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 a connected graph , the distance function between each pair of two vertices from a set vertex is the shortest distance between them and the vertex degree denoted by is the number of edges which are incident to the vertex The Schultz and modified Schultz polynomials of are have defined as:
respectively, where the summations are taken over all unordered pairs of distinct vertices in and is the distance between and in The general forms of Schultz and modified Schultz polynomials shall be found and indices of the edge – identification chain and ring – square graphs in the present work.
Amongst the literary writers who used their art to direct the attention towards the issue of woman and her rights in a proper life is the English poet and novelist Thomas Hardy (1840-1928), who has been praised for his “openness to the feminine principle” 1 as Irving Howe put it. Hardy’s wide readings have changed his way of dealing with and thinking about so many critical issues which started to float on the surface of the English society during the mid and late of the 19th century. His readings for a number of writers, who seem of huge impact on his writings as he later admits that – “[his] pages show harmony of view with
... Show Morebased search on two variables two main (Administrative empowerment ) and (technical innovation) target detection relationship and influence between the five dimensions (the delegation of authority , personnel training , effective communication, work teams , motivating employees) and
(technical innovation) conducted research in General Company for electrical Industries , and through the sample included the views of managers in the various administrative levels poll .
And adopted a researcher at a major tool for data collection is questionnaire designed to find, as was the contents of the questionnaire analysis according to the Statistical Information System ( Spss), The (55) to identi
... Show MoreThis article aims to establish and evaluate standards for critical equipment and materials in highway projects in Iraq. Delphi technique has been used to analyze, explore, and discover the main criteria and sub-criteria that affect equipment and materials in highway construction projects in Iraq. To determine the correct response to the criteria presented in this study, a program (IBM, SPSS/V25) was used to assess the main criteria and sub-criteria using the mean score (MS) and standard deviation (SD) technique, as well as to check reliability using Cronbach's alpha factor (α). The experts' qualifications and the extent to which the person is ready to commit are both important factors in panel selection. The design of a
... Show MoreBlogging is about more than just putting thoughts on a web; it's about connecting with and hearing from anyone who read the work. Many web sites now days help to get a free account to quick post thoughts and photos interact with people, and more. The fastest way to understand blogging is to try it out, but in that case securing the blog is important, by including authentication schemes. In this paper we suggest implications of our research for improving the design and usefulness of blogging systems, and also we divided the blogs depending on the subject and need, which are either to be used in public or only used by small group, so we can suggest different steps for securing the blogs.
Let be an infinite dimensional separable complex Hilbert space and let , where is the Banach algebra of all bounded linear operators on . In this paper we prove the following results. If is a operator, then 1. is a hypercyclic operator if and only if D and for every hyperinvariant subspace of . 2. If is a pure, then is a countably hypercyclic operator if and only if and for every hyperinvariant subspace of . 3. has a bounded set with dense orbit if and only if for every hyperinvariant subspace of , .
The objective of the study: To diagnose the reality of the relationship between the fluctuations in world oil prices and their reflection on the trends of government spending on the various economic sectors.
The research found: that public expenditures contribute to the increase of national consumption through the purchase of consumer goods by the state for the performance of the state's duties or the payment of wages to employees in the public sector and thus have a direct impact on national consumption
The results of the standard tests showed that there is no common integration between the oil price fluctuations and the government expenditure on the security sector through the A
... Show MoreEthnographic research is perhaps the most common applicable type of qualitative research method in psychology and medicine. In ethnography studies, the researcher immerses himself in the environment of participants to understand the cultures, challenges, motivations, and topics that arise between them by investigating the environment directly. This type of research method can last for a few days to a few years because it involves in-depth monitoring and data collection based on these foundations. For this reason, the findings of the current study stimuli the researchers in psychology and medicine to conduct studies by applying ethnographic research method to investigate the common cultural patterns language, thinking, beliefs, and behavior
... Show MoreExperiment was conducted in Baghdad, three factor were used in this research included Two types of Plows included moldboard and disk plows which represented the main plot, Three forward speeds of the tillage was the second factor included 1.85, 3.75 and 5.62 km / h which represented sup plot , and Three levels of Soil Moisture was third factor included 21, 18 and 14 % in all of Vertical and Lateral Plowing Deviation, Practical and specific productivity, actual time for plowing one donam and appearance (goodness) of Tillage represented by the number of clods > 10 cm in silt clay loam soil with depth 22 cm were studied. the experiment was used Split – split plot design under randomized complete block design with three replications and Le
... Show MoreIn general, the importance of cluster analysis is that one can evaluate elements by clustering multiple homogeneous data; the main objective of this analysis is to collect the elements of a single, homogeneous group into different divisions, depending on many variables. This method of analysis is used to reduce data, generate hypotheses and test them, as well as predict and match models. The research aims to evaluate the fuzzy cluster analysis, which is a special case of cluster analysis, as well as to compare the two methods—classical and fuzzy cluster analysis. The research topic has been allocated to the government and private hospitals. The sampling for this research was comprised of 288 patients being treated in 10 hospitals. As t
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