History and Objectives: Since arterial Oxygen saturation variations during diagnostic and therapeutic procedures, i.e. bronchoscopy and reported discrepancies on the prevalence of such condition and in order to determine the arterial Oxygen saturation (SPo2) during the passage of the bronchoscope through different part of the respiratory tract, the present investigation was undertaken on individuals referred to the out-patient clinic or hospitalized at the Imam Khomeini hospital of Tabriz (1994).

Materials and Methods: A descriptive study was conducted on 200 bronchoscopy candidates. Information pertaining to the personal data age, sex, major complaint, type of cardiac complication was recorded. At various stages of bronchoscopy (Before and after Oxygen administration, during Xylocaine treatment of the vocal cords, passage of the bronchoscope from the main body of the right and left bronchus, during washing and biopsy of the bronchus, during coughing and at the end of coughing), reduction of Oxygen saturation (More than 5%) was taken as the fall of the arterial Oxygen saturation.

Results: From 200 cases studied, 79 patients (39.5%) displayed fall of SPo2. 31 patients (15.5%) showed a fall of more than 10%. Total of 165 SPo2 falls were recorded during various stages of bronchoscopy. Falls were especially significant during later stages of bronchoscopy and during the washing stage, the passage of the bronchoscope through the main body of right principle bronchus and during biopsy. Correlation between atelectasis and fall of SPo2 was 0.24 and between cigarette smoking and fall of SPo2 was 17% and between occurrence of arrhythmia and fall of SPo2 was 0.25.

Conclusion: Since the fall of SPo2 is quite frequent during bronchoscopy, administration of the Oxygen before bronchoscopy and monitoring of the arterial Oxygen saturation by pulse oximeter during bronchoscopy is highly recommended. Further analytical investigation to the role of atelectasis and cigarette smoking on the fall of SPo2 is recommended and more experimental analysis in this subject is recommended.

History and Objectives: Arterial blood gases (ABG) have various clinical diagnostic values, however their normal values are not known in our country. Therefore, this investigation was conducted in order to determine normal values for PaO2, PaCO2, HCO3- and pH among healthy 18-74 years old in autumn and winter of 1995 in Kashan.

Materials and Methods: A descriptive study on 121 randomly selected healthy individuals from medical records. Arterial blood was taken from the radial blood arteries in order to determine the normal values and the confidence intervals.

Results: Normal values of PaO2 were 91.9±9.8 mmHg and 94.4±11.5 mmHg in men and women respectively. The linear formula was PaO2=103.59-0.29 X age (year) and PaCO2 values were 38±3.5 mmHg and 36±4.36 mmHg for men and women respectively. The normal values for HCO3- were 22.6±2.12 meq/L and 21.4±1.96 meq/L for men and women respectively and pH values were 7.4±0.02 and 7.4±0.04 for men and women respectively.

Conclusion: Values for arterial blood gases can have clinical application in Kashan and it is suggested that they may be used in clinical laboratories.

History and Objectives: The rate of pulmonary carcinoma tends to increase from second decade of 20 century and pneumonectomal surgery has been on the rise as well. Other conditions such as bronchiectasis, Tuberculosis and pulmonary metastasis also warrant the same surgical operation. The present study is conducted in order to characterize the patients undergoing pneumonectomy in Imam Khomeini hospital in 1993-1997.

Materials and Methods: The study was performed on 70 patients. Patient’s profile including, personal data, physical exam, data on surgical procedure, prognosis of the diseases, side effects, mortality and morbidity, cancer classification on the basis of pathological data, spirometry values and cigarette use were recorded. Descriptive statistical analysis was performed on patient’s data.

Results: Carcinoma (50 cases, 71.4%), bronchiectasis (18 cases, 25.7%) and TB (2.9%) were the most prevalent cases. The most prevalent age group was 50-70 (64%). SCC and adenocarcinoma were the most prevalent type of cancers. Left pulmonary malignancies were 1.5 times the right pulmonary malignancies. Cigarette use in SCC pulmonary malignancies were 90%. Adenocarcinoma patients had lower percentage of cigarette use. Mortality and morbidity in older patients and FEV1<80% were expected.

