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.
Some may think that the games, especially the folk games, are just a means of entertainment and fun and children may resort to them to alleviate the tension they are experiencing at home or school, but the truth is that they carry values and meanings that can be invested in education because they contribute to the development of the personality of the child and enhance self- confidence. The objective of the research is to learn how to use folk games to develop children's acting and performance skills in the kindergartens.
The research included a theoretical introduction of three sections: the first section: education through play. The second section: the folk tale and the development of imagination and the
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The purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to
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The objective of this study is to analyze the difficulties faced by intermediate-level Iraqi students in the use of Spanish unstressed pronouns as a foreign language (ELE). Through a mixed methodology, a descriptive and explanatory analysis was conducted based on written and oral productions of B1-level students at the University of Baghdad.The results show that factors such as interference from the native language (Arabic) and English, as well as grammatical differences between Spanish and Arabic, generate difficulties in the correct use of unstressed pronouns. A contrastive teaching approach is proposed that takes advantage of students' cognitive abilities to highlight similarities and differences between both languages.This stu
... Show MoreThis study was conducted to describe a protocol for the callus establishing culture of Lavandula angustifolia plant and estimating their content of volatile oil. The quantity of volatile oil callus tissues was compared with that of leaves production. Callus was induced from leaf explants on Murashige and Skoog medium (MS) supplemented with Naphthalene acetic acid (NAA) and Benzyl adenine (BA) in different concentrations. Maximum callus fresh weight was obtained in the combination of 10 mg/L BA and 3 mg/L NAA which reached 18 g after four weeks. The results of this work showed that the quantity of volatile oil from the highest fresh weight callus was 6 ml compared with quantity of 18g of leaves which gave 0.5 ml. Volatile o
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The treatment of migraine headache targets the neurovascular mechanism and involves the use of serotonin receptor antagonists. Some of these drugs are used for the treatment of acute attacks; while others are effective as prophylactic measures to decrease the duration and frequency of attacks. Pizotifen, a 5-HTA antagonist, is one of the prophylactic drugs for which the clinical use resulted in low outcomes in reducing migraine symptoms. Melatonin, a serotonin derived neurohormone, was reported to exert many functions like sleep induction, anti-inflammatory, neurovascular regulation, cytoprotection and modulation of neurotransmitter release. In the view of the involvement of serotonin in the pathophysiology of migraine a
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The research aims to identify ways of upgrading the quality level of university education at the Middle Technical University in light of its application for the National Ranking project for the quality of Iraqi universities in order to obtain advanced grades among the Iraqi universities , Which is qualified to enter the Ranking of universities worldwide, through displaying the mechanism of the Application of National Ranking project for the quality of Iraqi universities in the Middle Technical University and its formations consisting of (5) technical colleges and (11) technical institute.
The results of the application showed several observations: The most
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