Annals of Military and Health Sciences Research
Year:2006 | Volume:4 | Issue:1 (SERIAL NUMBER 13)|Papers Count:17

Background: Sulfur mustard (bis (2-chloroethyl) sulfide) is a strong alkylating agent with known mutagenic and suspected carcinogenic properties.Materials and methods: Eighty NMARI male rats, 3 months old, were divided into eight groups (10 in each groups), were injected with 2.5,5 and 10 mg/kg sulfur mustard plus Tyrods buffer. Rats were kept under optimal hygienic condition, temperature 25°C, relative humidity 40 to 45% and light provided for a 12-h day/12- h night cycle. They were given water and rodent pellets. After 2 and 8 weeks rats were killed. The samples were fixed in formaldehyde solution (%10), were stained with H&E and PAS and were studied with light microscope.Results: Increased blood cells in hepatic sinusoids, disappearance borders of liver lobules, irregulation of hepatic cord, apoptotic appearance of cells in lobule, and these signs were seen in 2/5 mg/kg (8 weeks), 5mg/kg (2 and 8 weeks) and 10 mg/kg (2 and 8 weeks) groups. Glycogen decreased in 5mg/kg (8 weeks) and 10 mg/kg (2 and 8 weeks) groups.Conclusions: All of changes were dependent on dosage and time duration.

Background: It was established that nerve conduction studies are very sensitive and reliable in diagnosis of the diabetic neuropathy. In addition, it was known that asymptomatic carpal tunnel syndrome diagnosed by neuroelectrophysiologic study, is common in patients with diabetes. So, they should be differentiated to select appropriate treatment. This study was designed to identify distal latency ratio of palmar cutaneous branch of median to main branch of median (PCDUMDL) in the normal, diabetic neuropathy and carpal tunnel syndrome (CTS).Materials and methods: In the analytic, descriptive cross-sectional study, 60 patients with diabetic neuropathy, 60 patients with CTS and 60 normal cases who presented to 501 army medical center in Tehran, included in the study during 2004.The latency of main branch of median and its palmar cutaneous branch was measured by using EMG-NCV device in each patients.Results: The mean distal latencies of main branch of median nerve in normal, diabetic neuropathy and CTS groups were 3.23±0.2, 4.48±0.29 and 4.10±0.21, respectively (P<0.05).The mean distal latencies of palmar cutaneous branch of median nerve in normal, diabetic neuropathy and CTS groups were 2.19±0.17, 2.81±0.12 and 2.25±0.18 (P<0.05). The mean ratio of PCDL/MDL in normal, diabetic neuropathy and carpal tunnel syndrome groups were 0.67±0.07, 0.62±0.02 and 0.54±0.04, respectively (P<0.05).The PCDL/MDL ratio was not statistically depended on sex in each group. In normal and CTS group, PCDL/MDL ratio had direct coloration with age respectively (0.4 and 0.2) (P<0.05). In patients with diabetic neuropathy, PCDL/MDL ratio had reverse coloration with age (P<0.05, -0.6).Conclusions: In patients with diabetic neuropathy, the mean PCDL/MDL ratio was more than that in patients with CTS (P<0.05).  

Background: Primary dysmenorrhea has relatively high incidence which can influence the well being and activities of the sufferers.Materials and methods: An experimental cross-over study was designed to compare the effectiveness of vitamin E and mefenamic acid on reducing the severity of dysmenorrheal symptoms. Eighty six female medical students, aged between 18-26 who were suffering from primary dysmenorrhea were recruited. After having written consent they were divided into two groups of 43 individuals who received 500 units of vitamin E (2 tablets of 400 and 100 units) and 750mg mefenamic acid (250mg TDS) per day respectively. Treatment with vitamin E was started 2 days before the beginning of menstruation and continued until the first day of bleeding (3 days in total) and mefenamic acid was administered only during the first 48 hours of menstruation (only two days). Severity of pain, duration of bleeding, duration of menstruation and other symptoms such as diarrhea, secondary nausea, vomiting, vertigo, headache, legache, epigastric pain, pelvic pain before and after the treatment were recorded. Severity of pain was monitored by visual analogue scale (VAS) method on a visual scale. Monitoring was carried out for 2 consecutive cycles in both groups. Crossover was carried out and observation was continued for another 2 cycles.Results: The result of this study indictatethat both vitamin E and mefenamic acid could reduce the severity of pain similarly nevertheless but vitamin E consumption, complications such as digestive disorders such aspyrosis, stomach-ache, nausea and fatigue were significantly less compared to mefenamic acid.Conclusions: It appears that mefenamic acid could be replaced by vitamin E in reducing complications of dysmenorrhea.

