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.
Do’a and Zikr al-Mā’thur (authentic supplications and remembrance of ALLAH ‘Azza wa Jalla) can be suggested to Muslims to help them deal with challenges or issues in life. Counselling cases affect a person’s feelings. Do’a and Zikr al-Mā’thur are often applied as a counselling intervention. Unfortunately, the authentic Do’a and Zikr al-Mā’thur are dispersed in many resources not visible to users, and the fact that not all online resources offer access to accurate Do’a and Zikr al-Mā’thur to users and the dubious Do’a and Zikr al-Mā’thur frequently credited to the Prophet (pbuh). The goal of this research is to develop an ontology
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The development of Web 2.0 has improved people's ability to share their opinions. These opinions serve as an important piece of knowledge for other reviewers. To figure out what the opinions is all about, an automatic system of analysis is needed. Aspect-based sentiment analysis is the most important research topic conducted to extract reviewers-opinions about certain attribute, for instance opinion-target (aspect). In aspect-based tasks, the identification of the implicit aspect such as aspects implicitly implied in a review, is the most challenging task to accomplish. However, this paper strives to identify the implicit aspects based on hierarchical algorithm incorporated with common-sense knowledge by means of dimensionality reduction.
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One of the important goals in the learning process is to be effective learning through the self-direction of the learner , because it has an impact on the effort of learners , it is better to be a learner responsible for learning and independent of the acquisition of knowledge ,
اذ اكدتكثيرAs many have confirmed منFrom الدراساتStudies والادبياتAnd literature انthat فشلالكثير The failure of many منFrom الطلبةStudents فيin a تنظيمgroup المعلوماتthe information ومعالجتهاAnd processed اثناءduring عمليةProcess تعلمهمLearn them لاNo يرجعReturns الىto me انخفاضdrop فيin a درجةDegree ذكائهمTheir intelligence اوor عدمNo
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DBN Rashid, Asian Quarterly: An International Journal of Contemporary Issue, 2018
Due to the importance of nanotechnology because of its features and applications in various fields, it has become the focus of attention of the world and researchers. In this study, the concept of nanotechnology and nanomaterials was identified, the most important methods of preparing them, as well as the preparation techniques and the most important devices used in their characterization.
This study Ajert to modify the chemical composition of milk fat cows and make it similar to the installation of milk fat mother through the addition of protein and soybean oil to be given Alkhltatnsp sensory protein that the best plan is the ratio of 1:1