The Role of C-reactive Protein and Procalcitonin in Predicting the Occurrence of Pancreatic Fistula in Patients who Underwent Laparoscopic Pancreaticoduodenectomy: a Retrospective Study.

The occurrence of postoperative pancreatic fistula following laparoscopic pancreaticoduodenectomy (LPD) is a significant concern, yet there is currently a lack of consensus on reliable predictive methods for this complication. Therefore, the aim of this study was to assess the clinical significance of C-reactive protein (CRP) and procalcitonin (PCT) values and their reliability in early predicting the development of clinically relevant pancreatic fistula (CRPF) following LPD.A retrospective analysis was conducted using data from 120 patients who had LPD between September 2019 and December 2021. Preoperative assessment data, standard patients' demographic and clinicopathological characteristics, intra- and postoperative evaluation, as well as postoperative laboratory values on postoperative days (PODs) 1, 3, and 7, including white blood cells (WBCs), CRP, and PCT, were prospectively recorded on a dedicated database. Two clinicians separately collected and cross-checked all of the data.Among 120 patients [77 men (64%), 43 women (36%], CRPF occurred in 15 patients (11 grade B and 4 grade C fistulas). The incidence rate of CRPF was 12.3%. A comparison of the median values of WBCs, PCT, and CRP across the two groups revealed that the CRPF group had higher values on most PODs than the non-CRPF group. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and cutoff values. It was discovered that POD 3 has the most accurate and significant values for WBCs, CRP, and PCT. According to the ROC plots, the AUC for WBCs was 0.842, whereas the AUC for PCT was 0.909. As for CRP, the AUC was 0.941 (95% CI 0.899-0.983, p < 0.01) with a cutoff value of 203.45, indicating a sensitivity of 93.3% and specificity of 91.4%.Both CRP and PCT can be used to predict the early onset of CRPF following LPD, with CRP being slightly superior on POD 3.

Clinical assessment of VSR site and size and its relation to the severity of heart failure in post-myocardial infarction ventricular septal rupture patients.

BACKGROUND: Ventricular septal rupture (VSR) is a rare but well-known mechanical consequence of an acute myocardial infarction (AMI). Even in the later stages of re-perfusion therapy, the result of VSR remains poor. Our aim is to assess the site and size of VSR in relation to the severity of cardiac failure. METHODS: From January 2016 to December 2022, a total of 71 patients with a diagnosis of post-myocardial infarction VSR were admitted to the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. Data records were retrospectively included in this registry. In all patients, clinical and echocardiographic data were gathered, and statistical analyses were performed. RESULTS: A total of 71 consecutive patients (mean age: 66.27 ± 8.88 years); 50.7% male, 49.3% female, with (M:F) ratio of almost (1:1). Left ventricular ejection fraction (LVEF) was (48.55 ± 10.44%) on echocardiography, and apical VSR was the most common site (69.0%). Overall, the VSD site was strongly related to the VSD size (p = .016), LVEF (p = .012), AMI site (p = .001), and affected coronary vessel (p = .004). Prodromal angina (p = .041), intra-aortic balloon pump (p = .002), affected coronary vessels (p = .020), pro-BNP (p = .000), and LVEF (p = .017) were predictors of the severity of heart failure. CONCLUSIONS: Diabetes mellitus is a common risk factor for post-myocardial infarction VSR. VSR site and size had no relation to the severity of heart failure. A presentation with prodromal angina predicted severe heart failure and a worse prognosis.

Assessment of Deep Learning Models for Cutaneous Leishmania Parasite Diagnosis Using Microscopic Images.

