3 forette prevention of alzheimer ifa 2012] 2ifa2012
The document discusses potential approaches for preventing Alzheimer's disease and dementia. It notes that while some observational studies have found associations between certain factors and reduced dementia risk, large randomized controlled trials have not shown that anti-inflammatory agents, antioxidants, or estrogen therapy can prevent Alzheimer's disease. The document does provide evidence from randomized trials that treating hypertension through blood pressure lowering agents can reduce incidence of dementia. It summarizes trials showing reduced dementia risk when treating hypertension with calcium channel blockers, ACE inhibitors, and diuretics.
Efficacy and safety of microvascular decompression for trigeminal in patients...neurologia segura
This study evaluated the efficacy and safety of microvascular decompression (MVD) for treating trigeminal neuralgia in patients with morbid obesity. The study found that while MVD surgery took longer and had higher risks in obese patients, it was still effective at reducing pain. Specifically, obese patients had longer surgery/anesthesia times, more pre-existing health issues, and higher complication rates during intubation. However, obese patients still experienced significant pain relief following surgery similar to non-obese patients, with over 65% reporting an excellent outcome. The study concluded that MVD should be considered for obese patients with TN when it is the only effective treatment option, and can be performed safely in specialized medical centers.
1) The document discusses the continuum of pain care for military service members and veterans, from the battlefield through transitions to different healthcare systems.
2) It describes reforms to the DoD and VA healthcare systems that implement a "medical home" model and "stepped care" approach to pain management, with primary care coordinating with pain medicine and rehabilitation specialists.
3) Key challenges include managing acute pain from battlefield injuries, preventing the transition to chronic pain, and ensuring continuity of care as service members move between active military health systems and the VA system.
Trever Duke, Centre for International Child Health, University of MelbourneJane Hawtin
This document discusses models of neonatal care in the Pacific and Asia regions. It outlines several key components of effective models of care including: 1) community-based care involving skilled birth attendants and essential newborn care, 2) facility-based obstetric and neonatal care with improved access to antibiotics and attention to thermal care, and 3) neonatal intensive care. The document also reviews evidence that implementing minimal standards of neonatal care at health clinics, district hospitals, and referral hospitals can significantly reduce neonatal mortality rates.
This document discusses efforts to improve healthcare in Camden, New Jersey, one of the poorest cities in the U.S. It describes the formation of the Camden Coalition of Healthcare Providers to coordinate care for high-cost, high-need patients through a citywide database and care management programs. The Coalition aims to reduce emergency room and hospital utilization by 20-30% through strategies like nurse-led clinics, same-day appointments, and assigning patients to medical homes for coordinated care. The document highlights lessons from Camden including focusing on high-cost patients, adapting to local needs, and standardizing processes gradually over time.
This document discusses compliance with narcotics guidelines for managing prescription drug abuse. It describes how managed care programs, employers, healthcare providers and insurers are susceptible to increased workers' compensation costs due to prescription drug abuse. It identifies strategies to help drug-dependent employees return to work, and describes how Washington State has addressed overuse of opioids in workers' compensation through dosing guidelines and a prescription drug monitoring program. The agenda includes discussing the problem of prescription drug abuse, efforts to prevent problems, and the cost of addiction.
3 forette prevention of alzheimer ifa 2012] 2ifa2012
The document discusses potential approaches for preventing Alzheimer's disease and dementia. It notes that while some observational studies have found associations between certain factors and reduced dementia risk, large randomized controlled trials have not shown that anti-inflammatory agents, antioxidants, or estrogen therapy can prevent Alzheimer's disease. The document does provide evidence from randomized trials that treating hypertension through blood pressure lowering agents can reduce incidence of dementia. It summarizes trials showing reduced dementia risk when treating hypertension with calcium channel blockers, ACE inhibitors, and diuretics.
Efficacy and safety of microvascular decompression for trigeminal in patients...neurologia segura
This study evaluated the efficacy and safety of microvascular decompression (MVD) for treating trigeminal neuralgia in patients with morbid obesity. The study found that while MVD surgery took longer and had higher risks in obese patients, it was still effective at reducing pain. Specifically, obese patients had longer surgery/anesthesia times, more pre-existing health issues, and higher complication rates during intubation. However, obese patients still experienced significant pain relief following surgery similar to non-obese patients, with over 65% reporting an excellent outcome. The study concluded that MVD should be considered for obese patients with TN when it is the only effective treatment option, and can be performed safely in specialized medical centers.
1) The document discusses the continuum of pain care for military service members and veterans, from the battlefield through transitions to different healthcare systems.
2) It describes reforms to the DoD and VA healthcare systems that implement a "medical home" model and "stepped care" approach to pain management, with primary care coordinating with pain medicine and rehabilitation specialists.
3) Key challenges include managing acute pain from battlefield injuries, preventing the transition to chronic pain, and ensuring continuity of care as service members move between active military health systems and the VA system.
Trever Duke, Centre for International Child Health, University of MelbourneJane Hawtin
This document discusses models of neonatal care in the Pacific and Asia regions. It outlines several key components of effective models of care including: 1) community-based care involving skilled birth attendants and essential newborn care, 2) facility-based obstetric and neonatal care with improved access to antibiotics and attention to thermal care, and 3) neonatal intensive care. The document also reviews evidence that implementing minimal standards of neonatal care at health clinics, district hospitals, and referral hospitals can significantly reduce neonatal mortality rates.
This document discusses efforts to improve healthcare in Camden, New Jersey, one of the poorest cities in the U.S. It describes the formation of the Camden Coalition of Healthcare Providers to coordinate care for high-cost, high-need patients through a citywide database and care management programs. The Coalition aims to reduce emergency room and hospital utilization by 20-30% through strategies like nurse-led clinics, same-day appointments, and assigning patients to medical homes for coordinated care. The document highlights lessons from Camden including focusing on high-cost patients, adapting to local needs, and standardizing processes gradually over time.
This document discusses compliance with narcotics guidelines for managing prescription drug abuse. It describes how managed care programs, employers, healthcare providers and insurers are susceptible to increased workers' compensation costs due to prescription drug abuse. It identifies strategies to help drug-dependent employees return to work, and describes how Washington State has addressed overuse of opioids in workers' compensation through dosing guidelines and a prescription drug monitoring program. The agenda includes discussing the problem of prescription drug abuse, efforts to prevent problems, and the cost of addiction.
