Medical Textbooks Research Articles

Temporal tendinosis: A cause of chronic orofacial pain.

Diverse musculoskeletal disorders and neuropathic symptoms of the face pose significant diagnostic challenges. In particular, temporal tendinosis is generally overlooked in the medical and dental literature and is therefore a poorly understood topic and often problematic cause of chronic orofacial pain. In this article, we explore temporal tendinosis as a cause of unresolved orofacial pain by reviewing the complex anatomy of the temporalis muscle, common presentations of temporal tendinosis, possible etiologies for injury and place a strong emphasis on required diagnostic evaluation and clinical management. Temporal tendinosis remains under diagnosed due to a combination of anatomical complexity and incomplete description in the majority of general anatomy medical textbooks. The two main presentations are unilateral facial pain with or without temporal headache and pain radiating from the distal temporalis tendon to the temporalis muscle. Diagnosis should be made with a combination of focused history, physical examination and specialised imaging, preferably with ultrasound but with MRI an alternate option. While many management options are available, optimal treatment remains unclear. Temporal tendinosis is an under-recognised and under-treated condition. Despite the fact that orofacial pain is one of the single most common complaints of patients presenting to physicians or dentists, it is widely acknowledged that training for diagnosis and manage of temporal tendinopathy among primary care physicians in both medical and dental professions is inadequate. This may result in extensive workups, leading to suboptimal management and chronic pain syndromes.

The Stethoscope in 19th-Century AmericanPractice: Ideas, Rhetoric, and Eventual Adoption.

The stethoscope was invented in 1816 by the French physician R.T.H. Laennec, who, after three years of clinical observations, published his treatise Mediate Auscultation in 1819. In his treatise, Laennec included details of his new method of using the stethoscope to provide physiological and pathological evaluation of patients. American physicians attended lectures and clinics at Paris hospitals and carried this information back to their respective medical schools and practices. This was accomplished by a relatively limited number of elite American physicians who were able to take advantage of travel abroad and whose practices were academically affiliated. However, it is a well-substantiated historical claim that the adoption of the stethoscope by most American physicians was slow. There are many reasons for slow adoption of the stethoscope in America, among which are lack of formal education, including bedside training in the stethoscope, complexity of interpretation of auscultatory information, hesitancy of the patient and physician to have an instrument placed between them, and lack of opportunities for continuing education for physicians after leaving medical school. As the nineteenth century progressed, scientific ideas and rhetoric related to auscultation and the stethoscope became more widespread, reflecting gradual acceptance and adoption of the stethoscope by American practitioners. In this article, I examine the ideas and rhetoric in medical journal articles, advertisements, and medical school textbooks to learn what was thought by physicians to be important in their practice. Advertisement of medical school curricula with mention of specific course work or lectures related to auscultation or the stethoscope is noted, reflecting increased interest in the stethoscope as an adjunct to physical examination. This information introduces evidence to test and bolster the existing historical claims of slow adoption of the stethoscope by addressing in more detail when and why adoption by American physicians became widespread.

Chronic Testicular Pain- A Review of Literature

Objective: To review the current understanding of testicular pain, possible etiology and the available treatment options. Materials and Methods: A literature search was made for abstract, original and review articles in the Medline, hand-searched relevant reference lists and conference proceedings and medical text book using the word “testicular pain” and orchialgia to find out possible etiology, understanding of testicular pain and treatment options. Results: After literature search, it has found that management of testicular pain sometimes a challenging work for an Urologist. Management differs for the original etiology and for testicular and extra testicular causes. Sometimes symptomatic treatment improve the quality of life but in few cases surgery is mandatory for relieve of pain. Conclusions: Management of chronic testicular pain depends on careful assessment of the causes. Relieve of symptoms is not always possible with analgesic only, in that case blockade of the spermatic cord will be helpful. Decision for surgery should not be undertaken quickly for there is no guarantee that there will always be resolution of pain For that reason patient should be counseled accordingly. Bangladesh Journal of Urology, Vol. 15, No. 1, Jan 2012 p.18-20

Usage of smart devices amongst medical practitioners in Universitas Academic Hospital.

