Objective: To determine frequency of hearing loss among medical students using electroacoustic devices like hands free, headphone etc. through Pure Tone Audiometry. Methods: This cross-sectional study was conducted among students at JSMU from December 2019 till February 2020. Ethical approval was obtained against Ref: JSMU/IRB/2019/-215. Calculated sample size was 194. Non-probability convenience sampling technique was employed. Students were invited to ENT OPD JPMC, Karachi. After informed consent, sociodemographic and electroacoustic device usage history was recorded. PTA was performed at octave frequencies for air (0.25-8kHz) and bone conduction (0.5kHz-4kHz). WHO grading of hearing impairment was used. Statistical analyses carried through IBM SPSS. Chi square test, Fischer exact test and independent t test were applied at 95% CI and p value <0.05 as statistical significance. Results: Out of 246 students, 221 fulfilled inclusion criteria. Male to female ratio was 1:3. Mean age was 21 years (S.D: ±0.927). 96.4% were regularly using electroacoustic devices. 47.9% reported their use over five years. Insert type earbuds (73.8%) were the most preferred. Smartphone being the most common source (90%). Upon PTA, one third of medical students demonstrated sensorineural hearing loss at 0.25kHz and 0.5kHz. 9.5% reported associated tinnitus. Daily listening duration exceeded one hour among 78.8% while 26.4% practiced high volume setting. Males’ average listening duration exceeded that of females (p=0.013). However, their mean audiometric thresholds did not vary significantly. Conclusions: Mild sensorineural hearing loss was detected among one third of participants using personal listening devices. Precautions should be practiced while using these devices. doi: https://doi.org/10.12669/pjms.38.3.4927 How to cite this:Asghar S, Khan H, Parveen S, Rafi SMT. Frequency of hearing loss among medical students using electroacoustic device. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4927 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Introduction: Chronic suppurative otitis media (CSOM) is middle ear infection, perforation and inflammation usually with purulent middle ear discharge. Different immune markers such as IgE and interferon were proved to be elevated in CSOM. Aim/Objective: The aim of the study is to evaluate of these inflammatory biomarkers (IL6, IL8 and TNF gamma) in patient of CSOM to suggest future therapy of chronic infections with inflammations. Methodology: This is a case-control study conducted in ENT ward in a tertiary care hospital in Jinnah Post Medical centre, Karachi during November 2017 to May 2018. Patients or healthy volunteers were divided into two groups as G1 (without any disease) and G2 (CSOM patients without treatment), G3 (CSOM patients treated with co-amoxicillin) and G4 (CSOM patients treated with ciprofloxacin). The serum was subjected for the quantitative measurement of IL6, IL8 and TNF Gamma by ELISA Kit method via antibody-antigen-enzyme complex formation and measured at 450 nm. Result: Study shows that IL6, IL8 and TNF gamma concentration was significantly high in G2 (positive control), G3 (ciprofloxacin) and G4 (co-amoxicillin) in contrast with G1 (negative control). Moreover, IL6 concentration was significantly low in G3 (ciprofloxacin) and G4 (co-amoxicillin) as compare to G2 (positive control). Conclusion: Elevated levels of IL6, IL8 and TNF gamma in CSOM showed alteration of immune response in chronic suppurative otitis media. Moreover, anti-inflammatory role of ciprofloxacin and co-amoxicillin in CSOM may provide additional benefit beside attenuation of infection.

Objectives: This study aimed to ascertain current practices prevalent among medical students using electroacoustic devices. We also aimed to determine pattern and frequency of hearing loss among medical students. Design: Cross-sectional Participants: Students of 3rd year and 4th year MBBS at Jinnah Sindh Medical University, Karachi, Pakistan were included. Data collection dated from December 2019 till February 2020 using convenience sampling technique. Setting: Students were invited to ENT OPD, Jinnah Postgraduate Medical Centre, Karachi. Through a structured proforma, we recorded practices regarding electroacoustic devices. We investigated hearing of medical students by tuning fork tests and Pure Tone Audiometry. Main Outcome Measures: Using SPSS software version 23 we applied Chi square test, Pearson correlation and independent t test at 95% CI and p=<0.05 as significance level. Results: A total of 221 students fulfilled inclusion criteria. 96.4%(n=213) regularly used electroacoustic devices. Students mostly used insert type earphones connected with a smartphone. More than 30% of medical students demonstrated low frequency (0.25-0.5kHz) sensorineural hearing loss (SNHL). Pearson correlation yielded strong positive correlation with hearing loss and years of exposure(p=<0.001). Male students used electroacoustic devices more frequently than female students(p=0.01). However, we did not observe significant difference between their mean thresholds. Conclusion: Acoustic trauma has been conventionally described to affect higher frequencies. We found low frequency SNHL among majority of students. This indicates that specific type of acoustic trauma can affect particular frequencies on audiogram. KEY WORDS: Low frequency hearing loss, medical students, Pure Tone Audiometry, personal listening devices, hearing thresholds, noise induced hearing loss, sensorineural hearing loss