ABSTRACTBackground: cochlear implants are electronic devices that convert sound energy into electrical signals to stimulate ganglion cells and cochlear nerve fibers. These devices are indicated for patients with severe to profound sensorineural hearing losses who receive little or no benefit from hearing aids. The implant basically takes over the function of the cochlear hair cells. The implant consists of external components (microphone, speech processor and transmitting coil) and internal components (receiver stimulator and electrode array). The implant is inserted via a trans mastoid facial recess approach to the round window and scala tympani.Objectives: to determine the effectiveness and safety of non fixation method in cochlear implantation.Methods: a prospective study carried out from September 2009 to September 2012 in Gazi Hariri Hospital. Eighty patients with congenital severe –profound sensorineural hearing loss prepared for cochlear implantation involved in the study and divided into 2 groups. Group A includes 40 patients in whom the internal device was fixed to the skull by nylon suture materials through small burr holes on both sides of the well. Group B includes 40 patients in whom the internal device placed in a tight sub pericranial pocket without nylon fixation to the skull. All patients followed postoperatively for 6 months observing wound healing and local complications (hematoma, infection, wound dehiscence, device extrusion and migration).Results: mean age 4.2 years and male-female ratio was 1.3:1.Group A: 1 patient (2.5%) developed minor wound infection treated conservatively. Three patients (7.5%) developedsevere wound infection with wound breakdown and device extrusion despite the use of antibiotics and local rotational flaps, the device was explanted in those 3 patients. Two patients (5%) developed hematoma without history of trauma and treated conservatively. One patient (2.5%) had device migration without affection of its function.Group B: 2 patients developed minor wound infection treated conservatively. One patient (2.5%) had severe wound infection ends up with wound dehiscence and device extrusion despite the use of antibiotics and local rotational flaps. Explantation of the device was done for this patient. Hematoma occurred in one patient (2.5%) without history of trauma and treated conservatively. Another one patient (2.5%) developed device migration without impairment of its function.Conclusion: creation of sub pericranial pocket without internal device fixation by nylon materials is an effective and reliable method in cochlear implantation without compromising the patient safety or device performance.Key words: cochlear implantation, non- fixation, sub pericranial pocket
This research aims to focus on the reality of the imbalance of the balance of trade structure in order to improve it and determine the size of the imbalance as a result of dependence on one commodity, namely crude oil in the structure of exports versus the diversity of the structure of imports of various goods and goods.
In order to achieve that goal, a deductive approach was adopted, which included a shift from general theory data to special applications.
We have reached through the research to a number of conclusions, most notably the effectiveness of public spending in correcting the imbalance of the balance of trade structure during the study pe
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Metabolic dysregulation and obesity are associated with many metabolic alterations, including impairment of insulin sensitivity and dyslipidemia. Recent studies highlight the key role of phosphatidylinositol 3,4,5-triphosphate-dependent Rac exchange proteins (PREX proteins) in the pathogenesis of obesity, advocating further elucidation of their potential therapeutic implications. The present study aimed to estimate the serum level of PREX proteins and its potential association with insulin resistance markers and plasma lipids level in obese and overweight non-diabetic patients. The study included 30 persons classified as obese, 30 as overweight, and 30 healthy individuals of similar age and gender. The levels of PREX1 and PREX2 were
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Abstract
The research Compared two methods for estimating fourparametersof the compound exponential Weibull - Poisson distribution which are the maximum likelihood method and the Downhill Simplex algorithm. Depending on two data cases, the first one assumed the original data (Non-polluting), while the second one assumeddata contamination. Simulation experimentswere conducted for different sample sizes and initial values of parameters and under different levels of contamination. Downhill Simplex algorithm was found to be the best method for in the estimation of the parameters, the probability function and the reliability function of the compound distribution in cases of natural and contaminateddata.
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بناء على ما تقدم يتضح ان القطاع العام والقطاع الخاص ليسا موقفا ايدولوجيا انتقائيا، وانما هو انبثاق من العمود الفقري للصيرورة الرأسمالية القائمة على تقديس الملكية الخاصة، وان الادوار التي يمكن ان يلعباها ليسا منعزلين عن الحركة العامة للاقتصاد في كليته، وليس هما ابنا السياسات الاقتصادية، والبناء الفوقي بقدر ماهما نتاج الحركة الموضوعية وصيرورة التطور الاجتماعي معبرا عنها في تطور علاقات الانتاج وقوى الانتا
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In order to a chive the aim of the research the researcher chose the (Nebras kindergarten) to be the search sample .the member of the sampleFrom(males and fameless)and the researcher chose the class of(butterfly) as experimental group to do the pantomime consist of(15)males and fameless, and put(singles, senses ,double senses and communal senses)in the binging of the experiment the researcher applied the measurement of(AL Kaswany and other)as(pre_ test)which prepare to measure, the movement skills for kindergarten, the measurement have the validity and reliability to knowledge the difference between the two experiment. The experiment continue from(20/1/201to 20/2/2014)in the end of experiment the researcher applied the measurement of(AL
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This paper discuses the mindset contribution of the organization Science in organizational effectiveness (OE), and the most valuable thoughts they introduced in this subject, starting from the pre- classical era, through classical era to present time. This paper has identified the main contribution in OE. The concept of OE didn’t arise until what had been introduced by Chester Barnard, although Max Weber mentioned this concept in his bureaucratic theory, but he didn’t explain it as Barnard does. After that no clear focus was pointed to this subject until Peter Drucker did so, which considered as the main participant in OE after Barnard. After that many researchers be interested in OE and they start studying this subject like
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AIM: To evaluate the short-term effectiveness of Gamma knife radiosurgery as a modality of treatment of brain arteriovenous malformation. METHODS: Sixty-three patients with arteriovenous brain malformations underwent Gamma knife radiosurgery included in this prospective study between April 2017 and September 2018 with clinical and radiological with MRI follow up was done at three months and six months post-Gamma knife radiosurgery. By the end of the 12th-month post-Gamma knife radiosurgery, the patients were re-evaluated using digital subtraction angiography co-registered with M.R.I. During the 12 months follow up, CT scan or MRI was done at any time if any one of the patients᾽ condition deteriorated or developed signs and s
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