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.
Nitrogen (N) and phosphorus (P) are the most important nutrients for crop production. The N contributes to the structural component, generic, and metabolic compounds in a plant cell. N is mainly an essential part of chlorophyll, the compound in the plants that is responsible for photosynthesis process. The plant can get its available nitrogen from the soil by mineralizing organic materials, fixed-N by bacteria, and nitrogen can be released from plant as residue decay. Soil minerals do not release an enough amount of nitrogen to support plant; therefore, fertilizing is necessary for high production. Phosphorous contributes in the complex of the nucleic acid structure of plants. The nucleic acid is essential in protein synthesis regulation; t
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The research study focused on the need to clarify the relationship between the Websites of Iraqi Newspapers and their roles in covering the internal crises in Iraq. The selection of Iraqi websites for the newspapers Al-Zaman and Al-Sabah was adopted as one of the most important media with a wide audience; and as a model of hot news and continuous coverage of those sites since 2003 so far. As a result, this necessitated the emergence of new types of methods of editing and writing news stories related to Iraq.
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This research aims to study and improve the passivating specifications of rubber resistant to vibration. In this paper, seven different rubber recipes were prepared based on mixtures of natural rubber(NR) as an essential part in addition to the synthetic rubber (IIR, BRcis, SBR, CR)with different rates. Mechanical tests such as tensile strength, hardness, friction, resistance to compression, fatigue and creep testing in addition to the rheological test were performed. Furthermore, scanning electron microscopy (SEM)test was used to examine the structure morphology of rubber. After studying and analyzing the results, we found that, recipe containing (BRcis) of 40% from th
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