Conclusion: Bronchiectasis was the most prevalent in the present study compared to developed nations and due to improper treatment, pneumonectomy is suggested. In patients with SCC and adenocarcinoma highest and lowest rate cigarette use was observed respectively. Other underlying causes of pulmonary carcinoma warrant further investigation. Contrary to developed nations left pulmonary malignancies were 1.5 time more prevalent compared to right pulmonary malignancies. Side effects of pneumonectomy can not be predicted merely on spirometry data alone.

History and Objectives: Yellow nail syndrome along with pleural effusion and lymphatic edema, with positive family history has been reported. A case familial yellow nail syndrome in the department of internal medicine of Shaheed Beheshti hospital of Kashan in 1996 is presented.

Patient’s profile: A 70 year old woman with yellow nail syndrome and right side pleural effusion and lower extremity edema was followed up and treated for 1.5 years. Her family and her grand children were examined. She reported an eight years of asthma history. Chylous ascite fluid aspiration, investigation of intensity of edema and pulmonary CT-scan were performed. In examining her nails, changes in shape, onycolysis and dystrophy of all nails of hand and foot were observed. CT-scan showed bronchiectasias of medullary lobus inferior of right pulmonary was observed. Chylous ascite fluid was transudative and intensity of edema was due to hypoalbuminemia.

Family study: Patient has four children (3 boys and 1 girl). Dystrophy, changes in color and shape of nails of hand and foot, along with lower extremity edema were observed in two boys and one girl. One of the boys had asthma. Other family members and patient’s grand children were healthy. Patient reported similar nail abnormalities and lower extremity edema in her own grandmother.

Conclusion: The present report show a case of yellow nail syndrome and implication of genetic factors pathogenesis of the disease. Therefore it essential that family history is considered in the characterization of the disease.

History and Objectives: Considering recent reports on the goitrogenic effect of Magnesium and the effect of iodine on thyroid gland, the present study was carried out in order to investigate the effect of the Magnesium alone and Magnesium alone with Iodine on the activity of thyroid gland on white rat in Ahwaz Medical University.

Materials and Methods: An experimental study on 73 rat was conducted. Animals were divided into 3 groups: Control (25 rat), Magnesium group (One gram of Magnesium is given per kilogram food (24 rat) and Iodine-Magnesium group (24 rat). Food was given in the form of pellet. The effect of Magnesium alone and along with Iodine was studied by determination of T3, T4, TSH and T3Uptake (Radioimmunoassay) at the 1.5 and 3.5 month of nutritional supplementation.

Results: Blood level of T3 and TSH did not give significant difference in 3 groups. TSH levels in Magnesium group (5.3±0.2 uIU/dl) showed 20% increase compared to the control group (4.4±1.2 uIU/dl, P<0.05) however there no significant difference between Magnesium-Iodine group compared to the control group. T3Uptake levels in the control group (48.6%±0.6) was 9% higher compared to the Magnesium group (44.3%±0.5, P<0.0002) and in the Magnesium-Iodine group was 42.1%±1.2 which had a 13% reduction compared to the control group (P<0.0001).

Conclusion: These findings indicate that Magnesium does not have goitrogenic effect however further histological analysis as to the influence of Magnesium on the thyroid gland is suggested.

History and Objectives: Due to the prevalence of pleural effusion and the importance of its differential diagnosis and recent reports on the cholesterol levels of the pleural fluid, the present study was carried out in order to assess its diagnostic value in various types of pleural effusion on patients referred to the Shaheed Beheshti hospital in Kashan in 1996-1997.

Materials and Methods: A diagnostic clinical trial was conducted on 85 patients. In a sitting position, pleural fluid aspiration was obtained and cholesterol, lactate dehydrogenase (LDH), protein content and at the same time blood total protein and LDH was obtained. On the basis of light (Golen Standard) characteristics, pleural fluid is categorized as exudate or transudate. Cholesterol levels were determined based on the enzymatic method. Cholesterol levels higher than 42 mg/dl was taken as exudatives and otherwise it is taken as transudative. Hence on the basis of pleural cholesterol four other variables (Sensitivity, specificity, positive and negative predictive values) were determined.

Results: From 85 patients, 36 patients were transudate and the rest (49) were exudates. Sensitivity and specificity of cholesterol were 92 and 89 percent respectively and positive and negative predictive values and usefulness were 92, 89 and 91 percent respectively.

