JOURNAL OF MILITARY MEDICINE
Year:2007 | Volume:9 | Issue:2 (32)|Papers Count:14

Introduction: As a consequence of radio-terrorism or nuclear-radiological accidents dispersion ‎of 131I can lead to internal contamination resulting in salivary gland damage. 99mTc salivary ‎scintigraphy is a simple and confident technique for measuring indices of salivary gland function ‎quantitatively by which the severity of salivary gland dysfunction can be determined.‎ The chance of the accidents are significantly higher among active, employed people (18-50yr).The objective of our study is collecting a normal data base of quantitative indices for salivary ‎scintigraphy in this age group as a base for post-accident evaluation of victims.‎Material and Methods: Dynamic salivary gland scintigraphy was performed for 120 ‎consecutive patients (18-50yr‎‏ ‏mean 31.6) excluding those with signs or symptoms of xerostmia.From 30 second frames time-activity curve was extracted and post-stimulatory excretion fraction (EF) and relative integral of uptake (Int%) was calculated for each major salivary gland.‎Results: Mean EF with 95% confidence interval for parotid and submandibular was 77-79.5% ‎and 58.8-61.5% respectively. Mean Int% for parotid and submandibular was 27.3-29% and 21-‎‎22.5% respectively. Generally Int% of parotid and submandibular in 95% of the patients was ‎‎>15% and >10.7% respectively and EF of parotid and submandibular in 95% of the patients was ‎‎>57% and >36.8% respectively.‎Discussion: The normal ranges can be used in working patients suspected for salivary gland ‎dysfunction after an accident.‎

Introduction: T-2 toxin, an important member of trichothecene mycotoxins family, disturbs ‎structures and functions of many parts of human and animal immune system. Our previous ‎studies showed that peritoneal inoculation of T-2 toxin changes normal proportion of mouse‎peripheral blood lymphocytes and antioxidants may affect the phenomenon. In the present study, ‎the effects of two well-known antioxidants, Selenium and Vitamin E, on these T-2 toxin induced ‎abnormalities are compared.‎‏‏Material and Methods: A single sub lethal dose of T-2 toxin (2 mg/Kg) inoculated to a group ‎of mice and at different times after intoxication the peripheral blood lymphocytes counted by ‎flow cytometry method. Then, 4 separate groups of mice received T-2 toxin and selenium ‎sulphide or vitamin E, and proportion of the lymphocyte subpopulations were determined in their ‎peripheral blood samples.‎Results: The results showed that T-2 toxin affects normal proportion of all studied lymphocytes. ‎CD19+ and CD8+ lymphocytes decreased and CD4+ cells increased after receiving a single sub ‎lethal dose of the toxin. Peritoneal injection of selenium in both condition, concomitant or before ‎T-2 toxin, prevented CD19+ cells reduction but, vitamin E had no effect on reduction process of ‎this subpopulation. When, selenium inoculated at intoxication time, the increasing of CD4+ ‎population prevented completely but, vitamin E had no efficacy in this condition. In contrast, ‎injection of vitamin E, 24 h before the toxin, significantly affected the CD4+ proportion and ‎prevented the increasing of the subpopulation while, selenium was ineffective in this manner. ‎Receiving of vitamin E in both condition, before and at intoxication, prevented reduction of ‎CD8+ cells while selenium repair the problem only when received concomitant with the toxin.Discussion: It is concluded that to cure T-2 toxin induced abnormalities in lymphocyte ‎subpopulations, efficacy of selenium and vitamin E varies depending on inoculation time of ‎these antioxidants as well as type of disturbed lymphocyte, and it seems that selenium received ‎immediately after intoxication provides more efficacious results while usefulness of vitamin E is‎more when received prior to intoxication.‎

Introduction: Bacteria are the most important factors for food contamination and intoxications, ‎and more than 70% of these diseases are only due to a couple of important bacteria (‎Staphylococcus aureus, Eschersia coli, Listeria monocytogenes, Clostridium perfringenes and ‎Bacillus cereus). The aims of this study are determining of microbial contamination and survey of‎ Coli forms and pathogens bacteria in the consumpted foods and compaired to international ‎standards as well.‎Material and Methods: In this descriptive study, 72 samples of 4 types of consumpted foods in ‎‎6 centers evaluated and tested with respect to bacteria contamination with the standards method ‎of American Public Health Association (APHA) and Food and Drug Administration (FDA).‎Results: According to total bacteria and coli form count and contamination to pathogenic ‎bacteria, roast meat and fish are known as the most contaminated and safe foods respectively. ‎ From 18 tested samples, 7 sample ( 38.9%) and 10 samples (55.6%) contaminated with E.coli ‎and S.aureus respectively. None of 72 tested samples were also confirmed with respect to‎Salmonella and Listeria monocytogenes.‎Discussion: According to bacterial standard of cooked foods, some of prepared foods in the ‎belonging centers to Baqyatallah University were contaminated more than the recognized ‎standard level, that is possibilities of the university.‎

