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 study of history has begun to become increasingly important for those interested in the field of education in general, and physical education and sports sciences in particular. It is a recent study of the past and relying on it. Therefore, studying the history of sports for people with disabilities and their development is of great importance, as it is one of the means to measure the extent of development of societies and their culture in this field. Weightlifting is a sport for people with motor disabilities, and the way to play is for the contestant to lie on the bench (ping bar) and most often the legs are tied to the bench to ensure that the hip and legs do not contribute to the lifting process with the arms, when the player grabs t
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Abstract
The aim of this research is to concentrate on the of knowledge management activities, initial activities: (Acquisition, Selection, Generation, Assimilation, Emission) knowledge, and support activities: (Measurement, Control, Coordination, Leadership) that is manipulate and controlling in achieving knowledge management cases in organization, that’s is leads to knowledge chain model, then determining the level of membership for these activities to knowledge chain model in a sample of Iraqi organization pushed by knowledge (Universities). The research depends on check list for gaining the data required, theses check list designed by apparently in diagnosing research dimensions and measurem
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his project try to explain the using ability of spatial techniques for land cover change detection on regional level with the time parameter and did select for explain these abilities study case (Hewaizah marsh ) . this area apply to many big changes with the time. These changes made action on characters and behaviors of this area as well as all activities in it . This Project concerting to recognize the Using importance of remote sensing and GIS Methodology in data collecting for the changes of land use and the methodology for the analyses and getting the results for the next using as a base data for development and drawing the plans as well as in regional planning .This project focus on practical
... Show MoreThe first flow injection spectrophotometric method is characterized by its speed and sensitivity which have been developed for the determination of promethazine-HCl in pure and pharmaceutical preparation. It is based on the in situ detection of colored cationic radicals formed via oxidation of the drug with sodium persulphate to pinkish-red species and the same species was determined by using homemade Ayah 3SX3-3D solar flow injection photometer. Optimum conditions were obtained by using the high intensive green light emitted diode as a source. Linear dynamic range for the absorbance versus promethazine-HCl concentration was 0-7 mmol.L-1, with the correlation coefficient (r) was 0.9904 while the percentage linearity (r2%) was 98.09%. the L.
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Began the process of re-engineering processes in the private sector as a way to assist organizations in re-thinking how to run the business in order to improve production processes and reduce operational cost, to get to compete on a global level. That was a major restructuring by further evolution in the use of technology to support innovative operations.
Entered the technology in all areas of life and different regulations, This led to use as a change in all aspects The companies achieved success and progress today through the use of resources so as to ensure the wishes of the customers and their needs, and the requirements of the market primarily, Which is reflected on the basis of building strate
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The physical substance at high energy level with specific circumstances; tend to behave harsh and complicated, meanwhile, sustaining equilibrium or non-equilibrium thermodynamic of the system. Measurement of the temperature by ordinary techniques in these cases is not applicable at all. Likewise, there is a need to apply mathematical models in numerous critical applications to measure the temperature accurately at an atomic level of the matter. Those mathematical models follow statistical rules with different distribution approaches of quantities energy of the system. However, these approaches have functional effects at microscopic and macroscopic levels of that system. Therefore, this research study represents an innovative of a wi
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With the increasing use of antibiotics around the world, the study and appreciation of antibiotics has become essential. An antibiotic formulation may include one or added active ingredients depending on the type and method of manufacturing the antibiotic. Antibiotics can only combat diseases of bacterial origin. As for viral diseases such as the common cold and influenza, antibiotics will not be able to combat them. The objective of this review is to digest the literature related to estimation of antibiotics and to show the methods that have been used in the estimation of the antibiotics (amoxicillin, ampicillin, cephalothin, carbenicillin, and cefotaxime) in medicinal preparations and a biological fluid for example blood
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In this study, we design narrow band pass filter for window (3_5) ?m dependent on the needle optimization method , and a comparison with global designs published -Also, the effect of change parameter design on the optical performance of filter was studded and being able to overcome the difficulties of the design.In this study, the adoption of homogeneous optical properties materials as thin film depositing on a substrate of germanium at wavelength design (? = 4 ?m). For design this kind of filters we used advanced computer program (Matlab )to build a model design dependent both matrix characteristic and Needle technique. In this paper we refer to the type of Mert function , which is used for correct optical performance acces
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