مجله تحقیقات نظام سلامت حکیم
سال هشتم شماره 3 (پیاپی 30، پاییز 1384)

About 10-15% of adult population experience degrees of tinnitus in their life. The purpose of present study was to determine the effectiveness of AES on tinnitus improvement and associated psychological complaints.

Completing a standard tinnitus questionnaire, otolaryngological, comprehensive audiological and psycho acoustical tinnitus assessment in patients was made before and after AES. The patients received AES with a Nucleous Promontory Stimulation system. patients received bipolar square waves fewer than 400 Hz pulses (often 50 Hz) with duration of 0.5 sec. during the seven sessions of 30 min. In an attempt to measure the effects of tinnitus before and after AES, we used the Persian Tinnitus Questionnaire (TQ), designed to assess the dimensions of tinnitus complaints. The patients of our study had been unsuccessfully treated by many medical methods and gave their written consent to participate in the study, which was approved by the department & Research Center of Otolaryngology, Head & Neck Surgery, Iran University of Medical Sciences.

We used extratympanic auditory electrical stimulation (EAES) to treat 42 patients with persistent tinnitus. For each patient the standard tinnitus questionnaire (TQ) was filled before and after intervention of AES. In the group of patients in whom tinnitus was improved (n = 28), the global score of TQ decreased significantly (P=0.0001), whereas the same dimension of TQ showed no remarkable changes (P=0.064) in the “unimproved” group (n = 14). The decrease in the loudness of tinnitus was significant (P=0.002), but in the unimproved group the difference in the loudness was not significant (P=0.336).

The TQ is an instrument which provides a broad description from both factor analysis and clinical evidence. Our findings indicate that the dimensions of psychological complaints due to tinnitus from before to after treatment with AES were significantly decreased. In conclusion, EAES reduces the effects of the tinnitus but presents limitations, mainly due to the short duration of the electrical residual inhibition of the tinnitus. It seems that the continuous use of the electrical stimulation by external electrical stimulation produces a progressive inhibition of the tinnitus in distressing tinnitus patients.

It is essential for the management of the pregnant patients with a recent rash or in contact with a rubelliform illness that differential diagnosis of primary rubella infection from reinfection could be accomplished. The presence of rubella specific IgM has been taken in the past as a reliable indicator of primary infection, but in some cases the presence of IgM can be due to other causes. In this study, considering the fact that IgG avidity in primary rubella is much lower than in reinfection, the main objective was to use a convenient serological method for rubella IgG Avidity assay.

For this purpose 72 serum samples from measles negative exanthematous patients were investigated. These samples were divided in two categories of A and B according to the serological markers (HI test results and IgM detection) and also the age of patients, presence of low avidity IgG for group A and high avidity IgG for group B was expected. An avidity IgG ELISA test was performed by elution method for each group using Radim commercial kit and 6M urea (a mild protein denaturant) and avidity index was calculated.

Using Splus software CART method (classification and regression tree), the borderline achieved for separation the high avidity IgG from low avidity one was 47.5% and using Roc curve in SPSS software specificity and sensitivity of the test were calculated.

The results show that, this method is suitable for differential diagnosis of primary rubella infection from reinfection.