BackgroundThere has been a rapid rise in the use of smart devices amongst medical practitioners throughout the world. This study aimed to identify how smart devices were being used by medical practitioners at the Universitas Academic Hospital (UAH), Bloemfontein, and the associated factors thereof. We also identified the views of medical practitioners regarding the usage of smart devices at their workplace.MethodsA prospective cross-sectional study was conducted. Anonymous questionnaires were distributed to medical practitioners working at UAH during weekly departmental meetings or monthly morbidity and mortality meetings. The following largest departments were included: Surgery, Anaesthetics, Paediatrics, Internal Medicine, Family Medicine, and Obstetrics and Gynaecology.ResultsThe response rate was 82.7% of those attending the meetings. All the respondents owned a smart device and brought it to their workplace. The most common applications used on these smart devices were that for drug references (65.9%), medical textbooks (63.6%) and medical calculators (58.1%). Significantly larger percentages of doctors aged 21–39 years compared with those aged 40–65 years used drug reference applications and medical calculators. A quarter (24.8%) of respondents communicated with patients through a smart device, 21.7% used an online storage platform to backup patient data, whilst 56.6% used their devices to store and view patient information. More than one-third (36.7%) agreed that smart devices threatened patient confidentiality, but the majority (58.8%) did not agree that these devices hinder patient communication. The majority felt that these devices improved both personal performance (69.2%) and patient care (79.0%).ConclusionSmart devices usage is common in this setting. Hence, integration of such usage in medical curricula, discussion on professionalism, ethics and confidentiality in this context, and guidance from institutions and professional bodies become necessary.

Neuroinflammation and the blood–brain interface: New findings in brain pathology

AbstractTwo fundamental concepts have impeded the development of research in brain, behavior and immunity during the past century. They have been presented in neuroscience textbooks since the beginning of the 20th century. Recent discoveries require that both views are in serious need of being updated in the scientific literature and medical textbooks. These two age‐old concepts are lack of lymphatic drainage in the brain and immune privilege of the central nervous system associated with impermeability of the blood–brain barrier.

Knowledge of first aid management of epistaxis among medical interns attending King Fahad Armed Forces Hospital in Saudi Arabia

Aim: The aim of this study is to explore the knowledge of medical interns about first aid in the management of epistaxis. Materials and Methods: An anonymous, cross-sectional, and validated survey-based study was conducted in January 2020 at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. Results: A total of 57 medical interns responded to the survey. The vast majority of survey respondents were male (78.9%) and single (80.7%). Around 57.9% of the respondents declared that epistaxis is regarded as one of the emergency situations. A sum of 71.9% of medical interns correctly identified “finger nail trauma” as the most common cause of epistaxis. In addition, while 71.9% of medical interns correctly answered, “sitting with head tilted forward” as the proper management position for a patient with epistaxis, only 52.6% of medical interns correctly answered, “pinching the lower cartilaginous part of the nose” as the primary measure to stop epistaxis. When medical interns were asked about what to do if the patient continued to bleed from the nose in the emergency room after the primary measures had been done, only 50.9% of medical interns correctly answered with “refer the patient to an otolaryngologist to take further care.” Using two-tailed Chi-square test, there were no differences in the percentages of correct answers among the surveyed medical interns according to gender (P > 0.05). With regard to the sources of information about first aid in the management of epistaxis, the top selected source by medical interns was “self-taught” (52%), followed by “medical textbooks” (19%). Conclusion: The surveyed interns had unsatisfactory knowledge about epistaxis first aid. There is a pressing need to establish solid curricular, extracurricular, and institutional measures to increase the intern's awareness of first aid knowledge in the management of epistaxis.

Representation of Fitzpatrick skin type in dermatology textbooks compared with national percentiles

As time progresses, more patients with skin of color will be seen by dermatologists. To meet the needs of the ever-changing population, medical education needs to analyze how residents are trained in recognizing dermatological disorders in patients with skin of color. The aim of this study was to analyze dermatology textbooks to evaluate how well skin of color patients are represented compared to the current national distributions. The most common skin types depicted in the textbooks were Fitzpatrick skin types II and III, whereas the least common skin types depicted were skin types V and VI. There was a significant difference between a national distribution of skin types when compared to photographs in each of the textbooks (P<0.001). These findings emphasize the need to better represent patients with skin of color in medical textbooks.

THE ROLE OF JOHN THE BAPTIST LALANGUE IN THE DEVELOPMENT OF CROATIAN PUBLIC HEALTH AND MIDWIFERY IN THE CONTEXT OF IMPLEMENTATION OF THE IMPERIAL PUBLIC HEALTH LAW FROM 1770.

