: a cross-sectional study

BackgroundHearing loss in children constitutes a serious obstacle to their optimal development; early detection of hearing disability is vital to improve the outcome of management; currently, in Sudan, there is no national neonatal hearing screening program. The aim of this study is to discuss the results of neonatal hearing screening among newborns admitted to neonatal intensive care unit (NICU) and well-baby nursery, at Soba University Hospital, Khartoum (Sudan), and to reflect the magnitude of risk factors for hearing impairment present in these two different groups of newborns.MethodsIn this hospital-based cross-sectional study, newborns who were admitted to the NICU or being observed in the well-baby nursery in the period from February 2014 to February 2019 were screened for hearing loss using automated otoacoustic emission (OAE) device after recording the risk factors for hearing loss according to the Joint Committee on Infant Hearing (JCIH) year 2007 position statement and after conducting a detailed ear and general physical examination. Newborns who failed this screening test were rescreened using the same device after 48 h, and if they failed again, they underwent confirmatory auditory brainstem response test when they are 6 months old.ResultsOne thousand one hundred twenty newborns were tested; 736 were NICU and 384 were well-baby nursery newborns. The prevalence of hearing impairment after confirmatory test was found to be 10.8 per 1000 in the NICU group and 5.2 per 1000 in the well-baby nursery group considering that the drop rate for the confirmatory test was 50% and 66% respectively which is very high and reflect the poor compliance to the program. The risk factors for hearing loss were more encountered in the NICU group compared to well-baby nursery group. Unmonitored ototoxic drug use was found to be very prevalent and need urgent reconsideration.ConclusionIn this study, the estimated prevalence of neonatal hearing impairment is alarming; risk factors are very evident especially in the NICU group; this reflect the urgent need for establishing an efficient national program for neonatal hearing screening and working to eliminate the preventable risk factors for neonatal hearing impairment in this developing country.

Maternal and child predictors associated with loss to follow-up in the newborn hearing screening program: a cohort study in maternity hospitals in northeastern Brazil.

Analyze maternal and child predictors associated with loss to follow-up in the newborn hearing screening program at maternity hospitals in northeastern Brazil. Retrospective cohort study, including secondary data from infants (n=604) referred to the newborn hearing screening program in two maternity hospitals for monitoring and/or diagnosis. The predictors evaluated included socioeconomic factors, such as maternal age, marital status, income, schooling, place of residence, number of children and number of prenatal visits. In addition, maternal and child health factors, such as smoking and drug intake during pregnancy, consanguinity, congenital infections, craniofacial malformations, use of ototoxic drugs, syndromes and a history of hearing loss in the family. Statistical analysis was performed based on binary logistic regression models, using the stepwise method. The logistic regression model containing the number of prenatal visits and the history of hearing loss in the family was significant [χ2(2) =34.271; p<0.001]. The number of prenatal visits (OR = 2.343; 95% CI = 1.626 - 3.376) and family history of hearing loss (OR = 2.167; 95% CI = 1.507 - 3.115) were significant predictors. The other predictors were not significant. The results reveal that newborns whose mothers had ≤ 5 prenatal visits and those with a family history of hearing loss increased their likelihood of loss to follow-up by 2.3 and 2.1 times, respectively. It is important to provide subsidies for public health improvements in order to help advise, guide and educate mothers, especially during prenatal care.

Maternal Perspectives of Newborn Hearing Loss in Resource Constrained Settings of Rawalpindi Pakistan

