- Too suspicious about other's talking
- Irritability, distraction etc. as emotional problems
- These types of behavioural problems will suggest that
the person is having difficulty in hearing.
1. Conversational voice test: Use
common words which are familiar to the patient. Keep the patient
at a distance of about 20 feet and ask him to repeat the words
said to him by the tester. Each ear to be repeated separately
2. Whisper test: Distance of about 3 feet between the
tester and the patient
3. Watch tick test
4. Crumbling sounds-using tissue papers etc.
5. Dropping of a coin or metallic piece without the
knowledge of the patient
6. Using various pitch pipes-different frequencies low, middle
and high tones and other screening sound (if possible calibrated)
7. Tuning fork tests
8. Communicate with the patient as far as possible without
showing your face or lips
9. Audiometry if available.
THE LECTURE LASTED FOR AN HOUR. TWO CASES
OF TYPICAL OTOSCLEROSIS WERE DEMONSTRATED.
The process of ageing brings on with it several
changes in the organ systems. The creatinine clearance falls
down, as the glomerular filtration rate of the elderly is
Iow, and the capacity for tubular reabsorption is low. The
excretory function is impaired, due to decreasing expulsive
force of the bladder and an enlarging prostate which causes
obstruction to the free voiding of urine. The other problem
of the elderly is loss of potency.
Examination of the patient with urinary complaints
Micturition problems are elicited using the
screening schedule. The complaints often are: (1) increase
in frequency especially nocturnal polyuria, (2) hesitancy
in passing urine where initiation is impaired. The patient
may have urgency, tending to wet his clothes as he walks to
the toilet, (3) He may pass a large amount of urine, (4) a
major complaint is retention of urine. Leading questions must
be asked to elicit whether or not the patient has haematuria,
a history of drug intake especially analgesics. tetracyclines,
other chemotherapeutic' agents. Past history of diabetes and/
or hypertension must be enquired for.
During general examination one must include
the presence or absence of pitting oedema feet, puffiness
of face, anaemia. Examination of the abdomen should be directed
towards, assessing the distention of the bladder. Rectal examination
is to be