Annals of Military and Health Sciences Research
Year:2008 | Volume:6 | Issue:2 (SERIAL NUMBER 22)|Papers Count:15

Background: Considering the high prevalence of zinc deficiency in Iran and important role of zinc in health of men, especially diabetic patients, this study was carried out to determine the effects of zinc supplementation on zinc, insulin and glucose levels in men with type 2 diabetes mellitus aged 50-65 years.Materials & Methods: A randomized double-blind placebo controlled clinical trial was conducted on 54 diabetic patients. None of them suffered from any disease other than type 2 diabetes mellitus. The subjects were matched according to age, duration of the disease, body mass index (BMI) and waist to hip ratio (WHR).Then subjects were randomly assigned to receive either a zinc supplement (25 mg Zn/day, in sulfate form) or placebo for 2 months. Before and after the study period, fasting blood samples was taken from each patient to determine blood glucose, HbA1c, insulin, C-peptide concentrations, serum and leukocytes zinc. 2hpp and urinary glucose and zinc concentration were measured.Results: After treatment mean fasting blood glucose and 2hpp increased in both groups (p£0.01). Also urinary glucose concentration increased, but it was not significant. Mean HbA1c, serum insulin and C-peptide decreased significantly in test and control groups (p<0.01). After treatment serum zinc decreased significantly in both groups, while leukocytes zinc increased (p<0.01). In this study, no significant difference was seen between two groups.Conclusion: In the present study, zinc supplementation had no significant effects on zinc, insulin and glucose levels in diabetic subjects.

Background: Foot drop is one of the most common causes of soldiers referral to electrodiagnostic clinics. With respect to importance of disability due to Foot drop specially in young adults, this study was performed.Materials and Methods: This cross- sectional and retrospective study was done on 75 soldiers referred to electrodiagnostic clinic of 501 army hospital in years 1378-1386. Demographic information, History, physical examination and electrodiagnostic tests were obtained of patients files and were written in the questionnier.The results were then analyzed by statistical soft ware of SPSS 13.Results: causes of foot drop with respect to electrodiasgnostic results included: 62 cases (82.7%) damage at common peroneal never, 3 cases (4%) at level of roots, 7 cases (9.3%) peripheral neuropathy, and Deep peroneal nerve, sacral plexus and sciatic nerve damage, each of, 1 case (1.3%). There was meaningful correlation between onset of symptum and severity of lesion.Conclusion: Common peroneal nerve lesion at head of fibula is the most common cause of foot drop in studying group and nearly all patients were involved in military education period. Reassessment of military education is recommended.

Background: Hydrofluoric acid and other fluorine compounds are used in different industries worldwide. Fluoride ion bonding with Calcium and Magnesium ions interferes with cell enzymatic systems and causes cell death. Any hesitation in diagnosis and treatment can lead to irreversible injuries in exposed individuals.Material & Method: This cross - sectional study was conducted on 74 workers who had occupational exposure to Hydrofluoric acid. After dermal contamination, treatment procedures at the time of exposure and later in the medical center included decontamination with water, topical application of Calcium Gluconate Gel 2.5% and/or Benzalkonium Chloride solution. Workers and physicians were asked to fill in separate questionnaires providing data on the type and extent of burn and treatment procedures. Data were analyzed by descriptive and analytical methods in SPSS data bank.Results: 56 cases (75.7%) had carried out decontamination with water and 24 cases (32.4%) had applied Calcium Gluconate Gel immediately after exposure. In the clinic, treatment procedures included: decontamination for 46 cases (62.16%) and Calcium Gluconate Gel for 70 cases (94.59%). More than 80% of burns were first degree at the time visited by physician and no complications observed in later follow-ups.Conclusion: It can be concluded that the initial washing with water and application of Calcium Gluconate Gel 2.5% at the time of exposure and later in the medical center is an effective and acceptable method in HF burn.

