The role of pulse oximetry in the evaluation of peripheral vascular disease (PVD) was investigated. In addition, the value of elevating the limb to improve the sensitivity of detection of PVD by the pulse oximeter was also determined. Pulse oximetry reading in the toes were obtained in 40 young, healthy volunteers and in 40 randomly selected patients referred to the vascular investigation laboratory over a period of two months. All 40 healthy volunteers had normal pulse oximetry readings. Normal pulse oximetry reading in the toes was defined as > 95% O2 Sat and +/-2 of finger pulse oximetry reading. In all 40 patients, pulse oximetry readings were either normal or not detected at all. Since there was no gradation in decrease in the pulse oximetry reading with severity of disease or with elevation of the patient's lower extremity, an absent or no reading was considered as an abnormal result from the test. The frequency of abnormal pulse oximetry readings increased significantly in groups with abnormal ankle-brachial pressure index (ABPI) and also varied significantly with elevation of the patients' lower limbs. In patients with no PVD detected by Doppler (ABPI > 0.9), pulse oximetry readings were normal in all. However, in patients with moderate PVD (ABPI, 0.5-0.9), 84% of the patients' lower limbs had normal pulse oximetry readings and 16% had an abnormal reading at baseline level (flat). An additional 12% of the lower limbs in this group had an abnormal reading on elevation of the limb to 12 inches. In patients with severe PVD (ABPI < 0.5), 54% of the patients' lower limbs had an abnormal reading at baseline and an additional 23% had an abnormal reading at elevation of the limb to 12 inches. In conclusion, pulse oximetry was not a sensitive test for detecting early PVD.

Background: Diabetes mellitus (DM), named Ziabites in Persian medicine (PM), was categorized as hot or cold Ziabites according to the Mizaj of patients. This study aimed to compare the Mizaj of patients with newly diagnosed type 1 DM (T1DM) with chronic cases and healthy children. Materials and Methods: In a case–control study, three groups including chronic T1DM patients ( n = 31), newly diagnosed T1DM patients ( n = 37), and healthy children as the control group ( n = 80) were recruited. Mojahedi Mizaj Questionnaire was used to measure two subscales, hot/cold and wet/dry, of Mizaj for participants. The mean scores of the Mizaj subscales were compared between the groups. Cutoff values were determined using receiver operating characteristic analysis, and the corresponding odds ratio (OR) for each subscale was identified. Results: Overall 148 participants, with a mean age of 10.0 ± 6.2 years, were enrolled in the study. Analysis showed that the mean total heat and total dryness scores were significantly higher in new T1DM than that of chronic patients and healthy children (19.59 ± 1.7 vs. 16.6 ± 2.1 and 18.17 ± 1.9, P < 0.001 for hot/cold and 4.70 ± 1.0 vs. 4.09 ± 0.9 and 4.31±0.8, P = 0.02 for wet/dry). “Extra heat” based on the cutoff value of >18.5 was found to be a risk factor for T1DM (OR = 3.62, 95% confidence interval = 1.52–8.63). Conclusion: New T1DM patients have higher frequency of hot and dry Mizaj, which is consistent with the concept of hot Ziabites in PM. Most importantly, we found that “extra heat” in children can be considered as a risk factor for T1DM.

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Introduction. Nephrotic syndrome (NS) is a common chronic kidney disorder during childhood. The most important characteristic of this disease is proteinuria. The Persian medicine (PM) has important dietary recommendations for strengthening the kidney function and treatment of this disease. The aim of this study was to investigate the effect of a diet including PM recommendations and general principles of Western medicine. Materials and Methods. Twenty children with nephrotic syndrome were randomly divided into intervention and control groups and monitored for one month. The control group received a diet based on the general principles of Western medicine. In the intervention group, in addition to the Western medicine diet, dietary recommendations of PM were also prescribed including the pomegranate (Cydonia oblonga mill.), quince (Cydonia oblonga mill.), and whole grains (wheat and barley). A 24-hour dietary questionnaire was applied and anthropometric and biochemical indices including spot urine protein (proteinuria), albumin (Alb), urea, creatinine (Cr), total cholesterol (TC), and triglyceride (TG) were measured before and after the study. Results. The amount of protein intake reduced significantly in the diet of both groups but the differences between the two groups were not significant. Proteinuria reduced significantly in both the Western and PM groups; however, proteinuria was significantly lower in the Persian medicine group compared to the control group. TC and Cr levels reduced significantly in the intervention group, although the changes were not significant compared to the control group. Conclusion. The results of this study showed that adding dietary recommendations of the Persian medicine to the general rules of the Western medicine diet reduced proteinuria and improved the combat against nephrotic syndrome.

Objective: Thirst (Attash) is a diagnostic sign of diseases from the perspective of Iranian Traditional Medicine (ITM).The purpose of this study is to provide a functional definition for the concept of thirst and its causes in ITM. Methods: In this study, we used the concept analysis (hybrid model) which has three phases; in the theoretical phase, the content related to the definition of thirst and its causes were searched in ITM books and an efficient definition of thirst was presented. In the fieldwork phase, main themes were obtained after semi-structured interviewing of 16 ITM specialists. In the final (analytical) phase, the results of the two previous phases were compared to each other to present the final definition for thirst. Results: The thirst is defined as the need for water and any food that is cold and wet, and the increase and decrease in thirst is a sign of disease. For its examination, it is necessary to pay attention to the change in the degree of thirst and the amount of consumed water or cold/wet foods. It is important to differentiate between drinking water as recommended, drinking water as habit, or drinking water because of dry mouth with thirst. Different characteristics of thirst can be used to diagnose the affected organs. Conclusion: In this study, using the concept analysis method, a functional definition of the thirst as a symptom was presented and its causes were investigated. The low number of studies on thirst and lack of access to some ITM specialists were some of the limitations of our study. It is recommended to investigate the prevalence of thirst in patients and its relationship with dystemperament in future studies.

Objective (s):In Persian Medicine (PM) diabetes mellitus is known as a dystempramental diseases (Su-e-mizaj) and is divided into two main types, hot and cold. Achieving agreed diagnostic criteria among PM experts for standardizing such criteria for identification of two types of diabetes and its management is essential. This study aimed to examine diabetes mizaj criteria via consensus of PM physicians. Methods: This was a cross sectional survey and conducted by the Delphy method. Diabetes mizaj symptoms was collected from PM literature, and patient and PM experts interview. Sixteen PM experts were requested to evaluate quantitative and qualitative value of these symptoms during 3 rounds of Delphi. Results: Based on the results of third round; thirst, touch condition of hand and kidney, impressibility of air and food and face puffing, were considered as major criteria and urine color and smell and face and eye color were considered as minor criteria for identification of diabetic children Mizaj or Su-e-mizaj Conclusion: This study extracted the agreed criteria for determining the diabetic children Mizaj. These criteria, can be used to diagnose, different Su-e-mizaj of hole body and organs and so two types of diabetes (hot and cold) in diabetic children. Quantifying the intended criteria might lead to more exact diagnosis of the patients' mizaj.