Conclusion: Cholesterol has a high diagnostic value for the differentiation of transudative and exudative pleural effusion. Since cholesterol determination is a simple laboratory procedure, its determination is recommended for patients suffering from pleural effusion.

History and Objectives: Due to discrepancies on the effect of low power Helium-Neon laser on healing of bone fracture, the present study intends to investigate such effect on healing of bone deformation of rabbit tibia.

Materials and Methods: An experimental study on 39 albino rabbits was carried out. They were randomly divided into control and experimental groups. Under aseptic condition and using anesthesia, an incision was made on skin with deep fascia on the internal surface of tibia bone on the left side of the animal. With an electric drill (2mm), a small deformation or hole was created on this surface. The day of surgery was considered as zero day and animals were divided into 3 groups of 14, 21 and 28 days. A low power laser, 1.2 J/cm², was applied daily once every day. Animals were killed and the left tibia bone was removed. Biomechanic studies were performed on the bones. The degree of fragility was determined by using 3 point bending of the bones. The absorbed energy at the point of fracture and the extent of bone deformation and elastic stability was measured.

Results: The extent of elastic stability and absorbed energy was significant in 21st and 28th day of experimental group respectively (P<0.05). Augmentation of biomechanic specificities was observed in the 3 experimental groups and differences were significant for day 14-28 and 21-28.

Conclusion: Laser radiation with low power Helium-Neon with energy density of 1.2 J/cm² is performed according to the procedure in the present study increases the speed of bone healing at the site of tibia bone deformation.

History and Objectives: Due to prevalence of asthma and due to the reduction of systemic adrenergic response of heart with increasing age and current discrepancies on the effect of age on response to treatment in pulmonary adrenergic system and in order to address the issue whether age will effect treatment of patients suffering asthma, the present study was prepared on patients referred with acute asthma attack in 1998.

Materials and Methods: A cohort study on 62 patients who were divided into control (Under the age of 35 22 cases) and experimental (Over the age of 35 40 cases) was conducted. Diagnosis was based on ATS characterization and all patients were treated for one week with 3 medications, salbutamol spray, sodium cromolyn capsule and oral prednisone. Response to treatment was determined by pulmonary function tests.

Results: FEV1 was changed from 1.5±0.5 liters and 1.1±0.3 liters before treatment to 2.4±0.5 liters and 1.7±0.4 liters after treatment (P<0.001). In 77% of young asthmatic patients and in 80% of older asthmatic patients FEV1 was higher than 15%. Relative and designated risk were 0.96 and 1.03 respectively mean FEV1 variation from basal levels in young and older patients were 78.2±56.1 and 71.6±46.8 percent respectively (P<0.62) and among male and female patients of young and old age was 69.8±43 and 71.6±46.8 percent (P=0.62) and 96.3±78.4 and 78.3±48 percent (P=0.44) respectively. Mean of maximum improvement of FEV1 among young and old asthmatic patients was 57.3±25.6 and 46.3±22 percent respectively (P=0.08) and among male and female patients of young and old age was 56.4±28 and 37.1±15.8 percent (P<0.05) and 59.3±21.5 and 54.6±23.9 percent (P=0.65) respectively.

Conclusion: Response to treatment was significant both in young and old age groups suffering from acute asthmatic attack. Except among young male patients where FEV1 was increased compared to older patients, maximum rate of improvement of FEV1 among other patients and rate of changes of FEV1 between

History and Objectives: Astigmatism is one of eye diseases, which its correction specially in severe astigmatism may not be corrected with eyeglasses. The present study is designed to investigate the effect of arcuate incision on the correction of astigmatism among patients referred to the Labafi-Nejad hospital in 1996 to 1997.

Materials and Methods: An experimental study was carried out to compare before and after the surgery on 24 patients. In order to correct the astigmatism, arcuate incisions were made for 30 to 90 degrees. The distance between the incisions from the center of retina was 7mm. Patients were followed seven months after the surgery, effect of operation on the patient’s corrected vision and uncorrected vision, extent of astigmatism were determined and McNemar and paired student t-test analytical methods were carried out.