SUMMARYTo understand the development of public health in Croatia, there are newer insights into the life and work of John the Baptist Lalangue. John the Baptist Lalangue is most valued for implementation of the imperial law on public health and promotion of midwifery in Croatia during the second half of the 18th century. Lalangue is the author of the first printed medical textbook in Croatian, published in 1776, entitled Medicina ruralis iliti Vrachtva ladanyszka, za potrebochu musev, y sziromakov Horvatczkoga orszaga y okolu nyega, blisnesseh mest, Trattnern, Varaždin. In the same period, Lalangue published the first Croatian midwifery textbook entitled Brevis institute de reobstetritia iliti kratek navuk od mestrie pupkorezne za potrebochu muskeh y sziromaskeh ladanovskaya horvatskoga orszaga y okolo nyega blisnesseh sztrankih, Trattnern, Zagreb. In 1779, Lalangue published his balneological debut in Croatian, the book Tractatus de aquis medicati Regnorum Croatiae et Slavoniae Iliti Izpiszavanye vrachtvenih vod Horvatzkoga y Slavonskoga orszaga y od nachina nye vsivati za potrebochu lyudih, Trattnern, Zagreb. Lalangue’s works were used in systematic training and education of midwives and they, as well as Lalangue, have an inevitable place in the history of Croatian midwifery. During his life and work, John the Baptist Lalangue made immeasurable contribution to the development of Croatian public health.

Application of Low Doses of Ionizing Radiation in Medical Therapies.

The discovery of X-rays and radioactivity in 1895/1896 triggered a flood of studies and applications of radiation in medicine that continues to this day. They started with imaging fractures/organs and progressed to treating diseases by exposing areas to radiation from external and internal sources. By definition, low-dose treatments stimulate damage control (or adaptive protection) systems that remedy diseases. Publications are identified on low-dose ionizing radiation (LDIR) therapies for different cancers, infections, inflammations, and autoimmune and neurodegenerative diseases. The high rate of endogenous DNA damage, due to leakage of oxygen from aerobic metabolism, and the damage control systems that deal with this are discussed. Their stimulation and inhibition by radiation are described. The radium dial painter studies revealed the radium ingestion threshold for malignancy and the dose threshold for bone sarcoma. The radiation scare that misled the medical profession and the public is a barrier to LDIR therapies. Many studies on nasal radium irradiation demonstrated that children are not unduly radiation sensitive. Omissions in the medical textbooks misinform physicians about the effects of LDIR therapy, which blocks clinical trials to determine optimal doses, efficacy, and thresholds for onset of harm. Information from many recent case reports on LDIR therapies, including successes with radon therapy, is provided.

Mapping the genicular arteries to provide a caution zone during knee surgery.

Reports from the current literature show a lack of detail with depictions of the genicular arteries (GA). The intricate anatomy and infrequency of operating in the posterior knee may lead to surgeons being unfamiliar with the anatomy. The goal of this cadaveric study was to quantitatively map the arteries and create a caution zone that can be utilized when preparing and performing surgical procedures involving the knee. The left knees of 46 cadavers were used. The distance of the GAs were from the joint line (JL) (+, superior to JL; -, inferior to JL) was measured in two locations: popliteal artery (PA) branch point and medial/lateral knee. The angle the artery traveled between these two points in the posterior knee was measured. A caution map was created. The superolateral GA branched from PA at +47.3 mm and traveled superiorly at 57.7° to +52.2 mm at the lateral knee. The superomedial GA branched from PA at +55.2 mm and traveled superiorly at 66.8° to +57.3 mm at the medial knee. The inferolateral GA branched from PA at -0.6 mm. It traveled superiorly at 74.1° or inferiorly at 62.1° to -1.0 mm at the lateral knee. The inferomedial GA branched from the PA at +9.9 mm. It traveled inferiorly at 21.2° to -33 mm at the medial knee. The GAs have a predictable pattern of location in the knee. There is a mismatch between medical textbooks and reality regarding arterial depictions. Knowledge regarding where the arteries are located may help reduce vascular complications in patients in the future.

Abdominal palpation and percussion maneuvers do not affect bowel sounds.

