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Ashish K, Bansal V, Patel V, Bhavsar D, Jani K, Bhonde M, Gajjar S, Abraham A. Marker Based IGRT in Prostate Radiotherapy - Merits and Pitfalls. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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German U, Weinstein M, Abraham A, Alfassi ZB. Comments to the author's response to our letter on "The thermoluminescence dose-response and other characteristics of the high-temperature TL in LiF:Mg,Ti (TLD-100)" by Y.S. Horowitz, L. Oster and H. Datz. RADIATION PROTECTION DOSIMETRY 2008; 129:495-497. [PMID: 18650206 DOI: 10.1093/rpd/ncn176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Abstract
BACKGROUND Approximately a third of all fractures in children occur at the wrist, usually from falling onto an outstretched hand. OBJECTIVES We aimed to evaluate removable splintage versus plaster casts (requiring removal by a specialist) for undisplaced compression (buckle) fractures; cast length and position; and the role of surgical fixation for displaced wrist fractures in children. SEARCH STRATEGY We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (October 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 4), MEDLINE (from 1966), EMBASE (from 1988), CINAHL (from 1982) and reference lists of articles. Date of last search October 2007. SELECTION CRITERIA Any randomised or quasi-randomised controlled trials comparing types and position of casts and the use of surgical fixation for distal radius fractures in children. DATA COLLECTION AND ANALYSIS Two authors performed trial selection. All three authors independently assessed methodological quality and extracted data. MAIN RESULTS The 10 included trials, involving 827 children, were of variable quality.Four trials compared removable splintage versus the traditional below-elbow cast in children with buckle fractures. There was no short-term deformity recorded in all four trials and, in one trial, no refracture at six months. The Futura splint was cheaper to use; a removable plaster splint was less restrictive to wear enabling more children to bathe and participate in other activities, and the option preferred by children and parents; the soft bandage was more comfortable, convenient and less painful to wear; home-removable plaster casts removed by parents did not result in significant differences in outcome but were strongly favoured by parents. Two trials found below-elbow versus above-elbow casts did not increase redisplacement of reduced fractures or cast-related complications, were less restrictive during use and avoided elbow stiffness. One trial evaluating the effect of arm position in above-elbow casts found no effect on deformity. Three trials found that percutaneous wiring significantly reduced redisplacement and remanipulation but one of these found no advantage in function at three months. AUTHORS' CONCLUSIONS Limited evidence supports the use of removable splintage for buckle fractures and challenges the traditional use of above-elbow casts after reduction of displaced fractures. Although percutaneous wire fixation prevents redisplacement, the effects on longer term outcomes including function are not established. Further research is warranted on the optimum approach, including splintage, for buckle fractures; and on the use of below-elbow casts and indications for surgery for displaced wrist fractures in children.
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German U, Weinstein M, Abraham A, Alfassi ZB. Comments on 'The thermoluminescence dose-response and other characteristics of the high-temperature TL in LiF: Mg.Ti (TLD-100)' by Y.S. Horowitz, L. Oster and H. Datz. RADIATION PROTECTION DOSIMETRY 2008; 128:509-515. [PMID: 18420571 DOI: 10.1093/rpd/ncn075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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181
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Raffel OC, Abraham A, Ruygrok PN, Finucane AK, McGeorge AD, French RL. Cardiac transplantation and aortic coarctation repair in severe heart failure. Asian Cardiovasc Thorac Ann 2008; 14:522-4. [PMID: 17130333 DOI: 10.1177/021849230601400618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 37-year-old man presented with severe dilated cardiomyopathy secondary to occult aortic coarctation. He was successfully managed with combined orthotopic heart transplantation and aortic coarctation repair.
