JOURNAL OF MILITARY MEDICINE
Year:2016 | Volume:18 | Issue:1|Papers Count:10

Aims: The current study surveyed and compared the complications and clinical outcomes in patients with ventilator-associated pneumonia in patients with and without traumatic brain injury admitted to ICU.Methods: This is a prospective cohort study which was carried out in Nov 2012-Nov 2013 in the ICU ward of Imam Hossein Hospital. The patients over 18 years old, that were developed VAP in the ICU participated in this research. Patients who were hospitalized due to TBI were considered as a group and patients who were hospitalized due to non-TBI were considered as another group. Necessary data were recorded for all patients in both groups. All patients were followed up until hospital discharge. Incidence of death or recovery, incidence of serious complications, length of stay (LOS), duration of intubation and type of microorganisms were recoded and compared between two groups.Results: In this study 38 patients (81.6% male) in group 1 and 57 patients (54.4% male) in group 2 were surveyed. The mean age of the patients in group 1 (42 years) was significantly less than group 2 (57 years) (P=0.002). The mean of LOS in ICU for patients of group 1 was 14 days and for patients of group 2 was 32 days ((P<0.001). The sputum culture results in 28 patients (75.7%) of group 1 and in 50 patients (89.3%) of group 2 was positive (P=0.081). Also, the results of blood culture was positive in 5 patients (23.8%) of group 1 and 18 patients (46.2%) of group 2 (P=0.09). The recorded severe complications between the two groups were not significant. In terms of clinical outcome, ICU mortality in group 1 and 2 was 23.7 % and 38.6%, respectively (P=0.129) and hospital mortality the patients of group 1 was 26 % and in group 2 was %49 (P=0.116).Conclusion: The findings of this study demonstrated that the incidence of complications and clinical outcomes in patients with ventilator-associated pneumonia were not significantly different between patients with and without traumatic brain injury.

Aims: The aim of this study was to evaluate the antibacterial effects of aqueous and organic extracts of Arctium lappa on Brucella melitensis 16M in vitro, in macrophage culture and in the animal model.Methods: In this experimental study aquatic, ethanolic, and acetonic extracts of Arctium lappa were prepared. The antibacterial effect of the extracts investigated by agar well diffusion and macrodilutionon methods for determination of MIC and MBC. Then the intramacrophge survival of the B.melitensis 16M was studied from the cell culture of Balb/c mice. Also, the antibacterial effect of the extracts were studied in the animal model.Results: The MIC and MBC of leaves and inflorescences extracts of Arctium lappa on B. melitensis 16 M were 101 and 116 mg/ml, respectively. The maximum inhibition zone diameter was related to an ethanolic extract. In the macrophage culture and in the animal model, the aquatic extract of inflorescences of Arctium lappa was the most effective.Conclusion: The aquatic and organic extracts of Arctium lappa have antibacterial activity against intramacrophage B. Melitensis 16M. The aquatic extract has the most effective antimicrobial activity on intramacrophage B. Melitensis 16M. These extracts can be useful in the treatment of brucellosis.

Aims: The current study was designed in order to assess the historical formation of the military health care- named Behdari- system.Methods: The study was conducted using a qualitative and historiography approach. Purposeful sampling of primary and secondary sources was done. At the end, 11 books, 6 articles and 5 participants were selected for an interview. Participants were asked to describe their experiences about military clinics. Then, all interviews were taped and transcribed word by word. For analyzing, all books and transcribed interviews were read by the research team members several times and significant statements were extracted and eventually historical trends were identified and historical periodization was done.Results: Results showed that military medicine with primary backgrounds at prewar periods has passed difficult path to complete during the war in a non-classical and non-customary manner.Conclusion: Finally, it seems that the formation of military clinics during the war period in Iran has been affected by political, social and professional factors. This has eventually created a unique structure for military clinics.

Aim: This study aimed to compare the effectiveness of three methods of patience, stress and telecommunication issues in military job satisfaction.Methods: The study followed an experimental method with a pretest-posttest design. The tools used during this study were the Job Descriptive Index questionnaire.Results: The results showed that all the three methods of increasing job satisfaction were effective in this study. The average of job satisfaction had the highest increase in the patience exercise, telecommunication and externalized stress groups respectively.Conclusion: According to the efficacy of each three methods, defusing, patience practice and telecommunication on increasing job satisfaction, using each of these three manners is possible for increasing job satisfaction. In addition, as patience practice had the best efficacy, this method may be used as the most effective method compared to the two others.

Aims: The purpose of the present study was to examine the effectiveness of emotion regulation strategies training on difficulties in emotion regulation.Methods: This research was an experimental study. To this end, 20 university students (9 males and 11 females) from the Kharazmi University voluntarily participated in this study. The volunteers were trained emotion regulation strategies for 10 sessions in a group. In all the three stages of training (prior to training, while receiving the training and subsequent to the training) individuals were tested using the Difficulties in Emotion Regulation Scale (DERS). The obtained data were entered into SPSS 18 and were analyzed using Repeated Measures ANOVA and Bonferroni tests.Results: Results indicated that, process emotion regulation training meaningfully decreases the scores of difficulties engaging in goal directed behavior (P<0.001), lack of emotional awareness (P<0.001), impulse control difficulties (P<0.01), limited access to emotion regulation strategies (P<0.01), lack of emotional clarity (P<0.01) and non-acceptance of emotional responses (P<0.05) in the participants.Conclusion: With regards to the results of the present research, it can be concluded that modifying maladaptive emotion regulation strategies can be a good solution to prevent emotion problems.

