Journal of Military Medicine
Year:2008 | Volume:10 | Issue:2 (36)|Papers Count:17

Introduction: Because of exposing to mustard gas a lot of chemical victims suffer from chronic lung disease (such as chronic bronchitis, bronchiolitis and bronchectasia) and hypersensivity of airways that there are different treatments for controlling symptoms. The aim of this survey is comparing the rate of clinical recovery and lungs function finding in chemical war victims with bronchiolite before and after treatment. The goal of chronic lung disease treatment is achieve to a condition without any symptoms with a good function of lung by using the lowest dose of drugs.Materials and methods: We conducted a prospective self-control clinical trial and enrolled 30 chemical war victims with bronchiolite who came to lung clinics of Baqiyatallah (a.s) hospital, in the six month of 2007. History, physical exams, spirometry, HRCT and completing questionary were done for all patients. Then patient treat by azithromycin protocol and prednisolone Results: Twenty eight patients (93.3%) were male and 2 patients (6.7%) were female. The mean age was 44.1±6.1 years old. The mean BMI of patient was 25.7±3.4kg/m2. The mean of FVC percent before and after treatment with full dose were 73.56±11.5 and 73.12±11.2 respectively (p=0.714) and after treating by Azithromycin & prednisolone was 71.65±12.6 (p=0.491). The mean of FEVI percent before and after treatment with full dose were 62.94±17.8 and 63.51 ±14.6 respectively (p=0.726) and after treating by Azithromycin & prednisolone was 64±15.2 (p=842). The mean of FEV1/FVC before and after treatment with full dose were 68.4±14.3 and 70±12.9 respectively (p=0.348) and after treating by Azithromycin & prednisolone was 69±11.3 (p=613).Conclusion: As the patient's didn't show a good response to full dose of corticosteroid. We used Azithromycin instead of increasing the dose of prednisolone, but the patients didn't show a good response to this new protocol too, due to pathogenesis of sulfur mustard gas.

Introduction: Tinnitus and hypersensitivity to sound are abnormal perception of sound, and exposure to noise in military environments is an important etiology of these auditory disorders. In present study, hearing loss, tinnitus and hypersensitivity to sound were evaluated in a group of fighters. Materials and methods: This cross-sectional study was conducted on 250 men who were referred from devotee foundation commission of Tehran with mean age of 41.0 5.3 years. Study was included basic audiology tests (pure-tone, speech, and impedance audiometries) and fill out a questionnaire of hearing disorders (tinnitus and hypersensitivity to sound). Results: The average years of being in military environment were 2.4 1.7 years (range: 1-10 years). Near to two third of subjects had normal hearing, and different degrees of hearing loss with more loss of high frequencies and more frequency of sensory neural hering losses (92.0%) were shown in about one third of patients. Tinnitus was shown in 78.0% of subjects with subjective (98.8%) and continuous (76.0%) characteristics frequently. Tinnitus loudness was in moderate and high levels mostly (84.3%) and no effective treatment has been down generally. Hypersensitivity to sound was revealed in 76.0% of cases with higher annoyance of environmental sounds (78.9 %), and sensitivity to other sensory stimuli specially visual ones (27.6%) too. The burst sound was mentioned as the major cause of hypersensitivity to sound (89.8%) and this disorder was shown in both sudden (57.3%) and gradual (42.7%) forms. Hypersensitivity to sound in 38.%, tinnitus in 35.0%, and hearing loss in 28.0% of cases were mentioned as the main problem. There was significant correlation between hypersensitivity to sound and tinnitus (p<0.001). Conclusion: Exposure to high level of noise is one of the most hazardous factors for the auditoy system and main cause of hearing loss, tinnitus and hypersensitivity to sound. Exposure to noise in military environments can lead to tinnitus and hypersensitivity to sound even without hearing loss that may result behavioral and social problems.

Introduction: The researches had shown that; chronic illness may affect on sexual function. Therefore, the purpose of this research was determining related between sexual dysfunction and demographic factors with chemical injuries.Materials and methods: In this descriptive research we have selected and studied 185 cases of chemical venture refereed to Tehran hospitals. Data gathering tools were structural interview. The items of interview were including 28 questions of DSM- IV criteria for sexual dysfunction. The statistical methods were T test, ANOVA and Correlation.Results: The results showed 65/4% of veterans with chemical injured at least have one of sexual dysfunction. The most dysfunction includes: Erectile problem and libido reduction. Also results show that, there were related between demographic factors and sexual dysfunction in chemical injured veterans.Conclusion: On the basis of results sexual libido reduction rates in chemical injured veterans like rate of this in COPD patients. Therefore, the sex therapy; psychotherapy and couple therapy must be a component for treatment of chemical injured veterans.

