Objective: To study the prevalence of hearing loss (HL) and to identify the possible risk factors causing HL. Methods: This retrospective study was conducted from January 2014-December 2016 at a tertiary hospital in Malaysia. All neonates admitted to the neonatal intensive care unit (NICU), Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were screened with a two-step protocol using an automated auditory brain response (AABR) and/or Otoacoustic Emission and auditory brain response (ABR). Descriptive analysis was used for the prevalence of HL, degree of HL and number of risk factors per infant. Results: A total of 2713 babies underwent hearing screening in NICU was enrolled in this study. Two thousand six hundred eight (96%) babies passed the screening test and 214 (4%) babies required further diagnostic test. Only 105 (49%) babies completed diagnostic tests. Out of 105 babies, 40 (38.1%) babies had HL. Mild HL was the commonest HL with 22 (55%), moderate HL was in seven babies (17.5%), severe HL in two babies (5%), and profound HL in nine babies (22.5%). The presence of craniofacial anomalies was the only significant independent risk factor for HL with p<0.05 with an odds ratio of 0.105 CI 95% [0.028-0.389]. Of Babies with the presence of three or more risk factors, 100% of them had HL. There was an increased risk of hearing loss in those with craniofacial anomalies up to 11 times higher compared to those without such anomalies. Conclusion: The prevalence of HL among the NICU babies was 1.5% and mild HL was the commonest degree of HL (55%).
Background Primary thyroid leiomysosarcoma is a rare and aggressive disease which represents 0.014% of primary thyroid cancers. It confers a diagnostic conundrum, due to difficulty to make a preoperative diagnosis of thyroid leiomyosarcoma and to differentiate it from anaplastic thyroid carcinoma. Case presentation We herein report a rare case of primary thyroid leiomyosarcoma. A 48-year-old male presented with history of anterior neck swelling for the past 2 months. Computed tomography (CT) neck showed hypodense nodule at the right thyroid lobe with calcification causing tracheal deviation, with intratracheal extension at 1st and 2nd tracheal rings and presence of lung metastases. The histopathology analysis yield high grade spindle cell neoplasm suggestive of sarcoma. Immunohistochemistry showed that neoplastic spindle cells were positive for smooth muscle actin, vimentin, caldesmon while no reactivity was reported for thyroglobulin, calcitonin, thyroid transcription factor-1, S-100, CD45, CD 5, and cytokeratins. Patient had undergone tracheostomy and chemotherapy but he succumbed to death 1 month after completion of chemotherapy. Conclusion Primary thyroid leiomyoarcoma is a very rare and aggressive disease. The treatment ranging from surgery, adjuvant radiotherapy and chemotherapy, with high recurrence rates.
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