JOURNAL OF MILITARY MEDICINE
Year:2004 | Volume:6 | Issue:3|Papers Count:15

Introduction: The problems of landmines left after armed conflicts have been increasingly publicized in recent years and are now recognised as reaching crisis proportions in many countries. In view of the fact that landmines pose a major health problem, this study sought to investigate landmine injuries in patients admitted to Sanandaj Besat Hospital between 1997 and 2002.Materials and Methods: This descriptive study recruited 134 landmine victims admitted to Besat trauma center in Kurdistan Province. Data were analyzed with descriptive statistical methods.Results: There were134 patients afflicted with landmines; most of them were referred from the Marivan City (41.2%) and 33.1% of them were students.The mean of hospitalization was 15 days (SD=13), and 278 surgical procedures were performed on 125 of our subjects. Lower limbs carried the highest rates of injuries.Discussion: Landmines are a major health risk with the lower limbs prone to the highest rates of injury.Consequently, raising awareness of landmines and their dangers seems urgent.

Introduction: Provision and supply of safe drinking water for armed forces is a very important health issue that can affect a countrys military power. Disinfection methods of drinking water include: chlorination; ozonation; flouridation; U.V; boiling and use of chlorine dioxide or a combination of these methods. This survey aimed at assesssing the disinfection methods of drinking water in military centers affiliated to Sepah.Material and Methods: 182 centers from across the country were randomly sampled in this descriptive study. Data, having been collected with a questionnaire, were analyzed with SPSS software.Results: Of the182 centers, the highest and lowest frequencies were 46.7% and 3.8%from Moghavemat Forces and the Navy, respectively. Drinking water was supplied in 63.7% of the cases from tap water, in 25.3% of the cases from well water and in 11% of the cases from other sources. Only 38.7% of the centers chlorinated their drinking water. Half of the 63.4% of the centers that performed chlorimetry reported no residual chlorine. 50% of the centers that chlonirated their own water supplies failed to add sufficient chlorine to the water. In 65% of the centers outfitted with hypochlorinator systems, the system operators were not sufficiently trained.Discussion: Surveying of drinking water quality is one of the most important health research subjects. The results of this study show that residual chlorine in dinking water in many centers was not enough. The concentration of residual chlorine is estimated to be lower than the standard level. The absence of free available chlorine (FAC) in drinking water is indicative of possible contamination and the concomitant increase in the incidence of waterborne diseases.Although disinfection is a vital process in drinking water treatment, some of the above-mentioned centers failed to perform it because either there was no equipment or the available equipment was inoperative. Monitoring the quality of drinking water through microbial sampling methods, daily chlorination and detection of contamination sources is necessary. Our results indicate that the qualitiy of drinking water in Sepah centers is not up to standard. Needless to say, provision of drinking water with the highest quality is of outmost importance.

Introduction: Paralysis of skeletal muscles, which can lead to paralysis of respiratory muscles and death, is one of the most toxic effects of organophosphates (OPs), and oximes are the only available antidotes that can reverse or prevent such toxic effects. In the present study, the possible reversal or preventive effect of different concentrations of obidoxime (toxogonin) on changes induced by paraoxon (as an OP) on the function of skeletal muscles was investigated in chicken biventer cervices nerve-muscle (CBC) preparation using the twitch tension recording technique.Material and Methods: Twitches of the CBC muscle were evoked by stimulating the motor nerve at 0.1 Hz with pulses of 0.2 msec duration and a voltage of greater than that required to produce the maximum response. Twitches were recorded isotonically using Narco Biosystems. Previous studies indicate that paraoxon at 100 nM induces a significant increase (more than 100%) in the twitch amplitude; therefore, this concentration was used to examine the possible capability of obidoxime to reverse or prevent such effects.Results: Obidoxime at 300 µM could almost fully reverse (when used as post treatment) or prevent (when used as pretreatment or at the same time as toxin) the effect of paraoxon. However, oxime at, 10, 30 and 100 µM could only reverse or reduce this effect to about 30-80%. Oxime alone had also no significant effect on the function of the muscle at concentrations used.Discussion: These data suggest that obidoxime alone may fully reverse the effect of paraoxon on skeletal muscle tissues.

