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The Brugada syndrome has been described as a genetic disorder involving aborted sudden cardiac death in patients with apparently structurally normal hearts. Exercise has been shown to unmask the electrocardiographic (ECG) findings in this disease; however, this is yet to be validated as a useful testing method. This is a case of exercise-induced typical Brugada syndrome ECG changes with no occurrence of arrhythmias during exercise and no ECG evidence prior to testing.

Background Puberphonia is the perseverance of high pitched voice after the pubertal age in males which causes a huge psychosocial impact. Voice therapy is one modality of management of Puberphonia. Aim The Objective of our study was to evaluate the efficacy of voice therapy in patients as the sole treatment to improve the pitch and quality of voice, the psychosocial impact and patient's satisfaction. Methods A retrospective study was carried out on 71 patients who were presented to ENT unit at the National hospital of Sri Lanka for fifteen years from 2002. Pre and post voice therapy subjective assessment was done by the speech therapist for pitch and quality and patient's perceptual assessment using an analog scale (0-extremely poor to 10normal voice) and a psychosocial impact assessment was also done. Results The time duration of voice therapy ranged from 1 to 10 months (average-3.6 months). Pitch and quality of the voice became normal in 78.9% and 35.2% of patients respectively. Pre-therapy perceptual score range(PSR) was 0 to 6 (mean-3.0). Post-therapy PSR was 5 to 10 (mean-7.7). 95.8% patients had improved psychosocial impact and patient satisfaction after voice therapy. Remaining opted for surgical management. Conclusion Voice therapy significantly improves the pitch, patient's satisfaction and psychosocial impact and can be used as an effective modality of treatment for Puberphonia.

DOI: http://dx.doi.org/10.4038/cjo.v3i1.5217 Ceylon Journal of Otolaryngology Vol.3(1) 2013 pp.31-33

No abstract available