JOURNAL OF MILITARY MEDICINE
Year:2018 | Volume:19 | Issue:5 |Papers Count:16

With all the medical advances of the century, vitamin D deficiency is still epidemic in the world, and recent studies have demonstrated new epidemics of vitamin D deficiency all over the world. Many studies have addressed a disturbingly high prevalence of vitamin D deficiency in many communities and sectors in Iran and all over the world. However, very limited studies have been conducted on military personnel.The prevalence of vitamin D deficiency in military personnel in Iran is unclear, however, given that the prevalence of vitamin D deficiency in military personnel in other parts of the world, such as the US military, has reported more than 50%, the same prevalence of vitamin D deficiency is possible in Iranian military personnel.On the other hand, due to the negative effects of vitamin D deficiency on the performance of military personnel, such as physical and cognitive impairment, increased risk of musculoskeletal or bone damage, stress fractures, muscle weakness and central nervous system fatigue, adverse cardiovascular consequences, therefore, vitamin D deficiency monitoring in this group is necessary.To determine the prevalence of vitamin D deficiency in military personnel, as well as its impact on operational performance of military personnel, can help the relevant health and medical organizations in planning and implementing more effective prevention programs for the health of military personnel. In the current review study, the prevalence of vitamin D deficiency in military personnel in Iran and the world and its effects on the performance of military personnel is considered.

The teratogenic effect is thought to be the effect of an agent that is able to cross the pair and may cause serious damages to the fetal or embryo development and will lead to abnormalities in the fetus or newborn. Each pregnant woman may have a condition that can be contracted in or during pregnancy. Some of these maternal diseases or medications which are used to treat these diseases may have teratogenic effects on the fetus and impair the development of the fetus. According to previews studies, control of maternal diseases before and during pregnancy is necessary. Regarding to the harmful effects of teratogenic factors on the fetus, in this review we studied some teratogenes such as radiations, infection agents, maternal conditions, teratogenic medications etc.

Background and Aim: Amputation is known to be the most common movement disability. Physical, behavioral and mental disorders after that are the most serious problems of amputee veterans. The aim of current study was to determine the conditions of renal and urinary tracts complications in amputee's veterans in Mazandaran, north of Iran.Methods: This is a cross-sectional study which conducted on amputees' veterans living on Mazandaran, north of Iran, in 2013. All precipitants were examined by a nephrologist. Demographic data was collected and renal and urinary tract complications data was recorded by standard questionnaire.Results: 256 (44.52%) of 575 amputee's veterans completed the study. The mean age of them was 46.44±2.6 years old, with the age range of 22-70 years. All of them were men, 94.9% (n=243) were married and 78.8% had graduated in diploma and under diploma. Also, 110 (43%) of the veterans had urinary infections and 53 (20.8%) had kidney and urinary tract stones. Among them 9 (3.5%) suffered from kidney failure. Also, results reveal that 99 (38.7%) of veterans' libido had changed and 76 (29.7%) of them were encountered with decreased libido.Conclusion: Considering the high prevalence of the renal system complications in amputees' veterans, it seems necessary to run preventive, educational, treatment and rehabilitation programs.

Background and Aim: Many scientific evidence confirms the impact of imagery on the enhancement of learning and performance of sports skills as well as the adjustment of athletes’ emotions and thoughts about the tournament. Therefore, imagination not only facilitates performance but also facilitates the athletes’ thoughts and reactions in the competitions. The purpose of this study was to compare the effect of using a simulator with that of imagery of movements in piloting techniques on the performance of UAV athlete pilots.Methods: The present research belongs to the category of applied research and falls in the field of semi experimental research. The statistical population of this study was Tehran's UAV pilots. Among them, 20 participants were selected by the available sampling method with a mean age of 32.2 years. After the homogenization of the samples based on their ability of mental imagery, they were randomly assigned into two groups, one using a simulator and the other using a simulator plus mental imagery. They were trained in piloting drones for eight weeks.Results: The results of the study indicated that after eight weeks of specialized training in drone piloting and practicing real-time flights, the simulator had a positive effect on the performance of pilots in actual and practical flights. The use of the simulator in combination with the imagery techniques also had a positive effect on the performance of the pilots and improved their actual flying. A comparison of the two training methods showed that the effect of the combined training technique was significantly greater than the effect of the actual practice on the performance of pilots.Conclusion: The use of combined training exercises (simulator plus mental imagery) has a positive effect on the learning of piloting techniques and better helps the optimal performance of UAV pilots.

