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Biomedical subjects

N N Mathur

Publications and source records attributed to N N Mathur.

15 recordsLinked to original sources
PubMed2006

An alternative strategy for universal infant hearing screening in tertiary hospitals with a high delivery rate, within a developing country, using transient evoked oto-acoustic emissions and brainstem evoked response audiometry.

OBJECTIVE: To formulate an alternative strategy for universal infants hearing screening in an Indian tertiary referral hospital with a high delivery rate, which could be extended to similar situations in other developing countries. The system should be able to diagnose, in a timely fashion, all infants with severe and profound hearing losses. METHODS: One thousand newborn were randomly selected. All underwent testing with transient evoked oto-acoustic emissions (TEOAE) in the first 48 hours of life. All TEOAE failures were followed up and repeat tests were performed at three weeks, three months and six months of age. Infants with acceptable TEOAE results at any of the four ages were discharged from the study. Infants with unacceptable TEOAE results at all the four ages underwent brainstem evoked response audiometry and oto-endoscopy. The 'pass rate' for TEOAE testing was calculated for all four ages. The time taken to perform TEOAE and brainstem evoked response audiometry was recorded for all subjects. These recordings were statistically analysed to find the most suitable strategy for universal hearing screening in our hospital. RESULTS: The pass rate for TEOAE was 79.0 per cent at < or =48 hours, 85.0 per cent at three weeks, 97.0 per cent at three months and 98.0 per cent at six months. The average time taken to perform the test was 12 minutes for TEOAE and 27 minutes for brainstem evoked response audiometry. Obstructed and collapsed external auditory canals were the two factors that significantly affected the specificity of TEOAE in infants < or =48 hours old. CONCLUSION: The concept of screening all neonates within the first 48 hours of life is impractical because the specificity of TEOAE is lowest at that age. Many false positive results are generated, such that a larger number must undergo brainstem evoked response audiometry, wasting time and resources. This can easily be avoided by delaying TEOAE screening until three months of age, when it has a substantially lower false positive outcome. We expect that implementation of this alternative strategy in our hospital will maximise the benefits of such a programme.

Audiometry↗
PubMed2005

Effect of tractor driving on hearing loss in farmers in India.

BACKGROUND: Indian tractor drivers operate their tractors and other implements/equipment in an environment which can have extreme temperatures and high level of suspended particulate matter. In addition, Indian tractors do not have adequate vibration and noise attenuating designs features. This cross-sectional study compares the hearing status of tractor driving farmers (TDFs) (study group) and non-tractor driving farmers (NTDFs) (control group) matched for age, sex, generic/ethnic group, land holding, education levels, and work routines. METHOD: Two groups of 50 experienced tractor-driving farmers and 50 non-driving farmers were selected from 2 villages, 50 km from Delhi. All participants were interviewed for details of work routine and noise exposures. An audiogram was performed and noise measurements taken on tractors and other machines. RESULTS: Self-reported hearing problems were similar (4 cases each) in both the groups of 50 farmers. However, audiogram analysis showed higher prevalence of abnormalities in TDFs. TDFs (24) had more often high frequency hearing loss when compared to NTDFs (14). The noise levels observed on tractors in different operations were in the range of 90-110 dB (A). CONCLUSIONS: Tractor noise levels exceeded the recommended safe limits of OSHA and NIOSH prescribed standards. TDFs had higher high frequency hearing loss than NTDFs. The mechanism of damage and prevention needs to be studied further.

Adult↗
PubMed2005

Hearing loss in chronic myeloid leukemia.

A 12-year-old girl presented with abdominal pain, fever, and hearing impairment of 6 months duration. She had massive hepatosplenomegaly and anemia. On the basis of her peripheral blood and bone marrow findings, she was diagnosed as chronic myeloid leukemia (CML) in chronic phase. Her hearing was assessed by brainstem evoked responses (BERA), which showed objective improvement in hearing with hydroxyurea. The rare occurrence of deafness in CML is reviewed and possible pathogenesis is discussed.

Child↗
PubMed2004

Simple method of vocal cord lateralization in bilateral abductor cord paralysis in paediatric patients.

OBJECTIVE: To simplify the procedure of suture lateralization of a vocal cord in children with bilateral abductor cord palsy and to evaluate its results. METHODS: Ten tracheostomised infants and children with bilateral abductor cord palsy where there was either minimal or no recovery of vocal cord movement even after 2 years' observation were taken up for suture lateralization of one vocal cord. In this simplified procedure needles were passed twice through the larynx from one side of neck to the other. The aim was to reduce the microlaryngoscopic or telescopic manipulation inside the small larynx. Two techniques (1 and 2) were used to carry out this procedure. In technique 1 the needle used was one with a slit in the eye situated at its tail end whereas in technique 2 it was a lumbar puncture needle. Patient follow-up ranged from 6 months to 5 years. RESULTS: Intraoperative manipulation inside the larynx was considerably reduced. The technique 2 was even simpler and faster than technique 1. With both techniques the placement of suture was accurate without any knot inside the larynx. All the patients could be decanulated with only minimal stridor on exertion in two and an acceptable voice in all. CONCLUSIONS: Suture lateralization of one vocal cord using technique 2 can be tried as the first line of management in cases of bilateral abductor cord palsy requiring lateralization.

