Objectives Two main digital signal processing technologies inside the modern hearing aid to provide the best conditions for hearing aid users are directionality (DIR) and digital noise reduction (DNR) algorithms. There are various possible settings for these algorithms. The present study evaluates the effects of various DIR and DNR conditions (both separately and in combination) on listening comfort among hearing aid users.Methods In 18 participants who received hearing aid fitting services from the Rehabilitation School of Shahid Beheshti University of Medical Sciences regularly, we applied acceptable noise level (ANL) as our subjective measure of listening comfort. We evaluated both of these under six different hearing aid conditions: omnidirectional-baseline, omnidirectional-broadband DNR, omnidirectional-multichannel DNR, directional, directional-broadband DNR, and directional-multichannel DNR.Results The ANL results ranged from −3 dB to 14 dB in all conditions. The results show, among all conditions, both the omnidirectional-baseline condition and the omnidirectional-broadband DNR condition are the worst conditions for listening in noise. The DIR always reduces the amount of noise that patients received during testing. The DNR algorithm does not improve listening in noise significantly when compared with the DIR algorithms. Although both DNR and DIR algorithms yielded a lower ANL, the DIR algorithm was more effective than the DNR.Conclusion The DIR and DNR technologies provide listening comfort in the presence of noise. Thus, user benefit depends on how the digital signal processing settings inside the hearing aid are adjusted.

Objective Hypovitaminosis D3 is a significant concern among pregnant women and their newborns because vitamin D3 (Vit-D3) plays a crucial role in embryonic growth, development, and health. This study aimed to evaluate the Vit-D3 status of a group of pregnant Iranian women and its association with newborn Vit-D3 levels, medical and clinical indices after delivery.Methods A total of 206 pregnant women and their newborns were assessed for Vit-D3 levels and their correlation with gestational age. Mean±standard deviation (SD) or the orders (non-parametric tests) of variables were compared, and correlation estimations were performed to elucidate any differences or associations between groups, with a confidence interval of at least 0.95.Results The mean±SD of mothers’ age and gestational age were 29.65±6.18 years and 35.59±1.6 weeks, respectively. Neonatal Vit-D3 levels were associated with maternal age. Using a 30 ng/mL cutoff point for serum Vit-D3 levels, 83.5% of pregnant women and 84.7% of newborns had hypovitaminosis D3. The average Vit-D3 levels of mothers and newborns at delivery time were 23.5±8.07 ng/mL and 20.76±9.14 ng/mL, respectively. Newborn Vit-D3 levels were positively correlated with maternal Vit-D3 serum levels (R=0.744; <i>P</i><0.001) and gestational age (R=0.161; <i>P</i>=0.022). In newborns, head circumference was inversely correlated with bilirubin level (R=-0.302; <i>P</i><0.001) but directly associated with weight (R=0.640; <i>P</i><0.001).Conclusion Hypovitaminosis D3 remains a significant challenge for pregnant Iranian women. Maternal Vit-D3 levels provide for the newborn’s needs, particularly in the late stages of pregnancy. Therefore, Vit-D3 supplementation and regular monitoring are essential for pregnant women and their newborns.

Background and Objectives: The speech-in-noise test is typically performed using an audiometer. The results of the digit-in-noise recognition (DIN) test may be influenced by the flat frequency response of free-field audiometry and frequency of the hearing aid fit based on fitting rationale. This study aims to investigate the DIN test in unaided and aided conditions. Subjects and Methods: Thirty four adults with moderate and severe sensorineural hearing loss (SNHL) participated in the study. The signal-to-noise ratio (SNR) for 50% of the DIN test was obtained in the following two conditions: 1) the unaided condition, performed using an audiometer in a free field; and 2) aided condition, performed using a hearing aid with an unvented individual earmold that was fitted based on NAL-NL2.Results: There was a statistically significant elevation in the mean SNR for the severe SNHL group in both test conditions when compared with that of the moderate SNHL group. In both groups, the SNR for the aided condition was significantly lower than that of the unaided condition.Conclusions: Speech recognition in hearing-impaired patients can be realized by fitting hearing aids based on evidence-based fitting rationale rather than by measuring it using free-field audiometry measurement that is utilized in a routine clinic setup.

Background and Aim: Although cochlear implantation (CI)  is a safe  surgical  procedure for severe to profound sensorineural hearing loss (SNHL) but, due to the embryological and anatomical connection between the vestibular and cochlear structures, vestibular dysfunction may occur after CI. Video head impulse test (vHIT) is a reliable test for assessing the function of semicircular canals (SCCs). This study aimed to determine the early effect of CI on SCCs function, by comparing pre- and post-operative vHIT results. Methods: In this cross-sectional study, participants were 22 adults with SNHL scheduled for unilateral CI in the right ear and 22 age-matched healthy subjects as a control group. The vHIT was conducted before and two weeks after CI. Results: The mean vHIT gains in the SNHL group were significantly lower than in controls, with a large effect size. Furthermore, the mean vHIT gains in the right lateral SCCs (p<0.001) and right anterior SCCs (p=0.003) were significantly reduced  after  CI,  compared  to the gain values before CI, with a large pooled effect size. However, these differences were not statistically significant for the right posterior SCCs. The comparison of vHIT gains in the non- implanted ear showed no statistically significant difference between pre- and post-operative phases. Conclusion: The vHIT is a useful clinical method to detect the early effects of CI on the function of SCCs. These effects are more obvious in the lateral and superior SCCs in the implanted ear. Keywords: Cochlear implantation; semicircular canals; video head impulse test