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 research illustrated that the theory of constraints is "A group of concepts and basics that aim at helping the management in order to determine the difficulties and how to overcome these difficulties through determining the necessary change and how these change can be done efficiently and effectively ".
The research showed that the theory of constraint including its tools calls for magnifying throughput, constricting the product cycle , determining the optimal production mix , utilization of scare resources and canceling the idle time , that achieving throughput increasing then increasing profit .
Moreov
... Show MoreThe research aimed at identifying the effect of using constructive learning model on academic achievement and learning soccer dribbling Skill in 2nd grade secondary school students. The researcher used the experimental method on (30) secondary school students; 10 selected for pilot study, 20 were divided into two groups. The experimental group followed constructive learning model while the controlling group followed the traditional method. The experimental program lasted for eight weeks with two teaching sessions per week for each group. The data was collected and treated using SPSS to conclude the positive effect of using constructive learning model on developing academic achievement and learning soccer dribbling Skill in 2nd grade seconda
... Show MoreA simple, accurate, and cost-efficient UV-Visible spectrophotometric method has been developed for the determination of naphazoline nitrate (NPZ) in pure and pharmaceutical formulations. The suggested method was based on the nucleophilic substitution reaction of NPZ with 1,2-naphthoquinone-4-sulfonate sodium salt in alkaline medium at 80°C to form an orange/red-colored product of maximum absorption (λmax) at 483 nm. The stoichiometry of the reaction was determined via Job's method and limiting logarithmic method, and the mechanism of the reaction was postulated. Under the optimal conditions of the reaction, Beerʼs law was obeyed within the concentration range 0.5–50 μg/mL, the molar absorptivity value (ε) was 5766.5 L × mol–1 × c
... Show MoreUnused and expired pharmaceutical drugs are a novel type of organic corrosion inhibitor. They are less expensive, more effective, and less harmful than conventional organic corrosion inhibitors. This study investigated the effects of concentration, adsorption mechanism and thermodynamic parameters of enalapril malate (ENAP) as a corrosion inhibitor for carbon steel in a saline solution (3.5 % NaCl). The polarization method was used to determine the corrosion rate and inhibition efficiency. Field emission scanning electron microscopy (FE-SEM) and atomic force spectroscopy (AFM) were used to investigate the surface morphology and topography of carbon steel after immersion in both uninhibited and inhibited media for 24 h. Fourier transform inf
... Show MoreThis research aims to show the nature of the impact of proactive and analytical strategic orientation in the dimensions of tax organizational excellence (leadership, strategic planning, information and analysis and knowledge management, focus on taxpayers, focus on operations, focus on workforce, business results), in the General Tax Authority The questionnaire was used as a tool to collect data and information from the sample of (110) who are (Associate Director General, Head of Department, Under-Head of First Division, Under-Head of Second Section, Division Officer). Arithmetic mean, intestinal deviation the research has reached a number of conclusions, the most prominent of which are: -
- There is an effect of
The general budget is usually linked to the role of the state in public life and economic activity, whether this role is neutral or interventionist and thus reflects the general objectives that the state seeks to achieve.
for importance of the public budget in clarifying the image of the political state philosophy and its objectives it seeks to achieve on the one hand and clarifying the degree and rank it occupies in the ladder of development among the other countries. This study is intended to highlight the concepts of the general budget and how its concept has evolved since the Middle Ages. Of the importance of the general budget in Iraq was not based on scientific and objective and then the study
... 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
The present work presents design and implementation of an automated two-axis solar tracking system using local materials with minimum cost, light weight and reliable structure. The tracking system consists of two parts, mechanical units (fixed and moving parts) and control units (four LDR sensors and Arduino UNO microcontroller to control two DC servomotors). The tracking system was fitted and assembled together with a parabolic trough solar concentrator (PTSC) system to move it according to information come from the sensors so as to keep the PTSC always perpendicular to sun rays. The experimental tests have been done on the PTSC system to investigate its thermal performance in two cases, with tracking system (case 1) and without trackin
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