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      Impact of bowel preparation on caecal intubation time during colonoscopy

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          Abstract

          Objective:

          To determine the caecal intubation time depending on bowel preparation as per Boston Bowel Preparation Scale.

          Methods:

          This cross-sectional study was conducted at Dr. Ruth K. M. Pfau, Civil Hospital Karachi between August 2018 to February 2019. A total of 201 patients were included in the study. Time was recorded from insertion of colonoscope to the time required to reach the cecum. Bowel preparation was graded during withdrawal of colonoscope by using Boston Bowel Preparation Scale. Pearson Correlation test was used to study correlation of BBPS scores with CIT, gender, BMI, adenoma and polyp detection.

          Results:

          In this study 201 patients undergoing colonoscopy were included. Mean ±SD of age of patients was 36.9 ±15.8 years. Out of the 201 patients 112 (56%) were males and 89 (44%) were females. The results of our study showed that increased Boston Bowel Preparation Scale Scores were associated with decreased caecal intubation time. The mean CIT was 10.7 ±5.4 minutes and Pearson correlation was significant at 0.002. Significant correlations of BBPS were also found with BMI and adenoma detection.

          Conclusion:

          The diagnostic effectiveness of colonoscopy depends upon the quality of the preparation. Good bowel preparation improves the speed of colonoscopy and its completeness.

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          Most cited references13

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          Comprehensive validation of the Boston Bowel Preparation Scale.

          The Boston Bowel Preparation Scale (BBPS) is a novel bowel cleanliness rating scale that has undergone partial validation previously. To fully validate the BBPS and assess the ease of its dissemination. Observational study. Various endoscopy units worldwide. Endoscopists. Video recordings of colonoscopies with varying degrees of cleanliness were viewed twice by gastroenterologists at 1 medical center. For each video, participants assigned segment and total BBPS scores. Endoscopists worldwide were also surveyed about their experience with the BBPS after viewing an instructional video. Intraclass correlation coefficients and weighted κ values assessed inter- and intrarater reliability, respectively. The BBPS was used among 983 patients undergoing screening colonoscopy. The BBPS demonstrated near-perfect interrater reliability (intraclass correlation coefficient = 0.91) and substantial intrarater reliability (weighted κ = 0.78; 95% CI, 0.73-0.84). Among 983 colonoscopies, right and left colon segment scores of 2 or 3 had a multivariate odds ratio of 1.60 (95% CI, 1.01-2.55) and 2.58 (95% CI, 1.34-4.98), respectively, for polyp detection compared with segment scores of 0 or 1. Endoscopists from a variety of settings worldwide found the BBPS easy to implement and applicable to their patient population. Single-center reliability testing. The BBPS is a valid and reliable instrument for assessing bowel cleanliness during colonoscopy. Segment scores may represent a standardized way to determine bowel preparation adequacy. The BBPS can be easily disseminated through the use of a brief instructional video. Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
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            Validated Scales for Colon Cleansing: A Systematic Review.

            Bowel cleanliness is a critical determinant of colonoscopy quality, mandating its standardized assessment, yet bowel preparation scales have been variably validated. The objective of this study was to assess validity and reliability of existing bowel preparation scales.
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              Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy

              The risks of missed findings after inadequate bowel preparation are not fully characterized in a diverse cohort. We aimed to evaluate the likelihood of missed polyps after an inadequate preparation as assessed by using the Boston Bowel Preparation Scale (BBPS).
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                Author and article information

                Journal
                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                1682-024X
                1681-715X
                Nov-Dec 2019
                : 35
                : 6
                : 1516-1519
                Affiliations
                [1 ]Prof. Haris Alvi, MBBS, FCPS. Dow University of Health Sciences, Karachi, Pakistan
                [2 ]Dr. Tazeen Rasheed Assistant Professor, Dow University of Health Sciences, Karachi, Pakistan
                [3 ]Dr. Majid Ahmed Shaikh Assistant Professor, Dow University of Health Sciences, Karachi, Pakistan
                [4 ]Dr. Faiza Sadaqat Ali Senior Registrar, Dow University of Health Sciences, Karachi, Pakistan
                [5 ]Prof. Bader Faiyaz Zuberi, Dow University of Health Sciences, Karachi, Pakistan
                [6 ]Dr. Asad Ali Samejo Postgraduate Trainee, Dow University of Health Sciences, Karachi, Pakistan
                Author notes
                Correspondence: Prof. Bader Faiyaz Zuberi, C-404, Al-Habib Pride, CL-8/5, Civil Lines, Karachi, Pakistan. Email: bader@ 123456zuberi.net
                Article
                PJMS-35-1516
                10.12669/pjms.35.6.1031
                6861472
                0c0a8ea3-6052-4270-b931-b2a3d371d3d1
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 May 2019
                : 24 August 2019
                : 26 August 2019
                Categories
                Original Article

                boston bowel preparation scale,colonoscopy,caecal intubation time,adenoma detection rate

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