JOURNAL OF MILITARY MEDICINE
Year:2004 | Volume:6 | Issue:2|Papers Count:16

Introduction: Today hepatitis B is one of the biggest challenges the medical community faces the world over. Transmission modes are non-percutaneous and percutaneous; of the former those thought to have the greatest impact are sexual contact and prenatal transmission. We conducted a cross-sectional study to determine the prevalence of hepatitis B infection among family members of HBV carriers with particular emphasis on the clusteration of infection in the families of military patients. Materials and Methods: Family members of 250 HBV patients at Tehran Hepatitis Center were evaluated between 2001 and 2002. Questionnaires were filled out including the patients demographic information, disease and vaccination status and the status of HBsAg in their family members. Vaccination and prevalence rates of HBsAg were calculated for different groups. Results: From a total of 1086 family members, 1057(97.2%) were checked for HbsAg. 16.3% of those checked were HBsAg positive. The highest carriage rate was observed in the mothers of the patients (33.3%), followed by their sibling (30.7%), fathers (28.8%), spouses (8.0%) and children (6.5%) The prevalence rate in the family members of female patients was found to be significantly higher than that in the males (28.8% vs. 11.7%, p<0.05). The families of military patients were significantly less HBsAg positive in comparison with those of the civilians (1.98% vs. 20.8%, p <0.05). Discussion: The results of this study indicate that the families of HBV carriers are considered a center of clusteration of infection in Iran and that percutaneous exposure is the main mode of transmission. A higher contribution of health centers for armed forces and commitment to discipline in the military population have led to a significant decrease in the carriage rate in this group. Screening of family members of HBV carriers and subsequent vaccination of seronegatives are highly recommended

Introduction: The objective of this research was to evaluate the mental health level of 430 randomly selected recruits to the Land Force, Air Force, Navy and the University of Sepah (The Islamic revolutionary guards) who were doing their basic military training course.Methods: The data obtained from questionnaires on the personal details and symptoms checklists (SCL-90-R) of the subjects were analyzed by T-test, ANOVA and LSD.Results: The results showed that the average age stood at 21.85 ± 3.07 and that while paranoia, obsessive- compulsive disorder and interpersonal sensitivity were the most common problems, phobia, aggression, somatic problems and anxiety were the least frequent ones. Furthermore, the average of positive symptom total (PST) was 28.72±53.18. Those serving in the Land Forces exhibited the most symptoms, whereas the ones recruited to the University had the fewest problems, which indicated a significant difference between the groups. The cut-off point of mental health showed that 81.9% were recognized as healthy individuals, but 18.1% were prone to mental disorders.Discussion: A comparison based on SCL-90-R between these two groups is indicative of a significant difference, hence the necessity of a thorough evaluation of mental health level in the recruitment process of Sepah personnel.

Introduction: Conducted in 2001, this descriptive study aimed at investigating the problems faced by the families of those personnel of Sepah (The Islamic Revolutionary Guard) who died between 1980 and 1998.Methods: 210 families were recruited to the study randomly, and the data were analyzed by t - test and ANOVA.Results: The findings revealed that in order of frequency, economic hardship followed by difficulties in running the household affairs and supervising the children, and problems in cultural and social relationships were the most significant challenges. These results were analyzed based upon such variables as the number of children and their age educational qualifications, occupational status, time elapsed since the passing of the father and whether or not the mother had remarried.Discussion: we found out that different problems in childrens of families that their mothers worked out was less than families that their mothers did not work and management of problems was easy. Management of families that their mother was studied at high school or university and in families that they have 3 or less children was easier than other families.Also financial problem in families that their mother is less than 30 years old is less than others.