Cutaneous leishmaniasis (CL) is a common illness that causes skin lesions, principally ulcerations, on exposed regions of the body. Although neglected tropical diseases (NTDs) are typically found in tropical areas, they have recently become more common along Africa's northern coast, particularly in Libya. The devastation of healthcare infrastructure during the 2011 war and the following conflicts, as well as governmental apathy, may be causal factors associated with this catastrophic event. The main objective of this study is to evaluate alternative diagnostic strategies for recognizing amastigotes of cutaneous leishmaniasis parasites at various stages using Convolutional Neural Networks (CNNs). The research is additionally aimed at testing different classification models employing a dataset of ultra-thin skin smear images of Leishmania parasite-infected people with cutaneous leishmaniasis. The pre-trained deep learning models including EfficientNetB0, DenseNet201, ResNet101, MobileNetv2, and Xception are used for the cutaneous leishmania parasite diagnosis task. To assess the models' effectiveness, we employed a five-fold cross-validation approach to guarantee the consistency of the models' outputs when applied to different portions of the full dataset. Following a thorough assessment and contrast of the various models, DenseNet-201 proved to be the most suitable choice. It attained a mean accuracy of 0.9914 along with outstanding results for sensitivity, specificity, positive predictive value, negative predictive value, F1-score, Matthew's correlation coefficient, and Cohen's Kappa coefficient. The DenseNet-201 model surpassed the other models based on a comprehensive evaluation of these key classification performance metrics.

Histopathological and immunological study of rats liver hydatid cysts isolated from human, sheep, goat and cows.

In endemic places, liver hydatidosis is a life-threatening health issue. Many consequences such as hepatomegaly, infiltration with inflammatory cells and histopathological changes might arise as a result of liver hydatidosis. This study aimed to look into pathogenic changes in the livers of the rats that experimentally infected with hydatid cysts. These hydatid cysts were isolated from naturally infected humans, sheep, goats and cows. Liver hydatid cysts were collected from the main abattoir of Al-Muthanna province while human hydatid cysts were collected from Al-Hussein Teaching Hospital in Al-Muthanna province. The hydatid cysts were grossly and histology examined for inspection of hydatid cysts. The in vivo experiments were done by injection of hydatid protoscoleces or sand (fluid) in rats intraperitoneally. The results showed that the gross signs were same in all infected livers which range from paleness, hepatomegaly, hemorrhage and calcification. The hydatid cysts isolated from sheep and goat livers were highly fertile compared to others isolated from humans and cows. Injection of hydatid protoscoleces and hydatid fluid isolated from sheep and goat livers in rats induced the highest immune response compared to that isolated from humans and cows. The liver sections of rats that were injected with human, goat and sheep hydatid protoscoleces and fluids showed hyperplasia in the bile duct, aggregation nonnuclear cells with congested blood vessels. While liver sections of rats were received goat hydatid fluid, cow hydatid protoscoleces and hydatid fluid showed normal liver tissue. These findings suggested that the immunogenicity of hydatid materials is different according to the host and the component of hydatid cysts.

Non-Infectious Dermatological Manifestations among Patients with Diabetes Mellitus in Basrah, Iraq.

Diabetes mellitus (DM) is a clinical illness usually linked to a wide range of skin manifestations; however, skin, as the greatest organ in the body, has received little attention. As a result, this study aimed to detect the prevalence and pattern of non-infectious skin disorders among patients with diabetes. This study was carried out at the Faiha Specialized Diabetes, Endocrine, and Metabolism Center, Basrah Province, Iraq, from September 2020 to September 2021. The data were collected from 347 patients with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM). The exclusion criteria were patients with skin changes due to some medications, pregnancy, iatrogenic factors, skin infections, established hypo- or hyper-thyroidism, Cushing or adrenal insufficiency, pituitary disorders, end-stage renal impairment, malignancy, and established rheumatological disease and those who were on chemotherapy. Full dermatological examinations and screenings were performed under the supervision of a dermatologist expert and all clinically definable cutaneous lesions were recorded. The prevalence of skin lesions was estimated at 71.5% in patients. Pruritus, xerosis, acrochordon, diabetic dermopathy, acanthosis nigricans, and insulin-related lipohypertrophy were the commonest skin lesions reported among the patients. The occurrence of skin lesions in diabetic patients was proportional to the female gender, duration of disease, obesity, insulin therapy, and worse glycemic control. There was a broad spectrum of skin lesions in both T1DM and T2DM with corresponding prevalence.

Total Testosterone to Estradiol Ratio as a Predictor Marker of Metabolic Syndrome in Males.

