Auditory neuropathy in two patients with generalized neuropathic disorder: A case report

Background: Although it is not a new disorder, in recent times we have attained a greater understanding of auditory neuropathy (AN). In this type of hearing impairment, cochlear hair cells function but AN victims suffer from disordered neural transmission in the auditory pathway. The auditory neuropathy result profile often occurs as a part of that of the generalized neuropathic disorders, indicated in approximately 30-40 of all reported auditory neuropathy/auditory dyssynchrony (AN/AD) cases, with approximately 80 of patients reporting symptom onset over the age of 15 years. In the present report, the results of audiologic tests (behavioral, physiologic and evoked potentials) on two young patients with generalized neuropathy are discussed. Case report: Two brothers, 26 and 17 years old, presented with speech perception weakness and movement difficulties that started at 12 years of age and progressed as time passed. In their last examination, there was a moderate to severe flat audiogram in the older patient and mild low tone loss in the younger one. The major difficulty of the patients was severe speech perception impairment that was not compatible with their hearing thresholds. Paresthesia, sural muscle contraction and pain, and balance disorder were the first symptoms of the older brother. Now he can only move with crutches and his finger muscle tonicity has decreased remarkably, with marked fatigue after a short period of walking. Increasing movement difficulties were noted in his last visit. Visual neuropathy had been reported in repeated visual system examinations for the older brother, with similar, albeit less severe, symptoms in the younger brother. In the present study of these patients, behavioral investigations included pure-tone audiometry and speech discrimination scoring. Physiologic studies consisted Transient Evoked Otoacoustic Emission (TEOAE) and acoustic reflexes. Electrophysiologic auditory tests were also performed to determine Auditory Brainstem Response (ABR), Auditory Middle Latency Response (AMLR) and Auditory Late Response (ALR). The results of these examinations for these two siblings are discussed and compared with the results of other studies. Conclusion: Distinguishing auditory neuropathy from other speech perception disorders can be performed by conducting audiologic evaluations as a battery of tests. The probability of generalized neuropathy must be considered in patients with auditory neuropathy symptoms. © 2008, Tehran University of Medical Sciences. All rights reserved

Effect of reoperation embolization on Glomus Jugulare tumors

22 patients were reviewed retrospectively to determine the effects of embolization on Glomus Jugulare tumors. 6 patients underwent embolization and 16 did not. All tumors were removed with a type A infratemporal foassa approach. The patients were evaluated for operative blood loss, operative time, length of hospitalization and new post-operative nerve deficits. The embolized group lost less blood and shorter operative times and less hospitalization. Embolization did not reduce the incidence of new post-operative cranial nerve deficits. The experience of the surgeon and operative team also play a significant role in the reduction of blood loss and operating time. Embolization carries a risk of significant morbidity, and its use depends on the experience of the radiologist

Relationship between air pollution (sulfur dioxide)

IntroductionLow birth weight as a result of premature labor or limited intrauterine growth is the most important measure of neonatal mortality. It has many causes of which air pollution has been recently gained attention. The Purpose of this historical cohort study was to determine the relationship between sulfur dioxide and low birth weight in term neonates of women referring to selected hospitals in Tehran in 2007. Materials and Methods225 women referring to selected hospitals and residing at 5-Km distance from stations for air pollution measurement were selected. An information form was used to collect data. Its validity and reliability were achieved by content and test-retest methods respectively. Women were divided into 2 groups of exposure (low and high) according to their contact with the pollutant. The groups were matched in terms of factors effective on low birth weight.  ResultsFindings showed a significant relationship between sulfur dioxide and low birth weight (

The Relationship between CO Ambient and Low Birth Weight

Background and Objectives: LBW is the strongest factor related to prenatal, neonatal, postnatal and childhood mortality and morbidity. Air pollution is one of the risk factors that is recently gaining attention. This study was carried out to determine the relationship between the CO ambient and low birth weight in women referring to Tehran hospitals in 2007-2008. Methods: In this historical cohort study 225 pregnant women having lived within 5 kilometers of a monitoring station during pregnancy and referring to selected hospitals in Tehran were investigated. An information questionnaire was used for data collection and sampling was done by multistage sampling and convenience method. Women were assigned to low exposure group and high exposure group based on mean exposure to each pollutant during pregnancy. These two groups were matched with respect to confounding factors. SPSS software version 15, T statistics, 2, Man Withnney, and Relative Risk procedures were used for data analysis.Results: The result showed that 31.6% of CO high exposure group and 7.4% of CO low exposure group had Low birth weight baby. The result also showed a significant relationship between exposure to high amount of CO and LBW (p=0.001). Relative Risk calculated with confidence interval (RR=4/67, CI=(1/76-9/43) was found to be 95% and the amount of attributable risk was 66%.Conclusion: Based on these finding, exposure to carbon monoxide pollution can cause LBW. There should be an educational program about the disadvantages of CO pollutant on pregnant women living in densely populated areas of the city. Moreover, practical approaches should be provided to reduce these pollutants