JOURNAL OF MILITARY MEDICINE
Year:2007 | Volume:8 | Issue:4 (30)|Papers Count:15

Introduction: The current study aimed to estimate the self reported smoking habit in subjects with chronic Bronchiolitis Obliterans (BO) due to Sulfur Mustard; Not only healthy people smoke, but also patients with chronic lung disease.Materials and Methods: In this cross-sectional study, 473 subjects with chronic BO due to sulfur mustard were selected from clients to pulmonary clinic in Baqyiatallah (a.s.) hospital in 2005. Consecutive sampling was done. Demographic, clinical and para-clinical data [spirometry and chest HRCT (High-resolution computed tomography)] were registered. Self reported cigarette smoking habit (pack/year and history of smoking cessation) was also asked.Results: 56 subjects (11.8%) reported cigarette smoking. 8 patients (1.7%) had the positive history of cigarette quitting, all had lost the quitting. Smoking was associated with a higher frequency of obstructive pattern in spirometry (p=0.034), but was not significantly correlated with other spirometric findings, patients history, symptoms or HRCT findings (p>0.05)., History of smoking cessation was not statistically correlated with any of the study variables (p>0.05). 7 veterans (1.7%) from those claimed to be never-smoker had emphysema in HRCT.Discussion: However the prevalence of self reported cigarette smoking was not high in the current study, it seems that smoking prone this population to obstruction of airways. It is essential for health care supervisors and providers of population affected with chronic BO in Iran to pay more attention on smoking cession programs. While about 2% of veterans claimed no smoking, emphysema showed that they do smoke for several years, smoking assessments need to be done using laboratory and more reliable techniques.

Introduction: Stress is a phenomenon puts human in the shade by development of technology. This study was performed to determine the stress of military personnel of Persian Gulf with respect to geographic features (warm, humidity...) and the sensitivity of the region.Material and Methods: This was a descriptive cross-sectional study. The samples were 766 military personnel of Persian Gulf selected via clustered sampling. The instruments of the study were a self-made stress questionnaire and Holmes and Rahe questionnaire.Results: Mean score of samples was 204. While the accepted score of Homes and Rahe questionnaire is 100. Also, 34% of samples scored higher than 250 and 38% from 100 to 250. Discussion: Mean score of samples was at least double than normal range and in respect of questionnaire prediction norm the persons who scored between 100 -250 were more vulnerable (50%) to psycho-physiological disorders.

Introduction: Knee pain is one of the most common musculoskeletal complaints.Musculoskeletal injuries resulted of overuse, reduce the efficiency of training among recruits underwent basic military instruction. The aim of this study was to determine the effect of basic military training on knee pain and muscular flexibility of lower limbs.Materials and Methods: 100 soldiers (having no complaint of knee pain) from military training center of Birjand (0-4) were studied. Physical examination of knee and passive range of motion of lower limbs were assessed before and immediately after a 3-month priod of basic military training. All musculoskeletal complaints and injuries were documented prospectively during the study. Data was analyzed with SPSS11.5. Wilcoxon and ANOVA were used to compare mean values and significancy level was considered at p<0.05.Results: During the study, 20 soldiers (20%) complained of knee pain. Frequency of positive sherug test increased (p<0.05) but no significant changes in the results of other tests were seen.At the end of the training, flexibility of all tested muscles was improved: Hamestrings (7.91±0.57%), Gasterosuleus (25.72±2%), Thigh adductors (32.66±2.52%) and Quadriceps (7.81 ±0.79%).Discussion: Pattelofemoral syndrome was the most common finding in new cases of knee pain during the military training period. Due to high incidence of muscle shortness, an appropriate stretching exercise is recommended both to improve flexibility and prevent injuries.

