Background: urethrocutaneous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for surgeon and the patient. The problem is exacerbated because the urethrocutaneous fistula may recur which adds more demands surgery. Objectives: The purpose of this study is to evaluate of the use of oral mucosal graft for management of recurrent urethrocutaneous fistula after hypospadias repair. Patients and Methods: twelfth patients with age ranging from 4 year to 15 years were presented with history of recurrent fistula. Most of fistula were located in proximal penile and penoscrotal region (58.3%) . those patients were repaired by using oral mucosal graft with mean postoperative follow up period up to 6 months. Results: analysis of results showed 10 out of 12 cases (83.3%) had a final successful outcome with no recurrent fistula during follow up period. The two patients with failed repair were candidate for another attempt for fistula repair later on. No donor site morbidity was observed in all patients. Conclusion: Oral mucosal graft showed very good take and promising results when used for management of recurrent urethrocutaneous fistula after hypospadias repair. Key words: urethrocutaneous fistula, hypospadias, mucosal graft.
Engineering equipment is essential part in the construction project and usually manufactured with long lead times, large costs and special engineering requirements. Construction manager targets that equipment to be delivered in the site need date with the right quantity, appropriate cost and required quality, and this entails an efficient supplier can satisfy these targets. Selection of engineering equipment supplier is a crucial managerial process .it requires evaluation of multiple suppliers according to multiple criteria. This process is usually performed manually and based on just limited evaluation criteria, so better alternatives may be neglected. Three stages of survey comprised number of public a
... Show MoreThe advancements in horizontal drilling combined with hydraulic fracturing have been historically proven as the most viable technologies in the exploitation of unconventional resources (e.g., shale and tight gas reservoirs). However, the number of fractures, well timing, and arrangement pattern can have a significant impact on the project economy. Therefore, such design and operating parameters need to be efficiently optimized for obtaining the best production performance from unconventional gas reservoirs. In this study, the process of selecting the optimal number of fractures was conducted on a section of a tight gas reservoir model (based on data from the Whicher Range (WR) tight gas field in Western Australia). Then, the optimal number
... Show MoreThe objective of this study is to highlight the skills of office managers and it's impact on the effectiveness of time management in the institutes and faculties of middle technical university and a group of cognitive and practical aims. The managers skills forms mthe modern trend and the main source to provide organizations with highly skilled managers with distinctive performance and because of the sharp changes in the environment which today's organizations works in it , business organizations generally and managers especially realise the importance of time management and it's role in achieving competitive advantage . The problem of this study raised from this point which reflect the extent of departments managers realisation
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Objective(s): to Evaluation of Parents’ Knowledge about Nutritional Management of kids with Phenylketonuria; to Identify the association between parents’ Knowledge about nutritional management then their demographic variables of fathers, mothers (parents age, residence then socioeconomic position).
Methodology: A non-experimental project; was accompanied on parents of phenylketonuria kid in Baghdad town since the period 3 June to 5 October 2022. A Non-probability sample (convenience) of 35 PKU children and their parents (father and mother) was selected Purposively from the hospitals that are select for the study. A survey is built for the purpose of the educa
... Show Moreتتحقق اهداف الدول عبر توظيف امكانياتها ومواردها ، وهذا التوظيف يقترن بوسائل مختلفة باختلاف الامكانيات المتاحة. وتتفاوت هذه الوسائل ما بين الاكراه والترغيب ، واحياناً من الممكن استخدام كلا الوسيلتين ، وتندرج هذه الوسائل من حيث تصنيفها ضمن نوعين رئيسين هما: القوة الصلبة ]القوة العسكرية والاقتصادية[ والقوة الناعمة ]استخدام جميع ادوات الترغيب وتسخيرها من اجل ان تُعجب بها الدول الاخرى وتنصاع
... Show MoreThe last ten years observed a shift enormous scientific in the method and way that it deals professional with the cost accounting and reflected the result those shift enormous scientific of increase the competitive environmental that accompanied the emergence of a modern manufacturing environmental on surface the long roductive life and emergence advanced information technology that give a central focus of his important on client with growing global markets growth on a large scale.
The research aim to define the concept of cost awareness, the concept and methods of strategic cost management and the role of cost awareness for managers of industrial units in strategic of cost managem
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