JOURNAL OF MILITARY MEDICINE
Year:2011 | Volume:12 | Issue:4 (46)|Papers Count:14

Introduction: International disarmament conventions lack necessary compliance and consistency by production and application of new generation weapons, shortly after their development. Also by emergence of new threats of microbial weapons, bioterrorism and development of new biological technologies, the necessity of revising the content of these conventions is felt. In this formative research, the stages of growth and development of biological weaponry studies, international laws and conventions on the prohibition of production, development and stockpiling of biological weapons is studied in an interdisciplinary setting and the necessity of revision and reform in these conventions is proposed.Conclusion: Growth of biological sciences in current century has been very fast, but development of international laws on control of military and weaponry trends of this science has been under the influence of weaponry authorities and developed governments and with no explicit prohibition of the use of these weapons, has imposed restrictions on developing countries which want to achieve the peaceful aspects of biological agents. Production of sustainable aerosols resistant to identification and detection techniques, will inevitably lead to convention's content reform.

Aims: Precise pistol shooting is influenced by arousal, which has been recently defined as an individual’s energetic state at a particular time and is measured by skin conductance level. On the other hand, task related activation has been defined as the change in arousal, from a resting baseline to the task situation. Present study was performed in order to investigate whether previous theories on functional differentiation between arousal and activation could be generalized from laboratory tasks to military skills.Methods: This quasi experimental study was performed on 21 military elite shooters including 4 women and 17 men with mean age of 34 years who voluntarily took part in the study, in year 2009. Skin conductance level was recorded as an index of arousal. Several performance measures including scores, inter-shot intervals, and the total shooting time were also electronically recorded. Data was analyzed using inferential statistical methods including repeated measures analysis of variance and stepwise linear regression analysis by SPSS 16 software. Results: There was a linear negative correlation between activation and all three performance measures. Arousal didn’t have correlation with any of performance measures.Conclusion: Findings of present field study support previous laboratory results and shows that quality of task performance, regardless of its type, is affected by activation and not by arousal.

Aims: Ocular injury by mustard gas (HD) leads to severe eye damage. Long term characterization of mustard gas ocular toxicity has not been described in detail yet. Present study was performed in order to explore chronic histological and immunopathologic effects of HD ocular exposure and try to find etiology for these effects.Methods: This descriptive case study was performed on corneal and conjunctival samples of 22 chemical injured victims with late-onset keratophathy who needed surgical treatment between 1997 to 2007 in Baqiyatallah hospital. Samples were selected by simple sampling method. Both eyes underwent surgery in 7 cases; therefore 29 samples were delivered to pathology section. 29 limbus specimens were studied by light, direct immunofluorescence and electron microscopy.Results: Histological findings revealed signs of chronic inflammation. Conjunctivalization, epithelial thinning and goblet cell depletion in light microscopy as well as corneal edema, basement membrane destruction and cytoplasmic vacuolization in electronic microscopy were dominant findings. Fluorescent microscopy demonstrated nonspecific changes.Conclusion: There are no diagnostic histopathologic or microscopic findings in late-onset HD ocular injuries. According to our observations, neither humoral nor cell mediated immunity could explain all histological damages. It seems that primary alkalizing injury is the keystone of HD late-onset pathogenesis.

Aims: Risk management assessment in the hospital is the infrastructure of planning in field of crisis management and is one of fundamental issues in medicine. This study was performed with the aim of assessing the risk management in selected hospitals of Tehran.Methods: This observational cross-sectional study was performed on the wards staff of selected hospitals. Data was collected by a researcher-made questionnaire using five-point Likert scale. Data was analyzed using variance analysis and independent t-test by SPSS 16 software.Results: Staffs’ understanding of risk management scored 3.2±0.69, risk management organizing state scored 3.58±0.74, the state of policies and trends in risk management scored 3.72±0.7, education scored 3.71±0.8, risk management position scored 3.59±1.49 and monitoring of risk management assessment and control scored 3.72±0.75. Results of statistical test of components’ means only showed significant statistical difference in monitoring and assessment of risk between different sex groups.Conclusion: Hospital managers’ regard to the position of risk management is essential for developing the quality of treatment and creating a safe environment for the staff and patients. Adopting policies and planning for education and monitoring risk management activities in hospitals should be pursued seriously.

Aim: Kidney is a high vascularized organ which can be affected by sulfur mustard. Sulfur mustard causes tubular necrosis and urinary epithelial cell sloughing. The aim of this study was to evaluate the cellular and tissue damages in rats exposed to sulfur mustard.Methods: This experimental study was performed on 100 rats. 10 mg/kg was assigned as the desirable dose which rats could live at least 10 weeks while receiving it. 2.5 and 5 mg/kg were also assigned as doses in which tissue changes were studied. Tissue changes were evaluated after 2, 14, 28 and 56 days in 12 experimental groups (3 groups for each time period each one receiving one of the 3 mentioned doses). 4 natural groups (one for each time period) received no injection and 4 control groups only received Tyrode’s solution. Prepared slides of all groups were compared and histological changes were evaluated. Data was analyzed using one-way ANOVA and Tukey’s Post-hoc test by SPSS 13 software.Results: Data of this study revealed no remarkable difference between natural and control groups. Tubular necrosis and urinary epithelial cell sloughing were observed in all experimental groups. The rate was statistically significant only in group which received 10 mg/kg sulfur mustard for 56 days compared to the control group. Conclusion: Exposure to sulfur mustard cause tubular necrosis and urinary epithelial cell sloughing in rats and its increase in statistically significant in rats receiving 10 mg/kg for 8 weeks.