Introduction: Pruritus, a chronic symptom caused by Sulfur Mustard, is a common problem among veterans. Numerous treatments like anti-histamines, local anesthetics and corticosteroids have been prescribed in order to control pruritus in these patients, while long term and widespread use of each one has its own restrictions. Nowadays different mixtures including Unna's Boot, are being used. They are effective and have limited adverse effects. So in this study we compared this product with corticosteroids.Materials and Methods: In this double-blind randomized clinical trial in Baqiyatallah (a.s.) hospital, 90 veterans were included and randomly divided into three groups. Subjects of each group received one of the Betamethasone 1%, Unna's Boot or placebo creams for three weeks. They used their medication on an itching area of body, one finger tip unit every night. To evaluate the drugs' efficacy we used pruritus score and (Visual Analysis Score) VAS indecies. Results: From 90 patients, 75 patients completely used the medication and the rest 15 subjects, excluded from the study. All three drugs caused significant decrease in both pruritus and visual analysis score indecies (P<0.001). Betamethasone and Unna's Boot were significantly more effective than placebo and despite more efficacy of betamethasone rather than Unna's Boot, they did not have any significant difference (P>0.05).Discussion: Pruritus is a chronic symptom in veterans which needs long time symptomatic treatment. Regarding definite side effects of local long term therapy with corticosteroids and nearly equal efficacy of Unna's Boot and betamethasone, Unna's Boot seems to be a better choice in controlling Sulfur Mustard-related pruritus.

Introduction: This study was carried out to determine the relationship between value system and adjustment in women who work in Sepah-pasdaran.Materials and Methods: It was a cross sectional-descriptive study. 662 military were selected randomly from ten states of Iran. Lotfabadi's questionnaire of value system and Bell's questionnaire of adjustment were given to the participants and asked to fill them. Collected data was analyzed via descriptive statistics and analysis of variance.Results: The value preferences in this study were religious, national, social, familial, scientific, economic, art, individual, political and globalization, ordinarily. The results demonstrated that good adjustment had positive relationship with religious value and negative relationship with economic and globalizational values.Discussion: Level of adjustment will decrease if a value opposes the values of society.

Introduction: The changes in blind locomotion originate in stress on musculoskeletal tissue and cause different musculoskeletal dysfunctions. This study aimed to determine epidemiology of musculoskeletal pain in blind veterans.Material and Methods: Data collection in this cross-sectional study was through questionnaire and physical examination from all 385 blind veterans participated in therapeutic and sportive camp of Iranian blinds veterans (mashhad, 2005).Results: The results of this study showed the epidemiology of musculoskeletal pain in blind veterans as the following: knee pain (63.3%), low back pain (35.84%), ankle pain (30.64 %), shoulder pain (30.12%), neck and back pain (22.59%).Discussion: According to the findings, the prevalence of musculoskeletal pain in blind veterans is more than normal population, and they should be trained to prevent, care and treat musculoskeletal pain.

Introduction: According to World Health Organization (WHO), 1.2 million die because of car accident annually. Car accidents result to approximately 20-50 million injuries and disabilities. More than 90 percent of road death belongs to the countries with low and averaged income. In spite of decreasing car accidents in developed countries, its rate has been increased about 65 percent in developing countries in two recent decades. In Iran, car accidents are increasing despite all efforts to control it and this statistics has been greatly occurred in military organizations. This study was done on the land forces of Sepah-Pasdaran in Tehran. Materials and Methods: This was a cross-sectional descriptive study included all 197 recorded car accident files in the center of land force in Tehran. A researcher made questionnaire with high validity and reliability was used to collect data. The collected data was analyzed by SPSS software.Results: The results indicated that 45.7 percent of drivers having accident were soldiers 32.5 percent were official personnel and the rest included day and conventional workers. Among all accidents, 26.4% was reported inside the centers, 32.5% in city area, 12.2% between cities and others were occurred in undetermined domains.Official members, soldiers, and day workers were guilty in 67.9%, 75.6%, and 76.9% of accident respectively. Moreover, the persons who educated below diploma had more car accident comparing diploma or higher.Discussion: The results showed that high educated drivers had lower car accident because of obeying driving rules. Therefore, to reduce different losses of life and property, it is recommended to use official and married personnel rather than soldiers and day workers. 

