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 Wonderful Wizard of Oz and Peter and Wendy present universal ideas that exist in all times, despite being written in the beginning of the 20th century. Among the most significant ones is the concept of “home”. The article discusses the essentiality of the idea of “home” where the identity of an individual shapes, and where one’s spiritual, psychological, and physical being develop. It also studies the attitudes of each protagonist towards the concept of ‘home’ based on their understanding of it and according to their gender differences. The characters in both stories tread on the path of perplexity between leaving their homes and returning to them. Peter’s world is the world of imagination while Doro
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This research aims to determine the role of the quality of higher education in achieving organizational excellence at the universities of Baghdad and Al-Nahren, was based on research on the main hypothesis is:First:- There is correlation and between the quality of higher education dimensions (continuous improvement, measurement and analysis, the culture of the organization, optimal use of resources , customer satisfaction) and organizational excellence dimensions (strategic planning, focusing on the market and the customer, information and analysis, the effectiveness of operations, processes and resources), Second:- Second, there is the impact of relationship sig
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Social networking sites have become very popular since the beginning of the current decade and have become linked to our daily life. We follow the news, Analyses and opinions on the one issue in a way that attracts millions of users and the number grows every secon On Twitter, one of the most important social networking sites, all social groups rushed from the president to the last citizen to open accounts when they found themselves forced to do so . During the recent Gulf crisis, Twitter was buzzing with Twitter, which achieved the largest circulation globally. Instead of serving the issue and directing it to serve the Arab interest, most of the publications were on th |
(1)
The purpose of this study is to show the constants and variables geography in Russian
policy in light of variables geostrategic witnessed by the world, especially after the collapse
of the Soviet Union and the disintegration to fifteen Republic became the Russian Federation
and the heir to the Soviet Union, Geography particularly important because the impact of its
data in policy making less change ofothers, and explain the political choices cannot achieve
security through its relationship constants geographical (natural or human) paint forms of
economic activity and determine the points they national security. issue is the geographical
this or that country is determined by its policy also specifies the way in which
Objective: The aim of this study is to determine the means and the difficulties faced by students of
nursing maternal and child health nursing / College of Nursing / University of Baghdad in obtaining scientific
information in practical training.
Methodology: A purposive sample of (100) Nursing college student - Maternal and Child Health Nursing
Department were selected. Data were collected through the use of the questionnaire form during the
period from the November 2010 to April 2011. Descriptive statistical procedures were used to analyze the
data.
Results: The results showed that the highest percentage of members of the study sample aged between
(20-21 years), females are the most inhabitants of the city of Ba
The study area is witnessing divergence where I am North wind North East wind as we find that the north wind is getting replicated as we move from the south, The reason can be attributed to the nature of the surface of the region, with at least repeat this wind the northern region to the presence of mountain ranges, while we find that energizes the surface in the center and south helped to increase repeat this wind gusts, It also finds that the North wind East prevail in the northern region and least replicated as we move from the north to the south and to the fact that North stations are within blowing this wind sites for the circles near the display of high pressure located centers to the north-east, north and distancing itself from pa
... Show MoreThe trading banks in Iraq invest their funds according to regulations imposed by the Central Bank in Iraq in different financial fields like stock exchanges, acquire stocks as assets that could be sold at any time as well as make loans and contributing in corporations establishment also magnitude foreign capital through direct contacts with foreign exchange markets.
We can summarize the problem of this paper as shortage in mathematical models that used in studying and analyzing these investments and according to this problem we used (a constructed mathematical model ) consists of three major indicators: profitability of total investment assets which is divided into three sub-indicators: owners equity risk indicator, debits risk i
... Show MoreBackground: Radiologic evaluation of breast lesions is being achieved through several imaging modalities. Mammography has an established role in breast cancer screening and diagnosis. Still however, it shows some limitations particulary in dense breast.
Methods : Magnetic resonance imaging is an attractive tool for the diagnosis of breast tumors1 and the use of magnetic resonance imaging of the breast is rapidly increasing as this technique becomes more widely available.1 As an adjunct to mammography and ultrasound, MRI can be a valuable addition to the work-up of a breast abnormality. MRI has the advantages of providing a three-dimensional view of the breast, performing wit
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The research dealt with the topic ' the aesthetics of design shape of interior spaces for the syndicate of physicians' as it reflects visions evolving to the level of tasting and positive interpretation for the space of work to be on a high design level.The research consisting of four chapters as follow; The first chapter examined the problem of the research contracted in the following question: Have the design shapes any role in achieving and showing the aesthetic side for the syndicate of physicians? so the goal of the research was showing the aesthetics of design shape of interior spaces for the syndicate of physicians, The chapter also included the objective spatial and temporal limits of research .Finally the terms were specified. T
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