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.
Sliding Mode Controller (SMC) is a simple method and powerful technique to design a robust controller for nonlinear systems. It is an effective tool with acceptable performance. The major drawback is a classical Sliding Mode controller suffers from the chattering phenomenon which causes undesirable zigzag motion along the sliding surface. To overcome the snag of this classical approach, many methods were proposed and implemented. In this work, a Fuzzy controller was added to classical Sliding Mode controller in order to reduce the impact chattering problem. The new structure is called Sliding Mode Fuzzy controller (SMFC) which will also improve the properties and performance of the classical Sliding Mode control
... Show MoreIn this modern Internet era and the transition to IPv6, routing protocols must adjust to assist this transformation. RIPng, EIGRPv6 and OSPFv3 are the dominant IPv6 IGRP (Interior Gateway Routing Protocols). Selecting the best routing protocol among the available is a critical task, which depends upon the network requirement and performance parameters of different real time applications. The primary motivation of this paper is to estimate the performance of these protocols in real time applications. The evaluation is based on a number of criteria including: network convergence duration, Http Page Response Time, DB Query Response Time, IPv6 traffic dropped, video packet delay variation and video packet end to end de
... Show MoreA study of characteristics of the lubricant oils and the physical properties is essential to know the quality of lubricant oils. The parameters that lead to classify oils have been studied in this research. Three types of multi-grades lubricant oils were applied under changing temperatures from 25 oC to 78oC to estimate the physical properties and mixture compositions. Kinematic viscosity, viscosity gravity constant and paraffin (P), naphthenes (N) and aromatics (A) (PNA) analysis are used to predict the composition of lubricants oil. Kinematic viscosity gives good behaviors and the oxidation stability for each lubricant oils. PNA analysis predicted fractions of paraffin (XP), naphthenes (XN),
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Obiovisly that the holy thresholds are directly related to Islam and Muslims and related to the general culture of the Islamic peoples. In terms of architecture, it is considered a distinctive architectural scene that reviews the history of this origin and its architectural styles. Recently, with the increase in the number of pilgrims and visitors to the holy shrines, there is a need to develop and expand the buildings and provide them with services and introduce modern technology. The building of the holy thresholds consists of a number of functional design indicators: The general problem of research is that there is no clear theoretical framework for the design indicators for the development of the holy shrines according to the functio
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Find interested in the harmonization of variables and determinants of supply chain planning needs of the material, leading to the results start effective supply chain management, and end up quickly modify the sizes to suit the demand and turnover in the market. As well as identifying relationships between variables, and type of relationship used by the company with the processors and their feasibility, and indicate the level of interest and willingness to redesign the supply chain Company for Electrical Industries and build an integrated model for supply chain with the MRP system can be applied in the company.
Research depend on quantitative and descriptive method, It
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This research studies Reinforcing and applied load of Wear Rate for Epoxy composites contains from epoxy resin (Ep) as a matrix material and reinforced by Gawain red wood flour , Russian white wood flour , glass powder and rock wool fibers , with volume fraction (20%) for all samples in lab conditions. by using the load (10,20 ,30 ,40) Newton of iron disc for testing time(10) minute, and the results have shown that the reinforcing of epoxy resin led to decrease wear rate for all samples except the hybrid composites reinforced earth glass powder , that the wear rate values decrease from (22×10-9g/cm) to (4×10-9g/cm) of composite material(Ep+R.W.F) and thus(Ep+W.W.F) at la
... Show MorePeople with diabetes can develop different foot problems. In the blood stream glucose reacts with hemoglobin to make a glycosylated hemoglobin molecule called hemoglobin A1c or HbA1c, the more glucose in the blood the more hemoglobin A1c will be present in the blood. The HbAlc test is currently one of the best ways to check diabetes to be under control. The aim of study is to compare between the blood investigations which includes the fasting blood sugar and HbAlC (glycosylated hemoglobin), and to evaluate the benefit of HbAlc (measurement for diabetic patients with foot ulcer, to be a good indicator for controlling blood glucose). Sixty patients with type2 diabetes mellitus from the outpatient clinic of Baghdad Teachin
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In this work Nano crystalline (Cu2S) thin films pure and doped 3% Al with a thickness of 400±20 nm was precipitated by thermic steaming technicality on glass substrate beneath a vacuum of ~ 2 × 10− 6 mbar at R.T to survey the influence of doping and annealing after doping at 573 K for one hour on its structural, electrical and visual properties. Structural properties of these movies are attainment using X-ray variation (XRD) which showed Cu2S phase with polycrystalline in nature and forming hexagonal temple ,with the distinguish trend along the (220) grade, varying crystallites size from (42.1-62.06) nm after doping and annealing. AFM investigations of these films show that increase average grain size from 105.05 nm to 146.54 nm
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