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.
Abstract
Personality is one of the most important elements that should be developed in university student. Thus, we have to develop the positive traits and neutralize the negative traits of students as well as we have to pay attention to the level of student achievement at the same time, the researcher designed a scale to measure the traits of study sample. The research come out with a number of recommendations and proposals, the most important of which Enhancing the positive characteristics of university students in order to reach them to the level of mature personality with mental health. Enhancing the positive role of the high level of achievement by motivating the stude
... Show MoreThe tourism industry has undergone exponential transformation, reshaped by online travel agencies (OTAs), shifting consumer preferences, and technological advancements. Established OTAs like TripAdvisor and Travelocity face pressures to adapt their strategies to capitalize on these disruptive landscape changes. This research involves a comparative analysis examining the key challenges confronting TripAdvisor and Travelocity, with a focus on opportunities to leverage artificial intelligence (AI) in enhancing personalization and the traveler experience. The study utilizes publicly available data on the companies and academic literature on AI innovation diffusion. Findings reveal that while TripAdvisor has actively developed AI-based trip plan
... Show MoreThermal energy storage is an important component in energy units to decrease the gap between energy supply and demand. Free convection and the locations of the tubes carrying the heat-transfer fluid (HTF) have a significant influence on both the energy discharging potential and the buoyancy effect during the solidification mode. In the present study, the impact of the tube position was examined during the discharging process. Liquid-fraction evolution and energy removal rate with thermo-fluid contour profiles were used to examine the performance of the unit. Heat exchanger tubes are proposed with different numbers and positions in the unit for various cases including uniform and non-uniform tubes distribution. The results show that
... Show MoreThe steel jetty selected for strengthening is in Baghdad city, over Tigris River, consists of 55 short spans, each of approximately 4 meters and one naviga-tional opening of 12 m. The bridge is 224 meters length and 8 meters in width. The strengthening system was designed to remove overstresses that occurred when the bridge was subjected to abnormal loads of 380 tons. A strengthening system which installed in spring 2008 was used where the main concept is to depend on added side supporting elements which impose reversal forces on the bridge to counteract most of the loads expected from the abnormal heavy loads. The bridge was load tested before and after the strengthening system was activated. The load test results indicate that the strengt
... Show MoreThe process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MoreAbstract---The aim of the current research is to identify the level of logical reasoning skills in chemistry students at the Faculty of Education for Pure Sciences/ Ibn Al-Haytham for the academic year (2021-2022). The differences in their level of skills according to the gender variable (males and females) and the academic stages (first- second - third - fourth). The descriptive approach was adopted because it corresponds to the nature of the research objectives. The research sample consisted of (400 )students selected in a relatively random stratified way. The researcher constructed a logical reasoning test, which includes (6) sub-skills , which is (proportional - probabilistic- synthetic- deductive- logic- variable adjustment). The psych
... Show MoreThe study aims to elucidation Difference distribution of the labor force by occupation in Sulaymaniyah governorate for the year 2013 by result field study to governorate and explain different Spatially for labor force by career. and The study reaches That Executive staff and Scribes and who join their high ratio from Total the labor force And the second Grade to Specialists and Technicians and who join their While Occupied career Production workers and who join their and Operators Transport Equipment and Engaged the third Grade from the total labor force and Continued Height in career Executive staff and who join their on the male labor force too . while Production workers in second Grade for male labor force , while the female labor for
... Show MoreThe concept of quality of auditing profession comes on top of the concerns of the international business community and international institutions particularly now following the impact of the several failures and financial hardships suffered by the major companies in the recent collapse of money markets in some countries of the world and fear of their recurrence in the future.An observer of the local and international rules and standards (or principles) finds that these include such implications have direct or indirect effects on the performance of the service of the accountant and auditor, which should upgrade their professional performance in these services to a high level of quality so as to be in line with the requirements, principles
... Show MoreThe development of a future mechanism for sustainable development in Iraq to meet the current and future challenges requires an analysis of the indicators of sustainable development. This research aims at presenting and analyzing the social care aspect and highlighting the important role of taxes with a focus on social sustainable development to determine the extent and direction of changes. Level of progress, the researcher concludes the weakness of the financial allocations to the Ministry of Labor and Social Affairs and in line with the large number of people who apply the conditions and controls, and recommends the researcher the necessity of participation of all segments of society between the public and private sector In terms of o
... Show More