The document provides an overview of tinnitus management, including the role of hearing aids. It discusses that tinnitus is the perception of sound without an external source, often described as ringing or buzzing. Hearing loss is present in most tinnitus patients and is a risk factor for developing tinnitus. Psychological issues like anxiety and depression are also associated with tinnitus severity. Management options presented include hearing aids, sound therapy, counseling and cognitive behavioral therapy, though there is no cure. Hearing aids are emphasized as central to management by potentially reducing neural hyperactivity related to auditory deprivation from hearing loss.
Hearing loss among elderly patients in an ear clinic in nigeriaAlexander Decker
This study investigated hearing loss patterns among elderly patients seen at an ear clinic in Nigeria. Of the 586 patients who underwent audiometry over 3 years, 88 (15%) were elderly (age 65+). The mean age was 72.4 years and most were males. Over 80% had hearing loss, and 82% of those had disabling hearing loss. While sensorineural hearing loss was most common, mixed and conductive hearing losses were also present. Moderately severe hearing loss was the most prevalent. The majority had a sloping audiometric pattern typical of presbycusis, but other patterns occurred as well. Disabling hearing loss is very common in the elderly and often goes unaddressed, risking social
This study investigated the prevalence of four otologic (ear-related) complaints (otalgia, tinnitus, vertigo, hearing loss) in 200 patients with temporomandibular disorder (TMD) and compared it to a control group without TMD. The study found that TMD patients reported significantly higher rates of otologic complaints than the control group, with over three-quarters of TMD patients reporting at least one complaint. Otalgia was the most commonly reported complaint across the different TMD subgroups. However, there were only a small number of patients that had objective evidence of hearing loss related to their subjective complaints. The study suggests TMD may be associated with increased reports of otologic symptoms.
Transnasal EGD (t-EGD) was proposed in 1994 as an alternative to conventional EGD to improve tolerance and allow unsedated procedures. Developments since have addressed early concerns regarding image quality and maneuverability. Evidence shows t-EGD is feasible in 95-100% of patients, safe, and as accurate as conventional EGD for diagnoses and biopsies. Studies found t-EGD better tolerated than unsedated conventional EGD. Self-training for t-EGD requires no special skills for experienced endoscopists. T-EGD may also provide direct cost savings compared to sedated conventional EGD.
This document summarizes outcomes from 496 patients with vestibular schwannomas treated with fractionated stereotactic radiotherapy between 1995-2007. Treatment failed in 11 patients (3%) who required salvage surgery. Radiological progression was observed in 30% of patients, including 9% whose tumor volume more than doubled. Larger initial tumor volumes and higher radiation doses were associated with increased radiological progression. Neurological side effects included new facial weakness in 1.6%, trigeminal paresthesias in 2.8%, and hydrocephalus in 0.9% of patients. Long term follow up shows radiological progression occurs frequently after fractionated stereotactic radiotherapy for vestibular schwannomas, though the
This document discusses a case of tuberculosis (TB) transmission among healthcare workers in Thailand. It presents the case of a nurse with active TB who had been in contact with her roommate and other OR nurses. The document examines whether this was a result of human error or system error. It explores options for post-exposure management, including contact tracing and preventive treatment. It also discusses developing TB infection control interventions in resource-limited settings through measures like administrative controls, environmental controls, and respiratory protection.
This study evaluated 120 thyroid nodule patients using ultrasonography to assess diagnostic accuracy. Ultrasonography detected multiple nodules in 58% of patients, compared to 17% on clinical exam. 50% of clinically solitary nodules were shown to be multiple by ultrasound. Ultrasound features like composition, borders, calcifications and vascularity were analyzed. 80 patients (66.6%) were diagnosed with benign disease and 40 (33.3%) with thyroid malignancy based on ultrasound and histopathology results. The study concludes that ultrasonography is a useful complementary method to physical exam for diagnosing thyroid nodules due to its ability to detect more nodules and evaluate characteristics that suggest benign or malignant lesions.
Tinnitus is a ringing, swishing, or other noise that seems to originate in the ear or head, and is not a disease itself. It can be caused by ageing, noise exposure, ear infections, medications, and other conditions. Treatment depends on the underlying cause but often involves sound therapy, medications, or cognitive behavioral therapy since there is no cure. Laser therapy applied to the external ear and mastoid bone area is also used as a treatment approach.
Patterns of facial palsy in a tertially hospital in ghanaAlexander Decker
1) The study examined patterns of facial palsy (FP) in 86 patients seen at a hospital in Ghana over one year.
2) The most common cause of FP was Bell's palsy (67 cases, 78%), followed by middle ear infections (10 cases, 12%).
3) Treatment including steroids, physiotherapy, and vitamin C was effective in recovering facial function in most cases of Bell's palsy and middle ear infections. However, cases of herpes zoster oticus and temporal bone fractures did not recover.
This study examined the bio-socio-demographic characteristics of 70 individuals with pterygium. The mean age was 37.23 years, with most cases between 26-50 years old. Pterygium was slightly more common in females (55.71%) than males. The majority of cases were housewives (52.86%) or labourers (14.29%) with high sun exposure (80%). The average pterygium size was 2.616 mm. Keratometry found average astigmatism of 1.35D while Scheimpflug imaging found 1.22D, indicating pterygium induces corneal astigmatism.
Using linked medical records, this study explored outcomes for people with mental illness discharged from inpatient care over several decades. Some key findings include:
- There is significant risk of death within the first year of discharge, especially from natural causes.
- Mortality rates within 30 days of discharge have markedly decreased over time, especially from natural causes.
- Admission rates for those over 65 with mental illness have significantly decreased while rates of community-based care have increased.
- Working with encrypted medical records presents challenges for outcomes research but record linkage is still advantageous for studying mental health outcomes over long periods.
Tympanosclerosis is a condition where the tissues of the middle ear and eardrum become hardened and thickened. It is commonly caused by chronic or repeated middle ear infections. In one study of 115 patients who underwent surgery for tympanosclerosis, those with fixation of the malleus and mobile stapes had better hearing results after surgery than those with stapes fixation. Another study found that 11.6% of 775 patients with chronic middle ear infections also had tympanosclerosis. The majority of hearing loss associated with tympanosclerosis was of the conductive type. The exact causes and pathogenesis of tympanosclerosis are still being researched.
This document discusses the role of various imaging modalities in evaluating thyroid cancer. It covers:
1) Ultrasound is the primary imaging modality for evaluating thyroid nodules and detecting features suspicious for malignancy. CT and MRI are used for advanced staging.
2) Pre-operative imaging with CT or MRI helps determine the extent of primary tumor invasion and lymph node involvement.
3) Ultrasound and thyroglobulin levels are used for post-treatment surveillance, while radioactive iodine scans, MRI and PET are used if those are abnormal.
