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
The aim of study was to explore pharmacist insights toward the impact of prospective implementation of the national health insurance program on patients, providers and Iraqi health system.
This was a qualitative study including semi-structured face-to-face (mostly) interviews with experienced pharmacists. The interview guide included open-ended questions about the impact of the national health insurance program on patients and healthcare providers at three levels: quality of services, costs, and frequency of visits. Potential challenges were also discussed. Interviews were conducted in four provinces from March to May 2022. Thematic analysis was used to analyze the interview findings and generate themes and subthemes.
The
... Show MoreThe impacts of numerous important factors on the Energy Absorption (EA) of torsional Reinforced Concrete (RC) beams strengthened with external FRP is the main purpose and innovation of the current research. A total of 81 datasets were collected from previous studies, focused on the investigation of EA behaviour. The impact of nine different parameters on the Torsional EA of RC-beams was examined and evaluated, namely the concrete compressive strength (f’c), steel yield strength (fy), FRP thickness (tFRP), width-to-depth of the beam section (b/h), horizontal (ρh) and vertical (ρv) steel ratio, angle of twist (θu), ultimate torque (Tu), and FRP ultimate strength (fy-FRP). For the evaluation of the energy absorption capacity at di
... Show MoreThe topic of urban transformations has attracted the attention of researchers as it is one of the basic issues through which cities can be transformed towards sustainability. A specific level of transformation levels according to a philosophical concept known as a crossing. This article has relied on a specific methodology that aims to find a new approach for urban transformation based on the crossing concept. This concept derives from philosophical entrances based on the concepts of (being, process, becoming, and integration). Four levels have been for the crossing are (normal, ascending, leap, and descending). Each of these levels includes specific characteristics that distinguish it. The results showed that there is no descending
... Show MoreBackground: Due to the complicated and time-consuming physiological procedure of bone healing, certain graft materials have been frequently used to enhance the reconstruction of the normal bone architecture. However, owing to the limitations of these graft materials, some pharmaceutical alternatives are considered instead. Chitosan is a biopolymer with many distinguishing characteristics that make it one of the best materials to be used as a drug delivery system for simvastatin. Simvastatin is a cholesterol lowering drug, and an influencer in bone formation process, because it stimulates osteoblasts differentiation, bone morphogenic protein 2, and vascular endothelial growth factor. Objectives: histological, histochemical and histomorp
... Show MoreThe foreguts of a total of 515 fish of Chondrostoma regium (Heckel, 1843) (locally: Bala’aot Malloky) were studied. These fish were collected from Tigris River at Salah Al-Deen Province (between Al-Hagag & Yathrib) for 20 months between March and October of the next year. Detritus, plant in origin materials (19.6%, 23.0% & 24.9%); green and blue green algae, mostly Cladophora, Cosmarium and Merismpedia sp. (17.1%, 12.9% & 12.2%) and diatoms, mostly Diatoma, Chanathes, Amphora and Cyulbella sp. (16.9%, 8.8% & 8.2%) were the main food categories taken by these fishes according to occurrence (O%), volumetric methods (V%) and ranking index (R%). Debris (not part of the diet) took 45.3% of the studied fish foreguts by volume. Detritus was also
... Show MoreThe research aims to clarify the importance of adoption of International Accounting Standard No. (12) "Income Taxes" as a tool for the measurement and disclosure of income taxes in the financial statements، and how to deal with the differences that arise as a result of difference in net profit accounting for net tax profit ،The problem of the research focused on the disparity between the income tax estimate in Iraq in accordance with the accounting standards and financial reporting and assessment of income tax in accordance with the tax laws and legislation, this discrepancy has led to the emergence of differences between accounting profit and tax profit (temporary differences and permanent differences) and these differences of w
... Show MoreIn this work a model of a source generating truly random quadrature phase shift keying (QPSK) signal constellation required for quantum key distribution (QKD) system based on BB84 protocol using phase coding is implemented by using the software package OPTISYSTEM9. The randomness of the sequence generated is achieved by building an optical setup based on a weak laser source, beam splitters and single-photon avalanche photodiodes operating in Geiger mode. The random string obtained from the optical setup is used to generate the quadrature phase shift keying signal constellation required for phase coding in quantum key distribution system based on BB84 protocol with a bit rate of 2GHz/s.
Time-domain spectral matching commonly used to define seismic inputs to dynamic analysis in terms of acceleration time history compatible with a specific target response spectrum is used in this study to investigate the second-order geometric effect of P-delta on the seismic response of base-isolated high-rise buildings. A synthetic time series is generated by adjusting reference time series that consist of available readings from a past earthquake of the 1940 El Centro earthquake adopted as an initial time series. The superstructure of a 20-story base isolated building is represented by a 3-D finite element model using ETABS software. The results of the base isolated building show that base isolation technique significantly reduces inter-s
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