Objective: to evaluate the benefit of coverage of
the urethral repair by dorsal dartos flap as a second
layer for preventing fistula and V like incision on
the tip of the glans for preventing meatal stenosis.
Patients and Methods:
Forty five children included in this study age
ranged ( 11 months – 7 years), they underwent
hypospadias repair between December 2008 to
March 2012, all cases with distal hypospadias,
same technique used for all patients, a combination
of techniques used for reconstruction starting
withtubularized incised plate urethroplasty with deepithelialized
or stripping of the skin from both
sides of U shaped incision surrounding the urethral
plate, adding a V like incision on the top (tip of
glans) of the midline urethral plate incision that
give wide meatus subsequently prevent meatal
stenosis and no need for dilatation after stent
removal, followed by harvesting well vascularized
dartos flap from de-epithelialized preputial skin
and transposing itventrally by buttonholing
maneuver and suturing the flap as a second layer
along the neourthral suture line, finally
approximation of glans , so achieving three layer
closure.
Results :All patients are followed for (6 months-
24 months) mean was 15 months, only two patients
(4.4%) complicated with small fistula at the
subcoronal region at the beginning of the study
operated after 6 months and the fistula closed
successfully. Twenty five cases (55.5%) with
Chordee were completely released with no
recurrence. No dilatation was needed after removal
of stent for neomeatus developed a good stream of
urine with no problems regarding stenosis.
Conclusions: In this study hypospadias repair
should achieve three layer closures by using a
dartosfalp as a second layer to cover neourethral
suture line combined with stripping the skin on the
edge of the U shaped incision to gain secure
closure of the neourethra, which will prevent
fistula formation. We recommend adding a
Vincision on the tip of the glans connected with
midline urethral plate incision to prevent meatal
stenosis.
The widespread of internet allover the world, in addition to the increasing of the huge number of users that they exchanged important information over it highlights the need for a new methods to protect these important information from intruders' corruption or modification. This paper suggests a new method that ensures that the texts of a given document cannot be modified by the intruders. This method mainly consists of mixture of three steps. The first step which barrows some concepts of "Quran" security system to detect some type of change(s) occur in a given text. Where a key of each paragraph in the text is extracted from a group of letters in that paragraph which occur as multiply of a given prime number. This step cannot detect the ch
... Show MoreThe aim of this study is to assess the influence of some risks factors on the fistula development after palatoplasty to improve the outcome of the patients
A total of 48 patients (the males were 22, The females were 26) were included in this study. All the patients were examined weekly for the first month postoperatively to assess any breakdown in the wound by inspection and by asking the parents for any nasal regurgitation during fluids feeding.
Stuck pipe is a prevalent and costly issue in drilling operations, with the potential to cost the petroleum industry billions of dollars annually. To reduce the likelihood of this issue, efforts have been made to identify the causes of stuck pipes. The main mechanisms that cause stuck pipes include drill cutting of the formation, inappropriate hole-cleaning, wellbore instability, and differential sticking forces, particularly in highly deviated wellbores. The significant consequences of a stuck pipe include an increase in well costs and Non-Productive Time (NPT), and in the worst-case scenario, the loss of a wellbore section and down-hole equipment, or the need to sidetrack, plug, or abandon the well. This paper provides a comprehensive
... Show MoreBackground: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular
... Show MoreBackground: Techniques of Inguinal hernia repair have seen an evolution from the pure tissue repair to the prosthetic repair and in the recent years past to laparoscopic repair. High recurrence rates using fascia for the hernia repair or the use of sutures under tension prompted the development of polypropylene mesh to reinforce the posterior wall of the inguinal canal.The aim of this study is to compare the post operative results of Lichtenstein mesh technique with Dar ning repair.<br />Patients and methods:-A prospective study of "100" patients with inguinal hernia were conducted to evaluate two methods, of open repair of inguinal hernia Lichtenstein mesh technique with Traditional non-mesh technique (modified Bassini or Darning)
... Show MoreBackground: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswit
... Show MoreBackground: The treatment of high anal fistulae needs to meet a balance of cure and continence. There are many surgical treatment options available for high fistula-in-ano. The best surgical operation for high anal fistulas is difficult to define because they have varying cure and incontinence rates. A loose Seton is a loop of flexible material (silastic tube, silk, and nylon) placed through the fistulous track to allow drainage by keeping the external skin opening patent. Some surgeons use the loose Seton to allow drainage and others believe that it promotes healing by inducing fibrosis
Objective: To check the efficacy of loose Seton in the management of high anal fistulas.
Patient and method: A prospectiv
Objectives: This study aimed to findout approaches which used by midwives for avoiding episiotomy and assess their knowledge regarding complications of episiotomy in three main cities of Kurdistan region. Methodology: A cross-sectional study was conducted between 1st January and 15th April 2014 in the three biggest maternity teaching hospitals. The study population included all the midwives (n=53) working in delivery rooms. Data were collected through interview with midwives. Results: The Midwives stated the followings as complications of episiotomy: tear into the rectum muscle or rectum itself (52.8%), bleedi
Background: Inguinal hernias are a common medical problem that can significantly decrease the quality of life.Repair of inguinal hernia is one of the commonest surgical procedures worldwide irrespective of the country, race, or socioeconomic state. The inguinal hernia repair has been a controversial area in surgical practice from the time it has been conceived. Laparoscopic inguinal hernia repair has shown a great deal of promise as a treatment for the condition.
Objectives: To compare the outcome of laparoscopic versus open inguinal hernia mesh repair in terms of operative time , analgesics requirement , postoperative complication , hospital stay and return to daily activities and work.
Patients and methods: A prospective study of
The importance of the research comes from dealing with the problem of lack of traffic awareness, which causes accidents and the occurrence of human and material losses, and the research aims to study the role of satellite channels in forming traffic awareness among the public, and a sample was chosen from Baghdad consisting of (280) individuals, male and female, and used the questionnaire tool. To obtain the data, which included several questions, the results were analyzed statistically and several results were reached, the most important of which is that there is an interest among the public in following traffic programs at a rate of one to two hours to receive information through traffic programs and to identify and apply gener
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