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.
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In the geotechnical and terramechanical engineering applications, precise understandings are yet to be established on the off-road structures interacting with complex soil profiles. Several theoretical and experimental approaches have been used to measure the ultimate bearing capacity of the layered soil, but with a significant level of differences depending on the failure mechanisms assumed. Furthermore, local displacement fields in layered soils are not yet studied well. Here, the bearing capacity of a dense sand layer overlying loose sand beneath a rigid beam is studied under the plain-strain condition. The study employs using digital particle image velocimetry (DPIV) and finite element method (FEM) simulations. In the FEM, an experiment
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In this paper the concept of (m, n)- fully stable Banach Algebra-module relative to ideal (F − (m, n) − S − B − A-module relative to ideal) is introducing, we study some properties of F − (m, n) − S − B − A-module relative to ideal and another characterization is given
Research on the automated extraction of essential data from an electrocardiography (ECG) recording has been a significant topic for a long time. The main focus of digital processing processes is to measure fiducial points that determine the beginning and end of the P, QRS, and T waves based on their waveform properties. The presence of unavoidable noise during ECG data collection and inherent physiological differences among individuals make it challenging to accurately identify these reference points, resulting in suboptimal performance. This is done through several primary stages that rely on the idea of preliminary processing of the ECG electrical signal through a set of steps (preparing raw data and converting them into files tha
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This study investigates the possibility of removing ciprofloxacin (CIP) using three types of adsorbent based on green-prepared iron nanoparticles (Fe.NPs), copper nanoparticles (Cu. NPS), and silver nanoparticles (Ag. NPS) from synthesized aqueous solution. They were characterized using different analysis methods. According to the characterization findings, each prepared NPs has the shape of a sphere and with ranges in sizes from of 85, 47, and 32 nanometers and a surface area of 2.1913, 1.6562, and 1.2387 m2/g for Fe.NPs, Cu.NPs and Ag.NPs, respectively. The effects of various parameters such as pH, initial CIP concentration, temperature, NPs dosage, and time on CIP removal were investigated through batch experiments. The res
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This work investigates generating of pure phase Faujasite-type zeolite Y at the ranges chosen for this study via a static aging step in the absence of seeds synthesis. Nano-sized crystals may result when LUDOX AS-40 is used as a silica source for gel composition of range 6 and the crystallization step may be conducted for a period of 4 to 19 hr at 100 ⁰C. Moreover, large-crystals with high crystallinity pure phase Y zeolite can be obtained at hereinabove conditions but when hydrous sodium metasilicate is used as a silica source. The other selected ranges also offer pure phase Y zeolite at the same controlled conditions.
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Zusammenfassung: Das Drama " Minna von Barnhelm von Lessing ist ein weltbekannts Drama, das in verschiedene Sprachen übersetzt wurde. Es beschreibt die Schwierigkeiten eines Offiziers, der bestraft wurde. Er verlor seinen Job und auch seine Ehre. Minna ist seine Verlobte, die ihn suchte und auch neben ihm stehen wollte. Trotzdem sie ihm in einem Hotel zufällig begegnete, hatten die beide immer noch Probleme. Am Ende des Dramas könnten sie alle ihrer Probleme lösen und hatten schönes Ende.
Abstract:
Mina von Barnhelm is a German play written by the author ( Lessing ) , it's a well-known comedy play that was translated into many languages including Arabic language .
This play is about a
Extracorporeal Shock Wave Lithotripsy (ESWL) is the most commonplace remedy for kidney stone. Shock waves from outside the body frame are centered at a kidney stone inflicting the stone to fragment. The success of the (ESWL) treatment is based on some variables such as age, sex, stone quantity stone period and so on. Thus, the prediction the success of remedy by this method is so important for professionals to make a decision to continue using (ESWL) or tousing another remedy technique. In this study, a prediction system for (ESWL) treatment by used three techniques of mixing classifiers, which is Product Rule (PR), Neural Network (NN) and the proposed classifier called Nested Combined Classi
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