Objective: The objective of this study was to assess knowledge of mothers regarding risk factors, early identification, and intervention for infant hearing loss and to determine association between hearing loss and consanguineous marriages in Pakistan.&#x0D; Study Design: Analytical cross-sectional study.&#x0D; Place and Duration of Study: Out Patient Department of tertiary care hospitals in Rawalpindi Pakistan, from Mar to Jun 2021.&#x0D; Methodology: 111 mothers consented to participate. Data was collected using a structured researcher administered questionnaire. It included four sections with 37 questions that were answered in yes, no, or unsure. Analysis was done using SPSS software.&#x0D; Results: Mothers' knowledge of two risk factors was high with most respondents being aware of head injury or slap to the ear (n=94) being a risk for hearing loss, followed by ear pain/discharge (n=88). 66.7%(n=72) of participants considered use of ototoxic drugs by mother during pregnancy to be a potent risk factor for neonatal hearing loss. The mothers' understanding of natal causes such as delayed birth cry and neonatal jaundice was poor. Their understanding of postnatal causes such as high fever, frequent hospitalization, and long stay in NICU was also limited. Mothers who were employed had significantly more awareness in certain factors than housewives. 45.4% (n=49) of the mothers believed being in a cousin marriage influenced infant hearing loss while 38.9% (n=42) disagreed, and 15.7% (n=17) were unsure.Conclusion: Only half of all participating mothers were fully aware of the possible risk factors and causes of infant hearing loss. Seminars and public awareness programs should be arranged to educate mothers about risks of infant hearing loss.

Noise-Induced Hearing Loss in Police Officers: Systematic Review.

Introduction:Noise-induced hearing loss (NIHL) is defined as the sensorineural hearing loss caused by acute acoustic trauma or chronic exposure to high-intensity noises. Exposure to noises can lead to irreversible damage to the inner ear and, consequently, to a permanent shift of the hearing threshold. Police officers are particularly at risk of acute or chronic hearing damages. The aim of this study is to evaluate the hearing loss of police officers in relation to the occupational risk factors and clinical-anamnestic characteristics by collecting and analyzing existing data and evidence available in public databases.Materials and Methods:A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses group (PRISMA). Studies were included if they met inclusion and exclusion criteria. Study selection, data extraction, and quality assessment were conducted independently by two researchers. Results:Our initial literature search yielded 29 peer-reviewed articles. Out of 29 papers, only 10 were included in the review, after inclusion and exclusion criteria were applied the.Conclusions:Hypertension, smoking and alcohol intake significantly affect hearing performance. In addition, a history of acoustic trauma, use of ototoxic drugs, exposure to noise in leisure-time activities and failure to use ear protectors are often found in a fair number of subjects. NIHL is also related to the age of the subjects as well as the extent and duration of noise exposure. Furthermore, NIHL is also influenced by shooting practice sessions police officers are required to undertake as well as by the chronic exposure to traffic noise, especially in motorcycle police officers.

Association of hypertension and age-related sensorineural hearing loss among elderly: A cross-sectional study

Background: Hearing loss (HL) has negative impact on quality of life. The prevalence of HL increases with age. Aims and Objectives: The present study was planned to explore the possible association of hypertension with age-related sensorineural HL (SNHL) in the elderly. Materials and Methods: This was a cross-sectional study done in the ENT Department of Great Eastern Medical School and Hospital, Srikakulam. Consecutive sampling method used. Sample size was considered using the formula – 4pq/l2 and 137 subjects from age group 60–75 years were included in the study. Hypertension was verified through a mercury sphygmomanometer and by a systematized questionnaire about hypertension and the use of medication for blood pressure. The hearing was assessed through threshold audiometric and audiological assessment. The study period: 4 months. All patients from the ENT department in the age group 60–75 years and who gave written informed consent were involved in the study. Participants with a history of ear surgery performed in the past, exposure to loud sounds, recently use of ototoxic drugs, patients with hearing aids, and ear diseases were excluded from the study. Results: Out of 137 subjects 52% had hypertension and 48% had no hypertension. Grade 1 hypertensives suffered from mild HL (7.9%), moderate HL (73%), severe HL (11%), and profound HL (7.9%). In Grade 2, hypertensives suffered from moderate HL (11%), severe HL (33.3%), and profound HL (55.5%). The P-value calculated by the Chi-square method was found to be &lt;0.05 and an odds ratio of more than 1, showing a significant association between hypertension and an increase in HL. Moreover, also a statistically positive correlation of MAP and duration of hypertension with age-related SNHL in both ears. Conclusion: HL in the population under study suggested that hypertension is an accelerating factor of degeneration of the hearing apparatus along with age-related SNHL. Hypertension and ageing were significantly associated with the risk of HL. Patients with hypertension have a greater increase in hearing threshold as compared to those without hypertension.

