Aetiology of Ludwig van Beethoven’s hearing impairment: hypotheses over the past 100 years – A systematic review

Objectives Even 250 years after Beethoven’s birth, the irrevocable cause of his hearing impairment remains unclear despite multiple publications by different professional groups. This study aimed to analyse the development of the most likely aetiologies during the last 100 years by a systematic review of the relevant medical literature. Methods A systematic review of medical literature in PubMed®, PubMed Central®, and Web of Science® for the period 1920–2020 was conducted. Medical publications between 1920 and 1935 were additionally searched manually by review of reference lists. Studies were eligible when a statement regarding the most likely aetiology of the hearing loss of Beethoven was the aimed objective of the publication. Results 48 publications were included. The following aetiologies were supposed: otosclerosis (n = 10), syphilis (n = 9), Paget’s disease (n = 6), neural deafness (n = 5), immunopathy with inflammatory bowel disease, neural deafness with otosclerosis, sarcoidosis or lead intoxication (n = 2), and systemic lupus erythematosus, trauma, labyrinthitis or inner ear disease (n = 1). There is an ongoing effort with a mean publication frequency in this topic of 0.48/year. From 1920 to 1970, otolaryngologists were the group with the highest interest in this field (67%), whereas since 1971 most authors have belonged to non-otolaryngologic subspecialities (81%). Conclusion Over the past 100 years, otosclerosis and syphilis were predominantly supposed to be the underlying causes. The hypothesis of syphilis—although rejected for a long time—has had a remarkable revival during the past 20 years. Regarding the outcome following therapeutic intervention by cochlear implantation, the differential diagnosis of neural deafness would be relevant today.

Seroprevalence of TORCH infection among pregnant women

Background: TORCH infection complex during pregnancy has bad obstetric outcomes starting from low birth weight to congenital anomalies, sensory neural deafness, mental retardation, cerebral palsy and sometimes to fatal outcomes like abortion and still birth. As these diseases remain mostly asymptomatic these are rarely tested during pregnancy. Serology is the mainstay of diagnosing these infections..Methods: A cross sectional study was undertaken to estimate the burden of these infections in a rural belt of western Odisha where majority of the population depend upon agricultural work. A total number of 402 antenatal cases were screened by ELISA test for presence of IgG&IgM antibodies against toxoplasma, rubella virus, cytomegalovirus (CMV), herpes simplex virus (HSV) 1 & 2; RPR test was done to know seroprevalence of Syphilis.Results: It was found that Rubella is the most predominant infection being positive in 69.1% of the cases (IgG 68.4%, IgM 0.5%, and both IgG&IgM 0.25%), followed by CMV infection-66.7% (IgG 57.2%, IgM 1.7%, both 7.7%), Toxoplasma infection-39.8% (IgG 38.3%, IgM 0.7%, both 0.7%), HSV 1-23.6% (IgG 21.1%, IgM 2%, both 0.25%) and HSV 2 – 13.2% (IgG 11.7%, IgM 1.6%, both 0.25%). The seoprevalence of syphilis by RPR was least common with 0.5%.Conclusions: This study showed that most of the infections have occurred by 20 years of age and before or during the 1st pregnancy. It is less common among the antenatal cases who have better education and have spouses servicing in private or government sectors signifying the more health and sanitation awareness among this group.

A case of dengue fever in a health worker in university of Port-Harcourt teaching hospital

Dengue fever is a mosquito borne disease which can easily be missed or misdiagnosed in early stages as a result of poor surveillance, similarity with other febrile illness and unavailability of PCR necessary for its diagnosis. We hereby report a 44year old female nurse living around a bushy and swampy environment, who presented to university of Port-Harcourt teaching hospital (UPTH) with high grade fever of 1week duration, also developed joint pains, passage of coke colored urine, sensor neural deafness, hyperglycemia and petechial hemorrhage while on admission. Patient continued to have persistent fever despite having completed her anti-malaria and antibiotics, viral studies were subsequently done for her and she was found to have dengue virus. Patient was conservatively managed and discharged for follow-up in medical outpatient and Ear nose and throat clinic.

Prevalence and factors influencing sensorineural hearing loss among type II diabetes mellitus patients

Background: The typical hearing loss described among diabetes patients is progressive, bilateral, sensorineural deafness of gradual onset that predominantly affects the higher frequencies. Although there is mounting evidence for a relationship between diabetes and hearing impairment the awareness of auditory organ involvement in the course of diabetes is still not widespread among healthcare providers involved in diabetes care. Objective of present study was to assess the prevalence and the factors influencing sensorineural deafness among the patients with type II diabetes mellitus.Methods: A cross-sectional study was conducted at our hospital for a period of 6 months. All type II diabetes patients without any other major systemic illness (CVA, coronary artery disease, thyroid disorders) were included for the study. A total of 300 patients were included in our study and the informed consent was obtained from all the study participants. A detailed history related to hearing loss and diabetes status was elicited from all the patients. All basic blood investigations along with HbA1c was performed on all the patients. All the patients were subjected to pure tone audiometry and it was performed using a pure tone audiometer model AUL 12096 audiometer of Labat company in a sound proof room.Results: The total prevalence of sensori-neural deafness among the study subjects was found to be 51.3% with majority of them having mild to moderate degree of sensori-neural deafness. Increase in age, female gender, longer duration of diabetes and higher HbA1C levels are the factors which had influenced the state of sensorineural deafness among the study subjects.Conclusions: The use of audiological test at primary care level should be made mandate for screening all the diabetes patients for hearing loss such a way the quality of life can be improved for patients requiring therapeutic interventions for their hearing improvement.

Occupational related hearing impairment in Basrah

Noise induced hearing loss NIHL is irreversible sensory neural deafness in one or both ears which develops gradually due to chronic exposure to injurious noise. In this study there were 92 workers chosen under exclusion and inclusion criteria, most of the samples study were male due to hard handling working, 40% of the samples studied were complaining of SNHL (sensory neural hearing loss) are variable from mild to sever one. Although they have normal otoscopic finding, the longer the duration of noise exposure the more damaging effect with SNHL result. There are no preventive measures used in our sample study. NIHL is preventable disease which needs the role of social media in education of peoples.

Cognitive Mapping of the Noun Domains When Zero-deriving Proper from Common Nouns in Macedonian

Noise induced hearing loss NIHL is irreversible sensory neural deafness in one or both ears which develops gradually due to chronic exposure to injurious noise. In this study there were 92 workers chosen under exclusion and inclusion criteria, most of the samples study were male due to hard handling working, 40% of the samples studied were complaining of SNHL (sensory neural hearing loss) are variable from mild to sever one. Although they have normal otoscopic finding, the longer the duration of noise exposure the more damaging effect with SNHL result. There are no preventive measures used in our sample study. NIHL is preventable disease which needs the role of social media in education of peoples.