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.
To finalize any construction investment project, it would be necessary to identify the most significant problems and obstacles that lead to project reluctance and stalling. Unexpected events and conflicts may have disrupted these strategies and impacted project development. Due to the high initial investment costs of construction projects, crises can have an immediate impact, resulting in significant financial losses. The 2014 financial crisis was one of the most prominent crises that Iraq faced, which prompted the researcher to identify and evaluate those obstacles through this research and questionnaires using Pareto scientific theory to exclude factors that do not contribute to project lag. It was discovered that 28 o
... 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
Volcaniclastic rocks of Al Muqdadiya Formation (Pliocene) in Injana area, southern Hemrin anticline, NE of Iraq, were studied ( petrographically, physically, mineralogically and geochemically , as well as the engineering properties) to assess the suitability of volcaniclastic rocks to use them in industry as refractories. The results show that the physical and engineering properties change with the temperature change. The bulk density and the specific gravity increase by increasing temperature while the apparent porosity, water sorption and the linear shrinkage decrease. On the other hand the compressive strength increase by increasing temperature. The volcaniclastics have very low thermal conductivi
... Show MoreA method is developed for the determination of iron (III) in pharmaceutical preparations by coupling cloud point extraction (CPE) and UV-Vis spectrophotometry. The method is based on the reaction of Fe(III) with excess drug ciprofloxacin (CIPRO) in dilute H2SO4, forming a hydrophobic Fe(III)- CIPRO complex which can be extracted into a non-ionic surfactant Triton X-114, and iron ions are determined spectrophotometrically at absorption maximum of 437 nm. Several variables which impact on the extraction and determination of Fe (III) are optimized in order to maximize the extraction efficiency and improve the sensitivity of the method. The interferences study is also considered to check the accuracy of the procedure. The results hav
... Show MoreBackground: Patient satisfaction is of increasing importance and widely recognized as an important indicator of quality of the medical care. There was no homogeneous definition of patient satisfaction, since satisfaction concerns different aspects of care or settings, as well as care given by various professions.
Objective: The objective of this study is to assess the patients’ level of satisfaction with diabetes care and to identify the underlying factors influencing it.
Methods: This cross-sectional study had been conducted in the Specialized Center for Diabetes and Endocrinology in Baghdad Al- Rusafa 2018. Where150 type two diabetic patients attending their follow-up
... Show MoreAs tight gas reservoirs (TGRs) become more significant to the future of the gas industry, investigation into the best methods for the evaluation of field performance is critical. While hydraulic fractured well in TRGs are proven to be most viable options for economic recovery of gas, the interpretation of pressure transient or well test data from hydraulic fractured well in TGRs for the accurate estimation of important reservoirs and fracture properties (e.g. fracture length, fracture conductivity, skin and reservoir permeability) is rather very complex and difficult because of the existence of multiple flow profiles/regimes. The flow regimes are complex in TGRs due to the large hydraulic fractures n
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 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 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
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