Intratympanic methylprednisolone injections for subjective tinnitus

2009 ◽  
Vol 123 (11) ◽  
pp. 1221-1225 ◽  
Author(s):  
M Topak ◽  
A Sahin-Yilmaz ◽  
T Ozdoganoglu ◽  
H B Yilmaz ◽  
M Ozbay ◽  
...  

AbstractObjectives:This study aimed to determine whether intratympanically injected methylprednisolone is effective in treating subjective tinnitus refractory to medical treatment.Study design:Prospective, randomised, placebo-controlled, single-blinded study.Methods:Seventy adult patients with subjective tinnitus of cochlear origin were randomly assigned to receive intratympanic injection of either methylprednisolone or saline solution. The treatment protocol comprised three intratympanic injections, one per week for three weeks. Improvement in tinnitus severity was measured by a self-rated tinnitus loudness scale and by the tinnitus severity index, at baseline and two weeks after the last injection.Results:Data for 59 patients were available for analysis. There was no significant difference between the two treatment groups regarding age, sex, pure tone average, pretreatment tinnitus intensity, tinnitus laterality or tinnitus duration. There was a significant post-treatment improvement in self-rated tinnitus loudness scale results in both groups. No significant post-treatment changes in the tinnitus severity index individual and total scores were observed in either group. The most frequently encountered side effects were pain during injection, vertigo, a burning sensation around the ear and in the throat, and a bitter taste. A burning sensation and bitter taste were observed more often in the methylprednisolone group compared with the placebo groupConclusion:The results of this study indicate that intratympanic methylprednisolone has no benefit, compared with placebo, for the treatment of subjective tinnitus of cochlear origin refractory to medical treatment.

2019 ◽  
Vol 57 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Hilal Yücel ◽  
Abitter Yücel ◽  
Hamdi Arbağ ◽  
Erkan Cure ◽  
Mehmet Akif Eryilmaz ◽  
...  

Abstract Introduction. It is known that hyperlipidemia reduces hearing functions. In this study, we aimed to study the effect of antihyperlipidemic drugs on hearing functions and tinnitus. Methods. Eighty-four patients aged 18 to 84, who were diagnosed with hyperlipidemia and started treatment with the statin group (atorvastatin 20 mg and 40 mg, rosuvastatin 10 mg and 20 mg, and simvastatin 20 mg) of antihyperlipidemic drugs, were included in this study. All patients underwent pure-tone audiometry before starting treatment with antihyperlipidemic drugs. Patients with tinnitus were evaluated by Tinnitus Severity Index and Visual Analogue Scale. In the 6th month of therapy, otologic examination, pure-tone audiometry and tinnitus evaluation of the patients were repeated. Results. No significant difference was found in the pure-tone averages of the patients before and after statin use (p > 0.05). However, it was found in the audiometry that, after statin use, all drugs caused to statistically significant decrease in the hearing thresholds at 6000 Hertz (p < 0.05). Also, a strong increase was found in the Speech Discrimination percentages after treatment in patients using rosuvastatin 10 mg (p = 0.022). A significant decrease was found in the tinnitus frequency, duration, severity and degree of annoyance in patients using rosuvastatin 10 mg and 20 mg (p < 0.05). Conclusion. Statin group of drugs can have a positive effect on the hearing functions and subjective tinnitus. In particular, it is seen that rosuvastatin group of statins has a more notable effect on tinnitus. It was considered that further studies with larger patient groups are needed.


Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S21.1-S21
Author(s):  
Christiane Paney ◽  
Marci Johnson ◽  
Alina Fong ◽  
Mark Allen

PurposeWe propose that our individualized Enhanced Performance in Cognition (EPIC) Treatment can effectively address PCS in sports-related concussions by employing functional NeuroCognitive imaging (fNCI) in conjunction with post-concussion symptom scale measurements to inform and direct treatment modalities. fNCI is a specialized application of fMRI that utilizes a normative reference sample and biomarkers for concussion to provide sensitive and specific predictive diagnostic values. The fNCI addresses neurovascular coupling (NVC) dysregulation that commonly arises in PCS. These results inform individualized EPIC Treatment to restore normal NVC function with a treatment protocol that strategically integrates cardiovascular therapies with cognitive training.MethodsTwo hundred four sports concussion patients were assessed pre- and post-treatment using both objective (fNCI) and subjective Post-Concussion Symptom Scale (PCSS) measures, establishing pre-treatment benchmarks to measure therapeutic effectiveness. Patients underwent EPIC Treatment, which is a week-long, multiple treatments per day period consisting of cognitive, occupational, and neuromuscular therapy informed by fNCI and standardized PCSS findings.ResultsfNCI Severity Index Score (SIS) reported an average 80 percent reduction in objective measurements from the pre-treatment scan. Subjective measurements from the Post-Concussion Symptoms Scale (PCSS) reveal 59 percent reduction of symptoms as described by patient report. The SIS measurements are stable in follow-up scans 1-year post-treatment.ConclusionWe provide evidence that fNCI can be used in assessment and treatment of chronic PCS resulting from SRC. Furthermore, the results provide evidence that our fNCI-guided treatment has positive outcomes in both objective and subjective measurements. This supports the hypothesis that our treatment effectively addresses PCS symptoms resulting from SRC. Follow-up fNCI scans indicate that improvements are stable following treatment.SignificanceSRC patients suffering from chronic PCS who were assessed by fNCI and underwent EPIC treatment report immediate, sustainable, and longitudinal reduction in symptoms resulting in significant improvements to quality of life and functionality.


