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.
The purpose of this study is to assess the performance of government units (Iraqi hospitals) by trying to determine the possibility of the current governmental accounting system to provide information on the performance reports of government units. In order to improve the efficiency of hospital resources management, the services provided by the hospital should be subject to performance measurement and evaluation The importance of the health sector in the provision of services, in order to raise the efficiency of the performance of services provided by government units has reached the researcher a set of conclusions, the most important
- The financial reports produced by the accounting s
The research shows the importance of orientation towards the formulation of the green strategy and its effect in determining the behavior of the green municipal institution in Babel governorate. The research highlighted the formulation of the green strategy as an important variable, especially today, the trend towards protecting the environment and minimizing the damage resulting from the delivery of services, and through it also the type of green behavior or performance adopted by the municipal institution and the emergence of the need for a strategy that is not harmful to the environment. The research took the sample intentionally comprehensive size of 222 personnel of municipal institutions and some formations concerned with t
... Show MoreThe current research aims to evaluate the level of inclusive leadership within the General Secretariat for the Council of Ministers, and its role in achieving integration in work through the need to improve relationships between different administrative levels, facilitate participation, expression of opinions, and belonging to the organization. In order to achieve the research objective, the descriptive analytical statistical method was chosen using the SPSS V.25 programs, with various statistical methods and measures, including mean, standard deviation, variance coefficient, relative importance, and simple regression, through a questionnaire tool for data collection. The research community included the leadership in the sample of resear
... Show MoreThis work aimed to produce PVA and PVA/Ag nanofibers ultra-high sensitivity photodetector by electrospinning. The electrospinning process was used to successfully prepare PVA nanofibers and a PVA-Ag nanofiber composite. FE-SEM, XRD, UV, I-V characterizations are used to study the morphological, structural, optical, and electrical properties of the material. In contrast, the PVA-Ag nanofiber composite film displayed a cubic structure with favored orientation (200) that indicated the presence of Ag NPs in the PVA-Ag nanofibers film. While the optical energy gap for PVA was 3.96 eV, it was only 2.14 eV for PVA-Ag nanofibers composite film, making this composite sensitive to visible light, particularly green light at 550 nm with a 65% photosens
... Show MoreNative speakers of English from different parts of the world have different accents,but the differences of accents are mainly the result of differences in the sound of vowels and consonants . The actual use of all these sounds in combination leads the speaker to produce a number of segments which only appear on the production level and realized on the perceptual one . RP pronunciation represents the teachable variety in all Iraqi universities because it is the most acceptable and understandable accent all over the world and not only in South East London ..The structure of the English syllable in RP pronunciation is influenced by the appearance of certain allophones especially aspiration and glottalization which ch
... Show MoreThe main objective of resources management is to supply and support the site operation with necessary resources in a way to achieve the required timing in handing over the work as well as to achieve the cost-realism within the budget estimated. The research aims to know the advantage of using GIS in management of resources as one of the new tools that keep pace with the evolution in various countries around the world also collect the vast amount of spatial data resources in one environment easily to handled and accessed quickly and this help to make the right decision regarding management of resources in various construction projects. The process of using GIS in the management and identification of resources is of extreme importance in t
... Show MoreThis study attempts to test the possibility of developing organizational performance in Zain Telecom by adapting the philosophy and concept of Organizational Identification and its dimensions, the most important of which are (Organizational Identification, organizational loyalty, organizational affiliation).To achieve the goal, the research relied on the questionnaire method, which is one of the methods of collecting information in field studies.
Massive multiple-input multiple-output (MaMi) systems have attracted much research attention during the last few years. This is because MaMi systems are able to achieve a remarkable improvement in data rate and thus meet the immensely ongoing traffic demands required by the future wireless networks. To date, the downlink training sequence (DTS) for the frequency division duplex (FDD) MaMi communications systems have been designed based on the idealistic assumption of white noise environments. However, it is essential and more practical to consider the colored noise environments when designing an efficient DTS for channel estimation. To this end, this paper proposes a new DTS design by exploring the joint use of spatial channel and n
... Show More