Iranian Journal of War and Public Health
Year:2024 | Volume:16 | Issue:1|Papers Count:13

Aims: Numerous studies have established that resistance training is highly effective in preventing and addressing age-related muscle loss (sarcopenia) by enhancing the physiological function of skeletal muscle tissue. Thus, the objective of this study was to assess the impact of 12 weeks of incremental resistance training on the serum levels of myostatin, follistatin, and insulin-like growth factor-1 (IGF-I) in sedentary elderly men. Materials & Methods: Thirty sedentary elderly men voluntarily participated in this semi-experimental study and were randomly assigned to either a control group (15 men) with an average age of 62.1±3.7 years and weight of 85.1±7.7 kg, or a resistance training group (15 men) with an average age of 61.3±1.6 years and weight of 82.3±7.8 kg. The resistance training group undertook a 12-week training protocol, while the control group did not engage in any training program during this time. Blood samples and body composition measurements (using dual X-ray absorptiometry) were taken before the study commenced and 48 hours after the last training session concluded. Serum levels of myostatin, follistatin, and IGF-I were determined using the ELISA method. An independent t-test was employed to establish statistical significance between the groups, utilizing SPSS 21 software. Findings: After 12 weeks of resistance training, there was a significant decrease in serum myostatin levels and significant increases in serum follistatin and IGF-I levels in comparison to the control group (p≤0.05). Conclusion: Incremental resistance training proves to be an effective intervention for preventing sarcopenia in elderly individuals by decreasing serum levels of myostatin and increasing serum levels of follistatin and IGF-I.

Aims: Suicide is a leading cause of death globally, necessitating its assessment through valid tools. Among these tools, the Literacy of Suicide Scale (LOSS), developed by Calear et al., has not yet been validated for Persian-speaking populations. Therefore, this study aimed to translate, evaluate, and validate the LOSS within a young military community. Instrument & Methods: This cross-sectional study employed a methodological approach. The sample consisted of young military personnel who visited counseling and psychology clinics and were selected via convenience sampling. Initially, the original version of the scale was translated into Persian using the Forward-Backward method. To evaluate content validity, ten experts assessed the scale, calculating the content validity ratio (CVR) and the content validity index (CVI). Face validity was also assessed with a sample of 20 subjects from the study population. Reliability was tested through a test-retest procedure with a two-week interval and measurement of Cronbach's alpha. Finally, the questionnaire was administered to 415 subjects to assess construct and convergent validity. Findings: The CVR, CVI, and face validity of all questions on the LOSS were at acceptable levels. The Cronbach's alpha for the subscales ranged from 0.71 to 0.76, and for the total scale, it was 0.75. Additionally, all components of the LOSS showed a significant relationship with the total score of the questionnaire (r>0.2). Conclusion: The Persian version of the LOSS demonstrates acceptable validity and reliability for use among young military personnel.

Aims: Effects of spiritual practice alongside medical care on health outcome in war combats suffered from mental disorders hospitalized due to COVID-19. Materials & Methods: In a single-blinded clinical trial study, hospitalized war survivors with COVID-19(n=70) were randomly assigned in two groups. Spiritual practice intervention was the recitation of “Surah Al-Hamd” and “Ya-Allah” for 7 days (total of 21times). Information gathered on demographic characteristics, Short Form Survey (SF-12), Satisfaction with Life Scale (SWLS), Hospital Anxiety and Depression Scale (HADS), length of hospitalization, ICU transfer, intubation, and death. Data were analyzed using SPSS and effect size. Findings: A total of 64 war combats completed the study (intervention (n=29), comparison (n=35)). In the group with spiritual practice, mean differences of social functioning (+11.5versus+4.3; effect size=0.3), vitality (+1.5versus-5; effect size=0.3) and mental component summary(+5.7versus+0.6; effect size=0.1) were more significantly improved (p<0.05). At the end of the study the life satisfaction score was significantly higher in the intervention group (P=0.007). Moreover, the mean difference of SWLS was better in the intervention group (+0.78versus-0.14; p=0.007; effect size=0.4). The mean difference of anxiety in the intervention group was +2.7 (±1.3) and in the control was -0.5 (±1.8; p<0.001; effect size=0.7). There was no significant difference between the two groups on the duration of hospitalization, ICU admission, intubation and death (p>0.05). Conclusion: The results of this study showed that spiritual practice along with routine medical management accompanied with better quality of life, more life satisfaction and less anxiety in war combat suffered from psychological disorders hospitalized due to COVID-19.