Introduction: Low back pain and one of its reasons, disk herniation, is one of the most prevalent musculosceletal complaints of military patiants resulting in loss of property and time.Discectomy is the most frequent surgery on these patients. The main purpose of this study was to compare the results of discectomy in military presonnel with civilians. Materials and Method: This cross-sectional study involved 117 military (54 combat and 63 official staff) and 115 civilian patients underwent discectomy surgery between 1999-2002 in Baqiyatallah (a.s.) Hospital. Demographic data was collected through patients' medical files; satisfactionary level after surgery was measured using (Visual Analog Scale) VAS; and the ability to return to work and complaints after surgery were assessed during follow up through a mean time of 50.8 months. Data analysis was done through descriptive indicators and statisical tests like X2, Mann-Whitney and Fitcher using SPSS13 software.Results: Two studied groups were similar in case of age and gender. Disability to return to work showed a significant difference between military and nonmilitary patients (p=0.002) and between combat and official staff (P<0.001). The mean value of patiants' satisfaction in civilians was significantly more than military patients (P=0.02). But This difference was not observed in military subgroups. Complaints after surgery have not significant difference between military presonnel and civilians.Discussion: According to the findings of this study surgery had poor outcomes in military patients especially in combat forces regarding their heavy activities. So, first of all it should be tried to prevent harmful damages to lumbar spinae; and in presence of disc herniation clinical symptoms, it preferred to keep implementation of military forces by conservative treatments. If these ways had no outcomes or in absolute surgery indications discectomy is inevitable. 

Introduction: Low back pain and one of its reasons, disk herniation, is one of the most prevalent musculosceletal complaints of military patiants resulting in loss of property and time.Discectomy is the most frequent surgery on these patients. The main purpose of this study was to compare the results of discectomy in military presonnel with civilians. Materials and Method: This cross-sectional study involved 117 military (54 combat and 63 official staff) and 115 civilian patients underwent discectomy surgery between 1999-2002 in Baqiyatallah (a.s.) Hospital. Demographic data was collected through patients' medical files; satisfactionary level after surgery was measured using (Visual Analog Scale) VAS; and the ability to return to work and complaints after surgery were assessed during follow up through a mean time of 50.8 months. Data analysis was done through descriptive indicators and statisical tests like X2, Mann-Whitney and Fitcher using SPSS13 software.Results: Two studied groups were similar in case of age and gender. Disability to return to work showed a significant difference between military and nonmilitary patients (p=0.002) and between combat and official staff (P<0.001). The mean value of patiants' satisfaction in civilians was significantly more than military patients (P=0.02). But this difference was not observed in military subgroups. Complaints after surgery have not significant difference between military presonnel and civilians.Discussion: According to the findings of this study surgery had poor outcomes in military patients especially in combat forces regarding their heavy activities. So, first of all it should be tried to prevent harmful damages to lumbar spinae; and in presence of disc herniation clinical symptoms, it preferred to keep implementation of military forces by conservative treatments. If these ways had no outcomes or in absolute surgery indications discectomy is inevitable.

Introduction: Bronchiolitis Obliterans (BO) is known as a side effect of sulfur mustard (SM) exposure. Long term prescription of low dose macrolides has been found to be effective in BO. There is no report on the side effects of these drugs on sulfur mustard-induced BO. We compared the side effects of Erythromycin (EM), a member of macrolide family, with low-doses (400 mg daily) for 6 months versus placebo in treatment of BO induced by S M.Materials and Methods: This study was a double blind clinicaltrial carried out in Chemical Injuries Research Center of Baqyatallah (a.s.) University of Medical Sciences. 120 SM- induced BO patients were categorized randomly in group 1 (n=60, EM 400 mg daily) and group 2 (n=60, Placebo). Patients received EM or placebo during a 6-month period. Side effects such as headache, maculopapular rash, pharyngitis, nausea, diarrhea, abdominal pain, dizziness, vomiting, fever and icter were assessed and compared in both groups before and after treatment. Results: The most common side effects in group 1 were pharyngitis (36.36%) and headache (36.36%), and in group 2 pharyngitis (37.50%) and maculopapular rash (37.50%). The prevalence of headache, abdominal pain, icter, dizziness, vomiting and diarrhea in group 1 was more than group 2 (p<0.05).Discussion: According to the previous studies which demonstrated severity of side effects of EM resulted in decreasing use of it and its therapeutic outcomes, it is recommended to use other macrolides like clarythromycin and azythromycin in Bronchiolitis Obliterans due to sulfur mustard.