Background: Music has great psychologic effects on not only human but animals and plants as well. Nowadays, music therapy is a specialized course in well-known American and European universities. Due to its effects and lack of previous surveys, this study was performed in three different periods from 1370 to 1382.Materials and methods: This was a cross-over clinical trial performed on sixty individuals who didn't have any somatic and psychological disorders. From each subject before and after being exposed to 20-minute music "Nay-Nava" and "Techno" with 60 db intensity, blood samples where obtained for six times to evaluate the number of WBCs. The data were analyzed with paired T-test.Results: The range of number of WBCs before exposing to Nay-Nava music was 4000-9200 per milliliter with the mean of 6481 per mililiter, and after 20 minutes exposing to the music it was 3700-8400 per milliliter with the average of 6263 per mililiter. The difference between two means was -1300 which was not statistically significant (P>0.05).Conclusions: This study indicates that Nay-Nava music can influence the number of WBCs. As a soma to and mood stabilizer, music can reduce the number of WBCs in peripheral smear. This study can be the basis of other surveys to evaluate of the effect of the different source of music on immune system.

Background: Urinary tract infection is one of the most common bacterial infections, that creates in outpatient and hospitalized patients. Since, E. coli is the most common bacteria in UTI infection, the aim of this study was to determine urinary tract infections by Escherichia coli, antibiotic resistance and plasmid profile detection of isolated E. coli in Jahrom city.Materials and methods: This investigation was carried out for 6 months on patients with urinary tract infection at Peimaniye hospital and Dr.jazayeri private laboratory Jahrom city in 2004. Totally, 3361 of urine samples were collected. Bacteria were isolated and identified by bacterial standard methods. Then, tests were carried out on 100 selected of E. coli randomly. Antimicrobial resistance tests were done by disk diffusion agar. The bacterial plasmid also was extracted by alkalin lysis and detected by electrophoresis through agarose gels.Results: Bacterial cultures of 356 samples were positive. isolated bacteria were E. coli (80.34%), Klebsiella (10.67%), Enterobacter (3.65%), Citrobacter (1.69%), Pseudomonas (1.41%), Staphylococci (0.84%), Serracia (0.84%) and Proteus (0.56%). E. coli isolates were shown the most resistance to cotrimoxazole (49%) and cephalexin (30%) and ciprofloxacin was known as the most effective antibiotic with 82% sensitivity. Eighty percent of bacteria had plasmids. The most plasmid bands were detected in isolated bacteria of hospitalized patients. All bacteria that were resistant to at least one kind of investigated antibiotics, had plasmids.Conclusions: Plasmid profile similarity of isolated bacteria from hospitalized patients, indicated probability these bacteria originate from one bacterial clone or high prevalence gene transition among hospitalized bacteria. So, arteriogram test for each patient, infection control and limitation of using antibiotics can prevent spreading of resistant bacteria.

