جستجوی مقالات مرتبط با کلیدواژه « عصبی » در نشریات گروه « پزشکی »

Impaired shoulder function and range of motion are important consequences of functional instability of the shoulder joint in overhead athletes. Therefore, the purpose of this study was to investigate the effect of a period of neuromuscular training on range of motion and shoulder function in athletes with functional instability of the shoulder joint.The present study was performed quasi-experimentally with pre-test and post-test design. The statistical sample consisted of 30 girls aged 22 to 35 years who were selected purposefully and available based on inclusion and exclusion criteria and finally were randomly divided into two groups of control and training. All subjects participated in the research voluntarily after completing the consent form. In the pre-test stage, shoulder joint function was assessed by YBT–UQ test and also shoulder joint range of motion was assessed by goniometer. After the pre-test, the subjects in the exercise group performed a neuromuscular training program for 8 weeks and 3 sessions per week. At the end of 8 weeks of training, all the measurements that were performed in the pre-test stage were performed again in the post-test stage. Two-way analysis of variance with repeated measures was used to analyze the obtained data.Findings showed that neuromuscular exercises of the shoulder joint significantly increase the score of the upper limb function test of the subjects of the exercise group in all three directions, as well as significantly increase the range of motion of the shoulder joint in flexion, abduction, internal rotation and external rotation (p≤0.05). However, no significant difference was observed in the above variables between pre-test and post-test in the control group (p≥0.05). Also, the results showed that in the post-test, there is a significant difference between all the investigated variables between the two groups (p≤0.05).Neuromuscular training develops muscle coordination and strength due to its multifaceted approach. Improving the efficiency of the neuromuscular system increases the function and range of motion of the shoulder joint. Therefore, this training method can be used as a suitable option in the rehabilitation of athletes with functional shoulder instability.

Hearing loss is one of the most common disorders in the elderly people. Sensory neural hearing loss mostly results from outer and inner hair cell damages in cochlea. The area wherein inner hair cells or auditory nerve fibers are inactive is named Dead Region (DR) or Cochlear dead Region (CDR). Many studies have investigated DR at high frequencies in sloping or sharply sloping audiograms, but few studies have investigated flat audiograms. Hence, the aim of the present study was to investigate the prevalence of DR in hearing impaired adults with mild to severe flat sensory neural hearing loss.
In the current descriptive-analytical study, 30 elderly people (60 ears) aged 65 years and above, with bilateral mild to severe flat sensory neural hearing loss were tested for DR at frequencies from 0.5 to 4 kHz using the threshold equalizing noise (HL) test. Based on the hearing thresholds, participants were divided into three groups of mild, moderate, and severe hearing loss.
The prevalence of DR at 2 kHz, 3 kHz, and 4 kHz were significantly higher than DR at frequencies below 2 kHz (p The results indicated a relatively high prevalence of dead regions in the elderly with severe degree of hearing loss (60-80dBHL) and at high frequencies. Furthermore, with increasing frequency, the number of dead regions increased correspondingly.

Ophthalmic disorders are more prevalent in children with hearing loss. This study aimed to investigate the types and frequencies of ophthalmic disorders in children with congenital sensorineural hearing loss and cochlear implant.
This descriptive cross-sectional study was conducted among 51 children aged 3-18 years in Isfahan City, Iran, in 2017. Patients were selected via simple random sampling method. Visual acuity and strabismus were examined and direct ophthalmoscopy, dry and cycloplegic refraction tests, and slit lamp examination with a hand-held lens were done. Results were analyzed using descriptive statistics and chi square tests.
Findings: Mean age (SD) of children was 8.0 (3.4) years. 26 (51%) were boys and 25 (49%) were girls. 24 patients (47.1%) had at least one ophthalmic disorder. There were 8 patients (15.7%) with decreased visual acuity, 13 (25.5%) with refractive errors, 4 (7.8%) with amblyopia, 4 (7.8%) with strabismus, and 9 (17.6%) with retinal abnormality. Diagnosis of 3 patients was consistent with Usher syndrome and one with Goldenhar syndrome. Decreased visual acuity was more frequent in boys than in girls (P = 0.02).
According to remarkable frequencies of ophthalmic disorders among our study sample, early screening of visual disorders is suggested to be done in children with definite diagnosis of hearing loss.

