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BACKGROUND AND OBJECTIVES: Cochlear implantation in late implanted prelinguals necessitates a complex decision-making process for clinicians and patients due to the uncertainty of achieving adequate benefit in auditory and speech perception. This study longitudinally evaluated clinical and social outcomes of prelingually deaf children with implantation in their late childhood. Subjects and. METHODS: A total of 113 (49 females and 64 males) participants, with an age range of 5-15 years, were assessed for the pre-implant parameters such as hearing loss etiology, aided responses, anatomical aspects, and psychological evaluation. The Category of Auditory Performance, Speech Awareness Threshold, Speech Reception Threshold, and Speech Discrimination Score were administered to assess the patient's auditory skills. Further, the Speech Intelligibility Rating scale was administered to evaluate the patient's speech intelligibility at 3, 6, 9, 12, 18, and 24 months post-surgery. Subjectively perceived benefits were evaluated using the satisfaction rating scale and a questionnaire. RESULTS: The statistical results showed a significant impact of cochlear implantation in all domains. Positive impact and improvement post-implantation were noted in all the spheres, including auditory, linguistic, social, and educational. CONCLUSIONS: The study highlighted that the outcomes of a cochlear implant at a later age might not parallel with the implantation at a younger age. However, this still provides measurable benefits even after a longer period of auditory deprivation.
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Patients with single sided-deafness (SSD) have hearing deficits amounting to a handicap to their everyday quality of life and are likely to suffer serious social challenges. There is a significant gap in the "disability" aspect of SSD in literature. The study was undertaken to compare the quality of life of SSD patients in various domains with normal hearing individuals. 51 patients of SSD with pure sensorineural hearing loss with impaired ear having a pure tone average of more than or equal to 70 dB was compared with 50 subjects with normal hearing sensitivity. Pure tone audiometric testing and the english version of Speech, Spatial and Qualities of Hearing Scale (SSQ) were used to enumerate subjective advantage. Total average SSQ score across domains in patients (6.6 ± 1.2) was significantly poorer in comparison to the control group (8.4 ± 0.9). Based on SSQ, patients with SSD experience hearing disability in comparison to the control group (p < 0.01). The ratings of all the items in the SSQ subdomains were higher in the reference group than in the patient group. Individuals with single sided-deafness experience significant auditory disability in all the three domains of speech, spatial & qualities of hearing. Therefore, these patients should be strongly counselled for currently available treatment options.
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BACKGROUND AND OBJECTIVES: Single-sided deafness (SSD) leads to non-participation of the diseased ear in generating adequate auditory input, which results in poor speech discrimination in noisy surroundings. The present study objectively compared the audiological benefits rendered by contralateral routing of signal (CROS) hearing aid and bone conduction device (BCD) in patients with SSD >70 dB HL using the modified hearing in noise test (HINT). MATERIALS AND METHODS: Patients with SSD >70 dB HL in poor and clinically normal hearing in the better ear were enrolled. Patients aged <18 or >70 years, with a history of neurological insult or ear infection in the last 3 months, mental retardation, psychiatric or developmental disorders, and diabetes were excluded. Modified HINT was performed with the affected ear unaided, aided with CROS hearing aid, and with BCD, generating three groups. Noise signal was presented at a fixed intensity of 65 dB at the neutral position in the center and speech signal was presented to either ear sequentially. The test was repeated with the speech signal fixed at the neutral position and the noise signal presented to either ear. RESULTS: BCD led to a better signal-to-noise ratio (SNR) than CROS hearing aid in all situations except when noise was centralized and speech was presented to the affected ear. CONCLUSIONS: A benefit was observed when auditory rehabilitation was used for the affected ear as demonstrated by better SNR scores. The results showed that BCD performed better than CROS hearing aid.
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ABSTRACT: Speech-language therapists along with affected individuals face various challenges for accomplishing the rehabilitation services. In the current COVID19 pandemic scenario, telerehabilitation has emerged as a substitute to the traditional face-to-face therapy, and is the only option possible in some cases. To subjectively assess the feasibility & acceptability of telerehabilitation provided by speech-language pathologist to patients of speech and language disorders. This qualitative study includes 20 patients suffering from disorders of fluency, voice, swallowing and neurogenic disorders. The participants included were undergoing face-to-face therapy at our institute. After the completion of face-to-face session series, telerehabilitation services were provided through a video calling app. The outcomes of teletherapy were assessed subjectively using a structured questionnaire on 11 parameters using a Likert scale. Of the included 20 patients, after completion of teletherapy, four patients chose the physical interaction as the preferred mode of therapy while 16 chose teletherapy as the preferred mode. Except three clients who rated their overall satisfaction as '3', others rated as '4' or '5'.The therapists were satisfied with the outcomes in 17 cases, and were pleased with the overall progress of all the clients (rated 4 or 5). Telerehabilitation is a reliable method to deliver speech and language services at community level, on long-term basis, as is proven by the high satisfaction scores among the clients as well as the service providers. CLINICAL TRIAL REGISTRATION: The trial has been registered in Clinical Trials Registry of India (CTRI) vide number CTRI/2018/04/ 012,922 (http://ctri.nic.in/Clinicaltrials/login.php) on 02/04/2018.
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OBJECTIVE: Euthanasia is a controversial issue that puts doctors into a dilemma and can have the capacity to end the patients' sufferings. However, it is never an easy decision; hence, this study was planned to find the attitude of practicing doctors of medical colleges in a South Indian city of Mangalore towards euthanasia. METHODS: A cross sectional study was conducted in March-April 2010 among the doctors practicing in the four medical colleges of Mangalore city. A pretested semi-structured questionnaire was used to collect data from 220 doctors after their informed consent. Data was analyzed using SPSS version 11.5. RESULTS: Mean age of the doctors was 37.9 years (SD=9. 4), most of them were males and belonging to the Hindu religion. Euthanasia was justified according to 46.8% of the doctors in order to curtail the sufferings of the patients or to ameliorate the emotional and financial burden. Another 41% said it should be legalized and 39% said that they would use it if it was legalized. Nevertheless 84.5% of them were concerned that it may be misused if legalized. More than half of them felt it was not justified in the face of moral obligations and legal complications. Religion and department were independently associated with the doctors feeling that euthanasia was justified with 69.4% of Muslim doctors saying it was justified as compared to 59.2% of Hindu doctors (OR=2.82; p=.001) and 59.3% of doctors from medical specialities said it was justified as opposed to 39.8% of doctors from surgical specialities (OR=2.3; p=.008). Despite the illegality of it, 25% of the doctors had received requests from patients and 22.3% from relatives for euthanasia. CONCLUSIONS: Though euthanasia is illegal in the country, there are doctors who feel it is justified in some situations, yet not without reservations. The fact that they had been requested for euthanasia by the patients and relatives show that even the public are being aware and accepting the practice. Yet, the law in our country has not changed and it would be worthwhile to garner opinions and attitudes of all stakeholders to aid the legislators in framing policy guidelines in the future.