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Singh A, Abraham A. Neuro linguistic programming: A key to business excellence. TOTAL QUALITY MANAGEMENT & BUSINESS EXCELLENCE 2008. [DOI: 10.1080/14783360701602353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Das S, Abraham A, Konar A. Automatic Clustering Using an Improved Differential Evolution Algorithm. ACTA ACUST UNITED AC 2008. [DOI: 10.1109/tsmca.2007.909595] [Citation(s) in RCA: 521] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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German U, Abraham A, Weinstein M, Alfassi ZB. Reassessment of doses in TLD100 by measuring the residual dose. J Radioanal Nucl Chem 2007. [DOI: 10.1007/s10967-007-0938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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185
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Ring J, Abraham A, De Cuyper C, Kim K, Langeland T, Parra V, Pigatto P, Reunala T, Szczepanski R, Möhrenschlager M, Bräutigam M, Rossi AB, Meents-Kopecky E, Schneider D. Control of atopic eczema with pimecrolimus cream 1% under daily practice conditions: results of a > 2000 patient study. J Eur Acad Dermatol Venereol 2007; 22:195-203. [DOI: 10.1111/j.1468-3083.2007.02368.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Weinstein M, Shemesh Y, Abraham A, German U. Use of statistical checks as maintenance tools for TLD readers. RADIATION PROTECTION DOSIMETRY 2007; 125:109-12. [PMID: 17533159 DOI: 10.1093/rpd/ncm205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Although the values of different parameters may remain within permissible limits during the operation of a thermoluminescent dosemeter (TLD) reader, certain effects can become apparent only when a long-term followup of these parameters is performed. In order to ensure an accurate and reliable operation of a TLD reader, the system characteristics must be monitored continuously. Long-term statistical checks of key system parameters may give a broader insight into the operational characteristics of the TLD reader and may help for proper maintenance of the system. The photomultipliers noise, the internal reference light source stability and the A to D reference voltage were found to be critical parameters, which have a major influence on the accuracy and stability of the system. A followup of these parameters for a period of about 10 y is presented, and some problems are seen to be reflected in the distributions.
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Abraham A, Weinstein M, German U, Alfassi ZB. On the reassessment of doses in TL-dosimetry by measuring the residual dose. RADIATION PROTECTION DOSIMETRY 2007; 125:113-6. [PMID: 17449909 DOI: 10.1093/rpd/ncm195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Second readouts and the photo-transferred thermoluminscence (PTTL) method are sometimes used to reassess high doses. When using the common LiF:Mg,Ti, if the second readout is performed by a regular readout cycle of 13.3 s, its efficiency is low and the estimations cannot be obtained with acceptable accuracy for low doses in the 10-100 mSv range. By applying the PTTL method, the efficiency is much higher, but a high background is also present, deteriorating the quality of the reassessment. A simple and efficient method was studied, which consists of expanding the heating time to 30 s. Although the efficiency relative to a standard readout is improved by only a factor of 3, the low background enables to obtain results with the same uncertainty as the more complicated PTTL method. By applying region of integration discrimination, the errors can be further diminished.
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Abraham A, Weinstein M, German U, Alfassi ZB. On the reassessment of thermal neutron doses in TLD-100 by measuring the residual dose. RADIATION PROTECTION DOSIMETRY 2007; 126:524-7. [PMID: 17507383 DOI: 10.1093/rpd/ncm105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
By employing second readouts and the Phototransferred thermoluminescence (PTTL) method, high doses may be reassessed on the basis of residual dose information. It was shown in the past that for TLD-100, gamma doses can be reassessed by using a simple and efficient method, which consists of expanding the heating time to 30 s. In the present study, the 'extended time' method and the PTTL residual dose evaluations are used for reassessing thermal neutron doses when using TLD-100 crystals. Reassessment characteristics are presented for relatively low thermal neutron doses, in the range between approximately 1 and 18 mSv gamma dose equivalent.
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Pelled O, German U, Abraham A, Tsroya S, Alfassi ZB. Improved localization of a 'hot spot' in the lungs for an array of four HPGe detectors--the isotopic ratio effect. RADIATION PROTECTION DOSIMETRY 2007; 125:465-8. [PMID: 17355983 DOI: 10.1093/rpd/ncm147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Considerable errors in the determination of radioactivity in lungs are caused by the usual assumption of homogeneous distribution, while actually the radioactive contamination can be distributed, and even in the form of a 'hot spot'. Modern lung counter systems use several HPGe detectors, and the ratio of the different count rates of the detectors can be used to locate a 'hot spot' and apply correction algorithms for activity calculation. In the present work it is shown that the variability of the isotopic composition of the uranium source has a major effect on the process of localization of the 'hot spot' in the lungs. A way to eliminate this effect is proposed by separate normalization of the count rates of each energy peak.
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German U, Weinstein M, Abraham A, Alfassi ZB. Optimisation of the readout parameters when evaluating thermal neutron doses by TL dosimetry with LiF:Mg,Ti. RADIATION PROTECTION DOSIMETRY 2007; 126:532-5. [PMID: 17513859 DOI: 10.1093/rpd/ncm107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The location of the glow peaks depends on the heating rate. It takes some time until the crystal reaches the heater temperature, and this time lag has a direct effect on the shift of peaks towards higher temperatures. Some information on the high-temperature peaks may be lost if the readout conditions (mainly length of time) are not properly chosen. Step heating profiles to a varying final temperature between 300 degrees C and 125 degrees C were used to study the time dependence of the collected information in the glow curves of (6)LiF:Mg,Ti crystals, and the minimal heating time for evaluation of thermal neutron doses was determined.
