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.
Need organizations today to move towards strategic thinking which means analyzing situations faced by particular challenges of change in the external environment, which makes it imperative for The Organization That to reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures, to try to achieve improvement root in the installation of the organization and methodscompletion of its work towards achieving high levels of performance and that is reflected to achieve its objectives, and this is what aims to Current search to deal with implications characteristics of strategic thinking in the stages of application re-engineering business of the company General Industries
... Show MoreThe research aims to develop a proposed mechanism for financial reporting on sustainable investment that takes the specificity of these investments.
To achieve this goal, the researcher used (what if scenario) where the future financial statements were prepared for the year 2026, after completion of the sustainable project and operation, as the project requires four years to be completed.
The researcher relied on the results of the researchers collected from various modern sources relevant to the research topic and published on the internet, and the financial data and information obtained to assess the reality of the company's activity and its environmental, social, and economic i
... Show MoreThis work deals with preparation of zeolite 5A from Dewekhala kaolin clay in Al-Anbar region for drying and desulphurization of liquefied petroleum gas. The preparation of zeolite 5A includes treating kaolin clay with dilute hydrochloric acid 1N, treating metakaolin with NaOH solution to prepare 4A zeolite, ion exchange, and formation. For preparation of zeolite 4A, metakaolin treated at different temperatures (40, 60, 80, 90, and 100 °C) with different concentrations of sodium hydroxide solution (1, 2, 3, and 4 N) for 2 hours. The zeolite samples give the best relative crystallinity of zeolite prepared at 80 °C with NaOH concentration 3N (199%), and at 90 and 100°C with NaOH concentration solution 2N (184% and 189%, respectively). Ze
... Show MorePracticing physical activity is a very necessary requirement for all segments of society. . Many individuals, regardless of environment, age and gender, are exposed to joint diseases and injuries and pain in the neck for many and varied reasons. Treatment methods and techniques vary according to the severity of the injury, as therapeutic exercises, including stretching exercises, specifically fixed ones, are one of the ways to eliminate cases of muscle and joint dysfunction. Many individuals, regardless of environment, age and gender, are exposed to joint diseases and injuries and pain in the neck for many and varied reasons. Treatment methods and techniques differ according to the severity of the injury, as therapeutic exercises, including
... Show MoreThe scholastic view of public religion differed, and this difference was on two extremes. All economic schools agreed that public debt is a monetary liquidity that was unjustly deducted from the income and output cycle as a result of the imbalance in the economic balance and the departure from the conditions of balance between aggregate demand and aggregate supply. Debt is a waste of financial resources allocated to productive accumulation. Except for the Keynesian school, which considers public debt to be an addition to aggregate demand after the decline in the role of the private sector in investment as a result of pessimistic expectations that warn of signs of economic contraction. Public debt is linked to the ex
... Show MoreThe banking industry, as a result of the great challenges it faced, required continuous development of the principles of management, control and mechanisms used. The Basel Committee on Banking Supervision has played a leading role in legalizing many of these developments and has been able to contribute significantly to establishing a common framework for banking supervision, The central role in the various countries of the world is based on coordination between the various regulatory authorities and thinking about finding mechanisms to confront the risks faced by banks, recognizing the importance of the banking sector in the stability of domestic and international banking systems or the danger of this sector in the emergence of F
... Show MoreThis paper deals with the subject of demarcating as appropriate scientific techniques to rationalize consumption and to control segments of the society for the technical conduct of its handling of the product depending on the mix of elements (product and the volume of demand, Price, promotion and distribution), but inverse manner designed to adjust the working condition of balance between supply and demand and to ensure that rates continue in the marketing process properly, and therefore the research aims to shed light on some of the practices that reflect the Demarketing techniques, As well as the statement of the reality of attitudes towards the practice of those techniques through a sample survey of officials in Baghdad company for so
... Show MoreAbstract:
The research aimed to know favoured mass media for children and
modifying their behaviour ,the child became aquires the information from
mass media that he exposure them without any guidance , where upon the
quidance proqrammes becomes real danger whereas qet out their civil
style and converting to deadly poisons,and because of little study for this
supject the two researchers opined to perform astudy to know the favoured
mass media to the children and what are the mass media that modify their
behavior according to ther parent points of view ,after propring the research
measurement and the suilable statical methods it has shown that there are
mass media affect in children behavior ,they are st