Background: Longstanding Tympanic Membrane (TM) perforations may cause hearing loss and middle ear infection even if they are small in size. Further, the patients have to observe water restrictions. The purpose of myringoplasty is to repair such perforations and thus to improve hearing and eliminate the susceptibility to middle ear infectionsObjectives: This study was carried out in ENT Department of Zagazig University Hospitals to compare the effectiveness of fat myringoplasty and perichondrium tympanoplasty in treatment of chronic tympanic membrane perforations in small and large sized perforations.Dialysis is dependent on the concentration of toxic solutes accumulating in renal failure. Urea has been successfully used as a toxic solute marker to define adequate dialysis therapy through urea kinetic models.Prescribing hemodialysis is affected by many components. These include estimation of dry weight which may be achieved by clinical assessment, biochemical markers, inferior vena cava diameter, bioelectric impedance, or noninvasive blood volume monitors.