Results: The study was performed on 24 patients (38 eyes) with mean age of 30±8.5 years and extent of astigmatism of 3.76±1.06 diopter. Patients were followed for 15.5±3.5 months. Surgery resulted in vision acuteness of more than 20/40 in 80% of the patients (P<0.001). Rate of astigmatism was reduced by 47% (P<0.001).

Conclusion: Surgery with arcuate incision was very effective in reducing astigmatism. It can improve patient’s vision without any need for eyeglasses. In patients with severe astigmatism where the use of eyeglasses is not useful in providing improvement of vision, arcuate incision can be very effective in improving vision. Further research is required to obtain complete results.

History and Objectives: In order to evaluate the nutritional status of athletes during preparation of important matches and one of the major games in Iran is basketball, the present study will determine the of nutritional intake, body fat and aerobic capacity of basketball athletes of national team in 1997.

Materials and Methods: A cross sectional descriptive study on 14 male basketball players was carried out. The mean age, height, weight and BMI was 25.6±3.1 years, 191±6 centimeters, 87.3±8.1 kilograms and 23.9±1.7 respectively. Weight, BMI, body fat and aerobic capacity on the basis of Oxygen consumption were determined in 3 stages of before the start of training, during the train and after training. In addition nutritional status and food intakes were assessed at the start and end of trainings by determining the food intake in 7 non-interval days. Foods were transferred into the laboratory for determination of proteins, lipids and carbohydrate content.

Results: Weight and BMI variation during training was insignificant. Intradermal fat thickness was reduced from 42.9±13.7 to 34.6±9.9 mm (P<0.02). Maximum Oxygen intake was increased from 42.3±3.3 to 44.5±2.2 mm/kg-min (P<0.05). At the first stage the caloric intake was 3900kcal, which consisted of carbohydrates (50%), protein (15%) and fat (35%). At the second stage the caloric intake was 3600kcal, which consisted of carbohydrates (55%), protein (15%) and fat (30%), which were in normal range. Intake of Iron, calcium and vitamin C was higher than recommended allowance, B1, B2 and Niacin was within the recommended range and vitamin A and B6 was lower than recommended allowance.

Conclusion: The food intake of athletes was within the recommended allowance range. Further research on the assessment of nutritional values taken by athletes, nutrition educational programs for athletes and their coaches and interventional nutritional study of a given nutritional program is suggested.

History and Objectives: Due to prevalence of cutaneous ulcers, different reports about their etiologic and drug resistance and worriment about contagiousness of the infectious cutaneous ulcers in warm and wet weather of Golestan province, this study was conducted to identify the bacterial and fungal microorganisms that produce cutaneous ulcers and their drug resistance in children younger than 10 years old referring to outpatient clinics to physicians in three cities in 1377.

Materials and Methods: A descriptive study was performed. After definitive diagnosis of cutaneous ulcers, specimens were collected by the physicians and cultured on specific culture media and the bacteria and fungal type was recognized through standard examinations. Then their resistance and sensitivity to the usual antibiotics were determined.

Results: Specimens were provided from 270 children less than 10 years old during a 6-month period. Bacteria were grown in 98 patients (36.6%) and in 105 children (59.6%) fungi were the etiologic agents. In 11 cases (4.1%) no microorganism was grown. Gram-positive bacteria were most resistant to penicillin, ampicillin and amoxicillin and least resistant to vancomycin and erythromycin. Gram-negative bacteria were most resistant to ampicillin and cephalexin and least resistant to kanamycin. The most common bacteria, dermatophyte and Candida were Staphylococcus, Microsporum canis and Candida albicans respectively.

Conclusion: The predominant bacterial and fungal pathogens were not observed in this study. Most of the bacteria were normal body flora and the prevalence of Microsporum canis is due to the presence of animal host in rural areas.

History and Objectives: Due to epidemiology of Tuberculosis in Iran and the consequent mortality and diagnostic therapeutic surgical measures and in order to determine the status of patients and the various diagnostic and surgical techniques, this study was carried out in patients referring to Imam Khomeini hospital in Tehran in the years 1367-1376.

Materials and Methods: This study was performed by existing data recorded in the records of patients undergone surgical pulmonary resection and/or diagnostic procedures. Tuberculosis was diagnosed by sputum culture and tissue pathology. Age, sex, occupation residential place during these ten years, clinical manifestations and paraclinical examinations type of resection and complication of the surgery were evaluated.

