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 this study, the effect of fire flame on the punching shear strength of steel fiber reinforced concrete flat plates was experimentally investigated using nine half-scale specimens with dimensions of 1500×1500 mm and a total thickness of 100 mm. The main investigated variables comprised the steel fiber volume fraction 0, 1, and 1.5% and the burning steady state temperature 500 and 600 °C. The specimens were divided into three groups, each group consists of three specimens. The specimens in the first group were tested with no fire effect to be the reference specimens, while the others of the second and third groups were tested after being exposed to fire-flame effect. The adopted characteristics of the fire test were; (one hour) b
... Show MorePolynomial IIR digital filters play a crucial role in the process of image data compression. The main purpose of designing polynomial IIR digital filters of the integer parameters space and introduce efficient filters to compress image data using a singular value decomposition algorithm. The proposed work is designed to break down the complex topic into bite-sized pieces of image data compression through the lens of compression image data using Infinite Impulse Response Filters. The frequency response of the filters is measured using a real signal with an automated panoramic measuring system developed in the virtual instrument environment. The analysis of the output signal showed that there are no limit cycles with a maximum radius
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Most of the adverse drug reactions were related to skin and subcutaneous tissue disorders(26.7%), f
A series of laboratory model tests has been carried out to investigate the using of pomegranate sticks mat as reinforcement to increase the bearing capacity of footing on loose sand. The influence of depth and length of pomegranate sticks layer was examined. In the present research single layer of pomegranate sticks reinforcement was used to strengthen the loose sand stratum beneath the strip footing. The dimensions of the used foundation were 4*20 cm. The reinforcement layer has been embedded at depth 2, 4 and 8 cm under surcharge stresses . Reinforcing layer with length of 8 and 16 cm were used. The final model test results indicated that the inclusion of pomegranate sticks reinforcement is very effective in improvement the loading cap
... Show MoreThis study aims to identify the level of quality of Islamic banking services in the Kingdom of Saudi Arabia. It also investigates the importance of the various dimensions of the quality of banking services. The sample of the study included 69 clients of Al Rajhi Bank and Al-Bilad Bank. The study concluded that the overall level quality of services that Islamic banking offer is high. However, their relative importance varies from one dimension to another. The security, confidence and physical aspects are very high which this is a good point. On the other hand, the application aspects do not get the same importance. These aspects include the customer's wishes, helping them to improve the services offered to them,
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