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BACKGROUND: Interferons are essential part of the innate immune system and have antiviral and immunomodulatory functions. We studied the effects of Interferon s-1a on outcomes of severe cases of COVID-19. MATERIAL AND METHODS: This retrospective study was conducted on hospitalized COVID-19 patients in Loghman-Hakim hospital from 20 February 2020 to 20 April 2020, Tehran, Iran. Patients were selected from two groups, the first group received Interferon s-1a in addition to standard treatment regimen, and the second group received standard care. The clinical progression of two groups during their hospital admission has been compared. RESULTS: We studied a total number of 395 hospitalized COVID-19 patients. Out of this number, 111 patients (33.5%) died (31.3% of the Interferon s-1a group and 34.1% of the control group). Mortality rate indicated no statistically significant difference between groups (p-value = 0.348), however for patients who were hospitalized for more than a week, the rate of mortality was lower in the Interferon s-1a group (p-value = 0.014). The median hospital stay was statistically longer for patients treated by Interferon s-1a (p-value

Background Males are more likely to die from COVID-19 than females. In addition, the mortality rate among positive and suspected COVID-19 patients were reported in many studies. The aim of this study is to evaluate the sex differential effect in the COVID-19 mortality by different age groups and polymerase chain reaction (PCR) test results. Research design In a multicenter cross-sectional study from 55 hospitals in Tehran, Iran, patients were categorized as positive, negative and suspected cases. Age group, sex and hospital wards were also assessed in the analysis. Results A total of 25481 cases (14791 males) were included in the study with a mortality rate of 12.0%. The mortality rates in positive, negative and suspected cases were 20.55%, 9.97% and 7.31%, respectively. Although the mortality in negative test group was considerable, sex was not associated with the death rate in this group. Using a Cox regression model, sex had a significant effect on the hazard of death due to COVID-19 in adult and senior male patients having positive and suspected PCR test results. However, sex was not found as significant factor for mortality in patients with a negative PCR test in different age groups. Conclusions Regardless of other risk factors, we found that the effect of sex on COVID-19 mortality varied significantly in different age groups. Therefore, appropriate strategies should be designed to protect adult and senior males from this deadly infectious disease. Furthermore, owing to the considerable death rate of COVID-19 patients with negative test results, new policies should be launched to increase the accuracy of diagnosis tests.

Background: COVID-19 is an infectious disease which caused a pandemic with many diseases and fatalities. This new variant of coronavirus called SARS-CoV-2 and is primarily characterized by respiratory symptoms. There are some data indicating that LDL-cholesterol (LDL-C) as well as HDL-cholesterol (HDL-C) levels are inversely correlated to disease severity and could act as a predictor for disease progression and unfavorable prognosis. However, the results of some other studies do not confirm this. This current study aimed to provide an answer to this question. ----- Methods: This prospective, single-center study analyzed 367 confirmed COVID-19 patients to find whether there are any differences in plasma lipoproteins between survivors and non-survivors patients or between the patients with a "duration of ≤10 days intensive unit care (ICU) stay" and patients with a "duration of >10 days ICU stay". ----- Results: No association between any lipid/lipoprotein parameter and the severity of COVID-19 could be found but survivors and non-survivors did differ concerning total cholesterol and LDL-C levels. ----- Conclusion: Multivariate cox regression analysis could not prove any association between lipids/lipoproteins and severe events in COVID-19 patients. Significantly less non-survivors with COVID-19 were taking atorvastatin than survivors which is consistent with the majority of previous findings.

