امیررضا مشاری

In many patients with ulcerative colitis,control of the disease is possible through medical methods, but in some cases,surgery is indicated.So far,no comprehensive study on the consequences of surgery in children with ulcerative colitis has been published in Iran. present study was conducted for the same purpose.

All children with ulcerative colitis admitted in Mofid Children Hospital with indication for surgery for ten years were included in the study.Information on demographic characteristics,surgical indications, duration of medical treatment,type of surgical procedure,complications of surgery, were evaluated.

21patients who underwent surgery during these years were included in the study. The mean age of patients was 11.12 ± 5.65 years. 42.9% were male. In terms of surgical indications, anemia in 100%, Intestinal bleeding in 33.3%, FTT in 14.3%, recurrent defecation in 9.5% and severe colic abdominal pain in14.3%.In terms of early surgical complications,intestinal perforation in4.8%, peritonitis 4.8%,wound infection23.8%, pelvic abscesses14.3%, deep vein thrombosis4.8%,intestinal obstruction9.5%, Pouchitis 9.5% and anal fissure 4.8% were reported.23.8% of patients underwent redo laparotomy for improvement surgical complications.The mean follow-up period of patients in terms of surgical outcomes was 6.79 ± 4.24years. During this period, improvement in gastrointestinal function was reported in 100% of patients. Long-term complications of surgery include , delayed fistulas were reported in 23.8% of cases. Fecal incontinence was reported at 4.8%. Long-term complication-free survival at 5 and 10 years after surgery was estimated to be 92.3% and 56.4%, respectively.

Surgical treatment in children with ulcerative colitis,candidate for surgery,accompanies with favorable outcomes and correctable short and long-term complications.

The purpose of this study was to identify and prioritize effective factors on decision making in ‎managers and commanders of forces Iran’s NAJA. The statistical population of this research ‎consisted of all managers and commanders of Najah. Of this society, 306 managers were ‎randomly selected. Semi-structured interviews and a questionnaires were used to collect data. To ‎identify the factors influencing decision making, a research background interview was used. ‎Finally, 11 factors of social consequences, managerial skills, behavioral skills, decision-making ‎style, rational factors, personality factors, external factors, creativity, religious factors and values, ‎organizational factors and cultural factors were identified as factors affecting decision making of ‎managers. To investigate the priority of these factors, the hierarchical analysis technique and ‎TOPSIS software were used. Data analysis showed that, in terms of NAJA's managers, cultural, ‎behavioral and social factors were first to third priority respectively. Therefore, it can be said that ‎issues such as the culture of organizational cooperation, trust in the organization, Islamic ethics, ‎trust, and attention to the consequences of decision are very important for managers. ‎