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.
Doses for most drugs are determined from population-level information, resulting in a standard ?one-size-fits-all’ dose range for all individuals. This review explores how doses can be personalised through the use of the individuals’ pharmacokinetic (PK)-pharmacodynamic (PD) profile, its particular application in children, and therapy areas where such approaches have made inroads.
The Bayesian forecasting approach, based on population PK/PD models that account for variability in exposure and response, is a potent method for personalising drug therapy. Its potential utility is eve
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Childhood is characterized by ahigh privacy in the life of the child overall educational institutions in the world. Based on this specificity, modern education begins with a holistic vision of the child through all developmental aspects (moral, religious, emotional, social, linguistic, physical, health, and mental). This integration could be achieved through taking into consideration the needs and rights of children and developing curricula that consider these needs and capacities to provide opportunities for developing and supporting the developmental aspects of the child. The contemporary technological developments in the field of computer and the Internet have brought with it new forms, ideas, and problems for children in recent years
... Show MoreElectrocoagulation is an electrochemical process of treating polluted water where sacrificial anode corrodes to produce active coagulant (usually aluminum or iron cations) into solution. Accompanying electrolytic reactions evolve gas (usually as hydrogen bubbles). The present study investigates the removal of phenol from water by this method. A glass tank with 1 liter volume and two electrodes were used to perform the experiments. The electrode connected to a D.C. power supply. The effect of various factors on the removal of phenol (initial phenol concentration, electrode size, electrodes gab, current density, pH and treatment time) were studied. The results indicated that the removal efficiency decreased as initial phenol concentration
... Show MorePermanent deformation, fatigue and thermal cracking are the three typical distresses of flexible pavement. Using hydrated lime (HL) into the conventional limestone mineral additive has been widely practiced, including in Europe, to improve the mechanical properties of hot mix asphalt (HMA) concrete and as the result the durability of the constructed pavement. Large number of experimental studies have been reported to find the optimum addition of HL for the improvement on HMA concrete mechanical properties, moisture susceptibility and fatigue resistance. Pavement in service is under complex thermomechanical stress-strain conditions due to coupled atmospheric and surrounding environment temperature variation and the traffic loading. To predic
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Diazotization reaction between 1-(2,4,6-trihydroxy-phenyl)-ethanone and diazonium salts produced the ligand 4-(3-Acetyl-2,4,6-trihydroxy-phenylazo)-N-(5-methyl-isoxazol-3-yl)- benzenesulfonamide, which in turn reacted with the metal ions (Ni2+, Zn2+, Pd2+ and Pt4+) forming stable complexes with Octahedral geometry suggest of (Ni2+ and Pt4+), Zn2+ complex Tetrahedral and Pd2+ complex Square planer. The creation of such complexes was detected by employing spectroscopic means involving ultraviolet-visible, which proved the obtained geometries; FT-IR confirmed the formation of the azo group and the coordination with metal ions through it. Thermogravimetric analysis studies demonstrated the coordination of water residues (aqua or hydrate) with m
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A biconical antenna has been developed for ultra-wideband sensing. A wide impedance bandwidth of around 115% at bandwidth 3.73-14 GHz is achieved which shows that the proposed antenna exhibits a fairly sensitive sensor for microwave medical imaging applications. The sensor and instrumentation is used together with an improved version of delay and sum image reconstruction algorithm on both fatty and glandular breast phantoms. The relatively new imaging set-up provides robust reconstruction of complex permittivity profiles especially in glandular phantoms, producing results that are well matched to the geometries and composition of the tissues. Respectively, the signal-to-clutter and the signal-to-mean ratios of the improved method are consis
... Show Moreمفهوم معامل الارتباط كمقياس يربط بين متغيرين هذا يجلب انتباهنا إلى موضوع الإحصاء في كل المستويات. أكثر من ذلك هناك ثلاث نقاط خاصة هي اعتيادياً نشدد عليها كما يأتي:-
(1 معامل الارتباط هو الدليل المعياري والذي قيمته لا تعتمد على قياسات
المتغيرات الأصلية.
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Abstract
In this study, we compare between the autoregressive approximations (Yule-Walker equations, Least Squares , Least Squares ( forward- backword ) and Burg’s (Geometric and Harmonic ) methods, to determine the optimal approximation to the time series generated from the first - order moving Average non-invertible process, and fractionally - integrated noise process, with several values for d (d=0.15,0.25,0.35,0.45) for different sample sizes (small,median,large)for two processes . We depend on figure of merit function which proposed by author Shibata in 1980, to determine the theoretical optimal order according to min
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