Papers by Nimalka Sequeira
Background: Hearing impairment can have a negative impact on an individual's social, educatio... more Background: Hearing impairment can have a negative impact on an individual's social, educational, and emotional life. If not detected early, it can affect the speech and language development. This delay in diagnosis and intervention can be mitigated by mandatorily implementing newborn hearing screening protocols. Objective: The primary objective of this study was to find the incidence of hearing loss in normal and high-risk neonates and recommend a protocol for the detection of hearing loss in the neonate. Materials and Methods: The study was carried out in a tertiary care teaching hospital over a period of 12 months. A total of 1000 babies including 693 normal and 307 high-risk babies were enrolled into the study. All neonates underwent otoacoustic emission (OAE) within the first 3 days of birth. Those who failed in this test underwent repeated OAE after 6 weeks, followed by brain stem-evoked response audiometry (BERA) if the second OAE was negative. Results: Of 307 high-risk b...
IP Journal of Otorhinolaryngology and Allied Science, 2020
Introduction: Diabetes mellitus (DM) has a projected rise in its affected population to almost do... more Introduction: Diabetes mellitus (DM) has a projected rise in its affected population to almost double by the year 2035 in India. Ongoing research regarding its microvascular complications has led to a disparity of opinion about involvement of the audio-vestibular system. Hence to evaluate the audio-vestibular functions in patients with diabetes mellitus and determine their correlation with duration and control of the disease, this study was conducted. Materials & Methods: 97 DM patients were included in this prospective, cross-sectional study and all of them underwent clinical examination, Dix-Hallpike maneuver and investigations like Pure tone audiometry (PTA) and Videonystagmography (VNG). Results: 64 of 97 patients, had varying degrees of sensorineural hearing loss on PTA and 16 patients had vestibular hypofunction noted on caloric test of VNG. It was identified that the occurrence of bilateral hearing loss and vestibular hypofunctioning were statistically significant with chi square test (p value 0.028 and <0.001 respectively), when 5years duration of DM was taken for cut off. Analysis of symptoms with PTA and VNG, found significant correlation of tinnitus and hearing loss (p value 0.03 and <0.001 respectively) with abnormal findings in both the investigations, revealing a subclinical nature of the vestibular dysfunction. However, there were no significant correlations found with the glycaemic control of DM. Conclusions: It is advisable to consider audio-vestibular evaluation with PTA and VNG, as screening tests for long term DM patients with or without symptoms of giddiness and hearing loss as a step for early identification of microvascular complications of the inner ear, though larger studies in other populations needs to be done for further confirmation of the correlation.
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2018
Background: Diabetes mellitus causes pathophysiological changes at multiple organs. Brainstem Evo... more Background: Diabetes mellitus causes pathophysiological changes at multiple organs. Brainstem Evoked Response Auditory (BERA) represents a non-invasive tool to detect diabetes related sensorineural hearing loss. The aim was to assess diabetes related central auditory pathway involvement using BERA.Methods: The study comprises two groups, (i) Diabetic group (n=15), (ii) Control group (n=15). The controls were matched for age and sex with the study group. BERA was done for all these patients after detailed clinical examination and relevant blood investigations. Results: There was significant latency differences found in wave III, V and interpeak latencies I-III, III-V and I-V between control and study groups at 70 dBnHL and 80 dBnHL. At 90 dBnHL the diabetic group demonstrated significant latency differences in waves I, III and V and interpeak I-III, III-V and I-V compared to controls. The duration of DM was 5-10 years in 8 patients (53.3%) out of which 7 subjects (87.5%) had prolong...
Audiology Research, 2015
One of the recent diagnostic tests to assess the function of otolithic organs is through vestibul... more One of the recent diagnostic tests to assess the function of otolithic organs is through vestibular evoked myogenic potential (VEMP) testing. There are equivocal findings on effect of aging on ocular VEMP (oVEMP) parameters with reference to latencies. Hence this study was taken up to investigate the age related changes in oVEMP parameters. This present study considered 30 participants in each age group <em>i.e.</em>, young adults, middle-aged adults and older adults. oVEMP were recorded using insert earphone at 100dBnHL at 500hZ short duration tone burst. The results showed in older adult significant difference in response rate, latencies and amplitude as compared to young and middle adult. Hence age should be taken into consideration when interpreting oVEMP results.
International Journal of Speech & Language Pathology and Audiology., 2014
Latest developments in technology has equipped the clinician’s ability to evaluate otolithic func... more Latest developments in technology has equipped the clinician’s ability to evaluate otolithic function through VEMP testing. The present study was taken up to investigate the changes in the VEMP parameters while recording VEMP response with visual feedback system to control EMG. VEMP testing was administered on 20 participants between 20-40 years of age. The study results showed no statistically significant difference in amplitude and latency of cVEMP and oVEMP responses with and without visual feedback system. However, with visual feedback system standard deviations were observed to be reduced for both cVEMP and oVEMP responses. Hence we can conclude that using the visual feedback system to monitor the muscle contraction in otological disorders is easier and more reliable than testing without visual feedback.
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Papers by Nimalka Sequeira