Aims: This study aimed to investigate the time management skills among military and civilian hospitals' managers.Methods: This was a cross-sectional and descriptive-analytical study conducted in 2015 on 240 senior, middle and first-line civilian and military hospitals' managers in Kermanshah. The required data were collected using a standard questionnaire (Time Management) consisting of 6 dimensions and 40 items. The collected data were analyzed using SPSS v21.0 through a few tests, including Mann-Whitney, Kruskal-Wallis tests and Spearman correlation coefficient.Results: The results showed that among the time management dimensions, the highest and lowest means were, respectively, related to the prioritization of objectives and activities (with the mean of 1.79) and goal setting (with the mean of 1.56). Also, the results revealed that all the dimensions of time management skills in the Imam Hussein Military Hospital had higher means than the civilian hospitals and its means was greater than the average significantly.Conclusion: Results showed that the studied managers were at a moderate level in terms of time management skills. Therefore, assessing the managers' time skills and behaviors in order to better understand the strategies used by them to manage their time and inform them about managing time can be suggested.

Aims: The main object of this study was to estimate the odd-ratio of factors affecting families’ exposure to catastrophic and impoverishing health expenditures.Methods: This research was a cross-section study with a clustered sampling method. The sampling units were Tehran’s households who had lived in Tehran for at least one year before the data collection. The data gathering tool was the WHO questioner. The Logistic model and the stata13 software were used for estimating the odd-ratio of the factors determining households’ exposure to catastrophic and impoverishing health expenditures.Results: According to the results of this study, the presence of a family member older than 60, using inpatient services and informal payments increase the probability of catastrophic expenditures. This is while insurance coverages reduces this issue.Conclusion: According to the obtained results, extending the insurance coverage and the prepayment mechanism, preparing low cost inpatient services by the extension of prepayments, codifying health care packages under the commitment of insurance agencies, reforming the payment systems and monitoring tariffs can prevent households from falling under the poverty line. This means that it can help families to overcome their poverty in order to have better lives.

Aims: Previous research have shown many organizational factors as determinants of unsafe behaviors. One of the most prominent is the lack of adequate knowledge, skill and ability in the field of safety. So, the aim of the present study was to examine simple and multiple relationships between safety knowledge, safety skill and safety ability with unsafe behaviors in an industrial company.Methods: The population of this descriptive-correlation study included all line employees who work in an industry company (N=1160). Among this population, 265 employees were selected by a stratified random sampling method. Participants in this study were measured by using the unsafe behaviors questionnaire of Hofmann & Stetzer (1996) and the Salleh (2010) safety competency scale. In order to analyze the data, the Pearson’s correlation coefficient and regression analysis (by use software SPSS v19) and in the validation stage, the confirmatory factor analysis (by use software AMOS-21) were applied.Results: Findings indicate that the correlation coefficients between safety knowledge and unsafe behaviors were significantly negative (r=-0.259, P<0.0001). Also, the correlation coefficients between safety skill and unsafe behaviors were significantly negative (r=-0.411, P<0.0001). Likewise, the correlation coefficients between safety ability and unsafe behaviors were significantly negative (r=-0.323, P<0.0001). The stepwise multiple regression analyses among the three independent variables, revealed that only two variables of safety skill and safety ability qualified for the inclusion criteria of the regression equation (R2=0.181, P<0.0001).Conclusion: The results of this study showed the importance of safety skill and safety ability as predictors of unsafe behaviors. Therefore, in order to select people for high risk environments such as the petrochemical industry and also in training courses we should rely on these variables.

Aims: This study aims to evaluate the impact of the introduced Indian gray mongoose, Herpestes edwardsii (É. Geoffroy Saint-Hilaire, 1818) on some non-target vertebrate and invertebrate native species of the Abu-Musa Island, in the Persian Gulf in southern Iran.Methods: This study was conducted during April to July 2013 in Abu-Musa and Greet Tunb islands, as case and control districts, respectively. For this purpose, the abundance and distribution pattern of lizards, snakes and scorpions that are hunted by the Mongoose was estimated in Abu-Musa and Greet Tunb Islands and were compared.Also the researcher’s observations among the population of the Indian gray mongoose and some of its behaviors were recorded.Results: The abundance ratio of lizards in wildlife Island (outside area of human habitat) to residential areas, was determined 0.25 (SE=±0.05), which is significantly less than Greet Tunb island with 0.48 (±0.04) (P=0.001). This implies the reduction of the lizard population in the wildlife of Abu-Musa Island. This is while there is no significant decrease in the population frequency of scorpion in the Abu-Musa Island (P=0.556).In this study, 4 species of Lizards including Geckonidae and Sphaeroductylidae were reported for the first time from this Iranian Island on the Persian Gulf.During the exploration on the Abu-Musa, with the exception of sea snakes that were visible on the coastal area, no snakes were seen. Probably snakes have disappeared in this island by Indian Gray Mongoose.Conclusion: Although the reduction or elimination of the snakes and even the lizards population from the Abu -Musa Island, may be of interest for the people and the military forces in this island, but this issue can affect the native species and the biodiversity and also the life of sensitive ecosystems of this island. Based on these findings and other experiences in the world, the Indian gray mongoose, Herpestes edwardsii, is not recommended to get introduced in the other islands and regions of Iran, as a biological control agent.