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.
This study aims to identify the teaching problems that teachers of students with intellectual disabilities face, in addition to exploring the solutions suggested by them in order to overcome such problems or challenges. The researchers used a qualitative approach in order to understand the teachers' perceptions about these problems in a more in-depth way. The interview tools (in-depth and semi-structured interviews) were used to collect data from (3) female teachers from special education programs in the Asir region. The results revealed a number of themes including problems related to students, teachers and the teaching methods they use, curricula, school environment, and school administration. Moreover, the results indicated that famil
... Show MoreThis research is qualitative in nature. It aims to investigate descriptively, analytically, and comparatively the modern AK model represented by the Sudan Open University Series, and the European framework, the common reference for Teaching Foreign Languages, to uncover what was achieved in them in terms of communication and language use. Accordingly, an integrated, multi-media approach has been adopted to enable the production and reception activities, and the spread of Arabic in vast areas of the world. Such a spread helps Arabic language to be in a hegemonic position with the other living languages. The study is based on getting benefit from human experiences and joint work in the field of teaching Arabic to non-Arabic speakers to mee
... Show MoreAbstract:
The tax is one of the elements of the general revenues of the state and contributes to covering its expenses. Taxes are imposed in most countries of the world. The tax proceeds depend on a set of factors that contribute either positively or negatively to the tax share by increasing or decreasing it. Therefore, the research aims to demonstrate the role of the tax examiner's procedures in achieving the validity of the taxable base and its reflection on the tax proceeds, as well as reviewing the tax examiner's procedures related to the tax return process. Examination and tax audit of the financial statements, as well as presenting the financial statements to an independent and i
... Show MoreThe mass collision energy loss (dE/dX), the mass radiative energy loss (Srad/) and the total mass stopping power of electrons in the energy range of 0.01 MeV up to 1000 MeV has been calculated for Lung, Urea and Skin. The results of the present work for the mass collision stopping power of electrons in Lung, Urea and Skin are in excellent agreement with the standard results given by ESTAR program, where the maximum percentage error between the present calculated values and that of ESTAR program in Lung tissue, Urea and Skin tissue is 0.27%, 0.3% and 0.8% respectively. The mass radiative energy loss of electrons in the same energy range is also calculated using a modified equation, and the results are found to be in very good agreem
... Show MoreThe current research aims to determine the necessary linguistic competencies for Arabic language teachers of the preparatory stage (fourth grade preparatory), which were five main competencies: Arabic grammar competencies, literary competencies, cultural competencies, rhetorical competencies, and expression competencies. To achieve the objective of the research, the researcher developed a questionnaire as the main tool for collecting data based on literature, it consists of (28) items including the five main competencies. The questionnaire was administered to (60) male and female teachers at Al-Karkh's first Education Directorate in the city of Baghdad. The findings of the research indicated that Arabic language proficiency got the highe
... Show MoreExponential distribution is one of most common distributions in studies and scientific researches with wide application in the fields of reliability, engineering and in analyzing survival function therefore the researcher has carried on extended studies in the characteristics of this distribution.
In this research, estimation of survival function for truncated exponential distribution in the maximum likelihood methods and Bayes first and second method, least square method and Jackknife dependent in the first place on the maximum likelihood method, then on Bayes first method then comparing then using simulation, thus to accomplish this task, different size samples have been adopted by the searcher us
... Show MoreThe construction sector consumes large amounts of energy during the lifetime of a building. This consumption starts with manufacturing and transferring building materials to the sites and demolishing this building after a long time of occupying it. The topic of energy conservation and finding the solution inside the building spaces become an important and urgent necessity. It is known that the roof is exposed to a high amount of thermal loads compared to other elements in a building envelope, so this needs some solutions and treatments to control the flow of the heat through them. These solutions and treatments may be achieved by using nanomaterials. Recently, nanomaterials have high properties, so that this made them go
... Show MoreEarth dams are constructed mainly from soil. A homogenous earth dam is composed of only one material. The seepage through such dams is quite high. Upstream impervious blanket is one of the methods used to control seepage through the dam foundations. Bennet's method is one of the commonly used methods to design an impervious upstream blanket. Design charts are developed relating the length of blanket, total reservoir head, total base width of the dam (excluding downstream drainage), the coefficient of permeability of the blanket material, blanket thickness, foundation thickness, and coefficient of permeability of the foundation soil, based on the equations governing the Bennet's method for a homogenous earth dam with a blanket of uniform
... Show More