JOURNAL OF MILITARY MEDICINE
Year:2009 | Volume:11 | Issue:3 (41)|Papers Count:14

Aims: This study was to determine the status of waste production in one of the hospitals of Tehran, in order to identify the sources and methods of reducing produced waste. Methods: This is an intervention field study. Effective procedures of produced waste reduction were carried out and their effects were followed. Data was collected by direct vision and filling checklists by questioners and was analyzed by SPSS13. Results: Separating and separate collection of general and infectious hospital wastes were done in 96% of wards by 10% of cooperation among doctors and 40% of cooperation among nurses. From the most effective ways of reducing hospital waste production was the necessity of existance of a purchasing pattern, warehousing, distribution and consumption of items and equipment and supplies with emphasize to produced waste reduction proportionated to the needs of the hospital. D espite of the 10% increasing number of patients admitted during the study than a year before, the waste production was reduced 20%. Conclusion: By performing simple programs in hospital, waste production can be controled and reduced. Reducing the cost of hospital waste management and reduction of its bioenvironmental dangers were also attained by identifying and performing economic and technical methods of produced waste reduction or elimination.

Aims: Nurses' health as caregivers influences the quality of care received by patients. The purpose of the present study was assessment of some aspects of mental health status among of military nurses. Methods: This descriptive and cross-sectional study was carried out on 272 military nurses. Subjects were selected using probable multistage sampling. Data was collected using demographic characteristics questionnaire and general health questionnaire (GHQ-28) by likert scoring method. The cutoff point of total score was set as 23. Results: 26% of nurses were symptomatic. These disorders were more common among females than males. Similarly, the mean of social dysfunctions were higher than other types of mental disorders. There was significant correlation between mental health and variables of job history, overtime work and marital status and sex. Conclusion: The study of mental health conditions of military nurses could provide valuable information in the field of preventing planning in different levels, continuing education, periodic examinations, treatment and prevention before the outbreak of mental disorders. This information is useful for planners and managers of the health system.

Aims: Fecal contamination determining in drinking water sources is a communicated problem, especially in locations without laboratory equipment. An alternative low-cost test for fecal contamination in drinking water is the hydrogen sulphide (H2S) method.Methods: Totally, 116 drinking water samples were collected from piped supplies, dug wells and surface water. The water quality was determined by the standard of most probable number (MPN), P/A, EC-M and H2S techniques. The influence of incubation period, incubation temperature and concentration of fecal coliform were tested by H2S method. Also the efficiency, predictive value for +ve, predictive value for–ve, specificity and sensitivity of H2S method were examined in comparison of a reference Methods. Results: 91.66% of positive samples in standard MPN technique were positive for H2S method with black precipitation. More than 90% of positive samples in standard MPN technique were positive by H2S method with black precipitation. In addition, the color changes would have been violent if the MPN had increased in sample. Temperature is the important factor to reduce the required incubation period. In fact, at higher temperature (45oC) the bottles turned black just after 6 hours of incubation. The sensitivity, specificity, predictive value for +ve, predictive value for –ve and accuracy of H2S test is 90.91, 67.74, 83.33, 80.77 and 82.56%, respectively. Conclusion: The results of H2S tests are visual and therefore it is simple for the operator to distinguish the contamination, as a black color change occurs when bacteria levels in drinking water are high.

Aims: Among Klebsiella spp. Klebsiella pneumoniae has special importance in nosocomial infections. Prevalence of strains producing extended spectrum b-lactamases (ESBL) and their resistance to b-lactam antibiotics is increasing in recent years. Because of the importance of ESBLs in Klebsiella pneumoniae, this study focused on detection of ESBLs producing Klebsiella pneumoniae and its resistance pattern to b-lactam antibiotics in Shahid Beheshti hospital of Kashan. Methods: This descriptive study was performed on clinical specimens isolated from Shahid Beheshti hospital of Kashan. ESBL production was investigated on isolates by double disk diffusion synergy technique. Detection of TEM1 and SHV1 genes that produce extended spectrum b-lactamase were carried out with their specific primers by PCR. Results: From 100 Klebsiella pneuomoniae species that were isolated in this study, 32 specimens were ESBL (32%). 7 isolates out of 32 (21.8%) included TEM1 and SHV1 genes. 16 specimens (50%) had SHV1 gene and 12 specimens (37.5%) had TEM1 gene. Conclusion: The prevalence of ESBL in Klebsiella pneumoniae and its resistance pattern is noticeable, so using the combination of b-lactam antibiotics with b-lactamase inhibitors is suggested only in patients with serious infection. Dosage of antibiotic and admission period in hospital correlate with ESBL.

Aims: Lack of chemical quality control of drinking-water (DW) in distribution systems may cause corrosion, precipitation and ultimately leads to economics and health damages. The goal of this study was to evaluate the chemical quality of DW in military centers and predict the potential of corrosion and precipitation within those DWs. Methods: In this cross-sectional and descriptive study the chemical quality of DW (underground) in 9 military centers located in different water basin of Iran were investigated in four different seasons. In any season, 3 grab samples with 2-3L of water volume have been obtained. All of the samples were collected, stored and preserved in glass or polyethylene container and analyzed based on standardMethods: The potential of corrosion and precipitation of DWs were calculated by Langelier saturation Index (LSI), Aggressive Index (AI) and Risnar Index (RI). Results: Based on the calculated values of indices, DW of G3, G4 and G5 centers had shown corrosive properties, but other centers showed precipitated properties. Based on LSI, AI and RI the DW of all centers showed a uniform quality of corrosion and precipitation potential. Conclusion: Monitoring of chemical quality, precipitation, corrosion potential and concentration of heavy metals should be considered in DW quality control programs.  

