These results show that in patients with renal impairment, the measurement of cTnT prior to commencing renal replacement is a significant independent predictor of survival. cTnT did show potential as a prognostic test to stratify patients with a high cardiovascular risk and may enable intensive risk factor modification in this patient group. This may be of further use in selection of patients' suitability for renal transplantation.

The purpose of this study was to identify patients of vocal cord paralysis and to establish an etiological diagnosis. Patients with vocal cord paralysis have been followed prospectively at a tertiary referral center. 120 patients identified with vocal cord paralysis by laryngeal endoscopy were evaluated clinically, radiologically and pathologically to make an etiological diagnosis. Those patients in whom no cause was found, a CT scan from base of skull to thorax was done before labeling them as idiopathic. Most of the patients presented in 5th (26.67 %) and 6th (21.67 %) decade. Males out numbered females in the ratio 2.3:1.0. The most common symptom of vocal cord paralysis was change in voice (98.21 %). Bilateral vocal cord palsy was found in 6.67 % patients and unilateral vocal cord palsy was found in 93.33 % patients. Among patients of unilateral vocal cord paralysis left vocal cord was paralyzed in 69.64 % and right cord in 30.36 %. Malignant (34.16 %) causes accounted for largest number of patients followed by central (15.00 %) and idiopathic causes (14.16 %). VCP has got a variable etiology which varies with the laterality of the vocal cord involvement. Malignant causes predominated in our series, occurring in 34.16 %, followed by central and idiopathic causes.

True tinnitus is a phantom auditory perception arising from a source or trigger in the cochlea, brainstem, or at higher centers and has no detectable acoustic generator. The most accepted is the famous neurophysiologic model of Jastreboff, which stresses that tinnitus, is a subcortical perception and results from the processing of weak neural activity in the periphery. The aim of this study is to determine the role of Vitamin B12 in treatment of chronic tinnitus. In this randomized, double-blind pilot study, total 40 patients were enrolled, of which 20 in Group A (cases) received intramuscular therapy of 1 ml Vitamin B12 (2500 mcg) weekly for a period of 6 weeks and Group B (20) patients received placebo isotonic saline 01 ml intramuscular. The patients were subjected to Vitamin B12 assay and audiometry pre- and post-therapy. Of the total patients of tinnitus, 17 were Vitamin B12 deficient that is 42.5% showed deficiency when the normal levels were considered to be 250 pg/ml. A paired t-test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS) after Vitamin B12 therapy. This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus.

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Background: Smoking, age, gender, socioeconomic class and education may contribute to the hearing loss. In this study hearing loss between smokers (current and ex) and non smokers was compared. Materials and Methods: 145 smokers [79 current (68 males, 11 females) and 66 ex smokers (60 males, 6 females)] and 145 non smokers (69 males, 76 females) were studied. Modified Kuppuswamy scale and smoking index were used. Hearing loss was assessed by Audiometry. P value of<0.05(unpaired t test and chi square test) was taken as statistically significant. Result: Statistically significant and non significant differences were found between the mean age and educational status of current-ex smokers and smokers-non smokers respectively. Statistically significant and non significant differences were found between the socioeconomic status of smokers-non smokers and current-ex smokers respectively. Difference was significant between smoking index of current and ex smokers (p=0.003). 70.05% males had hearing loss as compared to females (49.46%). About 59.24% and 26.09% hearing loss cases belonged to low education and upper and upper middle social class respectively. 68% and 24.24% of moderate and severe smoking index were of professional to graduate educational status. 36.17% and 30.30% of moderate to severe smoking index belonged to upper and upper middle socioeconomic class. 73.91% were from low social classes. 47.59% non smokers and 25.51% smokers had no hearing loss. The severity of hearing loss was more in heavy smokers. Conclusion: Hearing loss associated with smoking was found to be more in male gender, advancing age, low socioeconomic and educational classes.