360 million people worldwide have disabling hearing loss (1), and 32 million of these are children.
Hearing loss may result from genetic causes, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, exposure to excessive noise, and ageing.
60% of childhood hearing loss is due to preventable causes.
1.1 billion young people (aged between 12–35 years) are at risk of hearing loss due to exposure to noise in recreational settings.
Unaddressed hearing loss poses an annual global cost of 750 billion international dollars (2). Interventions to prevent, identify and address hearing loss are cost-effective and can bring great benefit to individuals.
People with hearing loss benefit from early identification; use of hearing aids, cochlear implants and other assistive devices; captioning and sign language; and other forms of educational and social support.
Over 5% of the world’s population – 360 million people – has disabling hearing loss (328 million adults and 32 million children). Disabling hearing loss refers to hearing loss greater than 40 decibels (dB) in the better hearing ear in adults and a hearing loss greater than 30 dB in the better hearing ear in children. The majority of people with disabling hearing loss live in low- and middle-income countries.

Approximately one third of people over 65 years of age are affected by disabling hearing loss. The prevalence in this age group is greatest in South Asia, Asia Pacific and sub-Saharan Africa.

Hearing loss and deafness

A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 25 dB or better in both ears – is said to have hearing loss. Hearing loss may be mild, moderate, severe, or profound. It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds.

‘Hard of hearing’ refers to people with hearing loss ranging from mild to severe. People who are hard of hearing usually communicate through spoken language and can benefit from hearing aids, cochlear implants, and other assistive devices as well as captioning. People with more significant hearing losses may benefit from cochlear implants.

‘Deaf’ people mostly have profound hearing loss, which implies very little or no hearing. They often use sign language for communication.

Causes of hearing loss and deafness

The causes of hearing loss and deafness can be divided into congenital causes and acquired causes.

Congenital causes
Congenital causes may lead to hearing loss being present at or acquired soon after birth. Hearing loss can be caused by hereditary and non-hereditary genetic factors or by certain complications during pregnancy and childbirth, including:

maternal rubella, syphilis or certain other infections during pregnancy;
low birth weight;
birth asphyxia (a lack of oxygen at the time of birth);
inappropriate use of particular drugs during pregnancy, such as aminoglycosides, cytotoxic drugs, antimalarial drugs, and diuretics;
severe jaundice in the neonatal period, which can damage the hearing nerve in a newborn infant.
Acquired causes
Acquired causes may lead to hearing loss at any age, such as:

infectious diseases including meningitis, measles and mumps;
chronic ear infections;
collection of fluid in the ear (otitis media);
use of certain medicines, such as those used in the treatment of neonatal infections, malaria, drug-resistant tuberculosis, and cancers;
injury to the head or ear;
excessive noise, including occupational noise such as that from machinery and explosions;
recreational exposure to loud sounds such as that from use of personal audio devices at high volumes and for prolonged periods of time and regular attendance at concerts, nightclubs, bars and sporting events;
ageing, in particular due to degeneration of sensory cells; and
wax or foreign bodies blocking the ear canal.
Among children, chronic otitis media is a common cause of hearing loss.

Impact of hearing loss

Functional impact
One of the main impacts of hearing loss is on the individual’s ability to communicate with others. Spoken language development is often delayed in children with unaddressed hearing loss.

Unaddressed hearing loss and ear diseases such as otitis media can have a significantly adverse effect on the academic performance of children. They often have increased rates of grade failure and greater need for education assistance. Access to suitable accommodations is important for optimal learning experiences but are not always available.

Social and emotional impact
Exclusion from communication can have a significant impact on everyday life, causing feelings of loneliness, isolation, and frustration, particularly among older people with hearing loss.

Economic impact
WHO estimates that unaddressed hearing loss poses an annual global cost of 750 billion international dollars. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity, and societal costs.

In developing countries, children with hearing loss and deafness rarely receive any schooling. Adults with hearing loss also have a much higher unemployment rate. Among those who are employed, a higher percentage of people with hearing loss are in the lower grades of employment compared with the general workforce.

Improving access to education and vocational rehabilitation services, and raising awareness especially among employers about the needs of people with hearing loss, will decrease unemployment rates for people with hearing loss.


Overall, it is suggested that half of all cases of hearing loss can be prevented through public health measures.