4) Recent advances discussed include elastography, optical coherence tomography, and MR spectroscopy for improved evaluation and differentiation of thyroid lesions.
This document discusses the role of various imaging modalities in evaluating thyroid cancer. It covers:
1) Ultrasound is the primary imaging modality for evaluating thyroid nodules and detecting features suspicious for malignancy. CT and MRI are used for advanced staging.
2) Pre-operative imaging with CT or MRI helps determine the extent of primary tumor invasion and lymph node involvement.
3) Ultrasound and thyroglobulin levels are used in follow-up surveillance to monitor for recurrence. PET/CT may be used if those are inconclusive.
4) Recent advances discussed include elastography, optical coherence tomography, and MR spectroscopy for improved evaluation and differentiation of thyroid lesions.
The document discusses various treatment controversies for Meniere's disease. It describes the definition of Meniere's disease and outlines different medical and surgical treatment options including diuretics, intratympanic gentamicin injections, and vestibular nerve section surgery. While some treatments like intratympanic gentamicin show promise, the document indicates that more research is still needed to determine the most effective therapies for controlling symptoms of Meniere's disease.
The document discusses various treatment controversies for Meniere's disease. It outlines the history and definition of the disease, as well as current understandings of physiology and pathophysiology. It then summarizes different medical, mechanical, intratympanic, surgical, and ablative treatment options and discusses evidence from studies evaluating their efficacy and side effects, finding that many options remain unproven or controversial while intratympanic gentamicin titration and vestibular nerve section/labyrinthectomy can reliably reduce vertigo.
Ultrasound can cause biological effects through thermal and non-thermal mechanisms. Thermal effects are caused by ultrasound energy being absorbed and converted to heat, while non-thermal effects include cavitation and direct mechanical effects. While some studies have reported associations between ultrasound exposure and fetal effects, most clinical studies have found no biological effects, even at higher intensities. Regulatory bodies have established safety indices and output limits, and recommend using the minimum exposure needed for diagnosis. Overall, diagnostic ultrasound is considered safe when used prudently according to established guidelines.
The document discusses new therapies and clinical trial results for treating drug-resistant epilepsy. Recent drug approvals include lacosamide and rufinamide. Drugs still in development include brivaracetam, eslicarbazepine, and retigabine. Deep brain stimulation and responsive neurostimulation devices are also being studied. Intranasal midazolam may provide a new rescue therapy option, while gamma knife radiosurgery is an alternative to open surgery for some epilepsy foci. Overall drug development is a long, expensive process requiring large clinical trials to demonstrate safety and efficacy.
Abnormalities of hormones and inflammatory cytokines in women affected with p...Alexander Decker
Women with polycystic ovary syndrome (PCOS) have elevated levels of hormones like luteinizing hormone and testosterone, as well as higher levels of insulin and insulin resistance compared to healthy women. They also have increased levels of inflammatory markers like C-reactive protein, interleukin-6, and leptin. This study found these abnormalities in the hormones and inflammatory cytokines of women with PCOS ages 23-40, indicating that hormone imbalances associated with insulin resistance and elevated inflammatory markers may worsen infertility in women with PCOS.
The document provides an overview of tinnitus management, including the role of hearing aids. It discusses that tinnitus is the perception of sound without an external source, often described as ringing or buzzing. Hearing loss is present in most tinnitus patients and is a risk factor for developing tinnitus. Psychological issues like anxiety and depression are also associated with tinnitus severity. Management options presented include hearing aids, sound therapy, counseling and cognitive behavioral therapy, though there is no cure. Hearing aids are emphasized as central to management by potentially reducing neural hyperactivity related to auditory deprivation from hearing loss.
Hearing loss among elderly patients in an ear clinic in nigeriaAlexander Decker
This study investigated hearing loss patterns among elderly patients seen at an ear clinic in Nigeria. Of the 586 patients who underwent audiometry over 3 years, 88 (15%) were elderly (age 65+). The mean age was 72.4 years and most were males. Over 80% had hearing loss, and 82% of those had disabling hearing loss. While sensorineural hearing loss was most common, mixed and conductive hearing losses were also present. Moderately severe hearing loss was the most prevalent. The majority had a sloping audiometric pattern typical of presbycusis, but other patterns occurred as well. Disabling hearing loss is very common in the elderly and often goes unaddressed, risking social
This study investigated the prevalence of four otologic (ear-related) complaints (otalgia, tinnitus, vertigo, hearing loss) in 200 patients with temporomandibular disorder (TMD) and compared it to a control group without TMD. The study found that TMD patients reported significantly higher rates of otologic complaints than the control group, with over three-quarters of TMD patients reporting at least one complaint. Otalgia was the most commonly reported complaint across the different TMD subgroups. However, there were only a small number of patients that had objective evidence of hearing loss related to their subjective complaints. The study suggests TMD may be associated with increased reports of otologic symptoms.
Transnasal EGD (t-EGD) was proposed in 1994 as an alternative to conventional EGD to improve tolerance and allow unsedated procedures. Developments since have addressed early concerns regarding image quality and maneuverability. Evidence shows t-EGD is feasible in 95-100% of patients, safe, and as accurate as conventional EGD for diagnoses and biopsies. Studies found t-EGD better tolerated than unsedated conventional EGD. Self-training for t-EGD requires no special skills for experienced endoscopists. T-EGD may also provide direct cost savings compared to sedated conventional EGD.
This document summarizes outcomes from 496 patients with vestibular schwannomas treated with fractionated stereotactic radiotherapy between 1995-2007. Treatment failed in 11 patients (3%) who required salvage surgery. Radiological progression was observed in 30% of patients, including 9% whose tumor volume more than doubled. Larger initial tumor volumes and higher radiation doses were associated with increased radiological progression. Neurological side effects included new facial weakness in 1.6%, trigeminal paresthesias in 2.8%, and hydrocephalus in 0.9% of patients. Long term follow up shows radiological progression occurs frequently after fractionated stereotactic radiotherapy for vestibular schwannomas, though the
This document discusses a case of tuberculosis (TB) transmission among healthcare workers in Thailand. It presents the case of a nurse with active TB who had been in contact with her roommate and other OR nurses. The document examines whether this was a result of human error or system error. It explores options for post-exposure management, including contact tracing and preventive treatment. It also discusses developing TB infection control interventions in resource-limited settings through measures like administrative controls, environmental controls, and respiratory protection.