Aims: Disasters take millions of lives each year and cause large financial damages. In all disasters, the first persons who try to rescue the others are who present at the scene of disaster. In this research, the effect of educational pamphlets for responding disasters was surveyed. Methods: This is a pre- and post-test research, which was done in Afsariyeh, Vesal-e-shirazi and Pasdaran regions of Tehran. Some blocks and families living in these places were selected randomly. Then, some of (15-65 years old) people from selected blocks filled in questionnaires. The sample size, as per scientific principles was 380 persons in each area, which was selected by cluster sampling. For collecting data, a questionnaire with 20 four-itemed questions in 8 parameters (earthquake, fire, flood, frost, chemical dangerous materials, thunder, fire front, volcano) was used. At the end of the interview, the pamphlets were distributed among the target people. After two weeks, again the same persons filled in the questionnaires. Then the data were collected and evaluated. Results: 53.4% of samples were women. Average of women was 26.1 and men was 27 years old. 35.5% of the samples were in district 3, 31.8% in district 6 and 32.7 in district 14. Maximum awareness before distributing the pamphlets referred to flood and minimum to foster. The maximum awareness after distributing the pamphlets referred to volcano and minimum to fire. Conclusion: Educational pamphlets of disaster dealing increase the awareness of people in all fields.

Aims: The evaluation of microbiological, chemical and organoleptical of cooked foods by traditional and modern equipment can help the military commanders for feed management. The aim of this stady was comparing the quality of cooked foods by above.Methods: 120 samples of cooked foods by traditional and modern equipment were chosen and tested by standard microbial, chemical and sensory evaluationMethods: Then, results were analized by SPSS 11 and Mann-Whitney and Wilcoxon statistical tests.Results: The mean of TBC in cooked foods by traditional and modern equipment were 3.51×102 (±4.09×101) and 1.07×102 (±1.28×101), respectively. The average of fat quantity was 25.80 and 15.82 gr/100gr and peroxide value was 10.19 and 5.27 mg/kg, respectively. Also quantity of vitamin B1 and B2 and organoleptic characteristics were evaluated in cooked foods by two equipment (p<0.05). Conclusion: Hygiene quality and nutritional value of cooked foods by modern equipment is better than foods cooked by traditional equipment and replacing the old equipment by modern ones have important role in military health.

Aims: According to the nature of surgery operation, every surgery room has different quantity of bioaerosols. In this research, the effect of control systems on bioaerosols in surgery room was investigated. Methods: This is a descriptive-analytical research and studied samples which were seven operating rooms in one of the central hospitals of Tehran city were studied by filtration method with impactor. Sampling was accomplished before and after surgery. The samples immediately transported to laboratory and cultured in agar. After 48 hours of incubation, counting was done. The concentration of bioaerosols is calculated in term of cfu/m3. UVGI performed after finishing the surgery to starting the next, in spectrum of C with 253.7nm. Results: The concentration of bioaerosols before and after surgery was less than the standard in operating time. Also, urology surgery room in all of the conditions had the most quantity of colonies. There was a significant correlation between concentration of bioaerosols and UVGI (p<0.05). Conclusion: I ncrease the ACH during surgery cause to decrease of bioaerosols content after that.

Aims: Stress along with genetic and biological potentials is considered as a main factor in incidence and prevalence of psychosomatic disorders. This study was to describe the rate of stress as well as the prevalence rate of psychosomatic disorders and to find the association between these two variables. Methods: From 2275 martyrs' wives of Mazandaran province in 2007, by means of two stage sampling method (cluster and proportional), 318 martyrs' wives were selected as study samples. Required data was collected by means of a questionnaire with interview. Wheaton stress scale is used to measure the level of stress and for measuring prevalence rate of psychosomatic disorders, respondents were asked to clarify that how much suffered from the 20 most prevalent symptoms over the last years (self reported health status). Results: 41.8% of martyrs' wives were under "medium to high" levels of stress and 54.4% suffered from "medium to high" levels of psychosomatic disorders. Headache, shoulder and back pain, knee and elbow pain, lack of appetite, arteries and wounds in digestive organs were the most prevalence psychosomatic disorders. There was a positive and significant association between the stress and psychosomatic disorders. Conclusion: It is necessary for Bonyad-e-shahid to increase the quality of services to martyrs' wives and also some psychosocial interventions in order to enhancing their self-esteem, as well as teaching them how to cope with stress.

Aims: This study was to investigate the relation between automatic thoughts and well-being in disabled veterans of Qom. Methods: 452 disabled veterans with disability severity from 25 to 70% participated in this study. Participants selected by systematic categorical random sampling. Then, "automatic thoughts scale" and "personal well-being Index" performed on them. Results: Most of the negative relationships between automatic thoughts and well-being were explained by "security feelings", "life's standards" and "healthy status". Severity of disability affected on well-being and its components in interaction with disability type. Furthermore, disability type has affected automatic thoughts, life's standards and the satisfaction of religion and spirituality. Conclusion: Cognitive therapy help disabled veterans to relief automatic thoughts. Paying more attention to veterans with chemical and psycho-chemical disabilities provide better well-being for them.