Background: Interferons are essential part of the innate immune and have antiviral and immunomodulatory functions. In the lack of definite medication for COVID-19, Interferons can be effective in treatment of severe cases of COVID-19 and may decrease mortality of this disease.Material and methods: This retrospective study was conducted on hospitalized COVID-19 patients in Loghman-Hakim hospital from 20 February 2020 to 20 April 2020, Tehran, Iran. Patients were selected from two groups, first group received Interferon β-1a in addition to standard treatment regimen and patients of second group received standard care. The clinical progression of two groups during their hospital admission have been compared.Results: We studied total number of 395 hospitalized COVID-19 patients. Out of this number, 111 patients (33.5%) died (31.3% of Interferon β-1a (Recigen) group and 34.1% of control group). Mortality rate indicated no statistically significant difference between groups, however for patients who hospitalized more than a week, the rate of mortality was lower in Recigen group. The median time of staying in hospital was statistically shorter for patients treated by IFN-β1a. The Odds of death in control groups who hospitalized for at least one week, compared to Recigen group was 3.96 (95% CI: 1.37-11.43, P.value=0.011) Conclusion: This study showed IFN-β1a have significant efficacy in treating severe COVID-19 patients who hospitalized for at least one week and improve the outcomes of patients and decrease the duration of hospitalization.

Background: Males are more likely to die from COVID-19 than females. In addition, the mortality rate among positive and suspected COVID-19 patients were reported in many literatures. The aim of this study is to evaluate the sex differential effect in the COVID-19 mortality by different age groups and polymerase chain reaction (PCR) test results. Methods: in a multicenter cross-sectional study from 55 hospitals in Tehran, Iran, patients were categorized as the positive, negative and suspected cases. Age group, sex and hospital wards were also assessed in analysis. Results: A total of 25481 cases (14791 males) were included in the study with the mortality rate of 12.0%. The mortality rate in positive, negative and suspected cases were 20.55%, 9.97% and 7.31%, respectively. Although the mortality in negative test group was considerable, sex was not associated with the death rate in this group. Using Cox regression model, sex had a significant effect on the hazard of death due to COVID-19 in adults and senior patients having positive and suspected PCR test results. However, sex was not found as significant factor for mortality in patients with negative PCR test occurring to different age groups. Conclusion: Regardless of other risk factors, we found that sex differential effect in COVID-19 mortality varies significantly in different age groups; therefore, appropriate strategies should be designed to protect adult and senior men from this deadly infectious disease. Furthermore, owing to the considerable death rate of COVID-19 patients with negative test results, new policies should be launched increase the accuracy of diagnosis tests.

The outbreak of COVID-19 has laid unprecedented psychological stress on healthcare workers (HCWs). We aimed to assess the immediate psychological impact of COVID-19 epidemic on the HCWs at Baqiyatallah Hospital in Tehran, Iran.We conducted a cross-sectional survey of HCWs using questionnaires in February and March 2020 in Baqiyatallah Hospital, Tehran. We evaluated depression, stress, and anxiety levels using the DASS-21 questionnaire. Participants were selected by using census sampling. All statistical analyses were performed using R version 3.5.1.The study population included 217 HCWs (111 male, 116 female) and the mean age of the study group was 39.6 years old. Approximately two-thirds of the HCWs stayed in the hospital for 2-3 weeks. The mean scores of depression and stress were at a "severe" level, while anxiety scores were at an "extremely severe" level. The prevalence of severe scores was 38.71%, 2.30%, and 48.97% for depression, anxiety, and stress, and the prevalence of extremely severe scores was 46.54%, 97.24%, and 4.98% depression, anxiety, and stress, respectively. In stress subscale, moderate stress was 47.46%. Female HCWs reported higher levels of depression compared with males.In this study, HCWs reported experiencing severe and extremely severe psychological burdens. Timely interventions to promote mental health in HCWs exposed to patients with COVID-19 need to be immediately implemented, with female nurses requiring particular attention. This process could be facilitated via tests for molecular biomarkers in accessible body fluids, such as saliva, plasma, and serum.

