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.
We propose a new method for detecting the abnormality in cerebral tissues present within Magnetic Resonance Images (MRI). Present classifier is comprised of cerebral tissue extraction, image division into angular and distance span vectors, acquirement of four features for each portion and classification to ascertain the abnormality location. The threshold value and region of interest are discerned using operator input and Otsu algorithm. Novel brain slices image division is introduced via angular and distance span vectors of sizes 24˚ with 15 pixels. Rotation invariance of the angular span vector is determined. An automatic image categorization into normal and abnormal brain tissues is performed using Support Vector Machine (SVM). St
... Show MorePublic private partnership PPP is a method to procure public projects in order to achieve additional value for money in terms of efficiency and quality of services. This thesis studies the concepts of PPP, advantages and disadvantages of PPP. In addition, current Iraq infrastructure projects situations and needs, as well as, some aspects relating to the Iraq’s construction market, legal and contract systems were discussed. A financial model was carried out and applied to a real-life case study project. Finally, a survey targeted researchers; public and private- sectors were applied.
We define L-contraction mapping in the setting of D-metric spaces analogous to L-contraction mappings [1] in complete metric spaces. Also, give a definition for general D- matric spaces.And then prove the existence of fixed point for more general class of mappings in generalized D-metric spaces.
In The Bluest Eye (1970), the American-African writer, Toni Morrison explores how
Western standards of ideal beauty are created and propagated with and among the black
community. The novel not only portrays the lives of those whose dark skinned and Negroid
features blight their lives; it also shows how the standard of white beauty, when imposed on
black youth, can drastically damage one’s self-love and esteem which usually occurs when
beauty goes unrecognized. Morrison in this novel focuses on the damage that the black
women characters suffer through the construction of femininity in a racialised society where
whiteness is used as a standard of beauty.
Sub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static tim
... Show MoreThis paper introduces a non-conventional approach with multi-dimensional random sampling to solve a cocaine abuse model with statistical probability. The mean Latin hypercube finite difference (MLHFD) method is proposed for the first time via hybrid integration of the classical numerical finite difference (FD) formula with Latin hypercube sampling (LHS) technique to create a random distribution for the model parameters which are dependent on time t . The LHS technique gives advantage to MLHFD method to produce fast variation of the parameters’ values via number of multidimensional simulations (100, 1000 and 5000). The generated Latin hypercube sample which is random or non-deterministic in nature is further integrated with the FD method t
... Show MoreElectrical Discharge Machining (EDM) is a non-traditional cutting technique for metals removing which is relied upon the basic fact that negligible tool force is produced during the machining process. Also, electrical discharge machining is used in manufacturing very hard materials that are electrically conductive. Regarding the electrical discharge machining procedure, the most significant factor of the cutting parameter is the surface roughness (Ra). Conventional try and error method is time consuming as well as high cost. The purpose of the present research is to develop a mathematical model using response graph modeling (RGM). The impact of various parameters such as (current, pulsation on time and pulsation off time) are studied on
... Show MoreThis research aims to suggest formulas to estimate carry-over effects with two-period change-over design, and then, all other effects in the analysis of variance of this design, and find the efficiency of the two-period change-over design relative to another design (say, completely randomized design).
In this article, the partially ordered relation is constructed in geodesic spaces by betweeness property, A monotone sequence is generated in the domain of monotone inward mapping, a monotone inward contraction mapping is a monotone Caristi inward mapping is proved, the general fixed points for such mapping is discussed and A mutlivalued version of these results is also introduced.