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.
In this paper, we propose a method using continuous wavelets to study the multivariate fractional Brownian motion through the deviations of the transformed random process to find an efficient estimate of Hurst exponent using eigenvalue regression of the covariance matrix. The results of simulations experiments shown that the performance of the proposed estimator was efficient in bias but the variance get increase as signal change from short to long memory the MASE increase relatively. The estimation process was made by calculating the eigenvalues for the variance-covariance matrix of Meyer’s continuous wavelet details coefficients.
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In this paper, the exact solutions of the Schlömilch’s integral equation and its linear and non-linear generalized formulas with application are solved by using two efficient iterative methods. The Schlömilch’s integral equations have many applications in atmospheric, terrestrial physics and ionospheric problems. They describe the density profile of electrons from the ionospheric for awry occurrence of the quasi-transverse approximations. The paper aims to discuss these issues.
First, the authors apply a regularization meth
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The Costing Accounting is one the analytic tools which plays important role by support the management in planning& control and decisions-making ,as it became attendant necessity to establish any project whether industrial ,commercial ,service or agriculture ..etc.
The consolidated accounting system has committed the companies to have their active costing system in which the management can obtain their own data, but we found most of the economic units face problems of applying the costing system because of reasons related to the system design itself or might be related to the requirements of the application success.
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The development of wireless sensor networks (WSNs) in the underwater environment leads to underwater WSN (UWSN). It has severe impact over the research field due to its extensive and real-time applications. However effective execution of underwater WSNs undergoes several problems. The main concern in the UWSN is sensor nodes’ energy depletion issue. Energy saving and maintaining quality of service (QoS) becomes highly essential for UWASN because of necessity of QoS application and confined sensor nodes (SNs). To overcome this problem, numerous prevailing methods like adaptive data forwarding techniques, QoS-based congestion control approaches, and various methods have been devised with maximum throughput and minimum network lifesp
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Desalination is a process where fresh water produces from high salinity solutions, many ways used for this purpose and one of the most important processes is membrane distillation (MD). Direct contact membrane distillation (DCMD) can be considered as the most prominent type from MD types according to ease of design and modus operandi. This work studies the efficiency of using DCMD operation for desalination brine with different concentration (1.75, 3.5, 5 wt. % NaCl). Frame and plate cell was used with flat sheet PTFE hydrophobic type membrane. The study proves that MD is an effective process for desalination brines with feed temperature less than 60˚C especially for feed with low TDS. 37˚C, 47˚C, and 57˚C was feed t
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This study deals with The Millstone (1965) which is a dramatic depiction of a single
mother heroine in a classic predicament. This novel is considered as representative of the age
in which it was written. The primary theme is her intense preoccupation with questions of
fatalism and will. The work also involves, both explicitly and implicitly, feminist concerns.
Because the central protagonist is a woman and the society in which she lives is depicted,
accurately, as deeply patriarchal and class-bound, the problem of the individual's capacity for
self-determination is inevitably tied to the feminist perspective.
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