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.
Checkpoint inhibitors are a type of immune therapy used to treat different types of cancers. These drugs block different checkpoint proteins, for example, CTLA-4, PD-1, and PD-L1 inhibitors.
They block proteins that stop the immune system from attacking the cancer cells. Checkpoints are also described as a type of monoclonal antibody that antagonizes binding between B7 to CTLA-4 and PD-L1 to PD-1.
Immune checkpoint inhibitors are used to treat BARCA mutated triple-negative breast cancer (TNBCS) in patients who do not respond to chemotherapy, and also in the treatment of highly mutated and solid tumors such as brain tumors, liver, and pancreatic cancers.
Immune checkpoint inhibitors exhibit an effect on solid tumo
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This study relates to the estimation of a simultaneous equations system for the Tobit model where the dependent variables ( ) are limited, and this will affect the method to choose the good estimator. So, we will use new estimations methods different from the classical methods, which if used in such a case, will produce biased and inconsistent estimators which is (Nelson-Olson) method and Two- Stage limited dependent variables(2SLDV) method to get of estimators that hold characteristics the good estimator .
That is , parameters will be estim
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The study aims to indicate the role of the mechanisms and principles of corporate governance in the activation of social responsibility reports, and increase disclosure, to achieve sustainability, legitimacy, and integrity of the business. Through the presentation of the conceptual framework for corporate governance and social responsibility, identify the key dimensions of social responsibility and the statement of the relationship between the mechanisms of governance and social responsibility reports in accordance with these dimensions. To prove the hypothesis research has selected a sample of listed companies in the Iraqi market for securities,
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The researcher tried to show the importance of obligation with the rules of professional conduct set by the Association of Accountants and Auditors of Iraqis when expressing an opinion the financial statements submitted tax administration and enhance the confidence of these lists, and adopted in the tax settling accounts process and its impact on tax revenues, and touched a researcher at the theoretical side of the search to the problem of research and of my Is there a trace of non- not to obligation by the rules of professional conduct in Iraq affect the tax revenue with the rules of professional conduct in tax revenue for companies research sample, the research aims to study the rules of professional conduct set by the Associatio
... Show MoreThe present study discusses the significant role of the historical memory in all the Spanish society aspects of life. When a novelist takes the role and puts on the mask of one of the novel’s protagonists or hidden characters, his memory of the events becomes the keywords of accessing the close-knit fabric of society and sheds lights on deteriorating social conceptions in a backwards social reality that rejects all new progressive ideas and modernity. Through concentrating on the society flawing aspects and employing everything of his stored memory, the author uses sarcasm to criticize and change such old deteriorating reality conceptions.
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