Neonatal hyperbilirubinemia is a common problem that can be potential toxicity effects on the nervous system in infants، especially on the hearing ways. Regarding to hearing impairment leaves so negative effects on speech، language and cognitive development. The aim of this study was the assessment of the incidence of sensorineural hearing loss among icteric infants admitted to the hospitals of Gorgan، Iran in 2012.

In this longitudinal study، 223 infants were recruited by convenience sampling، that OAE screenings at the birth time was normal. Using Automated Auditory Brainstem Response (AABR) was performed for infants at the hospitalization and they were assessed after discharge، and with Auditory Brainstem Response (ABR) were confirmed.

The mean age of the infants on admission was 3. 84±4. 58 days and 55. 6% of them were female. The mean birth weight was 3431±218 grams and the mean gestational age was 39±1. 3 weeks. Serum total bilirubin levels in 61. 4% of infants were between 12-20 mg/dL and of 38. 6% were higher than 20 mg/dL. 13. 0% received conventional phototherapy، 72. 6% intensive phototherapy and 14. 3% of patients had exchange transfusions. Totally، 8 (3. 6%) of infants in admission had disturbance waves in AABR. Subsequent studies have shown improvement in 7 patients، but one patient problem still remains، and from other patients with normal admitted AABR in following 6 infants was impaired in ABR. Finally، 7 (3. 1%) of hearing loss were remains. There was a statistically significant difference between the hearing loss، serum total bilirubin level and total AABR impairment result on admission and final result (p<0. 05)، but there was no significant difference with variable of gender and kind of delivery (p<0. 05).

This study indicated that hyperbilirubinemia in the neonatal period can cause sensorineural hearing loss. Hence، regular screening in icteric newborns seems to be necessary.

Various inherited or acquired disorders are characterized by palmoplantar kera-toderma hyperkeratosis of hands and feet، and when accompanied with deafness indicates mutations in the gene encoding connexin -26 or a particular mutation (A7445G) of the mito-chondrial t-RNA coded for serine (MT-TS1) is created. Case Report: On skin examination of a 7 year old boy، we observed hyperkeratosis of palm and sole، elbows and knees (Keratoderma of palms &soles with extensor surface of limbs involvement)، and found out the history and evidence of sensory-neural deafness since birth-day and he had undergone cochlear implant at the age of two. Thus this patient is placed in a rare group of keratoderma associated with sensory-neural deafness. Since there is no his-tory of similar disease in his pedigree، we suspected the boy had a rare type of keratoderma associated with sensory- neural deafness that has mitochondrial inheritance. In reported cases of this disorder in the world there is no involvement of limb''s extensor. So we probably report a new subtype of the rare disorder or a rare separate disorder. The patient is a case with diffuse palmoplantar keratoderma with the involvement of extensor surfaces and sensory-neural deafness that have mitochondrial inheritance that is unlikely to be reported yet. The disease should be controlled with maintenance treatments. (Sci J Hamadan Univ Med Sci 2013; 20 (4): 342-345)

Auditory neuropathy spectrum disorder (ANSD) is a pattern of hearing loss characterized by preservation of outer hair cell function despite severe damage or absent brainstem auditory evoked responses. Management of children with ANSD is debatable. The purposes of the current study were to compare the effect of cochlear implantation on these developmental skills of children with and without ANSD and to investigate the age of cochlear implant reception on language (receptive and expressive) and speech skills of children.

This cross-sectional analytic study was conducted between eight cochlear implanted children with ANSD and eight match children with profound sensory-neural hearing loss (SNHL). Newsha developmental scale was used to evaluate three investigated skills.

Significant correlation was shown between the age of hearing loss diagnosis and the score levels in three developmental skills (p < 0. 012). All children were lingered in the investigated skills compared to normal hearing children; however، there was no significant difference between the cochlear implanted children with and without ANSD (p ≥ 0. 636).

The receptive language، expressive language and speech skills of children with ANSD and their matches were the same. It seems that cochlear implantation can be considered as an appropriate approach in the management of these children، especially at lower ages.

