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SUNDAY, NOVEMBER 29, 2015 (PAGE-4) PERSONALITY NATURE Hearing loss in Children A study of Chatlam Conservation Reserve Sajad-ul- Akbar Wani1, Shehla Ishaque Dr. Sohit Paul Kanotra, Assistant Professor in Otolaryngology-Head and Neck Surgery, Louisiana State University, and Khursheed Ahmad New Orleans, USA, was invited to conduct a continuing medical education on ‘Pediatric Deafness and implantable The present study was carried out during 2012-2015 to assess hearing devices’ on Children’s day, 14th Nov. 2015,at Government Medical College Jammu with the object of the current status, distribution and conservation issues of water sensitizing the pediatricians, ENT specialists and audiologists on the topic of childhood hearing loss. On this birds in Chatlam-Fushkoori Wetland Conservation Reserve and associated wetlands of Pampore, Srinagar, Kashmir. The regular occasion talks were presented by Dr. Kanotra on Newborn hearing screen, evaluation of hearing loss in children surveys were carried out following the point count method in the and Cochlear implants and other devices for restoring hearing in children wetland in different time periods of the day in all the four seasons. Prior to September 2014 floods, overall 56 species of birds belong- IN CONVERSATION WITH EXCELSIOR, ing to 15 families including 14 species of migratory waterfowl EC. What is the magnitude of the hearing loss in were recorded. This was compared to a record number of 90 dif- children? ferent species of birds belonging to 30 families including 20 SPK: Deafness in newborn and children is fairly common species of migratory waterfowl that were observed in the pampore with 1-3/1000 live births having severe to profound hearing wetlands especially in Chatlam-Fushkoori wetland Conservation loss and another 1-2/1000 having mild and one sided hearing Reserve during 2015 winter. loss.In the developing countries its prevalence is higher due to The most dominant waterfowl families recorded during the ascertained further . Also, sighting of 07 individuals of Great lack of immunization, greater exposure to ototoxic agents, study period in the peak winter time was Anatidae followed by Crested Grebe which has never before been reported visiting malnutrition, consanguinity etc..About 50% of the causes of Ardeidae and Rallidae.The population of waterfowl which start Kashmir wetlands was for the first time sighted in Chatlam Wetland on first week of February 2015 as a passage migrant and disabling hearing loss worldwide are preventable. their arrival usually in mid November from Siberia and Central stayed here for two weeks. EC. How does hearing loss affect child’s develop- Asia to Kashmir Valley peaks to around more than 30,000-50,000 In Chatlam wetland we observed breeding of many water-birds ment? in pampore Wetlands during the last week of February and starts like Mallards, Common Poachards, Gadwall, Northern Shoveler, SPK: Profound hearing loss has lifelong consequences not declining as the temperature in the valley rises before their return Pheasant tailed jacana, Common Coot, Common Moorhen, Little only for the child but also his family .A profoundly deaf child migration during early spring (late March). The wetlands of Grebe, Indian Pond Heron, Grey Heron and so on. However, this will not be able to develop any speech and eventually end up Pampore are under various anthropogenic pressures owing to fish- of any rehabilitative measure. Most important thing is the fact ing, encroachments of land for saffron cultivation,seting up of year for the first time we observed overstaying of Gray Lag Goose, ‘Deaf and Mute’. Without any oral communication ,his learn- that children born deaf can become near normal members of Poultry Farms cattle rearing and human disturbance with incessant Ruddy Shelduck, Ferrogineous Poachard,Tufted Duck, Garganey, ing abilities are affected compromising his educational the society if their hearing loss is diagnosed before a critical waste disposal by locals into the wetland of Chatlam-Fushkoori Northern Pintail, Common Teal, Eurasian Wigeon and a single achievements and later his employment opportunities. With period. Universal new born hearing screening programs are CR. There is a serious problem with the breeding behavior of Common Shelduck in Chatlam Conservation Reserve. During con- lesser degrees of hearing loss the speech does develop but will based on the 1-3-6 rule according to which, a new born should migratory birds at Chatlam-Fushkoori CR as their peak period of tinued and regular monitoring of the species, we could record this be defective.In fact ,the commonest cause of delayed or defec- be screened for hearing loss by 1 month of age by OAE and if breeding activity coincides with the peak time period of catching year for the first time the unusual breeding of Gadwall and tive speech in children is hearing impairement.The earlier the he fails this test, by 3 months , a complete evaluation should fishes by local people. Besides, cattle rearing and other agricultur- Northern Shoveler within Indian Limits at Chatlam-Manibugh hearing