Differential diagnosis of tinnitus

Tinnitus is a common clinical symptomthat can be debilitating. Risk factors forits development are hearing loss, use of ototoxic drugs, head injury and depression. At the onset of the disease, the likelihood of ear pathology, the presence of anxiety and depression should be considered. There are no effective drug treatments for tinnitus, although a number of scientific studies are ongoing to determine the mechanisms of the development of this condition and to search for possible options for its treatment. When ear pathology is detected, surgical interventions can be effective, but tinnitus associated with this disease persists. Available treatment approaches include hearing aids for diagnosed hearing loss (even mild or unilateral), broadband sound therapy, and counseling. Cognitive-behavioral therapy is indicated for some patients, but availability remains inadequate. The evidence base is most significant for the combination of sound therapy and CBT-based counseling, although clinical trials are complicated by the heterogeneity of the tinnitus patient population.

Newborn Hearing Screening: Analysing the Effectiveness of Early Detection of Neonatal Hearing Loss in a Hospital in Greece.

IntroductionThe introduction of newborn hearing screening programs (NHSP) has drastically contributed to the early diagnosis of hearing loss (HL) in children, with the prospect of children developing speech as early as possible. This retrospective study aims to present and discuss the preliminary results of the NHSP at the University Hospital of Patras, Greece, highlighting the strengths and weaknesses of the program. The evaluation of the implementation of NHSP is important to confirm the effectiveness of the process and elaborate system failures.MaterialsThe study describes the results of previous data collected from the NHSP in the Rio hospital of Patra and analyzed the conditions of the sample collected. The random sample involved newborns born between November 2018 - December 2020 at the University Hospital in Patra, Greece, which was assessed using transient evoked otoacoustic emissions (TEOAEs). Testing was performed twice per week on Thursday and Friday with a random sample, specifically examining the babies in the hospital these days. From the 2014 newborns assessed, 1491 were healthy neonates, while the other 523 required hospitalization in the neonatal unit.ResultsIn total, there were 2014 live births; 1491 healthy neonates were screened with TEOAEs. Of them, 44 did not pass the first test. After retesting one month later, 31 passed the test, while the other 13 were referred to a hearing centre for further audiological testing with auditory brainstem response (ABR) tests. Two infants never showed up for the follow-up appointment. Of the remaining 11, six infants had normal hearing, three had otitis media with effusion or other conductive HL. The last two infants had HL. Specifically, one had bilateral sensorineural HL greater than 40db, and one had unilateral sensorineural HL greater than 40db.Risk factors were identified in 523 newborns admitted to the unit. The most common risk factors identified were the use of ototoxic drugs, low Apgar scores, and prematurity. Of all the newborns, 491 passed the test the first time, and the rest 32 infants came back 1-2 months after leaving the neonatal unit. All the babies who had failed in the first screening test appeared for the follow-up appointment for the second screening test. Of these, 24 babies passed the test, but eight did not. Of these, four were diagnosed with media otitis with effusion or other conductive HL. Sensorineural HL was identified in the last four babies using ABR tests. In detail, two had unilateral sensorineural HL greater than 40db, while two had bilateral sensorineural HL greater than 40db.ConclusionIn conclusion, we found that for the NHS programs to be effective, they must be implemented long-term and have monetary support. Early diagnosis and cochlear implantation are the keys to excellent outcomes. Cooperation between different specialties and a patient-centred approach will help physicians holistically face neonatal HL. Building trust between the parents and doctor is essential for the program's success and reducing the lost-to-follow-up rate. To run a successful program, trained staff, equipment, and financial support are required. However, the gold standards for the success of the program are proper implementation of the program, close follow-up, strict adherence to the guidelines in the neonatal intensive care unit (NICU), and the early detection and diagnosis of HL.

Pharmacogenetic screening of A1555G and C1494T mitochondrial mutations and the use of ototoxic drugs among Jordanians.