This study evaluated 120 thyroid nodule patients using ultrasonography to assess diagnostic accuracy. Ultrasonography detected multiple nodules in 58% of patients, compared to 17% on clinical exam. 50% of clinically solitary nodules were shown to be multiple by ultrasound. Ultrasound features like composition, borders, calcifications and vascularity were analyzed. 80 patients (66.6%) were diagnosed with benign disease and 40 (33.3%) with thyroid malignancy based on ultrasound and histopathology results. The study concludes that ultrasonography is a useful complementary method to physical exam for diagnosing thyroid nodules due to its ability to detect more nodules and evaluate characteristics that suggest benign or malignant lesions.
Tinnitus is a ringing, swishing, or other noise that seems to originate in the ear or head, and is not a disease itself. It can be caused by ageing, noise exposure, ear infections, medications, and other conditions. Treatment depends on the underlying cause but often involves sound therapy, medications, or cognitive behavioral therapy since there is no cure. Laser therapy applied to the external ear and mastoid bone area is also used as a treatment approach.
Patterns of facial palsy in a tertially hospital in ghanaAlexander Decker
1) The study examined patterns of facial palsy (FP) in 86 patients seen at a hospital in Ghana over one year.
2) The most common cause of FP was Bell's palsy (67 cases, 78%), followed by middle ear infections (10 cases, 12%).
3) Treatment including steroids, physiotherapy, and vitamin C was effective in recovering facial function in most cases of Bell's palsy and middle ear infections. However, cases of herpes zoster oticus and temporal bone fractures did not recover.
This study examined the bio-socio-demographic characteristics of 70 individuals with pterygium. The mean age was 37.23 years, with most cases between 26-50 years old. Pterygium was slightly more common in females (55.71%) than males. The majority of cases were housewives (52.86%) or labourers (14.29%) with high sun exposure (80%). The average pterygium size was 2.616 mm. Keratometry found average astigmatism of 1.35D while Scheimpflug imaging found 1.22D, indicating pterygium induces corneal astigmatism.
Using linked medical records, this study explored outcomes for people with mental illness discharged from inpatient care over several decades. Some key findings include:
- There is significant risk of death within the first year of discharge, especially from natural causes.
- Mortality rates within 30 days of discharge have markedly decreased over time, especially from natural causes.
- Admission rates for those over 65 with mental illness have significantly decreased while rates of community-based care have increased.
- Working with encrypted medical records presents challenges for outcomes research but record linkage is still advantageous for studying mental health outcomes over long periods.
Tympanosclerosis is a condition where the tissues of the middle ear and eardrum become hardened and thickened. It is commonly caused by chronic or repeated middle ear infections. In one study of 115 patients who underwent surgery for tympanosclerosis, those with fixation of the malleus and mobile stapes had better hearing results after surgery than those with stapes fixation. Another study found that 11.6% of 775 patients with chronic middle ear infections also had tympanosclerosis. The majority of hearing loss associated with tympanosclerosis was of the conductive type. The exact causes and pathogenesis of tympanosclerosis are still being researched.
This document discusses the role of various imaging modalities in evaluating thyroid cancer. It covers:
1) Ultrasound is the primary imaging modality for evaluating thyroid nodules and detecting features suspicious for malignancy. CT and MRI are used for advanced staging.
2) Pre-operative imaging with CT or MRI helps determine the extent of primary tumor invasion and lymph node involvement.
3) Ultrasound and thyroglobulin levels are used for post-treatment surveillance, while radioactive iodine scans, MRI and PET are used if those are abnormal.
4) Recent advances discussed include elastography, optical coherence tomography, and MR spectroscopy for improved evaluation and differentiation of thyroid lesions.
This document discusses the role of various imaging modalities in evaluating thyroid cancer. It covers:
1) Ultrasound is the primary imaging modality for evaluating thyroid nodules and detecting features suspicious for malignancy. CT and MRI are used for advanced staging.
2) Pre-operative imaging with CT or MRI helps determine the extent of primary tumor invasion and lymph node involvement.
3) Ultrasound and thyroglobulin levels are used in follow-up surveillance to monitor for recurrence. PET/CT may be used if those are inconclusive.
4) Recent advances discussed include elastography, optical coherence tomography, and MR spectroscopy for improved evaluation and differentiation of thyroid lesions.
The document discusses various treatment controversies for Meniere's disease. It describes the definition of Meniere's disease and outlines different medical and surgical treatment options including diuretics, intratympanic gentamicin injections, and vestibular nerve section surgery. While some treatments like intratympanic gentamicin show promise, the document indicates that more research is still needed to determine the most effective therapies for controlling symptoms of Meniere's disease.
The document discusses various treatment controversies for Meniere's disease. It outlines the history and definition of the disease, as well as current understandings of physiology and pathophysiology. It then summarizes different medical, mechanical, intratympanic, surgical, and ablative treatment options and discusses evidence from studies evaluating their efficacy and side effects, finding that many options remain unproven or controversial while intratympanic gentamicin titration and vestibular nerve section/labyrinthectomy can reliably reduce vertigo.
Ultrasound can cause biological effects through thermal and non-thermal mechanisms. Thermal effects are caused by ultrasound energy being absorbed and converted to heat, while non-thermal effects include cavitation and direct mechanical effects. While some studies have reported associations between ultrasound exposure and fetal effects, most clinical studies have found no biological effects, even at higher intensities. Regulatory bodies have established safety indices and output limits, and recommend using the minimum exposure needed for diagnosis. Overall, diagnostic ultrasound is considered safe when used prudently according to established guidelines.
The document discusses new therapies and clinical trial results for treating drug-resistant epilepsy. Recent drug approvals include lacosamide and rufinamide. Drugs still in development include brivaracetam, eslicarbazepine, and retigabine. Deep brain stimulation and responsive neurostimulation devices are also being studied. Intranasal midazolam may provide a new rescue therapy option, while gamma knife radiosurgery is an alternative to open surgery for some epilepsy foci. Overall drug development is a long, expensive process requiring large clinical trials to demonstrate safety and efficacy.
Abnormalities of hormones and inflammatory cytokines in women affected with p...Alexander Decker
Women with polycystic ovary syndrome (PCOS) have elevated levels of hormones like luteinizing hormone and testosterone, as well as higher levels of insulin and insulin resistance compared to healthy women. They also have increased levels of inflammatory markers like C-reactive protein, interleukin-6, and leptin. This study found these abnormalities in the hormones and inflammatory cytokines of women with PCOS ages 23-40, indicating that hormone imbalances associated with insulin resistance and elevated inflammatory markers may worsen infertility in women with PCOS.
