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.
Long-term use of sulfonylureas including chlorpropamide, is known to potentiate the antidiuretic action of arginine vasopressin (AVP), predisposing to hyponatremia.The present study was designed to evaluate the effect of long term use of glibenclamide on serum and urinary levels of sodium and potassium in Type 2 DM patients in Iraqi DM centers. Ninety eight patients with Type 2 DM who were maintained on different doses of glibenclamide for at least 1 year, attending the centre for Diabetes and Endocrinology in Al-Rusafa, Baghdad, were enrolled in the study, in addition to 15 normal healthy subjects. Patients were allocated into three groups according to the dose of glibenc
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The love of the world and its lusts are the head of sins and the corruptors of religion, and the one who loves and loves them who prefers them over the hereafter is one of the most pitiful of creation, and the least intelligent of them, as he prefers imagination over reality, sleep over wakefulness, fleeting shadow over eternal bliss and the mortal abode over the eternal abode, and he sold the life of eternity for the most luxurious life. In life, it is dreams and sleep or as a fleeting shadow, and as it was said: The intelligent person is not deceived.
The reason for choosing this topic is due to two things:
The first: When I contemplated the reasons for the differences and conflicts that afflicted our wounded and occupied country
تعد المحاسبة بشكل عام علماً لكنها ليست من العلوم الصرفة وإنما من العلوم الإجتماعية مما يتطلب للتعامل مع المواضيع المحاسبية الأخذ بنظر الاعتبار الأشخاص المعنيين بالموضوع سواء كانوا المعدين للمخرجات المحاسبية أي المحاسبين، أو الاطراف ذوي المصالح المعنيين والمستفيدين من هذه المخرجات أي المستخدمين، ويعد المحاسب جزءاً من العملية الاجرائية نفسها وبهذا يكون دوره مزدوجاً يجمع بين كونه القائم بالبحث والقي
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She noted most of the results of research conducted on the use of computers and the Internet in the areas of administrative, economic, agricultural and educational to a significant improvement in learning outcomes of these groups in the development of mechanisms of action, has increased rates of computer use and applications in various spheres of life at very fast pace so that the computer and the Internet is a vital part of any activity, whether administrative or research or the media, hence it can be said that the use of computers and the Internet in the management of public relations activities in any organization can accelerate the pace of echo positive goals and purposes of public relations, this study comes to looking at us
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Rheumatoid arthritis is an autoimmune diseasecharacterized by chronic inflammationthat affects joints and cartilage. Bone complications such asRA-relatedosteoporosis are one of the most extra-articular manifestations. Many inflammatory mediators are released during RA disease pathophysiology; these mediators stimulate osteoclast genesis of bone by direct effects on RANKL and OPG. The study aimedto measure RANKL, OPG in RA patients treated with Etanercept only and other groups treated with Methotrexate onlyat baseline and after three months to evaluate bone state. An observational case-control prospective study was done on 30 RA patients who received MTX, 30 RA patients who received ETN, and 30 healthy,age-matched control groups. The
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(1)
The current study aims to investigate the effect of the interaction between the use of the improve strategy in teaching mathematics and the level of academic achievement on the acquisition of algebraic concepts and habits of mind among tenth-grade students in Oman. The study adopted the experimental method, based on a quasi-experimental design with two groups: experimental and control groups and pre-post-measurement. The study sample consisted of (28) 10th-grade students as an experimental group and 26 of 10th-grade students as a control group in Al-Tufail bin Amr School in South Al Batinah. The differences in the pretest and posttest gains were analyzed using mean, standard deviation, ANCOVA, t-test, effect size (eta-square), and two-wa
... Show MoreThis study was conducted to detect the relationship between organic content in the sediment of Rivers Tigris and Diyala, at two locations south of Baghdad, with some environmental factors and the benthic invertebrates and values of diversity indices. Monthly samples collected from the area for the period November 2007 to October 2008. Results showed differences in the physical and chemical characteristics of the two sites, Where the annual average in Tigris and Diyala were respectively for: water temperature (19, 20) C°, pH (8, 8), dissolved oxygen (4, 8) mg / l , Biochemical oxygen Demand BOD5 (3,44 ) mg/l, TDS (632,1585) mg / l, TSS (42, 44) mg / l, turbidity (28,74) NTU, and total hardness as CaCO3 (485,823) mg / l ,Sulfat
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the research was exposed to a study the importance of the role of the supportive entities in providing the useful information to the tax administration and their ability to extend the level of the tax base of taxpayers, through the improvement of the tax payers determination and their tax settle for the purpose of increasing the tax revenue, and shed light on the legal evidence through which these entities become officially assigned to perform a supplementary task to the General Committee for Taxes GCT, to help it to perform its task efficiently, and to study the reasons of the weak cooperation of the supportive entities and their reluctance to provide useful information which leads to limiting the tax base.
The research data hav
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The current research aimed to analyze the importance, correlation and the effect of independent variables represented by marketing variables on the dependent variable represented by local brand, through taking ENIEM as a model for this study, which represents a sensitive sector for the Algerian consumer. The results of the study evinced that the Algerian consumer has a positive image toward the brand ENIEM given marketing variables which has acquired considerable importance to this consumer. Also, the results of this study showed a statistically significant correlation between marketing variables and good perception toward the brand ENIEM, at the same time, the existence of a statistically significant effect for each of these variables o
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