Congenital hearing loss. Is CT enough?

The aim of this study is to evaluate the value of high resolution CT scan (HRCT) in diagnosis and management of congenital hearing loss.Patients and methods: This is a prospective study including 60 patients, 24 males and 36 females aged from 1 to 7 years, who were presented by unilateral or bilateral congenital conductive (CHL) or/and sensorineural hearing loss (SNHL). All patients were evaluated by HRCT scan withpost-processing multiplanar reconstruction (MPR). Only three Results: External auditory canal atresia (EACA) was diagnosed in 10 patients, while both EACA and middle  r anomalies were diagnosed in another 6 patients. Variable inner ear anomalies were diagnosed in the patients with SNHL. One patient with SNHL had cochlear nerve aplasia that was missed by HRCT and was diagnosed by MRI, in addition to the CT diagnosed  vestibulocochlear anomalies.Conclusion: Although HRCT scan can be used as a solitary diagnostic imaging tool for diagnosis of pure CHL, combined CT and MRI examination is crucial for preoperative evaluation of SNHL patien

The Economic Impact of Lower Extremity Amputations in Diabetics. a Retrospective Study From a Tertiary Care Hospital of Faisalabad, Pakistan

Background: Among the various complications of diabetes, lower-extremity amputation due to diabetic foot is a common problem. In Pakistan, 6-7% of patients with diabetes suffer from diabetic foot ulceration. Objectives: Our primary objective was to explore the frequency of diabetic foot amputations, and the secondary objective was to calculate the economic burden of these preventable surgeries on the health budget of the provincial government. Materials & Methods: It was a retrospective cross-sectional observational study conducted after obtaining approval from the Ethical Review Committee of Allied hospital, Faisalabad Medical University. The data of diabetic foot patients who underwent amputations between July 2017 and December 2017 were retrieved from three Surgical Units (I, II & III), using a purposive sampling technique. All amputations carried out for reasons other than diabetic foot were excluded. The direct medical cost of one diabetic foot amputation was calculated via a local survey of the various private hospitals of Faisalabad. The indirect costs in terms of loss of productivity and disability costs, transport costs, rehabilitation costs were not included in this study. The data were evaluated by using SPSS Version 23. Results: A total of 85 patients were included in our study. The male to female ratio was 2.7 to 1. The mean direct treatment cost for minor amputation was PKR 46926.00 ± 11730.90 ($382.35 ± 95.58), and the mean direct treatment cost for major amputation was PKR 53720.00 ± 12401.24 ($437.71 ± 101.40). Out of 85 amputations, 63 (74%) were major amputations, and the remaining 22 (26%) were minor amputations. The total cost for 63 major amputations was PKR 3,384,360 ($27568.91) and for 22 minor amputation was PKR 1,032,372 ($8409.67). The net cost came out to be PKR 4,416,732 ($35978.59) for all the 85 cases being reported in a tertiary care hospital of Faisalabad for six months. Conclusion: Diabetic foot, a preventable complication of long-term diabetes mellitus, has an economic burden on the hospital budget, which, if adequately addressed via primary prevention programme, can yield not just economical but medical benefits as well

An Integrated Review of Developmental Outcomes and Late‐Preterm Birth

Objective: To evaluate existing evidence on long‐term developmental outcomes of late‐preterm infants (LPI; infants born 34‐36 6/7 weeks gestation). Data Sources: Computerized bibliographic databases and hand search for English language articles published between January 1995 and November 2010 yielded 817 articles. Study Selection: Twelve studies (10 cohort and two cross‐sectional) were identified that defined late‐preterm (LP) birth as 34 to 36 6/7 weeks gestation and addressed growth and neurodevelopmental outcomes in LPI. Data Extraction: Using a modified Downs and Black scale for assessing the quality of experimental and observational studies, two reviewers who were blind to each other's ratings assessed study quality. Ratings ranged from 12.5 to 14 with moderate to very good interrater agreement. Kappa (κ) values were 0.83 (reporting), 0.63 (external validity), 0.73 (internal validity), and 0.83 (design) for the four subscales and 0.56 for the whole scale, with no major systematic disagreements between reviewers. Data Synthesis: Studies were divided into five categories to include the following developmental outcomes: neurodevelopment, behavioral, cognitive, growth, and function. Using the Meta‐analysis of Observational Studies in Epidemiology (MOOSE) guidelines, synthesis of the findings is provided as an integrative review. Conclusion: Significant variations in study populations, methodology, and definition of LP exist. Due to paucity and heterogeneity of the existing data especially in infants born 34 to 36 6/7 weeks, there is no clear characterization of the long‐term risks, and future research is needed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86856/1/j.1552-6909.2011.01270.x.pd

