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 long-term monitoring of land movements represents the most successful application of the Global Navigation Satellite System (GNSS), particularly the Global Positioning System. However, the application of long term monitoring of land movements depends on the availability of homogenous and consistent daily position time series of stations over a period of time. Such time series can be produced very efficiently by using Precise Point Positioning and Double Difference techniques based on particular sophisticated GNSS processing softwares. Nonetheless, these rely on the availability of GNSS products which are precise satellite orbit and clock, and Earth orientation parameters. Unfortunately, several changes and modifications have been mad
... Show MoreThe prediction of the blood flow through an axisymmetric arterial stenosis is one of the most important aspects to be considered during the Atherosclrosis. Since the blood is specified as a non-Newtonian flow, therefore the effect of fluid types and effect of rheological properties of non-Newtonian fluid on the degree of stenosis have been studied. The motion equations are written in vorticity-stream function formulation and solved numerically. A comparison is made between a Newtonian and non-Newtonian fluid for blood flow at different velocities, viscosity and Reynolds number were solved also. It is found that the properties of blood must be at a certain range to preventing atheroscirasis
Sphingolipids are key components of eukaryotic membranes, particularly the plasma membrane. The biosynthetic pathway for the formation of these lipid species is largely conserved. However, in contrast to mammals, which produce sphingomyelin, organisms such as the pathogenic fungi and protozoa synthesize inositol phosphorylceramide (IPC) as the primary phosphosphingolipid. The key step involves the reaction of ceramide and phosphatidylinositol catalysed by IPC synthase, an essential enzyme with no mammalian equivalent encoded by the AUR1 gene in yeast and recently identified functional orthologues in the pathogenic kinetoplastid protozoa. As such this enzyme represents a promising target for novel anti-fungal and anti-protozoal drugs. Given
... Show MoreA winglet is devices attached at the wing tips, used to improve aircraft wing efficiency by reduction influence wing tips vortices and induct drag, increasing lift force at the wing tips and effective aspect ratio without adding greatly to the structural stress and weight in the wing structure. This paper is presented three-dimensional numerical analysis to proposed modification swept back wing by adding Raked winglets devices at the main wing tips belong the two seat trainer aircraft type Aermacchi Siai S211 by using Fluent ANSYS 13 software. CFD numerical analysis process was performed at the same flight boundary conditions indifferent wing angle of attacks with constant air flow velocity V∞ =50 (m/sec), ambient pressure Po=101325 (P
... Show MoreThe present work intends to study of dc glow discharge were generated between pin (cathode) and a plate (anode) in Ar gas is performed using COMSOL were used to study electric field distribution along the axis of the discharge and also the distribution of electron density and electron temperature at constant pressure (P=.0.0mbar) and inter electrode distance (d=4 cm) at different applied voltage for both pin cathode system and plate anode and comparison with experimental results.
This study presents certain modifications done to the conditions set by Searle
(1969: 57) concerning the speech act of promising in order to render them to selected
sayings of Prophet Muhammad (P.B.U.H.) and Jesus Christ (P.B.U.H.) and to
political texts. These modifications make the conditions of the speech act of
promising appropriate for sincere promises made by the Messengers of God since
they deliver their Messages of God but they are unable, as Messengers, to fulfill
God’s promises which they make as part of their Messages and by representatives of
States who deliver speeches on behalf of their Governments. These are the only two
situations where the speakers can make promises and do not fulfill these prom