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 aim of the research is to: Analyzing the content of the mathematics textbook of the 5th bio-scientific grade according to the Common Core State Standard for mathematics (CCSSM), and to identify the extent of their inclusion of these standards. To achieve this goal, the researcher built the CCSSM after reviewing the literature that dealt with those standards, and its validity was verified by presenting it to a group of referees specialized in the field of methods of teaching mathematics. Thus, the criteria in their final form consisted of six main criteria which are:(numbers and quantities, algebra, conjugations, modeling, geometry, statistics and probability) and included (47) sub-indicators, Then the researcher analyzed the content of
... Show MoreSovereign wealth funds have attracted the attention of the governments of the oil and non-oil countries alike, with a variation of the size of those funds to those states, based on the size of the financial surpluses resulting from Alriadat oil or foreign reserves, or state revenues for other sovereign assets. Raj use these funds remarkably during the financial crises the world has seen, including the crisis of 2008-2007., And Iraq is a oil-producing countries, which has the third largest reserves of crude oil (Crude Oil) at the level of the Arab world and of 140 300)) million barrels after Saudi Saudi Arabia and the Islamic Republic of Iran, and the fourth reserves of crude oil in the world after issued Venezuela to the reserve
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... Show MoreThe present work aimed to study the efficiency of nanofiltration (NF) and reverseosmosis (RO) process for water recovery from electroplating wastewater and study the factors affecting the performance of two membrane processes. Nanofiltration and reverse osmosismembranes are made from polyamide as spiral wound module. The inorganic materials ZnCl 2 CuCl2 .2H2O, NiCl.2.6H2O and CrCl3.6H2O were used as feed solutions. The operating parametersstudied were: operating time, feed concentrations for heavy metal ions, operating pressure, feed flow rate, feed temperature and feed pH. The experimental results showed, the permeateconcentration increased and water flux decreased with increase in time from 0 to 70 min. Thepermeate concentrations incre
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