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 current research aims to determine the requirements of Trends of International Mathematics and Science Study (TIMSS 2019) and to find out the extent to which the content of science textbooks for grades (1-4) in the Sultanate of Oman includes the requirements of (TIMSS 2019). Only the Cognitive Process dimension has been considered when conducting the analysis. The study population includes all science books from the first to the fourth grade for the academic year 2021-2022. The study identified and organized the requirements in the study tool, which is a list of requirements of (TIMSS 2019). After confirming its validity and reliability, the analysis was performed, and data were collected and analyzed statistically using frequencies
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Organizations adopt a number of procedures and instructions in their field of activities in order to aid their resources development and energies to serve their entrepreneurial orientations. This calls for preparing a range of mechanisms to mitigate the strictness and complexity of procedures. The ambiguity and severe complexity of procedures means acknowledging the loss in energy and this in turn impedes the hopes while in the same time weakens the enthusiasm in these organizations and an impedes the possibility to achieve continues innovation, thereby losing opportunities to the level of surrender to the risks and assuming them to be unconquered obstacles.
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Precision irrigation applications are used to optimize the use of water resources, by controlling plant water requirements through using different systems according to soil moisture and plant growth periods. In precision irrigation, different rates of irrigation water are applied to different places of the land in comparison with traditional irrigation methods. Thus the cost of irrigation water is reduced. As a result of the fact that precise irrigation can be used and applied in all irrigation systems, it spreads rapidly in all irrigation systems. The purpose of the Precision Agriculture Technology System (precision irrigation) , is to apply the required level of irrigation according to agricultural inputs to the specified location , by us
... Show MoreJava is a high-level , third generation programming language were introduced Javaoptics Open Source Physics (OSP) as a new simulation for design one of the most important interference optical coating called antireflection coating. It is recent developments in deign thin-film coatings. (OSP) shows multiple beam interferences from a parallel dielectric thin film and the evolution of reflection factors. It is simple to use and efficiently also can serve educational purposes. The obtained results have been compared with needle method
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This research aims to analyze and simulate biochemical real test data for uncovering the relationships among the tests, and how each of them impacts others. The data were acquired from Iraqi private biochemical laboratory. However, these data have many dimensions with a high rate of null values, and big patient numbers. Then, several experiments have been applied on these data beginning with unsupervised techniques such as hierarchical clustering, and k-means, but the results were not clear. Then the preprocessing step performed, to make the dataset analyzable by supervised techniques such as Linear Discriminant Analysis (LDA), Classification And Regression Tree (CART), Logistic Regression (LR), K-Nearest Neighbor (K-NN), Naïve Bays (NB
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