Results: During 10 years a total of 500 patients with pulmonary and thoracic Tuberculosis were studied 44% of patients were female and the other 56% were male. The patients were 15-20 years old. Complications of Tuberculosis were 5 times more common in males as females and pericardial involvement was twice in men than women. The most common occupations were house-keeping and workers. The most common clinical manifestations were pleuritic chest pain (82%), dyspnea (80%) and cough (78%). PPD was negative in 50% of patients. The differential leukocyte count was neutrophils 73%, lymphocytes 24% and the remainder were eosinophils and basophiles. ESK was abnormally elevated in 88% of the patients. Pulmonary resection was done in 34% of patients. Total pericardiectomy and pericardial window were performed in 18% and 6% of patients respectively. Limited diagnostic thoracotomy for hilar lymphadenopathy and SPN was performed in 24% of the cases. All paraclinical examinations were negative in these patients despite the presence of pulmonary Tuberculosis. Clavicular resection was performed in 6% of patients. Eloesser flap in 6% and superior vena cave obstruction in 2% diagnostic thoracotomy was performed in these cases.

Conclusion: complication in men aged 15-20 years were five times the women. Pericardial involvement was also twice more common in men than women. The patients were often housekeeper or workers. In 24% of patients who were suspicious to have Tuberculosis all paraclinical examinations were negative but limited thoracotomy confirmed Tuberculosis. One patient in this group had upper lobe Tuberculosis accompanied by squamous cell carcinoma of the lung. Therefore thoracotomy is recommended in these cases and lung cancer should be considered whenever Tuberculous involvement of the upper lobe especially its anterior segment is present. In our series mortality and morbidity were 4% and 12% respectively that are compatible with foreign reports.

History and Objectives: Due to the importance of diabetes and its increasing prevalence and since this micro organs (Langerhans islets) are invaded by the immune system in insulin-dependent diabetes mellitus, it seemed essential to extract and purify Langerhans islets by different methods and then compare the products. Determining the insulin secretory pattern of the islets due to the effect of potassium and glucose is another aim of this research.

Materials and Methods: An experimental study was performed on rats. The animal was anesthetized and the common bile dust was cannulated and Hanex solution was injected into it immediately afterwards the pancreas was excised and immersed in Kerbs-Ringer-Bbicarbonate-Hepes solution. After adding collagenase, it was incubated at 37 degrees of centigrade. Purification was performed by handpicking under stereomicroscope and discontinuous method of sucrose and ficoll gradient. Perfusion of insulin secretion of the islets. The secreted insulin was measured by RIA and the number of islets yielded from each method and also the insulin content of the islets, yielded by each method, were statistically analyzed with t-test in contrast with other methods.

Results: The number of islets from handpicking methods, sucrose gradient and ficoll gradient were 202±22.5, 84±14.5 and 230±26 respectively. Also the insulin content of the yielded islets from the above mentioned methods were in order: 106±7.6, 49±13 and 210±17 MU/10 islets (P<0.0001). Insulin secretory pattern was monophasic, when affected by potassium and biphasic due to the effect of glucose.

Conclusion: Purification of the isles by ficoll is advantageous over the two other methods both quantitatively and qualitatively. Also, the insulin secretory pattern due to the effects of glucose and potassium is biphasic and monophasic respectively. Insulin release is probably due to depolarization of the cytoplasmic membrane of beta cells of the islets and further research in this field is recommended.

History and Objectives: The ultimate objective of rehabilitation in sport injury is the rapid and safe return of the individual to his pre-injury status. If the therapeutic plan is oriented only to increase strength, tolerance and range of motion and such factors as balance, agility, deep sensation and neuromuscular coordination are not stressed the risk of repeated injury will increase. In this study the effect of walking and running as the main function of lower limbs are considered.

Materials and Methods: This study has been carried out as a clinical trial using six functional performance tests of single leg hop distance test, vertical jump, anaerobic power test, modified Romberg test, shuttle run and single leg hop for time before and after exercise in two groups of 15 healthy girls matched for age. All the girls had three sessions of 15 minutes running forward and background each week for six consecutive weeks. At the end of each week, some of the tests were performed and finally after eight weeks, all the tests were repeated again.

