Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Lucknow
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MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




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An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
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Dr. Mamta Gupta
Consultant
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Aug 2018




Dr. Rajendra Kumar Ghritlaharey

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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2010 | Month : August | Volume : 4 | Issue : 4 | Page : 2878 - 2882

The study of Iran-Iraq war Victim Ear Finding in Golestan Province(Gorgan-IRAN)

TAZIKEI M H *, BEHNAMPOUR N**, MANSOURIAN A R***

*Assistant Professor. ENT department , Gorgan Medical School .Golestan university of medical sciences. Gorgan- IRAN, **Academic member . Biostatistics department. Gorgan Medical School. Golestan university of medical sciences,.Gorgan-IRAN. ***Associate Professor. Biochemistry and Metabolic Disorder Research Center department of Biochemistry. Gorgan Medical School, Golestan university of medical science. Gorgan-IRAN

Correspondence Address :
Dr. Azad Reza Mansourian, Biochemistry and Metabolic Disorder Research Center. Golestan University of Medical Sciences. Gorgan – IRAN, Email: azad_r_mansourian@yahoo.com

Abstract

Background and aim: Ear as vestibule auditory system can be damaged by many cases. The Army personals whom are exposed to many traumas, ear can also be traumatized. Many of injuries to ears are irreversible, because of eight years of war in Iran and as far as there is not any study in Golestan Province about such an abnormality, this research was done for the determination of common findings in Golestan province about war victims, ear’s problems.

Material and Methods: This is a descriptive cross-sectional study on 256 war victims of Golestan province which were choosen on randomized sampling. Hearing loss tinnitus, othorea, vertigo, tympanic membrane perforation audiologic findings and the type of trauma were considered. B.C over than 15dB considered as hearing loss. Hearing loss were divided in few groups and the questionnaire was filled for all of the sample population. Dates were analyzed by SPSS soft ware and exact Fisher test.

Findings:In this study the sample population were exclusively male subjects, 21.5% complained from audiologic problems. 94.6% had hearing loss, 83.6% tinnitus without hearing loss, but there was a hearing loss on the audiologic findings. 80% of hearing loss was bilateral, 10.9% on the Wright and 9.1% on the left side. 89% of hearing loss was sensory neural 88% in high frequency. The intensity in 48.5% of sample population was 15-30dB, 6.4% of them had tympanic membrane perforation only in 3.6% of them othorea, was observed none had complained of vertigo.
Discussion: Also there are few years passed from the end of the war but still the hearing abnormality is a common problem among the war victims. Therefore it is necessary to look for manufacturing the sound protective instruments, at the same time proper training are required for those army personals in war front. On the condition where the sounds can cause reversible lesions the health care personal should be ready to look after of those victims. Also the risk factor should be omitted and the remaining hearing in the war victims to be preserved.

Keywords

Hearing loss, War trauma, War victims

How to cite this article :

TAZIKEI M H , BEHNAMPOUR N, MANSOURIAN A R. THE STUDY OF IRAN-IRAQ WAR VICTIM EAR FINDING IN GOLESTAN PROVINCE(GORGAN-IRAN). Journal of Clinical and Diagnostic Research [serial online] 2010 August [cited: 2019 Oct 14 ]; 4:2878-2882. Available from
http://jcdr.net/back_issues.asp?issn=0973-709x&year=2010&month=August&volume=4&issue=4&page=2878-2882&id=801

Introduction
The ears as a vestibule auditory system while containing sound stimulator and protective mechanism, still can be susceptible toward some specific sounds. The different parts of ear also are injured by various forms of responsible for the medical examination on the proposed items in this investigation. The war victims complain from hearing loss, tinnitus. Othorea, vertigo tympanic and membrane perforation audiologic findings were obtained from the war victims files. The sample population were faced various types of traumas. The major traumas, which was also was a matter of consideration by the war victims themselves was the basis for this research, and in this regards, those victims which were experienced the direct bullet or aquiver were not slected to participate in this study. The level of hearing loss was sub-divided in three groups. Pattern of audiogram, of the affected ears and the type of tymponogram were recorded.
In this study the determination thresholds for the hearing loss was considered when the level of bone trauma (2). Loss of hearing due to Noise Induced hearing loss[NIHL] is the reason for visiting the ENT specialists in at least by 10 millions annually in USA [3,4]. NIHL can be produced in two types, it is either reversible loss which is happened by facing the sudden high, low explosion or permanent threshold shift [PTS] which is caused by continuous contact with moderate sound level. The former type of hearing loss can be improved in few minutes or few days if the ears are not faced the other sounds [5,6]. The irreversible hearing loss can be accompanied with others findings such as tinnitous [7,8]. In occupational sound trauma in both ear there is similar threshold, but in the right- handed soldiers the left ear is more at risk of hearing loss (6).
The ear’s permutable level of sound is clearly well defined (9), so the sound over this threshold is obviously harmful to the ear (9). The balanced system is also can be damaged by the sound, but for such abnormality the heavier sounds are needed. The sound trauma are happening gradually, therefore the balancing incidence, occur rarely and there is some controversy in this area [10,11]. The ear and it is belonging can be traumatized by damage and temporal bone fracture(5).
In the war front where the combatants are faced with various types of sounds trauma, due to explosion, a quiver and bullet, the ears are among the more susceptible, organs. Bearing in mind the above facts, the eight years of Iran-Iraq war and the importance of recognizing the ear’s symptoms among the war victims and due to not having any documented study in the Golestan Province in the Islamic republic of Iran, this present study was designed to investigate the ears abnormalities and the findings among the war victims in this province.

