sadegh jafarzadeh

The available evidence about hearing loss in Coronavirus disease (COVID-19) patients mostly show sensorineural hearing loss, and the long-term effects of COVID-19 on auditory thresholds are unknown. This study aimed to compare the auditory threshold results in COVID-19 patients (several months after infection) with a control group. The clinical diagnosis of COVID-19 was confirmed with positive polymerase chain reaction findings and radiology images. Hearing evaluation was performed with an audiometry test and a calibrated audiometer in a sound-treated room. The results of 177 patients were compared with those of the 589 matched control group. In both groups, subjects over 50 years old or with any history of ear disease were excluded from the study. The time interval between infection with COVID-19 and hearing tests was 170.51±98.38 days. There was no significant difference between the auditory thresholds in different frequencies in both groups. Also, no significant difference was observed between the auditory thresholds of the two groups in the first, second, and third trimesters after being infected. This study did not show the long-term effects of COVID-19 on auditory thresholds, and the findings do not support hearing loss as a long-term COVID symptom.

The possible effects of refractive errors on vestibulo-ocular reflex (VOR) has been a conflicting issue. The aim of this study was to evaluate the effects of induced myopia on VOR using the ocular Vestibular Evoked Myogenic Potential (oVEMP).

In this cross-sectional quasi-experimental study, 35 emmetropic and normal subjects with the mean age of 23.89 ± 3.93 (range, 20–40 years) without any ocular, nervous system, and vestibular disorders, underwent the oVEMP test in the comprehensive rehabilitation center of Mashhad University of Medical Sciences. The oVEMP was performed under five different conditions of testing binocularly, monocularly, and when myopia was induced with the use of spherical lenses of +1.00, +3.00, and +5.00 diopters, respectively. There were 2 to 5 min of rest with closed eyes after each condition to avoid adaptation, fatigue, and any other sources of bias. Mean latencies of oVEMP waves (N1 and P1) and amplitudes of N1–P1 complex were measured.

There was no significant difference between the right and left sides (P > 0.05). The induced myopia significantly increased the N1 and P1 latencies using lenses of +1.00, +3.00, and +5.00 diopters but the amplitudes of N1–P1 complex were not influenced by the different amounts of induced myopia. There was no significant difference among the different conditions of induced myopia either (P > 0.05).

Induced myopia could affect the VOR due to prolonging the latencies of oVEMP waves. However, the amplitudes were not affected and the effects of multiple degrees of induced myopia were not significantly different.

Electricity is a fundamental infrastructure for any country, including Iran, and nuclear energy offers one pathway for its generation. However, Iran’s nuclear energy issue is often viewed more politically than scientifically. A key aspect requiring attention is the national and international legal framework governing nuclear power. Nuclear electricity production involves various technical and political considerations. While nuclear energy can reduce greenhouse gas emissions and air pollution, it also entails high costs for plant operation and nuclear waste management. Nuclear plants have long lifespans and operate with minimal fuel compared to combined-cycle plants, which makes them efficient, though not without challenges. Iran, as a country with high electricity demand and a developing nuclear industry, currently generates limited electricity from nuclear sources.The primary question addressed by this article is whether Iran’s upstream legal documents and overall legal framework support or hinder nuclear power development. This question is explored through an analytical-critical review of the constitution and key legal documents of the country. The research reveals that, due to numerous legal complexities surrounding nuclear energy, a lack of clear national priorities, and ambiguities in specialized areas such as domestic nuclear production capacity, it is difficult to reach a definitive conclusion on Iran’s stance toward nuclear energy development. The study concludes that the challenges to nuclear electricity production in Iran are more political than technical. Political factors, outlined in the Joint Comprehensive Plan of Action (JCPOA), create obstacles that affect Iran's nuclear energy trajectory, reflecting a blend of political and technical issues embedded in this international agreement.

This research takes an analytical approach, examining economic, environmental, and political perspectives through legal documents to gain insights into Iran’s nuclear energy policies.