Wolfram syndrome is a neurodegenerative autosomal recessive disorder. The occurrence of the disease should be suspected if non-autoimmuneinsulin-dependent diabetes occurs in an under-sixteen year old person having bilateral optic nerve atrophy. Diabetes insipidus (DI), neurosensory deafness, urinary track disorders, and nervous system complications are also seen in this disorder. The current report presents a 13-year-old female patient with diabetes mellitus type I (since age 4) along with recurrent urinary infection and enuresis and progressive renal failure (since age 10). Bilateral optic atrophy was evident on fondues examination. The patient also had diabetes insipidus, neurosensory deafness, neurogenic bladder, short stature, combined with delayed sexual maturity.

Vitiligo is a systemic disease which leads to the destruction of melanocytes of the body. The hallmark of vitiligo is the formation of white patches in the affected skin but، because of the presence of melanocytes in the auditory and vestibular apparatuses، these systems may also be involved at some point in the course of the disease. 21 patients with vitiligo (12 females، 9 males) and 21 healthy controls (11 females، 10 males) were enrolled in this case-control study. Pure tone audiometry (PTA)، Auditory brainstem responses (ABR) and Vestibular evoked myogenic potential (VEMP) were carried out for all participants. High frequency sensory neural hearing loss was indicated in 8 (38. 09%) patients. ABR analysis revealed that 10 (47. 61%) patients had an abnormal increase in latency of the wave III، which was statistically meaningful in both right and left ears (P = 0. 024 and P = 0. 001، respectively) and that 6 subjects (28. 57%) had an abnormal prolongation of the IPL I-III. However، findings from the VEMP measurements showed no recorded responses in the left ear of 1 (4. 76%) patient and statistically significant prolongations in the latency of the p13 were shown in 5 (23. 80%) patients (P = 0. 001). Because of antioxidant، ion-recycling and protective roles of melanocytes in the auditory and vestibular systems، the involvements of these systems are possible in vitiligo vulgaris.

Foot dropis a common and distressing problem that can lead to falls and injury. Considering the respective Patients and physicians’ concerns regarding the prognosis of this condition، relative improvement in some cases and no complete study about this problem in our country despite various treatments attempted، a closer study to assess prognosis in these patients seems necessary. The aim of this study is to investigate the associated factors in foot drop improvement including age، gender، site، cause and type of injury، time between the incidence and referral، and type of treatment. The present study is a cross- sectional one carried out with the patients referred to electordiagnosis department of Pursina hospital of Rasht in 2010-11. After entering the patient into study، demographic information، cause and damage started time were recorded. All the patients after a complete neurological examination were assessed by a neurologist experienced in EMG-NCV. Afterwards، the vulnerable patients were treated routinely. No intervention was done in the process of treatment and recorded the type of treatment. Patients had monthly visits، with improvement and changes in treatment recorded. If a patient withdrew he was excluded. Six months later، based on the age، gender، site، cause and type of injury time between the incidence and referral and type of treatment، all the patients were compared in terms of recovery. Totally، 105 patients (61 males and 44 females) with mean age of 45±17. 3 years participated in this study. 56. 2% of them were cured. The improvement in the root was (44. 1%)، sciatic nerve (75%)، common peroneal nerve (75%)، deep peroneal nerve (88. 9%)، which was statistically significant (P< 0. 005). The recovery rate of axonal lesion (53. 5%) and Demyelinating lesion (100%) which were statistically significant (P<0. 028). The recovery rate of foot drop in trauma was (75. 6%)، radiculopathy (38. 6%) and local compression was (85. 7%) which was also statistically significant (P<0. 0001). The recovery rate of foot drop according to type of treatment was not statistically significant in 95% of improved patients، the average age was 35-43 years (P<0. 0001) and time between the incidence and referral in 95% of improved patient، were within 0. 8 to 2 months، which was statistically significant (P<0. 0001) Predictive factors of recovery were age of the patient and time between the incidence and referral.

