RESUMO
Background: Globally, the use of multiple psychoactive substances (MPS), either together or at different times, is on the rise. It is associated with a significant public health burden, including an increased risk for hearing impairment. This study aimed to determine the hearing thresholds among individuals with dependence on multiple psychoactive substances. Methodology: It was a comparative cross-sectional study of 41 subjects with dependence on multiple substances and an equal number of age and sex-matched comparison groups. The test group further had three subgroups, based on their predominant substances of dependence; Group I: Cigarettes, Cannabis, and Codeine; Group II: Group I substances and intravenous Pentazocine. Group III: Group II substances and intravenous Ketamine. Specific Substance Involvement scores for each of the psychoactive substances and their associated level of risk were determined, based on the ASSIST V3 questionnaire. All participants had tympanometry and pure tone audiometry. A Pure Tone Average (PTAv) was calculated. Data were analysed using SPSS 25 and statistical significance was set at a p-value 0.05. Results: There were 36 (87.8%) males and 5 (12.2%) females. The mean age of the test and comparison groups was 27.93 5.47 years and 27.98 5.70 years (p = 0.969). The mean PTAv of the test and comparison groups were 16.07 ± 5.53 dBHL and 11.01± 3.52 dBHL: (p 0.001). The p-value for the difference in the mean PTAv between sub-groups of the test group was 0.173, 0.037, and 0.719, respectively, between Group I and II, Group I and III, and Group II and III, respectively. Conclusion: Hearing thresholds were higher among individuals with dependence on MPS and statistically significant in those that were dependent on cigarettes, cannabis, and codeine. Further studies are needed on the relationship between PS and hearing loss.
RESUMO
Introduction: Remnants or the regrowth of adenoid tissue after adenoidectomy may present with clinical symptoms that could warrant a revision surgery. Aim and Objectives: This study aims to determine the prevalence and risk factors of revision adenoidectomy in our centre. Materials and Methods: This is a retrospective case-control study conducted in a tertiary otorhinolaryngology centre over a 10-year period. Cases of revision adenoidectomies were identified and matched with controlled cases of single-stage adenoidectomies within the same period. All information was entered into the Statistical Package for the Social Sciences (SPSS) version 25 and analysed using descriptive and cross-tabulation analysis. Results: A total of 1249 adenoidectomies were performed during the period of review with 26 being revision cases. The prevalence of revision adenoidectomy was found to be 2.1% with the mean interval between surgeries being 2.1 years. Age ≤ 2 years (odds ratio (OR) = 95.25, P < 0.0001), allergy (OR = 0.09, P < 0.0001), recurrent tonsillitis (OR = 0.79, P = 0.006), recurrent/chronic middle ear infections (OR = 7.5, P < 0.0001), and the primary surgeon being a junior registrar (OR = 11.5, P < 0.0001) were significantly associated with revision adenoidectomy. The performance of adenoidectomy without tonsillectomy also carries a significant odd (P = 0.04). Conclusion: Revision adenoidectomy is low in our setting. Young age at primary surgery, the presence of allergy, surgeon's designation, the extent of surgery, and recurrent middle ear and tonsil infections are factors associated with revision adenoidectomy. These should be considered in risk stratification and surgery planning.