Background and Aim: Ethical leadership, as one of the new approaches to leadership, embraces management and leadership methods in which the rights and dignity of the employees are valued and respected as human beings. The aim of this study was to investigate the effect of ethical leadership and leadership styles on organizational commitment in a military health organization in Tehran.Methods: This cross-sectional study is conducted in Tehran, Iran in 2016. The study population consisted of employees of a selected military health organization, selected by stratified and simple random sampling method.For data collection, the standard questionnaire of Brown's ethical leadership scale (three-part model of staff), Bass& Avolio’s multi-factor questionnaire and organizational commitment questionnaire of Meyer and Allen have been used. The descriptive data were analyzed using descriptive statistics and SPSS 16.0 software and for analyzing the relationship between components, structural equation modeling and AMOS 18.0 software were used.Results: The results showed that the average organizational commitment in the sample was 71.6±4.9 at a high level. Also, the highest score of organizational commitment in the staff was related to the dimension of normative commitment. Regarding the leadership style, the results showed that the dominant leadership style was the transformational and transactional leadership style, respectively. In the case of ethical leadership, the results showed that the average score of leadership style of managers was 36.8±6.89 from the perspective of the employee. The fitting results of the model showed that the independent variables predicted 22 percent of the changes in the dependent variables of organizational commitment.Conclusion: Considering the high score of organizational commitment at the university, it can be concluded that the use of ethical leadership and transformational leadership style has been effective and has a direct effect on employees' commitment. Ethical leadership in this organization, by establishing ethical relationships (interpersonal relationships) and seriousness in addressing ethics in the organization, has added to the organization's commitment. Therefore, managers with knowledge of the amount and type of commitment of employees can be used to improve and increase the performance of employees in order to achieve organizational and social goals as well as personal goals of the employees.

Background and Aim: Today, teaching styles and the interaction of teachers in the field of teaching-learning has become very important. Therefore, it is important to study the influential factors in the field of teaching and their chosen approaches to education. In fact, the kind of curriculum ideology and educational philosophy can be considered as a critical and influential element in the field of education and teaching. Therefore, the present study aims to investigate the relationship between curriculum ideology and educational philosophy with the teaching methods of medical science professors (one of the military medical universities of Tehran).Methods: This is a descriptive-correlational study. The population of this study was a faculty members of one of the military medical sciences universities in Tehran who were selected by convenience sampling method. The data collection tools consisted of curriculum ideology questionnaire, educational philosophy and teaching approaches that the validity and reliability of them had been confirmed. Pearson correlation was also used to analyze the information in SPSS 16 software.Results: The findings of the study indicated a significant relationship between the social efficiency ideology (r=0.23, p<0.05) and learner-centered ideology (r=0.25, p<0.05) with the existentialism philosophy of education, social efficiency ideology with teacher teaching approach Axis (r=0.26, P<0.05), as well as learner-centered ideology with a student-centered approach (r=0.26, P<0.05). Other results of the study showed that there was a significant relationship between teacher-centered teaching with progressivism (r=0.23, P<0.05), perennialism (r=0.25, P<0.05), fundamentalism (r=0.30, P<0.01) and existentialism (r=0.27, p<0.05), as well as the relationship between student-centered teaching approach and perennialism educational philosophy (r=0.26, p<0.05).Conclusion: Since the findings point to the significant relationship between the dimensions of the curriculum ideology and the educational philosophies with the teaching methods of the faculty, the studied universities and also similar universities can provide education and programs to raise the level of the quality and familiarity of the faculty with the orientations of the curriculum and the philosophies governing the field.