Aim The COVID-19 was declared a pandemic in early 2020 and is associated with high public anxiety all over the world. The healthcare community is at the highest risk of infection and thereby prone to most distress. The aim of this study was to explore and evaluate the degree of depression, anxiety, and stress levels among medical college students during the COVID-19 epidemic in Iran. Methods A cross-sectional study was conducted in February and March 2020, 3 weeks after the first reported COVID-19 infection was identified in Iran. All medical college students who entered clinical courses were eligible for the study. Depression, stress, and anxiety were evaluated in these students using the DASS-21 questionnaire. Participants were selected by using availability sampling. All statistical analyses were performed using R version 3.5.1. Results The total number of participants was 207, with 143 males and 64 females. More than half of the participants (57.97%) were married. The mean duration of working experience among students with COVID-19 infection and experience in a medical ward was 3.00 ± 1.27 days and 17.40 ± 7.26 months, respectively. The majority of students had 2 or 3 days working experience with COVID-19 infection. The mean anxiety score of participants was 28.56 ± 4.68, the depression score was 29.36 ± 4.42, and the stress score was 28.99 ± 4.53. Our findings indicated that the mean scores of depression were at an "extremely severe" level, while stress and anxiety were at "severe" levels. The prevalence of "severe" symptoms of depression, stress, and anxiety was 69.57%, 60.87%, and 99.04%, respectively. Conclusions There is a high prevalence of anxiety and depression among medical students who were exposed to COVID-19-infected patients. Our results highlight the need to establish psychological support programs, training, and self-care for medical college students in relation to mental health. We recommend incorporation of molecular biomarker tests into an algorithm to aid in assessments and consideration of the appropriate therapeutic responses.

Patients with confirmed COVID-19 infection can develop several psychological consequences. Epidemiological data on mental health and psychological disorder inpatients infected with COVID-19 pneumonia are not available in Iranian patients. The purpose of this study was to evaluate the anxiety, stress, and depression of patients with COVID-19.This cross-sectional survey was conducted in 2020. All confirmed patients with COVID-19 were included in the study by census sampling. Assessment of depression, stress, and anxiety was performed using the DASS-21 questionnaire. All statistical analyses were performed using R version 3.5.1.The questionnaires were completed by 221 patients with COVID-19 infection (204 males, 17 females). The mean age was 45.90 ± 7.73 years. Our results indicated that the mean scores of depression and anxiety were at "extremely severe" levels, while stress levels were "severe." The prevalence of "extremely severe" symptoms of depression and anxiety was 54.29% and 97.29%, respectively. The prevalence of severe stress was 46.61%.In this study, patients infected with COVID-19 reported severe and extremely severe experience psychological distress. Further studies should focus on the combined use of psychological and molecular biomarker testing to increase accuracy. Overall, the findings demonstrate the necessity of special intervention programs for the confirmed patients with emerging infectious disease COVID-19 to promote mental health needs.

Aim The ongoing COVID-19 outbreak has not only had an impact on physical health but also on psychological health. The aim of this study was to measure the prevalence and severity of psychological distress in the community due to the COVID-19 pandemic. Methods This cross-sectional survey was conducted in February and March 2020 in Tehran, Iran. We analyzed demographic characteristics and assessed depression, anxiety, and stress levels in 241 people using convenience sampling and the DASS-21 questionnaire. All statistical analyses were performed using R. Results The study population included 241 community-dwelling participants, of whom 145 were women and 96 were males. The mean age was 49.16 ± 8.01 years. Approximately two-thirds of participants (n = 158) reported no history of comorbid illness. The mean scores of depression and stress were at a "severe" level, while anxiety levels were at an "extremely severe" level. The prevalence of severe and extremely severe depression readings was 51.45 and 38.17%, respectively. In the anxiety subscale, the prevalence of severe and extremely severe depression was 95.90 and 4.1%, and in the stress subscale the prevalence was 48.97 and 4.98%, respectively. Conclusion In this study, people reported experiencing severe and extremely severe psychological distress. Therefore, there is an urgent need to implement mental health intervention policies to cope with this ongoing challenge. We suggest that the incorporation of molecular biomarker tests into the algorithm could aid in assessment of patients and guide the most appropriate therapeutic response.

