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.
أن لعبة كرة السلة في تقدم وتطور مستمر حالها في ذلك حال الألعاب الرياضية الأخرى حيث أن الفضل في ذلك يعود إلى المعرفة بالعلوم المختلفة وكذلك البحث العلمي من اجل تحقيق نتائج متقدمة تنشدها معظم الدول ومنها العراق على الصعيد المحلي والعربي والدولي. ومما لاشك فيه أن متطلبات تطور مستوى نتائج القدرات البدنية في أيُة لعبة مرتبطة بالبرمجة والتخطيط الصحيح للمناهج التدريبية إذ تقودنا هذه الحقيقة إلى إجراء المزيد من الا
... Show MoreThis study addresses quantum computers as one of the most significant contemporary technological transformations that promise to reshape the future of global computing. It aims to clarify the conceptual foundations of quantum computing and to identify the fundamental differences between quantum and classical computers in terms of processing mechanisms, computational speed, and the ability to solve highly complex problems. The study focuses on key concepts such as the qubit, superposition, and entanglement, highlighting their role in enabling computational capabilities that exceed the limits of classical computing. It also discusses the future applications of quantum computers in areas such as cryptography, artificial intelligence, big data
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There is no doubt that teachers are the leaders of positive changing in community where they directed the students and build their brains. In our current generation that characterized by accelerated technological development that communication changes, economic and politics, needs from the teacher an active leadership skills that match with the soul of our generation and contribute in confrontation the current challenges and the future challenges in the form that lead to create a conscious generation where they will be a basic brick for the future community where the listeners looking forward the education where they support the continuity communication of develop process, economy, scientifically and in all life fields. In our study we take
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A load flow program is developed using MATLAB and based on the Newton–Raphson method,which shows very fast and efficient rate of convergence as well as computationally the proposed method is very efficient and it requires less computer memory through the use of sparsing method and other methods in programming to accelerate the run speed to be near the real time.
The designed program computes the voltage magnitudes and phase angles at each bus of the network under steady–state operating conditions. It also computes the power flow and power losses for all equipment, including transformers and transmission lines taking into consideration the effects of off–nominal, tap and phase shift transformers, generators, shunt capacitors, sh