مجله طب نظامی
سال بیست و دوم شماره 4 (پیاپی 89، تیر 1399)

According to the latest estimate published by the World Health Organization in 2017, there are 219 million malaria cases and 435,000 deaths. With the emergence of drug-resistant strains in malaria, there is a need for new drug targets every time. In this study, the design and docking study of the pyrimidine derivatives for inhibiting Methionine aminopeptidase1B enzyme (Metap1b) has been considered as antimalarial agents as a new drug and against drug resistance.

Docking studies were done with the AutoDock program. The structure of the molecules was drawn with the Hyperchem program and optimized by semi-empirical method.

Docking studies have shown that the most important links involved in drug binding are peptide receptor, π-cation and hydrogen bonding. Increasing the π-π and π-cation bonds in enhancing the strength of this group of compounds is effective. It was also found that Combination No. 7 was the most effective compound in binding to the active site of the enzyme.

Based on the results of docking studies, all designed compounds exhibit significant inhibitory effects on the active site of the enzyme, but the compound 7 showed the best inhibitory effect. According to the results of cheminformatics, compound 7 can be a candidate for a new anti-malarial drug.

Little attention has been paid to the effects of combined exposure to noise and vibration. Exposure to noise and vibration can effect stress hormones and may lead to high blood pressure and cardiovascular disorders. This study aims to investigate the effects of noise and vibration on urinary Metanephrine and Normetanephrine among men.

In this experimental study, 30 male students were deemed eligible for entry. Background variables such as temperature, light intensity, sound pressure level and vibration acceleration (before and after exposure) were measured throughout each experiment. Participants were randomly exposed to two noise levels and two vibration accelerations for 30 minutes in a combined and independent exposure condition. Urine samples were taken an hour before and an hour after exposure. Metanephrine and Normetanephrine levels were measured using the ELISA method and a specialized Metanephrine/Normetanephrine urinary measurement kit. A repeated measures regression with a Generalized Estimating Equations (GEE) approach was applied for data analysis.

The exposure to noise (at 85 and 91 dB(A)) and independent exposure to whole body vibration at 1.85 m/s2 caused an increase in Normetanephrine and a decrease in Metanephrine concentration although these changes were not statistically meaningful (P>0.05). Combined exposure to noise and vibration caused an increase in Metanephrine and Normetanephrine concentration. These changes were also not statistically significant (P>0.05).

Study subjects’ stress hormone concentrations changed when exposed to noise but did not follow a particular trend. Short term exposure (30 minutes) did not have a distinguish effect on urinary Metanephrine and Normetanephrine concentrations. Therefore, urinary Metanephrine and Normetanephrine concentrations cannot be considered appropriate indicators for noise and whole body vibration exposure.

Nowadays, social trust, which has a great role in the development and health of societies, is considered one of the most important aspects of social capital and human communications. Therefore, this study aims to compare the patients' social trust (before and after hospitalization) toward the medical staff of Kohgiluyeh and Boyer-Ahmad hospitals.

A total of 400 patients admitted to Kohgiluyeh and Boyer-Ahmad hospitals were selected by multi-stage cluster sampling and evaluated by a researcher-made questionnaire of social trust. The study includes patients who were (according to the decision of the treatment staff) hospitalized for at least one day and then were discharged.

The patients' trust toward nurses and operating room personnel is not significantly different before and after hospitalization (P> 0.05). However, patients' trust toward physicians before and after hospitalization is significantly different (P <0.05), with an increase of 0.27 percent in patients' trust toward physicians after hospitalization. It was also shown that patients' trust toward admission personnel has a significant difference before and after hospitalization (P <0.05), with a decrease of about 0.24 percent in patients' trust toward admission personnel after hospitalization.

Considering the decrease in patients' trust toward the operating room personnel and admission staff after the treatment process, it is expected that some measures be taken to increase the patients' trust toward this group.

Autotoxic substances such as JP-4 jet fuel can have negative effects on the auditory system by the various means such as cochlear dysfunction. The purpose of this study was to investigate the combined effects of exposure to JP-4 jet fuel and noise on hearing loss in rats, to determine the possible interference effects of these two risk factors on rat auditory system.

