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.
This study aims to know the role of strategic leadership to achieving competitiveness in industrial establishments by identifying the respondents’ perceptions about the level of availability of dimensions of leadership strategies (creativity and innovation, risk tolerance, available opportunities) in Bashir Al-Siksek & Partners Company for the manufacture of sanitary and plastic ware in Gaza strip
To achieve this, a questionnaire was developed and distributed to a sample of managers, auditors, accountants, and administrative employees in the study sample company. The questionnaire tool was distributed to 60 employees and employees, of which (52) were retrieved, or 86.6%, and (8) were excluded for la
... Show MoreThe research aims to measure the net nominal protection coefficients for the products table eggs and poultry meat and the extent of its impact on domestic production volume for the period of 1990- 2013 has been the use of mathematical formulas simplified in the calculation of the transaction process with a view to the extent of support and protection offered by the state pricing policy for products Resources Sector Animal in Iraq and reach search Highlights and most important, there are volatile price state policy with regard to eggs and poultry meat, as it ranged net nominal protection coefficients between the larger and less than the right one, which means that values are unstable to support local producers or consumers, and can be The
... Show MoreThe research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like
... Show MoreThe research aims to develop physical exercises with auxiliary training tools that work to develop the explosive power of the arms and legs, and then find out their effect on the accuracy of shooting from free throw and correction from jumping of advanced basketball players, as the researchers found a problem that these players have weakness in the skill of throwing Free throwing and shooting by jumping calculated with two points as a result of adopting unhealthy physical and technical positions, which led to a lack of focus and accuracy, and thus negatively affected the performance technique of free throw and jump shot, as most teams use traditional exercises without the use of auxiliary training tools, and this topic gave researchers the
... Show MoreThat internal control is particularly important in improvingperformance and tax reform، they play an important role in the regularity ofwork and development and the anti corruption and activating the decisionsand tax legislation، as contained in the organizational plan and the means،procedures and components designed from which to ensure a policy andimplementation plans The research aims to review the reality of the internalcontrol in the General Commission for Taxes and stand on the deficiencies init, with the strengthening of the role of internal control in the GeneralAuthority for taxes based on the laws and regulations and by using modernmeans to work as well as developing the performance of employees in thebody، including helpin
... Show MorePurpose: This research is to identify the most important challenges for the local investment commissions and to develop solutions and proposals to encourage local and foreign investment in local governments in Iraq (the Iraqi provinces are irregular in the region). Theoretical Framework: This research suggests a conceptual framework for the local investment commissions in order to solve their problems, the most important of which was to identify the most critical challenges which are facing the Baghdad Investment Commission BIC and how to overcome them. Design/The methodology approach: Research involved a mixed-methods approach through two stages. During the first stage, the researcher gathered quantitative data from all inves
... Show MoreThis study aims to recognize the most common thinking styles and level of the need for cognitive university students , the relation between thinking styles and the need for cognitive, and there are differences according to gender .The sample consists of (250) males and females university students for the academic year (2013-2014), and the researcher uses two scales;" thinking styles scale (Harison &Bramson, 1986), and the need for cognitive scale" (Cacioppo, Petty & Kao , 1996).
The results show that there is difference in the range of the prevalence of the thinking styles among university students , the scientific thinking style is the most common , the students have got the arrange level of the need for cognitive , and there
A new method for construction ion-selective electrode (ISE) by heating reaction of methyl orange with ammonium reineckate using PVC as plasticizer for determination methyl orange and determination Amitriptyline Hydrochloried drug by formation ion-pair on electrode surface . The characteristics of the electrode and it response as following : internal solution 10-4M , pH (2.5-5) ,temperature (20-30) and response time 2 sec. Calibration response for methyl orange over the concentrationrange 10-3 -10-9 M with R=0.9989 , RSD%=0.1052, D.O.L=0.315X10-9 MEre%=(-0.877- -2.76) , Rec%.=(97.230 -101.711) .