From an economic perspective, there is justification for expanding nuclear electricity production in Iran. Environmentally, nuclear energy presents both benefits and challenges: while it could reduce greenhouse gas emissions, nuclear waste management remains a significant challenge.

The JCPOA introduces obstacles to the development of nuclear electricity in Iran. Additionally, the absence of a clear national nuclear plan diminishes the decisiveness needed to draw firm conclusions about the country’s future in nuclear energy.

The aim of this study was to investigate hearing outcome of stapes surgery, considering the post-operative air and bone conduction (AC&BC) changes, in a frequency specific approach.

This was a retrospective cohort study. A total of 245 ears (231 patients), who underwent Stapedotomy at our tertiary referral center in a period of 5 years were enrolled in the study. Pure tone audiometry (PTA) was evaluated preoperatively and one month postoperatively. AC, BC, and Air-bone gap (ABG) were documented. Moreover, one-year post-op PTA was also recorded for more than a quarter of the cases.

Overall, significant improvements were observed in AC thresholds with a mean AC gain of 20.44±13.64 dB. At higher frequencies the results were poorer (AC gain of 27 dB at 250 Hz vs 7 dB at 8000 Hz). ABG significantly improved at all frequencies after one month. BC thresholds were typically better after surgery. However, there appears to be a worsening trend in BC thresholds at frequencies higher than 2000 Hz. In 68 patients with 1-year follow-up, BC thresholds were slightly worse (but not statistically significant) at most frequencies, in comparison to the one-month results.

Stapes surgery significantly improves air and bone conduction hearing, particularly at lower frequencies. Nonetheless, there exists a potential for sensorineural hearing loss (SNHL) at high frequencies. However, the changes are insignificant and not within the speech frequencies. Therefore, patients are typically satisfied with the hearing outcome of the surgery.

Tinnitus is a common symptom and affects patients differently. The Iowa Tinnitus Primary Function (ITPF) questionnaire evaluates tinnitus in four areas: concentration, emotion, hearing, and sleep. This study aimed to translate and then assess the psychometrics of the ITPF questionnaire.

This is a cross-sectional and methodological (test construction) study. The questionnaire was translated by the Word Health Organization protocol. The validity and reliability of the questionnaire were assessed. The measured validities were the content, face, and discriminative. The reliability was estimated by internal consistency and test-retest stability. We also measured the effects of age and sex on the questionnaire’s score.

The questionnaire was translated based on the protocol. Each item of the questionnaire was understandable for patients and healthy participants. The face and content validities were confirmed by the patients and specialists, respectively. The score of 10.97 was determined as the cutoff point between patients and healthy participants, with a sensitivity of 86.70% and a specificity of 96.10%. The Cronbach α was found to be 0.958, and the intraclass correlation coefficient was 0.975. No significant effect was observed for age (p=0.314) and gender (p=0.866).

The Persian version of the questionnaire showed high validity and reliability. It could be used in research and clinical settings.

There is an integration between visual and vestibular systems. Changes in visual inputs can result in different changes in the Vestibulo-Ocular Reflex (VOR). This review study investigate the changes in VOR due to changes in visual inputs. In this regard, the effects of different conditions such as visual deprivation, changes in visual acuity, visual-vestibular conflict, and binocular vision dysfunction on VOR were assessed.

Changes in visual inputs and visual-vestibular conflicts can lead to different changes in VOR.

The changes in VOR effects vary from slight to severe transformation dependent on the time course, severity and duration of changes in visual inputs.

Hearing loss is one of the most common congenital disorders. The Early Diagnosis and Intervention Process is designed for the early diagnosis and intervention of hearing loss in infants. The present study aimed to examine the results of Early Hearing Detection and Intervention (EHDI) in northeastern Iran from 2005 to 2019. Setting: Northeastern Iran.

