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Öğe The effect of melatonin on tinnitus with respect to sleep and depression : a randomized clinical trial(Aves, 2012) Köybaşı, Serap; Boztaş, Mehmet Hamid; Biçer, Yusuf Özgür; Serin, Erdinç; Süslü, Ahmet Emre; Funda, Yasemin Ongun; Şereflican, MuratObjective: In this study we aimed to investigate the psychological status of tinnitus patients as well as the sleep quality and their relation to handicap caused by tinnitus using various scales. Additionally, serum melatonin levels and the effectiveness of melatonin treatment were studied. Study Design: Prospective, double blind, randomized controlled trial Materials and Methods: Patients were divided randomly into two groups as study (melatonin, n=13) and placebo (control, n=11) groups. Tinnitus Handicap Inventory (THI), Symptom Check List (SCL), Hospital Anxiety and Depression Scale (HAD), Beck Depression Inventory (BDI), Pittsburg Sleep Qualty Index (PSQI) were applied. After filling the scales and giving the venous blood sample for melatonin measurements the patients were instructed to take one tablet (placebo or 3 mg melatonin) before sleep every night. After 8 weeks, second order scales were filled and melatonin measurements were repeated. Results: Serum melatonin levels were between 1-260 pg/ml; the mean was 38,7 pg/ml. The correlation of melatonin levels with THI and tinnitus duration was not significant. THI was found to correlate with different measures of the PSQI, HAD, and BDI in both groups. Statistical analysis failed to show any significant difference within and between groups in respect of anxiety, depressive symptoms and sleep as well as melatonin and handicap levels. When the groups were assessed according to the THI severity (mild/moderate to severe;THI2); in the control group there was significant differences in PSQI(1) and PSQI(1) (p=0.0008, p=0.18), NAD(1), HAD(2) (0.002, 0.03), HAD Depression(1-2) (0.0, 0.006) BDI (p=0.007) PSQI(2 sleep) (disturbance) (P=0.018) parameters. However, in the melatonin group it was found that there were significant differences in SCL2 (sleep) (latency), PSQI(2) (sleep) (duration) and total PSQI(2) parameters. (p=0.022, 0.027, 0.006 respectively) Conclusion: Patients with higher handicap may benefit melatonin in respect of sleep latency and duration as well as sleep quality comparing with the patients taking placebo. Moreover, melatonin efficiency may be related to its antidepressive effect.Öğe The effect of melatonin on tinnitus with respect to sleep and depression: A randomized clinical trial(2012) Koybasi, Serap; Boztas, M. Hamid; Bicer, Yusuf Ozgur; Serin, Erdinc; Suslu, Ahmet Emre; Funda, Yasemin Ongun; Sereflican, MuratObjective: In this study we aimed to investigate the psychological status of tinnitus patients as well as the sleep quality and their relation to handicap caused by tinnitus using various scales. Additionally, serum melatonin levels and the effectiveness of melatonin treatment were studied. Study Design: Prospective, double blind, randomized controlled trial Materials and Methods: Patients were divided randomly into two groups as study (melatonin, n=13) and placebo (control, n=11) groups. Tinnitus Handicap Inventory (THI), Symptom Check List (SCL), Hospital Anxiety and Depression Scale (HAD), Beck Depression Inventory (BDI), Pittsburg Sleep Quality Index (PSQI) were applied. After filling the scales and giving the venous blood sample for melatonin measurements the patients were instructed to take one tablet (placebo or 3 mg melatonin) before sleep every night. After 8 weeks, second order scales were filled and melatonin measurements were repeated. Results: Serum melatonin levels were between 1-260 pg/ml; the mean was 38,7 pg/ml. The correlation of melatonin levels with THI and tinnitus duration was not significant. THI was found to correlate with different measures of the PSQI, HAD, and BDI in both groups. Statistical analysis failed to show any significant difference within and between groups in respect of anxiety, depressive symptoms and sleep as well as melatonin and handicap levels. When the groups were assessed according to the THI severity (mild/moderate to severe;THI 2); in the control group there was significant differences in PSQI 1 and PSQI 1 (p=0.0008, p=0.18), HAD 1, HAD 2 (0.002, 0.03), HAD Depression 1-2 (0.0, 0.006) BDI (p=0.007) PSQI 2 sleep disturbance (p=0.018) parameters. However, in the melatonin group it was found that there were significant differences in SCL 2 sleep latency, PSQI 2 sleep duration and total PSQI 2 parameters. (p=0.022, 0.027, 0.006 respectively)Conclusion: Patients with higher handicap may benefit melatonin in respect of sleep latency and duration as well as sleep quality comparing with the patients taking placebo. Moreover, melatonin efficiency may be related to its antidepressive effect. © 2005 The Mediterranean Society of Otology and Audiology.