Results: In the group walking or running forward, vertical test revealed 0.46% (P>0.003), single leg hop for time 10.52% (P>0.005), vertical jump 9.95% (P>0.005), anaerobic power 4.58% (P>0.005), modified Romberg test 59.26% (P>0.003) and shuttle run test 2.19% (P>0.001) improvement and for those with backward walking or running, single leg hop distance test revealed 4.5% (P>0.003), single leg hop for time 23.89% (P<0.005), vertical jump 2.98% (P>0.005), anaerobic power test 0.53% (P>0.005), modified Romberg test 68.33% (P>0.003) and shuttle run test 6.88% (P<0.001) improvement.

Conclusion: In rehabilitation planning, when improvement of strength, velocity, agility, static balance and aerobic power is considered, walking and running backwards and when increase in vertical jump, or aerobic power is the aim, walking and running forward is recommended.

History and Objectives: Due to the prevalence of blunt abdominal trauma and availability, relative ease, economic consideration of sonographic applications and current controversy regarding sonography on diagnosis of intra-abdominal injury, the present study was carried on blunt abdominal traumatic patients at Rasul hospital in 1997-98 in order to assess the diagnostic power of sonography on intra-abdominal injury.

Materials and Methods: A clinical diagnostic experimental study was performed and patient’s information and characteristics of the injury was recorded. Definite diagnosis of injuries was based on CT scan and laparotomy findings. PPV and NPV of sonography were defined.

Results: Study covered 94 patients (76.6% male and 23.4% female) with age of 26.9±14.8 years. Car accident was the major cause of trauma. PPV and NPV of sonography for diagnosis of intra-abdominal organs injury were 76.5 and 84.8 respectively and for diagnosis of intra-abdominal free fluid were 100 and 96.6 respectively.

Conclusion: Sonography has sufficient power for diagnosis of intraperitoneal free fluid however it dose not have sufficient power for diagnosis of intraperitoneal organs injury. Further study regarding the cause of low power is recommended.

History and Objectives: Light’s criteria in which serum and pleural LDH activity and proteins levels are the most common variables to differentiate exudative from transudative pleural effusion, for the past 3 decades. Several other biochemical parameters have been suggested, one of which is serum pleural effusion albumin gradient (>1.2: transudate, <1.2: exudate). The present study was performed to assess diagnostic value serum and pleural gradient in the patient with pleural effusion.

Materials and Methods: A descriptive study was carried out on 76 patients. In a sitting position, pleural fluid aspiration was obtained and albumin, lactate dehydrogenase (LDH), protein level and at the same time blood total protein, LDH and albumin was obtained, on the basis of Light’s criteria, pleural fluid is categorized as exudate or transudate. 76 patients presented with pleural effusion referred to the Shaheed Beheshti hospital (Kashan) were studied according to the Light’s criteria and gradient method.

Results: According to Light’s criteria, 41 patients (54%) had transudate and 35 patients (46%) had exudate. These measures were 59% and 41% respectively in gradient method. Thus discrepancy was noted in 6 cases, labeled exudate according to Light’s criteria however transudate according to gradient method. Sensitivity, specificity, positive and negative predictive value were 82.9%, 95%, 93.5% and 86.6% respectively for gradient method.

Conclusion: Sensitivity of Light’s criteria is higher than albumin gradient, but the gradient method has a higher specificity for patients who are clinically suspect of transudate but labeled exudate according to Light’s criteria, albumin gradient is helpful.

History and Objectives: Due to the importance of and different factors related to failure of pregnancy and since little is known about failure of pregnancy in Kashan, the present study was carried out in order to determine prevalence and factors related to failure of pregnancy in Dr. Shabihkhani hospital in Kashan in 1998.

Materials and Methods: A descriptive study concerning 1077 pregnant women and failure of pregnancy including abortion and fetal death and its relationship with maternal age, paternal age, parity and previous abortion was carried out.

Results: The prevalence of failure of pregnancy, abortion and fetal death was 13.8%, 11.4% and 2.4% respectively. High maternal age was the most prevalent factor involved with abortion (21.8% with the age of 40 or older and 10% with age group of 20-30). The prevalence of abortion and fetal death was increased with maternal age, paternal age, previous history of pregnancies (>6 time) and previous abortion.

