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  1. Zam Zam TZHBT, Dzulkarnain AAA, Rahmat S, Jusoh M
    J Audiol Otol, 2019 Jul;23(3):129-134.
    PMID: 30727717 DOI: 10.7874/jao.2018.00395
    BACKGROUND AND OBJECTIVES: Sine a self-reported questionnaire for hearing-impaired listeners is not available by Malay language yet, it is important to develop or translate any available existing questionnaires. The aim of this study was to translate, adapt and validate the Hearing Handicap Inventory for Adult (HHIA) to be used by the audiologist among the hearing-impaired population in Malaysia.

    SUBJECTS AND METHODS: The HHIAs was translated to Malay language using forward-backward translation techniques by four-panellists (two for each level). The translated HHIA was then reconciled and harmonized for cultural aspects and content of the questionnaire by the researchers and two expert panels before being pilot-tested among 10 hearing-impaired patients. Questionnaire validation was conducted among 80 adults with a hearing loss to calculate for Cronbach's α (internal reliability), Spearman's correlation (inter-item correlation) and factor analysis.

    RESULTS: None of the translated items were removed from the scale. The overall Cronbach's α was 0.964; 0.927 and 0.934 for both social and emotional subscales, respectively. The factor analysis (force-concept inventory) demonstrated a two-structure with a strong correlation between all items in either component 1 or 2, that resembled the original scale. The Mann-Whitney test revealed significantly higher scores for those adults with a hearing loss than those adults with normal hearing.

    CONCLUSIONS: The Malay HHIA has been successfully translated and validated for the purpose of determining the psychosocial aspects of adults with hearing loss in the local population.

  2. Jamal FN, Arafat Dzulkarnain AA, Shahrudin FA, Marzuki MN
    J Audiol Otol, 2021 Jan;25(1):14-21.
    PMID: 32575950 DOI: 10.7874/jao.2020.00073
    BACKGROUND AND OBJECTIVES: There is growing interest in the use of the Level-specific (LS) CE-Chirp® stimulus in auditory brainstem response (ABR) due to its ability to produce prominent ABR waves with robust amplitudes. There are no known studies that investigate the test-retest reliability of the ABR to the LS CE-Chirp® stimulus. The present study aims to investigate the test-retest reliability of the ABR to the LS CE-Chirp® stimulus and compare its reliability with the ABR to standard click stimulus at multiple intensity levels in normal-hearing adults.

    SUBJECTS AND METHODS: Eleven normal-hearing adults participated. The ABR test was repeated twice in the same clinical session and conducted again in another session. The ABR was acquired using both the click and LS CE-Chirp® stimuli at 4 presentation levels (80, 60, 40, and 20 dBnHL). Only the right ear was tested using the ipsilateral electrode montage. The reliability of the ABR findings (amplitudes and latencies) to the click and LS CE-Chirp® stimuli within the same clinical session and between the two clinical sessions was calculated using an intra-class correlation coefficient analysis (ICC).

    RESULTS: The results showed a significant correlation of the ABR findings (amplitude and latencies) to both stimuli within the same session and between the clinical sessions. The ICC values ranged from moderate to excellent.

    CONCLUSIONS: The ABR results from both the LS CE-Chirp® and click stimuli were consistent and reliable over the two clinical sessions suggesting that both stimuli can be used for neurological diagnoses with the same reliability.

  3. Dzulkarnain AAA, Sani MKA, Rahmat S, Jusoh M
    J Audiol Otol, 2019 Jul;23(3):121-128.
    PMID: 30857383 DOI: 10.7874/jao.2018.00381
    BACKGROUND AND OBJECTIVES: There is a scant evidence on the use of simulations in audiology (especially in Malaysia) for case-history taking, although this technique is widely used for training medical and nursing students. Feedback is one of the important components in simulations training; however, it is unknown if feedback by instructors could influence the simulated patient (SP) training outcome for case-history taking among audiology students. Aim of the present study is to determine whether the SP training with feedback in addition to the standard role-play and seminar training is an effective learning tool for audiology case-history taking.

    SUBJECTS AND METHODS: Twenty-six second-year undergraduate audiology students participated. A cross-over study design was used. All students initially attended two hours of seminar and role-play sessions. They were then divided into three types of training, 1) SP training (Group A), 2) SP with feedback (Group B), and 3) a non-additional training group (Group C). After two training sessions, the students changed their types of training to, 1) Group A and C: SP training with feedback, and 2) Group B: non-additional training. All the groups were assessed at three points: 1) pre-test, 2) intermediate, and 3) post-test. The normalized median score differences between and within the respective groups were analysed using non-parametric tests at 95% confidence intervals.

    RESULTS: Groups with additional SP trainings (with and without feedback) showed a significantly higher normalized gain score than no training group (p<0.05).

    CONCLUSIONS: The SP training (with/ without feedback) is a beneficial learning tool for history taking to students in audiology major.

