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.
This research dealt with the process of reducing costs through some strategic methods of management accounting targeted cost analysis unassembled and Alkeisen, where he focused this research through his theory on a review of some administrative accounting strategic technologies, while the second practical side through the application of targeted cost analysis unassembled and Alkeisen, acquired Search importance of focusing on the decisions to cut costs, through the use of some administrative accounting strategic methods and this we can unassembled analysis, continuous improvement, and the cost of quality) when applied quality, "in light of this has been reached to a set of conclusions that the most important of the company's relian
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الخلفية: العقدية المقيحة المعروفة أيضًا باسم ""(GAS) هي احدى مسببات الأمراض ذات الأهمية الصحية العامة، حيث تصيب 18.1 مليون شخص في جميع أنحاء العالم وتقتل 500000 شخص كل عام. الهدف: حددت هذه المراجعة المقالات المنشورة حول عوامل الخطر واستراتيجيات الوقاية والسيطرة لأمراض المكورات العقدية. المواد والأساليب: تم إجراء بحث منهجي لتحديد الأوراق المنشورة على قواعد البيانات الإلكترونية Web of Science و PubMed و Scopus و Google Scholar في مح
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Abstract
The mine object for this research is determine the nature of the relation and effect between Human resources management strategic to less the work stress , Human resources management strategic represent a set of procedures and practices to manage the human resources at the organization. the stress of work effect on the performance of the human resources , al rasheed bank select to applied the qustioneer on the 32 person the work on the sebaa branch , using the qustioneer as a tool to collect data that is design according some of the standards and make the validity and stability. to analyses this data by using spss for computation " percentage , mean , standard , deriation
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Management of Foreign Exchange Rate Exposure by Using Financial Hedging An Analytical Empirical Study The main purpose of this Research is to investigate the ability to reduce the effect of exchange rate fluctuation on firm value , by usage appropriate hedging strategies to provide the firms force to adopted with complex and highly uncertainty conditions , characteristic of the most of the financial markets . The field of this study is the giant five Multinational on the world. Nokia, Toyota Motor, Intel , Coca Cola, Microsoft. practical analysis is provide the truth of all study's hypothesis , and it is reach to many of conclusion, the most important of them is Stem from unexpected fluctuation on nominal ex
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The process of composting which involves the treatment of organic wastes to obtain a stable clean product, has become an increasingly desirable choice, at any scale from home to large waste treatment plants. Composting serves as an alternative to landfilling for managing biodegradable waste while also increasing or preserving soil organic matter, decreasing solid waste, and reducing disposal costs. The compost product improves the condition of the soil, reduces erosion, and helps reduce plant diseases without having adverse impacts on the environment. This study aims to manufacture high-quality compost as a solid waste management method by converting organic waste into a useful resource for the community in a financially and ecologi
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Objective: The aim of the study to evaluate the nursing care management for diabetes mellitus patient
with total hip replacement after fractured hip.
Methodology: A field study carried out on patients with diabetes mellitus and have total hip
replacement after fractured hip in orthopedic ward at the hospital of surgical specialization (malefemale)during
January 2002 to January 2003.Physical and psychological nursing
assessment
immediately after the surgery was done for the both subjects (control and experimental) and then a
scientific management with daily nursing care were provided to the experimental subject with daily
nursing care to the patient condition by using a scientific and practical methods and leave th
The study aims to use the European Excellence Model (EFQM) in assessing the institutional performance of the National Center for Administrative Development and Information Technology in order to determine the gap between the actual reality of the performance of the Center and the standards adopted in the model, in order to know the extent to which the Center seeks to achieve excellence in performance to improve the level of services provided and the adoption of methods Modern and contemporary management in the evaluation of its institutional performance.
The problem of the study was the absence of an institutional performance evaluation system at the centre whereby weaknesses (areas of improvement) and st
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Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associa
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AIM: To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients. METHODS: From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded. RESULTS: Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in
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