Background: During Iran-Iraq war between the years 1980-1988, several chemical warefare agents were used which the most common was Mustard gas (SM). The side effects of mutation and tumor-formation of sulfur mustard in human beings and animals are well described. The aim of current study is to determine the late-onset complications in Iranian veterans exposed by SM in formation of skin tumors.Materials and methods: During this retrospective descriptive-analytic study, 9605 chemically injured patients who were examined by dermatologists and their characteristics were studied.Results: Sixty-two out of 9605 of chemically injured patients exposed to sulfur mustard after 10-15 years from exposure had skin tumors, four of them were malignant and diagnosed as BCC and the others were benign. Lipoma and Becker nevus where the most common benign lesions.Conclusions: The results showed that no significant difference between prevalence of BCC in the chemically injured patients and the general population based on previous reports and as far as the age range and frequency of exposure was considered (P>0.05).  

Background: One of measles manifestations -especially in adolescents- is liver malfunction which can vary from just changes in liver enzymes to hepatitis with prominent jaundice. It is important to screen hepatitis patients in order to special medical treatment and avoidance of prescribing hapatotoxic drugs and some pain relief medications. In addition, patients of such complications are high risk for long duration of hospitalization and secondary complications and long duration of the disease.Materials and methods: This was a cross-sectional study of 172 patients selected from 180 patients with clinical measles admitted in Be'sat hospital of NAHAJA. CBC and liver enzymes were checked.Results: Patients aged between 18 to 24 years. Mean of hospitalization time was 6.48 +/- 2.37 days and ranged from 2 to 14. Mean of white blood count was 4153.85 +/-1706.08 and ranged from 1700 to 13000. PMNs percentage was 61.01+/-16.27 in mean and ranged from 26% to 89%. Mean of total PMN count was 2591.38+/-1409.42 (from 513 to 10270). ALT (SGPT) was 40.86+/-33.68 in mean (from 10 to 280). Mean of AST (SGOT) was 53.23+/- 35.76 ranged from 15 to 250. Total bilirobin was 0.9+/-0.31 (from 0.2 to 2.1) in mean. Mean of direct bilirobin was 0.2+/-0.8 ranged from 0.1 to 0.8. ALKP was 195.19+/-88.6 (from 41 to 590). 9.5 %of patients (16 patients) had liver malfunction (2 times increase of enzymes levels). No one had jaundice at the time of admit. Comparison of evaluation of lab values of the patients with duration of hospitalization with Pearson test, only in two cases PMN percentage and total PMN had significant relation (P<0..05).Conclusions: When measles patients had no complications such as secondary bacterial infections and had no history of hepatotoxic drugs, increase in liver enzymes levels is mild and had no significant clinical interest.

Background: Counseling and psychotherapy are essential for today life. Military staffs and their families are exposed to stresses of military environment along with their common life stressors. Therefore, their demand of counseling service is more.Materials and methods: This was a descriptive study performed on 1892 selected subjects in 2003 to recognize the demands of Sepah personnel and their family members for counseling and psychotherapy. The sampling method was double-cluster and the selected data were obtained by questionnaire and analyzed by statistical mean, percentage and Chi-Square tests.Results: Results revealed that counselors and psychotherapies are secondary source for counseling life problems and the major life problems of subjects in order were as follow: family relationship, parenting or child rearing and psychological problems. Most subjects asked for establishment of counseling centers to be accessible and application of specialized counselors.Conclusions: The counseling services in military organization have to be adjusted with clients' neediness.