In most cases, the two‑stage protocol (otoacoustic emissions [OAE] and automated auditory brainstem response [AABR]) has been used. Infant assessment methods included the use of OAE, ABR, auditory steady‑state response, high‑frequency tympanometry, and behavioral audiometry. Interventions included medical interventions, hearing rehabilitation, hearing aids, and cochlear implants.

1,162,821 infants were screened. The screening coverage increased from less than 1% in 2005 to about 99% in 2018. The referral rate has been about 1%. 2.17 out of every 1000 infants are hearing impaired, and the most common cases are bilateral hearing loss and mild to moderate hearing loss.

During 2005 to 2019 the coverage rate reached to more than 95% of live births. To improve the EHDI process in this population, better follow‑up of diagnosed neonates and expansion of diagnostic and intervention services are needed.

COVID-19 could induce vestibular neuritis in some patients, and there is limited information on their vestibular evaluation and rehabilitation. Three cases infected by COVID-19-induced vestibular neuritis underwent vestibular evaluation and rehabilitation. They showed unilateral dysfunction in caloric and video head impulse tests. A home-based vestibular rehabilitation (VR) was used for their treatment. Although the symptoms in one patient significantly improved, she still had a mild episode of vertigo. The other two patients completely recovered. They also had no remaining vertigo or imbalance at the end of VR. The final physical examinations were normal, and the total score onthe Dizziness Handicap Inventory showed no handicapping. VR could be effective in the management of COVID-19-induced vestibular neuritis. So, we could expect a good recovery similar to other disorders with unilateral vestibular hypo-function.

Ischemic injury is a major cause of hearing loss and oxidative stress is an important part of ischemic injury. The goal of this study was to evaluate the cochlear oxidative stress effect on auditory responses in male rats.

Cochlear oxidative stress was induced by bilateral carotid artery occlusion for 20 minutes. The rats were evaluated by biochemical inflammatory factors tumor necrosis factor-α [TNF-α] and C-reactive protein (CRP) in the day before and 1st, 4th, and 7th days following surgery. The auditory brainstem response (ABR) and electrocochleography (ECochG) were evaluated on the day before surgery and 14th, 21th and 28th days after surgery.

TNF-α and CRP levels concentrations increased one day after ischemia and subsequently decreased on the 7th day. The click and tone burst evoked ABR showed increased thresholds on day14th, 21th, and 28th. The highest threshold was recorded on day14th. The ECochG results also were abnormal for 55%, 70%, and 45% of cases on day 14th, 21th, and 28th, respectively.

Cochlear oxidative stress affects hearing sensitivity. The ABR shows elevated thresholds and abnormal ECochG was found in many cases.

Type two diabetes mellitus may relate to auditory and vestibular dysfunction. This relationship was frequently observed in elders. The present study aimed to evaluate the auditory and vestibular function of diabetic patients and compare the results with those of a healthy adult control group.   Patients were asked to complete demographic characteristics form. Moreover, fasting blood sugar, as well as hemoglobin A1C tests, were carried out on them. Both the patients and control group were evaluated using several auditory and vestibular tests including Pure Tone Audiometry (PTA), video Head Impulse Test (v-HIT), ocular Vestibular Evoked Myogenic Potential (o-VEMP), and cervical Vestibular Evoked Myogenic Potential (c-VEMP).   The PTA showed a significant difference in some frequencies between the two groups. These differences were minimal in lower frequencies and become greater at 8000Hz. The v-HIT was abnormal for some patients and also showed a significant difference between the two groups. The o-VEMP and c-VEMP results were normal in most patients.   Based on the obtained results, auditory and vestibular dysfunctions are related to Diabetes. Patients with type two diabetes mellitus showed mild auditory and vestibular dysfunctions compared to the healthy control group.

congenital severe to profound sensorineural hearing loss (SP-SNHL) causes serious difficulties in production and comprehension of speech, necessitates use of a thorough rehabilitation program at early age. The aim of this study was to evaluate the relationship between hearing thresholds and the result of auditory rehabilitation in children with bilateral congenital SP-SNHL.  

