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
Objective (s): To evaluate reasons for partial compliance and non-compliance to the
routine childhood vaccination schedule in Al-Karkh district
Methodology: Descriptive study , using the evaluation approach, is carried throughout the present study to determine the reasons for the Routine Childhood Vaccination at health care sectors and primary health care centers at Al-Karkh District in Baghdad City, Convenient, non-probability, sample of (90) mother who are recruited from health care sectors at Al-Karkh District in Baghdad City. All mothers, who ha
... Show MoreThis research aims to show the nature of the impact of proactive and analytical strategic orientation in the dimensions of tax organizational excellence (leadership, strategic planning, information and analysis and knowledge management, focus on taxpayers, focus on operations, focus on workforce, business results), in the General Tax Authority The questionnaire was used as a tool to collect data and information from the sample of (110) who are (Associate Director General, Head of Department, Under-Head of First Division, Under-Head of Second Section, Division Officer). Arithmetic mean, intestinal deviation the research has reached a number of conclusions, the most prominent of which are: -
- There is an effect of
The general budget is usually linked to the role of the state in public life and economic activity, whether this role is neutral or interventionist and thus reflects the general objectives that the state seeks to achieve.
for importance of the public budget in clarifying the image of the political state philosophy and its objectives it seeks to achieve on the one hand and clarifying the degree and rank it occupies in the ladder of development among the other countries. This study is intended to highlight the concepts of the general budget and how its concept has evolved since the Middle Ages. Of the importance of the general budget in Iraq was not based on scientific and objective and then the study
... Show MoreThe research illustrated that the theory of constraints is "A group of concepts and basics that aim at helping the management in order to determine the difficulties and how to overcome these difficulties through determining the necessary change and how these change can be done efficiently and effectively ".
The research showed that the theory of constraint including its tools calls for magnifying throughput, constricting the product cycle , determining the optimal production mix , utilization of scare resources and canceling the idle time , that achieving throughput increasing then increasing profit .
Moreov
... Show MoreForm recurrence of financial crises phenomenon disturbing and attention , and returns the reasons so that its negative effects were sharp and dangerous , because of the nature and cause of Ncaha , threatened political and economic stability of the countries in which they occur these crises , in addition to Machmlh these crises spread of contagion across multiple channels to include other countries many developed and developing , and the reason for this to the openness of the economic and financial witnessed by the countries affected by crises and other countries concerned, the financial crisis is a case of financial turmoil appears in one of the sections of the financial system one and extends to
... Show MoreThe fluctuations in oil prices in world markets affect the general budget and the trade balance of the rent countries, because oil is a strategic commodity affected by economic and political factors. The fluctuations in oil prices affect the public budgets of the rent countries through the public revenue side of oil revenues. On the other hand, these fluctuations affect the balance of trade through the volume of oil exports, which lead to imbalance of trade surplus or deficit . &nbs
... Show MoreBanks face many of the various risks: which are of dangerous phenomena that cause the state achieved a waste of money and a threat to future development plans to be applied to reach the goals set by: prompting banks and departments to find appropriate solutions and fast: and it was within these solutions rely on Banking risk management and effective role in defining and identifying: measuring and monitoring risk and trying to control and take risks is expected to occur in order to encircle and make it in within acceptable limits: and try to avoid them in the future to reduce the losses that are likely to be exposed to the bank: and it began to emerge and dominate a lot of legislation that seeks to structure the year risk management and t
... Show MoreThis work includes preparation of Az, Qz, and Tz derivatives from the reaction of Schiff base (Sb) derivative with anthranilic acid, chloroacetyl chloride, and sodium azide, as well as, the characterization via FT-IR, 1H-NMR, and 13CNMR. The anticorrosion inhibition of these compounds was studied and the measurements of carbon steel (CS) corrosion in sodium chloride solution 3.5% (blank) and inhibitor in solutions were calculated at a temperature range of 293-323 K by the technique of electrochemical polarization. In addition, some thermodynamic and kinetic activation parameters for inhibitor and blank solutions (Ea⋇, ΔH⋇, ΔS⋇, and ΔG⋇) were determined. The results showed high inhibition efficacy for all the prepared compounds,
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