Journal of Military Medicine
Year:2007 | Volume:9 | Issue:3 (33)|Papers Count:17

Introduction: The prevalence of active asthma in Iran is between 2.8%-3.8%. A lot of treatments exist for acute and chronic asthma. The goal of chronic asthma treatment is achieve to a condition without any symptoms with a good function of lung by using the lowest dose of drugs. The aim of this survey is comparing the rate of clinical recovery and lungs function finding in persist asthma patient before and after treatment. Material and Methods: We conducted a prospective self-control clinical trial and enrolled 30 persistent asthma patient who came to lung clinics of Baqiyatallah(a.s) hospital. In the six month of 2007. By using history, physical exams, spirometry and completing questionary. Then patient treat by azithromycin protocol and prednisolone. Results: The mean age was 44.36±25.8 years old. The mean BMI of patient was 25.8±4.2kg/m2. Twelve patients (40%) were male and 18 patients (60%) were female. The mean of FVC percent before and after treatment with full dose were 68.03±18.03 and 70.69±14.44 respectively (p<0.226) and after treating by Azithromycin & prednisolone was 81.61±20.1 (p<0.004). The mean of FEV1 percent before and after treatment with full dose were 56.69±20.45 and 60.37 ±17.2 respectively (p<0.085) and after treating by Azithromycin & prednisolone was 79.58±16.9 (p<0.0001). The mean of FEV1/FVC before and after treatment with full dose were 66.78±12.15 and 66.97±12.6 respectively (p<0.446) and after treating by Azithromycin&prednisolone was 78.11±11.08 (p<0.0001). Discussion: We use Azithromycin instead of increasing the dose of prednisolone because patient didn’t show a good response to full dose and the response was good. In spite of lack of control group for Azithromycin treatment, this survey shows that instead of increasing the dose of prednisolone we can use Azithromycin.

Background: In spite of decrease in burden of stomach cancer in the ‎developed world, the incidence of this disease is still high in the developing ‎countries including Iran. Due to the slow progression of the cancer within ‎stomach, the cancer is usually diagnosed in advanced stage leading to a high ‎mortality rate. The stomach cancer is the second cause of death due to ‎cancer after lung cancer. In this study, we studied the survival rate of ‎stomach cancer among patients hospitalized in Baghiatollah hospital in ‎Tehran, Iran between 2000 and 2005.Patients and Methods: In overall, we studied the survival rate of 209 ‎patients hospitalized for stomach cancer in Baghiatollah hospital. We used ‎patient files and abstracted demographic data as well as information about ‎stomach tumor, i.e. histopathology, stage of the disease. Crude survival rates ‎were studied by of stomach cancer using Kaplan-Meier and Life Table ‎methods. Cox regression model estimated the effect of demographic ‎information and tumor characteristics on death due to stomach cancer.‎ Results: we found a poor prognosis for our stomach cancer patients. More ‎than 20 percent of patients died of stomach cancer in the first three months ‎and only half of patients were still alive after nine months of follow-up. One, ‎three, and five years survival were 44, 19, and 11 percents, respectively. ‎Stage of tumor was the most important prognostic factor in this study, ‎although patients diagnosed with a stomach cancer staged IB, II, IIIA, and ‎IIIB had almost similar prognosis. Study of 13 patients with stomach ‎lymphoma showed a better survival rate compared to adenocarcinoma in ‎overall. ‎Conclusion: stomach cancer patients had a considerably poor prognosis in ‎Iran. Further studies are needed to improve the diagnostic and therapeutic ‎approached to improve the prognosis of these patients.

Introduction: Prisoner of wars is one of stressful in the life event in POW lives, which caused the severe changes in their psychosocial as well as physical domains. The main aim of the present study is to evaluate the level of depression in prison of war (POW) in Iran-Iraq imposed war. The main hypothesis is to find the level of depression and its relationships with anxiety, aggression and physical complaints in POWs.Methods and Material: The study is a descriptive study. 129 of released POW's were randomly selected from the released POW's population in province of Isfahan and were requested to participate in the study three months after their release. All subjects filled in the Beck Depression scale, depression subscale of SCL-90, and a demographic questionnaire.Results: The results showed that nearly all of POW's either their selves tortured or have observed their friends' torture. In addition, they, all, suffered from the worse conditions and weak health situation (physical and mental). Data revealed that most of the POW's had not showed depression symptoms (74%) when they entered home.Discussion: However, they are expected to complaint of more psychological and physical problems, particularly depression, anxiety, and hostility. The results supported that there were significant associations between depression, anxiety, hostility, and somatic complaints.