Aim: Hearing loss, caused by chronic otitis media or trauma, is very common among military personnel. This study aimed at evaluating the practical results of the application of one type of prosthesis for partial or total Ossicular Chain Reconstruction (OCR) in patients referred to Baqiyatollah Hospital.Method: This is a retrograde review of 149 medical records for O.C.R. between 1997 and 2002. The aforementioned prostheses had been used during tympanoplasty as the need arose.Results: Favorable results were achieved in 85% of all the cases: 91% with the PORP and 56% with the TORP.Discussion: The PORP yields better hearing results than the TORP. Hearing results achieved with the PORP in our study are better than those reported in other studies and are comparable to autograft .TORP results in our study are same as those reported by others. In conclusion, in patients with good health status, the said prostheses are recommended for ossicular chain reconstruction.

Introduction: The routine treatment of chronic bronchitis is bronchodilator drugs and antibiotics. Sulfur mustard is cytotoxic and compromises the immune system, rendering the patient prone to various microorganisms; as a result, there is a possibility of microbial resistance to antibiotics. This study aimed at assessing common microorganisms and microbial resistance to antibiotics.Material and Methods: In this study 214 patients treated with antibiotics for chronic bronchitis induced by chemical and non-chemical agents. The subjects were divided into two groups based on the cause of infection: 117 cases induced by sulfur mustard and 97 cases caused by non-chemical agents. Streptococci A, streptococci D and streptococci non A.D, staphylococcus aurous, streptococci epidermitis, Entrobacter, Pseudomonas, E. coli, klebsiella and citrobacter were evaluated in the two groupsResults: The most common microorganism in both groups culture were: 57.9% Streptococci non A non D (50% in chemical victims and 50% in non chemical victims), 10.3% staphylococcus aurous (63.6% in chemical victims and 36.4% in non chemical victims), 9.3% pseudomonas aeroginosa (70% in chemical victims and 30% in non chemical victims).In pseudomonas aeroginosa group: in chemical victims 12 patients (85.7%) were sensitive and 2 patients (14.3%) were resistance to ciprofloxacin, in non chemical victims 6 patients (100%) were sensitive and no resistance to ciprofloxacin were reported. also in chemical victims 8 patients (57.1%) were sensitive and 4 patients (28.6%) were resistance to amikacin, in non chemical victims 4 patients (66.7%) were sensitive and no resistance to amikacin were reported.In staphylococcus aurous group: in both groups no resistance to ciprofloxacin were reported. also in chemical victims 2 patients (14.3%) were sensitive and 12 patients (85.7%) were resistance to vancomycin, in non chemical victims 8 patients (100%) were sensitive and no resistance to vancomycin were reported.In streptococci non A non D group: in chemical victims 46 patients (90.2%) were sensitive and 2 patients (3.9%) were resistance to ciprofloxacin, in non chemical victims 39 patients (72.2%) were sensitive and 7 patients (13%) were resistance to ciprofloxacin.Discussion: Since, the patient's response to ciprofloxacin was higher in both groups and also against all three common bacteria; this study could be considered a good medication in treatment of chemical or non chemical chronic bronchitis. However further analytic studies are needed to confirm this results.

Introduction: Immobility, along with other factors, results in osteoporosis in patients with spinal injury. Given immobility and possibility of local injuries among patients with spinal injury, this study sought to determine the relation between the prevalence of osteoporosis and dietary calcium intake in this group of patients.Material and Methods: This is a cross-sectional study of 27 patients with spinal injury hospitalized in Baqiyatallah (a.s) Medical Center. Demographic data and other relevant information about the patients life styles and medication for osteoporosis were obtained. Bone Mineral Density (BMD) of femoral and lumbar regions was performed, and statistical analysis was carried out using SPSS software. P<0.05 was considered statistically significant.Results: Of all the patients one case was female, and the mean age of the patients was 41.1 years (SD=4.5). The mean duration of spinal injury was 20.1+4 years. In 74.1% of the patients, injury was in the lumbar region and in 25.9% of them was in the cervical zone of the spinal cord. Mean T score of femoral BMD was -2.2+2.16 gr/Cm2; consequently, 14.8% of the patients were osteoporotic and 70.4% osteopenic. Mean T score of Lumbar BMD was 1.53+0.16; as a result, only 22.2% were osteopenic and 3.7% were osteoporotic. Of all the osteoporotic patients 92.9% and of the osteopenic ones 55.6% had daily calcium intake of less than 400 mg (P=0.023). Despite the significant correlation between BMD of femoral and lumbar regions (r=0.627, P=0.001), there was no statistically significant relation (p=0.518) for the classification of osteopenic and osteoporotic patients on the basis of the said criteria. Discussion: Our study established that the prevalence of osteoporosis in patients with spinal injury was higher than that in the normal population. Our findings tie in with those reported in other similar studies. Despite the fact that patients with spinal injury are prone to osteoporosis because of immobility, their nutritional behavior is poor. Those with a lower calcium intake have lower bone density. Fine lumbar spine fractures due to osteoporosis and immobility may explain the differences shown between femoral and lumbar BMD findings, which suggests that femoral BMD is a more appropriate diagnostic procedure in such patients.

