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.
General propositions have dealt with various indicators and features that frame and describe basic architectural concepts, and from those concepts, the concept of identity will be presented here, which represents the nerve of intellectual vision of the state of architecture development, transformation and change. Due to its deep intellectual basis, it was necessary to study multiple features, especially the achievement feature that was considered a major stage describing the nature of change and shift related to the achievement of concept and its role in the development of the architectural field . &nb
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Investment Bases directly and closely to an environment characterized by political, social and economic stability, and through a range of policies and institutions and economic laws that affect investor confidence and convince him directing investments to country without the other, where inter conditions and circumstances affecting the trends of capital and settle in, and political situation of the country and what is characterized of stability or disorder as well as economic conditions that are affected by what is distinguishes the country from geographic and demographic characteristics are reflected on availability of production elements and country's infrastructure.
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Greenhouses are provide that produce of vegetable in non times seasons production by controlling the various environmental factors that appropriate atmosphere in temperature and humidity for the growth of plants in the plastic houses and owner plastic.
The objective of this research is to study of the most important natural and human factors affecting the Greenhouses in the province of Baghdad and study geographic distribution for the Greenhouses in the province.
Some properties on curriculum geographical descriptive analytical that used in describe and analysis of data and information that could be available from Directorate of agriculture in Baghdad to 2014. As it turns out that district of Mahmudiya acquired (45.3%) of the total
Energy use is second to staffing in building operating costs. Sustainable technology in the energy sector is based on utilizing renewable sources of energy such as solar, wind, glazing systems, insulation. Other areas of focus include heating, ventilation and air conditioning; novel materials and construction methods; improved sensors and monitoring systems; and advanced simulation tools that can help building designers make more energy efficient choices. The objective of this research is studying the effect of insulations on energy consumption of buildings in Iraq and identifying the amount of energy savings from application th
... Show MoreOver the last few years, the interior designer has been given the ability to access many innovative tools for new forms of unprecedented diversity and efficiency. Some design experts have described the new parametric procedures they are introducing to create new interior projects as a radical transformation that carries all the elements of a qualitative shift in interior design. The best of these parametric procedures is the technical capabilities offered by us to create new forms that are different from what has been discussed in everything that has been produced by designers and architects since modernity and even before it to the present time, which returns our design products through a series of computer programs that perform the pro
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