Background: Genuvarum is an essential health disturber in army soldiers. At present, above 10 cm of bicondylar distance exempt men from soldiering, but they have problems with much less degrees. Assessment of pain related to degrees of genuvarum in old cases seems to be a reliable method of predicting these young knee situations in future.Materials and methods: This research was done according to the descriptive method by observation and measurement. 200 old male cases referred to 501 Army hospital, 100 military and 100 non military, with genuvarum also were examined for bicondylar distance, as mild (0-5 cm), moderate (5-10 cm) and severe (> 10 cm), their pain and other symptoms were recorded. Then we compair military group’s data with that of non-military. Statistical analysis of the data was performed with SPSS.Results: The prevalence of mild, moderate, and sever genuvarum was equal in the military and non military persons, and so the prevalence of pain and discomfort in mild and sever genuvarum. But, in the moderate group, the symptomatic genuvarum was much more frequent in military persons than non military (53% versus 16%).Conclusions: The severity of genuvarum is equact to increase in the severity of symptoms. Mild, moderate, and sever genuvarum is seen equally in military and non military persons. In the two groups, pain and discomfort is equal in mild and sever degrees in both groups, but the military ones with moderate genuvarum are more symptomatic. Thus, 7.5 cm (mean of moderate degrees) is offered to be considered forexempting soldiers of routine 10 cm.

Background: Uterine leiomyomas (myomas) are the most frequent benign uterine tumors, several studies have suggested that each leiomyoma arises from a single neoplastic cell within the smooth muscle of myometrium and in 4 percent of pregnant women, sonographically detectable myomas are present.Methods and materials: A cohort study done in years of 1385-86 to compare obstetric outcomes between normal pregnant and pregnant women with myomas, 87 pregnant with myoma and 375 normal pregnant selected for pre, intra and post partum complications.Results: Myoma in pregnancy is a risk factor for first trimester bleeding, spontaneous first trimester abortion, placenta previa, noncephalic presentation, post partum hemorrhage and cesarean delivery but frequency of preterm labor, premature rupture of membrane, placental abruption and intra uterine growth restriction were not different between group with myoma and control group. Furthermore the rate of post partum hemorrhage in group with myoma larger than 5cm in diameter was greater than in group with myoma 5cm or smaller in diameter (P=0.02). After multiple logistic regression analysis, advanced maternal age, nulliparity were independently associated with presence of myoma in pregnancy.Conclusion: Presence of myoma documented by gestational sonography is associated with high risk pregnancies which necessitate patient education and labor staff preparation for intra and post partum probable complications controlling.

Background: oxidative stress is one of important risk factors of deiseases specially in military recruits who are under sever practices Vitamin C is one of the major antioxidant factors which also help to increase iron absorption. Vitamin C and probably iron deficiency due to that, can decrease soldier forces and cause various diseases particularly pulmonary diseases. The purpose of this study is to determine serum level of vitamin C and iron and TIBC in military recruits to prevent following problems due to deficiency of Vitamin C.Materials and Methods: This study was done as a cross-sectional study in September 2007 in Tehran and 51 soldiers were chosen randomly who were between 17 and 24 years old. 5cc bloods were collected for determining serum vitamin C, iron and TIBC. Prevalence of vitamin C and iron deficiency and relationship between vitamin C and iron serum levels and between vitamin C and iron serum levels and between vitamin C and TIBC serum levels were calculated.Results: Mean value of serum level of vitamin C 0.57±0.23 SD was less than normal range. (0.6-2 mg/dl), and prevalence of vitamin C deficiency among the soldiers of this study was 56.8%. However, mean value of serum iron 102.57±53.78 mg/dl SD was in normal range (60-180 mg0dl) and also TIBC amounts 364.51±59.00 mg/dl SD was in normal range (230-410 mg/dl). Relationship between vitamin C and TIBC serum levels was reversely significant (P<0.001).Conclusions: It is advisable to get more attention to provide more vitamin C resources for young soldiers for preventing to iron deficiency status or other potent dangers.

Background: Based on the studies which have been done till now, resynchronization of ventricular contraction results in clinical improvement in patients who suffer from moderate to severe heart failure with intraventricular conduction disturbance. and using this method is increasing in our country. Study in this filed seems to be necessary.Material and methods: Sixty-five consecutive patients with advanced heart failure, NYHA Class III and IV, LV ejection fraction (EF)£35%, QRS³120 were studied before and 3 months after CRT. Mean age was 60, 57 and 8 patients with NYHA class III and IV respectively. All patients received furosemide, spironolactone, carvedilol, ACE inhibitors and angiotensin II –receptors blockers at the optimal tolerated dosage. Mean LVEF was 20.83%. Echocardiographic (Tissue Doppler Imaging), ECG and Function class (NYHA) were assessed at baseline before implantation and 3 months after.Result: LV ejection fraction increased +6.8% (21.10±7 vs. 27.93±8.4%, P<0.001). Mitral valve regurgitation severity reduced (P<0.013). Interventricular mechanical delay reduced (53.83ms±18.45 vs. 26.53ms±13.90 P=0.000) and also Intra ventricular mechanical delay reduced (62.53ms±25.08 vs. 45.55ms±13.47, P=0.000). Dilated cardiomyopathic group has more mean changes in LVEF than Ischemic group (+9.06%±7.3 vs. +4.08%±6.5, P=0.01).Conclusion: Biventricular pacing results in significant clinical improvement in patients who have moderate to severe heart failure.