  4. Zakaria MN, Wahat NHA, Zainun Z, Sakeri NSM, Salim R
    J Audiol Otol, 2020 Apr;24(2):107-111.
    PMID: 31995977 DOI: 10.7874/jao.2019.00297
    The present study aimed to determine the test-retest reliability of subjective visual horizontal (SVH) testing when tested with solid and dotted line images. In this repeated measures study, 36 healthy young Malaysian adults (mean age=23.3±2.3 years, 17 males and 19 females) were enrolled. All of them were healthy and had no hearing, vestibular, balance, or vision problems. The SVH angles were recorded from each participant in an upright body position using a computerized device. They were asked to report their horizontality perception for solid and dotted line images (in the presence of a static black background). After 1 week, the SVH procedure was repeated. The test-retest reliability of SVH was found to be good for both solid line [intraclass correlation (ICC)=0.80] and dotted line (ICC=0.78). As revealed by Bland-Altman plots, for each visual image, the agreements of SVH between the two sessions were within the clinically accepted criteria (±2°). The SVH testing was found to be temporally reliable, which can be clinically beneficial. Both solid and dotted lines in the SVH testing are reliable to be used among young adults.
  5. Mukari SZS, Umat C, Chan SC, Ali A, Maamor N, Zakaria MN
    J Audiol Otol, 2020 Jan;24(1):35-39.
    PMID: 31914504 DOI: 10.7874/jao.2019.00262
    BACKGROUND AND OBJECTIVES: The cortical auditory evoked potential (CAEP) is a useful objective test for diagnosing hearing loss and auditory disorders. Prior to its clinical applications in the pediatric population, the possible influences of fundamental variables on the CAEP should be studied. The aim of the present study was to determine the effects of age and type of stimulus on the CAEP waveforms.

    Subjects and METHODS: Thirty-five healthy Malaysian children aged 4 to 12 years participated in this repeated-measures study. The CAEP waveforms were recorded from each child using a 1 kHz tone burst and the speech syllable /ba/. Latencies and amplitudes of P1, N1, and P2 peaks were analyzed accordingly.

    RESULTS: Significant negative correlations were found between age and speech-evoked CAEP latency for each peak (p< 0.05). However, no significant correlations were found between age and tone-evoked CAEP amplitudes and latencies (p>0.05). The speech syllable /ba/ produced a higher mean P1 amplitude than the 1 kHz tone burst (p=0.001).

    CONCLUSIONS: The CAEP latencies recorded with the speech syllable became shorter with age. While both tone-burst and speech stimuli were appropriate for recording the CAEP, significantly bigger amplitudes were found in speech-evoked CAEP. The preliminary normative CAEP data provided in the present study may be beneficial for clinical and research applications in Malaysian children.

  6. Dzulkarnain AAA, Salamat S, Shahrudin FA, Jamal FN, Zakaria MN
    J Audiol Otol, 2021 Oct;25(4):199-208.
    PMID: 34425654 DOI: 10.7874/jao.2021.00248
    BACKGROUND AND OBJECTIVES: No known studies have investigated the influence of stimulus polarity on the Auditory Brainstem Response (ABR) elicited from level-specific (LS) chirp. This study is important as it provides a better understanding of the stimulus polarity selection for ABR elicited from LS chirp stimulus. We explored the influence of stimulus polarity on the ABR from LS chirp compared to the ABR from click at 80 dBnHL in normal-hearing adults.

    SUBJECTS AND PURPOSE: Nineteen adults with normal hearing participated. The ABRs were acquired using click and LS chirp stimuli using three stimulus polarities (rarefaction, condensation, and alternating) at 80 dBnHL. The ABRs were tested only on the right ear at a stimulus rate of 33.33 Hz. The ABR test was stopped when the recording reached the residual noise level of 0.04 µV. The ABRs amplitudes, absolute latencies, inter-peak latencies (IPLs), and the recorded number of averages were statistically compared among ABRs at different stimulus polarities and stimuli combinations.

    RESULTS: Rarefaction polarity had the largest ABR amplitudes and SNRs compared with other stimulus polarities in both stimuli. There were marginal differences in the absolute latencies and IPLs among stimulus polarities. No significant difference in the number of averages required to reach the stopping criteria was found.

    CONCLUSIONS: Stimulus polarities have a significant influence on the ABR to LS chirp. Rarefaction polarity is recommended for clinical use because of its larger ABR peak I, III, and V amplitudes than those of the other stimulus polarities.

  7. Wali HA, Mazlan R
    J Audiol Otol, 2018 Jan;22(1):20-27.
    PMID: 29061035 DOI: 10.7874/jao.2017.00227
    BACKGROUND AND OBJECTIVES: Although ethnicity effect on wideband absorbance (WBA) findings was evident for adults, its effect on neonates has not been established yet. This study aimed to investigate the influence of ethnicity on WBA measured at 0 daPa from neonates with healthy middle ear functions.

    SUBJECTS AND METHODS: Participants were 99 normal, healthy, full-term newborn babies with chronological age between 11 and 128 hours of age (mean=46.73, standard deviation=26.36). A cross-sectional study design was used to measure WBA at 16 one-third octave frequency points from 99 neonates comprising of three ethnic groups: Malays (n=58), Chinese (n=13) and Indians (n=28). A total of 165 ears (83.3%) that passed a battery of tests involving distortion product otoacoustic emissions, 1 kHz tympanometry and acoustic stapedial reflex were further tested using WBA. Moreover, body size measurements were recorded from each participant.

    RESULTS: The Malays and Indians neonates showed almost identical WBA response across the frequency range while the Chinese babies showed lower absorbance values between 1.25 kHz and 5 kHz. However, the differences observed in WBA between the three ethnic groups were not statistically significant (p=0.23). Additionally, there were no statistically significant difference in birth weight, height and head circumference among the three ethnic groups.

    CONCLUSIONS: This study showed that Malays, Chinese and Indians neonates were not significantly different in their WBA responses. In conclusion, to apply for the ethnic-specific norms is not warranted when testing neonates from population constitute of these three ethnicities.

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