Functional and Speech Outcome of Unilaterally Cochlear Implanted Children after 1 year of Implantation in NIENT: A Retrospective Study

Hearing loss can be congenital or acquired. Most of the time congenital hearing loss means profound sensorineural hearing loss. The invention of cochlear implantation has already an established role in improving the hearing capability in congenital sensorineural hearing loss. To speak properly after cochlear implant, one needs to go for speech therapy or audio-verbal therapy. Speech therapy has become an integral part of the cochlear implantation program. In Bangladesh cochlear implantation (CI) programs started around 15 years ago, which was limited to Bangabandhu Sheikh Mujib Medical University (BSMMU) and Combined Military Hospital (CMH). Our government takes initiative to provide this service to poor and lower income people. National Institute of ENT (NIENT) was the first government hospital where CI started in 2018 and the project is now ongoing. After CI auditory, verbal therapy (AVT) was given at the same institute. No study has not been done to find out the outcome of AVT. NIENT has taken steps to find out the functional and speech outcome of cochlear implanted children considering the two standard criteria: CAP and SIR score. This retrospective study was done to find out the auditory verbal outcome of unilaterally CI children in different ages and conducted at department of Audiology, National Institute of ENT, Tejgaon, Dhaka, Bangladesh from January 2021 to June 2021. The children who underwent cochlear implants and took the auditory verbal therapy were included in this study. Though it is a retrospective study, a written informed consent has been taken from the patient's parents as the cases are minor in age. From the record review, CAP and SIR scores were recorded four times: before implantation 1 time, after cochlear implantation 3 times (At the end of 3, 6 and 12 months after starting of AVT of Cochlear implantees). From the study it has been observed that out of 50 implantees, 48.0% of children's age range was in between >3 to ≤5 years. Most of the implantees were from rural areas and also from lower income group. The study showed significant association with CAP and SIR score at the end of one year of AVT. No significant association was found in different age groups with scores of CAP and SIR. But the parent's education showed significant association with CAP score at the end one year of AVT. Though the age of the recipient is not significantly associated with the AVT outcome but maternal education plays an important role in improving CAP and SIR score. So, maternal education or understanding along with professional speech therapy is vital for better AVT outcome.

A Review of the Association of Cardiovascular Diseases and Maternal & Offspring Health Risk Factors

Objectives

Since cardiovascular disease (CVD) is considered to be one of the most expanding collections of health disorders in terms of severity and progression, the relationship of maternal and offspring health risk factors with CVD needs study. The objective of this review was to identify how developmental origin and maternal health are related to disease progression in both mothers and their offspring, apart from general risk factors such as lifestyle, eating behavior and genetic factors.

Methods

A computer based literature search through PubMed, Medline, Google Scholar and Google Search was carried out. The keywords for searching included maternal health, cardiovascular diseases, maternal and offspring cardiovascular health and developmental origin.

Results

Increasing evidence demonstrates that women with pregnancy-related complications, such as preeclampsia, preterm birth and maternal hypertension, are at risk for CVD in any phase of their life. Further, maternal malnutrition plays an influential role in the progression of CVD in the adulthood of their offspring. Also, in-utero exposure to high cholesterol or maternal hypercholesterolemia can demonstrate early lesion of atherosclerosis in children.

Conclusions

A clearer perception on how different domains of maternal health complications independently or synergistically lead to CVD or vice-versa, as well as their impact on offspring's wellbeing, is required. This will assist in developing new preventive techniques and therapeutic treatments for CVD.

Funding Sources

Texas Tech University.