File Name: the role of music and young children azazi .zip
The project was done as ear surgery campaigns in peripheral areas in Egypt, Yemen, and other countries, to train young ENT specialists and to treat patients there. Our plan was put according to the frequency of different causes of deafness as shown by previous surveys.
We used the previous local and evidence-based researches to make our protocols of management of different diseases. These protocols were further evaluated during our work. The project has five stages. The first stage included management of sudden sensory neural hearing loss SSNHL , otitis media with effusion OME , and local anesthesia for the ear surgery—cartilage tympanoplasty and ossiculoplasty.
The second stage included mastoidectomy cholesteatoma surgery and otoendoscopy. The third stage included more advanced surgery as stapedectomy and tympanosclerosis. The fourth stage included combating SNHL mainly through audiology and rehabilitation program, beside referral for cochlear implants to specialized centers.
The fifth stage was only a plan for doing stem cell research in management of hearing loss. Our teams did about 42 campaigns only and the data of 31 were recorded. There were attendants, 70 had hands on training, and 35 were well trained and became trainers. We did tympanoplasties, 52 mastoidectomies, and cholesteatoma surgery beside 16 operations of stage III. Training an ear surgeon is a tedious and long process, but it is at the end very fruitful and useful for the community.
Most causes of HL are preventable. We think that our project plan to combat HL is very suitable to be applied in developing countries in Africa and the Middle East.
Hearing loss HL is one of the most common health problems affecting people around the world. It can affect any age and it has many causes. A high prevalence of hearing impairment was also reported in Africa [ 3 ]. In Uganda, There is evidence suggesting that the prevalence of hearing impairment is higher than reported and that much of it is avoidable or treatable [ 3 , 4 ].
HL in children may be a cause of delayed development of language, speech, and cognitive skills so early diagnosis and treatment is mandatory. The aim of this project is to combat deafness by training local doctors in developing countries on evidence-based management of HL and ear surgery in order to treat their local patients with low cost as possible.
Professor S. Soliman in Ain Shams University ASU conducted a survey to know the magnitude of deafness in rural areas in Egypt, and the incidence of otitis media was about 2. The needed equipment to do the surgery were available in ministry of health hospitals but trained surgeons were not enough to do surgery.
This aroused me to submit the first written project of temporal bone dissection course TBDC in The temporal bone lab was established under supervision of Prof. Magdy Hamed And I had the honor to be a demonstrator, lecturer, and then the head of the TBD lab till Although TBDC is the most important step, yet it is not all ear surgery. Soft tissue dissection and tympanic membrane reconstruction, which are needed in all tympanoplasty operations, were lacking in the training.
Also, wrong decision-making was prevailing among many trainees as they thought that tympanoplasty is equal to mastoidectomy although the latter was not needed in most ear surgeries. Besides, there was also a lack of knowledge about the magnitude of different causes of hearing loss and the proper protocol to manage them.
Ear surgery campaigns were done in remote hospitals to treat and to teach local ear surgeons. We designed 5 stages for these campaigns which began as sporadic efforts in the early nineties. The project was shared also by ministry of health hospitals in Egypt, ASU, and Al-Azhar University members, beside some Arab and African countries look list of contributors.
Another twenty-four training campaigns were done in Egyptian provinces during that time; clever trained surgeons became trainers to continue their work locally. In Yemen, we began in till , at al Asaad Hospital in Taiz. Several Yemeni doctors worked with me, the program leader, as assistants, and many attended my operations beside the other scientific activities.
Now in Yemen, we have more than 30 competent trained surgeons; many of them became trainers for their junior colleagues. They have independent training teams. I am very proud of my Yemeni colleagues and their achievements which are still going on. The first step was to know the causes of hearing loss and the frequency of each cause. The work program was planned according to this knowledge.
The data of these researches were plotted in Fig. Causes of deafness in Egypt. Hatched column refers to the more frequent cause, the light one refers to the less frequent one as cited below the columns, and the black column refers to the sum of both.