The collection and disposal of waste has always posed a problem for human society. Mountains, ever so popular with people and tourists eager to spend time in nature, require more attention in this regard. This survey was designed and carried out to assess waste collection and disposal by a large number of army personnel climbing Mount Sabalan as part of a military maneuver.Material and Methods: 205 questionnaires were randomly distributed at the location, and the data were analyzed by statistical methods and SPSS software. In addition, everyone was given a plastic rubbish bag and instructed to take the rubbish to a designated spot on his return. Sampling, analysis and weighing were done in the place.Results: The results of this study show that on each day of the three-day maneuver there was 485 grams of rubbish per capita, comprising 18.6% cans of food, 9.3% recyclable food plates, 53.6% cardboard containers, 16.5% bread and 2% decaying substances. The average years of membership in Basij (Volunteer Mobilized Forces), climbing experience and age were 13.47%, 5.87% and 33.93%, respectively.Discussion: The survey reveals that the collection and disposal of rubbish in this camp was undesirable, although 94% of those answering the questionnaire stressed the importance of waste disposal and stated that the best way to reduce the accumulation of rubbish in mountains is to raise public awareness, consume high- calorie food and oblige individuals to collect rubbish at designated spots. There was also a direct relationship between the length of service in Basij, climbing experience and age with the rate of waste collection and disposal. Raising public awareness and education, the most fundamental factors in tackling pollution in mountains, can reduce up to 70% of the rubbish usually accumulated. Furthermore, environmentally friendly packaged food, allocation of clearly-signed waste disposal spots and deployment of a team of hygiene experts are highly recommended.

Introduction: The aim of this survey was to assess the diagnostic coordination level between psychiatric interviews and psychological tests. The validity of MMPI and severity of PTSD were also evaluated.Material and Methods: The authors compared MMPI scores of 20 inpatients and 20 outpatients diagnosed as post-traumatic stress disorder (PTSD) from semi structured PTSD clinical interviews. We also compared other clinical data and validity of MMPI and severity of PTSD in both groups.Results: Among the main symptoms and signs of PTSD, the scores of recurrent distressing dreams of event, hyperarousal and startled response, diminished interest and sleeping difficulties were higher in the inpatient group, and the scores of irritability, restricted range of emotions, flash backs, difficulty in concentration and physiological reactivity were higher in the outpatients. Except K-Hs and Ma scales, there were no significant differences in clinical and validity of MMPI between inpatients and outpatients.Discussion: The findings of this survey demonstrate coordination between clinical diagnosis and validity of MMPI. 

Introduction: Many respiratory, skin and other health disorders are associated with and spread by outdoor and indoor bioaerosols. Air born infectious, allergen agents and fungal agents can be sampled and enumerated by various collection and analytical equipment.Method: The impactor, impinger, filter and spin con are introduced in this study and the efficiency of various devices is compared with one another.Results: The review of findings shows that the spin con collects a larger number of spores in comparison with other devices. The number of collected spores by this unit per volume of air sampled is close to that by the AGI-30.Discussion: The spin con is a device that has efficiency for sampling high volumes of air and can analyze samples for the presence of spores and fungi. The AGI-30 has good efficiency for pollens, microbes and spores. Basically, air filtration has very high efficiency of up to 99% -100%, but it is more applicable for dryness resistant bioaerosols.

Introduction: Armed conflict is associated with significant long-term psychiatric morbidity. The concept of early psychological intervention in response to traumatic events has been a compelling notion since World War I. The objective of this survey is to assess and provide an approach to psychological problems in war zones.Methods: Psychological interventions to reduce the incidence of psychiatric disorder following psychological trauma may be classified into three categories: 1- Primary prevention includes the selection, preparation and training of individuals likely to be exposed to potentially traumatizing events; 2- Secondary prevention comprises a variety of brief psychological techniques immediately or shortly after traumatizing life events, the best known of which is Psychological Debriefing; and 3- Tertiary interventions consist of the treatment of established PTSD and others.Results: Relying on five principles and devised in World War I, standard intervention for combat stress reaction.Discussion: The end of a mission finishes stress. Being informed about the time of the end of the mission and its related stress elevates ones tolerance. In general, one-year missions reduced the number of psychological traumas.