2007 ◽  
Vol 122 (3) ◽  
pp. 277-281 ◽  
Author(s):  
M Dagli ◽  
I Sati ◽  
A Acar ◽  
R E Stone ◽  
G Dursun ◽  
...  

AbstractObjective:The aim of this study was to evaluate the outcomes of therapeutic intervention in patients with mutational falsetto, by applying perceptual and acoustic analysis before and after voice therapy.Materials and methods:Forty-five consecutive patients with mutational falsetto were studied retrospectively. Acoustic analysis (i.e. fundamental frequency, jitter, shimmer, and formants one, two and three) was performed using the Multi-Dimensional Voice Program. Perceptual voice analyses were performed, including graded severity–roughness–breathiness–aesthenicity–strain assessment.Results:Subjects' fundamental frequency, voice formants one, two and three, jitter, and shimmer were greater before than after treatment. There were statistically significant differences between pre- and post-treatment average values for fundamental frequency, jitter and shimmer. There were also statistically significant differences between pre- and post-treatment average values for formants one and two. These results were maintained after six months of follow up, and there was no significant difference between results at three- and six-month follow up. According to perceptual evaluation, each subject's voice had altered from mutational falsetto to chest voice by completion of the intervention. Thus, all of the patients successfully lowered their modal speaking voice to an appropriate level.Conclusion:In the light of objective evaluations, and by applying the study treatment protocol, these results suggest that normal voice can be maintained after intervention, at six months' follow up.


Author(s):  
Rajendra Joshi ◽  
N. B. Mashetti ◽  
Rakesh Kumar Gujar

Dushta Vrana is a common and frequently encountered problem faced in surgical practice. The presence of Dushta Vrana worsens the condition of the patient with different complications and may become fatal. Local factors on wound like slough, infection and foreign body, affect the normal process of healing. A healthy wound in a normal body heals earlier with a minimum scar as compared to a contaminated wound. Therefore in this study all the efforts are made to make a Dushta Vrana into a Shuddha Vrana. Once the Vrana becomes Shuddha, Ropana of the Vrana will start. The objective of the study was to evaluate the clinical efficacy of Jatyadi Taila and Jatyadi Ghrita in Dushta Vrana. Clinically diagnosed 60 Patients of Dushta Vrana were randomly divided into two groups, each consisting of 30 Patients. Group A were treated with the Jatyadi Taila and Group B was treated by Jatyadi Ghrita. The results observed was based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz, size of ulcer, discharge, smell, pain, burning sensation, itching and granulation were found significant (P Lass Than 0.05). On the basis of assessment criteria and overall result of treatment, the patients of Jatyadi Taila group showed better results when compared to Jatyadi Ghrita group. Even though statistically there is no much significant difference between the two groups, but by seeing the effect on individual parameters (subjective and objective) and over all response, Jatyadi Taila seems to be effective when compared to Jatyadi Ghrita. It is having more Ropana qualities when compared to Shodhana.