From Fig. So, the first and the second teaching stages were directed to treat these diseases. The third stage is advanced training directed to treat less frequent causes of hearing loss 8. This was provided by the audiology team. The fifth stage is planned to do stem cell research to treat profound SNHL as a cheap alternative for cochlear implants, if it is successful. Trainers: 2—4 training personnel were needed. Candidates: attendance of 10—30 ENT specialists interested to do ear surgery, 2—6 of them were trained as hands on and the rest were observers for another chance.
Candidates chosen for hands on should have at least master degree and did TBDC. Equipment: the local hospital should have examination equipment, audiometers for hearing evaluation, lecture room with data show for presentations, operating rooms equipped with 1—2 surgical microscopes with camera and monitors, micro-instrument sets, and drill. Also, the local hospital should have requirements for general and local anesthesia. They also should prepare local patients for surgery according to the campaign stage.
Portable equipment were also brought by the campaign supervisors including 1—2 microscopes with camera and monitor, 3—4 sets of ear micro-instruments, portable drills and burr terminals, with local anesthesia LA requirements, beside teaching tools as printed notes, power point presentations, and operative videos which were given to the attending candidates.
Program: each campaign had theoretical lectures introducing the program and practical training including methods of examination, decision-making, and the surgical procedures. Demonstration of the procedures was first done by the supervisors, then candidates did these procedures using well-defined, repeatable steps at least twice in the course under supervision of their trainers.
Then they did surgery later on, under supervision of their senior colleagues in their local hospitals. Those who were well trained can help as trainers or supervisors in the next courses. To spread this knowledge, a moral obligatory agreement was done that everyone who becomes well trained should teach and train at least ten of his younger colleagues. The program was divided into five stages or educational levels.
Each campaign concentrates on one stage only as possible. We concentrated on the first 3 stages. Clinical methods of examination and evaluation with decision-making. Protocol for management of sudden sensory neural hearing loss SSNHL Appendix 1 as an emergency, early management may save a patient from permanent hearing loss [ 5 , 6 ].
Protocol for local anesthesia in ear surgery as it has many advantages, reduces markedly the surgical costs and complications [ 7 , 8 , 9 ]. Evidence-based treatment protocol for OME was put and applied in 6 steps Appendix 2 [ 10 ]. Local researches were mainly considered stressing on the role of endoscopy in management [ 11 ], peritubal adenoidectomy [ 12 ], steroid therapy [ 13 ], and the role of milk allergy [ 14 ].
The protocol was further evaluated after application. Different methods of middle ear exploration, permeatal, endaural, postauricular, and endoscopic and their indications. Also, fascia graft is another option for those who prefer it. Regain ossicular continuity mostly with the cartilage graft [ 15 ], or using preserved homograft ossicles [ 16 ]. Butterfly grafts for small residual perforations with healthy middle ear [ 17 ].
Postoperative care: using special ointment applicator [ 18 ], to protect the graft from infection till complete healing. The practical training included intratympanic injection, tympanostomy tube application, adenoidectomy specially peritubal adenoids , local anesthesia, aural polypectomy, cartilage tympanoplasty, and butterfly grafts.
In this stage, our aim was to teach different types of mastoidectomy and cholesteatoma surgery, beside the use of endoscopy in ear surgery. One of the prerequisites to share as hands on is prior training on temporal bone dissection course TBDC.
Mastoidectomy training included decision-making specially when to do it with tympanoplasty. Cholesteatoma management protocol included patient evaluation and decision-making depending on endoscopic examination, audiometry, and CT findings. Cartilage grafts were used to reconstruct the tympanic membrane and the attic wall [ 19 ]. The surgical protocol was published before by the authors [ 20 , 21 ]. In most cases with sclerosed mastoid cavity , canal wall down CWD using retrograde attico-antrostomy with variable extent of mastoidectomy following the extension of cholesteatoma was done.
This was followed by endoscopic control of hidden areas [ 20 ] then partial or complete obliteration of the cavity [ 21 ], then followed by tympano-ossicular reconstruction with cartilage graft [ 19 ] and homograft ossicles [ 16 ].
In some cases, with well-pneumatized mastoid, posterior approach was used. It was applied for expert surgeons and trainers. It included the following: management of otosclerosis with the classic endaural approach. Endoscopy provided good exposure and assistance [ 22 ].