In children under 15 years of age, 60% of hearing loss is attributable to preventable causes. This figure is higher in low- and middle-income countries (75%) as compared to high-income countries (49%). Overall, preventable causes of childhood hearing loss include:

Infections such as mumps, measles, rubella, meningitis, cytomegalovirus infections, and chronic otitis media (31%).
Complications at the time of birth, such as birth asphyxia, low birth weight, prematurity, and jaundice (17%).
Use of ototoxic medicines in expecting mothers and babies (4%).
Others (8%)
Some simple strategies for prevention of hearing loss include:

immunizing children against childhood diseases, including measles, meningitis, rubella and mumps;
immunizing adolescent girls and women of reproductive age against rubella before pregnancy;
preventing cytomegalovirus infections in expectant mothers through good hygiene; screening for and treating syphilis and other infections in pregnant women;
strengthening maternal and child health programmes, including promotion of safe childbirth;
following healthy ear care practices;
screening of children for otitis media, followed by appropriate medical or surgical interventions;
avoiding the use of particular drugs which may be harmful to hearing, unless prescribed and monitored by a qualified physician;
referring infants at high risk, such as those with a family history of deafness or those born with low birth weight, birth asphyxia, jaundice or meningitis, for early assessment of hearing, to ensure prompt diagnosis and appropriate management, as required;
reducing exposure (both occupational and recreational) to loud sounds by raising awareness about the risks; developing and enforcing relevant legislation; and encouraging individuals to use personal protective devices such as earplugs and noise-cancelling earphones and headphones.
Identification and management

Early detection and intervention are crucial to minimizing the impact of hearing loss on a child’s development and educational achievements. In infants and young children with hearing loss, early identification and management through infant hearing screening programmes can improve the linguistic and educational outcomes for the child. Children with deafness should be given the opportunity to learn sign language along with their families.

Pre-school, school and occupational screening for ear diseases and hearing loss is an effective tool for early identification and management of hearing loss.

People with hearing loss can benefit from the use of hearing devices, such as hearing aids, cochlear implants, and other assistive devices. They may also benefit from speech therapy, aural rehabilitation and other related services. However, global production of hearing aids meets less than 10% of global need and less than 3% of developing countries’ needs. The lack of availability of services for fitting and maintaining these devices, and the lack of batteries are also barriers in many low-income settings.

Making properly-fitted, affordable hearing aids and cochlear implants and providing accessible follow-up services in all parts of the world will benefit many people with hearing loss.

People who develop hearing loss can learn to communicate through development of lip-reading skills, use of written or printed text, and sign language. Teaching in sign language will benefit children with hearing loss, while provision of captioning and sign language interpretation on television will facilitate access to information.

Officially recognizing national sign languages and increasing the availability of sign language interpreters are important actions to improve access to sign language services. Encouraging organizations of people with hearing loss, parents and family support groups; and strengthening human rights legislation can also help ensure better inclusion for people with hearing loss.

WHO response

WHO assists Members States in developing programmes for ear and hearing care that are integrated into the primary health-care system of the country. WHO’s work includes:

providing technical support to Member States in development and implementation of national plans for hearing care;
providing technical resources and guidance for training of health-care workers on hearing care;
developing and disseminating recommendations to address the major preventable causes of hearing loss;
undertaking advocacy to raise awareness about the prevalence, causes and impact of hearing loss as well as opportunities for prevention, identification and management;
developing and disseminating evidence-based tools for effective advocacy;
observing and promoting World Hearing Day as an annual advocacy event;
building partnerships to develop strong hearing care programmes, including initiatives for affordable hearing aids, cochlear implants and services;
collating data on deafness and hearing loss to demonstrate the scale and the impact of the problem;
promoting safe listening to reduce the risk of recreational noise-induced hearing loss through the WHO Make Listening Safe initiative; and
promoting social inclusion of people with disabilities, including people with hearing loss and deafness, for example, through community-based rehabilitation networks and programmes.


Deafness-deafness is loss of hearing in any frequency >20 db.
I found this catogery of patient in my opd is > 50%
Conductive hearing loss is caused by anything that interferes with the transmission of sound from the outer to the inner ear. Below are some possible causes of conductive hearing loss.
1. Middle ear infections (otitis media).
2. Collection of fluid in the middle ear (“glue ear” in children).
3. Blockage of the outer ear, most commonly by wax.
4. Otosclerosis.
5. Damage to the ossicles.
Sensorineural hearing loss is due to damage to the pathway that sound impulses take from the hair cells of the inner ear to the auditory nerve and the brain. Below are some possible causes.
1. Age-related hearing loss (presbyacusis).
2. Acoustic trauma (injury caused by loud noise) can damage hair cells.
3. Meningitis can lead to loss of hair cells or other damage to the auditory nerve.
4. Meniere’s disease.
5. Acoustic neuroma. This is a benign tumor affecting the auditory nerve.
1-Avoid bottle feeding in childrens
2-check the family members with the help of tv volume,group talk,voice of family member wheather it is loud/not.
3-check the child hearing by clapping (reflexes of baby )
4-avoid sounds >70 db for a long time.
5-Avoid ototoxic drugs.
6-Avoid vigrous yoga.
7-Avoid exessive use of cell phone & micro wave.
8-Do not put any substance in ear with out consultation with specialist.
9-Avoid trauma to ear in any form.
10-Aoid unnecessary earclenig.
11-Health check up is mandatory every ear or sos to pick up the other diseses which effect hearin Like-DIABETES etc.
Hearing loss and deafness are serious disabilities that can impose a heavy social and economic burden on individuals, families, communities and countries. Children with hearing impairment often experience delayed development of speech, language and cognitive skills, which may result in slow learning and difficulty progressing in school. In adults, hearing impairment and deafness often make it difficult to obtain, perform, and keep employment. Its big challenge to our society is to help and support the deaf people who are unable to afford and are uncapable to take of own health.