This is a retrospective study. Thirty-five children (23 males and 12 females) with bilateral congenital SP-SNHL were evaluated based on Auditory Steady-State Response (ASSR). The mean age of children at the beginning of rehabilitation was 37.36 (±17.10) months. They received bilateral superpower hearing aids and auditory rehabilitation based on Auditory-Verbal Therapy (AVT) approach. Their Speech production and comprehension were assessed at the beginning and end of rehabilitation via Speech Intelligibility Rating (SIR) and Categories of Auditory Performance (CAP).

The SIR and CAP scores showed improvement in 12 (34.3%) and 25 (71.4%) children, respectively. These children had lower ASSR thresholds in 0.5 to 4 k Hz relative to others. The mean ASSR thresholds were 85.63 to 97.50 versus 96.09 to 104.75 (p < 0.05). Also, lower hearing thresholds were related to better results in auditory rehabilitation (p < 0.05).

Lower hearing thresholds in children with SP-SNHL are associated with better rehabilitation results.

This study aimed to evaluate the effects of bilateral carotid artery occlusion on cochlear oxidative stress and hearing status in rats.

The rats were divided into two sets. The first set was used for electrophysiological recording (click and 4 kHz tone burst auditory brainstem responses and electrocochleography) on the day before surgery and then on the first, fourth, and seventh days after surgery. Animals of the second set were used for biochemical analysis. The cochlea of animals in the second set was collected on the first, fourth, and seventh days after carotids occlusion for biochemical analysis. For the control groups, no carotids occlusion was done. For ischemia induction, both common carotid arteries were occluded for 20 minutes.

 Electrophysiological analysis showed that burst auditory brainstem thresholds significantly elevated after common carotid arteries occlusion on the first, fourth, and seventh days after surgery with abnormal electrocochleography results at 75%, 70%, and 85% on the first, fourth, and seventh days after surgery, respectively. The electrophysiological finding confirmed by biochemical results that showed malondialdehyde and nitric oxide levels increased and superoxide dismutase and catalase activities decreased after occlusion in cochlea tissue.

This study showed that bilateral common carotid artery occlusion increases cochlear oxidative stress and induces hearing loss in rats.

Hearing loss is a debilitating condition that even mild degrees can disrupt speech processing, communication and limit social interaction. The prevalence of hearing loss and its causes in various age and people groups is different. The aim of this study was conducted to determine the frequency of hearing loss and related factors in patients referred to audiology Clinic of Ghaem Hospital in Mashhad from October 2017 to April 2018.

This cross-sectional study was performed on 493 people referred to Audiology Clinic of Ghaem Hospital in Mashhad. The cause of referring and family history and related diseases was obtained by a questionnaire and then compared with the results of their tympanometry and audiometry tests. The results were obtained using descriptive statistics and Pearson correlation coefficient.

average age of participants were 41.2 (±18.96) years old and 342 out 493 (69/4%) had hearing loss. 79.8% men and 62.6% of women had hearing loss. Sensorineural hearing loss was the most common type of hearing loss (35.2% of all patients). The Otitis media was the most common cause of hearing loss among patients with hearing impairment (10.7%). Also, there was a significant relationship between aging and degree of hearing loss.

According to this results, hearing loss are frequent among Referents of Audiology Clinic. Some causes of hearing loss, such as infections, noise exposure, and Ototoxic drugs can be controlled, Therefore, preventive health care and appropriate treatments can be helpful in reducing the risk of hearing loss.

Auditory rehabilitation is an essential step after hearing aid fitting for children with hearing loss. The aim of this study was to evaluate the auditory rehabilitation results based on auditory verbal therapy approach in children with severe to profound sensory-neural hearing loss. Auditory verbal therapy is a popular approach for rehabilitation children with hearing loss.

