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Article
Comparison between Single and Double Dartos Layers Snodgrass Technique for Hypospadius Repair : Results of Our Experience

Author: Ali Hadi Sabhan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 330 -336
Publisher: Babylon University جامعة بابل

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Abstract

To compare our results with single versus double dartous layers Snodgrass technique for hypospadius repair, a comparative study was done and the results were compared in term of : the overall success and complications rates, percentage of each complication (urethrocutaneous fistula, meatal stenosis, urethral diverticulum and glandular or complete neourethradehiscence) with final cosmetic appearance and straightening of urinary stream.The study was extended from January 2013 to June 2015; including a randomly selected fourty three children with median age of 29 months (range from 12 to 66 months) with a primary hypospadias. Patients were divided into 2 groups: Group 1 include 21 patients that were selected to be operated by a single layer TIP technique.Group 2 include 22 patients that were selected to be operated by a double layer TIP technique.All patients under went Snodgrass technique urethroplasty in the surgical theater of Al-Diwaniya teaching general hospital under general anesthesia.The results shows a higher overall success rate and cosmetic appearance with lower complications for patients in group 2in comparison to those in group 1with no statistically significant difference. The neourethral covering in TIP hypospadias repair(Snodgrass technique) with double-dartos flap yield a better cosmetic and functional results in comparison to single dartos flap cover in terms of increasing success rate and minimizing complications specially in decreasing the rate of urethrocutaneous fistula formation which is the most common complication following this type of surgery.


Article
The Effects of Combined Oral Antioxidants on Male Infertility

Author: Ali Hadi Sabhan علي هادي سبهان
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2015 Volume: 11 Issue: 20 Pages: 143-151
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

BackgroundHigh reactive oxygen species (ROS) levels was considered as an important factor of male infertility that can result in DNA damage, decrease motility and damage membrane integrity. The role of antioxidants is to maintain the balance between ROS production and their clearance which improve sperm parameters and enhance male fertility.Patients and methodsSixty six male patients with median age of 29 years with a mean period of infertility of 1.5 year that attend the infertility clinic in Al-Diwaniya Maternity and Pediatric Hospital were selected randomly in this study which extend from January 2013 to October 2014 (22 months).The patients were selected to have idiopathic oligo-astheno-teratozoospermia, they underwent a detailed history, general and genital physical examination, Two semen analyses, baseline hormone profile and scrotal Doppler ultrasound examination . All344patients were given a combination of oral antioxidants including vitamin E (400 IU. once daily), coenzyme Q10 ( 75 mg. tablet twice a day), zinc sulphate (15 mg. tablet three time a day) and L-carnitine ( 1000 mg. twice a day) for three months duration of treatment. Semen analysis was repeated after three months from initiation of therapy and was evaluated for changes in volume, concentration, motility and morphology in comparison with baseline semen analyses and any pregnancy was also documented.ResultsThirteen patients (19%) get pregnancy after a period of 2 to 3 months, other patients show variable changes in their seminal analysis after 3 months. Thirty patients (45%) show increasing in seminal volume of 0.5 to 2 ml. , while the sperm concentration was increased in 28 patients(42%) . Twenty two patients (33%) show increasing in motility , morphology was increased in 34 patients (51%) .From all 66 patients; 6 patients (9 %) get improvement in all four parameters, while 9 patients (14 %) get improvement in only 3 parameters, 20 patients (30 %) get improvement in only 2 parameters, 23 patients (35 %) get improvement in only one parameter and 8 patients (12 %) had no improvement in any parameter.ConclusionThis study demonstrates a possible role of combined oral antioxidants in the improvement of semen parameters and pregnancy rate for selected infertile men with superiority for the use of combination of antioxidants rather than single agent treatment.

مقدمه:يعتبر ارتفاع نسب أصناف الأكسدة التفاعلية في السائل المنوي للرجال من احد أسباب العقم لديهم ولذلك فاناستعمال العلاجات المضادة للاكسده تعمل على خفض مستوياتها من خلال تحقيق توازن بين عملية إنتاجها وعمليةالتخلص منها والذي يؤدي إلى تحسين نوعية النطف ورفع نسبة الإنجاب.طريقة البحث:أجريت هذه الدراسة على 66 مريض من الذكور بمعدل عمر 92 عام ومعدل فترة عقم 3.1 سنه حيث تم اختيارهمعشوائيا لهذه الدراسة التي امتدت من شهر كانون الثاني 9131 وحتى شهر تشرين الأول 9134 للمرضى المراجعينلعيادة العقم في مستشفى النسائية والأطفال في الديوانية.تم اخذ التاريخ المرضي لجميع المرضى واجري لهم الفحصالسريري العام والتناسلي وفحصت عينتان من السائل المنوي وإجراء التحاليل الهرمونية اللازمة وفحص سونارالدوبلرالملون للخصيتين.أعطي جميع المرضى مجموعة من علاجات مضادات الأكسدة لمدة ثلاثة اشهر وتم بعدها إعادةفحص السائل المنوي لمتابعة التغيرات في كمية السائل,تركيز النطف,مظهر النطف وحركتها مع توثيق حدوث إيحمل.النتائج:تحقق الحمل لثلاثة عشر مريض ) 32 %( خلال فترة الدراسة في حين حصلت تغيرات ايجابية في السائل المنوي لدىالمرضى الآخرين الذين لم يتحقق لهم الحمل حيث إن 11 مريض ) 41 %( ازدادت لديهم كمية السائل المنوي و 92مريض ) 49 %( ازداد لديهم تركيز النطف في السائل.99 مريض ) 11 %( حققوا زيادة في حركة النطف و 14 مريض ) 13 %( تحسن مظهر النطف لديهم كما وكانت هناكنتائج مختلفة بين المرضى في تحسن عدد عناصر السائل المنوي )عنصر واحد أو أكثر( وبنسب مختلفة.الاستنتاج:أظهرت هذه الدراسة دورا مشجعا لدمج علاجات مضادات الأكسدة في تحسين عناصر السائل المنوي وتحقيق الحمللدى بعض الرجال الذين يعانون من العقم وكما أظهرت أفضلية دمج تلك المضادات على استعمالها بشكل منفرد.

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