Aims: Lung complications are a common issue among chemical warfare veterans, highlighting the need to strengthen their respiratory systems. This study aimed to explore the impact of a 24-session aerobic exercise program on the lung volumes and capacities of chemical warfare veterans. Materials & Methods: This quasi-experimental study was conducted in 2023 using a pre-test and post-test design. Seventeen chemical warfare veterans with a disability rating of 25-35% were selected through purposive and convenience sampling methods and randomly divided into two groups: experimental (10 participants) and control (7 participants). The experimental group underwent an interval aerobic exercise regimen at 45-60% of heart rate reserve, three times per week for eight weeks. Lung functions were assessed using the Lung Test 1000 spirometry device. Repeated measures statistics analyzed the differences between pre-test and post-test results. Findings: Aerobic exercise significantly increased vital capacity (p=0.007), peak inspiratory flow (p<0.001), peak expiratory flow (p=0.016), forced expiratory volume in 1 second (p=0.017), maximum voluntary ventilation (p<0.001), and peak expiratory flow rates at 75% (p<0.001), 50% (p=0.001), and 25% (p=0.007). However, it did not significantly affect the ratio of forced vital capacity to forced expiratory volume in 1 second (p=0.960) or forced expiratory flow from 25 to 75% (p=0.690). Conclusion: Aerobic exercises in chemical veterans improve lung volumes and capacities.

Aims: The aim of this paper was to provide a comprehensive review of using low-level laser therapy (LLLT) as a therapeutic method for recurrent aphthous stomatitis (RAS), including analyzing its underlying mechanisms, clinical applications, and potential benefits. Information & Methods: A database search was conducted to identify relevant papers investigating the use of LLLT for RAS treatment. Articles published in scientific journals and selected for review in Science Direct, Google Scholar, and PubMed were categorized and analyzed. Findings: During the initial search, a total of 88 articles were found. Five phases were performed to select articles, and eventually, 8 papers that met the inclusion criteria were chosen. Conclusion: This literature review supports the idea that LLLT is a non-invasive and potentially effective therapy for RAS symptoms by accelerating the healing process and having beneficial effects in reducing pain and inflammation.

Aims: Urinary tract infection is the most common adult bacterial infection worldwide. Antigens of ABO and Lewis blood groups may influence bacterial adherence and lead to an increase in the frequency of urinary tract infections in adults. This study aimed to evaluate the relationship of ABO and Lewis blood groups with urinary tract infections. Materials & Methods: In this experimental study, a blood sample of 80 urinary tract infection patients from AL-Sader Teaching Hospital, Iraq, and 50 healthy persons was used for the determination of ABO and Lewis blood groups by agglutination assay. Urine samples of urinary tract infection patients were cultured and identified based on culture characteristics, gram staining, and biochemical tests. Findings: Urinary tract infection was significantly higher in patients with the O blood group (42.5%) and the Lewis (a-b-) phenotype (38.8%) than in patients with other blood groups and the control group. Escherichia coli was the most common bacterial isolate observed in urinary tract infection patients. Also, E. coli was significantly higher in the UTI patients with the O blood group and the Lewis (a-b-) phenotype. Conclusion: People of the O blood group and the Lewis (a-b-) phenotype are more susceptible to urinary tract infections. Escherichia coli is the main cause of urinary tract infections.

Aims: This study aimed to look into the scientific literature's shifting position on the right to health and human rights-based approaches to health among Indonesian war veterans. Information & Methods: This systematic review examined the global literature on the right to health or human rights-based approaches to war veterans' health. PRISMA guidelines for Grant and Booth typology of reviews as systematic reviews. Indonesian veterans uphold several of the Universal Declaration of Human Rights principles in their constitution and even use them in medicine. Literature studies use qualitative methods and a constructivist theoretical approach to gather data from books, reports, news articles, and journal articles. Findings: There were notable variations in how human rights frameworks and procedures are implemented for war veterans in the medical field. There were compelling reasons to approach health from a human rights standpoint, but as examining various human rights guidelines demonstrated, doing so risks undermining the right to health. Undermining the right to health jeopardized the right to health and rights-based approaches to health because the right to health had significant and distinct characteristics that other rights did not. Conclusion: To ensure the realization of the right to health, the state must be responsible and involve all relevant stakeholders, including the general public and non-governmental organizations.