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Abraham A, Hajipour L, Innes AR, Phillips H, McCaskie AW. Are national guidelines for total hip replacement in the UK reflected in practice? Ann R Coll Surg Engl 2006; 88:108-15. [PMID: 16551395 PMCID: PMC1964041 DOI: 10.1308/003588406x82943] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION A cross-sectional study was performed to compare the practice of total hip replacement (THR) in the UK against national guidelines. MATERIALS AND METHODS A postal questionnaire was sent to all fellows of the British Orthopaedic Association. RESULTS Of the 1587 questionnaires sent out, 966 (60.9%) were returned. Of these, 706 (73.1%) were available for data collection and analysis. CONCLUSIONS Consensus was observed in several areas including the use of pre-admission clinics and modern cementing techniques. Facilities deemed necessary for THR surgery such as HDU/ITU back-up, ultra-clean air and dedicated orthopaedic wards are almost universally available. However, a lack of consensus is evident in many areas including the process of obtaining written consent, thrombo-embolic prophylaxis, duration of antibiotic prophylaxis, supervision of trainee surgeons and follow-up arrangements. The proliferation in the range of implants, particularly aimed at 'younger' patients, available to surgeons has once again been highlighted.
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Abraham A. Adaptation of Fuzzy Inference System Using Neural Learning. FUZZY SYSTEMS ENGINEERING 2005. [DOI: 10.1007/11339366_3] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Jain R, Abraham A. A comparative study of fuzzy classification methods on breast cancer data. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2005; 27:213-8. [PMID: 15712589 DOI: 10.1007/bf03178651] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In this paper, we examine the performance of four fuzzy rule generation methods on Wisconsin breast cancer data. The first method generates fuzzy if-then rules using the mean and the standard deviation of attribute values with 92.2% correct classification rate. The second approach generates fuzzy if-then rules using the histogram of attributes values with 86.7% correct classification rate. The third procedure generates fuzzy if-then rules with certainty of each attribute into homogeneous fuzzy sets with 99.73% correct classification rate. In the fourth approach, only overlapping areas are partitioned with 62.57% correct classification rate. The first two approaches generate a single fuzzy if-then rule for each class by specifying the membership function of each antecedent fuzzy set using the information about attribute values of training patterns. The other two approaches are based on fuzzy grids with homogeneous fuzzy partitions of each attribute. The performance of each approach is evaluated on breast cancer data sets. Simulation results show that the simple grid approach has a high classification rate of 99.73%.
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Abraham A. Crit Care 2005; 9:P32. [DOI: 10.1186/cc3095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ansari MH, Abraham A. Anaesthetic management of unexpected subglottic stenosis in an achondroplasic dwarf. Acta Anaesthesiol Scand 2004; 48:928-9. [PMID: 15242447 DOI: 10.1111/j.0001-5172.2004.00433.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Conaglen P, Sebastian C, Jayaraman C, Abraham A, Makkada V, Devlin G. Management of unstable angina and non-ST-elevation myocardial infarction: do cardiologists do it better? A comparison of secondary and tertiary centre management in New Zealand. THE NEW ZEALAND MEDICAL JOURNAL 2004; 117:U890. [PMID: 15156208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Internationally, differences have been noted in how specialist cardiologists and general physicians manage acute coronary syndromes (ACS). Whether a similar practice difference exists in New Zealand is unclear. AIM To test the hypothesis that management differences exist between cardiologists and general physicians in patients presenting with a non-ST-segment elevation acute coronary syndrome in a New Zealand setting-and whether these differences (if present) impact on patient outcome. METHODS A retrospective chart review of 324 consecutive patients presenting with a non-ST-segment elevation acute coronary syndrome to Taranaki Base and Waikato Hospitals from 1 January 1999 was undertaken. Patients in Taranaki were managed by general physicians and in Waikato they were managed by cardiologists. RESULTS Patients presenting to Taranaki Base Hospital were more likely to have high-risk ECG changes with ST-segment depression noted in 34.4% of patients there compared to 16.8% of patients in Waikato (p<0.001). Medical management during patient stabilisation was similar in Taranaki and Waikato with high use of anti-thrombotic (89%) and anti-platelet therapy (94%), respectively. However angiography (5.1% versus 23.4%; p=0.0045) and revascularisation procedures (4% versus 16.7%; p=0.0002) were performed less frequently in Taranaki. No significant difference was noted in mortality at 6 months (9.6% in Waikato versus 13.4% in Taranaki; p=0.4) Readmission rates were also similar; occurring overall in approximately one-quarter of the study population. CONCLUSION In New Zealand, differences exist in how cardiologists and general physicians manage non-ST-elevation acute coronary syndrome. In particular, the low referral rates for angiography by general physicians is of concern and requires correction as current best-practice guidelines suggest high-risk patients are disadvantaged by a conservative approach to management.