2021 ◽  
pp. 1357633X2110098
Author(s):  
Aya Sedky Adly ◽  
Afnan Sedky Adly ◽  
Mahmoud Sedky Adly ◽  
Mohammad F Ali

Introduction Rheumatoid arthritis (RA) disease is a systemic progressive inflammatory autoimmune disorder. Elderly-onset RA can be assumed as a benign form of RA. Until recently, face-to-face therapeutic sessions between health professionals and patients are usually the method of its treatment. However, during pandemics, including coronavirus disease 2019 (COVID-19), teletherapeutic sessions can extensively increase the patient safety especially in elderly patients who are more vulnerable to these infections. Thus, the aim of this study was to evaluate a novel teletherapy approach for management of elderly patients suffering from RA by utilizing laser acupuncture. Methods A teletherapy system was used for management of elderly patients suffering from RA. Sixty participants were allocated randomly into two groups and the ratio was 1:1. Patients in the first group were treated with laser acupuncture and telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Patients in the second group received telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Evaluation of patients was done by using the Health Assessment questionnaire (HAQ), the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire, and the analysis of interleukin-6 (IL-6), serum C-reactive protein (CRP), plasma adenosine triphosphate (ATP) concentration and plasma malondialdehyde (MDA). Results A statistically significant difference was found in CRP, RAQoL, IL-6 and MDA between the pre- and post-treatments in the first group ( p < 0.05) favouring the post-treatment group, while the HAQ showed a statistically significant difference between pre- and post-treatments ( p < 0.05) in both groups. Statistically significant post-treatment differences were also observed between the two groups ( p < 0.05) in RAQoL, CRP, ATP and MDA, favouring the first group. Discussion Laser acupuncture teletherapy could be suggested as a reliable treatment method for elderly patients suffering from RA, as it can provide a safe and effective therapeutic approach. Teletherapy provided safer access to health professionals and patients while giving a high patient satisfaction value with a relatively lower cost (ClinicalTrials.gov Identifier: NCT04684693).


Author(s):  
Reem M. Alwhaibi ◽  
Noha F. Mahmoud ◽  
Mye A. Basheer ◽  
Hoda M. Zakaria ◽  
Mahmoud Y. Elzanaty ◽  
...  

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.


Author(s):  
Gamze Akkus ◽  
Barış Karagun ◽  
Hilal Nur Yaldız ◽  
Mehtap Evran ◽  
Murat Sert ◽  
...  

AbstractObjectivesProlactinoma is the most common cause of pituitary tumours. Current medical guidelines recommend dopamine agonists (cabergoline or bromocriptine) as the initial therapy for prolactinoma. However, surgical removal can also be considered in selected cases, such as patients with macroadenomas with local complications (bleeding or optic chiasm pressure) or those not responding to medical treatment.MethodsThe present retrospective study included patients with prolactinomas (n=43; female, 24; male, 19) who were primarily managed with medical (n=32) or surgical (n=11) treatment.ResultsMacroadenoma (n=29.67%) was commonly detected in both genders (female, 54%; male, 84%). Moreover, the mean pre-treatment prolactin levels were similar in both genders (female, 683.3 ± 1347 ng/mL; male, 685.4 ± 805 ng/mL; p=0.226). Surgically treated patients had a greater reduction in tumour size (27.7 ± 17.9 mm pre-treatment vs. 8.72 ± 14.2 mm post-treatment) than non-surgically treated ones (12.5 ± 7.5 mm pre-treatment vs. 4.1 ± 4.2 mm post-treatment; p=0.00). However, the decrease in prolactin levels was similar between the two patient groups (p=0.108). During the follow-up period (10.6 ± 7.0 years), the average cabergoline dose of the patients was 1.42 ± 1.47 mcg/week.ConclusionsAlthough a surgical approach was considered for selected cases of prolactinoma, the average dose used for medical treatment was highly inadequate for the patients in the present study.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A153-A153
Author(s):  
Goeun Kim ◽  
Hyojin Nam ◽  
Huisu Jeon ◽  
Sooyeon Suh

Abstract Introduction Bedtime Procrastination (BP) is defined as the behavior of voluntarily delaying going to bed, without having external reasons for doing so. Recent research on procrastination behavior suggests that when negative emotions are elevated, procrastination behaviors can be triggered in order to find pleasure to avoid and alleviate them. Procrastination can also occur when there is difficulty regulating emotions. In addition, the reason for bedtime procrastination may be different depending on whether the individuals present with insomnia. According to previous studies, patients with insomnia may exhibit more pronounced negative avoidance of bedtime due to prolonged sleeplessness. Therefore, this study compared the difference between of the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Methods This study was conducted in 582 adults (mean age 23.06 ±2.16 years), 81.6% females. Individuals scoring higher than 15 on the Insomnia Severity Index (ISI) were classified into the insomnia group (n=375), and those less than 15 were classified into the healthy group (n=207). Participants completed the Bedtime Procrastination Scale (BPS), Emotional Regulation Strategies Checklist. Data was analyzed using descriptive statistics, chi square test, and independent t tests. Results The insomnia group had significantly higher bedtime procrastination scores than the healthy group (t=-6.241, p&lt;.001), and also the avoidant/distractive regulation style score was significantly higher (t=-1.969, p&lt;.05). In addition, the score of active regulation style was significantly lower in the insomnia group than in the healthy group (t=3.050, p&lt;.01). There was no significant difference between the two groups in the support-seeking regulation style. Conclusion Based on these results, it was confirmed that there was a difference in the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Support (if any) This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2018S1A5A8026807)


2021 ◽  
Vol 20 (4) ◽  
pp. 12-16
Author(s):  
Aml El-Shabrawy ◽  
◽  
Ahmed Elsheikh ◽  
Samy Gebreel ◽  
Mohammed Elsokkary ◽  
...  

