Background:Tinnitus is the perception of noise or ringing without external acoustic stimulants which affects almost 10% of general population. Many therapies have been recommended including diet modifications, herbal remedies, and chemical drugs. Most common utilized drugs for tinnitus are melatonin and antidepressants such as sertraline which have been proven in different studies. In this study, we aimed to compare the efficacy of melatonin and sertraline in treating tinnitus for the first time.Methods:In this clinical trial, 70 patients with tinnitus according to inclusion and exclusion criteria were included and randomly divided into two groups: melatonin group, taking melatonin 3 mg once daily and sertraline group taking sertraline 50 mg once daily, all treating for 3 months. Before and after treatments, every patient received Tinnitus Handicap Inventory (THI) questionnaire and severity of tinnitus was assessed, and data analysis was performed.Results:Before treatments, the mean of THI score for melatonin and sertraline groups were 45.02 ± 17.67 and 44.85 ± 20.57, respectively. There was no significant difference between both groups THI score (P = 0.23). After 3 months, the mean of THI scores for melatonin and sertraline groups were 30.29 ± 19.62 and 36.96 ± 25.03, respectively which the mean of THI scores in two groups was decreased significantly (P < 0.01, for-both). In addition, indicated the significant decline in THI score of melatonin group who were under treatments with melatonin 3 mg once daily (P = 0.02).Conclusions:Here in this clinical trial, we demonstrated that both melatonin and sertraline are efficient in treating tinnitus, but the usage of melatonin 3 mg once daily is more effective.

Background:Smoking is one of the most important risk factor in increasing of non-communicable disorders, especially chronic diseases such as cancer, stroke, heart and respiratory diseases. Cigarette smoking could damage the cochlea and causing hearing loss. The otoacoustic emission (OAE) is a source of information for determining cochlear responses to sound stimuli and how to change the response of the auditory system in some diseases. OAE test was sensitive to outer hair cells (OHCs) activity.Materials and Methods:In this study, tried to evaluate a hearing threshold of the smoker group versus non-smoker ones through pure tone audiometery, transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) tests.Results:The results indicated that significant decrement of 8000 Hz threshold, reduced DPOAE/TEOAE amplitude in the smoker group than non-smoker one (P < 0.05). DPOAE amplitudes decline reflects the cochlear damage caused by smoking.Conclusion:OAEs test was clinically non-invasive, accurate, and objective evaluation of the performance of cochlear OHCs.

Background:Otitis media (OM) is the most common cause of childhood hearing loss and reason to visit the pediatrician. Furthermore, gastroesophageal reflux (GER) has been associated with a variety of upper aerodigestive tract symptoms or diseases, such as sinusitis, laryngitis, and otits. The objective of the present study was to determine the frequency of GER in children, aged 3 months to 7 years, with OM.Materials and Methods:This retrospective case-control study was conducted on 50 children with OM and 50 healthy children. Presence of GER as the main variables was diagnosed by clinical examination in all studied children using the questionnaires with 2 age-stratified versions of the pediatric GER disease symptoms for children 2 years old and younger, and children 3–7 years old.Results:The prevalence of GER in children with OM and controls was 58% and 22% respectively (P = 0.0005). The frequency of irritability, congestion, and feeding complex in children with OM were significantly more than in control groups. Among children with recurrent acute OM (AOM), and chronic serous OM (CSOM) the prevalence of GER was significantly more than controls (61.1%, vs. 22% for AOM, P = 0.004, and 72.7% vs. 22%, P= 0.003). In children with AOM, regurgitation, vomiting, irritability and congestion were significantly higher than controls included. In children with CSOM, regurgitation, vomiting, and congestion were significantly higher than controls.Conclusion:Results show a significant association between GER and OM, AOM and CSOM in children with OM compares to healthy children. This shows that looking for GER in children with OM may help improving treatments outcomes.

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Introduction: Despite the improvement in COVID-19 therapeutic management the mortality of mechanically ventilated COVID-19 patients remains high. In this study, we determined risk factors of mortality in these cases. Methods: This retrospective study examined clinical and paraclinical data of COVID-19 patients mechanically ventilated at the time of hospitalization to ICU admission until death or discharge from hospital between April and September in 2021 in three COVID-19 referral hospitals. Results: One hundred twenty-five patients (60% male, mean age 62 ± 15.18, range 17 to 97 years old) were recruited to this study. 51(40%) survived and 74 (60%) didn’t survive. At the time of hospital admission, the vital signs were not significantly different between the survivors and non-survivors groups, also diarrhea was not reported in non-survivors, but reported in 9.5% of survivors (P = 0.02). The mean age of 74 non-survivors was higher than 51 survivors (65.1 ± 14.17 vs 56.9 ± 15.41, P = 0.003). The intubation time since the patients were admitted to hospitals was not significantly different between the two groups (3.38 ± 2.88 days vs 4.16 ± 3.42 days, P = 0.34). The mean LDH and D-dimer at the time of ICU admission were significantly higher in the non-survivors group (863 ± 449 vs 613 ± 326, P = 0.01; 4081 ± 3342 vs 542 ± 634, P = 0.009; respectively). However, the mean CRP was not significantly different between the two groups (76 ± 66.4, 54 ± 84.3; P = 0.1). Mean APACHE-II score was higher in the non-survivors than the survivors (15 vs 13; P = 0.01). Use of remdesivir, interfrone beta-1a, and low dose corticosteroids were significantly higher in the survivors group (P = 0.009, P = 0.001, P = 0.000). Conclusion: Success of weaning and hospital discharge among mechanically ventilated COVID-19 patients are probably higher in younger patients with lower D-dimmer and LDH levels that received low dose corticosteroids during treatment.