2023 CiteScore: 0.7
pISSN: 0044-6025
eISSN: 1735-9694
Editor-in-Chief:
Ahmadreza Dehpour, PharmD, PhD
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
Vol XX, No 3-4 (1977)
Articles
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Hepatitis B surface antigen CHBsAg) was found in 1% of controls, 2.1% of professional blood donors, 2.0% of leprosy patients and 76.1% of acute hepatitis in Tehran and Mashhad, Iran. All HBsAg positive samples also possessed antibody to the hepatitis B core antigen and all were subtype ayw. Type B hepatitis and the HBsAg state aloe frequent in Iran, but most must be accounted for by u nonparenter- al" or "rnapparent'' parenteral exposure.
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The purpose of this article is to diseuse the philosophy of our approch to the severely ischemic extremity and ourcurrent methods of treatment. 1 - The natural history of artheriosclerotic arterial obstruction should always be borne in mind. There is no doubt that many people have some degree of arterial stenosis or obstrcction and never suffer symptoms, either because of the reduced demand due to senility or because they are prepared to tolerate minor inconveniences which do not significantly interfere with their lives or livelihood. It should also be remembered that a proportion of patients with claudication improve spontaneously ever a time scale extending to many months or years. Taylor and Cale (1962), in a long term follow up of patients with untreated intermittent claudication, found spontaneous relief of symptoms in 39 per cent of the cases, no change in 45% and 16% worsening. Because of this it is impossible to lay down precise rules concerning the treatment of patients with intermittent claudication. It would be wrong to advise major arterial surgery in an elderly patient with extensive main' vessel disease and relatively mild claudication, and equally wrong to deny surgical treatment to an active younger patient with a we 11 localized arterial lesion. It is superfuous to add that anyhow, the surgery must not make the patient worse. 2- In a survey of a decade of experience, the arterioplastie treatment of occlusive disease seems to fall int three groups based on the anatomic distribution of the lesion. (Ref, 13). A - These in whom the obstructive disease is limited to the aortoiliac segments of the arterial tree supplying the leg. B - Those with both aort-iliao and femoral arterial disease. C - These with only femoropopliteal or proximal part of the popliteal arteries. Results in both the aorto-iliac and femoral arterial disease operations were in general satisfactory. The good early results of aorto-iliac operations showed only a slight deterioration during follow up, after femoro-popliteal operations the rate of early success rapidly declined. Aotrto-iliac stenosis is a more promising situation for reconstruction. Either grafting or endarterectomy is available. We abondon endarterectomy in small arteres below the popliteal arteries to avoid reobstruction due to thrombosis. We agree that sympathectomy should be performed at the time of trophic changes in the skin of the foot, and for early gangrene, we remove the third and fourth lumbar ganglia. This operation should increase the circulation to the skin below the knee. We do not recommend sympathectomy as the treatment for claudication. 3- Apart from the data derived from our group, patients gave us the following information. a - many patients come from the northern part of Iran which has a Medite ranean climate . . b - None of them had a hight cholesterol level. c - Only one patient had high blood pressure. d - Half of the patients had occlusion below the popliteal arteries Cmostely Buerger type in character) and femoro popliteal obstruction which were segmental occlusion or iliac arteries.
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Through our experience gained with adult patients during the last ten years we have found it useful to divide them into three groups:- l- Those who are very strongly motivated to accept orthodontic treatment for cosmetic purposes and with whom treatment will usually be satisfaotory. 2- Those who are suffering from anxiety states and who have developed a fixation on a dental fault and with whom it is very unwise to begin treatment before a favourable paychiatric report is obtained. 3- Those patients who need treatment before prosthetic rehabilitation or for other physical disorders and in whom treatment mayor may not be successful, depending on the degree of co-operation shown by the patient and on good teamwork between dental specialists.
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