Peptic ulcers are the most common cause of UGIB. Comorbidities, hemodynamic instability, high-risk endoscopic stigmata, history of smoking and taking NSAIDs, gastric and esophageal malignancies, may be important predisposing factors for rebleeding and mortality in patients with UGIB.

Background: Humerus shaft fracture is one of the most common orthopedic problems, accounting for approximately 5% of all fractures. This study aimed to compare the surgical treatment results of humerus shaft fractures by intramedullary nailing and palate. Methods: This study was performed as a retrospective cohort. Eighty patients were referred to the Madani hospital with humerus shaft fracture, of which 40 patients were treated with either IMN or palate methods. All patients were followed up in outpatient clinics at six weeks and 3 and 6 months. Evaluation of the results was evaluated based on performance improvement, ability to return to previous jobs after six months, time of union formation, rate of union formation, and incidence of complications. Data were analyzed using the SPSS program. Results: The mean amount of blood lost during the operation and the duration of surgery in the IMN group were signicantly lower than the DCP group (P <0.05), but there was no signicant difference between the two groups in terms of length of hospital stay (P> 0.05). On the other hand, the mean of Constant and ASES criteria and the frequency of unions in the two groups were not signicantly different (P> 0.05). Conclusion: The present study results showed that the rate of intraoperative bleeding and duration of surgery in the IMN group was signicantly lower than the DCP group. Still, there was no signicant difference between the two groups in terms of length of hospital stay and functional criteria.

Background and Aims: Achieving proper axial rotational alignment of the femoral component for varus knees is a critical step in total knee arthroplasty (TKA). Trans epicondylar axis (TEA) is the most reliable reference for alignment of femoral component. Yet, nding the exact location is sometimes difcult and time consuming. The aim of this study was to determine the correlation between the TEA and posterior condylar line reference (PCL) in varus knees. Besides, the other aim of this study was to nd the relationship between lateral distal femoral angle (LDFA) and femoral component external rotation (ER) measured intraoperatively. Material and Methods: This retrospective study was conducted on patients who were candidates for total knee arthroplasty from May 2016 to December 2019. LDFA, VA were calculated based on hip-to-ankle (HTA) radiographs before the surgery. All patients underwent TKA through an anterior midline incision. ER was calculated by determining TEA intraoperatively. All data were entered into SPSS software for data analysis. Results: One hundred and four patients were included in the nal analysis. Nineteen patients (18.3%) were male and 85 out of 104 (81.7%) were female. (P value = 0.001). No signicant relationship between the amount of ER measured during surgery and the amount of varus angle in varus knees was observed. Furthermore, there were no correlations between ER and LDFA in varus knees. Conclusion: Adjusting femoral component in 3 degrees external rotation relative to posterior condylar line reference achieves proper rotational alignment of the femoral component in the axial plane in varus knees. Also, the lateral distal femoral angle measured preoperatively from knee radiographs is not a predictor of ER in varus knees

Background: In different ways, drugs are administered to reduce postoperative analgesia after arthroscopic anterior cruciate ligament (ACL) reconstruction. The purpose of this study is to compare the dexmedetomidine (DEX) intra-articular injection with bupivacaine hydrochloride and sterile 0.9% saline administration following arthroscopic ACL reconstruction.   Methods: Sixty cases who underwent ACL reconstruction were randomly divided into three groups. The first group received intra-articular DEX; the second group received intra-articular bupivacaine, and the final group received intra-articular 0.9% saline. Postoperative pain was measured by Visual Analogue Scale (VAS).   Results: The mean VAS scores at 6 and 24 hours after surgery were lower in the bupivacaine group, compared to the other groups. Pain was more severe in the control group (0.9% saline), with higher VAS scores reported at 1, 6, and 24 hours after surgery.   Conclusions:  Bupivacaine has more significant effects than  DEX  in postoperative pain management after arthroscopic ACL reconstruction.

Background: Osteochondroma is the most common benign tumor of the bone. Case Report: In this case, we present a young patient complaining of sensation of a mass in her abdomen since a few weeks ago and abdominal pain, which caused her visit to the clinic. Imaging studies revealed a well-defined lobulated lesion, and pathological examination was correlated with osteochondroma of the iliac bone Conclusion: This site for osteochondroma is very rare, and this case was the solitary type.