Background and Aim: Oral health is an essential component of general health status which has an impact on physical and psychological health. Due to the importance of oral health, limited study in the field of dental problems among veterans and also the high number of chemically injured veterans, this study was conducted in order to determine the prevalence of dental treatment needs in chemically injured veterans in Zanjan.Methods: This cross-sectional descriptive study was conducted using Cluster Random Sampling. After coordination with the Foundation of Martyrs and Veterans Affairs the veterans who met the criteria were examined by an oral medicine specialist in the oral medicine ward of the Zanjan University of Medical Sciences with the aid of examination devices. Identification data for veterans, past medical history and their current treatment needs based on teeth number and type of dental treatment, were recorded in the questionnaire (standard WHO 2007) and were analyzed by SPSS 16.Results: The project was done on 141 patients with the mean age of 50.7±34.6 years (maximum 79 and minimum 42 years). Dental treatment needs were as follow: root canal treatment 78%, filling 73.8%, extraction 73.8% and prosthesis 34.8%.Conclusion: A large number of veterans were in need of dental treatment mainly root canal therapy and dental extractions. This fact emphasis the need of periodic checkups and dental care for them.

Background and Aim: During the military service, soldiers suffer from fatigue and reduced motivation. The purpose of this study was to compare the effect of chronic and acute sodium bicarbonate supplementation loading along with exhaustive work on the performance and fatigue indicators of soldiers.Methods: In this study, 30 soldiers were divided into a semi-experimental design into two groups (control, intervention). The control group received dextrose (% 0.02) and the intervention group consumed two methods of chronic loading (0.5 g/kg) and acute (0.3 g/kg) sodium bicarbonate supplementation. In order to calculate the chemical variables (bicarbonate, lactate, PH), blood samples were taken before and after the exercise test and one hour later. The exercise test for Wingate test was used to assess the subjects.Results: Results reveal that the level of the acidity of the blood with chronic sodium bicarbonate supplementation has led to the alkalization of the blood and fatigue to be postponed. The results showed that the use of bicarbonate in the acute and chronic loading led to an improved excretion of the lactate.Conclusion: Due to the buffering properties of sodium bicarbonate supplementation and delaying the time to fatigue and improve performances, chronic loading for short and severe activities in soldiers and even athletes can be recommended.

Background and Aim: The prevalence and incidence of coronary artery disease is seriously affected by the unhealthy lifestyle of people. The aim of the current study was to determine the effect of progressive muscle relaxation on the four dimensions of lifestyle in patients undergoing coronary artery bypass graft surgery.Methods: In current randomized, triple blind clinical trial, 80 patients with coronary artery bypass graft surgery were randomly divided into two intervention (40 patients) and control (40 patients) groups. In the intervention group, the patients were trained and performed the progressive muscle relaxation technique, but the control group did not receive any intervention.Data collection was done by the demographic form, self-report checklist for performing of progressive muscle relaxation technique and the lifestyle questionnaire in four dimensions of nutrition (11 questions), sleep (10), physical activity (5 questions), and Tobacco (3 questions). At the end, the data were compared between the two intervention and control groups.Results: The age (P=0.66), gender (P=0.664), marital status (P=0.643), occupation (P=746), BMI (P=728), and family members P=0.760) had no significant differences in the intervention and control groups. Covariance analysis showed a significant difference between two intervention and control groups (p<0.05) for all four dimensions of lifestyle including nutrition, sleep, physical activity and smoking along with overall lifestyle score.ANOVA with repeated measures for each of the four dimensions of lifestyle with overall lifestyle score for comparing the interaction between time and group showed a significant difference between the two intervention and control groups (P<0.05) Conclusion: The implementation of progressive muscle relaxation technique significantly improved the four dimensions of lifestyle including nutrition, sleep, physical activity and tobacco in the intervention group compared to the control group.