Aims: Entering the military environment in early youth is a very critical period in young people’s lives in all countries and being in such conditions is often accompanied by tension, anxiety and emotional reactions. This study was performed with the aim of evaluating the demographic characteristics related to emotional reactions in training course soldiers.Methods: In this cross-sectional descriptive-analyzing study, two companies with a total number of 320 soldiers were selected by simple random sampling method from some garrisons in different states of the country, and 291 soldiers entered the study. Their stress, anxiety and depression status was assessed using DASS 21 standard questionnaire. Data was analyzed using descriptive statistics and parametric statistical tests by SPSS 15.Results: The amount of stress, anxiety and depression was severe or very severe in 14.8%, 31.3% and 18.2% of soldiers, respectively. Considering the relationship between emotional responses and demographic factors, results showed that there was a significant relationship between education, previous job, satisfaction with income, type of supervision, drug history and family history of mental disease with the rate of emotional reaction (p<0.05).Conclusion: Considering the great amount of emotional reactions in soldiers and the impact of military environment stress factors on intensification of such reactions, administrative and educational measures should be taken in order to prevent, control and reduce these reactions during soldiers’ training course.

Aims: More than half of brain is involved in visual processing in sighted people. Blinds have different information processing method compared to sighted people. The purpose of present study was to compare executive cognitive functions of blind veterans and matched sighted people through behavioral test. Methods: This cross-sectional comparative case-control study was performed on 93 blinds and 116 age and education matched sighted people in year 2008 in Mashhad. Executive functions were evaluated by Dysexecutive (DEX) questionnaire. Data were analyzed using inferential statistical tests including independent t-test, Kolmogorov-Smirnov test and U Mann-Whitney test by SPSS 17 software.Results: Results didn’t show significant difference between two groups in executive memory, awareness and restlessness subscales. Findings showed significant difference between two groups in inhibition and intentionality subscales and total scores. Significantly higher importance and necessity in all dimensions of executive cognitive functions was observed for sighted samples compared to the blind.Conclusion: Blind individuals not only have no dysfunction in executive function compared to sighted people, but also have better performance in inhibition and intentionality subscales. This is related to paucity of basic information needed for executive cognitive functions.

Aims: Evaluation of performance and effectiveness in hospitals is one of the essential issues. Many indicators are expressed as known performance indicators and hospital situation can be evaluated by calculation and comparison of these indicators with standards. This study aimed to investigate and evaluate the performance indicators of one of hospitals of Tehran and compare the favorable performance to existing conditions in order to provide a picture of the actual performance of the mentioned hospital.Methods: In this cross-sectional descriptive study some performance indicators of a selective hospital was compared to results from the years before and also to the available standard in year 2007. Performance indicators used in Iran were extracted from electronic and library resources. The standard questionnaire of Ministry of Health was used for collecting data. Data were analyzed using c2 statistical method by SPSS 17 software.Results: Most of studied indicators including active/fixed bed ratio, bed occupancy rate and rate of admissions per bed had a favorable condition compared to other studies and existing standards, but turnover rate and average length of stay were in unfavorable condition.Conclusion: Turnover rate and average length of stay which are in direct relationship have an unfavorable condition and essential measures should be taken for their improvement. Other indicators are in favorable condition and some are even in higher than expected situation.

Aims: Correct identification of limb amputee veterans' health and treatment needs can have a significant effect on complications' decrease and also increase in their quality of life and life expectancy. This study was performed in order to determine the frequency of clinical and rehabilitation assessment results in limb amputee veterans in Mazandaran province.Methods: This cross-sectional descriptive study was performed on limb amputee veterans who referred to the specialized clinic affiliated to Foundation of Martyrs and Veterans Affairs of Mazandaran province in years 2006-7. From the 375 amputee veterans' medical files, 295 entered the study and the rest were excluded. All clinical orthopedic and rehabilitation evaluations of amputee veterans were done by an orthopedist and a rehabilitation specialist in mentioned clinic. Data were documented in a researcher-made questionnaire and were analyzed using descriptive statistics by SPSS 16 software. Results: 168 (56.9%) of lower limb amputee veterans complained of lower limb pain, 65 (22%) complained of skin infection, and 58 (19.7%) complained of neuroma in site of amputated limb. Change or repair of lower extremity prosthetics with 253 (76.85%) requests, was the most frequent therapeutic command. Conclusion: It seems that majority of veterans don't have acceptable physical strength and capabilities and this fact has reduced their quality of life. Therefore, appropriate protection and rehabilitation measures are recommended for this group of veterans.

Aims: Visual disorders have recently become a matter of concern for World Health Organization. Since most clients of military medical ophthalmic commission are young, assessment of visual disorders is very important in this group. This study was performed in order to determine the frequency distribution of common visual disorders among people who refer to military medical ophthalmic commission of Ardabil province.Methods: This cross-sectional descriptive study was performed on all patients of Alavi Ophthalmology Clinic of Ardabil during years 2000-5 who referred to Medical Exemption Commission. 5203 people were studied and the data registered in medical files were collected in a questionnaire and were analyzed by SPSS 13 software. Chi square test was used for comparison of qualitative variables.Results: 4935 (94.84%) of clients had a kind of visual disorder. 94% had refractive errors from which 33.8% were mild, 48% were moderate, and 18% were severe. 3413 (65.6%) of patients had myopia and 1479 (28.4%) had hyperopia. 4806 (92.37%) of patients had astigmatism and 35.15% had anisometropia. Corneal disease (1.07%), strabismus (0.99%) and cataract (0.78%) were other major visual disorders. Conclusion: Special refractive errors lead to exemption from military service and most of referees despite having refractive disorders are summoned to military service; therefore, determining the prevalence of refractive errors and visual disorders may be useful in major defensive programs for military medicine authorities. Retrospective evaluation of the above results may also be useful in Amblyopia preventing programs.