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.
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the prophet as a mercy to the worlds and on his family and companions. The phenomenon of suicide is one of the most expanding social phenomena in the world, where many groups of society of different ages try to put an end to their lives, especially young men and girls. The numbers always remain on the rise, and there is no doubt that the one who does this matter, that he has reasons that made him resort to suicide, and despite that, whatever those reasons. However, this is not a justification for the assault on the soul that God has forbidden to infringe on or lead them to perdition, or to what harms them. Modern psychology has tried to explain this phenomenon and try to
... Show MoreGeneral propositions have dealt with various indicators and features that frame and describe basic architectural concepts, and from those concepts, the concept of identity will be presented here, which represents the nerve of intellectual vision of the state of architecture development, transformation and change. Due to its deep intellectual basis, it was necessary to study multiple features, especially the achievement feature that was considered a major stage describing the nature of change and shift related to the achievement of concept and its role in the development of the architectural field . &nb
... Show MoreThe purpose of this paper is to develop a hybrid conceptual model for building information modelling (BIM) adoption in facilities management (FM) through the integration of the technology task fit (TTF) and the unified theory of acceptance and use of technology (UTAUT) theories. The study also aims to identify the influence factors of BIM adoption and usage in FM and identify gaps in the existing literature and to provide a holistic picture of recent research in technology acceptance and adoption in the construction industry and FM sector.
Arts acts to reduce and exclude everything that is not necessary in the delivery of meaning, especially representative performance, which is based on the intensification of the physical and vocal actions, and in drawing the dimensions of the character. And because that, the artistic staff, among others in the ministry of education, are considered the cornerstone, in the development of theatrical activities in schools, this research came to find out the extent to which teachers in primary schools, in secondary schools and artistic supervisors rely on shorthand mechanisms in the representative performance.
The current research relied on the descriptive approach, in analyzing his sample, which was deliberately chosen, Among the most imp
Thin films of Zinc Selenide ZnSe have been prepared by using thermal evaporation in vacuum technique (10-5Torr) with thickness (1000, 2700, 4000) A0 and change electrode material and deposited on glass substrates with temperature (373K) and study some electrical properties at this temperature . The graphs shows linear relation between current and voltage and the results have shown increases in the value of current and electrical conductivity with increase thickness and change electrode material from Aluminum to Copper
Most of the studies conducted in the past decades focused on the effect of interest rates and exchange rates on domestic investment under the assumption that the independent variables have the same effect on the dependent variable, but there were limited studies that investigated the unequal effects of changes in interest rates and exchange rates, both positive and negative, on domestic investment. This study used a nonlinear autoregressive distributed lag (NARDL) model to assess the unequal effects of the real interest rate and real exchange rate variables on domestic investment in Egypt for the period 1976 - 2020. The results revealed that positive and negative shocks for both exchange rates have unequal effects on
... Show MoreWhile traditional energy sources such as oil, coal, and natural gas drive economic growth, they also seriously affect people’s health and the environment. Renewable energies (RE) are presently seen as an efficient choice for attaining long-term sustainability in development. They provide an adequate response to climate change and supply sufficient electricity. The current situation in Iraq results from a decades-long scarcity of reliable electricity, which has impacted various industries, including agriculture. There are diverse prospects for using renewable energy sources to address the present power crisis. The economic and environmental impacts of renewable energy systems were investigated in this study by using the solar pumpi
... Show MoreThe most important issue that 21-century in knowledge organization try successfully to face and solve is the determination of the ways and the processes through which they can measure and assess the intellectual capital (IC). In spite of the importance of the human capital in the knowledge organization, The accounting as an information systems, does not give a great deal of consideration to the human capital, and does not treat investment in it as an original factor, but it shows it on the base of salaries and payrolls that is appears in the financial statements as a revenue expenditure. As a result of that the financial statement are not a true expression of the actual status and then some of the decisions taken under the present circum
... Show MoreThe ability of four local fungal isolates for extracellular laccase production has been tested with five grams 1:1(w/v) humidified sawdust as substrate in mineral salt medium. After 21 day of incubation at 25±1 ? C and using one mycelial plug (5mm), higher level of laccase activity (0.15U/ml) and specific activity (15U/mg) were observed by Pleurotus ostreatus in comparison with other fungal isolates. The results of optimum conditions for laccase production from selected isolate showed that, the maximum laccase activity (0.55U/ml) and specific activity (55U/mg) were obtained at moisture ratio 1:3 (w/v), using 3 mycelial plugs (5 mm), after 15 days incubation period at 25±1 ? C. The results of phenol degradation by crud laccase revealed th
... Show More