Aims: The current investigation aimed to study the effect of certain parameters, including IL-17A, creatinine, lymphocytes, and basophils, on patients suffering from systemic lupus erythematosus-induced renal failure. Materials & Methods: This clinically controlled study involved 105 patients (35 males, 70 females) confirmed to have systemic lupus erythematosus in Thi-Qar Province, Iraq. Researchers collected 5ml of venous blood from 50 healthy controls to conduct immune tests (to determine the levels of IL-17A by ELISA), biochemical tests (to measure creatinine levels by colorimetric method), and CBC tests (to assess lymphocyte and basophil counts). The data was analyzed using SPSS 23 software using the Chi-square and Welch's T-tests. Findings: The systemic lupus erythematosus rate was 83%, and females exhibited a higher infection rate (66.7%) than males (33.3%). Significant differences between the sexes were identified. Also, significant increases were seen in the levels of IL-17A and creatinine in patients compared to healthy controls. Furthermore, females aged 13-45 were more affected than males. While levels of IL-17A and creatinine were elevated in some patients, lymphocyte and basophil levels were decreased in others compared to the healthy group. Conclusion: IL-17A, creatinine, lymphocytes, and basophils play a fundamental role in the pathogenesis of systemic lupus erythematosus.

Aims: Laryngoscopy and endotracheal intubation are critical steps in general anesthesia and elicit significant sympatho-adrenal responses. Mitigating these responses is essential for safely inducing anesthesia, especially in patients with cardiac or cerebrovascular disease, as these responses can lead to serious complications. This study evaluated the effectiveness of two methods of administering lidocaine in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation. Materials & Methods: In this experimental study, 78 patients were divided into three groups (each 26 members). The control group received 5ml of intravenous normal saline and induction drugs. The intravenous lidocaine group received 1.5mg/kg of 2% intravenous lidocaine 2 minutes before laryngoscopy and intubation. The nebulized lidocaine group was administered 4ml of 2% lidocaine via a cirrus nebulizer with a 5L/min oxygen flow, usually 10 to 15 minutes, followed immediately by induction. Findings: Demographic data across the three groups showed no significant differences. However, when comparing the control and nebulized lidocaine groups, nebulized lidocaine had a significant advantage in attenuating hemodynamic responses. Comparisons between the control and intravenous lidocaine groups revealed significant differences in some readings, indicating an incomplete blunting effect. Conclusion: Nebulized lidocaine is more effective than intravenous lidocaine in reducing the hemodynamic changes associated with direct laryngoscopy and endotracheal intubation.

Aims: In chronic persistent bronchial asthma, the combination of inhaled long-acting B2-agonists with inhaled steroids has long been used to reduce hospital admissions and improve quality of life, as opposed to using either medication alone. This study aimed to determine whether this type of inhaler therapy for patients with chronic asthma reduces symptoms, decreases the need for hospital admissions, improves the quality of life, and whether a high-dose combination is superior to a low dose in managing patients. Materials & Methods: In this prospective descriptive cross-sectional study, 207 patients with chronic persistent bronchial asthma, using various inhalers, were randomly enrolled, of whom 120 cases (58.0%) were female and 87 cases (42.0%) were male, with ages ranging from 16 to 75 and a mean age of 45.59±14.67 years. The study assessed the type and dose of inhalers used, control over asthma symptoms, hospital admission rates, inhaler adherence, confidence in treatment, and pulmonary function test parameters (FEV1, FVC, and PEFR) while patients used their prescribed inhalers. Findings: We found a statistically significant difference in FEV1/FVC between patients using single inhalers and those using combined inhaler therapy for chronic persistent asthma (p=0.005). However, there was no significant difference between the types of combined inhaler therapies (p=0.12). Age had no statistically significant effect in either comparison (p=0.85, 0.47, respectively). Conclusions: Combined inhaler therapy for patients with persistent asthma is preferred by patients and shows superior efficacy compared to using either medication alone. Age does not significantly influence treatment response or patient preference.