Background: Patients who use Permcath permanent catheter as the vascular access for hemodialysis are occasionally confronted with catheter-related infections. Permcath infections can lead to catheter removal in Haemodialysis patients. Successful use of a ‘locked-in’ antibiotic has decreased catheter infections. This study evaluates the impact of the intraluminal vancomycin in comparison with intravenous antibiotic administration.Material & Methods: This experimental nonrandomized controlled study included 67 end stage renal disease patients enrolled for HD from 2005 to 2007 at our hospitals. The patient was studied in to 2 groups. In the first group (intervention group), vancomycin was injected via each lumen of permcath, with IV Ceftriaxone for 7 days, and then oral antibiotics was administered according to the culture fore three weeks. If the culture was negative, Cefixime was administered. In the second group intravenous Vancomycin + intravenous Amikacin prescribed. In both groups, if the patients had it enough response after 72 hours, permcath was removed. Our endpoint is to assessment of catheter removal.Results: Patients characteristics didn’t differ between 2 groups. Of 28 patients in group 1, 1 catheter removal, and of 39 patients in group2, 22 catheter removals were done. There is a significant reduction of catheter removal in the first group (p<0.001).Conclusions: This study has shown that administration of Vancomycin via permcath is more effective than intravenous, and increase life time of catheter.

Background: The propose of present article is introducing methods and instrument of assessment and diagnosis of anxiety disorders in child and adolescents.Materials and Methods: This research is descriptive- Liberian study. To collecting data, all of available psychological and psychiatric references and literature was studied and those results summarized.Results: Structured interviews facilitate clear and correct diagnosis by information quantifying and reducing validity problems of non-structured interviews. Self- report instruments administrate easily and fast, and provide information about nature and severity of anxiety symptoms. These instruments are complement of clinical interviews and aren’t used as major diagnosis instrument. Behavioral instrument as a substitution to structured interviews and self- report instruments can provide proper information about problems of young child. Because this group of patients cannot easily express her/ his fears and anxieties.Conclusion: Application of these instrument to research and therapeutic proposes aren’t sufficient and using a set of its recommended. Although application of introduced instruments to providing precision diagnosis and assessment of therapy outcomes can be helpful.

Background: Broad Beta disease is one of the genetically disorders in lipoprotein that cause aggregation of lipoprotein in plasma and Incidence risk of Ischemic heart disease among these patients is high.Case presentation: An eight year old boy was admitted to the hospital because of an abrupt onset chest pain, faint and ST depression in inferior leads. He has been well one day earlier, when an exertional chest pain developed. Laboratory values obtained before admission showed hypercholesterolemia, and physical exam showed mild supravalvular aortic stenosis. ECG: ST depression in inferior leads. TT Echo: Mild supravalvular aortic stenosis. Angiography: Three vessel disease. Lab: Only hypercholesterolemia. (Cholesterol upper than 400 mg/100). Treatment: CABG, Three graft.Conclusion: There are few data regarding the preoperative risk in patients with hypercholesterolemia. In patients with familial hypercholesterolemia, there is a high incidence of premature Coronary Artery Disease.These patients are also at risk for both valvular and supravalvular aortic stenosis as well as atherosclerosis of the carotid and femoral arteries. There is a higher than expected incidence of proximal lesions in the coronery and in the left main artery in patients with familial hypercholesterolemia.

Background: Recent studies show that dairy consumption and associated nutrients may be protective against some metabolic disease. Especially in Iran, Peak bone mass is lower than that in normal white western population. Men are not exception in this story too.Material and Method: This cross sectional study try to demonstrate the food consumption pattern in a randomize collection of people as staff of different part of a military educating hospital and military students who was resident in dormitory.Result: We found that dairy consumption was less than standard recommendation. The high rate of different metabolic disorder specially bones and teeth may be related to this nutritional behavior.Conclusion: It is important to consider the influence of income, education, sex, ethnicity, marital status, and physical activity on food consumption patterns when planning diets, nutrition education programs and interventions for young adult.