Nowadays, metabolic syndrome (MetS) represents a global health challenge in developed and developing countries. The sex hormones disorders in males are related to many clinical co-morbidities. This study aimed to evaluate the total testosterone (TT) to estradiol (E2) ratio as a predictor marker of MetS. This case-control study included 88 MetS patients and 88 healthy individuals (control), in the age range of 18-69 years who were selected among patients who were referring to an outpatient clinic, using a convenience sampling method. The study participants were selected based on their medical history and physical examination, which included waist circumference, blood pressure, serum E2, TT, fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein-cholesterol (HDL-C). Diagnosis of MetS was confirmed according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. The findings revealed that the mean TT level was significantly lower among patients with MetS (P<0.001), while the mean E2 level was significantly higher among patients with MetS (P<0.001). The mean TT to E2 ratio was significantly lower among patients with MetS (OR=9.6, P<0.001). There was a significant correlation between MetS components and TT to E2 ratio and waist circumference (WC) (r = - 0.49, P<0.0001). The means of weight, WC, blood pressure, and FBG levels were significantly higher in patients with MetS (P<0.001, P<0.001, P<0.001, P=0.04, respectively), and the lipid profile of patients with MetS was abnormal (TG, P<0.001, HDL-C, P<0.001). Eventually, it can be concluded that the TT to E2 ratio can be regarded as a significant predictor of MetS in males.

Facial Features Detection System To Identify Children With Autism Spectrum Disorder: Deep Learning Models.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with brain development that subsequently affects the physical appearance of the face. Autistic children have different patterns of facial features, which set them distinctively apart from typically developed (TD) children. This study is aimed at helping families and psychiatrists diagnose autism using an easy technique, viz., a deep learning-based web application for detecting autism based on experimentally tested facial features using a convolutional neural network with transfer learning and a flask framework. MobileNet, Xception, and InceptionV3 were the pretrained models used for classification. The facial images were taken from a publicly available dataset on Kaggle, which consists of 3,014 facial images of a heterogeneous group of children, i.e., 1,507 autistic children and 1,507 nonautistic children. Given the accuracy of the classification results for the validation data, MobileNet reached 95% accuracy, Xception achieved 94%, and InceptionV3 attained 0.89%.

Serum Level of Heat Shock Protein 70 in Patients with Type 2 Diabetes Mellitus in Basrah, Iraq.

Diabetes mellitus is a chronic metabolic disease with an increasing prevalence, caused by a defect in insulin production, insulin action, or both, and can increase the risk for the development of microvascular as well as macrovascular complications. Heat shock protein70 is considered a family of a larger group of proteins known as heat shock proteins, which their expression is induced when the cells are subjected to environmental stress. They are believed to keep the native folding of proteins in cells under stressful conditions and their therapeutic role. Therefore, this study aimed to investigate the serum level of HSP70 in patients with type 2 diabetes mellitus (T2DM) to assess if there is an association of HSP70 with T2DM and to evaluate the effect of age and duration of disease on the serum level of HSP70. Ninety-one patients with T2DM were recruited, and 85 individuals with the same age range and sex as healthy controls. Serum HSP70, fasting blood sugar, and HbA1c were measured. The results revealed that the level of HSP70 was significantly higher in the diabetic group compared to the control group (P value<0.05). The level of HSP70 showed a significant positive correlation with age and duration of disease as well as with fasting blood sugar and HbA1c. The study suggested that HSP70 may have the potential to be used as an indicator of metabolic derangement and a prognostic biomarker in diabetes.

Geographic information system-based approach and statistical modeling for assessing nitrate distribution in the Mitidja aquifer, Northern Algeria.

The Mitidja alluvial aquifer in northern Algeria is an important drinking, industrial, and agricultural water source. Unfortunately, nitrate contamination has led to a decrease in water quality in several areas that benefit from this source. This study employed geographic information system and statistical modeling methods to evaluate the origin, evolution, and spatiotemporal distribution of groundwater nitrate in the aquifer and investigate the influence of different hydrogeological parameters on its extent. Control points were established across various regions of the Mitidja groundwater aquifer. A total of 1185 nitrate concentrations were measured at 316 sampling points between June 1985 and May 2015. The results showed variable rates, with the 50 mg/L nitrate consumption limit exceeded in 423 samples at 84 observation points. Statistical modeling showed that nitrate concentration was related to groundwater characteristics (aquifer nature, water table depth, and thickness of saturated zone) and human activities (land use, agricultural practices, and population density). Analysis of the nitrate distribution showed that the eastern and western watersheds experienced the greatest contamination. The significant nitrate concentrations in the eastern area were correlated with urban contamination, including uncontrolled urbanization, high population density, and industrial activity, while the primary origin of nitrate in the western area was correlated with agricultural activity, particularly fertilizers. The findings of this study can aid local government and water agencies in the development and implementation of regulations to help mitigate increases in nitrate concentrations.