We sought to evaluate the effetc of metformin on body mass index (BMI) and metabolic parameters in HIV-positive patients. We performed a comprehensive search through five major indexing databases, using keywords (“metformin” OR “dimethylguanylguanidine” OR “biguanide” OR “Glucophage”) AND (“HIV” OR “human immunodeficiency virus” OR “AIDS” OR “Acquired immunodeficiency syndrome”), and all possible combinations until January 15, 2021. We measured standardized mean differences (SMD) and 95% confidence intervals (CI) for each outcome. We finally included 12 RCTs (577 participants, 274 in the metformin group and 303 in the comparators). Metformin did not significantly change BMI index compared to various comparators. Metformin generally improve LDL levels (SMD = 0.29, 95% CI: − 1.00 1.57, P = 0.01), HDL levels (SMD = − 0.15, 95% CI: − 0.72 0.41, P = 0.001), triglycerides values (SMD = 0.46, 95% CI: − 0.36 1.27, P

Aim The outbreak of COVID-19 has laid unprecedented psychological stress on healthcare workers (HCWs). We aimed to assess the immediate psychological impact of COVID-19 epidemic on the HCWs at Baqiyatallah Hospital in Tehran, Iran.

Aim The COVID-19 was declared a pandemic in early 2020 and is associated with high public anxiety all over the world. The healthcare community is at the highest risk of infection and thereby prone to most distress. The aim of this study was to explore and evaluate the degree of depression, anxiety, and stress levels among medical college students during the COVID-19 epidemic in Iran. Methods A cross-sectional study was conducted in February and March 2020, 3 weeks after the first reported COVID-19 infection was identified in Iran. All medical college students who entered clinical courses were eligible for the study. Depression, stress, and anxiety were evaluated in these students using the DASS-21 questionnaire. Participants were selected by using availability sampling. All statistical analyses were performed using R version 3.5.1. Results The total number of participants was 207, with 143 males and 64 females. More than half of the participants (57.97%) were married. The mean duration of working experience among students with COVID-19 infection and experience in a medical ward was 3.00 ± 1.27 days and 17.40 ± 7.26 months, respectively. The majority of students had 2 or 3 days working experience with COVID-19 infection. The mean anxiety score of participants was 28.56 ± 4.68, the depression score was 29.36 ± 4.42, and the stress score was 28.99 ± 4.53. Our findings indicated that the mean scores of depression were at an "extremely severe" level, while stress and anxiety were at "severe" levels. The prevalence of "severe" symptoms of depression, stress, and anxiety was 69.57%, 60.87%, and 99.04%, respectively. Conclusions There is a high prevalence of anxiety and depression among medical students who were exposed to COVID-19-infected patients. Our results highlight the need to establish psychological support programs, training, and self-care for medical college students in relation to mental health. We recommend incorporation of molecular biomarker tests into an algorithm to aid in assessments and consideration of the appropriate therapeutic responses.

Aim Patients with confirmed COVID-19 infection can develop several psychological consequences. Epidemiological data on mental health and psychological disorder inpatients infected with COVID-19 pneumonia are not available in Iranian patients. The purpose of this study was to evaluate the anxiety, stress, and depression of patients with COVID-19.

Aim The ongoing COVID-19 outbreak has not only had an impact on physical health but also on psychological health. The aim of this study was to measure the prevalence and severity of psychological distress in the community due to the COVID-19 pandemic. Methods This cross-sectional survey was conducted in February and March 2020 in Tehran, Iran. We analyzed demographic characteristics and assessed depression, anxiety, and stress levels in 241 people using convenience sampling and the DASS-21 questionnaire. All statistical analyses were performed using R. Results The study population included 241 community-dwelling participants, of whom 145 were women and 96 were males. The mean age was 49.16 ± 8.01 years. Approximately two-thirds of participants (n = 158) reported no history of comorbid illness. The mean scores of depression and stress were at a "severe" level, while anxiety levels were at an "extremely severe" level. The prevalence of severe and extremely severe depression readings was 51.45 and 38.17%, respectively. In the anxiety subscale, the prevalence of severe and extremely severe depression was 95.90 and 4.1%, and in the stress subscale the prevalence was 48.97 and 4.98%, respectively. Conclusion In this study, people reported experiencing severe and extremely severe psychological distress. Therefore, there is an urgent need to implement mental health intervention policies to cope with this ongoing challenge. We suggest that the incorporation of molecular biomarker tests into the algorithm could aid in assessment of patients and guide the most appropriate therapeutic response.

