Frequency of hearing loss among medical students using electroacoustic device.

Objective: To determine frequency of hearing loss among medical students using electroacoustic devices like hands free, headphone etc. through Pure Tone Audiometry. Methods: This cross-sectional study was conducted among students at JSMU from December 2019 till February 2020. Ethical approval was obtained against Ref: JSMU/IRB/2019/-215. Calculated sample size was 194. Non-probability convenience sampling technique was employed. Students were invited to ENT OPD JPMC, Karachi. After informed consent, sociodemographic and electroacoustic device usage history was recorded. PTA was performed at octave frequencies for air (0.25-8kHz) and bone conduction (0.5kHz-4kHz). WHO grading of hearing impairment was used. Statistical analyses carried through IBM SPSS. Chi square test, Fischer exact test and independent t test were applied at 95% CI and p value <0.05 as statistical significance. Results: Out of 246 students, 221 fulfilled inclusion criteria. Male to female ratio was 1:3. Mean age was 21 years (S.D: ±0.927). 96.4% were regularly using electroacoustic devices. 47.9% reported their use over five years. Insert type earbuds (73.8%) were the most preferred. Smartphone being the most common source (90%). Upon PTA, one third of medical students demonstrated sensorineural hearing loss at 0.25kHz and 0.5kHz. 9.5% reported associated tinnitus. Daily listening duration exceeded one hour among 78.8% while 26.4% practiced high volume setting. Males' average listening duration exceeded that of females (p=0.013). However, their mean audiometric thresholds did not vary significantly. Conclusions: Mild sensorineural hearing loss was detected among one third of participants using personal listening devices. Precautions should be practiced while using these devices.

Effects of ciprofloxacin or co-amoxicillin with and without antidepressants on behavioral deficit in rats induced with chronic suppurative otitis media.

Chronic suppurative otitis media (CSOM) is chronic infection of middle ear which is usually managed with antibiotic therapy. This infection may cause the depression and cognitive changes in patients. The aim of present study was to evaluate the effect of antibiotic (ciprofloxacin and co-amoxicillin) with antidepressant or without antidepressants (bromazepam and imipramine) at low doses on rats with induced with CSOM. Pseudomonas aeruginosa was used to induce CSOM by in rat ear (tympanic bulla). The rats were divided into eight groups having six animals in each group. Neuropharmacological activities and gross behavior were observed in open field activity, force swimming cage, maze test, light and dark activity box and traction test. Observations were noted weekly after the administration of ciprofloxacin (15.3mg/kg), co-amoxicillin (15.3mg/kg), imipramine (1.15mg/kg) and bromazepam (0.09mg/kg) intraperitoneally. The altered behavior and depression was observed in control positive but reverted back in groups maintained on antidepressants with antibiotics with significant improved locomotor activity, memory in memory cage, muscular co-ordination and body balance and decreased anxiety. On the other hand, groups treated with only antibiotics showed significant improvement only in force swimming and traction test at day 14. Therefore, the antidepressant effects of the drugs can be employed to attenuate stress and depression in patients with CSOM.

Serum Immunoglobulin E and Serotonin levels in Chronic Supporative Otitis Media Patients with and without treatment.

OBJECTIVE: To determine the serum immunoglobulin E and serotonin levels of patients with chronic suppurative otitis media (CSOM) with and without treatment. METHODS: This is a case-control study carried out in ENT ward of Jinnah Postgraduate Medical Centre Karachi Pakistan from May to September 2018.. Sample (n=160) was divided into four groups (40 individuals per group) as G1: control negative (group-1 without any disease), G2: positive control (patients didn't received medicines), G3: group (patients treated with co-amoxicillin 1000mg per day) and G4: group (patients treated with ciprofloxacin1000mg per day). After treatment period of One week serum immunoglobulin E and serotonin concentrations were evaluated by Elisa method at 450nm.Statistical evaluation was carried out using one-way ANOVA (p<0.05) followed by post hoc (tukey test) for further group comparison. In order to find out correlation between IgE and serotonin with CSOM Pearson's correlation was applied. RESULTS: There was no significant (p > 0.05) association found between genders with serotonin as well as with IgE levels in CSOM patients. One way ANOVA showed significant difference (p<0.05) for IgE and serotonin levels and post hoc (tukey test) showed significant higher of IgE levels in CSOM patients of G2 positive control (diseased patients) was observed when compared to the control negative group (healthy individuals) and also from treated groups of G3 and G4. This also showed that serotonin levels were significantly low in G2 (positive control) as well as in treated groups of G3 and G4 in contrast with healthy individuals of group G1. CONCLUSION: Antibiotics may revert the higher levels of IgE but cannot attenuate the decreased levels of neurotransmitter (serotonin) like healthy individuals, therefore, depression levels of CSOM patients should be monitored, scored and attenuated with proper intervention of antidepressants or counseling.

Association of hearing loss with depression, anxiety and stress in patients suffering from Chronic Suppurative Otitis Media.

OBJECTIVE: To study the correlation of hearing loss with depression, anxiety and stress in patients suffering from chronic suppurative otitis media in local population of Pakistan. METHODS: This is a cross-sectional study conducted from May to September 2018 at tertiary care hospital of Karachi. One hundred and twenty patients of chronic suppurative otitis media were divided into three groups: Group-1 (maintained on ciprofloxacin), Group-2 (maintained on co-amoxicillin) and Group-3 (did not subject to the treatment).The measurement of hearing loss was carried out by pure tone audiometry (PTA) and the depression, anxiety and stress were scored taking depression, anxiety and stress scale (DASS) as tool. To observe the effect of hearing loss on different groups one way ANOVA was applied and Spearman correlation was used to find correlation of depression with hearing loss. RESULTS: There was no significant difference found for hearing loss and severity among the groups treated with ciprofloxacin, co-amoxicillin and not maintained on antibiotic therapy. Positive correlations found between hearing loss and depression, anxiety and stress in patients of the three groups. CONCLUSION: Depression induced by hearing loss as a result of CSOM in patients need to be monitored during and after treatment and scored so that can be treated by counseling and antidepressant (if required). Information regarding this topic on population of Pakistan will be helpful for health care takers and policy makers to manage mental stress with hearing loss in CSOM.