Recurrent subacute visual loss presenting in a 52-year-old Caucasian woman with chronic relapsing inflammatory optic neuropathy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Chronic relapsing inflammatory optic neuropathy is a recently described form of recurrent isolated subacute optic neuropathy. The condition is highly responsive to systemic steroid treatment and prone to relapse on steroid withdrawal. A complete work up for demyelination, autoimmune disease and sarcoidosis must be made before considering chronic relapsing inflammatory optic neuropathy.</p> <p>Case presentation</p> <p>We describe the case of a 52-year-old Caucasian woman who presented with isolated subacute optic neuropathy. There was no evidence of demyelination, autoimmunity or sarcoidosis. There was an abrupt and prompt response to systemic corticosteroids and a relapse of the condition on steroid withdrawal.</p> <p>Conclusions</p> <p>Chronic relapsing inflammatory optic neuropathy requires careful consideration and differentiation from demyelinating optic neuritis and ischemic optic neuropathy since the treatment is different and the outcome without treatment is likely to be poor. The importance of identifying these patients has considerable clinical implications as the condition is highly responsive to steroids.</p

Selenium and hydrogen selenide: essential micronutrient and the fourth gasotransmitter?

Selenium (Se) is an essential micronutrient required by organisms of diverse lineage. Dietary Se is converted to hydrogen selenide either enzymatically or by endogenous antioxidant proteins. This convergent biochemical step crucially underlies the subsequent biological activity of Se and argues for inclusion of hydrogen selenide as the fourth endogenous gasotransmitter alongside nitric oxide, carbon monoxide and hydrogen sulfide.Endogenously generated hydrogen selenide is incorporated into numerous 'selenoprotein' oxidoreductase enzymes, essential for maintaining redox-status homeostasis in health and disease. Direct effects of endogenous hydrogen selenide on cellular and molecular targets are currently unknown. Given exogenously, hydrogen selenide acts as a modulator of metabolism via transient inhibition of mitochondrial cytochrome C oxidase. Here we provide an overview of Se biology, its impact on several physiological systems (immune, endocrine, cardiovascular and metabolic) and its utility as a supplement in acute and critical illness states. We further explore the evidence base supporting its role as the fourth gasotransmitter and propose a strategic case towards generation of novel selenomimetic therapeutics

Catatonia with GABAA receptor antibodies

A 22-year-old African woman developed acute behavioural change, against a background of sickle cell disease with strokes requiring a ventriculoperitoneal shunt. She alternated between mutism with prolonged staring and posturing, and a state of agitation with elation and echolalia. Cerebrospinal fluid (CSF) protein was elevated and electroencephalogram showed mild slowing with bitemporal slow and sharp waves. We suspected catatonia secondary to possible autoimmune encephalitis but her condition persisted despite intravenous methylprednisolone. After identifying a positive serum anti-gamma-aminobutyric acid-A (GABAA) antibody, treatment with intravenous immunoglobulin, oral corticosteroids and rituximab led to gradual improvement. Patients with catatonia may show reduced GABAA receptor density and there are two other reports of catatonia with anti-GABAA antibodies. This patient's treatment response supports the antibody's causative role

Drug utilization pattern in OPD of government dental college and hospital, Aurangabad

Background: To study drug prescription pattern in dental OPD of Government Dental College and Hospital.Methods: 100 prescriptions were screened & analyzed as per the study parameters from OPD of Government Dental College & Hospital, Aurangabad. Groups of drugs commonly prescribed, like antibiotic, analgesics & others prescription were recorded.Results: Most common groups of drugs prescribed by dental surgeons were NSAIDs, antimicrobials, antiseptics and multivitamins. NSAIDs- 86%; Antimicrobials- 85%; Antiseptics- 8.6%; Multivitamins- 12.3%. The average number of drugs prescribed per patient was 3 and the average number of antimicrobial prescribed per patient was 1.Conclusions: For rational prescribing of drugs there is a need of mass-awareness amongst dental surgeons about the good prescribing by following 6 steps of WHO program on rational use of drugs