Introduction: Crimean-Congo hemorrhagic fever is a viral zoonotic infection which several ‎cases of that have been reported in Iran.Regarding the recent breakouts in many countries ‎including Eastern bordering countries of Iran and high mortality rate, this study was performed to ‎determine geographical distribution of ovines - with positive IgG antibody against Crimean - ‎Congo hemorrgagic fever in Isfahan province of Iran in 1383-1384.‎Material and Methods: This cross sectional study is a collaborative work with Arbovirus and ‎hemorrhagic fever laboratory of Iran Pasteur Institute. 107 ovines were selected randomly from ‎Isfahan grassland and then were checked for Crimean - Congo antibody by Elisa method.‎Results: out of 107 ovines, 58 (54.2%) had positive serology, 47 (43.9%) had negative serology ‎and 2 (1.9%) had borderline result. Regarding Geographical distribution, the most infected ‎Grassland was Natanz (71.4%) and after that Isfahan, Borkhar, Falavarjan and Freydan. ‎considering age distribution the most infection was reported between the ages 4 to 5 (62.5%).‎Discussion: The results of this study revealed the endemic spreading of CCHF in the ovines of ‎Isfahan province. Although, the incidence rate is increased in comparison to the past decades, the ‎same has not been observed in the recent years which is inline with the similar studies. therefore, ‎improvement the health care and conducting serial seroepidemiologic studies to assess the effect ‎of such measures seems necessary.‎

Introduction: Safety is the state in which the risk of harm to persons or of property damage is ‎reduced, and maintained at or below, an acceptable level through a continuing process of hazard identification and risk management. A safety management system is an organized ‎approach to managing safety, including the necessary organizational structures, accountabilities, ‎policies and procedures. The responsibility for safety and effective safety management is shared ‎among a wide spectrum of organizations and institutions on whole of succession of management.‎Material and Methods: The study, cross-sectional, was conducted in the 2006. the wards of ‎Bagiyatallah (a.s) hospital comprised the study population. The data was collected by a self-‎constructed questionnaire and cheklist. Content validity and test-retest were used to determine ‎validity and reliability of the instrument. Data analysis was carried out throgh SPSS‏.‏‎Results: The findings of the study showed that organization and management of safety ‎committee (55.33 of 100) have proper condition. policy, regulation and rules with 52.50±‎‎11.54 score were to the average. Training and socialization on safety with 100 score was ‎founded the saturation point.Organization structure (52‎‏±‏‎17/88) were the middling. Risk‎management on hospital (67.51±9.75) to be suitable. safety and health (55.56‎‏±‏‎8.81) From the ‎viewpoint of structural were founded to medium extent.‎Discussion: In any system, it is necessary to set and measure performance outcomes in order to ‎determine whether the system is operating in accordance with expectations, and to identify ‎where action may be required to enhance performance levels to meet these expectations. The‎introduction of the concept of acceptable level of safety responds to the need to complement the ‎prevailing approach to the management of safety based upon regulatory compliance, with a ‎performance-based approach. In order to keep safety risks at an acceptable level with the ‎increasing levels of activity. Modern safety management practices are shifting from a purely ‎reactive to a more proactive mode. It must be emphasized that this approach complements senior‎management’s commitment to the management of safety, effective implementation of standard ‎operating procedures systems, analyse and share safety-related data arising from normal ‎operations, integration of safety training.‎

Introduction: Workplace violence has become a global alarming phenomenon and its ‎expression in physical assault, homicide, verbal abuse, bullying mobbing and sexual and racial ‎harassment. Health sector personnel are particularly at risk of violence in their workplace whose ‎precise dimensions of the problem have not been found. The aim of this study was assessment of ‎exposure or non exposure of‏ ‏nurses with Physical violence during last year and role of some ‎related factors.‎Material and Methods: Study population consisted of nurses with at least one year of ‎employment employed in academic hospitals of Baqiyatallah medical university‏ ‏which 450 ‎nurses were selected by simple randomized sampling. Data collection was carried out with a ‎standard questionnaire derived from cooperation of WHO, ILO and other authoritative centers. ‎Questionnaires were given and taken by a general physician. Period of data collection was six ‎months (October 2006 to February 2007) Data analysis was carried out by Chi square method.‎Results: Of total 450 nurses, 96 (21.3%) had at least one experience of physical violence in their ‎workplace. Exposures were higher in persons more than 35 years old, in nurses with longer time ‎of experience in men and in registered nurses. Most of violent persons were relatives and patient‎respectively. In most cases there were no reporting and most of reports had not any results.‎Discussion: In this survey the prevalence of workplace violence was not higher than some ‎similar studies (22% to 38.9%). But this result should be interpreted carefully because of nurses’ ‎hesitation, recall bias etc. Furthermore explaining of preventive programs, good management ‎and appropriate reporting should be considered.‎