Preclinical Experiments for Hypospadias Surgery: Systematic Review and Quality Assessment.

Background: There is a steadily growing number of different reconstructive surgical procedures for hypospadias that were tested on animal models prior to their human application. However, the clinical translatability and reproducibility of the results encountered in preclinical urethral reconstruction experiments is considered poor, with significant factors contributing to the poor design and reporting of animal experiments. Our objective was to evaluate the quality of the design and reporting in published articles of urethral reconstructive preclinical studies. Methods: Both PubMed and EMBASE databases were searched for animal urethral repair experiments between January 2014 and September 2019. Internal quality (bias) was evaluated through several signaling questions arising from the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE), while the quality of reporting was assessed by the Animal Research: Reporting of In vivo Experiments (ARRIVE) guidelines by scoring of a 20-item checklist. Results: A total of 638 articles were initially screened after the literature search. Employing the inclusion and exclusion criteria, 30 studies were chosen for full-text screening and 21 studies were considered eligible for the quality assessment. The mean score of the checklist was 66%. The elements that accomplished the highest grades included the number of animals utilized, the number in each investigational and control group, and the delineation of investigational conclusions. The items that were least commonly stated comprised information about the experimental method, housing and husbandry, rationalization of the number of animals, and reporting of adverse events. No paper stated the sample size estimation. Conclusion: We found that several critical experiment design principles were poorly reported, which hinders a rigorous appraisal of the scientific quality and reproducibility of the experiments. A comprehensive implementation of the ARRIVE guidelines in animal studies exploring urethral repair is necessary to facilitate the effective translation of preclinical research findings into clinical therapies.

Scrotal base distance: A new key genital measurement in males with hypospadias and cryptorchidism.

BACKGROUND: Anogenital distance (AGD) in both humans and animals is a known reflection of fetal endocrine effect on genital virilization and the related abnormalities, including cryptorchidism and hypospadias. However, we introduce here and investigate scrotal base distance (SBD) as a sensitive genital anthropometric biomarker in human infants with cryptorchidism and hypospadias, which are considered early manifestations of testicular dysgenesis syndrome. We aim to assess SBD in patients with cryptorchidism or hypospadias against healthy subjects. MATERIAL AND METHODS: Patients with hypospadias (n = 61, age 17.4 ±â€Š6.3 months) or cryptorchidism (n = 51, age 11.4 ±â€Š4.8 months) were enrolled for assessment of SBD, AGD, and penile length; and compared with a cohort of 102 full-term healthy boys for standard ritual circumcision by measuring age-specific standard deviation scores. RESULTS: Patients having hypospadias had lower mean SBD, AGD, and penile length standard deviation scores than the control group (p < 0.01). These values in patients with cryptorchidism were longer than mean values in boys with hypospadias (p < 0.01) and shorter than mean values in the control group. CONCLUSIONS: We showed that SBD, AGD, and penile length were lower in patients with cryptorchidism or hypospadias compared to normative data measured from a control group of healthy boys for ritual circumcision. These results enforce the use of SBD as an objective anthropometric measurement and a viable biomarker to assess the effects of fetal endocrine imbalance on male external genitalia development.

Basrah experience among 6404 patients with COVID-19

AbstractsO_ST_ABSBackgroundC_ST_ABSThe first case of COVID-19 report in Basrah was in early March 2020. This study aimed to assess some of the characteristics of patients with COVID-19 in Basrah for the period from March, 4th to September, 8th 2020. MethodsRetrospective database analysis of the University of Basrah database. All RT-PCR positive patients during the study period were enrolled. ResultsOf 6404 patients included, male constituted 54.8%. Healthcare workers constituted 11.4% of the infected people. Of health care workers 16.1% were physicians. The mean age for the whole cohort was 39{+/-}16.7 years; adolescents and children younger than 20 years constituted 12.4%. The peak age was 31-40 years, those aged 61 years or more constituted 9.8% only. The case fatality rate was 3% (males 55.2% and females 44.8%). No death was reported in adolescents or children. The highest death rate was among those age 61 years or more. ConclusionThe situation of COVID-19 infection in Basrah, Iraq is evolving like other countries. Furthers studies are needed to assess associated comorbidities, treatment lines, outcomes and variables associated with mortality.