Adolescent↗
PubMed2004

Intramural foreign body in oesophagus.

Intramural foreign body in oesophagus is very rare and is mostly associated with complications leading to high morbidity and mortality. Recently we came across a coiled metallic wire discovered unexpectedly in a chest X-ray of a 6-month-old male baby. This was further investigated and was found to be located intramurally in the oesophagus. It was successfully removed with rigid oesophagoscopy performed under telescopic guidance. No such foreign body has been reported in an infant so far in English literature.

Esophagoscopy↗
PubMed2003

Rigid pediatric bronchoscopy for bronchial foreign bodies with and without Hopkins telescope.

This study was undertaken to evaluate the merits and demerits of pediatric bronchoscopy with or without the use of Hopkins telescope in 60 pediatric patients at the Otolaryngology clinic of tertiary level teaching hospital. Group-I comprised of 30 children who underwent a non-telescopic procedure, while Group-II included another 30 who went through a telescopic-guided removal using standard forceps. It was observed that due to better illumination, higher optical resolution and magnification owing to the use of the telescope, foreign body removal using this technique was completed with minimal complications. The precision in foreign body removal using telescopic-guided procedure in Group-II cases was immense though the operative time in comparison to the non-telescopic one was found to be statistically higher (P = 0.0019). This group also had a shorter hospital stay. The use of standard forceps in place of optical forceps gave an easier maneuverability through small-sized pediatric bronchoscopes, thereby giving an edge over the latter.

Bronchi↗
PubMed2002

Bronchial foreign body presenting as an accidental radiological finding.

The aspiration of a foreign body in an airway is usually associated with respiratory distress, wheeze and persistent cough. The highest incidence of foreign body inhalation occurs between the age of 1 and 3 years [Ann. Otol. Rhinol. Laryngol. 89 (1980) 434: Med. J. Aust. 2 (1983) 322]. Asymptomatic and long standing foreign bodies may lead to complications such as recurrent pneumonia, bronchiectasis, atelectasis and even death. We present here a case of a metallic bronchial foreign body, which was discovered only as an accidental radiological finding on a chest X-ray, which was done for a mild lower respiratory tract infection, presumably 4 months after such an aspiration.

Bronchi↗
PubMed2002

Foreign body aspiration.

OBJECTIVE: To analyze the clinical and radiological profile of foreign body aspiration in children reaching a tertiary care center and identify areas of possible interventions for proper management of such cases. SETTING: Tertiary level teaching hospital. SUBJECTS: Case records of patients suspected to have foreign body aspiration over the past four years were analyzed. Clinico-radiological features, types and location of foreign bodies were studied. RESULTS: Of 75 children who underwent rigid bronchoscopy, 70 had tracheo-bronchial foreign bodies. History of choking was elicited in 90 percent cases. In 30 percent cases chest radiographs were non-contributory, while the commonest finding (63 percent) was distal emphysema. Over three-fourth of the cases were below the age of 2 years. Vegetative foreign bodies, mainly peanuts, were commonly present. In many cases, referral was delayed as the diagnosis was missed initially. CONCLUSION: Foreign body aspiration remains a common unintentional childhood injury due to improper exposure of young children to otherwise innocuous looking nuts and other small objects.

Child↗
PubMed2001

Is there a functioning vestibulocochlear nerve? Cochlear implantation in a child with symmetrical auditory findings but asymmetric imaging.

The finding of an abnormally narrow internal auditory meatus during the assessment of a child for cochlear implantation raises the possibility that the meatus may not contain the normal number of nerves. Even with currently available MRI techniques it may be extremely difficult to decide whether or not to offer cochlear implant in such cases. We present a child of 4 1/2 years, assessed for cochlear implantation. MRI and CT imaging suggested aplasia of one vestibulocochlear nerve and hypoplasia of the other. However, audiological tests showed clear responses to sound in both ears and functional use of sound in her daily life. This child was eventually implanted with encouraging postoperative results.

Audiometry↗
PubMed1999

Adult tracheocele with large cervical presentation.

A case is described in which a middle-aged male presented with a large tracheocele in the neck arising from the right postero-lateral aspect of trachea at the level of T2 vertebra. It was not associated with any predisposing factors and except for the swelling in the neck the patient was asymptomatic. It was excised completely through the cervical approach and there has been no recurrence in two years follow-up.

Hernia↗
PubMedDate not supplied

Tubercular retropharyngeal abscess in early childhood.

We present two cases of Pott's lower cervical spine with retro-pharyngeal abscess presenting at an unusually young age. These children presented with a life threatening respiratory distress; one of them had neurological deficit in the form of paraparesis. External drainage of abscess without anterior cervical fusion was adequate as a surgical measure for their prompt recovery while these cases were on conventional anti-tubercular therapy.

Antitubercular Agents↗