Introduction: Hospitals are the most importance organization in healthcare sector, that with special facility to possess the critical role on health, research and training the skillful personnel. Control & management of medical equipment to accede the rising lifetime of medical equipment, decrease of cost control, presenting the service with the best quality, arising of the satisfactory of patients. The study aimed at assessing the medical equipment maintenance management at two Hospitals military. Material and Methods: The study, cross-sectional, was conducted in the second half of 2003. The data was collected by a self-constructed questionnaire. Content validity and test-retest were used to determine validity and reliability of the instrument. Data analysis was carried out through SPSS. Results: The findings of the study showed that the planning for maintenance management was passable (53%). only 24% of study population believed that the overall organizing of medical equipment management was favorable condition. Form the viewpoint of 47% of responsible, co-ordination &communication on maintenance management was found to be satisfactory. 60% of responsible believed that control &assessment system was passable, form the viewpoint of 18% of responsible, purchase systems was unsatisfactory. Discussion: Control & management of medical equipment to accede the rising lifetime of medical equipment, decrease of cost control, presenting the service with the best quality, arising of the satisfactory of patients.

Background: Readmission of injured veterans imposes heavy financial burdens on the health system in different countries; thus, determining its controllable risk factors can result in lowering such costs. This study was designed to evaluate the risk factors associated with readmission due to exacerbation in chemical injured patients who suffer from chronic pulmonary diseases. Material and Methods: In this prospective study that was carried out in 2006, 96 chemical injured veterans from Sardasht were chosen in a simple randomized fashion. They were followed up for readmission (2 times or more within 6 months) due to exacerbation in signs and symptoms. Demographic data (age, sex, marital status, monthly income and level of education), spirometric findings (Predicted VC, Predicted FVC, and Predicted FEV1), somatic comorbidities (Ifudu), scale of anxiety and depression (HADS) and Body Mass Index (BMI) were recorded for each participant. Risk factors of readmission due to exacerbation of pulmonary signs and symptoms were analyzed using the multivariate regression test. Finding: Of all 96 individuals, 23 (24%) were readmitted due to aggravation of signs and symptoms within 6 months which showed a significant relationship with age (P=0.016), sex (P=0.05), comorbidity score (P=0.008), level of anxiety (P=0.05) and depression (P=0.05) while reevaluation with Predicted VC (P=0.717), Predicted FVC (P=0.664) and Predicted FEV1 (0.353) was not statistically significant. Predicting factors of readmission in patients suffering from chronic pulmonary diseases were comorbidity scale (P=0.007) and anxiety (P=0.040) which predicted readmission as follows: Logit (readmission) = 0.19 8* comorbidity (unit) * anxiety (unit)-3.93 .Discussion: According to this study, comorbid somatic conditions and level of anxiety are risk factors of readmission due to aggravation of signs and symptoms in chemical injured patients who suffer from chronic pulmonary diseases. Considering such variables would assist decision makers in lowering heavy costs of readmissions in such patients.

Background: Cytokines play a major role in acute and chronic inflammations such as the inflammation caused by Sulphur Mustard (SM).Methods: In this study, response of the macrophages from rats exposed to SM was evaluated for Interleukin 1-beta (IL-1b), Interleukin-6 (IL-6), Interleukin-12 (IL-12), Tumor Necrosis Factor a (TNF-a) and Transforming Growth Factor Beta (TGF-b). Twelve rats were exposed to 1 dose of SM through inhalation and were then compared with the control group. After 2, 4, and 6 months following the exposure, rats were killed by anesthesia and their splenic and pulmonary macrophages were retrieved. Macrophages were then counted and cultured (1000,000 cells per well) in 24-well microplates for 24 hours at 37°C and 5% CO2 after 3 times of washing. The supernatant was then evaluated for cytokines using ELISA.Results: After 2 months, no significant difference was reported between the case group and the control group except for IL-6 (P<0.01); while after 4 months, IL-1b, IL-6, IL-12 and TGF-b increased significantly in comparison with the control group (P<0.001) with the highest increase in IL-6 (54.6% for splenic macrophages and 64.29% for pulmonary macrophages (P<0.001)). Six months after the exposure, there was a significant differences (P<0.001) in the secretion of all cytokines in both splenic and pulmonary macrophages (P<0/05 for TNF-a). The highest increase was seen in IL-6 which was 84.3% in splenic and 69.83% in pulmonary macrophages (P<0.001). Discussion: overall, cytokines are secreted more in the group exposed to SM than the control group.Conclusion: We conclude that late complications of SM are in part due to the changes in cytokines levels.

