Background :Evening preparation for colonoscopy is often unsatisfactory and inconvenient. This study was performed to compare the efficacy of bowel preparation at two different timings: night before and morning of endoscopy and to compare the cecal intubation rate and disturbance of sleep hours between these two groups.
Methods: In this prospective randomized endoscopist- blinded trial, 150 patients were enrolled between March 2010 and August 2011. Patients aged between 18 to 80 years needing colonoscopy were included. Patients with prior bowel surgery, suspected bowel obstruction or those who didn't completely fulfill the preparation instructions were excluded. Patients received polyethyelen glycol electrolyte preparation in a morning and evening regimen. Bowel cleansing was scored using the Ottawa Bowel Preparation Quality Scale. Loss of sleep and cecal intubation rate was evaluated.
Results: Seventy five patients received morning regimen and 75 patients received evening regimen.
There was significant difference in total scores of bowel preparation for the two groups favoring the morning group (ρ < 0.0001) . Bowel cleansing for right and mid colon were significantly better in the morning group (ρ < 0.001), while the difference for the left colon was not significant. The cecal intubation rate was comparable for both groups ( ρ NS).Sleep was disturbed in 15 patients in morning group and in 42 patients in evening group (ρ = 0.003).
Conclusion: In conclusion, this study suggests that morning preparation provide better quality of bowel preparation for colonoscopy than evening preparation. Right and mid sided colonic preparation is superior in the patients who take the morning preparation than left sided preparation. Evening preparation is associated with a significant sleep disturbance. This would translate to considerable financial losses and patient discomfort.
This research has come out with that strategies made by Porter as generally strategies applicable to any size and type of economic units cannot be applied to many of the economic units in the world in generally and in Iraq especially not a lot of economic units have the resources and competencies that enable them to provide a unique product of its kind in the minds of customers and then adopt a differentiation strategy and not a lot of economic units have the resources and competencies that make them the cost leader. Differentiators and cost leaders are minority in the world while not differentiators and not cost leaders are majority in the world.
The economic units are not differentiators and not c
... Show MoreThe process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
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... Show MoreThe aim of the research is to prepare practical volleyball lessons by using the four pillars strategy for middle school students, and to identify the effect of the four pillars strategy in performing the transmission and volleyball skills in the second intermediate students, to assume that the two researchers assume that there are no statistically significant differences between the results of my skill performance tests Sending and preparing tribal and remote volleyball for the experimental and controlled groups, and there are no statistically significant differences between the results of the performance of the transmission and preparation skills of the volleyball between the two experimental and control groups, and the research co
... Show MoreTotal Quality Assurance Concept have appeared in Higher Education Institutions as a result of the continuous criticism for the lower quality of the outputs of these institutions and their inappropriacy to the needs of the job market. The faculty, i.e. teaching staff member, is one of the most important output for his/her responsibility to achieve the stated goals in higher education. This represents a problem that may influence the construction of society which has to limit his tasks, responsibilities, and competencies that should be found in a faculty, and evaluating his teaching profession in light of the prerequisites of the century to become an input to achieve quality assurance in Higher Education. Therefore, the present study aims
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The use of Conservatism significant impacts on the financial statements and thus on financial reporting which is produced by these lists so Rate Some of the professionals that the principle of accounting while Rate of others as a constraint, and brought this category based on the uses of this restriction sometimes used the accountant this restriction and especially with the uncertainties in the Sometimes it may collide with some of the cases in which the accountant may be forced to leave in custody as a result of emergence of economic events that gave rise to rights or future commitments should be disclosed.
The emergence in custody mainly was due to the uncertainty and its essence is to report on a
... Show MoreThe principal objective of this study is to demonstrate how green quality management and product life cycle costing may help an organization gain a competitive advantage. Green quality management's influence on increasing product quality and meeting environmental criteria, as well as tracking the activities of product life cycle before, during, and after production, is demonstrated. Orienting these activities toward the production of eco-friendly products that fulfill the needs of customers, hence increasing organization's market share. We found from our study that proposed framework can help organizations improve their competitiveness. Green quality management contributes to environmental protection and the provision of high-qualit
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