For this purpose, 24 healthy adult male Wistar albino rats, weighing 230±25 g, were selected and randomly divided into four groups of six. One group was exposed only to noise with a bandwidth of 500-8000 Hz with a sound pressure level of 95± 2 dBA and the second group was exposed to JP-4 jet fuel with a concentration of 1100±10 mg / m3 for 8 hours per 14 consecutive days. The third group also experienced both noise and jet fuel exposure to the same conditions and the fourth group was also considered control. The assessment of hearing system in male rats was used by Distortion Product Otoacoustic Emissions testing (DPOAE). Changes in the temporal and permanent distortion emissions (TTSdp and PTSdp) in the frequency range of 0 to 8.5 kHz were compared between groups.

In the exposed group to noise, the level of temporary and permanent hearing loss was 6.24 and 5.35 dB, respectively. Temporary and permanent hearing loss in rats exposed to jet fuel (JP-4) was measured as 3.02 and 2.85 dB, respectively.  In the group co-exposed to noise and jet fuel, permanent and temporary hearing loss were reported being 13.43 and 12.02 dB, respectively.

The results of the present study showed that independent exposure to noise and jet fuel (JP-4) can lead to temporary and permanent hearing loss; moreover, there was the stronger effects on auditory system in co-exposure condition. The exposure to Jet fuel may increase risk for noise adverse effect on hearing loss. However, more comprehensive research is required to reveal more aspects of the interference effect of co-exposure noise with different characteristics such as level and frequency and jet fuel with different types and concentrations.

Medical tourism is one of the most important industries in the field of health care, which not only protects the interests of the national economy, but also guides the health and treatment process, including access to optimal, cheap and fast medical services. The purpose of this study was to investigate and evaluate the feasibility of influential components and suggest ways to develop the medical tourism in military and civilian hospitals in Tabriz, Iran.

This applied and hybrid study was conducted in two qualitative and quantitative stages. The research population in the qualitative section was medical tourism experts and authorities related to tourism in Tabriz hospitals and tourists referred to hospitals and medical experts in the field of medicine. Sample size in the qualitative phase was 10 people and in quantitative phase 7 people who were selected by purposeful sampling. Semi-structured interviews were used to collect data in the qualitative phase to reach the saturation level and in the quantitative phase the dimensional technique was used. Qualitative data analysis was performed using MAXQDA10 software and quantitative data were analyzed with MATLAB software. Data collection was performed over 2019. Experts approved the various stages of the design for validity and reliability.

 After conducting interviews and eliminating overlaps, 72 initial codes were obtained. The initial codes were then classified into 5 themes (quality of service, cost, medical staff, medical equipment, facilities and amenities) and 23 sub-themes. The qualitative phase results were then analyzed to determine significance using the dimensional collective decision-making method in six steps, the most important of which were sub-themes. 

 According to the goals of medical tourism development research in military and civilian hospitals in Tabriz, it requires paying attention to setting up IPDs and VIP rooms, proportional to the competitive price of patient origin, recruiting and training physicians and medical staff, using health technology assessment science (HTA) and facilitates the patient admission process to improve the quality of services and attract medical tourists. The development of medical tourism alongside services and urban facilities requires in-hospital factors and, above all, the quality of services in line with international standards, in-hospital welfare services, up-to-date medical equipment and trained staff and departments plus the role of skills. Linguistic communication is also very significant.

Non-suicidal self-harm behaviors are prevalent in military settings, especially among soldiers, and are a major mental health concern. Thus, the aim of the current study was to examine the mediating role of self-compassion in the relationship of non-suicidal self-injury (NSSI) with mental pain.

The research method was descriptive-correlational through structural equation modeling. The study population consisted of all soldiers, referring to the psychiatric and psychology section of a military hospital in Tehran, Iran in 2018-2019. 207 soldiers were selected by convenience sampling from this population. Participants completed the questionnaire of Deliberate Self-Harm and scales of mental pain and self-compassion. Data was analyzed via Pearson correlation coefficient and the path analysis of structural equation modeling with using SPSS-20 and Lisrel-8.80.

NNSI have significant positive correlations with mental pain (r=0.30; p<0.001), and self-compassion (r=-0.31; p<0.001). There was a significant negative relationship between self-compassion and mental pain (r=-0.56; p<0.001). Moreover, the results of path analysis showed that self-compassion played a mediating role in the relationship of NSSI with mental pain.

Based on the current findings, self-compassion can serve as a protective factor against mental pain. Thus, this factor can be considered in the formulation of prevention and treatment programs for non-suicidal self-injury behaviors in soldiers.