Objective. Ectopic pregnancy adversely affects the patency of the fallopian tube and consequently the future pregnancy. There are different options of conservative treatment of tubal pregnancy such as methotrexate and salpingostomy [1]. There is little information on the success rate of maintaining tubal patency after methotrexate and salpingostomy [2]. Therefore, the aim of this study is to evaluate the ipsilateral tubal patency using HyCoSy after treatment of tubal pregnancy with methotrexate therapy versus salpingostomy. Patients and methods. This was a case-series study conducted in Ain Shams and Al-Azhar University Maternity Hospitals to evaluate the ipsilateral tubal patency using hysterosalpingo-contrast sonography (HyC0Sy) following salpingostomy and medical treatment of tubal pregnancy. This study included patients who were admitted to Ain Shams and Al-Azhar University Maternity Hospitals for having tubal pregnancy and were treated either with methotrexate or salpingostomy over a 4-year period between January 2017 and December 2020. The patients seeking fertility were re-evaluated for fallopian tubes patency by hysterosalpingogram 3 months after discharge. The study included 2 groups of women: group I (n = 200): women who were treated with methotrexate, and group II (n = 140): women who underwent salpingostomy. Results. HSG was performed in 200 cases of patients with tubal pregnancy who were treated with methotrexate and 140 cases of patients who underwent salpingostomy. The patency of the ipsilateral tube was 85% after methotrexate treatment and 84.2% after salpingostomy. There was no statistically significant difference between the two groups. Conclusion. The findings suggest similar success rate in maintaining the patency of the fallopian tube with either methotrexate or salpingostomy. Key words: ectopic pregnancy, hysterosalpingography, methotrexate, infertility, salpingostomy


2018 ◽  
Vol 23 (3) ◽  
pp. 187-197 ◽  
Author(s):  
Camille Dorbeau ◽  
John Galvin ◽  
Qian-Jie Fu ◽  
Elsa Legris ◽  
Mathieu Marx ◽  
...  

Cochlear implantation (CI) can benefit patients with single-sided deafness (SSD) in terms of sound localization, speech understanding in noise, tinnitus severity, and quality of life (QoL). In previous studies, CI outcomes have been largely reported for SSD patients with normal “unrestricted” hearing in the contralateral ear. However, SSD patients may often have some degree of hearing loss in the contralateral ear (“restricted” acoustic hearing). In this study, we report results from a French clinical trial for CI in in SSD patients (NCT02204618). Localization, speech reception thresholds (SRTs) in noise, tinnitus severity, and QoL were evaluated in 18 SSD patients 1 year after CI. Data were analyzed for 2 subject groups according to the pure-tone average thresholds in the non-implanted ear: unrestricted acoustic hearing (UNRES; ≤25 dB HL; n = 10) and restricted acoustic hearing (RES; > 25 dB HL; n = 8). Across all subjects, localization was significantly better with the CI on than off (p = 0.005); there was no significant difference between subject groups (p = 0.301). When speech and noise were co-located (S0N0), there was no significant difference in SRTs with the CI on or off (p = 0.480); SRTs were significantly better for the UNRES than for the RES group (p = 0.005). When speech and noise were spatially separated (SCINNH), SRTs were significantly better with the CI on than off (p < 0.001). While SRTs were better for the UNRES than for the RES group (p = 0.024), the CI benefit was more than 50% greater for the RES group due to the restoration of high-frequency speech cues. Questionnaire data showed that tinnitus severity was significantly reduced (p = 0.045) and QoL was significantly improved after one year of experience with the CI (p < 0.001). Age at testing was significantly correlated with SRTs for the S0N0 condition; duration of deafness was correlated with SRTs for the SCINNH condition. There were relatively few correlations between behavioral and subjective measures, suggesting that both were valuable when assessing CI benefits for SSD patients. The present data suggest that indications for CI should be expanded to include unilaterally deaf patients who have normal hearing or mild-to-moderate hearing loss in the non-implanted ear.


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