This is a retrospective study that evaluates the results of auditory rehabilitation of 19 children with severe to profound hearing loss. Most children were about three years old at the beginning of the rehabilitation process. They were received bilateral hearing aid and auditory rehabilitation based on auditory verbal therapy (AVT) approach. Each case progress was measured by Newsha developmental scale.

All of the children showed progress during the AVT program (p < 0.05). The Newsha developmental scale showed that hearing and receptive language categories had more progress. The progress was similar between male and female participants and there was no difference in all of categories (p > 0.05).

The AVT approach is beneficial for rehabilitation of older children with bilateral severe to profound sensory-neural hearing loss. The progress was observed in all categories of Newsha developmental scale.

Auditory steady-state response (ASSR) is a test for the estimation of auditory thresholds. It is used in infants, children, and adults. This case report presented unusual ASSR results in an elderly person.

Pure tone and speech audiometry, tympanometry and acoustic reflexes showed a moderate sensorineural hearing loss in both ears. However, the patient did not respond in the ASSR test to different carrier frequencies with frequency modulations of 40 and 80 Hz.

To date, the results of the different effects of the aging process obtained from ASSR responses have been reported. However, the absence of any response in the ASSR test has never been reported. The patient in this case report may have these results because of a neural deficit.

Auditory steady-state response (ASSR) has widespread usage in the clinical hearing assessment of infants and young children. The present study evaluated the effect of restricting maximum possible intensity to 100 dB HL on ASSR thresholds. This retrospective study was conducted in multiple audiology centers. ASSR thre sholds with restricted settings were evaluated in 58 infants (116 ears). They had absent otoacoustic emissions and click-evoked auditory brainstem response waveforms and bilateral severe to profound hearing loss in behavioral evaluations. ASSR thresholds were absent in 28 %, 25%, 60 %, and 70 % of ears in 500, 1000, 2000, and 4000 Hz, respectively. The mean value of remained thresholds was approximately 90−95 dB HL. Restricted ASSR settings are prevalent; however, they fail to provide extensive additional information about hearing sensitivity. Thus, manufacturers are suggested to improve ASSR setting and transducers and resolve the intensity restrictions. ASSR settings should be able to test auditory thresholds to level of 120 dB HL.

  Vestibular abnormalities are common problems in the whole world, which can lead to bilateral vestibular dysfunction (BVD). That results in symptoms, such as vertigo, unsteadiness, falling, oscillopsia, and lower quality of life. The Objective of this study was to determine BVD in adults and elderlies with vertigo and unsteadiness.

This study was conducted on 384 patients in two categories of adults (age range of 18-64 years) and elderlies (65 years old and above) through Electronystagmography (ENG), including caloric test and video head impulse test (vHIT). Patients called bilateral vestibular dysfunction when they have an abnormal bilateral weakness (summation of nystagmus response less than 20 for 4 stimulations and less than 12 for each ear) in caloric test and their vHIT has a gain lower than 0.6. The results of caloric tests were categorized into four groups, including normal, unilateral weakness, bilateral weakness, and central abnormalities.

The obtained results revealed that the frequency of BVD is higher than previously reported data in the medical literature. The frequency of BVD was 10.9% for the investigated patients (39.1% abnormal caloric, 12.5% abnormal vHIT, and 10.9% abnormal in both tests). The 38.5% of elderly patients had bilateral abnormal results in both tests.

The results of this study showed BVD in some cases by caloric and vHIT tests.Elderlies showed more cases of BVD compared to adult patients.