Hearing loss may impact an individual's psychosocial behaviors and lead to cognitive decline. The goals of this study were to describe the frequency of nonsyndromic hearing loss (NSHL) among Jordanian patients with regular exposure to ototoxic drugs, perform screening for A1555G and C1494T mitochondrial mutations (12S rRNA gene) and identify predictors of hearing loss. A cross-sectional study was conducted in which medical records were reviewed to record the pattern of ototoxic drug use among participants. The pure tone audiometry (PTA) test was used to assess hearing performance. Direct sequencing was performed following PCR amplification to screen for mitochondrial mutations of interest. One hundred sixty-two patients reported regular use of ototoxic drug(s); sixty-five percent of them suffered from NSHL, mostly of mild-moderate severity. No A1555G or C1494T mutation was detected in any participant. Aspirin (82%) was the most commonly used ototoxic drug, followed by loop diuretics (77%) and aminoglycosides (57%). Advanced age, more comorbidities and more ototoxic drugs taken increased the likelihood of hearing loss (p<0.01). Hearing loss is prevalent among Jordanian patients treated with ototoxic drugs. Early intervention and management services for this population remain critical needs.

Factors Associated with Hearing Loss in Helicopter Aircrew of Indonesian Army Aviation Center, Semarang

Introduction: Hearing loss and tinnitus may occur in pilots due to exposure of the high noise level (ranges from 104-110 dB) generated by aircraft/helicopters. In addition, flying time, acoustic trauma, diabetes mellitus, hypertension and smoking are risk factors of hearing loss. Objective : to identify the factors associated with hearing loss in the crew of the Indonesian Army Aviation Center, Semarang Methods: in the cross-sectional research, 114 military helicopter aircrews aged 20-58 years, working for the Army Aviation Center in Semarang were included. The exclusion criteria were history of previous ear surgery, infection of the outer and middle ear, the use of ototoxic drugs (kanamycin, cisplatin and carboplatin). The level of hearing loss and tinitus was assessed by otoscopy and audiometry. Whereas, tinnitus was obtained from the history taking. Data were analyzed using chi-square test and fisher's exact and Yates’s correction. Results: One hundred and fourteen subjects (mean age of 26.54 + 4.72) were included. Several factors such as flight time (p = 0.698), acoustic trauma (p = 0.151), diabetes mellitus (p = 0.596), smoking (p = 0.222), hypertension (p = 0.356) were not associated with sensorineural hearing loss. Several factors such as flight time (p = 0.706), acoustic trauma (p = 0.5160), diabetes mellitus (p = 0.789), smoking (p = 0.495), hypertension (p = 0.112) were not associated with tinnitus. Conclusion: There is no association between flight time, acoustic trauma, diabetes mellitus, hypertension, and smoking and hearing loss.

Neonatal Hearing Screening: Prevalence of Unilateral and Bilateral Hearing Loss and Associated Risk Factors.

Introduction: Newborn hearing screening is essential for early identification of hearing loss to decrease the adverse effects of hearing loss. The objective of this study was to determine the prevalence of hearing loss and risk factors of congenital hearing loss in newborns.Methods: In this analytical case-control study, a hearing screening test was performed for all newborns aged 3-14 days.Results: Of 5,500 newborns evaluated, 24 newborns had hearing loss. The prevalence of hearing loss was 4.36 per 1,000. Of 24 hearing-impaired newborns, 15 had bilateral hearing loss (BHL) (62.5%) and nine had unilateral hearing loss (UHL) (37.5%). Among the neonates with hearing loss, the prevalence of hearing loss was higher (77.8%) in the right ear. The main risk factors identified in this study were low gestational age (P=0.001), hospitalization in the neonatal intensive care unit (NICU) (P=0.008), exposure to ototoxic drugs (P=0.001), gestational diabetes P=0.01), craniofacial anomalies (P=0.01), convulsion (P=0.03), consanguineous marriage of parents (P=0.001), low birth weight (P=0.01), and hyperbilirubinemia (P=0.001).Conclusion: The prevalence of hearing loss was higher in the right ear than in the left ear. NICU stay, use of ototoxic drugs, low gestational age (<35 weeks), gestational diabetes, craniofacial anomalies, convulsion, consanguineous marriage of parents, low birth weight, and hyperbilirubinemia were significant risk factors for congenital hearing loss in studied newborns.