Patients with profound Sensorineural Hearing Loss (SNHL) are susceptible to vestibular disturbances following Cochlear Implant (CI) surgery. This study aimed to evaluate vestibular dysfunctions following unilateral CI in the congenitally deaf children.This was a cross-sectional study conducted on 24 children (mean age: 10.56 ± 5.49 years old) who underwent unilateral CI and 24 age-matched controls (mean age: 11.13 ± 6.21 years old). Vestibular functions were assessed by Vestibular Evoked Myogenic Potential (VEMP) and Computerized Dynamic Posturography (CDP). The VEMP test was performed for otolith's function (especially saccule) evaluation. Sensory Organization Test (SOT) protocol of CDP was also utilized to differentiate the role of various sensory systems contributing to postural stability. In addition, total equilibrium score was calculated. The variables were comparatively assessed between the two groups.The mean p13-n23 amplitude in the CI users was significantly lower than the controls (p0.05). However, the two groups showed no significant difference in cVEMP latency values (p0.05). The SOT analysis revealed that 45.83% (11/24) of the CI subjects had some kind of sensory abnormalities: 7 cases (29.17%) vestibular, 2 cases (8.33%) visual, 2 cases (8.33%) vestibular and somatosensory involvements. Furthermore, total equilibrium score was significantly reduced in implanted group than the controls (p0.001). At least, 70.59% (12/24) CI patients showed abnormal values in the CDP or cVEMP examinations.This study shows functional vestibular impairments in children who underwent CI. These patients showed significantly increased postural instability which was more evident in dynamic conditions. These findings provide the basis for better pre-operative counseling and postoperative vestibular rehabilitation to CI recipients.

Introduction Dizziness and imbalance are common dysfunctions in the elderly. Vestibular rehabilitation therapy is an effective method to alleviate chronic dizziness in patients with vestibular dysfunction. Transcranial direct current stimulation has reportedly improved balance function in patients with vestibular dysfunction. Objective This study was conducted to investigate the therapeutic efficacy of vestibular rehabilitation combined with transcranial direct current stimulation in elderly patients with vestibular dysfunction. Methods In a double-blinded randomized controlled trial, 36 elderly patients with chronic vestibular dysfunction were randomly assigned to either vestibular rehabilitation and transcranial direct current stimulation (n = 18) or vestibular rehabilitation alone (n = 18) group. The transcranial stimulation protocol consisted of multisession bifrontal electrical stimulation of the dorsolateral prefrontal cortex (2 mA intensity and 20 min duration), followed by rehabilitation exercises. The vestibular rehabilitation protocol consisted of habituation and adaptation exercises combined with gait exercises during a three week period. The primary outcome of this study was the dizziness handicap inventory score, and the secondary outcomes were activities-specific balance confidence and Beck anxiety inventory scores. Results For the dizziness handicap score, the repeated-measures analysis of variance showed a significant main effect of “time”, “stimulation” and stimulation × time interaction effect. There was a significant reduction in the overall dizziness handicap score with “time” for both the groups, which was more pronounced in the vestibular rehabilitation and electrical stimulation group. In terms of activities-specific balance confidence change scores, we found a significant main effect of “time” and “stimulation” main factors, but this effect for stimulation × time interaction was not significant. For the Beck anxiety score, we observed a significant main effect of “time”, but no evidence for the main effect of the “stimulation” factor. Conclusion Bifrontal transcranial direct current stimulation in combination with vestibular rehabilitation therapy is a promising approach to improve chronic vestibular symptoms in the elderly.