A usability evaluation framework for b2 c e commerce websitesAlexander Decker
This document presents a framework for evaluating the usability of B2C e-commerce websites. It involves user testing methods like usability testing and interviews to identify usability problems in areas like navigation, design, purchasing processes, and customer service. The framework specifies goals for the evaluation, determines which website aspects to evaluate, and identifies target users. It then describes collecting data through user testing and analyzing the results to identify usability problems and suggest improvements.
A universal model for managing the marketing executives in nigerian banksAlexander Decker
This document discusses a study that aimed to synthesize motivation theories into a universal model for managing marketing executives in Nigerian banks. The study was guided by Maslow and McGregor's theories. A sample of 303 marketing executives was used. The results showed that managers will be most effective at motivating marketing executives if they consider individual needs and create challenging but attainable goals. The emerged model suggests managers should provide job satisfaction by tailoring assignments to abilities and monitoring performance with feedback. This addresses confusion faced by Nigerian bank managers in determining effective motivation strategies.
A unique common fixed point theorems in generalized dAlexander Decker
This document presents definitions and properties related to generalized D*-metric spaces and establishes some common fixed point theorems for contractive type mappings in these spaces. It begins by introducing D*-metric spaces and generalized D*-metric spaces, defines concepts like convergence and Cauchy sequences. It presents lemmas showing the uniqueness of limits in these spaces and the equivalence of different definitions of convergence. The goal of the paper is then stated as obtaining a unique common fixed point theorem for generalized D*-metric spaces.
A trends of salmonella and antibiotic resistanceAlexander Decker
This document provides a review of trends in Salmonella and antibiotic resistance. It begins with an introduction to Salmonella as a facultative anaerobe that causes nontyphoidal salmonellosis. The emergence of antimicrobial-resistant Salmonella is then discussed. The document proceeds to cover the historical perspective and classification of Salmonella, definitions of antimicrobials and antibiotic resistance, and mechanisms of antibiotic resistance in Salmonella including modification or destruction of antimicrobial agents, efflux pumps, modification of antibiotic targets, and decreased membrane permeability. Specific resistance mechanisms are discussed for several classes of antimicrobials.
A transformational generative approach towards understanding al-istifhamAlexander Decker
This document discusses a transformational-generative approach to understanding Al-Istifham, which refers to interrogative sentences in Arabic. It begins with an introduction to the origin and development of Arabic grammar. The paper then explains the theoretical framework of transformational-generative grammar that is used. Basic linguistic concepts and terms related to Arabic grammar are defined. The document analyzes how interrogative sentences in Arabic can be derived and transformed via tools from transformational-generative grammar, categorizing Al-Istifham into linguistic and literary questions.
A time series analysis of the determinants of savings in namibiaAlexander Decker
This document summarizes a study on the determinants of savings in Namibia from 1991 to 2012. It reviews previous literature on savings determinants in developing countries. The study uses time series analysis including unit root tests, cointegration, and error correction models to analyze the relationship between savings and variables like income, inflation, population growth, deposit rates, and financial deepening in Namibia. The results found inflation and income have a positive impact on savings, while population growth negatively impacts savings. Deposit rates and financial deepening were found to have no significant impact. The study reinforces previous work and emphasizes the importance of improving income levels to achieve higher savings rates in Namibia.
A therapy for physical and mental fitness of school childrenAlexander Decker
This document summarizes a study on the importance of exercise in maintaining physical and mental fitness for school children. It discusses how physical and mental fitness are developed through participation in regular physical exercises and cannot be achieved solely through classroom learning. The document outlines different types and components of fitness and argues that developing fitness should be a key objective of education systems. It recommends that schools ensure pupils engage in graded physical activities and exercises to support their overall development.
A theory of efficiency for managing the marketing executives in nigerian banksAlexander Decker
This document summarizes a study examining efficiency in managing marketing executives in Nigerian banks. The study was examined through the lenses of Kaizen theory (continuous improvement) and efficiency theory. A survey of 303 marketing executives from Nigerian banks found that management plays a key role in identifying and implementing efficiency improvements. The document recommends adopting a "3H grand strategy" to improve the heads, hearts, and hands of management and marketing executives by enhancing their knowledge, attitudes, and tools.
This document discusses evaluating the link budget for effective 900MHz GSM communication. It describes the basic parameters needed for a high-level link budget calculation, including transmitter power, antenna gains, path loss, and propagation models. Common propagation models for 900MHz that are described include Okumura model for urban areas and Hata model for urban, suburban, and open areas. Rain attenuation is also incorporated using the updated ITU model to improve communication during rainfall.
A synthetic review of contraceptive supplies in punjabAlexander Decker
This document discusses contraceptive use in Punjab, Pakistan. It begins by providing background on the benefits of family planning and contraceptive use for maternal and child health. It then analyzes contraceptive commodity data from Punjab, finding that use is still low despite efforts to improve access. The document concludes by emphasizing the need for strategies to bridge gaps and meet the unmet need for effective and affordable contraceptive methods and supplies in Punjab in order to improve health outcomes.
A synthesis of taylor’s and fayol’s management approaches for managing market...Alexander Decker
1) The document discusses synthesizing Taylor's scientific management approach and Fayol's process management approach to identify an effective way to manage marketing executives in Nigerian banks.
2) It reviews Taylor's emphasis on efficiency and breaking tasks into small parts, and Fayol's focus on developing general management principles.
3) The study administered a survey to 303 marketing executives in Nigerian banks to test if combining elements of Taylor and Fayol's approaches would help manage their performance through clear roles, accountability, and motivation. Statistical analysis supported combining the two approaches.
A survey paper on sequence pattern mining with incrementalAlexander Decker
This document summarizes four algorithms for sequential pattern mining: GSP, ISM, FreeSpan, and PrefixSpan. GSP is an Apriori-based algorithm that incorporates time constraints. ISM extends SPADE to incrementally update patterns after database changes. FreeSpan uses frequent items to recursively project databases and grow subsequences. PrefixSpan also uses projection but claims to not require candidate generation. It recursively projects databases based on short prefix patterns. The document concludes by stating the goal was to find an efficient scheme for extracting sequential patterns from transactional datasets.
A survey on live virtual machine migrations and its techniquesAlexander Decker
This document summarizes several techniques for live virtual machine migration in cloud computing. It discusses works that have proposed affinity-aware migration models to improve resource utilization, energy efficient migration approaches using storage migration and live VM migration, and a dynamic consolidation technique using migration control to avoid unnecessary migrations. The document also summarizes works that have designed methods to minimize migration downtime and network traffic, proposed a resource reservation framework for efficient migration of multiple VMs, and addressed real-time issues in live migration. Finally, it provides a table summarizing the techniques, tools used, and potential future work or gaps identified for each discussed work.
