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.
Dynamic Thermal Management (DTM) emerged as a solution to address the reliability challenges with thermal hotspots and unbalanced temperatures. DTM efficiency is highly affected by the accuracy of the temperature information presented to the DTM manager. This work aims to investigate the effect of inaccuracy caused by the deep sub-micron (DSM) noise during the transmission of temperature information to the manager on DTM efficiency. A simulation framework has been developed and results show up to 38% DTM performance degradation and 18% unattended cycles in emergency temperature under DSM noise. The finding highlights the importance of further research in providing reliable on-chip data transmission in DTM application.
The introduction of concrete damage plasticity material models has significantly improved the accuracy with which the concrete structural elements can be predicted in terms of their structural response. Research into this method's accuracy in analyzing complex concrete forms has been limited. A damage model combined with a plasticity model, based on continuum damage mechanics, is recommended for effectively predicting and simulating concrete behaviour. The damage parameters, such as compressive and tensile damages, can be defined to simulate concrete behavior in a damaged-plasticity model accurately. This research aims to propose an analytical model for assessing concrete compressive damage based on stiffness deterioration. The prop
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Medication safety and effectiveness can be improved through interprofessional collaboration. The goals of this study were to measure the degree of physician–pharmacist collaboration within Iraqi governmental healthcare settings and to investigate factors influencing this collaboration.
This cross-sectional study was conducted in Al-Najaf Province using the Collaborative Working Relationship Model and Physician–Pharmacist Collaborative Instrument (PPCI). Four phar
For the most reliable and reproducible results for calibration or general testing purposes of two immiscible liquids, such as water in engine oil, good emulsification is vital. This study explores the impact of emulsion quality on the Fourier transform infrared (FT-IR) spectroscopy calibration standards for measuring water contamination in used or in-service engine oil, in an attempt to strengthen the specific guidelines of ASTM International standards for sample preparation. By using different emulsification techniques and readily available laboratory equipment, this work is an attempt to establish the ideal sample preparation technique for reliability, repeatability, and reproducibility for FT-IR analysis while still considering t
... Show MoreIn low-latitude areas less than 10° in latitude angle, the solar radiation that goes into the solar still increases as the cover slope approaches the latitude angle. However, the amount of water that is condensed and then falls toward the solar-still basin is also increased in this case. Consequently, the solar yield still is significantly decreased, and the accuracy of the prediction method is affected. This reduction in the yield and the accuracy of the prediction method is inversely proportional to the time in which the condensed water stays on the inner side of the condensing cover without collection because more drops will fall down into the basin of the solar-still. Different numbers of scraper motions per hour (NSM), that is
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