Background: urethrocutaneous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for surgeon and the patient. The problem is exacerbated because the urethrocutaneous fistula may recur which adds more demands surgery. Objectives: The purpose of this study is to evaluate of the use of oral mucosal graft for management of recurrent urethrocutaneous fistula after hypospadias repair. Patients and Methods: twelfth patients with age ranging from 4 year to 15 years were presented with history of recurrent fistula. Most of fistula were located in proximal penile and penoscrotal region (58.3%) . those patients were repaired by using oral mucosal graft with mean postoperative follow up period up to 6 months. Results: analysis of results showed 10 out of 12 cases (83.3%) had a final successful outcome with no recurrent fistula during follow up period. The two patients with failed repair were candidate for another attempt for fistula repair later on. No donor site morbidity was observed in all patients. Conclusion: Oral mucosal graft showed very good take and promising results when used for management of recurrent urethrocutaneous fistula after hypospadias repair. Key words: urethrocutaneous fistula, hypospadias, mucosal graft.
تتحقق اهداف الدول عبر توظيف امكانياتها ومواردها ، وهذا التوظيف يقترن بوسائل مختلفة باختلاف الامكانيات المتاحة. وتتفاوت هذه الوسائل ما بين الاكراه والترغيب ، واحياناً من الممكن استخدام كلا الوسيلتين ، وتندرج هذه الوسائل من حيث تصنيفها ضمن نوعين رئيسين هما: القوة الصلبة ]القوة العسكرية والاقتصادية[ والقوة الناعمة ]استخدام جميع ادوات الترغيب وتسخيرها من اجل ان تُعجب بها الدول الاخرى وتنصاع
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The last ten years observed a shift enormous scientific in the method and way that it deals professional with the cost accounting and reflected the result those shift enormous scientific of increase the competitive environmental that accompanied the emergence of a modern manufacturing environmental on surface the long roductive life and emergence advanced information technology that give a central focus of his important on client with growing global markets growth on a large scale.
The research aim to define the concept of cost awareness, the concept and methods of strategic cost management and the role of cost awareness for managers of industrial units in strategic of cost managem
... Show MoreThe important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms
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Abstract
The research aims to diagnose the reality of applying the eighth requirement (operation) of the business continuity management system according to the international standard (ISO 22301: 2019), in the General Tax Authority, which is related to planning, implementing and controlling specific processes and procedures to address risks and opportunities, and the research adopted the checklist of the standard ( ISO 22301: 2019), in obtaining information, to measure the extent of application and documentation, the percentages and the weighted arithmetic mean were relied upon, and the research reached a set of result
... Show MoreThe experiment was conducted in Al- Mahaweel Research Station in Babel Governorate, Ministry of Agriculture during autumn season 2016-2017 to determine the role of irrigation management processes and micronutrient fertilization in growth and productivity of two varieties of wheat IPA 99 and Al-Rasheed 22 in clay loam soil classified as Typic Torriflovent. The experiment included four irrigation treatments and six fertilization treatments. The experiment was designed under randomized complete block design (RCBD) with three replications. Wheat grain IPA 99 and Al-Rasheed 22 varieties were planted in 23/11/2016 and harvested in 13/5/2017. The amount and periods of irrigation depended on sensors reading of volumetric water content was measured
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Purpose – The main purpose of this research is to highlight the main role of strategic leadership skills for top managements in accessing to effective management in accordance with the (VUCA Prime) methodology in (VUCA) environment as Miniature virtual environment, which refers to (Volatility), (Uncertainty), (Complexity), and (Ambiguity).
methodology – To achieve the research objective, this study selected the quantitative approach in research design, Questionnaire was used as the main instrument for data collection, the sample comprised the opinion poll (106) individual who functions as a head department. (Structural equation modelling by (Smart Pls3)
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The research aims to; identify the management of conflict as perceived by secondary school managers toward the directors of directorates of education in wassat province, identify functional performance as perceived by secondary school managers toward the directors of directorates of education in wassat province. Besides, explore the relationship between Conflict management and functional performance among the directors of directorates of education in wassat province. A descriptive approach deemed more appropriate with study design. As a tool to collect the data of current research, the author used a questionnaire. Spss tools were used for data analysis