A survey on data mining and analysis in hadoop and mongo dbAlexander Decker
This document discusses data mining of big data using Hadoop and MongoDB. It provides an overview of Hadoop and MongoDB and their uses in big data analysis. Specifically, it proposes using Hadoop for distributed processing and MongoDB for data storage and input. The document reviews several related works that discuss big data analysis using these tools, as well as their capabilities for scalable data storage and mining. It aims to improve computational time and fault tolerance for big data analysis by mining data stored in Hadoop using MongoDB and MapReduce.
1. The document discusses several challenges for integrating media with cloud computing including media content convergence, scalability and expandability, finding appropriate applications, and reliability.
2. Media content convergence challenges include dealing with the heterogeneity of media types, services, networks, devices, and quality of service requirements as well as integrating technologies used by media providers and consumers.
3. Scalability and expandability challenges involve adapting to the increasing volume of media content and being able to support new media formats and outlets over time.
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Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It typically manifests as pimples, blackheads, or whiteheads, often on the face, chest, shoulders, or back. Acne can range from mild to severe and may cause emotional distress and scarring in some cases.
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1. **Excess Oil Production:** Hormonal changes during adolescence or certain times in adulthood can increase sebum (oil) production, leading to clogged pores.
2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
3. **Hormonal Factors:** Fluctuations in hormone levels, such as during puberty, menstrual cycles, pregnancy, or certain medical conditions, can contribute to acne.
4. **Genetics:** A family history of acne can increase the likelihood of developing the condition.
**Types of Acne:**
- **Whiteheads:** Closed plugged pores.
- **Blackheads:** Open plugged pores with a dark surface.
- **Papules:** Small red, tender bumps.
- **Pustules:** Pimples with pus at their tips.
- **Nodules:** Large, solid, painful lumps beneath the surface.
- **Cysts:** Painful, pus-filled lumps beneath the surface that can cause scarring.
**Treatment:**
Treatment depends on the severity and type of acne but may include:
- **Topical Treatments:** Such as benzoyl peroxide, salicylic acid, or retinoids to reduce bacteria and unclog pores.
- **Oral Medications:** Antibiotics or oral contraceptives for hormonal acne.
- **Procedures:** Such as chemical peels, extraction of comedones, or light therapy for more severe cases.
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- **Moisturize:** Use non-comedogenic moisturizers to keep skin hydrated without clogging pores.
- **Avoid Irritants:** Such as harsh cosmetics or excessive scrubbing.
- **Sun Protection:** Use sunscreen to prevent exacerbation of acne scars and inflammation.
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GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
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Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
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2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
Skin performs essential functions such as regulating body temperature through sweat production and blood flow control, synthesizing vitamin D when exposed to sunlight, and serving as a sensory interface with the external environment.
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Helminthiasis or Worm infestation in Children for Nursing students
Tinnitus among patients in ghana
1. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 2, No.6, 2012
TINNITUS AMONG PATIENTS IN GHANA
REV. DR. PETER AWUAH
Department of Eye, Ear, Nose and Throat
School of Medical Sciences, University of Science and Technology, Kumasi, Ghana, West Africa
ABSTRACT
A study to determine the prevalence of subjective tinnitus was carried out at the Kumasi Hearing Assessment Centre
in central Ghana. A total of two thousand two hundred and seven (2,207) out-patients aged between 6- >65 years,
who complained of hearing problems or tinnitus either in isolation or in association with hearing loss, were seen
from January 1995 to December 1998.
The procedure adopted included a detailed case history and a study of the patients medical notes, otoscopy and
audiometric evaluation. Out of the 2,207 patients seen, 384 (19.3%) complained of tinnitus. 87 (22.5) of the e84
patients suffering from tinnitus had normal hearing. In addition patients with mild hearing loss had more tinnitus
than other degrees of hearing loss. There was a relationship between tinnitus and associated symptoms. Tinnitus
was described as intermittent and constant and increased with advancing age; it also had varied degrees of annoyance
effect.
Key words: Subjective tinnitus, prevalence, associated symptoms, annoyance effect, management.
INTRODUCTION
Subjective tinnitus, the false perception of sound in the absence of acoustic stimulation in the environment is a
common problem. The etiology of tinnitus remains elusive despite increased knowledge of the anatomy and function
of the cochlea and the brain. Multiple factors such as age, exposure to noise and ototoxicity appear to play a role in
the cause of persistent tinnitus1.
Additionally, tinnitus is associated with hearing loss of many etiologies including sensorineural hearing loss
(SNHL), damage to the acoustic portion of the eighth cranial nerve by tumours or other conditions including
transaction of the nerve as well as minor disturbances including impacted wax.
Tinnitus, like hearing loss increases in prevalence with advancing age. The prevalence of tinnitus in children has
been reported in a number of studies2,3,4 . Also, studies have found tinnitus to be more common in those with a mild
to moderately severe hearing deficit (up to 70 dB) than normal hearing or profoundly deaf children. In advanced
countries, tinnitus affects almost a third of the population over the age of 55 and is reported as having a severe
impact on quality of life in about a third of that number.
“Even though studies have been conducted into the prevalence of deafness in Ghana”, there is no data on the
prevalence of tinnitus in the country. In this paper, we present the results of a study to determine the prevalence of
tinnitus among patients who attended a major teaching hospital in central Ghana between January 1995 and
December 1998.
MATERIALS AND METHODS
A total of two thousand two hundred and seven patients aged 6 to above 65 years who sought medical advice on
hearing impairment or complained of tinnitus (either in isolation or in association with hearing loss) were seen at the
Ear, Nose and Throat clinic at the Komfo Anokye Teaching Hospital (KATH) in central Ghana from January 1995 to
December 1998. As far as possible, a detailed case history was taken. The case history was based on the extracts of
the questionnaire used by Martin and Snashall9. This includes name, age, sex, hearing status, details of tinnitus and
related conditions, occupational noise exposure, hearing aid possession and use and success of any remedies.
Subjective tinnitus was operationally defined as an apparent acoustic sensation for which there is no external cause.
That is, the person hears the tinnitus, but it cannot be heard by others. Post Stimulus Tinnitus was also defined by
exclusion of those who heard it “only after a loud sound, or those in whom it did not usually last for longer that five
minutes.”10,11 Also, excluded were sensations which were described as pulsating and coincidental with the heart beat,
clicking sensation resulting from the spasm of stapaedial or tensor tympanic muscle, muscles of the Eustachian tube
and those with dysfunction of the temporal mandibular joint (TMJ)”.