Bilateral Meniere’s disease presents with attacks of vertigo leading to severe imbalance and oscillopsia. Sometimes, treatment of bilateral Meniere’s disease is challenging. The following case report presents an appropriate and successful management for a complicated Bilateral Meniere’s disease. Patient was a 42 years male referred with severe attacks of vertigo, severe to profound bilateral hearing loss and severe tinnitus as well as imbalance. Vestibular assessment was done with electronystagmography, head impulse test, cervical and ocular vestibular evoked myogenic potential that showed bilateral and widespread vestibular abnormality in the semicircular canals and otolith systems. Patient had different medical treatments before referring to us and we started some medical and rehabilitation treatments based on his unstable conditions and followed him up for over three years. Vestibular rehabilitation is an approach for the management of many vestibular abnormalities such as Meniere’s disease. It could help to resolve vertigo and imbalance in acute and chronic stage of Meniere’s disease. Vestibular rehabilitation may be helpful in controlling the acute symptoms and helps to improve imbalance and oscillopsia.

The auditory brainstem response (ABR) is one of the most common objective hearing tests conducting in animal and human. The purpose of this study was evaluating the morphology variations of ABR waveforms in rats with low and high rate click stimuli. First, rats with ABR thresholds higher than 55 dB SPL were excluded and total 81 ears remained in study. Absolute and interpeak latencies of wave I, II, IV were evaluated at low (17.7 Hz) and high rate (88.7 Hz) for click stimuli at 120 dB SPL. At low rate stimuli, ABR waveforms showed different morphologies. The most common complex for waves II to IV was wave III placed on downward slope of wave II (71% of cases). Almost the same morphologies were seen at higher rate; but in some waves, it rounded and decreased amplitude. For waves IV-V, the most common morphology was equal amplitude of wave IV and V in low and high rates (35% vs 56%, respectively). Generally, the high rate stimuli didn’t severely change morphology patterns except for later waves. Normal click-evoked ABR could result in different waveforms. Using click stimuli at low and high rate result in different morphology patterns. Recognizing morphology variations of ABR waveforms are essential for detecting any pathological conditions. The high rate stimuli increased latencies, especially for later waves.

Noise-induced hearing loss is a common causes of sensorineural hearing loss. Drivers of heavy vehicles such as bus and truck are more exposed to the noise associated with traffic and automobiles than other members of the community, which can damage their auditory system. The present study was conducted to investigate the hearing status of heavy vehicle drivers and its relationship with factors such as age under 40 years, work experience and mean daily working hours. The present study examined the level of sensorineural hearing loss in 132 drivers, i.e. 264 ears. The drivers’ details, including age, work experience and mean daily working hours, were first recorded. Every candidate then underwent otoscopy and pure-tone audiometry at frequencies of 500, 1000, 2000, 4000 and 8000 Hz performed by an audiologist in a sound treated room. The blood pressure of these drivers was also recorded using normal techniques of blood pressure measurement. The drivers with other sensorineural hearing loss factors, including presbycusis at ages over 40 and ototoxicity, were excluded from the study. The drivers’ mean age was found to be 34.0±5.097 years, their mean work experience 11.19±5.158 years and their daily working hours 5-16 hours with a mean of 9.2±56.275 hours. The highest frequency of hearing loss was observed at a frequency of 4000 Hz in about 23% of the drivers, followed the prevalence observed at 8000 Hz. No significant differences were found between hearing thresholds of intra-city and intercity drivers. Moreover, significant relationships were observed between the level of hearing loss and factors such as age, work experience and the mean daily working hours. Hearing loss was observed in about one quarter of the drivers, suggesting a high frequency of noise-induced hearing loss in drivers despite the elimination of other factors contributing to sensorineural hearing loss.

Distortion product otoacoustic emissions evaluate the function of outer hair cells in the cochlea. The present study aimed to compare distortion product otoacoustic emissions between normal hearing adult human and rat to better understand their differences.
In this study, signal to noise ratio of distortion product otoacoustic emissions was evaluated and the results of normal hearing persons (n=60) and rats (n=30) were evaluated in similar conditions at of 2, 3, 4, and 5 KHz.
The difference between the two groups was significant in most frequencies except 3 KHz. In rats, a higher signal to noise ratio was observed at 4 and 5 KHz and a lower ratio at 2 KHz. There was no significant difference among different frequencies in human samples.
Significant differences in distortion product otoacoustic emissions in the two groups may demonstrate the different mechanisms for cochlear function in human and rat. This result may indicate the need for extra cautions in using rats as an animal model

