Comparing the Efficiencies of Hyperbaric Oxygen Therapy and Intratympanic Steroid Treatment for Sudden Hearing Loss.

OBJECTIVES: To compare the efficiencies of hyperbaric oxygen therapy (HBOT) and intratympanic steroid (ITS)treatment for idiopathic sudden sensorineural hearingloss (ISSHL). MATERIALS AND METHODS: A total of 136 patients who were treated for ISSHL were reviewed fromthemedical records. All of the patients were given systemic steroid therapy (SST). Among them,33patients received HBOT and 36 patients received ITS treatment following SST. The starting time to treatment, risk factors, hearing level, hearing gain (HG), and recovery rate were evaluated from retrospectiverecords. RESULTS: No substantial change in HG was observed for either the HBOT or ITS treatment cohort (p>0.05). But the time to recovery was higher in the ITS treatment cohort (40%) than in theHBOT cohort (17%). The starting time to ITS treatment was 4 days (range: 1-30) and that to HBOT was 8 days (range:3-30). There was a significant difference in the starting time to treatment (Mann-Whitney U-test, p=0.043). Also, hearing loss in the HBOT group was significantly higher than in the ITS treatment group. A significant difference was observed before and after ITS treatment (p<0.05). CONCLUSION: In patients compared with late-onset treatment, ITS may be more effective than HBO after SST failure. It can be used as salvage therapy in patients with ISSHL who are unresponsive to a primary systemic steroid. We observed that HBOT didnot improve results when it was started late. Therefore, more studies that include both ITS treatment and HBOTas anearly treatment option are needed.

Genotoxic and Genoprotective Potential of Black Mulberry (Morus nigra) Fruit.

Black Mulberry (Morus nigra L.) belongs to Moraceae family. The present study evaluated the possible genotoxic and/or protective activities of black mulberry fruit juice (BMFJ), in vitro, using mitomycin C (MMC) as a positive control, by chromosomal aberrations and micronucleus assays. Human lymphocytes were treated with BMFJ concentrations alone (1/1, 1/2, 1/4, 1/8 dilutions), pretreatment (49h) (0.20 µg/ml MMC+ 1/1 BMFJ, 0.20 µg/ml MMC+1/2 diluted BMFJ, 0.20 µg/ml MMC+1/4 diluted BMFJ, 0.20 µg/ml MMC+1/8 diluted BMFJ) and simultaneous-treatment (48h) (0.20 µg/ml MMC+ 1/1 BMFJ, 0.20 µg/ml MMC+1/2 diluted BMFJ, 0.20 µg/ml MMC+1/4 diluted BMFJ, 0.20 µg/ml MMC+1/8 diluted BMFJ). The in vitro results demonstrated that BMFJ showed no genotoxicity, but it significantly decreased chromosomal aberration and micronucleus frequency induced by MMC. Our results showed that all concentrations of BMFJ revealed no genotoxicity but protective activity against genomic changes induced by anti-tumor agent MMC in human lymphocytes. Protective effects of BMFJ on MMC induced chromosomal damages most probably due to its free radical scavenging activity.

Alpha lipoic acid intoxication: An adult.

INTRODUCTION: Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. CASE REPORT: A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention. The patient was found in an altered mental state and confused. During the physical examination, the patient's Glasgow Coma Scale was 13 (E4M6V3); however, she was neither alert nor oriented. Vital signs revealed a mildly decreased blood pressure, tachycardia, and an increased respiratory rate. Cranial nerve examination was normal except a horizontal gaze nystagmus. Laboratory testing showed a decompensated metabolic acidosis. T wave inversions were seen in the electrocardiography (EKG). The patient was treated with supportive treatment and discharged within three days of intensive care unit (ICU) admission. CONCLUSION: ALA is a very common supplement that is easily accessible worldwide. Although ALA intoxication is very rare, it is sometimes seen after accidental or suicidal acute ingestion. Neurologic effects, metabolic acidosis, and t wave inversions in the EKG are observed when this acute poisoning occurs. Supportive treatment should be the main therapy.

A research on the genotoxicity of stevia in human lymphocytes.

Stevia extracts are obtained from Stevia rebaudiana commonly used as natural sweeteners. It is ∼250-300 times sweeter than sucrose. Common use of stevia prompted us to investigate its genotoxicity in human peripheral blood lymphocytes. Stevia (active ingredient steviol glycoside) was dissolved in pure water. Dose selection was done using ADI (acceptable daily intake) value. Negative control (pure water), 1, 2, 4, 8 and 16 µg/ml concentrations which were equivalent to ADI/4, ADI/2, ADI, ADI × 2 and ADI × 4 of Stevia were added to whole-blood culture. Two repetitive experiments were conducted. Our results showed that there was no significant difference in the induction of chromosomal aberrations and micronuclei between the groups treated with the concentrations of Stevia and the negative control at 24 and 48 h treatment periods. The data showed that stevia (active ingredient steviol glycosides) has no genotoxic activity in both test systems. Our results clearly supports previous findings.