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Again, those who were treated with medical therapy successfully were later excluded from the study. Otological
examination was also performed by an Ear, Nose and throat specialist and patients suspected of having objective
tinnitus were excluded from the study.
An assessment of hearing was done by using conventional pure-tone audiometry (Kamplex AD 27). Testing was
done in a modern purpose-built acoustically treated room at the hospital with an overall ambient noise level of
around 30 dB A (Crest Sound Level Meter, Model 2700). The frequencies used were from 250Hz through 8000 Hz
for air conduction testing and from 250 Hz through 4000 Hz for bone conduction. Threshold was defined as normal
if hearing level is equal to or less than 25 dB HTL. Measurements of frequency resolution and specific conditional
tests on tinnitus such as visual Analog Scales (12) could not be performed due to lack of this facility.
RESULTS
A total of 2207 patients were identified in the target age ranges of 6 to >65 years.. Table I depicts the number of
patients seen at the ENT Clinic at Komfo Anokye Teaching Hospital in central Ghana between 1995 and 1998 for
medical advice on hearing-impairment and tinnitus.
Table I. Number of patients seeking medical advice on hearing-impairment and tinnitus (PST) from 1995 to
1998.
Year No. seen No. with Tinnitus
1995 380 36
1996 430 56
1997 540 97
1998 857 195
Over All 2207 384
The proportion of patients complaining of tinnitus in different age bands was shown in Table II. A close inspection
of this table revealed that tinnitus increased with advancing age. For example, at the age rage of 6-15 years, the
number increased to 143 (20.9%).
Table II. Number of patients complaining of tinnitus in four age groups.
Percentage contributions to the total is also shown.
Age (Years) No. Tinnitus Percentages
6-25 626 56 8,9
26-45 600 95 15.8
46-65 553 105 19.8
>65 423 143 20.9
Over All 2207 384
Table III. Tinnitus as a function of hearing difficulty (1995-1998). Entries (tinnitus) are numbers and
percentages within each degree of hearing difficulty in worse ear and over all grades of hearing combined.
Hearing Difficulty Number No. Tinnitus at all Tinnitus
Normal 220 133 87 (22.5%)
Mild 438 339 99 (26.6%)
Mild- moderate 383 330 53 (12.8%)
Moderate 359 318 41 (10.9%)
Severe 483 403 80 (20.3%)
Profound 324 300 24 (7.1%)
All grades 2207 1723 384
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Table IV. Tinnitus and its Associated Symptoms.
Name Yes % No % Not sure %
Migraine, Recurrent Headache 60 36 4
Vertigo, Dizziness, Meniere’s
Disease 63 29 8
Ear Pain (Otalgia) 40 57 3
Table III displays tinnitus as a function of hearing difficulty. Observe that 87 (22.5%) of the 384 patients who
complained of tinnitus had normal hearing. The severity of hearing loss ranged from less than 25 dB to more than 90
dB HTL (average pure-tone threshold at .05 through 4 KHz inclusive). It can be observed that patients with mild
hearing loss had more tinnitus than other degrees of hearing-impairment (26.6%). Tinnitus was less prevalent in
patients with profound hearing loss.
In addition, the hearing loss was sensorienural in 40% cases, conductive in 3% and mixed in 57% cases. Constant
tinnitus was associated with normal hearing (Table IV), while intermittent tinnitus was associated with hearing loss
(P<.005). Other associated symptoms accompanying the tinnitus as reported by the patients included headache,
dizziness, features suggestive of Meniere’s disease and ear pain. 14% of patients reported no annoyance effect, 6%
indicated slight annoyance; 68% of patients complaining of tinnitus reported that tinnitus was bothersome, while
12% complained of severe annoyance effect (Table V).
Table V. Prevalence of Tinnitus by annoyance effect.
Annoyance Effect No. with Tinnitus %
No annoyance 54 14
Slight annoyance (difficulty concentrating) 23 6
Moderate (bothersome) 261 68
Severe (sleep disturbance) 46 12
Total 384 100
DISCUSSION
Subjective tinnitus is a common and occasionally disabling condition. We have studied 2207 patients attending the
ENT clinic at KATH in Kumasi in central Ghana. Out of this number, 384 (19.3%) complained of tinnitus. That is,
the prevalence of tinnitus in the population studied in Ghana was 19.3%. Other studies of the prevalence of tinnitus
have demonstrated that this disturbance was present in 10% of the British population (13,10), 32.4% in the USA (14),
14.2% in Sweden (15) and 14.5% in Italy (16). Thus, the prevalence of 19.3% of patients complaining of tinnitus, that
was noted in our data, was closer to the European figure of about 14.5% and lower than the 32.4% reported in the
USA study. Table II depicts the occurrence of tinnitus in relation to age. It was observed that age had an increasing
effect on the prevalence of reported tinnitus. For example, between the ages of 6-25 years, the prevalence of tinnitus
was 8.9%, but this has increased to 20.9% for patients who are older than 65 years. This confirmed other findings
which reported that tinnitus, like hearing loss increases in prevalence with advancing age5,6.
Our data revealed that 49.1% of our population had normal to mild hearing loss. In those with significant hearing-
impairment, all degrees of hearing loss were represented. We have also shown that tinnitus was less prevalent in
those with profound hearing loss (7.1%) than other degrees of hearing loss. We found tinnitus to be more common
in patients with a mixed hearing loss (57%), followed by those with sensorieneural hearing loss (40%) and
conductive hearing loss (3%). This is at variance with the findings of Mills and Cherry3 who found tinnitus to be
more common in children with secretory otitis media (44%) than children with sensorineural hearing loss. We
cannot stress this disparity too far, since this may be accounted for by the different age range in our study. Again
otosclerosis which is very common among Caucasians and is often accompanied by tinnitus and characterized by
progressive conductive hearing loss is very rare among people of Black origin17. This may explain the very low rate
of 3% with conductive hearing loss. Our data has also indicated that majority of patients complaining of tinnitus also
had recurrent headache and dizzy episodes. This is in agreement with other studies9. As reported, the study revealed
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the following annoyance effects of tinnitus: 14% - no effect, 6% slight annoyance, 68% moderate annoyance and
12% severe annoyance. Previous studies focusing on children, have found that most children with tinnitus are not
bothered by it. In contrast, only 14% of the population sampled by Martin and Snashall, reported that their tinnitus
did not bother them. The results of other studies attempting to link the psychophysical characteristics of tinnitus to
its emotional impact have produced conflicting results. Indeed Snufffer and Tyler19 noted a significant correlation
between the reported tinnitus and its degree of annoyance. In a conflicting report, Mekle et al found no correlation
between the perceived tinnitus and emotional impact. This conflicting results in the literature is not surprising, since
we know that tinnitus research has been hampered by the lack of suitable investigatory techniques. Lockwood et al21
observed that, while the psychophysiological characteristics based on the ability of patients to compare their internal
sensation to external stimuli have been described in detail, indirect testing with visual analog scales (VAS) and
questionnaire measurements in human subjects have not been available until recently. That is, the introduction of
functional imaging techniques that make it possible to study subjective phenomenon and sensation in humans, have
only recently been applied to the study of tinnitus 22,23.