Background: Meningococcal meningitis is one of the most feared disorders with high rate morbidity and mortality. There is no exact information of meningococcal meningitis incidence in military personnel. Obligate vaccination of the military with meningococcal vaccine is a strategy with the potency to provide active protection of the conscripts before being dispatched to training centers. Although, sporadic cases of meningitis in conscripts occurred. The aim of this study was stereotyping of the bacterium; Neisseria meningitides isolated from patients with meningitis which admitted to five military Hospitals.Materials and methods: In this cross- sectional study for determination of meningococcal meningitis serotypes in conscripts submit to five military hospitals the investigation was designed and carried out from September 2003 to September 2006. In this period, 12 cerebrospinal fluids of conscripts with clinical signs and symptoms of meningitis were collected, and the laboratory tests were done. In this study enriched Thayer Martin medium and standard bacteriological methods were used. The sample without bacterial cells or PMNs were centrifuged (10000 xg for 5 min), the precipitate was cultured and direct smear was performed. Isolated bacterial strains were recognized by biochemical tests, and Neisseria meningitides strains were serotyped by specific antiserum.Results: During the study, 12 cases of meningitis in conscripts were seen. Neisseria meningitides was isolated only from 6 patients. Serotyping analysis revealed that 5 strains belong to Serotype C and 1 strain was to serotype B. Neisseriasica was isolated from one patient. In three patients there was no bacteriological evidence. In two patients, consumption of antibiotic before lumbar puncture results to no bacterial growth, but direct smear showed gram negative diplococci. In one patient recurrent meningococcal infection was occurred. Complement components analysis revealed deficiency in C3, C4 and CH50 (the rate was below 80 mg per deciliter).Conclusions: the results of this study showed that, Neisseria meningitides was isolated from six patients which are all conscripts. It is necessary to find the reasons that why vaccinated conscripts infected by Neisseria meningitides serotype C. Further analysis showed that, five patients had complement deficiency and further research is necessary. However, 6 Neisseria meningitides strains were isolated from meningococcal vaccinated conscripts around the country (Tehran, Shiraz, Yazd and Oslavieh ) in the period of study. Based on the findings of this study, effectiveness of the vaccine was desirable and the disease had been controlled in this population group. Because of complements deficiency in patients with meningococcal meningitis, other preventing methods for eradication of disease are necessary.  

Background: Mucosal thickness of bladder increases following to the UTI, chemotherapy, neurogenic bladder, posterior urethral valve, stone and inflammation. Due to the importance of normal values of mucosal thickness and existing controversies, this study was performed on normal population visiting medical centers affiliated to Shahid Beheshti Medical University.Materials and methods: This was a cross-sectional study on 212 normal adult individuals. The studied group included all patients underwent ultrasonography. Not due to urinary problems such as abdomen pain, probable anomalies and routine check-up. All those didn't have predisposing factors on increase of mucosal thickness. The probe was 3.5-5 MHZ. The thickness was measured sagitally and cross-sectionally from posterior-lateral trigone. Age, sex and fullness of the bladder were determined as influencing factors on bladder thickness.Results: The range of age was 12 to 70. 78% were female and 22% male. The thickness of full bladder was 2.57+/0.57 mm with the range of 1.41 to 3.65 mm and the thickness of empty bladder was 5.48 +/- 0.12 mm with the range of 7.10 to 3.86 mm.Conclusions: The thickness of bladder was reported to be 2-3 mm in one reference and 4-6 mm in another.The previous findings are compatible to some extent with those from our study for full bladder but nothing mentioned for empty bladder.  

Background: More than 50% of patients with carcinoma of the esophagus or gastric cardia have incurable disease at presentation and require palliative treatment for dysphasia. Insertion of a self-expanding metal stent has become the treatment of choice for these patients. We report successful placement of a covered self-expanding metal stent in a patient with malignant squamous cell carcinoma (SCC) of esophagogastric junction.Case report: A 62-year-old man referred to the gastrointestinal division of the 501 medical center, Tehran, Iran due to dysphagia. During upper gastrointestinal endoscopy, a seven cm tumor was seen 35 cm distal to dental line. Histologic examination of the biopsy samples confirmed malignant SCC. The tumor was in stage lll/lV and therefore it was inoperable. Palliative therapy with 11-cm covered Choo stent (Ml-Tech Ltd., Seoul, South Korea) was considered for this patient. On March 12, 2006 after sedation with midazolam, the stent was placed under the fluoroscopic and endoscopic guide. The patient underwent radiotherapy, thereafter. During the two-month follow-up, the patient's general condition recovered and he gained weight. Conclusions: Fluoroscopically guided insertion of covered self-expanding metal stents is a safe and comfortable method of palliation for patients suffering with malignant dysphagia. For prevention of restenosis, covered types should be given priority.