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.
Background: Liver metastasis significantly complicates cancer prognosis, yet easily accessible markers for its early detection and monitoring remain crucial. This study aimed to comprehensively evaluate key hematological parameters as potential indicators for liver metastasis in Iraqi patients. Methods: We conducted a cross-sectional study comparing hematological profiles between 90 patients (presumably with liver metastasis) and 30 healthy controls. White Blood Cell (WBC) count, Lymphocyte percentage, Neutrophil percentage, and Neutrophil-to-Lymphocyte Ratio (NLR) were analyzed. Given non-normal data distributions (confirmed by the Shapiro-Wilk test), group comparisons were performed using the non-parametric Mann-Whitney U test.
... Show MoreThis research has come out with that strategies made by Porter as generally strategies applicable to any size and type of economic units cannot be applied to many of the economic units in the world in generally and in Iraq especially not a lot of economic units have the resources and competencies that enable them to provide a unique product of its kind in the minds of customers and then adopt a differentiation strategy and not a lot of economic units have the resources and competencies that make them the cost leader. Differentiators and cost leaders are minority in the world while not differentiators and not cost leaders are majority in the world.
The economic units are not differentiators and not c
... Show MoreThe research seeks to clarify the problems related to the aspects of the financial and accounting process resulting from entering into contractual arrangements with a period of more than 20 years, among which is the research problem represented by the lack of clarity of the foundations and procedures for the recognition of oil costs and additional costs borne by foreign invested companies, which led to a weakening of their credibility and reflection. Negatively "on the measurement and accounting disclosure of financial reports prepared by oil companies, and the research aims to lay down sound procedures for measuring and classifying oil costs and additional costs paid to foreign companies, and recognizing and recording them in th
... Show MoreThis research aims at recognizing the concept of Innovation in offering the banking services as well as the concept and dimensions of competitive advantage . And to identify and analyze the relationship ( correlation and impact ) between the concept of Innovation in offering the banking services and the dimensions of the competitive advantage under discussion . The research includes all Iraqi private banks in Baghdad city only of the (20) banks . The researcher adopted , in this study , a random sample of the distribution of the questionnaire to members of the research sample are managers , customers and employees in these banks , and were distributed ( 115 ) form questionnaire , ( 97 ) form w
... Show MoreIn This research a Spectroscopic complement and Thermodynamic properties for molecule PO2 were studied . That included a calculation of potential energy . From the curve of total energy for molecule at equilibrium distance , for bond (P-O), the degenerated of bond energy was (4.332eV) instate of the vibration modes of ( PO2 ) molecule and frequency that was found active in IR spectra because variable inpolarization and dipole moment for molecule. Also we calculate some thermodynamic parameters of ( PO2 ) such as heat of formation , enthalpy , heat Of capacity , entropy and gibb's free energy Were ( -54.16 kcal/mol , 2366.45 kcal/mol , 10.06 kcal /k/mol , 59.52 k
... Show MoreThe emerge of capitalism beside appearing modern and contemporary political systems which had become hold out it is semi-domination on more vital space of human community life, it is through some vital apparatus, which the free market apparatus had make important one which depend on achieve the privileges of the capitalism elite whom standing on it, especially the finance elite. Thus the achievement of the profit had become the main podcasted of those elite which whom the really advancer of the Globalization system, this is which incarnated by the appears and extend of the (COVID-19) fatality pandemic in the end of last year, whereas reveals widespread of it in more than one states in the world, especially the developed coun
... Show MoreThe Caputo definition of fractional derivatives introduces solution to the difficulties appears in the numerical treatment of differential equations due its consistency in differentiating constant functions. In the same time the memory and hereditary behaviors of the time fractional order derivatives (TFODE) still common in all definitions of fractional derivatives. The use of properties of companion matrices appears in reformulating multilevel schemes as generalized two level schemes is employed with the Gerschgorin disc theorems to prove stability condition. Caputo fractional derivatives with finite difference representations is considered. Moreover the effect of using the inverse operator which tr
In networking communication systems like vehicular ad hoc networks, the high vehicular mobility leads to rapid shifts in vehicle densities, incoherence in inter-vehicle communications, and challenges for routing algorithms. It is necessary that the routing algorithm avoids transmitting the pockets via segments where the network density is low and the scale of network disconnections is high as this could lead to packet loss, interruptions and increased communication overhead in route recovery. Hence, attention needs to be paid to both segment status and traffic. The aim of this paper is to present an intersection-based segment aware algorithm for geographic routing in vehicular ad hoc networks. This algorithm makes available the best route f
... Show MoreFormation evaluation is a critical process in the petroleum industry that involves assessing the petrophysical properties and hydrocarbon potential of subsurface rock formations. This study focuses on evaluating the Mauddad Formation in the Bai Hassan oil field by analyzing data obtained from well logs and core samples. Four wells were specifically chosen for this study (BH-102, BH-16, BH-86, and BH-93). The main objectives of this study were to identify the lithology of the Mauddud Formation and estimate key petrophysical properties such as shale volume, porosity, water saturation, and permeability. The Mauddud Formation primarily consists of limestone and dolomite, with some anhydrites present. It is classified as a clean for
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