Social Media Influencers: Who They Are and How They Influence

This paper extends research on persuasion and social media communication by reporting the results of a content analysis of 10 leading social media influencers, an untapped empirical issue in the field. Findings, offering insights into the particular communicator attributes influencers emphasize, were based on coding 121 videos of female beauty and lifestyle influencers. Influencers deploy a variety of communication strategies to engage followers, harnessing everyday behaviors, using colloquial terms, expressing emotions, showing vulnerabilities (in socially skilled ways), and strategically promoting products. Interestingly, when influencers mentioned the coronavirus, they did so as to emphasize its relevance to their personal life, rather than suggesting broader implications, such as to public health or its racial disparities. Followers’ many comments demonstrated their positive regard for, and parasocial relationships with, influencers. An appendix offers qualitative insights into influencers’ appeal

Factors Associated With Ostomy Adjustment In People Living With An Intestinal Or Urinary Ostomy

poster abstractMore than 120,000 new ostomies, or surgically created openings through the abdomen for bowel or urinary elimination, are created annually in North America. Up to 80% of patients with a new ostomy experience ostomy-related complications that can interfere with adjusting to living with an ostomy and diminish quality of life. Short hospital stays and fragmented follow-up care make it difficult for people with new ostomies to adjust and find the support and resources they need. Little is known about factors that influence positive adjustment to a new ostomy. The purpose of this study was to explore demographic factors that may be associated with adjustment to living with an ostomy. Potentially eligible participants who had ostomy surgery in the past 24 months were identified from lists generated by wound, ostomy, and continence nurses in 5 hospitals affiliated with a major health system in Indiana. Introductory study letters were mailed to potentially eligible participants. Trained research assistants telephoned participants who did not call the office to decline in order to assess eligibility, explain the study, and answer questions. Quantitative and qualitative data were collected via telephone interviews from 203 participants and entered directly into the RedCap database. The Ostomy Adjustment Inventory-23 was used to assess adjustment to living with an ostomy. Data were analyzed using correlations, t-tests, and analyses of variance using the Statistical Package for the Social Sciences. Results indicated that participants with higher incomes had significantly better adjustment scores than those with lower incomes (p<.000). No other demographic variables were associated with ostomy adjustment. People with lower incomes may be at risk for poor adjustment after ostomy surgery. Additional support and education may be needed to enhance ostomy adjustment for people at risk. Future research is needed to develop and test the effectiveness of interventions to support ostomy adjustment

Modelling reflected polarised light from close-in giant exoplanet WASP-96b using PolHEx (Polarisation of Hot Exoplanets)

We present the Polarisation of Hot Exoplanets (PolHEx) code for modelling the total flux (F) and degree of linear polarisation (P) of light spectra reflected by close-in, tidally locked exoplanets. We use the output from a global climate model (GCM) combined with a kinetic cloud model of hot Jupiter WASP-96b as a base to investigate effects of atmospheric longitudinal-latitudinal inhomogeneities on these spectra. We model F and P-spectra as functions of wavelength and planet orbital phase for various model atmospheres. We find different materials and sizes of cloud particles to impact the reflected flux F, and particularly the linear polarisation state P. A range of materials are used to form inhomogeneous mixed-material cloud particles (Al2O3, Fe2O3, Fe2SiO4, FeO, Fe, Mg2SiO4, MgO, MgSiO3, SiO2, SiO, TiO2), with Fe2O3, Fe, and FeO the most strongly absorbing species. The cloud particles near the relatively cool morning terminator are expected to have smaller average sizes and a narrower size distribution than those near the warmer evening terminator, which leads to different reflected spectra at the respective orbital phases .We also find differences in the spectra of F and P as functions of orbital phase for irregularly or spherically shaped cloud particles. This work highlights the importance of including polarisation in models and future observations of the reflection spectra of exoplanets.Comment: Accepted for publication in MNRA