Background:Hemoptysis is the expectorating of blood from the tracheobronchial tree or pulmonary parenchyma. There is conflicting information about usefulness of radiography, MDCT, and bronchoscopy for investigating site and cause of the bleeding in patients with hemoptysis. The present study attempted to evaluated efficacy of these methods for identifying hemoptysis’ cause and etiology on 40 patients with the disease.Methods:A total of 40 patients with Hemoptysis who were referred to Golestan and Emam Khomeini hospitals were evaluated. Complete history of symptoms, volume and duration of Hemoptysis and demographic information were documented. Radiography, MDCT, and bronchoscopy were performed on all patients in order to investigate the site and cause of the bleeding.Results:Results showed MDCT had higher efficacy in identifying bleeding site than radiography, while efficacy of radiography and bronchoscopy or efficacy of MDCT and bronchoscopy weren’t significantly different. In addition, sensitivity of MDCT (60%) for detecting cause of the bleeding was higher than that of radiography (25%) and bronchoscopy (32.5%).Conclusion:The present study suggests MDCT as a suitable method in screening patients with hemoptysis, because it managed to detect site and causes of bleeding more efficiently than other methods. Additionally, we concluded that MDCT is an appropriate technique for diagnosing malignancies that cause hemoptysis in patients.

Background:Differentiation of the etiologies of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and differential diagnosis of other causes of respiratory attacks in chronic obstructive pulmonary disease (COPD) patients are challenging. Serum procalcitonin (PCT) which is a biomarker of bacterial infection, but not viral infections, could possibly recognize AECOPD requiring antibiotic treatment from other etiologies of respiratory attack.Methods:Patients aged from 40–80 years who were diagnosed with COPD according to the GOLD criteria and who referred to the Imam Khomeini Hospital of Ahvaz in 2016 were divided into two groups of exacerbated and stable COPD. Exacerbation of COPD is defined as worsening of the patient's condition from the stable state and behind normal day-to-day variations that is acute in onset and may necessitate treatment in a patient with underlying COPD. BODE Index and 6MWDT were used to assess the patients, and the severity of their disease was determined based on the GOLD criteria. Subsequently, PCT testing using electrochemiluminescence (ECL) method was carried out on patients on the same day.Results:PCT level in the exacerbation group was 0.272 ± 0.586 and 0.066 ± 0.027 in the non-exacerbation group, and their difference was statistically significant with P value = 0.001. Based on the results, the cut point of differentiating between the AECOPD and the stable groups with a sensitivity of 68% and a specificity of 80% is 0.085.Conclusion:Overall, the findings of this study indicate that PCT levels could be regarded as a good diagnostic marker for patients with COPD, and for the differentiation of AECOPD patients from stable COPD patients.

Introduction: Phosphodiesterase inhibitors (PDEs) increase intracellular cyclic adenosine monophosphate, which results in a wide range of anti-inflammatory effects and pathologically leads to improve asthma disease. Because no human study has surveyed the effect of PDEs on pulmonary function, except some case reports and animal researches, we decided to perform a pilot study for evaluating the effect of sildenafil (PDE5) on pulmonary function in patients with severe asthma. Methods: This randomized controlled trials study was conducted on 20 patients with severe asthma in 2019 in Iran. For case group, was prescribed sildenafil (50 mg) daily and the control group received the placebo. In the beginning of the study and one month later, volume parameters, 6-minute walk distance (6MWD), and the quality-of-life questionnaire were measured and compared in the two groups. Results: Twenty patients were entered into this study. 8 patients (40%) were male and 12 (60%) were female. The results showed that mean forced vital capacity 1 in the sildenafil group turned from 1259 ± 170 to 1603 ± 527, while in the placebo group it changed from 1135 ± 125 to 1365 ± 251 (P-value = 0.215). There is no statistically significant difference between two groups. In addition, in comparison with placebo, sildenafil did not show any significant improvement in the volume parameters, the quality-of-life questionnaire scale, and 6MWD at the end of the study. Conclusion: According to present result can be concluded that sildenafil does not improve the severity of asthma and the quality of life in patients with severe asthma.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive process leading to major clinical problems in patients. There is no highly effective treatment for these patients and therapists only try to relieve the symptoms. Objectives: The present study was performed to investigate the effects of self-management program on exercise tolerance and dyspnea in patients with COPD. Patients and Methods:In this clinical trial, 50 patients with moderate and severe grade COPD who met the inclusion criteria were randomly assigned to control and intervention groups. The control group received usual care and the intervention group received usual care plus a self-management program based on the 5A model. Patients were assessed by six-minute walking test and the Borg scale for exercise tolerance and dyspnea at base line and after 12 weeks. SPSS software version 17, independent t-test, and chi-square test were used for data analysis. Results: There was no significant difference between the groups in exercise tolerance at base line; but, they were significantly different at the end of 12 weeks (P = 0.007). In addition, a significant reduction was found in patients' dyspnea in the intervention group, compared with the control group after 12 weeks (P < 0.0001). Conclusions: In short term, using the self-management program can lead to increased exercise tolerance and decreased dyspnea in patients with COPD; thus, this program is recommended as an effective way to improve the functional statuses of these patients.

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