Near diwali we should avoid fire crackers,to prevent the NIHL.There is a formula to calculate the time of exposure to noise.
At-85 dbs—-8hrs.
105dbs–1/2 hr.
110dbs–15 minutes.
115dbs–71/2 minutes.
125dbs–1/2 minute.
130dbs–00 ,perforation of ear drum & comlete hearing loss
crackers noise ranges from 1oo–120 dbs(exposure time is 3minutes to 1 hr.more than yhis is always hazardus to HEARING system.




1-New facilities -laser hair removal(unwanted hairs).
2—Scarless tympanoplasty(repair of ear drum).
3—Free all endoscopies in opd.
4–post op free hearing screening.
5–Charitable opd every sunday.
6–Vertigo & tinnitus clinics.
7-All revision surgery free.
8-Free tratment for poor patients.
9-Free camps for deaf & cancer patients in association with AWAKENING INDIA FOUNDATION.


The Centers for Disease Control and Prevention recommends flu vaccination for all people older than 6 months of age. An H1N1 virus is one component of the seasonal flu shot for 2014-15. The flu shot also protects against two or three other influenza viruses that are expected to be the most common during the flu season.

The vaccine will be available as an injection or a nasal spray. The nasal spray is approved for use in healthy people 2 through 49 years of age who are not pregnant. The nasal spray isn’t recommended for people who are older than 50, younger than 2, pregnant or allergic to eggs, or people who have asthma or a compromised immune system, or those who use aspirin therapy.

These measures also help prevent swine flu (H1N1 flu) and limit its spread:

Stay home if you’re sick. If you have swine flu (H1N1 flu), you can give it to others. Stay home for at least 24 hours after your fever is gone.
Wash your hands thoroughly and frequently. Use soap and water, or if they’re unavailable, use an alcohol-based hand sanitizer.
Contain your coughs and sneezes. Cover your mouth and nose when you sneeze or cough. To avoid contaminating your hands, cough or sneeze into a tissue or the inner crook of your elbow.
Avoid contact. Stay away from crowds if possible. And if you’re at high risk of complications from the flu — for example, you’re younger than 5 or you’re 65 or older, you’re pregnant, or you have a chronic medical condition such as asthma — consider avoiding swine barns at seasonal fairs and elsewhere.
Reduce exposure within your household. If a member of your household has swine flu, designate only one household member to be responsible for the ill person’s personal care.
It is like a viral infection .The only diffrence is it is associated with fast deteriorating breathing pattaren as compared to other viral infection


Vegetables appeared to offer more cancer prevention than fruits alone did. Adding just one serving of fruit or vegetables per each 1000 calories consumed daily resulted in a 6% reduction of risk.

In another study, broccoli and soy protein were found to protect against the more aggressive breast and ovarian cancers. When consumed together, digesting broccoli and soy forms a compound called di–indolylmethane (DIM). In lab experiments, the researchers found that DIM could affect the motility of breast and ovarian cancer cells, which could help keep cancers from spreading. Soy, acts like estrogen and is a nutritious, healthy food, and should be eaten in moderation.

Yet another study compared intake of flavonols to their risk of pancreatic cancer. Flavonols are protective compounds found in fruits and vegetables, such as onions, apples, berries, kale and broccoli. Those who had the highest consumption of flavonols reduced their risk of pancreatic cancer by 23%. The benefit was even greater for people who smoked. Smokers with high levels of flavonols reduced their risk of pancreatic cancer by 59%.


I personally feel that doctors live less number of years than non-doctors. One reason is professional hazards. The factors responsible are:
The stress level of doctor is much higher than the stress levels in non-doctors in other professions.
Stress level has increased in NCR since the introduction of the Consumer Protection Act.
The decision of Medical Council of India to suspend license on deficiency of service has also increased the stress in doctors. They always pray that if the patient has a complaint, he approaches the Consumer Court and not the Council.
Smoking and alcohol is not unknown in doctors.
Metabolic syndrome and pot belly obesity is again very common in doctors.
Diabetes and heart disease are also equally common.
Surprisingly, the incidence of coronary artery disease, angioplasty, stenting and bypass surgery in Cardiologists too is not less.
Doctors are more susceptible to hospital-acquired infection, tuberculosis, hepatitis B, hepatitis C, HIV as professional hazards.