Introduction: Blood loss is the major cause of death during the war. However, it can be ‎prevented by prompt medical interventions.‎Objectives: To design, build up and evaluate an elastic band utilizable by an unaided injured ‎combatant.Material and Methods: Sample bands made up of silicon underwent laboratorial and clinical ‎evaluation. For laboratorial evaluation, chemical and physical examinations were performed. For ‎clinical evaluation, 20 specialists and 20 patients applied the elastic bands experimentally. Their‎opinions were collected using a questionnaire.Results and conclusion: The results revealed that the quality of elastic bands in the points of ‎size, wound covering and hemostasis potentials, being washable, sterility, and usability by one ‎hand was acceptable.‎

Introduction: Solid waste is one of the important environmental pollution. With improvement of technology and increase of population, production of Solid waste is more and more diverse. The resultant special attention to solid waste management (SWM) is very important. Now day methods of SWM that were conducted in hospitals of IRAN, in some cases aren't correct and complete, and needs to optimize. The aim of this study was to survey quantity of solid waste production in hospital (that is specialist and one of the largest hospitals in Tehran with 682 beds) for determination of present situation and Comparison results with others.Material and Methods: This is a description cross sectional study, about quantity of solid waste production in one specialist hospital. We weighted infection and general waste production during 85 days in days of week Saturday - Friday in at 23-24 o'clock of night before transported to out of hospital by shahrdary. The data obtained were analyzed statistically using by SPSS software and ANOVA and Tukey test.Result: The results showed that the mean weight of general waste production had a significant difference between Friday and others days of week (p<.05). -Mean density of general and infection waste was 101.15 and 94.63 kg/m3. -Mean weight of general and infection waste 1297.6 and 640.86 kg/day and mean bedridden was 431 disease /day. -Mean weight of general and infection waste production per diseased per day were 3.07 and 1.52 and total 4.58 kg/diseased. -The cost of only disposal solid waste production from hospital per diseased per day was 2131 rials. From Total solid waste production, general and infection waste was %67 and %33.Discussion: In survey of SWM in hospital, determination the present situation, quantity and mean solid waste production per diseased or beds per day is very important and we attended that during this study. Production of total solid waste was 4.58 kg/day and in comparison with quantity of expected in IRAN (2.71 kg) and %33 from total waste production was infection waste and in comparison with quantity of expected in WHO for developing country (%10-%15) are very high, because the separation of general and infection waste wasn’t complete conducted. The result from this study show that stages of SWM in hospitals of IRAN to have need optimization and more attention through support by managers in hospitals and government.

Objective: To study the occurrence of emphysema and accuracy of Pulmonary Function Test ‎‎ (PFT), comparing with chest High Resolution Computed Tomography (HRCT), in smokers with ‎history of exposure to toxic fumes (Sulfur Mustard SM).Material and Methods: This was a cross sectional study (2003- 2004) on 20 symptomatic ‎smokers with mild SM exposure (Group I) and 20 smokers without SM exposure (Group II). ‎PFT and CHEST HRCT were performed for all patients to detect emphysema. Sensitivity, ‎specificity, and positive and negative predictive values were calculated for PFT.‎Results: PFT did not diagnose emphysema in group I while CHEST HRCT diagnosed five ‎patients (sensitivity=0). Group II developed emphysema (11 of 20, 55%) more frequently than ‎group I (5 of 20, 20%, p<0.05). No a1-antitrypsin deficiency was found in all 70 individuals.Conclusions: Smokers with an additional risk factor, such as exposure to toxic fumes, develop ‎emphysema at younger ages while they have normal PFT. CHEST HRCT should be regarded as ‎a useful tool in the early diagnosis of emphysema in such cases.‎

Background: the bam earthquake, which struck on 26 December 2003, at 5:26 am, destructed ‎Bam city and villages around it. In this event approximately 40000 of people were died and ‎injured. Knowledge about type and severity of injuries in victims is useful to selection an ‎appropriate management.‎Material and Methods: in this descriptive cross-sectional study, we evaluated medical records ‎of victims whom referred to the Tehran' s military and nonmilitary hospitals by statistical indices ‎whit SPSS Version 13 Chicago. These data including Reception information, Demographic ‎data, vital sign, consciousness level, diagnostic procedures, type of injury, diagnosis, treatment ‎type, and outcome in the Emergency department and ward.‎Results: Data from 854 victims of Bam earthquake who referred to Tehran hospitals, the ‎number of victims were admitted in military and nonmilitary hospitals were 510 (59.7%) and ‎‎344 (40.3%), respectively. Overall, 54.7% were male. The most common Therapeutic ‎intervention in Emergency room was: fixation of limbs in 389 (39.9%). Among 945 injuries, the ‎most common diagnosis were Lower extremity fractures in 291 (30.8%) ‎ ‎ In 242 cases, surgical procedures were done. 38 victims admitted in intensive care unite. Mean‎of ISS (Injury Severity Score) was 6.7 and 11.9% had ISS more than 15 (severe injuries).‎Conclusion: Majority of problem of victims were orthopedic injuries, thus, special attention has ‎to be focused for providing of recourses and expert personnel in peripheral areas.‎