Background and Aim: Heat stress is a work-related risk factor that could have a significant impact on occupational health. Therefore, the use of different approaches is important to control heat stress, including technical and management solutions. The aim of this study was to design and evaluate the performance of a cooling ice vest on the retention time of workers in hot environments.Methods: The ice vest has been designed and sewn in three types of simple, thin and thick aluminum using 32 packets of water. To evaluate the temporal performance of ice vest, a number of physiological parameters, including oral temperature, mean skin temperature, heart rate and retention time have been studied. This study was conducted in two groups of intervention and control. The control group included adapted, non-adapted and no-vest subjects. The intervention group consisted of adapted subjects who used simple, thin and thick aluminum vests.Results: The average retention time of non-adapted, adapted, thin and thick aluminum and simple vests was 20, 35, 90, 70 and 60 minutes, respectively. There was statistically significant differences among physiological factor results such as oral temperature, mean skin temperature and retention time (probability<0.05), but the heart rate of control group had no significant difference with the case group.Conclusion: The results showed that the use of cooling vest effectively increased the retention time, and the thin aluminum vest was more efficient than the thick aluminum and simple vests.

Background and Aim: Fungal infections, especially candida species, are the most common opportunistic fungal infections and the treatments with chemical drugs have many side effects. Melissa Officinalis has antimicrobial effects that has caused it to be considered in many microbial treatments. In this study, it has been tried to compare this herbal efficacy onCandida Albicans, Candida Glabrata and Candida Krusei.Methods: Aqueous and ethanol extracts of Melissa Officinalis was obtained by drench method. The diameter of non- growing zone of Candida Albicans, Candida Glabrata and Candida Krusei was estimated by the micro dilution method.Results: The mean diameter of the non-growing zone related to the extracts on Candida Albicans was 17.83 mm (versing 5.75 mm of aqueous extracts) and the mean diameter of the non-growing zone related to aqueous extracts on Candida Glabrata and Candida Krusei were 15.5 and 13.66 mm respectively (versing 10 and 7mm of ethanolic extracts).Conclusion: All extracts had an effect on non- growing fungal zone, however ethanolic extract of Candida Albicans and aqueous extract of Candida Krusei were more effective rather than the others. Also, there was no difference between the effect of Aqueous and ethanolic extracts in Candida Glabrata.

Background and Aim: Getting an informed consent as one of the principles of patients’ rights, is a process that he (she) decides on therapeutic intervention after receiving adequate information from the therapist team. The aim of this study was to explain the quality of the informed consent process of patients in surgical wards of a military hospital in Tehran and to present some solutions to improve it at 2016.Methods: The combined study was conducted in two phases. The quantitative phase was a cross-sectional descriptive study using the quality of an informed consent questionnaire that evaluated the six dimensions of informed consent with 19 questions. We evaluated the questionnaire’s content validity and its internal consistency.The Cronbach’s Alpha value of the whole questionnaire was 0.85. A stratified random sampling of 120 subjects was performed and the results were analyzed by SPSS 17 software. In the qualitative phase, which was based on the framework content analysis resulting from the results of quantitative phase, 7 experts were selected in a targeted manner and group interviews were conducted with the expert panel method. The results of the interviews were presented in two steps as: after a framework content analysis and re-approval of experts and were presented as improved suggestions.Results: In accessing the quality of the informed consent, the average score in the dimension of "providing information" with 18.93, "compliance with patients' decision-making competence" with 7.48, and "how to get written consent" with 5.47, were lower than the expected average, and the average score of "patient comprehension" with 9.77, "Volunteerism" with 8.16 and "Interaction between physician and patient" with 16.02, were in an acceptable level. The experts provided 15 improvement suggestions. The most important were "providing information to patients in the preparation clinic” and giving patients enough time to choose a therapeutic approach”." Conclusion: The quality of providing information and how to get a written consent was less than expected.Therefore, paying attention to patients’ role in the informed consent process, providing sufficient information to patients by a counseling physician in preparation clinic, training physicians and providing adequate opportunities to patients for choosing a therapeutic approach can be effective in improving the quality of informed consents.