chandigarh what do coaching classes tutors frequent discotheque visitors and regular jagrata participants have in common they are part of a new group of patients reporting to pgi with voicerelated complaints according to doctors and it is the background noise that is affecting voice in many caseswhen the background noise is above 90 decibels one tends to raise voice this causes trauma to the vocal cord consequently one keeps on continuously talking loudly sometimes a single exposure can also cause damage said dr sanjay munjal of department of ent at pgilongterm effect can make the voice turn hoarse usually the effects are temporary and can be reversed with voice rest if the voice is raised frequently it can have permanent changes for instance in case of hoarse voice the loudness of the voice can be reduced voice trauma can be treated with proper hydration speaking for short duration and restricting voice usage said dr munjal perhaps tutors in coaching classes are teaching for a longer duration and larger groups at discotheques noise levels are already high he saidit was observed that doctors and other paramedical students who attended the annual festival of association of resident doctors at pgi spring festival used to come back with hoarse voice so we decided to conduct a study how loud noise in the background affects voice said dr anuradha sharma speech therapist faculty member at the ent department in pgiboth the noise levels in the background and voice changes in students owing to howling and shouting during the festival were measured we found that out of 25 students 50 had hoarse voice while three developed nodules which if not treated needs surgery for removal the age group was from 1825 years of age and all were women said dr sharmathese kinds of nodules are seen in those talking loudly during kirtans and jagratras nodule formation can result in irritation in the voice and dryness of the throat we get mostly teachers untrained musicians and schoolchildren who shout in the playground or classrooms with nodules said dr sharmathe department now plans to include large group of students for its next study and follow them up after seven weeks until two months