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.
أن التطور العلمي الحاصل فيما يخص المجال الرياضي أرسى آفاق جديدة لمواكبة التطور الكبير في مجا ل الألعاب والفعاليات الرياضية المختلفة ,و أن تحقيق النتائج الجيدة في فعاليات العاب القوى بشكل عام والثلاثية بشكل خاص في التدريب الرياضي يتطلب إتباع الأساليب العلمية الدقيقة والموضوعية بشكل سليم ومخطط له،فضلا عنة تطبيق نظريات ومنحى جديد لمواكبة الاتجاهات الحديثة في تحقيق النتائج الجيدة للوصول إلى المستويات العالية
... Show MoreThe research aims to measure the impact of positive and negative fiscal policy shocks on monetary stability in Iraq, which represents monetary stability as an indicator of real and price stability. Fiscal policy shocks are quantitative changes in public spending and public revenue affecting the output and price cycle, and fiscal policy despite the accompanying time gaps, but it remains a policy Influential and has a significant degree of impact on economic growth and development in developing countries. The fiscal policy represents a numerical translation of the economic and social objectives planned in the state's general budget tool consistent with the GDP cycle. The economic and social goals stem from the core of the functions and the ma
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- There is an effect of
Background: Patient satisfaction is of increasing importance and widely recognized as an important indicator of quality of the medical care. There was no homogeneous definition of patient satisfaction, since satisfaction concerns different aspects of care or settings, as well as care given by various professions.
Objective: The objective of this study is to assess the patients’ level of satisfaction with diabetes care and to identify the underlying factors influencing it.
Methods: This cross-sectional study had been conducted in the Specialized Center for Diabetes and Endocrinology in Baghdad Al- Rusafa 2018. Where150 type two diabetic patients attending their follow-up
... Show MoreForm recurrence of financial crises phenomenon disturbing and attention , and returns the reasons so that its negative effects were sharp and dangerous , because of the nature and cause of Ncaha , threatened political and economic stability of the countries in which they occur these crises , in addition to Machmlh these crises spread of contagion across multiple channels to include other countries many developed and developing , and the reason for this to the openness of the economic and financial witnessed by the countries affected by crises and other countries concerned, the financial crisis is a case of financial turmoil appears in one of the sections of the financial system one and extends to
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... Show MoreAs tight gas reservoirs (TGRs) become more significant to the future of the gas industry, investigation into the best methods for the evaluation of field performance is critical. While hydraulic fractured well in TRGs are proven to be most viable options for economic recovery of gas, the interpretation of pressure transient or well test data from hydraulic fractured well in TGRs for the accurate estimation of important reservoirs and fracture properties (e.g. fracture length, fracture conductivity, skin and reservoir permeability) is rather very complex and difficult because of the existence of multiple flow profiles/regimes. The flow regimes are complex in TGRs due to the large hydraulic fractures n
A method is developed for the determination of iron (III) in pharmaceutical preparations by coupling cloud point extraction (CPE) and UV-Vis spectrophotometry. The method is based on the reaction of Fe(III) with excess drug ciprofloxacin (CIPRO) in dilute H2SO4, forming a hydrophobic Fe(III)- CIPRO complex which can be extracted into a non-ionic surfactant Triton X-114, and iron ions are determined spectrophotometrically at absorption maximum of 437 nm. Several variables which impact on the extraction and determination of Fe (III) are optimized in order to maximize the extraction efficiency and improve the sensitivity of the method. The interferences study is also considered to check the accuracy of the procedure. The results hav
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