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.
In this study water quality was indicated in terms of Water Quality Index that was determined through summarizing multiple parameters of water test results. This index offers a useful representation of the overall quality of water for public or any intended
use as well as indicating pollution, which are useful in water quality management and decision making. The application of Water Quality Index (WQI) with ten physicochemical water quality parameters was performed to evaluate the quality of Euphrates River water for drinking usage. This was done by subjecting the water samples collected from seven stations within Al-Anbar province during the period 2004-2010 to comprehensive physicochemical analysis. The ten physicochemical paramete
Material obtained from the demolition of concrete structures and milling of flexible pavements has the highest potential for recyclability. This study aimed to evaluate the performance of hot mix asphalt with the concurrent use of recycled asphalt pavement (RAP) and recycled concrete aggregate (RCA). Contents of RAP and RCA were varied from 0% to 50% by fixing the total recycling materials percentage to 50%. Penetration grade 40/50 virgin binder and waste engine oil (WEO) as rejuvenator were used in the present study. A series of tests, such as Scanning electron microscopy (SEM), Marshall stability, indirect tensile strength test, IDEAL CT, uniaxial compression test, and resilient modulus test, were carried out to assess the performance of
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The research sample included (179) respondents from communicators in a range of Media outlets such as (Press, Radio, and Television), The researcher was careful with the diversity of the sample, and
In this paper, membrane-based computing image segmentation, both region-based and edge-based, is proposed for medical images that involve two types of neighborhood relations between pixels. These neighborhood relations—namely, 4-adjacency and 8-adjacency of a membrane computing approach—construct a family of tissue-like P systems for segmenting actual 2D medical images in a constant number of steps; the two types of adjacency were compared using different hardware platforms. The process involves the generation of membrane-based segmentation rules for 2D medical images. The rules are written in the P-Lingua format and appended to the input image for visualization. The findings show that the neighborhood relations between pixels o
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For the purpose of reaching the results of the research and testing the assumptions about the relationship between smart leadership and methods of crisis management, the researcher adopted a questionnaire, designed especially to be a criterion for the research, as the main tool for data coll
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