Öğe Gürültüye maruziyetin işitme üzerindeki etkilerinin, sigara kullanımı ve kotinin ile ilişkisinin incelenmesi(Bolu Abant İzzet Baysal Üniversitesi, 2012) Funda, Yasemin Ongun; Şanal, Serap KöybaşıGürültüye maruziyetin işitme üzerindeki etkilerinin, sigara kullanımı ve kotinin ile ilişkisinin incelenmesi. Abant İzzet Baysal Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Tezi, Bolu, 2012. Sanayileşen tüm ülkelerde gürültü sağlık sorunlarına yol açan, işitmeyi etkileyen önemli bir faktör haline gelmiştir. Son yıllarda pek çok faktörün yanında sigara içiciliğinin de gürültüye bağlı işitme kaybına(GBİK) yatkınlığa neden olduğu konusu tartışılmaktadır. Çalışmamızda; GBİK'nın odyometrik inceleme ve distorsiyon ürünü otoakustik emisyon (DPOAE) ile değerlendirilip kıyaslanması, GBİK'da doz bağımlı sigara kullanımının, serum kotinin düzeyleri ölçülerek işitme üzerindeki etkisinin odyometri ve otoakustik emisyon ile araştırılması amaçlanmıştır. Bu çalışma prospektif boylamsal kontrollü bir klinik çalışma olarak planlanmıştır. Veriler 2009 ve 2011 yılında iki yıl arayla toplanmıştır. İşçilere araştırma öncesinde; yaş, çalışma süresi, sigara içme durumu, miktarı ve süresi, sistemik hastalık, bilinen kulak hastalığı olup olmaması, ilaç öyküsü bilgilerini içeren mini anketler doldurulmuştur. Sigara içen bireylerden alınan periferik venöz kan örneklerinde, iki yıl arayla serum kotinin düzeylerine bakılmış olup ve tüm bireylere çalışmanın başında ve sonunda odyometri(500, 1000, 1500, 2000, 3000, 4000, 6000 ve 8000 Hz'de ve PTA) ve DPOAE (1000, 1400, 2000, 2800, 4000 Hz) testleri yapılmıştır. İstatistiksel hesaplamalarda PASW (versiyon18) programı kullanılmıştır. Anlamlılık düzeyi ?=0,05 alınmıştır. Çalışmaya sigara içen grupta 82 işçi, sigara içmeyen grupta 88 işçi olmak üzere toplam 170 erkek işçi dahil edilmiştir. 2.kotinin seviyeleri ile 2.odyometrik ölçümlerde 1500 Hz, 2000 Hz, 3000 Hz ve PTA arasında (p<0,05)) ve yine 2. kotinin değerleri ile 2. DPOAE değerlerinden 2.DP1400 Hz,2800 Hz, 4000 Hz, 2. SNR 2800Hz, 4000 Hz değerleri arasında (p<0,05) anlamlı ilişki gözlenmiştir. Bu değerlerden DP 4000Hz ve SNR 4000Hz ile 2.kotinin değeri arasındaki güçlü korelasyon (sırasıyla r=-0,610; -0,601) bulunmuştur. Bu bulgular işitme kaybı arttıkça bireylerde sigara içmenin işitmeyi etkileyebileceğini göstermesi açısından önemlidir. Sigara içen ve içmeyen gruplarda başlangıçta yapılan ve 2. yılın sonunda yapılan işitsel test sonuçları ile gruplar arası interaksiyona bakıldığında tüm frekanslardaki ölçümlerde anlamlı ilişki görülmemiştir(p>0,05). Bu çalışma sigara alışkanlığı ve gürültüye maruziyette, kotinin çalışıldığı ilk çalışmadır. Sonuç olarak; sigara içme durumunun GBİK gelişmesini etkilemediği, ancak serum kotinin düzeylerinin göreceli olarak işitmesi az olanlarda önem kazandığı ve işitme kaybı gelişiminde kotininin bu düşüş üzerinde etkili olabileceği dolaylı olarak söylenebilir. Bu konuda daha güçlü bir yorum için ileri çalışmalara ihtiyaç vardır.Öğe Inner ear involvement in Behcet's disease(Elsevier Sci Ltd, 2010) Süslü, Ahmet Emre; Polat, Mualla; Köybaşı, Serap; Biçer, Yusuf Özgür; Funda, Yasemin Ongun; Parlak, Ali HaydarObjective: To assess cochlear involvement and hearing loss in patients with Behcet's disease (BD). Method: Forty-two patients with BD and 24 sex and age matched healthy subjects were included in the study. pure-tone audiometry including high frequencies (250-16000 Hz) and DPOAE were performed to all participants. Results of the audiological evaluation were compared and correlation between the audiologic status and clinical manifestations of the BD were investigated. Results: Bilateral sensorineural hearing loss was detected in 27 (64.3%) patients. Hearing thresholds were found to be higher in patients with BD at all of the frequencies except at 500 Hz when compared to control group (p < 0.05). The difference in the hearing levels tend to increase in high frequencies. Compared with control group, distortion products and SNR of the BD patients were lower in all of the tested frequencies (p < 0.05) which indicates weaker outer hair cell motility. There was no correlation between the clinical manifestations and the audiological parameters. Conclusion: Even having hearing levels within normal limits in speech frequencies, increased hearing thresholds in high frequencies and decreased signal-noise ratios (SNR) in distortion product otoacoustic emission (DPOAE) indicate a cochlear involvement in patients with BD. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