Introduction: Toluene (C6H5CH3) is a noncorrosive, volatile liquid solvent with an aromatic odor. Toluene use to producing materials such as T.N.T in military industries and also has a big number of chemical factories use it as a solvent, carrier, or thinner in the paint, rubber, printing, cosmetic, adhesives and resin industries, as a starting material for the synthesis of other chemicals and as a constituent of fuels. The high amount of its exposure in various related jobs has caused so significant harmful health effect on people that plenty of investigations have so far been done to control and reduce its vapour production in the workplaces. Materials and Methods: In order to remove toluene from air, it is suggested in this investigation to use a complex system of nano-particles of titanium dioxide on exposing them by ultraviolet radiation. To verify the performance of the nano-particle, it was intended to survey the measuring of degradation of toluene in various conditions. In this study we use a glass tube coated by TiO2 as a bed photocatalist and toluene vapour carried throw it. The amount of toluene concentration recorded before and after photocalytic process.Results: Passing of various concentration of toluene vapors from 150, 250, 350 and 450 ppm from photocatalyst surface was removed completely. Also this study showed that the irradiation of UV-A in 365nm wavelength created the most photocatalitic property. The results showed that TiO2 nano particles coated on glass tube has high efficiency to decompose gaseous toluene from various concentrations to threshold limit value.Discussion: Using the UV-A in TiO2/UV photocatalyst can reduce toluene vapors from air. For more experience we purpose to continue these experiences on other volatile organic compounds and especially on sculpture mustard.

Introduction: Penetrating wounds resulting from gunshot and fragmentation munitions (such as grenades, land-mines, mortars, various missiles and bombs) were the major factor of injury in this war. The aim of this study was to review files of war casualties to obtain demographic data, distribution of different factors of injury, and involved anatomic regions to propose guidelines for reducing mortality and morbidity of penetrating wounds in battlefield conflicts. Materials and Methods: In this cross-sectional study, available information such as age, educational degree, year and geographical location of injury, and factor of injury for 1000 casualties were obtained from accessible files of Supreme Medical Commission. Statistical indices such as frequency, mean and standard deviation were analyzed by SPSS 13 software. Results: Fragmentation munitions (58.3%) were the most prevalent factors of injury. The mean age of casualties was 21/9 years. Majority of injuries were occurred in 1361 (20.5%) and 52.3% were documented in southern fields. The most frequent involved anatomical regions were lower extremity and pelvis (30.5%), upper extremity (24%), head and neck (19%), abdomen and pelvic contents (10.5%), thorax (6.4%), brain (6.4%), and spinal column and cord (3.2%), respectively. Discussion: Regarding that fragments from explosion were the most frequent cause of injury, proper education for military personnel about appropriate application of body armors has a high importance.

Background: Sepsis is defined as systemic reactions against infection. Some risk factors of sepsis in infants are as follows: premature new born, PROM, maternal fever, chorioamnionitis, etc. Sepsis is categorized as early (within 7 days from birth) or late (day 8th to 28th) Objectives: In this study, the most common clinical manifestations and laboratory findings of sepsis in neonates and infants who were brought to Baqiyatalah hospital or Najmieh hospital between 1380 and 1384.Material and Methods: In this cross-sectional study, 140 neonates and infants were investigated with a mean age of 6.83 days ranging from 1 to 28 days. Results: According to this study, the prevalence of early sepsis was 85.6% and the most common manifestations were poor feeding (51.5%), lethargy (43.4%) and hyporeflexia (40.6%). Chief laboratory findings were positive blood culture (15.4%), positive CSF culture (2.2%), positive urine culture (13.3%), high ESR (7.9%), positive CRP (6.8%), neutropenia (2.9%), leucocytosis between 20,000 and 40,000 (2.1%), leucopenia (0.7%) and thrombocytopenia less than 100,000 (21%) which are in line with global statistics in most cases. Since sepsis is a major cause of infant mortality in the world, timely diagnosis and treatment as well as improving perinatal and infantile care can increase infants’ survival.