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.
Existing leachate models over–or underestimates leachate generation by up to three orders of magnitude. Practical experiments show that channeled flow in waste leads to rapid discharge of large leachate volumes and heterogeneous moisture distribution. In order to more accurately predict leachate generation, leachate models must be improved. To predict moisture movement through waste, the two–domain PREFLO, are tested. Experimental waste and leachate flow values are compared with model predictions. When calibrated with experimental parameters, the PREFLO provides estimates of breakthrough time. In the short term, field capacity has to be reduced to 0.12 and effective storage and hydraulic conductivity of the waste must be increased to
... Show MoreThe effect of cognitive trips via the Internet (web quest) accompanying practical lessons in learning some basic handball skills for female students
This paper is submitted as anew approach to simulate manufacturing control & planning system to define the problem of designing control system on the needs for materials.
Production planning & control is a total and complex operation, resides in the essence of manufacturing companies operations. The successful process of production planning and control systems is critical for the staying of manufacturing organizations in markets leading to the increasing consumer competition and which dominate most of manufacturing sectors because of the market oriented economy , thus , what has happened previously , that the companies possessed a great inventory of crude material, components, and groupings and they use in flexible techni
... Show MoreModern trends have appeared recently in educational thought that call for the achievement of the outcomes of the educational process. Some of these trends are the development of individual thinking skills, considering the individual differences, and learning basic skills. The five-year learning cycle is one of these models. It is called as five-year learning cycle because it passes through five stages. These five stages are: (operate - discover - clarify - expand – Evaluate), which make the learner as the main axis for activating thinking processes. This can be done by organizing study materials through research, investigation, and identifying concepts by himself, as in learning sports skills that depend on motor performance and teamwork,
... Show MoreThis research a study model of linear regression problem of autocorrelation of random error is spread when a normal distribution as used in linear regression analysis for relationship between variables and through this relationship can predict the value of a variable with the values of other variables, and was comparing methods (method of least squares, method of the average un-weighted, Thiel method and Laplace method) using the mean square error (MSE) boxes and simulation and the study included fore sizes of samples (15, 30, 60, 100). The results showed that the least-squares method is best, applying the fore methods of buckwheat production data and the cultivated area of the provinces of Iraq for years (2010), (2011), (2012),
... Show MoreArgumentation is not a contemporary, yet a deep rooted intellectual phenomenon dates back to Romans and Greeks times. The argumentative elements ,the author is trying to convey to the reader, are linguistic procedures aim at persuading and being persuaded of what is true. The present study traces, through Camus’ novel The plague, the best method to construct argumentative techniques used to express the author’s deep philosophies.
Résumé
L’argumentation n’est pas un phénomène intellectuel nouveau, ses origines reviennent aux savants grecs et romains. Elle est une act
... Show MoreHospitals are part of the service organizations and most importantly at the level of individuals because they are tied to the people health and their daily lives , the nursing service is one of the important services provided by hospitals, and nurses are the human resource that offers this service, from this standpoint the idea of research came to prepare work Scheduling for nurses in a scientific way to improve performance operational for their services and provide efficient service available 24 hours a day, the research use one of the modern and scientific rules of scheduling its “schedule of
... Show MoreAttention increased to the topic of academic accreditation by the university as a modern philosophy by which to improve its performance and provide high-quality education. Universities and colleges in general and Iraqi universities and colleges in particular have begun interest in accreditation and desire to get it. So starting from the pursuit of the Administration and Economics College / Baghdad University in obtaining accreditation of Association to Advance Collegiate Schools of Business (AACSB) The research is present which aims to determine the level of application (AACSB) International standards at the College of Administration and Economics / Baghdad University in preparation to get its accreditation in the future. Researc
... Show MoreThe information revolution، the new language has become one for all the peoples of the world through handling and exchange and to participate in all key areas (economic، cultural and scientific) and Accounting episode of this revolution has turned most of the traditional systems (manual) in companies to automated systems، this transformation in the regulations summoned from the auditors that develops their traditional examination automated systems so had to provide tools for auditing help auditors to keep abreast of developments and as a result there is no evidence checksum Local Private audited automated systems came search to provide evidence helps auditors for guidance as part of COBIT، which provides audit procedures Detailed inf
... Show MoreThis study was conducted at the Poultry Research Station, Animal Resources Research Department at the Agricultural Research Department / Ministry of Agriculture - Baghdad Abu Ghraib. To find the effect of adding different proportions of Bay Laurus powder on productive performance and some physiological characteristics of birds during the production stage as Eight Hundreds Female birds of quail were used at the age of 45 days, randomly deployed to 4 treatments with two replicates (100 birds / replicate ) each, and the bay laurel powder was added in the proportions 0.0, 0.5, 1.0, and 1.5% to the diets and for a period of 60 days divided into 4 periods of 15-day .The results indicated si