BackgroundHearing ability is important for children to develop speech and language skills as they grow. After a mandatory newborn hearing screening, group or mass screening of children at later ages, such as at preschool age, is often practiced. For this practice to be effective and accessible in low-resource countries such as Thailand, innovative enabling tools that make use of pervasive mobile and smartphone technology should be considered.ObjectiveThis study aims to develop a cost-effective, tablet-based hearing screening system that can perform a rapid minimal speech recognition level test.MethodsAn Android-based screening app was developed. The screening protocol involved asking children to choose pictures corresponding to a set of predefined words heard at various sound levels offered in a specifically designed sequence. For the app, the set of words was validated, and their corresponding speech power levels were calibrated. We recruited 122 children, aged 4-5 years, during the development phase. Another 63 children of the same age were screened for their hearing abilities using the app in version 2. The results in terms of the sensitivity and specificity were compared with those measured using the conventional audiometric equipment.ResultsFor screening purposes, the sensitivity of the developed screening system version 2 was 76.67% (95% CI 59.07-88.21), and the specificity was 95.83% (95% CI 89.77-98.37) for screening children with mild hearing loss (pure-tone average threshold at 1, 2, and 4 kHz, >20 dB). The time taken for the screening of each child was 150.52 (SD 19.07) seconds (95% CI 145.71-155.32 seconds). The average time used for conventional play audiometry was 11.79 (SD 3.66) minutes (95% CI 10.85-12.71 minutes).ConclusionsThis study shows the potential use of a tablet-based system for rapid and mobile hearing screening. The system was shown to have good overall sensitivity and specificity. Overall, the idea can be easily adopted for systems based on other languages.

Recently, oxidative stress has been reported to contribute an important role in the decline of physical function as age advances. Numerous antioxidants can improve both physical and psychological performances resulting in the increase of health-related quality of life (HQOL). Therefore, we hypothesized that Centella asiatica, a medicinal plant reputed for nerve tonic, strength improvement and antioxidant activity, could improve the physical performance and HQOL especially in the physical satisfaction aspect, of the healthy elderly volunteer. To test this hypothesis, a double-blind, placebo-controlled, randomized trial was performed. Eighty healthy elderly were randomly assigned to receive placebo or standardized extract of C. asiatica at doses of 250, 500 and 750 mg once daily for 90 days. The subjects were evaluated to establish baseline data of physical performance using 30-s chair stand test, hand grip test and 6-min walk test. The health-related quality of life was assessed using SF-36. These assessments were repeated every month throughout the 3-month experimental period using the aforementioned parameters. Moreover, 1 month after the cessation of C. asiatica treatment, all subjects were also evaluated using these parameters again. The results showed that after 2 months of treatment, C. asiatica at doses of 500 and 750 mg per day increased lower extremity strength assessed via the 30-s chair stand test. In addition, the higher doses of C. asiatica could improve the life satisfaction subscale within the physical function subscale. Therefore, the results from this study appear to support the traditional reputation of C. asiatica on strength improvement, especially in the lower extremities of the elderly. C. asiatica also possesses the potential to be a natural resource for vigor and strength increase, in healthy elderly persons. However, further research is essential.

Objective: To compare the efficacy of three common interventions for tinnitus patients: notched music therapy, conventional music therapy, and counseling. Study Design: Randomized, single-blinded, controlled, three-arm trial. Method: This study was conducted from January 2018 to January 2019. Eligible subjects were randomized into three groups. The first group received notched music therapy (n = 25), the second received conventional music therapy (n = 24), and the third received counseling only (n = 26). The three groups did not differ in terms of demographic data including age, sex, tinnitus duration, affected side, hearing level, side of tinnitus, and frequency of tinnitus. The patients were followed up on at month 1, 2, and 3 after initiation of therapy. Results: Tinnitus Handicap Inventory scores gradually decreased in all groups. The mean differences in Tinnitus Handicap Inventory score from baseline for patients who received notched music therapy, conventional music therapy, and counseling only were 20.49, 27.83, and 17.79 points, respectively (p < 0.05). However, there was no statistically significant difference among the groups (p = 0.246). Conclusion: There was no difference between the treatments. The selection of these therapies for tinnitus treatment may depend on the unique needs and proclivities of patients. Trial registration: clinicaltrials.in.th/TCTR20180225002.

Background: Hearing impairment affects communication, social interactions, and quality of life. Audiometry is the gold standard method for hearing assessment. However, it is impractical in a country with limited resources. This study aimed to validate the Thai version of the Five-Minute Hearing Test (Thai-FMHT) to screen hearing loss in the community. Methods: This prospective cohort study was conducted in Phu Wieng district, Khon Kaen Province, Thailand during July to September 2011. Subjects who were older than 18 years, could read or understand the Thai language, and wanted to participate were enrolled. Those who had aphasia, severe mental disability, or other conditions that precluded audiometry were excluded. The Thai-FMHT was first administered, followed by standard audiometry performed by audiologists who were blinded to the result of Thai-FMHT, and finally an ear examination was performed. This trial was registered with ClinicalTrial.gov as No. NCT01408992. Results: The 558 subjects, including 176 males (32%) and 382 females (68%), completed all of the procedures. The optimal cutoff point for hearing loss in this screen was 8. The sensitivity, specificity, and positive likelihood ratio of the Thai-FMHT to screen mild hearing loss (PTA_{0.5-2 kHz} >25 dB) were 64.7% (95% CI, 56.1-72.7%), 60.0% (95% CI, 55.1-64.7%), and 1.62 (95% CI, 1.36-1.92), respectively. Regarding screening moderate hearing loss (PTA_{0.5-2 kHz} >40 dB), the sensitivity, specificity, and positive likelihood ratio of the Thai-FMHT were 93.1% (95% CI, 77.2-99.2%), 56.5% (95% CI, 55.1-64.7%), and 2.1 (95% CI, 1.9-2.5), respectively. Conclusion: The Thai-FMHT has a lower cutoff point than does the original one. This test is suitable for use as a screening tool for hearing loss in the community.

Background Globally increasing number of elders is concerned. Hearing loss process in older adults cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in older adults. Methods This prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard. Results The prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77–91.64) and specificity of 52.19% (95% CI 48.24–56.13) for diagnosis hearing disability in Thai older adults, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%. Conclusions Either the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai older adults. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss older adults who will benefit and recommended for hearing rehabilitation. Trial registration The study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. Date of registration October 14, 2015.