Long-term fate of the incised urethral plate in Snodgrass procedure; A real concern does exist.

We present here a case of a patient post tabularized incised plate urethroplasty for distal hypospadias without chordee who developed urethral stenosis and acquired curvature along the territory of the incised plate necessitating a redo surgery. The histological analysis of the incised urethral plate revealed absence of smooth muscles, vessels and elastin fibers within the area of the incised plate which could explain the poor compliance of this segment and the development of the curvature. To our knowledge, this case is the first in humans displaying the long-term histological findings of healing post tabularized incised plate urethroplasty.

"Double-Lumen Valve-Controlled Intra-Operative Pyeloplasty Stent (VIPs)": A New Technology for Post-Pyeloplasty Stenting - Proof of Concept Study in a Preclinical Large Animal Model.

BACKGROUND: Pyeloplasty is a common surgical operation with a high success rate. However, significant challenges are to be optimized in the design of stenting systems in order to improve perioperative monitoring of urine drainage and enhance patient and family comfort through easier post-operative care. MATERIALS AND METHODS: In a preliminary study in six pigs, handling, mechanical and functional features of this stent system were tested. In our main study, six double-lumen stents (230 mm long each) and 6F/9F external diameter were implanted through the ureteric walls of six domestic pigs to allow postoperative drainage and monitoring following ureteroureterostomy. After a 7-day survival period, monitoring with intravenous antibiotic coverage, and pain control, contrast antegrade pyelogram, under valve control, and renal ultrasonography were conducted and stents explanted and the animals were then euthanized. RESULTS: The double-lumen valve-controlled stent supported the healing of the neo anastomoses and helped to monitor perioperative urine drainage and perianastomotic leakage accurately. It also guided a well-controlled more informative radiological contrast-supported imaging before removal of the stents that confirmed the healing of the neo anastomotic site and no leak formation. The double-lumen system demonstrated high feasibility regarding its insertion, functionality, and removal capacities. The excellent flexibility of the individual stents allowed exact anatomically controlled implantation. CONCLUSION: The double-lumen valve-controlled stent system was studied in a porcine model, which demonstrated its feasibility. Preclinical experience revealed favorable results concerning stent implantation, operability and functionality, in the perioperative management of pyeloplasty or ureteric surgery.

Bilateral Neonatal Testicular Torsion; Hidden Surgical Nightmare.

Perinatal testicular torsion is a relatively rare event that remains unidentified in many situations and managed only after an avoidable delay of time. Its current management approaches include watchful observation, delayed contralateral orchiopexy, and emergent contralateral orchiopexy. On the other hand, bilateral torsion is now being more frequently reported. However, the assessment of the contralateral testis through physical examination and imaging can be inaccurate in cases of perinatal torsion. We report a case of prenatal testicular torsion with incidentally discovered metachronous contralateral extravaginal testicular torsion. Therefore, immediate surgical intervention is recommended both when uni- or bilateral testicular torsion is suspected. Whenever possible, affected testes should be preserved as some endocrine function may be retained.

Suspected testicular torsion in children: diagnostic dilemma and recommendation for a lower threshold for initiation of surgical exploration.