Introduction: AIDS is a pandemic disease worldwide; W.H.O. has estimated that 75 million will have been infected by HIV by the end of 2005. Currently, there are 6600 AIDS patients in Iran. An effective way of curbing the AIDS pandemic is raising public awareness of HIV transmission.Methods: This is a descriptive study into AIDS awareness among 400 army cadets, who completed a twenty- item questionnaire on the transmission modes of AIDS. The answers were awarded points based on the three categories of questions: very significant, significant and insignificant. The results were then analyzed by SPSS v.12.Results: All the army cadets were men with a mean age of (19.11±1.06SD) years. The average score was (86), based upon which the levels of AIDS awareness were determined as excellent (16%); good (39%); mild (36%); and weak (11%). There was a significant correlation between the acquired and predicted levels of awareness (P<0.001). 99% and 95% of the subjects, respectively, gave correct answers about the tow most important ways of AIDS transmission, i.e. sexual contact and collective use of syringes. The television (46.8%) was the most important source of information on AIDS, followed by publications (23%). 82.8% of the subjects were holders of high school diplomas, and there was a significant relationship between the level of education and the degree of awareness (p=0.016).Discussion: We conclude that army cadets awareness of AIDS is insufficient; consequently, the mass media and the television in particular should heighten public awareness. We also recommend that the methods of education be further evaluated so that the best possible means can be determined.

Introduction: Tuberculosis is an infectious and contagious disease. In endemic societies, the young are more prone to this infection (<20 yrs).Military barracks, due to their special geographical locations and the congregation of different people with various social, economic and hygienic conditions, are regarded as high risk places.Tuberculin test or mantox is a common screening test of tuberculosis. The purpose of this research was to determine the prevalence of positive PPD among the military personnel located in Tehran.Material and methods: In this study, 1000 soldiers selected from two different barracks in Tehran completed a special questionnaire before undergoing a standard PPD test. The PPD reaction was observed after 72 hrs. Additional clinical studies for those with pulmonary signs and symptoms were performed, too.Results: The mean age of the conscripts was 20.8 (SD 3.3). In 4% of the subjects, the PPD test was positive. 30% of them, who had a positive PPD test, had a history of coughs. The results of the smear and sputum culture were negative.Discussion: Since all the cases had received a BCG vaccination program in childhood, we did not expect to have a positive PPD test with induration of over 10 mm. Yet, 4% had a positive PPD test with induration of over 10 mm. whereas positive PPD with induration of less than 10mm and without the clinical signs of tuberculosis is an indicator of the level of immunity, a positive PPD with induration of over 10 mm is evidence of PPD conversion.Although more research is required, our findings underscore the necessity of control in this group.

Introduction: Lactate threshold (LT), a measure of exercise capacity, is the highest oxygen uptake during exercise without developing lactic acidosis. The Gold standard method for determining LT is to measure blood lactate concentration. It is reported that in exercise saliva lactate can be measured non-invasively in lieu of blood lactate.Methods: This study was designed to determine whether measurement of saliva lactate can be used as an alternative for blood lactate in the chemically injured. For this purpose, 17 patients were randomly sampled. They pedaled on an ergo meter until exhaustion. Blood and saliva lactate levels were measured before, immediately after and thirty minutes after the exercise. Data were compared with those obtained in the sex and age-matched control group.Results: show that blood and saliva lactate increase during exercise in both groups (P<0.05). This increase, however, dose not show a significant correlation between blood and saliva lactate levels.Discussion: In light of this exercise protocol we conclude that measurement of saliva lactate cannot replace measurement of blood lactate.

Introduction: Coronary artery diseases, the most prominent of which is myocardial infarction, are the biggest causes of mortality (1) in the world.On account of the fact that there were no statistics about the mean age of infarction in military personnel and the possibility that it could be low, this study was conducted to determine the mean age of myocardial infarction in the military and compare the results with the mean age of infarction among civilians.Methods: 372 patients with diagnosis of myocardial infarction admitted to Baqiyatallah and Jamaran Hospitals between 1991 and 2001 were selected, and the results were analyzed statistically using SPSS software.Results: From a total number of 372 patients, 73 were military and the rest were non-military people. The mean age of MI in our overall study was 61.2 and 49.7 years among the civilians and non-civilians, respectively. In 1991, however, the mean age was 60.6±11 for non-members and 53.8±8.5 for the members of the armed forces (P=0.03). In 2001, the mean age was 61.8±11 for civilians and 45.7±8.4 for the military staff (P<0.001).Discussion: The mean age of MI is about 10 years lower in our country in comparison with that in developed countries, and there has been no significant change in the recent decade. This mean age is about 11 years lower in our armed forces. Risks factors, especially cigarette smoking and hyperlipidemia, and an unhealthy life style could be the probable causes of a lower myocardial infarction age among our military and non-military people.