I-131 Metaiodobenzylguanidine (MIBG) is a radiopharmaceutical which is proved effective in treatment of tumors with neuroendocrine origin, especially the neuroectodermal (sympathoadrenal) type, including pheochromocytoma, paraganglioma and neuroblastoma. It is also of some value in other neuroendocrine tumors (mainly carcinoid and medullary carcinoma of thyroid). The method employed in this research was a systematic bibliographic review, in which only valid studies or the clinically detailed enough open-labeled studies using validated scales were used. I-131 MIBG is the best nonsurgical method for treatment of pheochromocytoma. It not only increases survival, but also significantly improves patients’ symptoms (75-90%). Although the efficacy of this method for refractory or relapsing neuroblastoma has been 30%, adding other treatment modalities increases the impact of this treatment. For other neuroendocrine tumors including carcinoid tumor and medullary carcinoma of thyroid, MIBG therapy has been effective in reducing patients’ symptoms. The most important complication of this method is myelosuppression which needs follow-up and if necessary relevant treatment. I-131 MIBG has an important role in treatment of chromafin tumors. For pheochromocytoma and neuroblastoma it is the best nonsurgical treatment. It is effective in neuroblastoma especially if it is used in conjunction with other treatment modalities. I-131 MIBG can also diminish symptoms of carcinoid tumor and medullary thyroid carcinoma efficiently.

Orthognathic surgeries are used for correction of jaw discrepancies. One of the popular techniques in mandible is bilateral sagittal split osteotomy. The purpose of this study was to investigate sensory disturbance in lower lip up to 6 months after bilateral sagittal split osteotomy of mandible, and the effect of this sensory change on daily life of the patients as well as their level of satisfaction from the result of the operation. In this study, 22 patients (44 sides) with the average age of 21.4 years were operated with sagittal split osteotomy. For objective examination, 2-point discrimination test was done just before operation, and 3 and 6 months after the operation. For subjective examination, patients filled out questionnaires 3 and 6 months after the operation. Data were analyzed by Mc Nemar, Wilcoxon, t and Paired sample t-tests. In three month follow up, 63.3% and in six month follow up, 43.1% of cases had sensory changes. Wilcoxon test showed significant difference in the extent of anesthesia between three and six month follow ups (P=0.007) which showed recovery in regions with altered sense. The average result of 2-point discrimination test was 3.81 millimeters before operation, 6.9mm three months after operation and 5.2mm six months after the operation. In the six month follow up, the difference between right and left side was 1.04mm which was statistically significant (P=0.027). Despite the sensory changes in their lip, all patients were satisfied with the result of the operation. With passing the time (from 3 months to 6 months), the percentage of cases with sensory deficit decreased, which seems to be due to the spontaneous recovery of nerve. The results showed that sensory changes and their problems were not determinant factors in patient's satisfaction.

Sensory – neural hearing loss following mastoid surgery has been Reported with different severities. In the mastoid surgery, different factors can affect hearing. The aim of this study was to introduce the most common frequency that was affected during mastoid surgery and also to determine the correlation between duration of drilling and suction irrigation with the severity of sensory – neural hearing loss. Th is Longitudinal Study was performed in the E.N.T department of Khalili Hopistal-Shiraz University of Medical Sciences. Thirty consecutive patients with chronic otitis media were selected. Audiometry was done (250Hz – 8kHz) in two occassions, one day before the operation and 2 months after the operation. The results were analyzed using paired T- test and Pearson Correlation. There was not any significant change in threshold of bone conduction in all frequencies (250HZ-8KHZ) after 2 months. The average time of drilling, was 46.6 minutes (SD 8.77). There was a significant correlation between the time of drilling, suction, irrigation and change in bone conduction threshold in the 4KHZ, (p<0.05) but this correlation relation was not found in the other frequencies. We did not find persistent changes in the bone conduction thresholds after tympanomastoid surgery in the operated ear and the other ear after two months. So in case of SNHL Consequence of surgery we should consider other factors.