Electrically evoked compound action potential (ECAP) is an objective auditory response that can be used in the programing of cochlear implants. The aims of this study were to monitor ECAP thresholds and auditory, language and speech progress for 6 months after cochlear implant surgery and to evaluate any relationship between them.
Ten children with a mean age of 4.2 (±0.6) years and bilateral congenital and profound sensorineural hearing loss underwent cochlear implant surgery and post-operation auditory and speech training. The auditory, language, and speech abilities (Newsha level) and ECAP thresholds (for apical, medial and basal region of cochlea) were evaluated 1, 3 and 6 months after surgery.

ECAP threshold showed no significant improvement in any of the evaluated areas in the 6 months after surgery (P>0.05); however, the Newsha level improved for all patients (P=0.00).
There was no relationship between ECAP thresholds and auditory, language, and speech abilities (Newsha level) in the first 6 months after surgery. ECAP thresholds may be a poor indicator of improvement in auditory, language, and speech abilities, and depend on many factors.

Bilateral vestibular dysfunction (BVD) is an uncommon finding in vestibular assessment, and the combination of BVD and orthopedic problems represents a rare and challenging case for treatment.
Case Report: The patient had several previous back surgeries and received gentamycin after surgery. After 6 months, she experienced continuous dizziness, unsteadiness and oscillopsia. The patient underwent complete vestibular assessment and received an individualized vestibular rehabilitation program for 9 months. She achieved a complete recovery from all symptoms and returned to active social function.
Vestibular rehabilitation could be an effective treatment for complicated cases of BVD. Adaptation exercises may be useful in young patients with BVD.

Vestibular rehabilitation is a treatment option for the management of vertigo and unsteadiness, which are very common in head trauma patients and more challenging in the early months after trauma. This study evaluated the effectiveness of a vestibular rehabilitation program in the recovery of acute and sub-acute head trauma patients. The goal of this study was evaluation of the effect of early vestibular rehabilitation on patients with acute and sub-acute head trauma.
This study was performed in 20 head trauma patients with vertigo and unsteadiness. The patients were randomly divided into two groups: one group received medical therapy (Betaserc) and the other received rehabilitation and medical therapy. An individualized vestibular rehabilitation program was designed that was then revised and verified by a joint committee of vestibular rehabilitation groups. The effectiveness of interventions was measured using the Dizziness Handicap Inventory (DHI) by comparing the results before and after therapy.
The physical conditions and DHI scores of patients in both groups were similar at baseline. After 1 month of rehabilitation, patients receiving vestibular rehabilitation and medication showed greater progress than patients receiving medication only (P=0.000).
Vestibular rehabilitation can aid in the recovery from vertigo and increase the stability of head trauma patients. Simultaneous treatment with medicine and vestibular rehabilitation exercises can result in quicker and better therapeutic effects.

Frequency following response (FFR) is a neural response with multiple origins. The purpose of current study is to record FFR with alternative and single polarity 500 Hz tone burst stimuli in the setting of auditory brainstem response (ABR).
The population of this observational study consists of 21 adults (n=42 ears) with a mean age of 22.43 (SD=1.51), with 8 out 21 (38%) being female. The participant shows normal results in otoscopy, tympanometry, acoustic reflex, pure tone audiometry, speech recognition threshold, and speech discrimination score. They underwent ABR with a click and various polarities of 500 Hz tone burst stimuli.
First, latencies of ABR waveform with the alternative polarity of click and tone burst were compared and then with changing the polarity to single polarity, FFR was recorded in 24 ears (about 57%) using the 500 Hz tone burst stimuli. The results showed that in some patients changing the polarity caused a better morphology.
In some cases, FFR can be recorded in ABR setting. In addition, because of large amplitude, they fade away ABR waveforms.