Medical textbooks suggest that the frequency of bowel sounds may be altered by performing auscultation after palpation or percussion. We hypothesize that the frequency of bowel sounds is not affected by the order of abdominal examination. Both healthy volunteers (n= 80) and patients (n= 100) were enrolled in this crossover randomized study. Two different examination orders, one as inspection, palpation, percussion, auscultation (IPPA) and the other order as inspection, auscultation, palpation, percussion (IAPP) were used by two observers, one of which was blinded to the order of the physical examination and only performed auscultation. Bowel motilities of 40 participants were analyzed with duplex Doppler USG by a radiologist. The effects of changing the order of abdominal examination and palpation-percussion maneuvers on the frequency of bowel sounds were evaluated. Gender distribution was similar between the healthy patients and controls, and mean age of the entire study population was 47 (18-60) years. Differences between the mean bowel sound frequencies for abdominal examinations in order IPPA-IAPP versus IAPP-IPPA were evaluated for both healthy subjects and the patients. There were no differences between the first and second listening, nor were there differences between examinations performed in either order. Duplex Doppler Ultrasonographic (USG) assessments were performed on 20 healthy subjects and 20 patients before and after palpation and percussion; there were no statistically significant differences between the two listenings (p= 0.694). According to both abdominal examinations and Doppler USG, the order of auscultation, whether performed before or after palpation or percussion, did not change the frequency of bowel sounds in this subject population.

Myeloid Leukemias: A Glance at Middle Eastern Centers.

Background and objectivesMyeloid leukemias (MLs) are clonal stem cell disorders affecting myeloid lineage cells. Advances in cytogenetic and molecular studies partially disclosed the mystery about risk factors and pathophysiology of MLs. Regarding incidence, risk factors, response to treatment, and overall survival of patients, research showed differences among different countries. However, the Western registry data are the basis for the documented description of MLs in medical textbooks. This research aimed to study MLs in Middle Eastern health centers. Egypt has the highest population in the Middle East; furthermore, 96.6% of the population is native Egyptians; accordingly the study focused on Egypt.Patients and methodsData of 468 patients with MLs were collected from hospital records at two big tertiary health centers. They were grouped into group 1 (chronic myeloid leukemia, CML) and group 2 (acute myeloid leukemia, AML); the latter was subgrouped into 2a (primary AML) and 2b (secondary AML).Results and conclusionsThe median age of patients was 43 years; males predominate in group 2a and females in groups 1 and 2b. 37.2% of group 1 patients were treated with Gleevec. Hematopoietic stem cell transplantation was planned for only 5% of group 2 and 18% relapsed. Of groups 1 and 2 patients, 25% and 12%, respectively, stopped follow up, and 15% and 35% died. ORR and overall survival were 53%, 27% and 7%, 0.4% for groups 1 and 2, respectively. Conclusively, this study showed a young age of ML patients, with female predominance in CML, and poor outcome. This reflected racial, ethnic and risk factor differences in incidence of MLs.

Management of Fever in Children based on Persian Medicine

Background: Pediatric fever is the common cause of consultation in primary care services. Antibiotics that are prescribed widely, are not indicated in most patients. Using non-drug approaches in these situations can be helpful. We aimed to assess the information existing in Persian medical textbook for relieving pediatric fever and search their efficacies based on Conventional Medicine. Materials and Methods: In this study, data was extracted by searching a recent reliable Persian Medical Encyclopedia, Exir-e A’zam that is taught in Persian medical schools, and is the only reference that has a pediatric fever specific chapter. Then related information was searched and extracted from English (Medline, EMBASE and Web of Science, Scopus), and Persian (SID) online databases, based on both Persian and Conventional Medicine. Then investigation and analysis were done on findings.The period of research was between 2000 and 2019. Results: Based on Persian opinion, of every disease had principles that called health preservation management (Tadbir-e-hefz al-sehheh) that was applied in addition to the main treatment. Management that was prescribed for pediatric fever include: evacuation and retention, sleep and wakefulness, manual interventions and nutritional orders. These methods have ingredients that were applied as oral or topical or in life style. In conventional medicine some physical modalities which are used include: ice packs, cooling blankets and sponging. Some medicinal herbs are suggested for relieving fever, after finding the reason for the fever and administering the main treatment. Conclusion: According to this study, Persian medicine has several complementary and alternative methods that can reduce body temperature. Many of them can be effective based up on recent articles and conventional medicine. Further clinical studies are recommended to investigatetheir effectiveness.

Therapeutic Benefit of Dillenia indica in Diabetes and Its Associated Complications.

