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 research problem consisted in answering the question that revolves around whether there is a relationship to the settlement of salaries with the growth of bank deposits? The research also aimed to provide some initial solutions to improve the role of salary localization, in terms of reviewing the concept of electronic payment systems, its tools and channels, and then identifying the concept of salary localization, its importance, objectives and obstacles to its application, and then analyzing the reality of the state of the settlement of salaries and bank deposits for the research sample banks, which are each of the bank (Ashur International, Business Bay, the Iraqi Middle East for Investment, the Iraqi National, Development and the
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This research paper attempts to explore problems facing the teaching of written expression among first-year female university students. The focal point behind conducting this research is to show the importance that writing is taking as a skill in learning the language. To achieve this goal, the researcher prepared a questionnaire consisting of 20 items. The sample, whose size is 60 participants, was selected randomly from the department of Arabic, College of Education for Women, University of Baghdad. Through the use of a set of statistical means including weighting means and percentage, the findings revealed that the students face many difficulties in learning writing. The researcher suggested some recommendations, mainly improving the
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... Show MoreThis paper presents the Taguchi approach for optimization of hardness for shape memory alloy (Cu-Al-Ni) . The influence of powder metallurgy parameters on hardness has been investigated. Taguchi technique and ANOVA were used for analysis. Nine experimental runs based on Taguchi’s L9 orthogonal array were performed (OA),for two parameters was study (Pressure and sintering temperature) for three different levels (300 ,500 and 700) MPa ,(700 ,800 and 900)oC respectively . Main effect, signal-to-noise (S/N) ratio was study, and analysis of variance (ANOVA) using to investigate the micro-hardness characteristics of the shape memory alloy .after application the result of study shown the hei
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... Show MoreAny design subject to a set of forces contributing to the establishment of relations working to strengthen the internal elements of the design; any imbalance in these elements can make a fragmented and weak design, thus preventing it from achieving the goal or performance. Poor performance can be attributed to various factors: the extent and function of the elements and principles in the design, realization of the idea, especially in fashion design.
Moreover, there are many aspects of a design that go into achieving the realization of the designer’s idea. The design utilizes a lot of stimulants by drawing attention to its design, which is consistent with the need for psychological and material individuals. In this research, we will