Introduction: discopathy (deformity and malfunction of intervertebral disk) is one of the most prevalent sources of pain of vertebral column. Different risk factors are involved in developing discopathy, one of them are job and field of work. According to published articles discopathy is more prevalent in military personnel due to type of work and their mission. In this article we determine relation between job and field of work with spine discopathies in male military personnel admitted in the Baghit-Allah hospital.Materials and methods: This descriptive cross sectional study performed in 1999-2007 in Baghit-Allah hospital. Five hundred seventy six male military personnel admitted because of discopathy entered the study. We used a previously valid questioner with close ended questions to determine demographic data, type of lesion and field of work. Analyze using descriptive methods were performed after gathering the data.Results: Mean age, height, weight and work experience was 45.6, 170, 76.4 and 21.7 respectively. Discopathy in lumbar, cervical, thoracic spine was seen in 390 (67.8%), 153 (26.6%), 33(5.6%) patients respectively. Single discopathy was present in 504 (87.6%) cases, 72(12.4) cases have discopathy in more than one region. Out of 576 patients, 250 (43.3%) field of work was combat, 121 (21%) engineering, 59 (10.3%) service and 146 (25.3%) logistic. A significant association between region of discopathy and field of work was present (p=0.028). T12-L1 discopathy was associated with field of work (p=0.013). In combat field 36% of patients had T12-L1 discopathy, 25% in engineering field, 23.3% in logistic and 15.7% in service. Surgery was performed in 192 cases, physical therapy and rehabilitation was performed for 288 cases.Conclusion: Discopathy have a higher prevalence in military personnel. There is a significant association between region of discopathy and field of work. We recommend recurrent assessment of personnel and set them in appropriate field best fit with their physical situation, continuous training and correction of body posture in work, considering the ergonomic rules and regular exercise for military personnel.

Introduction: Giardia, a flagellate protozoan, is a sort of intestinal parasite in human and animal bodies. Despite of man-to-man conventional method of transferring, this parasite is one of the main causes of water born diseases, and addition of conventional rates of chlorine to water cannot remove it. Ozone is an excellent disinfectant and can inactivate the most resistant microorganisms. It is used periodically to disinfect drinking water. The aim of this study is to evaluate the rate of ozone used for removal of giardia cysts in water.Materials and methods: This is an experimental study and corona discharge method is used to generate ozone. Giardia cysts were separated by concentration density slope with sucrose, counted 10 times with Thoma lam and then the mean was calculated. This solution, containing 120,000 cysts/lit, was ozonated in 5, 7 and 9 min with the density of 1.3 mg/lit in city water, distillated water and physiology serum. In another test, the effect of elapsed time on resistance of giardia cyst was evaluated for a 6-day period, in the first, 3rd and the 6th day for various minutes of 1, 3, 5, 7 and 9 with the density of 2 mg/lit in the city water.Results: Durations of 5 and 7 minutes could not remove all of the cysts, but after ozonation for 9 minutes, all of the cysts were removed. When tests were performed in distillated water and physiology serum, all of the cysts were removed completely. In another test, all of the cysts were removed in the durations of 7 and 9 minutes of the first day, while in the third and the sixth day, the efficiency of cyst removal rate decrease in the 7 and 9 minutes and fresh cysts were observed.Conclusion: Distillated water and physiology serum caused disturbance in the test and resulted in incorrect data, so decolorized city water is used in this pilot study. As time elapsed, environmental conditions caused difficulties for cyst life continuing. Cyst's cell wall gets resistant and removal of all of giardia cysts with first day Ct is impossible.

Introduction: Health care worker always are in risk of injury with sharp devices that can be a risk factor for HIV, HBV, HCV and other blood borne pathogen. Nurses experience the most injuries from sharp devices. Severity and fatality consequences of such exposure and limitation of effective treatment result in preventive planning. Therefore we design this study to evaluation of needle stick prevalence in nurses of a military hospital and investigate the risk factors.Materials and methods: In this descriptive cross sectional study, we used a two-page questionnaire. At the time of the survey 613 nurses were employed in this military hospital. The questionnaire include sections for demographic items (such as age, sex and years of experience), type of device that caused the injury, the event that lead to the NSI, and whether the event was reported. We also asked the location where the NSI occurred. The survey instrument was distributed and collected during October 2007.We used SPSS version 12 for evaluation of collected data.Results: Of 613 nurses occupied, 201 nurses were been needle sticked (32.78), 107 nurses were male (53.2) and 94 female (46.8) average age in time of N.S was 34 (SD: ± 6.5). In education level in 15 nurses was "kardan" (7.5%) and 178 nurses was license (88.6) and 8 nurses were in level of master of sciences. Needle of syringe was most common for N.S percent of 70.6% (142 cases). Blood sampling was most action for N.S with 49 cases (24.4%). The most common organ that injured was the second right hand finger with 60 cases (32.8%). The most common time of injuries was in morning shift. Conclusion: High rate of N.S and occupational exposure with Blood is a alarm for nurses, there for in field education and informing for reporting the all person who needle sticked.