loss occurs in a child’s life,the more serious are the be done by a trained audiologist and by 6 months some sort of al activities nearby saffron fields by locals too coincides with the Wetland. This is the first breeding record of Gadwall and Northern effects on the child’s development.Similarly,the earlier the rehabilitation in the form of hearing aid should be given. The time period of breeding , thus creating disturbances to birds to a Shoveler in the Indian Subcontinent which needs further extensive problem is identified and intervention begun,the less serious earlier the problem is identified and intervention begun, the great extent. research. Keeping in view the above mentioned research work, the ultimate impact. A profoundly deaf child will not be able less serious the ultimate impact These activities were seen least in winter months when Icy Chatlam-Fushkoori Conservation Reserve assumes a great ecolog- to develop any speech and eventually end up ‘Deaf and mute’. EC: Is this newborn hearing screen being used period (Chillaikalan) hit the Kashmir Valley. Although,in 2014 an ical and biodiversity significance in the Indian sub-continent and The socioeconomic impact of ‘Deaf mutism’ is immense as they here. unusual breeding of 01 pair of Gray Lag Goose was also recorded long term conservation planning of the wetland is imperative. cannot contribute to the society in a productive way as normal SPK: No. However ,during the deliberations of the pro- in Fushkoori Wetland CR in April-May months which needs to be hearing individuals. gramme, there was a lot of enthusiasm among the participants EC. Does one sided deafness affect the child’s and it was decided to pursue the matter with the authorities development? HEALTHLINES and implement the programme at the earliest. SPK: One sided deafness in children is often undiagnosed EC. What are the rehabilitative measures? and undertreated. For optimal hearing,binaural meaning SPK: Various rehabilitative options available for hearing hearing from both the ears is essential. Children with one sided loss in children include hearing aids and cochlear implants. Surgically Correctable Hypertension deafness have difficulty in hearing in a noisy environment like The technology for cochlear implants has advanced a lot in classroom, which affects their academic performance. Also, recent years. Usually hearing aids are reserved for children Dr Arvind Kohli Pregnancy-induced hypertension has an incompletely one sided deafness leads to difficulty in localizing sounds who have moderate to severe hearing loss. Children who have understood neurohumoral mechanism (possibly initiated which can be problematic for the child. Hypertension may be primary or idiopathic which may profound hearing loss , don’t get much benefit from hearing by inadequate establishment of blood supply to the devel- EC. What are the causes of deafness in children? develop as a result of environmental or genetic causes, or aids and require cochlear implants. oping placenta) and occasionally can develop in the imme- SPK: The most common cause of newborn hearing loss is secondary hypertension which is elevated blood pressure EC. What is a difference between a hearing aid and diate postpartum period. genetic and this is commoner in case of consanguineous mar- that results from an underlying, identifiable, often cor- a cochlear implant? Primary hyperaldosteronism is defined as overproduc- riages.If a pregnant mother develops certain infections,is rectable cause, which has multiple etiologies, includng SPK: A hearing aid is a sound amplification device which tion of aldosterone independent of its usual regulator, the exposed to ototoxic drugs like gentamycin etc.,is suffering renal, vascular, and endocrine causes. Primary or essential renin-angiotensin system. The resulting retention of excess from diabetes,hypothyroidism or malnutrition,the child can can be worn in the ear or behind the ear and offers augmen- hypertension accounts for 90-95% of adult cases, and sec- salt and water suppresses renin levels (as opposed to ele- be born with deafness.Difficulties during birth causing tation of moderate to severe hearing loss. Cochlear implants ondary hypertension accounts for 2-10% of cases. Sec- vating renin levels, which causes secondary hyperaldostero- asphyxia i.e, prolonged lack of oxygen associated with convul- are devices which are implanted by surgery and directly stim- ondary hypertension is amenable to surgical correction. nism). Increased urinary excretion of potassium signals sions or coma can cause the child to be born deaf. Newborns ulate the hearing nerve and are used for cases which cannot Diagnosis of Secondary Hypertension hyperal-dosteronism, which should be suspected in all who are admitted to the intensive care unit due to immaturi- be fully rehabilitated by hearing aid. The cochlear implant can Accuracy hypertensive patients with unprovoked (i.e not diuretic- ty and other causes or those who develop jaundice or menin- cost as much as 6-8 lac rupees while the hearing aid costs only The first, most practical step in evaluating an elevated induced) hypokalemia.