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.
Before the unit environmental problems serious the issues of the environment and conservation of contemporary issues important in the developed and developing worlds, it was natural that leads increasing global awareness to alert a group of intellectuals, scientists and politicians to the seriousness of this problem and the call to take steps deeper and more comprehensive with respect to the environment humanitarian based on the study of the various elements of this environment and a greater understanding of the relationships among them, and on this basis, steps have been taken to target the environment and to identify problems and make efforts to achieve the goals I: stop the deterioration of the environment and the second impro
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The curriculum is the major effective tool in achieving the goals of
education and society.
Many countries that want to reach the forefront of developed countries
through their curriculum have realized this fact. School text book, the
application assessment for knowing the rang of success or fail of this text
book in achieving the general aims. therefore this study aims at assessing the
principals and techniques of geography text book for fourth secondary class of
literary studying from the teachers point of view according to the fields of the
book, style of material, technical arrangement of the material, ethnical
arrangement the language of the book, style of the material, technical
arrang
The tactical side in application of offensive plans in basketball did not take a large in scientific research because it always change because it related in mental ability of players and for the condition of the game and researchers notice that from their followed a lot of games for Duhok basketball club in Iraq league. There is a problem that connected in games results it clears in weakness in application of offensive plans in all kind (man to man & zone defense & side ball plans & under basketball and half court). The goal of study concentrate by designing a sheet for som offensive plans for study and analysis to Duhok club on Asian Championship 2011 at the base the sample contained (Iraq Duhok & application science Jordan & Lebanon sport
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ويعد مؤشر الانتاجية بصفة عامة وانتاجيتي العمل وراس المال بصفة خاصة من الم
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ABSTRACT
The research focuses on the key issue concerning the use of the best ways to test the financial stability in the banking sector, considering that financial stability cannot be achieved unless the financial sector in general and the banking sector in particular are able to perform its key role in addressing the economic and social development requirements, under the laws and regulations that control banking sector , as the only way that increases its ability to deal with any risks or negative effects experienced by banks and other financial institutions. The research goal is to evaluate the stability of the banking system in Iraq, through the use of a set of econometrics an
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الخلاصة
تعد الانتخابات بمثابة الطريق المؤدي إلى الديمقراطية كونها النمط الأكثر شيوعاً لمشاركة المواطنين في الحياة السياسية للبلدان واختيار ممثليهم في المجالس التشريعية، حيث أن مطلب إجراء انتخابات حرة ونزيهة لم يعد مطلباً داخلياً فحسب بل مطلباً دولياً يصرّ المجتمع الدولي على الوفاء به وهذا يلقي على عاتق كل دولة أن تضع من الضمانات ما يكفل ممارسة هذه الانتخابات ب
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A simple, fast, inexpensive and sensitive method has been proposed to screen and optimize experimental factors that effecting the determination of phenylephrine hydrochloride (PHE.HCl) in pure and pharmaceutical formulations. The method is based on the development of brown-colored charge transfer (CT) complex with p-Bromanil (p-Br) in an alkaline medium (pH=9) with 1.07 min after heating at 80 °C. ‘Design of Experiments’ (DOE) employing ‘Central Composite Face Centered Design’ (CCF) and ‘Response Surface Methodology’ (RSM) were applied as an improvement to traditional ‘One Variable at Time’ (OVAT) approach to evaluate the effects of variations in selected factors (volume of 5×10-3 M p-Br, heating time, and temperature) on
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Linear regression is one of the most important statistical tools through which it is possible to know the relationship between the response variable and one variable (or more) of the independent variable(s), which is often used in various fields of science. Heteroscedastic is one of the linear regression problems, the effect of which leads to inaccurate conclusions. The problem of heteroscedastic may be accompanied by the presence of extreme outliers in the independent variables (High leverage points) (HLPs), the presence of (HLPs) in the data set result unrealistic estimates and misleading inferences. In this paper, we review some of the robust
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Survival analysis is widely applied to data that described by the length of time until the occurrence of an event under interest such as death or other important events. The purpose of this paper is to use the dynamic methodology which provides a flexible method, especially in the analysis of discrete survival time, to estimate the effect of covariate variables through time in the survival analysis on dialysis patients with kidney failure until death occurs. Where the estimations process is completely based on the Bayes approach by using two estimation methods: the maximum A Posterior (MAP) involved with Iteratively Weighted Kalman Filter Smoothing (IWKFS) and in combination with the Expectation Maximization (EM) algorithm. While the other
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