Introduction: In recent decades, the figures of diseases and their related factors have been changed from infections disease to chronic ones. In this regards, the relation between improper nutrition models and non-infectious disease such as CVD, Cancers, and Diabetes has been diagnosed. This study examines to determine KAP of nutrition and food models by Sepah formal personnel.Materials and methods: This is descriptive study through a Cross-sectional method, conducted on 425 formal personnel of military populations including 393 men and 32 women with and age range of 19-65 years drawn by simple random sampling. To determine the subjects, KAP, a Researcher made questionnaire was used. The validity of the questionnaire was confirmed by experts. The collected data has been analyzed using the SPSS14. Three different levels, low, middle, and good was defined for KAP categorizing.Results: The mean of scores for knowledge, attitudes, and practice of nutrition by personnel was reported 63.1, 73.1, and 38.3 respectively. In knowledge domain, only 14.3% of the subject, more than 60% of the study population had a good attitude toward the issue. This percentage for the practical domain was reported only 0.2%. That is, the majority of the subjects (60.5%) has a desirable view and attitude toward the issue, and a positive powerful association has been proved between knowledge and attitudes toward food models by the subjects (r= 0.71). The association between knowledge and practice, however, was not statistically significant (r=0.303). In addition, subjects with academic levels of education have more knowledge about the issue than uneducated subjects (p<0.009). Based on the findings of the study, air forced personnel got more grade than other force in both knowledge and attitude domains (p<0.001).Conclusion: The findings of the study indicate that in spite of having good and desirable knowledge about the issue by the subjects, their attitude and practices were not acceptable. Thus, planning a educating them with regards the food and nutritional models through various for improving their nutritional status is recommended.

Background and aim of study: many factors such as a diabetes, hypertension, hyper lipidemia, smoking and occupational stress are in association with atherosclerosis. Up to now there isn't and study about risk factor differences between military occupation and non millenarian. Therefore we designed this study to investigate these differences.Materials and methods: in this cross-sectional study all patient had angiography, angioplasty or CABG in year of may 2006 to may 2008 in Baqiyatallah or Shahid rajaee hospital were investigated. We collect data by face to face questionnaire based material. Our variable include age, sex, smoking, hyper lipidemia, diabetes, psychological history, chemical weapons exposure, first line standing.Results: form 196 patient referred to Baqiyatallah and Shahid rejaee 2 patient were excluded, from 194 left, 132 (68%) were non military and 62 (32%) had military occupation. average age of CABG was 51.5 in miltaries and 57.5 in non militaries hypertension and diabetes were more common in non military occupation and smoking and psychological histories were more common in military occupation. All patent undergo CABG were male.Conclusion: in patient undergo CABG and who had chemical weapons exposure hand less average age that maybe because of military occupation and its occupational life style or because of exposure with chemical weapons that result in cardiovascular disease in lower age.

Introduction: To determine prevalence of long term pulmonary complications of war related Sulfur Mustard (SM) exposure in logistic forces.Materials and methods: Jahad Sazandegi personnels exposed to SM in war invited for compensation 15- 18 years after exposure from all Iranian provinces. Chest X- ray, HRCT, spirometry and other evaluations was done as required and lung complications were categorized according to arbitrary definitions. Results: Two hundred sixty six persons completed the study. Chest X- ray was normal in 88% and HRCT in 64%; there was significant air trapping in 12% of HRCTs. Prevalence of lung complications was: COPD 15% (40), asthma 11.3% (30), Bronchiolitis oblitrans 7.1% (19), simple chronic bronchitis 2.3% (6), lung fibrosis 0.4% (1), non specific dysnea 37.6% (100) and non specific cough 2.3% (5). Several patients not fulfill the definitions and took probable diagnosis. Conclusion: Logistic forces usually exposed to lower doses of SM compared to soldiers. It appears that in low dose SM exposure chronic airway disease like asthma and COPD is more common than large airway destruction as bronchiectasis and paranchymal disease as lung fibrosis.

Introduction: Sulfur mustard (HD) is a chemical warfare agent to be used on a large scale. Sulfur mustard leads to a destructive inflammatory reaction in the anterior chamber of eye. It has been shown that steroids intervene with inflammatory process in eye´s injuries. The aim of current research is to characterize effect of Betamethasone on HD-induced corneal lesions of rabbits after 14 days.Materials and methods: This study is a experimental study. 24 rabbits were randomly divided into 4 groups: control, Solution, HD and Betamethasone. In 4th group, Betamethasone was applied 10 minutes after HD exposure. Application of drug was performed 3 times a day, for 2 weeks. Clinical examinations were performed at 1, 2, 5, 7, and 14 days by ophthalmologist. Animals were sacrificed after two weeks. Specimens of cornea, were prepared by histological and Immunohistochemistry techniques for light microscopic studies.Results: HD caused a significant decrease of thickness and numbers of corneal epithelial layers and proliferating cells in corneal epithelium, and corneal epithelial defect (CED). Severity of corneal injuries in Betamethasone group was less than HD group but there was statistical significant difference when comfered with control group.Conclusion: Result of this study showed that we can offer Betamethasone drope for decrease corneal epithelial defect following HD exposure. It is recommended to do more studies for determination effective dose of drug.