Migrainous vertigo is a common cause of dizziness presenting to an otorhinolaryngology/otoneurology clinic. Although it causes a substantial burden to the individual and society there are no randomized controlled trails on prophylactic medication for this condition. Flunarizine, a calcium channel blocker has been used effectively in both migraine and vestibular conditions. This randomized control trial was undertaken in a tertiary academic referral center to evaluate the efficacy of flunarizine in patients with migrainous vertigo when compared to non-specific vestibular treatment of betahistine and vestibular exercises. The effect of flunarizine on two particularly disabling symptoms of vertigo and headache was studied. A total of 48 patients who were diagnosed with definitive migrainous vertigo completed the study of 12 weeks duration. Patients in arm A received 10-mg flunarizine daily along with betahistine 16 mg and paracetamol 1 gm during episodes, and arm B received only betahistine and paracetamol during episodes. Symptom scores were noted at the start of the study and at the end of 12 weeks. Analysis of the frequency of vertiginous episodes showed a significant difference between arm A and arm B (p = 0.010) and improvement in severity of vertigo between the two groups (p = 0.046). Headache frequency and severity did not improve to a significant degree in arm A as compared to arm B. The main side effects were weight gain and somnolence and this was not significantly different between the two groups. Flunarizine (10 mg) is effective in patients with migrainous vertigo who suffer from considerable vestibular symptoms.

Objective The current circumstances of the coronavirus disease 2019 pandemic necessitate the use of personal protective equipment in hospitals. N95 masks and face shields are being used as personal protective equipment to protect from aerosol-related spread of infection. Personal protective equipment, however, hampers communication. This study aimed to assess the effect of using an N95 mask and face shield on speech perception among healthcare workers with normal hearing. Methods Twenty healthcare workers were recruited for the study. Pure tone audiometry was conducted to ensure normal hearing. Speech reception threshold and speech discrimination score were obtained, first without using personal protective equipment and then repeated with the audiologist wearing an N95 mask and face shield. Results A statistically significant increase in speech reception threshold (mean of 12.4 dB) and decrease in speech discrimination score (mean of 7 per cent) was found while using the personal protective equipment. Conclusion Use of personal protective equipment significantly impairs speech perception. Alternate communication strategies should be developed for effective communication.

OBJECTIVE:To assess the functional status of the otolithic pathway in vestibular migraine by comparing the results of static and dynamic subjective visual vertical and horizontal [subjective visual vertical (SVV) and subjective visual horizontal (SVH)] testing in patients with vestibular migraine with that of normal individuals. MATERIALS and METHODS:This hospital-based prospective study was conducted in 82 normal adults and 66 adults with vestibular migraine. The SVV and SVH angles were measured under static and dynamic conditions using a software-based test protocol. The arithmetic mean of six readings in each situation was considered. The results were further analyzed by stratifying cases and controls into two age groups 20-40 years and 41-60 years and into gender. RESULTS:The clinical profile of the patients with vestibular migraine was comparable to the available literature. The dynamic SVV and SVH in both age groups and the static SVH in the 41-60 years age group were significantly higher compared to normal individuals (p<0.05). The dynamic SVV and SVH were significantly higher in the cases compared to controls among both males and females (p<0.05). CONCLUSION:There is evidence of otolithic pathway abnormalities in individuals with vestibular migraine. The inclusion of SVV and SVH testing for the evaluation of patients with vestibular migraine may be useful in the interpretation and rehabilitation of symptoms in these patients.

Neonatal hearing screening using BERAphone is a feasible service. The estimated prevalence of confirmed hearing loss was comparable to that in literature. Overcoming the large numbers of loss to follow-up proves to be a challenge in the implementation of such a program.

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