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 Audit evedances represent the reconciliation tools between the Financial data shown on financial statements, and the level of satisfaction level of the Auditor about these statements. According that, the Auditor try to achieve the highest quantity of These evidances, and the most satisfactive of it…, but that will be so hard sometimes, when the internal controlling system is not good, and when the Auditor had some satisfied evidences, but not sharp… So, this research comes to inspect the relation between the quantity, and the level of satisfaction, and argument to prove that evidences gives. This research assumes that getting enough evidences leads to reduce faults, improves the auditing operation, and avoids risks. The research
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The present study investigates the characterization of silver nanoparticles (AgNPs) synthesized using Fusarium solani and their impact on tomato seed germination, plant growth, and disease resistance. A visible color change from yellow to dark smoky indicated the formation of AgNPs, while UV-visible spectrophotometry revealed an absorbance peak at 437 nm, confirming their presence. Atomic force microscopy analysis showed that the AgNPs ranged from 0 to 39.27 nm in size, with an average height of 5.772 nm, while scanning electron microscopy highlighted their diverse surface morphology. The application of AgNPs and mycorrhizal fungi significantly improved tomato seed germination rates, plant height, and dry weight compared to untreate
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Aceclofenac (AC) is an orally active phenyl acetic acid derivative, non-steroidal anti-inflammatory drug with exceptional anti-inflammatory, analgesic and antipyretic properties. It has low aqueous solubility, leading to slow dissolution, low permeability and inadequate bioavailability. The aim of the current study was to prepare and characterize AC-NS-based gel to enhance the dissolution rate and then percutaneous permeability. NS.s were prepared using solvent/antisovent precipitation method at different drug to polymer ratios (1:1, 1:2, and 1:3) using different polymers such as poly vinyl pyrrolidone (PVP-K25), hydroxy propyl methyl cellulose (HPMC-E5) and poloxamer® (388) as stabilizer
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The study aims to select suitable ornamental plant species that can survive relatively with high concentrations of acetaminophen and methylparaben in constructed wetlands. Alternanthera spp, Asparagus aethiopicus and Chlorophytum comosum are examined to withstand three initial concentrations, 20, 100 and 200 mg/L of acetaminophen and methylparaben. A total of 21 plastic pails with each 3 L capacity consisting of nine pails are used for each pharmaceutical and personal care products (PPCPs) compounds (acetaminophen and methylparaben) for three ornamental plants (Alternanthera spp, Asparagus aethiopicus and Chlorophytum comosum), with three pails as plant controls. The results reveales
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Let be an infinite dimensional separable complex Hilbert space and let , where is the Banach algebra of all bounded linear operators on . In this paper we prove the following results. If is a operator, then 1. is a hypercyclic operator if and only if D and for every hyperinvariant subspace of . 2. If is a pure, then is a countably hypercyclic operator if and only if and for every hyperinvariant subspace of . 3. has a bounded set with dense orbit if and only if for every hyperinvariant subspace of , .
Blogging is about more than just putting thoughts on a web; it's about connecting with and hearing from anyone who read the work. Many web sites now days help to get a free account to quick post thoughts and photos interact with people, and more. The fastest way to understand blogging is to try it out, but in that case securing the blog is important, by including authentication schemes. In this paper we suggest implications of our research for improving the design and usefulness of blogging systems, and also we divided the blogs depending on the subject and need, which are either to be used in public or only used by small group, so we can suggest different steps for securing the blogs.