Diabetes, a metabolic disorder characterized by elevated fasting blood glucose levels, affects nearly 8% of the world population and was predicted that it would be the top seven leading cause of death in the next ten years. The incidence of diabetes and its morbidity are increasing rapidly in developing countries due to lifestyle change and intake of high-calorie diet occurring with urbanization. Medicinal plants and their products have been proven to be effective, less expensive, and safe for the treatment and prevention of diabetes. Although several medicinal plants known for the antidiabetic property are reported in the ancient medical textbook, there is always a scope to identify and validate less explored medicinal plants that are still practiced regularly by local and tribal people since ancient times. Here, in the present article, we would like to review a less explored medicinal plant, Dillenia indica, which has promising effects in treating diabetes and other diabetic-associated complications. In spite of its wide use in the Northeast region of India as traditional medicine, there is only one clinical study where the antidiabetic potential of the fruit powder has been shown. Further well-designed animal and human studies are needed to confirm the role of Dillenia indica in diabetes and its associated complications.

Rewriting Medical Textbooks: The Kidney as a Window to the Heart – The Role of Sodium–Glucose Transport Protein 2 Inhibitors in Cardiovascular and Renal Disease in Type 2 Diabetes Mellitus

This symposium took place during the 2019 meeting of the European Association for the Study of Diabetes (EASD). Focussing on the kidney as a window to the heart, the speakers discussed connections between the kidney and the heart, potential mechanisms, and the role of sodium–glucose co-transporter 2 (SGLT2) inhibitors in patient management. Prof De Nicola set the scene with projected numbers of patients with diabetes and diabetic nephropathy. Prof DeFronzo gave a description of the natural history of diabetic nephropathy, microalbuminuria as a predictor of chronic kidney disease (CKD), and the Steno hypothesis linking impaired vascular endothelial dysfunction with vascular leakage of albumin. He concluded his talk by describing why patients with CKD are predisposed to cardiovascular disease (CVD). Prof Groop provided insights into the mechanisms of renal protection by SLGT2 inhibitors. He explained the ‘tubular hypothesis’, whereby SLGT2 inhibitors correct glomerular hypertension by inhibiting tubuloglomerular feedback (TGF). Prof Perkovic highlighted data from randomised controlled trials which enhanced understanding of the potential effects that might be achieved with SLGT2 inhibitors. The meeting concluded with a lively discussion between panel members and the audience.

Dermatology in Ancient Rome: Medical ingredients in Ovid's "Remedies for female faces".

In Roman medicine, face packs, plasters, unguents, and peelings were part of the therapy of dermatological diseases, but also served cosmetic purposes. Ancient medical textbooks inform us about the ingredients for these applications. Beyond medical literature, other genres contain information about dermatological applications. The Roman poet Ovid (43 BC-17 AD) wrote a didactic poem recording five recipes for topical applications for female faces (Medicamina faciei femineae). Researchers debate the relation of Ovid's poem to Roman medicine: Does the poem contain therapeutical or cosmetical information, or is it mere belles lettres? The objective of the paper is to conduct a medico-historical classification of Ovid's poem by determining whether the ingredients of Ovid's recipes were thought to be effective by the authors of Roman medical textbooks. First, translation and identification of the ingredients were carried out. Second, comparison of the ingredients' functions regarding the therapy of dermatological diseases in two important Roman medical textbooks was realized. For this purpose, several commentaries on the text of Ovid were used and a keyword search in Romanmedical textbooks was performed. Ovid's five recipes contain 23 ingredients. All ingredients can be found in medical textbooks. We find that 14 of these ingredients serve cosmetic purposes, 17 serve the therapy of dermatological diseases, and 13 serve both. Ovid's recipes contain drugs that were considered effective by the authors of Roman medical textbooks. These drugs were recommended both for therapeutic and cosmetic purposes by the same authors. Therefore, Ovid's didactic poem is not mere belles lettres, but contains serious medical and cosmetical information. As far as we know, it is the first Roman text that contains dermatological recipes.

To evaluate the effect of Arka Pratisaraneeya Kshara in the management of Kadara w.s.r. to Corn

Kadara is a Kshudraroga which is characterized by hard thickened type swelling, largely confined to the Pada but also seen in Hastha. The disease Kadara is not a life threatening condition, but makes the life of the sufferer miserable. Aetiological factors include injury due to the thorn prick, stone, cut, friction, pressure or wearing ill-fitting and tight shoes. The disease Kadara described in Ayurveda and Corn in western medical textbooks have absolute similarity in their manifestation. The management of corn is done by application of salicylic acid, corn caps, and invasive procedures like cryotherapy, laser, chemical cauterization, electric cauterization and surgical excision. But the results by these procedures are not satisfactory and there are more chance of recurrence. Kshara is indicated in management of Kadara. Kshara Karma is unique procedure used since ancient time which best among Shastra and Anushastra due to its comprehensive multi-faceted effects. Hence the present study was undertaken for evaluation of efficacy of Arkapratisaraneeya Kshara obtained was compared with the results of Agnikarma using Panchalohashalaka which is a standard and established study.

