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.
In The Bluest Eye (1970) , Toni Morrison addresses a timeless problem of white racial dominance in the United States and points to the impact it has on the life of black females growing up in the 1930's. Morrison in this novel 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 standards of white beauty are imposed on black youth to cause a damage of one's self-love and esteem which usually occurs when beauty goes unrecognized
The aim of the current research is to find out the extent to which algebraic thinking skills are included in the mathematics textbook for the third intermediate grade for the academic year (2020-2021) by answering the main research question:What algebraic thinking skills are included in the mathematics textbook for middle third grade?The descriptive and analytical approach was used, and to achieve the goal of the research, a list of the main algebraic thinking skills and the sub-skills were prepared, and after analyzing the content of the mathematics textbook, the stability of the analysis was verified through the analysis over time and across individuals using the Holsti equation, and
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