Tympanosclerosis is common in Yemen, and it is managed according to its site and extent [ 23 ]. Congenital aural meatal atresia is treated through posterior approach as it is safer than anterior trans-canal approach [ 25 ]. Glomus tympanicum needs hypo-tympanotomy with endoscopic assistance [ 26 ]. Facial nerve decompression and grafting are very important if happened due to malpractice from any colleague.
An audiology program was added to stages I, II, and III including the following: training local audiologists on hearing evaluation and screening programs beside training the local ENT surgeons to read and interpret basic hearing evaluation including pure tone audiometry, speech audiometry, and tympanometry and how to make surgical decisions based on the audiological evaluation besides education about how to avoid SNHL. This stage included an audiological, rehabilitation, education, and screening program, which included the following:.
Those who failed in screening tests were sent to full hearing evaluation and rehabilitation in specialized centers.
Azazi was born at Peretorugbene in present Bayelsa State on 1 February Azazi was commissioned 2nd Lieutenant on 14 December At the end of the combined training he won the bronze medal for being first in Art subjects. He was appointed Director of Military Intelligence in Azazi had for some time had one of the fastest growing military careers in the history of present-day democratic Nigeria, between May, and June, the General had worn the ranks of Major General, Lieutenant General and General.
PDF | Damage to the brain is the most common cause of visual impairment in Visual disorders in children with cerebral palsy: The implications for Structured evaluation of all aspects of visual function, matched to each music, TV, or siblings while working. Holmström G, el-Azazi M, Kugelberg U.
Closing Ceremony Speech School. Dear Canadian Friends, We are gathered here again this evening, in your wonderful country, after 16 unforgettable days. Travel bans are in place around the world to stop the spread of coronavirus - with many countries, including.
Most people fail to understand the type of compensation they are asking for, according to Ahmed Al Othali, a legal consultant. Under UAE laws, diya, or blood money, is compensation for a human life and is set at Dh, for men and women. Payments are based on pre-determined amounts, and the percentage of disability is determined by a medical investigation team. The percentage is then calculated as a share of the Dh, diya.
She is also a former senior vice-president of Scotiabank.
The Cochrane Collection reviews of randomized clinical trials RCT showed a favorable result of music therapy MT on individuals with autism spectrum disorder ASD compared with a placebo treatment. Content type: Research. Published on: 25 June
Authors: Hamdy N. EL Tallawy, Wafaa M. Shehata, Amal M. Tohamy, Khaled O. Abdulghani, Mostafa K.
Каждую весну, когда частные фирмы начинают охоту за талантливой молодежью, соблазняя ее неприлично высокими окладами и фондовыми опционами в придачу, АНБ внимательно наблюдает за этим, выделяет наиболее подходящих и удваивает предлагаемую сумму. АНБ покупает все, что ему требуется. Дрожа от нетерпения, Сьюзан вылетела в Вашингтон. В международном аэропорту Далласа девушку встретил шофер АНБ, доставивший ее в Форт-Мид. В тот год аналогичное приглашение получили еще сорок кандидатов. Двадцативосьмилетняя Сьюзан оказалась среди них младшей и к тому же единственной женщиной. Визит вылился в сплошной пиар и бесчисленные интеллектуальные тесты при минимуме информации по существу дела.
Через минуту его усилия увенчались успехом, а телефон все звонил и звонил. Христа ради, Мидж. Ну хватит. Телефон заливался еще секунд пятнадцать и наконец замолк. Джабба облегченно вздохнул. Через шестьдесят секунд у него над головой затрещал интерком. - Прошу начальника систем безопасности связаться с главным коммутатором, где его ждет важное сообщение.
- Мисс Флетчер, вы проделали уже немалую часть пути. Постарайтесь пройти по нему до конца. Сьюзан вздохнула: - Программа принимает ключ только в цифровой форме. Мне кажется, что тут содержится некий намек на то, что это за цифра.
The project was done as ear surgery campaigns in peripheral areas in Egypt, Yemen, and other countries, to train young ENT specialists and to treat patients there.Mike C. 16.06.2021 at 12:16
function. It is a major cause of low vision. in children worldwide due to increasing. survival in paediatric and neonatal care. CVI can present in.