Background Treatment for polycystic ovary syndrome (PCOS) usually initiates with a series of lifestyle modifications such as diet, weight loss, and exercise. Aims We, therefore, conducted this meta-analysis to systematically review and evaluate the possible benefits of LGD on a range of anthropometric, clinical, and biochemical parameters in women with PCOS. Methods We performed a systematic search through major indexing databases, including Scopus, Pubmed/Medline, ISI web of science, Embase, Cochrane central, and CINAHL (1966–April 30, 2021) using key concepts of PCOS. Results Of 935 initial publications, 542 remain after duplicates removal. Then, 141 records were removed at the title and abstract screening level. After excluding 392 literatures, we finally included 8 articles. The final selected studies included 412 overweight and obese individuals with PCOS (207 cases in LGID group and 205 patients in comparators) with a mean age of 21–32 years. Measured emotional health (3 studies, 132 participants, SMD: -1.97; 95%CI:-3.54, -0.40, P = 0.01, I2 = 89%) and body hair (3 studies, 132 participants, SMD: -0.40; 95%CI:-0.46, -0.35, P < 0.0001, I2 = 0%), were found to be significantly lower in women in LGD vs control diet groups. Moreover, infertility (3 studies, 132 participants, SMD: 1.45; 95%CI: 0.30, 2.61, P = 0.01, I2 = 79%) was significantly higher in women in LGD vs control diet groups. Conclusion The present meta-analysis has shown that LGD may play a significant role in reducing the risk and improving the clinical and biochemical features of PCOS. So far the evidences for choosing the best dietary modalities for PCOS are not strong to make a definite recommendation., Glycemic index; Low-GI diets; Endocrine parameters; Blood lipids; PCOSQ domains.

Objective: Cochlear Implant (CI) users often suffer difficulties in perceiving speech in noisy environments that could be attributed to reduced Auditory Stream Segregation (ASS) ability. ASS is the process used to separate a complex sound into different perceptual streams. The evidence that CI listeners routinely experience stream segregation skill is limited and equivocal. The present study was aimed to investigate the effects of temporal cues on ASS performance in postlingually deaf listeners with CI. Methods: Nineteen (age range: 28-64 years old) monaurally cochlear implanted listener participated in this study. They were presented with 30-s sequences of alternating stimuli in a repeating A-B-A-A-B-A…sequence, where “tone A” corresponds to a stimulus applied to electrode 11, and “tone B” to a stimulus on one of the other electrode. To investigate the effect of temporal cues on ASS, four different tone repetition times (TRTs) were utilized: 50, 100, 150, and 200 ms. Speech discrimination scores in noise were also recorded for every CI recipients Results: Only 6 (32%) CI users demonstrated ASS pattern similar to the normal hearing subjects, while the majority of the users (n=13) possessed poorer ASS skills. An analysis of variance showed a significant effect of electrode separation (p

Background and aims COPD is an irreversible or persistent airflow obstruction, which affects up to 600 million people globally. The primary purpose of this systematic review was to explore the COPD-based alteration in the auditory system function by conducting a quantitative analysis of presently published data. Materials and methods We systematically searched seven diverse electronic databases and manual searching of references to identify relevant studies. Data from the selected studies were rated by two investigators independently in a blinded fashion. Meta-analysis was done on pooled data using Cochrane's Review Manager 5.3. Results Sixteen articles received suitable scores and were thus included for further processes. Hearing loss (HL) was defined as a change in pure tone audiometry (PTA) thresholds, auditory brainstem response (ABR), and auditory P300 parameters. ABR wave was significantly elongated in patients with COPD than in controls (standardized mean difference [SMD]=0.27, 95% CI: 0.05-0.48, P=0.02). PTA was significantly higher in patients with COPD when compared with controls (SMD=1.76, 95% CI: 0.43-3.08, P=0.0004). We found that patients with COPD had a significantly higher latency than controls (SMD=1.30, 95% CI: 0.79-1.80, P=0.0001). Conclusion COPD patients had considerably greater incidence of HL when compared with controls. Interestingly, although the mean PTA thresholds at every frequency for COPD patients were higher than those for controls, these values were still in the slight to mild HL ranges. Prolonged ABR wave latencies in the COPD patients suggest retro-cochlear involvement. Thus, COPD most frequently clusters with HL, but it is worth noting that alteration in hearing is not always recognized by medical experts as a frequent comorbidity associated with COPD.

