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 differential cross section for the Rhodium and Tantalum has been calculated by using the Cross Section Calculations (CSC) in range of energy(1keV-1MeV) . This calculations based on the programming of the Klein-Nashina and Rayleigh Equations. Atomic form factors as well as the coherent functions in Fortran90 language Machine proved very fast an accurate results and the possibility of application of such model to obtain the total coefficient for any elements or compounds.
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A new series of metal ions complexes of VO(II), Cr(III), Mn(II), Zn(II), Cd(II) and Ce(III) have been synthesized from the Schiff bases (4-chlorobenzylidene)-urea amine (L1) and (4-bromobenzylidene)-urea amine (L2). Structural features were obtained from their elemental microanalyses, magnetic susceptibility, molar conductance, FT-IR, UV–Vis, LC-Mass and 1HNMR spectral studies. The UV–Vis, magnetic susceptibility and molar conductance data of the complexes suggest a tetrahedral geometry around the central metal ion except, VOII complexes that has square pyramidal geometry, but CrIII and CeIII octahedral geometry. The biological activity for the ligand (L1) and its Vanadium and Cadmium complexes were studied. Structural geometries of com
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The current research aims to identify the effect of the Bransford and Stein model on the achievement of fifth-grade literary students for geography and their reflective thinking. To achieve the objective of the research, the following two null hypotheses were formulated:
- There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental group students who studied geography using the Bransford and Stein model and the average scores of the control group students who studied the same subject in the usual way in the achievement test. 2- There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental gr
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In this paper, some necessary and sufficient conditions are obtained to ensure the oscillatory of all solutions of the first order impulsive neutral differential equations. Also, some results in the references have been improved and generalized. New lemmas are established to demonstrate the oscillation property. Special impulsive conditions associated with neutral differential equation are submitted. Some examples are given to illustrate the obtained results.
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In light of this, attention should be paid to tax reform as part of a comprehensive economic reform program. Therefore, the research started from the problem of the weak efficiency of the tax reform process in the General Authority for Taxation, as well as the need to know the addition of new taxes or increase taxes.The research aims study the relative importance of each disabled person, whether organizational, human, financial, legislative or technical. The research led to a number of conclusions, the most important of which were that the financial obstacles occupy the highest importance of the other obstacles and for the success of the tax reform, the material resources must be provided in order to provide the n
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The Accounting Disclosure for non-current intangible assets is necessary to rely on accounting information by decision makers in the economic unity, two international accounting standards issued (IAS16,36), which aims to provide the foundations of the recognition, measurement and disclosure of appropriate assets Non-current tangible. (IAS16) allowed to use re-evaluation approach to measure assets entrance due to the inadequacy of the accounting information resulting from the application of the historical cost of the entrance under increasing technical developments and continuing that leave clear their effects on non-current intangible assets, As well as the requirements of what came (IAS36) the importance of accounting for the impairment
... Show MoreAccelerates operating managements in the facilities contemporary business environment toward redefining processes and strategies that you need to perform tasks of guaranteeing them continue in an environment performance dominated by economic globalization and the circumstances of uncertainty attempt the creation of a new structure through multiple pages seek to improve profitability and sustainable growth in performance in a climatefocuses on the development of institutional processes, reduce costs and achieve customer satisfaction to meet their demands and expectations are constantly changing. The research was presented structural matrix performance combines methodology Alsigma in order to improve customer satisfaction significantly bet
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