Introduction: Self-infliction by slashing the head with blades, albeit now treated as taboo by many religious authorities and their followers, is historical heritage for Shiite Muslims in Ashoura ceremony and is therefore still practiced sporadically. This study aims at describing various types of scalp laceration and their treatment for physicians unfamiliar with the management of this rare multiple injury.Materials And Methods: We descriptively compiled data on 103 consecutive Iranian adult pilgrims to Karbala, Iraq who were referred to an Iranian emergency field unit over a two-hour period. Evaluation was conducted in terms of age, place of birth, wound depth and length, severity of bleeding and treatment modalities.Results: The mean age of the injured was 33.49 (± 1.03). A large proportion of them spoke the Azari language (62.2%), but the rest were from Isfahan, Qum, Tehran, and Arabic speaking parts of Iran. Sagittal (64 %) and transverse (36 %) lacerations were the main types of injury. Of the 103 patients, 16.5 % had mild bleeding; 63% had moderate bleeding; and severe bleeding was observed in 16.5 %. 5.8 % needed serum therapy. The mean sagittal and transverse laceration lengths were 62.97 and 74.24 cm, respectively. Only 15 patients had their cuts sutured; 84.9 % of the cases did not consent to being sutured; as a result, the bleeding was staunched after the application of physiological saline and compressive dressing. There was a significant correlation between the number of lacerations and the wound depths (p< 0.047), as well as between the wound depths and the types of laceration (sagittal or transverse) (p< 0.03). In addition, there was a significant relationship between the wound depths and severity of bleeding (p<0.0001) and between the types of laceration and severity of bleeding (p<0.0001). The severity of bleeding and the depth of wound in transverse lacerations were higher.Discussion: When there is a mass reference of those suffering from the aforementioned head lacerations, triage principles must be adhered to. Consequently, those bearing a greater number of deep transverse cuts must be given the priority as they seem to be more prone to profuse bleeding. Suturing followed by prophylactic antibiotics aimed at preventing tetanus is highly recommended. On follow-ups, the possibility of such diseases as hepatitis should be taken into account.

Introduction: Biological attacks on urban areas; military complexes; Police departments; and academic, industrial and non-industrial facilities have always been a great concern of not only academic and research centers but also the mass media.Methods: Mass media and civil defense centers in a bid to prevent and lessen the devastating consequences of biological attacks subscribe to different educational methods. These methods, however, have failed to provide the desirable effects; some such as the fear tactic, employed to keep people from certain risk factors, have even backfired.Results and Discussion: In this paper, we will try to answer a few basic but important questions: why is it important to educate people on biological attacks; Which mass media are the most suitable ones to convery the massage, so what methods should be applied?, What should their contents and subjects be?, What kinds of educational aids should be used? In short, how can we Lay a scientific and practical foundation for the general public so as the make more effective defense preparation against biological attacks?A sample checklist for evaluating such program is also presented at the end.

Introduction: Field hospitals played a vital role in the 8 years of the Iraqi-imposed war against the I.R Iran, saving the lives of thousands of wounded soldiers. This article aims at discussing the history and development of the design, construction and organizational structure of these field hospitals over that eight-year period.Method: For this descriptive study, in addition to drawing upon the relevant documents, we interviewed 20 of the designers and 25 executives of these centers. Furthermore, we made use of two questionnaires with open and closed questions; the answers were collected, categorized and analyzed.Result: There was practically no such thing as a field hospital in the first years of the war, but we were able to construct 39 of them using such different construction materials as tarpaulin, concrete and alloys in the war zones. A study into the development of these centers shows a fundamental revolution and improvement over the aforementioned period.Discussion: Significant improvement was made in the construction and organizational structure of the field hospitals over the years of war, facilitating co-ordination and liaison among different sections as well as offering better and faster services to the patients. In addition, they gradually became so well-equipped that performing surgical operations became possible.