CONCLUSION
Tinnitus is known to create a lot of problems for the victims affected. It may lead to anxiety, irritability, tension,
interference with sleep, annoyance, prevention of work efficiency and so on. Indeed in Europe, it is cited often as a
cause of suicide. The purpose of this study was to determine the prevalence of tinnitus in Ghana and to ascertain the
associating symptoms and the emotional impact on the affected victims. Our results have demonstrated that the
disturbance is present in 19.3% of the population studied. Studies of the prevalence of tinnitus in other countries
produce varied results. But our data is closer to the prevalence rate of 14.2% in Sweden and 14.5% in Italy.
Regarding hearing difficulty, our results agreed with other studies. That is, tinnitus can occur in the absence of
hearing loss. In addition, the severity of hearing loss in those with tinnitus ranged from <25 dB to 90dB HTL.
Again, tinnitus was more prevalent in patients with mixed hearing loss than other types of hearing loss and that
headache and dizziness are the common associated symptoms. In addition, the etiology of tinnitus remains elusive
despite increased knowledge of the anatomy and function of the cochlea and the brain. Multiple facts, such as age,
exposure to noise and otoxicity appear to play a leading role in the cause and persistence of tinnitus. Even though
tinnitus is a real problem, modalities for therapy are far from satisfactory. In the past two decades various hypothesis
have been proposed with increasing emphasis on central processing. Many treatment modalities for tinnitus have
been presented with mixed results. These have been classified as the “five Ps” and supplemented with the “three
Ss”. These are, “prevention of mostly noise-induced tinnitus, pathological treatment of cause, psychological
management that is designed to reverse the psychological effects of tinnitus and promote habituation; prosthetic
management to mask or inhibit the tinnitus; pharmacological treatment to reduce tinnitus; surgery; suppression by
electrical stimulation and suppression by spontaneous oto-acoustic emissions. In our department, the use of
peripheral vasodilators like Ginnarizoine and Micotinic acid have proved to be efficacious in about 30-40% of our
patients. These drugs increase the peripheral circulation of the inner ear, thus allegedly reducing the irritation of the
cochlear eighth nerve. During the last two decades, hyperboric oxygenation therapy (HBO) has also been used in the
treatment of sudden deafness and chronic distressing tinnitus. But, out of the several management regimes known,
only two methods of tinnitus rehabilitation are currently prescribed in general to patients suffering from subjective
tinnitus. That is, tinnitus masking and psychological treatment, both being symptomatic forms of treatment. African
countries should train specialists in modern trends in tinnitus management since the prevalence of tinnitus is high, as
evidenced by this study.
REFERENCES
1. Axelssons, A. Causes of Tinnitus: Proceedings of the fourth International Tinnitus Seminar. Amsterdam,
NY. Kugler Publications 1990, 275-7.
2. Graham, J.M. Tinnitus with hearing loss in children. In: Evered, D. and Lawrenson, G. eds. Tinnitus:
CIBA Foundation Symposium, 85, London Pitman Books 1981b. 172 -81.
3. Mills, R.P. and cherry, J.R. Subjective tinnitus in children with ontological disorders. Int. J. Pediatric
Otolaryngology 1984, 7: 21- 7.
4. Nodular, R.H. and Lezak, M.H.W. Pediatric Tinnitus. J. of Laryngology and Otology 1984, 98(Suppl 9),
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6. Nadol, J.B. Hearing loss. N. Engl. Journal of Medicine 1993, 329, 1092- 102.
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8. Amedofu, G.K. Brobby, G.W. and Ocansey, G. The causes and prevalence of pre-school deafness in Ghana.
Afr. J. Health Sciences 1997, 4(1)13,29 -32.
9. Martin, K. and Snashall. S. children presenting with tinnitus: A retrospective study. Br. J. Audiology. 1994,
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Sept. 25th -28th 1990, 377 -402.
11. Sandlin, R.E. The management of tinnitus. Audecible: J. of the Int. Hearing Society 1994, 7 -9.
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14. Leske, M.C. Prevalence estimates of communication disorders in the US: language, hearing and vestibular
disorders. ASHA 1981, 23, 229 -237.
15. Axelsson, A. and Ringdahl, A. Tinnitus; A study of its prevalence and characteristics. Br. J. Audiology
1989,23,53- 62.
16. Quaranta, A., Assenato, G. and Sallustio, V. epidemiology of Hearing Problems among adults in Italy.
Scandinavian Audiology 1996, vol.25, suppl.42, 10-13.
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Medicine. 1986, (38), 292-295.
18. Mills, R.P., Albert, D. M. and Brain, L. E. Tinnitus in childhood. Clinical Otolaryngology 1986, 11- 431-
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20. Meikle, M.B. Vernon, J. and Johnson, R. M. The perceived severity of tinnitus. Otolaryngology, Head and
Neck Surgery 1984, 92, 689 -96.
21. Lockwood, A. H., Salvi, J. R., Burkard, F.R. and et al. Neuro-anatomy of tinnitus. Scandinavian Audiology
1999, Suppl. 51 (28), 47 – 57.
22. Carcace, A. T., Lovely, J. J., Moonen, C. T. W. and et al. In Vivo localization of phantom auditory
perceptions during functional magnetic resonance imaging of the brain. In: Reich, G. and Veron, J. A. eds.
Proceedings of the 5th International Tinnitus Seminar. Amsterdan Tinnitus Association, 1996, 397 – 401.
23. Arnold, W., Oestreicher, E., Romen, W. and et al. Focal metabolic activation in the predominant left
auditory cortex in patients suffering from tinnitus. Otorhinolaryngology and its related Specialties 1996, 58,
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those inseparable from gaining access to the internet itself. Printed version of the
journals is also available upon request of readers and authors.
IISTE Knowledge Sharing Partners
EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open
Archives Harvester, Bielefeld Academic Search Engine, Elektronische
Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial
Library , NewJour, Google Scholar