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.
Represents a supervisory and oversight role of the Central Bank towards finding a sober banking sector, as the procedures , regulations and laws that the Central Bank insists on its implementation with the utmost precision, and that was to protect depositors and shareholders' class basis rights, but it is in the interest of the bank in the end, as it seeks to improve the performance of commercial banks and vaccinated against falling into the blunders, they also contribute to building a sober and stable banking sector and security contributes to the welfare and employment optimization of economic resources, and treatment of research (and the presence of banks decline in financial performance, according to financial performance indic
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... Show MoreAbstract
The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an
... Show MoreThe research aims to identify the level of psychological burnout among the professors of Sana’a University in light of the armed conflicts in Yemen. The research sample consisted of (104) faculty members. A descriptive-analytical approach was adopted. The results of the research showed that university professors suffer from psychological burnout at a very high level in the overall score of the scale. There were no statistically significant differences in terms of gender, academic degree, teaching experience, marital status, number of family members, or salary. In light of the results, the researcher presented a number of relevant recommendations and suggestions.
The research aims to investigate the existence of a direct causal relationship between selected agricultural variables: agricultural output (as a representative of growth in the agricultural sector), agricultural terms of trade as a completely new variable in agricultural studies in recent years, agricultural labour which is an important part in the total workforce for Iraq, and finally, agricultural investment because of its importance and vital role in the production process, creating job opportunities, and then raising the level of employment, then it's role to achieving agricultural growth and development. For this purpose, the researchers used the Toda-Yamamoto causality methodology for a time series covering from 1990 to 2019. The res
... Show MoreThe current study introduces a novel technique to handle electrochemical localized corrosion in certain limited regions rather than applying comprehensive cathodic protection (CP) treatment. An impressed current cathodic protection cell (ICCPC) was fabricated and firmly installed on the middle of a steel structure surface to deter localized corrosion in fixed or mobile steel structures. The designed ICCPC comprises three essential parts: an anode, a cathode, and an artificial electrolyte. The latter was developed to mimic the function of the natural electrolyte in CP. A proportional-integrated-derivative (PID) controller was designed to stabilize this potential below the ICCPC at a cathodic potential of −850 mV, which is crucial for prote
... Show MoreThe skill scale in most of sport activity monitoring a lot of dynamic behaviours conducted with playing situations that help the excerpt's in sport field to evaluate and put right solutions ,soccer one of games that studies in third stage in college and take skills ,dribbling , passing, shooting these skills helps to execute the plans in game ,the researchers notice that there is no test measure the skills of the game in the beginning of the first semester especially in the method of soccer in physical education college and the problem of the research were by answering the question that is there test connect between one or more that one of skill to measure the ability of students to execute the plans in soccer and the conclusion was the bui
... Show MoreThe water injection of the most important technologies to increase oil production from petroleum reservoirs. In this research, we developed a model for oil tank using the software RUBIS for reservoir simulation. This model was used to make comparison in the production of oil and the reservoir pressure for two case studies where the water was not injected in the first case study but adding new vertical wells while, later, it was injected in the second case study. It represents the results of this work that if the water is not injected, the reservoir model that has been upgraded can produce only 2.9% of the original oil in the tank. This case study also represents a drop in reservoir pressure, which was not enough to support oil production
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