Material and Methods

This study is a descriptive cross-sectional study with the aim of analytical investigation on the basis of available documented findings in the alive war victims medical file.
On the basis of primarily study the sample population were found to be 256, persons using the equation where d=0.1, , P=0.8
The patients were choosen by randomized sampling using the war victims’ files in the Golestan Province. The ENT specialist was conduction was above the 15dB (12). The intensity of hearing loss was also sub-grouped in few divisions.
The war victims were sub-graded according to the patients medical history also the ENT specialist determination and the documentation availability therefore the war victims with hearing loss outside the war front were omitted from our study. The war victims which were not interested to participate in this study also were not considered in this study research project.
The gathered information were analyzed using SPSS software. The data were expressed by figures and tables and the confidence ratio was considered to be 95% [

Results

In this study 256 war victims were gone under investigation 55persons of the sample population complained about ear problems. Therefore 21.5% our war victims in this study had an ear abnormality, from the total of 55 with hearing loss complain we had the following findings: hearing loss [9 cases], tinnitous [43 cases], Tabel-1. In such cases when the audiograms results showed the presence of hearing loss, but went unnoticed by the war victims, it was due to tinnitous, which was the main trouble for the war victims.
From the 55 war victims with hearing abnormalities, 7 patients had tympanic membrane perforation, 4 case and 3 case had problems on the right ear and left ear respectively, from this 7 cases, 4 war victims were suffered from othorea. From the 55 patients, with hearing abnormalities 6 patients had difficulty in the right ear, 5 cases with the left ear, and 44 persons in both ears.
On other hand from 512 ears, which were studied in this research project. 99 ear had the hearing problems Table-2
The type of hearing loss were as follows sensory neural 98 case [89%], conductive 6 cases [5.5% ], mixed types of abnormalities 6 cases [5.5%].
Patron audiograms showed at high frequency [in 88%] of cases 12% were flat, and none of our patients had hearing loss in low frequencies. The intensity of hearing loss in 48.5% war victims were between 15-30 dB, in 32% of cases 30-60 dB, and in 18.5% of cases were more than 60 dB. The type of tympanograms in 91.4% of cases were type A, 6.4% type B, and in 2.2% type C respectively .
The traumatized cause of ear abnormalities in 68% of cases were wave explosion, in 3.1% quiver and in 28.9% of cases, combined wave explosion and a quiver. In this study each of our sample population at some points were contacted the noise from the heavy war equipment and some chemical agents.
None of the war victims in this study had complained about vertigo.

Discussion

In this study, 55 patients [21.5%] from 256 war victims complained about the ear problems. Out of this 55 patients, 52 war victims [94.3%], 3 patients [5.4%] suffered from hearing loss, and tinnitous without hearing loss respectively. In addition it should be mentioned, that, the audiograms findings showed those subjects with tinnitous also had a degree of hearing loss so, therefore as whole, every war victims in this study [100%] considered to have hearing loss.
The findings from this research is consistent with the results from other research project which carried out in EU during 1967-1968, on 147 soldiers whom had ear abnormality caused by explosions, and other study on the soldiers took part in the Bosnia war(12) .According to our available dates it seems that there is not hearing loss study on the war victims in the country, but in a study on the healthy subjects in Mashhad the capital city of Khorasan province in the north-east of the country, 5.3% of people were found to be with hearing loss(13). In the present study 80% of the patients with hearing loss, had this abnormality in both ears, which is in agreement with the recorded references (14). In this study 10.9% and 9.1% of cases had the abnormality in the right and left ear, respectively. This does not have any meaningful statistical correlation. There are some study reflecting that right-handed and left-handed soldiers are facing different ear problems (6). This differences can be due to the volume and consistency of sound trauma which hit the combatant in the war front. In our study 83.6% of patients whom complained about ear problems, had the tinnitous as an abnormality. In a study in Ureap during 1967-1968 on 147 soldiers with ear abnormality due to the explosion, 60% were seen with tinnitous, which is lower incidence compared to our results (12). The types of hearing loss in 89% of our cases were sensory neural which is in agreement with, other study (12). In this study also 88% of cases with hearing loss had the problem in high frequencies. Non of the cases had hearing loss in low frequencies, which is in agreement with other study (6). The intensity of hearing loss in 48.5% of cases were about 15-30dB, and tympanograms in 91.4% of cases were type A which is in agreement with other study (14). In this study 6.4% of ear were seen with tympanic membrane rupture. In other studies in Ureap (12) 70%, Saudi Arabia (15) 70%, and in London (16), 62% of the patients were reported to have tympanic ruptured membrane respectively.
The reason for high incidence of tympanic membrane perforation in those studies may be due to much shorter duration between the time of explosions and soldiers having ear problem and the time of investigation on such soldiers. It should be mentioned that tympanic membrane ruptures gradually were healed (17)
In this study only 3.6% our sample population were seen with otheora, which is lowered compared to other study (12). This difference also can be either due to shorter time of between the time of explosion with subsequent hearing abnormality and with time of soldier’s ear clinical examination, or due to improved health preventive measures of governmental organization responsible for the war victims, in Iran.
In this study true vertigo was not considered to be adaptation to vestibule-auditory system, it should be noticed that high intensity sound required for the clinical system of vestibilator (14).
In regard to the findings from this study and also due to the prevalence and consistency of ear problems among the war victims, even many years after the war cessation of the war itself, we conclude, that effort toward manufacturing sound preservative instrument and the other proper training for the combatants in how to use such facilities in the war front, also when the hearing loss of the combatant is in Temporary Threshold Shift phase, sound resting state should be observed, as preventive measures to protect the remaining hearing, also at the same time the possible risk factors should be omitted and taken into consideration. The periodical control also should be arranged to protect the remaining hearing in such war victims with hearing loss.

Acknowledgement

The authors thanks the war victim organization of Golestan province specially the health director of this organization. The academic staff, the personals of research deputy of Golestan university especially Mrs. Scarify.

References

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