Background and Aims: Chronic obstructive pulmonary disease (COPD) affects up to 600 million people worldwide and it is currently one of the leading causes of morbidity and mortality in patients suffering from chronic diseases. The primary purpose of this study was to conduct a systematic review in order to explore the effects of COPD on the auditory system function by performing a quantitative analysis of currently available published data on this subject. Methods: We systematically searched seven diverse electronic databases and manual searching of references to identify relevant studies. Data from the selected studies were rated by two investigators independently in a blinded fashion. Meta-analysis was done on pooled data using Cochrane's Review Manager 5. Results: Sixteen articles received suitable scores and were thus included for further processes. Hearing loss (HL) was defined by all studies as change in pure tone audiometry (PTA) thresholds, auditory brainstem response (ABR) and auditory P300 parameters. ABR waves was significantly elongated in patients with COPD than in controls (SMD = 0.27; 95%CI: 0.05-0.48; P = 0.02). PTA was significantly higher in patients with COPD when compared with control cases (SMD = 1.76; 95%CI: 0.43-3.08; P=0.0004). We found that patients with COPD had a significantly higher latency than controls (SMD = 1.30; 95%CI: 0.79-1.80; P=0

Background: Chronic vestibular dysfunction is a frustrating problem in the elderly and can have a tremendous impact on their life, but only a few studies are available. Vestibular rehabilitation therapy (VRT) is an important therapeutic option for the neuro-otologist in treating patients with significant balance deficits. Objectives: The purpose of this study was to assess the effect of vestibular rehabilitation on dizziness in elderly patients with chronic vestibular dysfunction. Materials and Methods: A total of 33 patients older than 60 years with chronic vestibular dysfunction were studied. Clinical and objective vestibular tests including videonystagmography (VNG) and dizziness handicap inventory (DHI) were carried out at their first visit, 2 weeks, and 8 weeks post-VRT. The VRT exercises were performed according to Cawthorne and Cooksey protocols. Results: Oculomotor assessments were within normal limits in all patients. Nineteen patients (57.57%) showed abnormal canal paralysis on caloric testing which at follow-up sessions; CP values were decreased remarkably after VRT exercises. We found a significant improvement between pre-VRT and post-VRT total DHI scores (P < 0.001). This improvement was most prominent in functional subscore. Conclusions: Our study demonstrated that VRT is an effective therapeutic method for elderly patients with chronic vestibular dysfunction.

Background: Auditory scene analysis (ASA) is the process by which the auditory system separates individual sounds in natural-world situations. ASA is a key function of auditory system, and contributes to speech discrimination in noisy backgrounds. It is known that sensorineural hearing loss (SNHL) detrimentally affects auditory function in complex environments, but relatively few studies have focused on the influence of SNHL on higher level processes which are likely involved in auditory perception in different situations. Objectives: The purpose of the current study was to compare the auditory system ability of normally hearing and SNHL subjects using the ASA examination. Materials and Methods: A total of 40 right-handed adults (age range: 18 - 45 years) participated in this study. The listeners were divided equally into control and mild to moderate SNHLgroups. ASA ability was measured using an ABA-ABA sequence. The frequency of the "A" was kept constant at 500, 1000, 2000 or 4000 Hz, while the frequency of the "B" was set at 3 to 80 percent above the" A" tone. For ASA threshold detection, the frequency of the B stimulus was decreased until listeners reported that they could no longer hear two separate sounds. Results: The ASA performance was significantly better for controls than the SNHL group; these differences were more obvious at higher frequencies. We found no significant differences between ASA ability as a function of tone durations in both groups. Conclusion: The present study indicated that SNHL may cause a reduction in perceptual separation of the incoming acoustic information to form accurate representations of our acoustic world.