Conclusion: The parental age in the time of pregnancy, previous abortions and parity were significant factors in failure of pregnancy. Further studies on the factors related to failure of pregnancy are recommended.

History and Objectives: Due to the prevalence of Behcet's disease and the importance of ocular complications and lack of information the present epidemiologic of ocular complication of Behcet's disease was studied in 1998.

Materials and Methods: A descriptive study was carried on 200 patients with Behcet's disease. Personal records and ocular complications were recorded.

Results: From a total of 200 patients, 58.5% were male and 41.5% were female. The mean age was 31.5 years (Range 5-58 years). Uveitis was the most common ocular complication in both sexes (87%), followed by retinal vasculitis (58.7%), cataract (38%), optic atrophy (24.5%) and episcleritis (7.7%) in patients under age of 30 years, macular edema, between 30-39, uveitis and over 40 years of age. Cataract was the most prevalent complication (P<0.001).

Conclusion: Ocular Behcet's disease is usually associated with bilateral vision impairment and is a major problem Behcet's disease, which require specific diagnosis and treatment.

History and Objectives: Upper gasterointestinal (UGI) bleeding is a common cause of admission in the medical and surgical wards. Due to its importance and different causes of bleeding, the present study was carried out to investigate the causes of UGI bleeding and their relationship to the laboratory and clinical data.

Materials and Methods: A descriptive study on existing data on 114 patients who were admitted to the ward with UGI bleeding was carried out.

Results: The most common cause of UGI bleeding was peptic ulcer (46.5%) and other less frequent causes of bleeding were gastritis (33.3%), duodenitis (6.1%), gastroduodenitis (3.5%), esophageal varices (3.5%), esophagitis (1.8%) and esophageal ulcer (0.9%). Five cases had normal endoscopic finding (4.4%) from which 4 cases were due to NASAIDs application. 45.6% of patients used NSAID60 for different causes.

Conclusion: UGI bleeding is one of the common causes of referral to emergency departments. NSAID plays an important role in UGI bleeding. Therefore correct usage of NSAID is recommended. The most common cause of UGI bleeding is peptic ulcer disease. Further researches are needed to evaluate the effect of H.pylori treatment to prevent UGI bleeding.

History and Objectives: Nocturnal hypoxemia in patients with chronic obstructive pulmonary disease (COPD) is a frequent side effect. Because there is frequent occurrence pulmonary hypertension and cardiac arrhythmia in these patients, it is important to diagnose and treat nocturnal hypoxemia. In this research we investigated the changes of hypertension and hypoxemia during day and night in patients with COPD who were referred to the internal medicine ward of Shaheed Beheshti hospital in 1999.

Materials and Methods: A descriptive study was conducted on 68 patients with COPD. Arterial blood gas measurement was performed from radial artery in supine position in duplicates in the day and at night. Mean PaO2 and PaCO2 during day and night and changes of mean PaO2 in different levels of hypercapnia were determined.

Results: Night time decrease in PaO2 and SaO2 and increase in PaCO2 was significant compare to the day time values (Day: PaO2=62.2±13.9 mmHg, night: 57.6±12.2, P<0.001, day: SaO2=88±7.5%, night: SaO2=66±9%, P<0.001, day: PaCO2=46±7.5 mmHg, night: PaCO2=47.6±8 mmHg, P<0.001). The decrease in PaO2 during night in patients with PaO2<60 mmHg was more than in patients with PaO2>60 mmHg (7.4±12.7 mmHg, 1.4±7.6 mmHg, respectively, P=0.019). In patients with PaCO2<45 mmHg and PaCO2>45 mmHg, PaO2 in the day and night were 66.8±12.7 mmHg, 62.1±10.4 mmHg, 57.7±13.8 mmHg, 53.1±12.4 mmHg respectively. The amount of changes in both groups was 6.97% and 7.85% respectively.

Conclusion: Hypoxemic and hypercapnia are increased during night in patients with COPD. The amount decrease in nocturnal hypoxemia depends on its amount in the day. The amount of decrease in hypoxemia depends on the degree of hypercapnia. In patients with COPD, who has hypercapnia and hypoxemia, O2 delivery in the night and the improvement of hypoxemia is very important.