The Food of Meditation

Abstract Beginning with stories of hunger and food magic in Tibetan biographies, I explore a dietary practice of total abstinence from material foods. Buddhist meditators are said to enjoy “the food of meditation” or “the food of the sky.” Texts teach meditators how to use visualization and yogic movement to “extract the essence” of breath and use it as food. When discussing illnesses that may be experienced by retreatants, these texts identify hunger as illness. Examining how dietary teachings for Buddhist contemplatives are also medical textbooks, I propose that these food practices reconstruct the pathology of hunger, turning hunger into a tool for enlightenment. After a quick look at dietary asceticism in Indic and other traditions, I suggest that in these Tibetan examples, dietary abstinence is ultimately about self-perfection.

Medicinal herbs useful in pediatric fever from the perspective of Persian medicine.

Background Fever is the most important and common symptom of pediatric diseases. Fever can be a sign or symptom or complication of disease. Considering the development of complementary and alternative medicine worldwide and the prevalence of this symptom in children, we aimed to investigate their application based on Persian medical textbooks by searching herbs used in pediatric fever. Materials and Methods In this review study, materials were extracted by searching in reliable Persian medical textbooks of the10th -20th century using related Persian medicine keywords. Then the documentations for herbs extracted were searched in the databases based on the conventional medicine. The interpretation was made based on the results. Results Based on the Persian medical textbooks, seventeen herbs have been prescribed for decreasing pediatric fever. Among them, 16herbs have proven mechanisms of action for treatment of fever, classified into five categories (diaphoretic, anti-inflammatory, anti-septic, immunomodulatory, anti-oxidant) based on literature review. On the other hand, according to Persian medicine, there were thirteen cold temperament herbs and only four hot temperament ones. They were administrated using various oral and topical methods. The maternal and neonatal treatment was emphasized. Conclusion According to this study and documentations of conventional medicine, many of these herbs can be effective in the treatment of pediatric fever, so further clinical studies are recommended for evaluating their efficacy.

The Signs and Symptoms Comparison of Gastrointestinal Diseases between Classic Medicine and Iranian Traditional Medicine: A Hybrid Qualitative Study

Background: Iranian traditional medicine is the oldest form of medical structure and is, in fact, an inseparable part of the life of various Iranian societies. On the other hand, gastrointestinal and liver diseases are one of the most common causes of morbidity in the world, including in Iran. Such that 10% of diseases are allocated to them and their diseases are spreading increasingly.
 Objective: Considering the mentioned issues and the high prevalence of gastrointestinal symptoms, the aim of this study is to investigate the compliance of the symptoms of gastrointestinal diseases in classical medicine with Iranian traditional medicine from the viewpoint of Iranian traditional medicine experts.
 Methods: This is a hybrid qualitative study which was conducted in three phases, including 1- theoretical, 2- field and 3- combinational phases. In the theoretical phase, two types of medical textbooks i.e. Iranian traditional and classic medicine textbooks. In the field stage, 13 academic Iranian traditional medicine experts with at least 5 years of work experiences in Iranian traditional medicine were interviewed. Then, in the combinational phase, the results of two early phases have been summarized using descriptive statistics.
 Results: The results of the study show that 12 of the 40 symptoms in this study had a compliance of 100%. These 12 symptoms are Increase of Salivation, Pica, Borborygmi, Hiccups, Abdominal distention, Melena, Anal Fissure, Anal Stenosis, Cryptitis, Anal pruritus, Halitosis, Rectal pain; also, the results showed that 10 of the 40 symptoms in this study had over 70% compliance. These 10 symptoms are as Dysphagia, Belching, Regurgitation, Hematemesis, Flatulence, Increased Bowel sound, Abdominal pain, Diarrhea, Jaundice and Anal prolapse. Also, the percentage of compliance with the other 18 symptoms was less than 70%.
 Conclusion: Considering the results of this study and the capabilities of Iranian medicine in relation to symptoms of gastrointestinal diseases with classical medicine, it is possible to design appropriate patterns to expose it. Also, an integrated approach to clinical research is recommended to improve the efficacy and safety of gastrointestinal treatments.