Introduction: It has been demonstrated that long-term Conductive Hearing Loss (CHL) may influence the precise detection of the temporal features of acoustic signals or Auditory Temporal Processing (ATP). It can be argued that ATP may be the underlying component of many central auditory processing capabilities such as speech comprehension or sound localization. Little is known about the consequences of CHL on temporal aspects of central auditory processing. Objective: This study was designed to assess auditory temporal processing ability in individuals with chronic CHL. Methods: During this analytical cross-sectional study, 52 patients with mild to moderate chronic CHL and 52 normal-hearing listeners (control), aged between 18 and 45 year-old, were recruited. In order to evaluate auditory temporal processing, the Gaps-in-Noise (GIN) test was used. The results obtained for each ear were analyzed based on the gap perception threshold and the percentage of correct responses. Results: The average of GIN thresholds was significantly smaller for the control group than for the CHL group for both ears (right: p = 0.004; left: p < 0.001). Individuals with CHL had significantly lower correct responses than individuals with normal hearing for both sides (p < 0.001). No correlation was found between GIN performance and degree of hearing loss in either group (p > 0.05). Conclusion: The results suggest reduced auditory temporal processing ability in adults with CHL compared to normal hearing subjects. Therefore, developing a clinical protocol to evaluate auditory temporal processing in this population is recommended. Resumo Introdução: Já foi demonstrado que a perda auditiva condutiva (PAC), em longo prazo, pode influenciar na detecção precisa das características temporais dos sinais acústicos ou do processamento auditivo temporal (PAT). Pode-se argumentar que o PAT pode ser o componente subjacente de muitos recursos do processamento auditivo central, como a compreensão da fala ou localização do som. Pouco se sabe sobre as consequências da PAC nos aspectos temporais do processamento auditivo central. Objetivo: Este estudo foi projetado para avaliar a capacidade de processamento auditivo temporal em indivíduos com PAC crônica. Método: Durante este estudo transversal analítico, 52 pacientes com PAC crônica leve a moderada e 52 indivíduos com audição normal (controle), entre 18 e 45 anos, foram recrutados. Para avaliar o processamento auditivo temporal, foi usado o teste de resolução temporal Gaps-in-Noise (GIN). Os resultados obtidos para cada orelha foram analisados com base no limiar de percepção da quebra de continuidade (gap) e na porcentagem de respostas corretas. Resultados: A média dos limiares no GIN foi significativamente menor para o grupo controle do que para o grupo PAC em ambas as orelhas (direita: p = 0,004; esquerda: p < 0,001). Os indivíduos com PAC apresentaram respostas corretas significativamente mais baixas do que os indivíduos com audição normal em ambas as orelhas (p < 0,001). Não houve correlação entre o desempenho no GIN e o grau de perda auditiva em ambos os grupos (p > 0,05). Conclusão: Os resultados sugerem uma redução da capacidade de processamento auditivo temporal em adultos com PAC comparados com indivíduos que apresentam audição normal. Portanto, o desenvolvimento de um protocolo clínico para avaliar o processamento auditivo temporal nessa população é recomendado.

Introduction & Objective: Acute otitis media (AOM) is the most common causes of acquired hearing loss in children with increasing incidence. In young children the diagnosis is restricted to otoscopy and tympanometry whereas evaluation of the auditory function is impossible due to noncompliance during pure tone audiometry. For this purpose, measurement of otoacoustic emissions, especially transient evoked ones (TEOAEs), can be applied. The aim of this study was to evaluate the effect of AOM on TEOAEs in young children before and after treatment course.Material & Methods: In an analytic, cross-sectional design, 42 young children with AOM, both sexes, aged 2 to 4.5 years were evaluated through tympanometry and transient otoacoustic emissions (TEOAEs). TEOAEs signal to noise ratio (SNR) and reproducibility of AOM patients were compared before, two weeks and six weeks after the treatment course. Then AOM responses were compared with an age-matched control group. The results were analyzed using SPSS 16.Results: Our findings revealed that TEOAE parameters in AOM subjects were the most affected on highest frequencies. Significant changes of TEOAE parameters were found 2 weeks after the treatment with further improvement 6 weeks after the treatment course (P < 0.01). The mean differences in TEOAE responses in AOM children 6 weeks after the treatment and the control group were not meaningful (P>0.05).Conclusion: The results of this study suggest that there was an improvement in TEOAE SNR and band reproducibility in serial TEOAEs measurements. Thus,application of TEOAEs is a beneficial method to follow up medical treatment in young children with AOM. (Sci J Hamadan Univ Med Sci 2011;18(3):17-21)