The study was conducted on 33 children aged 3-6 years who suffered from protein energy malnutrition (PEM) during infancy in comparison to 30 matching children to assess the long-term deficits in cognition and language skills. The patients' files were revised to record their admission and follow-up data and history, clinical examination, intelligence quotient and language assessment were done. The study revealed that 2-5 years from the acute attack the PEM patients were still shorter than the controls and their cognitive abilities were poorer. Their mental ages and language skills were mostly determined by their height and the duration of follow-up during their acute illness. Additionally their diet after the 3-5 years is still defective and does not meet their recommended daily allowance. These observations urge us to continue following these patients for longer durations to make sure no permanent damage occurs due to the PEM insult to the growing brain.

No abstract

EnAbstract Objectives Speech intelligibility is usually expressed as a percentage of spoken words, sentences, or phonemes correctly identified by a listener or a group of listeners when spoken by a talker or a number of talkers. Communicative disorders could have a deleterious effect on speech intelligibility. To date, there are no Arabic tests measuring speech intelligibility. Aim It is necessary to develop and standardize an objective Arabic speech intelligibility test that can be used to estimate the degree of deterioration of speech intelligibility in communicative disorders as an attempt to develop a valid and a reliable tool to assess the efficacy of different therapy programs for different communicative disorders. Patients and methods This study was carried out on 200 children with an age range of 4–12 years whose language skills were either fully developed or equivalent for age. All children were selected randomly from the outpatient clinic of phoniatrics and had any of five selected speech disorders affecting speech intelligibility. Each child included in the study was subjected to two evaluations: a subjective rating of the child’s speech intelligibility and the developed Arabic speech intelligibility test, which is meant to be an objective measure. Results The results showed a highly significant correlation between the scores of the Arabic speech intelligibility test and the average scores given by raters, the average scores for words, and the average scores for sentences (0.92, 0.98, and 0.84, respectively). Conclusion The developed test is proven to be valid and reliable for measuring speech intelligibility in children and could be categorically classified according to ranges of severity.

Background: Phonasthenia is a voice disorder where the larynx looks essentially normal and dysphonia is not heard but felt by the patient. This study aims to use videokymography (VKG) to detect any abnormalities in the vibratory pattern in phonasthenia and to find out whether or not these abnormalities change after vocal loading. Methods: Thirty-seven phonasthenic patients and 31 normal subjects participated in a detailed protocol, including analysis of subjective complaints and videokymographic quasi-objective parameters (baseline) followed by loading their voices through prolonged loud reading for 45 min. A second evaluation (experimental) was done after loading. Results: Before vocal loading, patients had significantly more symptoms in all questionnaire questions and higher maximum width difference in VKG than controls. When pre- and postloading values were compared, both groups experienced more symptoms after loading (significant in most of the questions), while the pre- and post-VKG parameters did not show significant differences neither in patients nor controls. On comparing their percent change, the only statistically significant difference between the 2 groups was a greater change in the total score of the questionnaire in the control group. Conclusion: Patients had more vocal fatigue symptoms and more amplitude asymmetry between left and right vocal folds than normal subjects.

EnAbstract Background Transient voice change associated with endotracheal intubation has generally been attributed to vocal fold trauma. Aim The aim of this study was to examine the effects of short-term endotracheal intubation on the vocal fold vibratory pattern using videokymography in order to aid the early detection and prevention of these changes. Participants and methods This study was carried out on 40 patients who were scheduled for a variety of elective surgical procedures under general anesthesia. They were 26 males, ranging in age from 17 to 61 years, mean age of 36.4±4.2 years, and 14 females ranging in age from 16 to 54 years, mean age of 34.6±5.3 years. Evaluation of vocal functions was carried out at three intervals, 1 day before intubation, 1 day after extubation, and 1 week later. All patients were subjected to analysis of their complaints, auditory perceptual assessment of their voice, and assessment of vocal fold vibration using videokymography. Results Sixteen patients complained of postoperative voice change, ranging in severity from good in 11, moderate in four, and bad in one patient. After 1 week, five patients were still complaining of voice change, ranging from good in four to moderate in one. There was a positive significant correlation between the degree of voice change and both the duration of anesthesia and tube size. There was postextubation mild to moderate voice change in 12 patients. The pitch was decreased in nine patients, increased in two patients, and there was diplophonia in one patient. The loudness was fluctuating in eight patients and was decreased in four patients; after 1 week, there was an improvement in all the perceived parameters; however, persistent dysphonia was perceived in three patients. There was a positive significant correlation between the degree of dysphonia and both the duration of anesthesia and the tube size. The normal video mode of videokymography, performed 1 day after extubation, indicated evidence of traumatic laryngeal lesions in 15 patients. In the high-speed mode of videokymography performed before intubation, 1 day after extubation, and 1 week after extubation, a significant difference was found in most of the parameters when comparing before intubation and 1 day after extubation; also, a significant difference in all the parameters was found 1 day after extubation and 1 week after extubation, whereas a nonsignificant difference was found when comparing before intubation and 1 week after extubation. There was a significant positive correlation between both the duration of intubation and the tube size with the severity of voice complaint and grade of dysphonia. Also, there was a significant positive correlation between the aperiodicity in both the amplitude of mucosal wave and the glottal cycle time, and both the duration of intubation and the tube size in the dysphonic group. Conclusion Traumatic lesions of the laryngeal structures that occur during intubation, in addition to possible subepithelial changes, are the most common causes of postoperative dysphonia, with a tendency toward a regressive course of the resulting dysphonia. As such, it is important to establish an early diagnosis and adopt preventive measures.