Aims: Leishmaniasis is a parasitic disease caused by the Leishmania parasite, transmitted through the bite of an infected sandfly. The disease presents in four primary clinical forms: visceral, cutaneous, diffuse cutaneous, and post-kala-azar dermal leishmaniasis. The clinical manifestations vary depending on the Leishmania species and the host's immune response. Current treatments include antileishmanial drugs such as amphotericin B, antimonials, sitamaquine, pentamidine, paromomycin, and miltefosine. However, these drugs present challenges, including resistance to pentavalent antimonials and nephrotoxicity. The World Health Organization recommends exploring plants as therapeutic agents due to their efficacy and affordability. Conyza Canadensis, a biennial plant, has been utilized for wound healing and has shown efficacy against both gram-positive and gram-negative bacteria. This study aimed to investigate the anti-leishmanial effect of extracts from C. canadensis on the Iraqi strain of Leishmania tropica. Materials & Methods: In this experimental study, the extracts were prepared as stock solutions and sub-cultured in RPMI-1640 medium. The cells were incubated in tissue culture flasks and treated with various concentrations of SSG and aqueous/alcoholic extracts. The anti-leishmanial activity of these extracts was evaluated using the sandwich enzyme-linked immunosorbent assay (ELISA) technique. The findings indicated that the extracts possessed anti-leishmanial activity. Findings: The Iraqi C. canadensis plant extract contained alkaloids, gallic acid, apigenin, chlorogenic acid, caffeic acid, quercetin, p-Coumaric acid, and glutathione. These compounds are known to reduce neopterin levels and enhance the immune response against L. tropica. Conclusion: The extracts of C. canadensis demonstrate anti-leishmanial activity, correlated with neopterin levels, showing promise as an alternative therapy for leishmaniasis. Further research is necessary to establish their effectiveness.

Aims: Two-thirds of all colonic polyps are adenomas, which are dysplastic and have the potential for malignant transformation. This study aimed to assess the prevalence of colorectal polyps and its relation with patients’ age and polyp histopathology. Instrument & Methods: This cross-sectional retrospective study was conducted on patients attending Gastroenterology and Hepatology Teaching Hospital, a major tertiary hospital in Iraq, who underwent colonoscopy for various indications from January 2020 to April 2022 using a colonoscopic and histopathologic reporting database. The eligible number of patients was 3494. Age, sex, symptoms, indications for colonoscopy, polyp types, location, size, histopathologic types, and grading of dysplasia were collected by manually reviewing the files. The chi-square test was used for categorical data. Findings: The polyp detection rate was 16.3%, increasing with age reaching (46.7%) at age ≥60. The adenoma detection rate was 5.8%, with the highest (18.7%) at age ≥60, with no difference between males and females. Retention and inflammatory polyps are the commonest findings in patients <30 years old, while most patients with adenoma were ≥30 years old. Younger patients tended to have more distally located lesions compared with older patients with lesions at different levels; high-grade dysplastic adenoma had more pedunculated morphology (38.6%) and their size ≥1 cm in 63% of patients. Conclusion: Increasing age is associated with an increased prevalence of colorectal polyps, especially adenoma, with male predominance. Tubulovillous adenoma and adenoma with advanced pathology are common findings. Over 1cm pedunculated polyps are associated with high-grade dysplasia.

Aim: This study assessed the potential of malignancy in patients presenting with clinically solitary thyroid nodules and compared the histopathology of excised samples and sonographic characteristics and fine-needle aspiration cytology results. Participants & Methods: This retrospective study was conducted over three years on data from 140 patients attended general surgery outpatient departments at Al-Sader Teaching Hospital and a private clinic with different complaints of solitary thyroid nodules. The collected data included initial diagnoses according to the results of clinical assessment, ultrasound evaluation, fine-needle aspiration cytology, and histopathological examination. Findings: As confirmed by histopathological examination, the prevalence of malignancy in clinical solitary thyroid nodules was 9.29% with male patients affected more than females (15% vs. 8.33%). Clinical assessment was a poor predictor for malignancy, as it was associated with a low sensitivity rate (69.23%), which means high false negative results, despite its high specificity rate (92.91%). According to the ultrasound examination, most malignancies were found in solid and mixed nodules (85% and 15%, respectively) with a significant association between the nature of nodules and malignancy potential. Fine-needle aspiration cytology was the most sensitive and specific investigation of thyroid nodules, it combined both high sensitivity and specificity for diagnosing malignant thyroid nodules (90.91% and 97.65%) respectively. Positive and negative predictive values were 79.83% and 99.06% respectively with an overall agreement of 97.02%. Conclusion: Fine-needle aspiration cytology is a minimally invasive diagnostic tool for the early detection of malignancy among patients with solitary thyroid nodules, which combines high degrees of both specificity and sensitivity with a high accuracy rate of 97.02% comparable to histological examination.