Use of hearing aids is a common and an important programming of auditory rehabilitation. Hearing aid is an important device especially in children with hearing loss, because good hearing is effective for development of speech. The aim of this study was to assess the usefulness and disadvantages associated with use of this device among patients with hearing loss. This cross-sectional retrospective and descriptive study included 100 patients, visiting Social Support Organization (behzisty center) of Ahvaz, with sensory-neural hearing loss on hearing aids. Demographic charteristics, medical records history, options of hearing aids, advantages and disadvantages of those were analyzed.Of the 100 cases of sensory neural hearing loss, 68 % of patients were under 20 years old. Eighty three % of cases were psychologically satisfied with their hearing aid, and 55% had good progress in their education. Eighty four % of cases used post-auricular hearing aids. The disadvantages reported of using hearing aid were: not enough power (18%), ear mold impression (24%) and allergy to the mold (12%).Hearing aids are useful in patients with sensory neural hearing loss and can be used with comfort in majority of patients who need them. Good selection of hearing aid, suitable mold and teaching the patients can reduce the disadvantages associated with use of hearing aids.

Sensorineural hearing loss (SNHL) is a probable complication of coronary artery bypass graft (CABG) Surgery, that may be due to embolism, perfusion failure and consumption of ototoxic drugs. Since the incidence of SNHL after CABG is different according to the various reports, the present study was designed to study hearing threshold change after CABG surgery. In this cross-sectional study, 65 patients candidated for CABG surgery were selected by convenient sampling. One week before and two weeks after the surgery, all patients were examined by E.N.T specialist, and underwent PTA and impedance test. Other information including history of previous diseases were collected too. Distribution and central indices were used for description of results and Wilcoxon test was used for comparison of pre- and post- operative hearing threshold. Comparison of Pre -and Post - operative audiometry results showed no significant change in hearing for all frequencies and in both ears. Hearing threshold difference in the right ear at 4000HZ and in the left ear at 2000HZ was meaningful (P=0.027, P=0.004 respectively). Although hearing threshold differences at all frequencies and in both ears were greater in men rather than women, the meaningful difference was only for the frequency of 1000HZ in the right ear (P=0.03) and 4000HZ in the left ear (P=0.034). Although, hearing loss can occur after nonotologic surgeries, the incidence is very low and this can be due to the improvement in surgical and anesthesia techniques. Meanwhile, hearing threshold change in some frequencies may be sex-dependent.

Multiple Sclerosis (MS) is characterized by the presence of multiple plaques within the central nervous system, manifesting as remission and exacerbation of neurologic dysfunction over variable time courses. Sensorineural hearing loss is an uncommon symptom of multiple sclerosis. Clinical presentation of multiple sclerosis is highly heterogeneous. The aim of this study was to determine the quality of hearing in MS and to evaluate prognosis. We studied 6 cases with confirmed MS who visited ENT clinic of Emam Khomeini Hospital of Ahwaz Jundishapur University between April 003 to March 005. Clinical, electrophysiological, auditory brain stem response (ABR),? ?? (ENG) and MRI radiological assessments were undertaken. In addition, the cochleovestibulat systems of these patients were also evaluated after treatment.The cases studies included were 7 males and 9 females with mean age of 3.5 years. In MS patients a wide range of symptoms due to lesions in different areas of the brain and spinal cord were recoded. Two of 6 cases had sensory neural hearing loss, with abnormal ABR, both patients had normal tympanometry and had no acoustic reflex.Further research is required to explore the variability in the levels of ability and functioning. The findings of this research work suggest that in patients with MS can show various abnormalities in the vestibulocochlear system and a multidisciplinary evaluation is required to be undertaken by investigating otolaryngologists.

Among all auditory assessment tools، auditory steady state response (ASSR) is a modern test. Modulation frequency for this test is usually 80 Hz. The purpose of this study، was to examined adult subjects with 40 Hz and 80 Hz ASSR and compare the results. Thirty adult (60 ears) were evaluated by ASSR and PTA test، Results were divided into three groups: normal hearing، mild and moderate sensorineural hearing loss. In all groups، forty hertz ASSR thresholds were relatively closer to behavioral threshold than those of 80 Hz ASSR (p<0. 05). Besides، the more severe hearing loss، the lower the difference between those two thresholds. Correlation coefficients were also higher in 40 Hz ASSR (p<0. 05). Frequency modulation thresholds with 40 Hz are more likely to be closer to the behavioral thresholds. Moreover، it has better results than the thresholds with 80 Hz.