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Abraham A, Baraniak L, Bernhard G. Bog ground aquifer system as a natural analogue for future redox conditions in flooded underground mines. J Radioanal Nucl Chem 2004. [DOI: 10.1023/b:jrnc.0000037101.94952.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Petrovic-Lazarevic S, Coghill K, Abraham A. Neuro-fuzzy modelling in support of knowledge management in social regulation of access to cigarettes by minors. Knowl Based Syst 2004. [DOI: 10.1016/s0950-7051(03)00049-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chauhan H, Abraham A, Phillips JRA, Pringle JH, Walker RA, Jones JL. There is more than one kind of myofibroblast: analysis of CD34 expression in benign, in situ, and invasive breast lesions. J Clin Pathol 2003; 56:271-6. [PMID: 12663638 PMCID: PMC1769930 DOI: 10.1136/jcp.56.4.271] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS Smooth muscle actin (SMA) positive myofibroblasts have been implicated in tumour invasion; however, acquisition of SMA is not limited to peritumorous fibroblasts and other changes in fibroblasts may be more specifically related to the malignant environment. CD34 is a sialomucin expressed by normal breast fibroblasts but lost in invasive carcinomas. The aim of this study was to establish the relation between CD34 and SMA expression in breast fibroblasts and to analyse whether loss of CD34 is specific for invasive disease. METHODS Immunohistochemistry for CD34 and SMA was performed on 135 cases including 10 normal, 10 fibroadenomas, 40 infiltrating ductal carcinomas, 55 cases of ductal carcinoma in situ (DCIS), and 20 radial scar/complex sclerosing lesions. The relation between staining pattern and histopathological features was recorded as positive, negative, or reduced. RESULTS Fibroblasts around all normal duct-lobule units and those showing epithelial hyperplasia were CD34 positive and mainly SMA negative. In fibroadenomas, fibroblasts retained CD34 but acquired SMA expression. In contrast, fibroblasts around invasive carcinoma were CD34 positive and SMA negative. In DCIS, loss of CD34 was significantly more frequent in high grade tumours than in low or intermediate grade ones (p < 0.001). The acquisition of SMA was seen more frequently than the loss of CD34, particularly in non-high grade DCIS. In all radial scars, fibroblasts were SMA positive but CD34 negative, and a similar pattern was seen in stromal cells in areas of fibrosis following core biopsy. CONCLUSIONS These results show that SMA positive myofibroblasts exhibit variable expression of CD34, indicating that these markers are not coordinately controlled. Loss of CD34 is strongly related to the malignant phenotype, in both invasive and preinvasive disease, but is not entirely specific because radial scar fibroblasts and fibroblasts in reactive fibrosis exhibit a similar phenotype. The functional relevance of altered CD34 expression is unclear but the very focal changes implicate local signalling mechanisms probably of epithelial origin.
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Cherian B, Singh T, Chacko B, Abraham A. Sensorineural hearing loss following acute bacterial meningitis in non-neonates. Indian J Pediatr 2002; 69:951-5. [PMID: 12503658 DOI: 10.1007/bf02726011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Sensorineural hearing loss (SNHL) is an important sequelae of acute bacterial meningitis (ABM) in children. This study was undertaken to determine the incidence of SNHL following meningitis in non-neonates and its correlation with various factors. METHODS Children between the ages of 1 month and 12 years with ABM admitted in a teaching hospital over a period of 18 months were enrolled. Detailed history was taken, clinical examination performed and cerebrospinal fluid analyzed at commencement of therapy, 48 hours later and at the end of treatment. On discharge brainstem evoked response audiometry (BERA) was recorded. Data were analyzed using appropriate statistical tests. RESULTS Out of 32 children enrolled, 9 (28.1%) developed SNHL, bilateral in 21.9% and unilateral in 6.2%. Among hearing impaired subjects, 11.2% had mild while 44.4% each had moderate and profound hearing loss. Age, presence of vomiting, altered sensorium seizures and aminoglycoside usage were not significantly different in those with and without SNHL, but the total duration of fever was (p<0.05). There was significantly higher protein content and neutrophils in the second CSF sample of those with SNHL. CONCLUSION There is a greater than 50% probability of the child developing SNHL if neutrophil percentage in the second CSF is 80% or more. Since the overall risk of SNHL is significant in children with meningitis, it is recommended that BERA be recorded in all, so that early intervention may be possible.
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