PURPOSE: Testicular torsion (TT) represents a clinical challenge that needs emergency surgical assessment. It is common to have negative scrotal exploration due to confounding symptoms and signs which makes it sometimes difficult to differentiate from similar surgical emergencies that do not warrant surgery. At the same time, several occasions of misdiagnoses or late interventions occur with devastating effects. We aim at delineating the significance of the different clinical, laboratory, and radiological variables in the detection of TT. METHODS: We retrospectively reviewed the charts of 52 patients who were surgically explored with a preoperative working diagnosis of suspected TT in our center over the period from 2011 to 2015. All the patients were examined by pediatric surgeons in the emergency room and had undergone ultrasound imaging of the testes. The ultrasound images were retrospectively reviewed by a pediatric radiologist who was blinded to the intraoperative findings. Univariate and multivariate and logistic regression analyses were performed. RESULTS: Of the studied group of patients, the majority (84.6%) had TT upon surgical exploration. The most frequently presented symptom was pain (80.8%), and only a minority (11.5%) presented with vomiting. Radiological findings with the highest sensitivity were heterogeneous echogenicity in favor of TT and enlarged epididymis indicating that TT is unlikely. However, the predictability of TT by any of the assessed clinical and imaging factors was statistically insignificant. CONCLUSION: It is important to gather all relevant data from clinical, laboratory, and imaging sources when assessing pediatric patients with suspected TT given the inaccuracy of each single one of them if used alone. Keeping this in mind, Doppler ultrasound has a significant role to aid in the accuracy of the diagnosis and hence the appropriate decision-making thereafter. However, we found no single clinical or imaging sign that is sensitive enough to prove or rule out TT. Therefore, surgical exploration should take place in a timely manner. Moreover, further research is necessary to construct scoring systems where different predictors collectively have higher reliability.

Production of functional spreadable processed cheese using Chlorella vulgaris.

BACKGROUND: Chlorella vulgaris alga is one of the most important additives for enhancing the nutritional content of conventional foods, hence positively affecting human health. This alga is known as a rich source of protein, fatty acids, fiber, essential vitamins and minerals. Also, it contains antioxidants, omega 3, antivi- ral and anticancer properties. The aim of this research is increasing the nutritional and potential therapeutic value of processed cheese by using Chlorella vulgaris alga, taking advantage of its high nutritional and health value. METHODS: The ingredients in the processed cheese blends were mature cheddar cheese, Ras cheese, butter, skimmed milk powder, Emulsifying salts (K-2394, S9s & S4), Chlorella vulgaris (in freeze- dried and slurry forms). Chemical, rheological and sensory evaluation properties were evaluated in processed cheese analogue (PCA) treatments when fresh and after three months of cold storage at 5–7°C. PCA treat- ments were enriched with 2%, 4% and 6% dried Chlorella vulgaris powder in the cheese blends and 4% Chlorella vulgaris slurry. RESULTS: The incorporation of alga into processed cheese led to an increase in their functional characteristics. The results of sensory evaluation of PCA samples demonstrated that 2% of alga addition was the best treat- ment, followed by 4%, but that the level of 6% was unacceptable to consumers. The studied alga enhanced the cheese analog with the high levels of selenium, zinc, iron, magnesium and potassium. Antioxidant activity in the cheese enhanced with Chlorella vulgaris was higher than the control sample. To improve some proper- ties of PCA, other emulsifying salts (S9S and S4) were tested and the alga was added in the form of slurry with value of 4% into the cheese blend. Both S9S and S4 emulsifying salts were good and the S4 was the best for oiling off and meltability. Also, when using the slurry of Chlorella vulgaris, the granular texture of the cheese analog completely disappeared. CONCLUSIONS: The results showed that the alga indeed increased nutrition values and health benefits to the processed cheese, making it a substantial functional food. Therefore, we recommend supporting the manu- facture of the processed cheese analogue with the addition of 2% Chlorella vulgaris alga in soft powder form and 4% Chlorella vulgaris alga in slurry form at the end of the processing.

Urethral Meatus and Glanular Closure Line: Normal Biometrics and Clinical Significance.

Purpose: The aim of this study is to explore the normal external urethral meatal and glans closure line in normal boys, and to investigate the correlation between these glans biometrics and the age of the participants. MATERIAL AND METHOD: 103 male children were asked to participate in the study during ritual circumcision. Par-ents of 94 of them (mean age 5.9 years, range 0.6-13) accepted while remaining 9 did not. Glans biometrics were measured using digital calipers. RESULT: 100% of the study participants had a vertical slit-like meatal opening located at the tip of the glans. The length of the meatal opening was 5.3 (± 1) mm and of ventral glans closure was 4.8 (±1.1) mm. Significant cor-relation between both the external meatal opening and closure lines lengths and age was observed. Moreover, the meatal opening size was correlated to the glans closure line as well (r = 0.36, confidence interval 0.14-0.54, P < .001). CONCLUSION: The site and size of the meatus opening in normal male children is consistent, and ventral glans clo-sure is equal to or slightly less than meatal length. These findings could aid in glanular reconstruction configuration during hypospadias surgery.