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.
Background: Giant middle cerebral artery (MCA) aneurysms are surgically challenging lesions. Because of the complexity and variability of these aneurysms, a customized surgical technique is often needed for each case. In this article, we present a modified clip reconstruction technique of a ruptured complex giant partially thrombosed middle cerebral artery aneurysm.
Case description: The aneurysm was exposed using the pterional approach. Following proximal control, the aneurysm sac was decompressed. Then, we applied permanent clips to reconstruct the aneurysm neck. The configuration of the aneurysm mandated a tailored clipping pattern to account for resi
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Many cities suffer from the large spread of slums, especially the cities of the Middle East. The purpose of the paper is to study the reality of informal housing in Al-Barrakia and the most important problems that it suffers from. The paper also seeks to study the presence or absence of a correlation between urban safety indicators and urban containment indicators as one of the methods of developing and planning cities. This can be achieved through sustainable urban management. The slums are a source of many urban problems that threaten the security and safety of the residents and represent a focus for the concentration of crimes and drugs. The paper seeks to answer the following question: How can urban safety be improved through urban cont
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The continuous technical development in the means of communication and information technologies has led to an increase in competition in the provision of service and product on the part of the organizations, as this competition does not know silence and stability on specific methods, but rather it is a world that is constantly moving and renewed in approaches, methods and approaches, and the focus of attention of integrated marketing communications practitioners are Customers, for them, organizations sell their goods, products, services, and ideas, and with them, they become stronger in competition.
This scientific study aimed to identify the trends of the initiators towards the integrated marketing communications of (the Emirates Tel
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The problem of the study and its significance:
Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease
That is interested psychologists and doctors searchin
... Show MoreThe issue of intellectual capital is a critical issue in the success and excellence of organizations, especially if it is linked to the management of customer experience, and because of the characteristic of the Iraqi environment, which affected all sectors, including the banking sector, it was important to discuss the types of intellectual capital and its relationship to the management of customer experience, especially when managers private banks, the importance of research lies in the linking of its variables to build the strategic capabilities of banks to achieve excellence and sustainability, it aims to diagnose the extent of interest in the types of intellectual capital and management of customer experience in the Iraqi ban
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Results showed that the optimum conditions for production of inulunase from isolate Kluyveromyces marxianus AY2 by submerged culture could be achieved by using inulin as carbon source at a concentration of 2% with mixture of yeast extract and ammonium sulphate in a ratio of 1:1 in a concentration of 1% at initial pH 5.5 after incubation for 42 hours at 30ºC.
The corrosion behavior of low carbon steel in washing water of crude oil solution has been studied potentiostatically at five temperatures in the range (30–70)°C .The corrosion potential shifted to more negative values with increasing temperature and the corrosion current density increased with increasing temperature. Folic acid had on inhibiting effect on the corrosion of low carbon steel in washing water at a concentration (5× 10-4-- 5× 10-3 ) mol/dm3 over the temperature range (30–70)°C. Values of the protection efficiency were calculated from the corrosion current density .From the general results for this study, it can be seen that thermodynamic and kinetic function were also calculated (?G, ?S, ?H and Ea )
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The study of the " Speech act " in grammatical codes reveals great efforts in the study of the elements of linguistic communication contained in their efforts, and is part of the study of the linguistics of heritage, and the research has been designed to identify the verbal act in the blog of Ibn al-Khabaz (guiding the shine) by studying its sections comprehensively; To the spirit of grammatical discourse as well as the combination of the concept of the semantic act already verbal according to Searle, and its response in the form of indirect verbal acts more than direct acts, as well as the pure formulas of the opinions of the violators in the speech of Ibn al-Khabaz other than the proven verbal formulas Approval and approval, the class
... Show MoreThis paper examines the decolonizing methods used by Leslie Marmon Silko in her novel Ceremony (1977) to heal the indigenous people from the patriarchal traditions of the white hegemony. This study aims to emphasize the vulnerable responses of the Pueblo people to the memories of the clan and to highlight Silko’s methods to sustain the history and lifestyle of the indigenous people. Therefore, Silko’s novel can be situated historically and culturally within memory-studies. To analyze the contrasting behaviors of characters, this paper projects the relationship between the collective patriarchal doctrines and that of the individual within the framework of memory studies. Theories of Jan and Aleida Assmann are used here to explore the
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