Hearing loss is a common problem affecting private and social life of the involved individuals. Prevalence and type of hearing loss vary in different communities. This study was conducted to identify the frequency of hearing loss and its related factors on patients referred to audiometry clinic of Kashan University Matini hospital in 2006. In a cross sectional study from November 2005 to April 2006, 462 patients referred to the audiometry clinic were enrolled to the study. The causative mechanisms of hearing loss, with a decrease of more than 10db, were considered in 3 main categories of conductive, neuro-sensory, and mixed types on the base of audiogram charts. The data were analyzed with c2 and fisher exact tests. Of 462 patients, 203 (43.9 %) had hearing loss, 53.7% of whom were male. Mean age was 33.4±19.5. Neuro-sensory hearing loss was the most common type (41.9%), followed by conductive hearing loss (38.9%) and mixed hearing loss (19.2%). The rates of bilateral and unilateral hearing loss were 65%, and 35%, respectively. Most cases had moderate (40-60 db) hearing loss. Among different factors causing hearing loss, otitis media was the most common (34%). hearing loss is highly prevalent. neuro-sensory loss was the most common type and otitis media the most common cause. These factors are totally treatable, so more attention should be paid to their proper treat.

The most common surgically treatable causes of hearing loss are middle ear diseases among which the greatest effect is related to ossicular chain dysfunction. Successful ossicular chain reconstruction certainly improves air conduction thresholds and closes air-bone gap in audiograms, but the effect of this procedure on bone conduction thresholds has remained to be elucidated. Only few standard clinical trials have been done and most studies are retrospective with methodological faults. The aim of the present study was to determine the effect(s) of ossicular chain reconstruction on bone conduction thresholds. Patients & In a controlled clinical trial, pre-and post-operative bone conduction(BC) thresholds of speech frequencies were investigated in 68 patients. In order to evaluate the effect of ossicular chain reconstruction on bone conduction, the patients were divided into two groups including 34 cases each. One group received ossicular chain reconstruction during the middle ear surgery and the other one was to receive it later. In each group, mean preoperative bone conduction thresholds of any frequencies were compared with postoperative ones using paired t-test. In the reconstruction group, the results revealed a significant improvement in the postoperative BC thresholds at 1000 and 2000 Hz with the largest mean improvement observed at 2000 Hz(about 9.7 db recovery). In the group without reconstruction, no significant changes were observed at any frequencies. The results indicated the remarkable effect of ossicular chain on bone conduction. This effect is eliminated in ossicular disruptions due to various middle ear diseases and is reproducible by successful reconstruction of the chain. The findings showed changes in bone conduction as a mechanical phenomenon affected by ossicular chain. In other words, BC thresholds are not exclusive indicators of chochlear function. We also observed that true sensorineural hearing loss is not a common major complication of middle ear surgery.

The measurement of skin thickness is an important method in diagnosis, control of treatment and studying the effects of drugs and their dosage on skin diseases. The development of high frequency ultrasound imaging systems in recent years has made the measurement of skin layers thickness possible. In this paper, a new method of identifying skin layers and measuring their thickness using B-scan ultrasound images is presented. The B-scan images of skin have been obtained using a Dermascan unit model C (Cortex Technology, Denmark) with a 20 MHz probe. In this research, feature matching and neuro-fuzzy classifier have been used to determine the boundaries between the skin layers. Feature matching is necessary for constructing the probability matrix followed by the neuro-fuzzy classifier which is used to extract the boundaries of skin layers. After finding these boundaries, a thickness of different skin layers is calculated. The proposed method has been tested on 50 ultrasound images. The results obtained for the distinction of different skin layers and the calculated skin thickness were compared against the result obtained from two dermatologists who examined the cases and the thickness calculated by histological technique, respectively. By applying this algorithm, different skin layers are extracted with 86% accuracy. The results of this method were also confirmed by histological experiments with a precision of one hundredth of a millimeter. Discrete cosine transform (DCT) coefficients feature has showed that it has the best performance for the identification of skin layers.Discussion and The neuro-fuzzy classifier can be used as a reliable tool for processing ultrasound images of skin. In contrast to existing methods, the proposed method doesnt require initialization and it has good noise immunity. Therefore, this method can be applied to clinical routine to find the effects of drugs precisely.