Having up-to-date knowledge and information and innovative behavior in professors is one of the main concerns of university administrators. The purpose of this study was to investigate the impact of knowledge management on organizational innovation mediated by organizational learning among faculty members of a military university.

This is a descriptive-correlational study. The study population consisted of faculty members of a military university in Tehran in 2018. 110 people were selected through stratified random sampling. Data were analyzed using three knowledge management questionnaires Gold, Malhotra and Segars, organizational innovation questionnaire (Jiménez-Jimenez and Peniades and Suhel et al) and Nife organizational learning questionnaire, whose validity and reliability were confirmed. Questionnaires were distributed among faculty members in different faculties of the university and after one week, they were collected. Pearson correlation coefficient and structural equation modeling were used for data analysis.

The correlation coefficient between knowledge management and organizational innovation was equal to 0.403 and between organizational learning and organizational innovation was equal to 0.433 (p=0.01). The positive correlation coefficients indicated that there is a direct relationship between these variables and indicates that with increasing knowledge management and organizational learning, the level of organizational innovation increases. Structural equation modeling also showed that organizational learning has a strong mediating role in the relationship between knowledge management and organizational innovation.

According to the research findings, university managers and military colleges can improve the knowledge management and organizational learning conditions leading to the development of innovative approach and behavior among faculty members and thereby increase in the efficiency of the university.

Healthy diet as one of the most important aspects of health has the main impact on physical and mental functioning of people under stress conditions. The aim of this study was to compare the intake of macronutrients and antioxidant compounds based on military stress.

105 military personnel aged 18 to 45 years in operational zones with different degrees of stress were enrolled in this study. Military personnel were allocated into two groups with high (n = 27) and low (n = 48) stress and the food intake of each group was compared. Dass21, IPAQ, FFQ 168 item and demographic data questionnaires were used to assess the subjects. Data were analyzed using SPSS software 20 version.

Both groups were match in terms of demographic data. The low stress group had significantly higher vitamin E, selenium, protein, total dairy and low fat dairy intake than the high stress group (p<0.05). The low stress group also had higher intakes of fruits, vegetables, energy, fat and meat than the high stress group. Fast food intake and biscuits were lower in the low stress group than in the high stress group, although these differences were not significant (p>0.05).

The study found that military people with low stress levels had higher levels of selenium, vitamin E, and vitamin C intakes than those with high levels of stress. Military people with low stress levels had a better dietary pattern.

Professional values are standards for action and provide a framework for evaluating professional behavior. Understanding the perception of professional values by nurses is an important step towards effective decision-making and improving patient care quality. Given the different perspectives of understanding the importance and application of professional values in nursing students, this study aimed to investigate the professional values from the perspective of nursing students at the selected military medical university.

This analytical cross-sectional study was performed on 134 students of a military nursing college in Tehran, Iran were selected through simple convenience sampling in 2019. Data were collected using a two-part questionnaire that included demographic variables and Nursing Professional Values Scale-Revised (NPVS-R) 26-item in the five dimensions (caring, activism, trust, professionalism, and justice). Data were analyzed using SPSS 16.

Mean scores of caring, activism, trust, professionalism, justice and overall dimensions were 4.10±0.62, 3.81±0.70, 4.01±0.70, 3.86±0.81, 4.13±0.69 and 3.99±0.58 respectively. From the students' perspective, justice and activism were the most important and least important aspects of professional values, respectively. There was a significant correlation between age, gender, marital status and level of education with professional values (P<0.05).

Although professional values from nursing students’ perspective were very important, understanding the importance of certain aspects of the professional values which are related to the nurses’ nonclinical tasks, participate in activities of scientific associations and professional nursing policy decisions requires further support. Therefore, it is recommended that appropriate educational planning is required to enhance the overall area of nursing professional values.

In recent years, the construction industry, especially hospitals affected by sustainable development, have created concepts such as "sustainable building" and "green hospital". With the development of implementation and evaluation systems of Green Hospital, various methods were presented. The common point of all these methods was the three areas of optimal consumption of water, energy, and less waste generation. This study was conducted to investigate the status of these areas.

This is a retrospective descriptive cross-sectional study. The research population includes a selected military hospital in Tehran, Iran. Information on the consumption and cost of energy, water, and also the amount of waste production over a period of three years (2014-2016) in 2017 were collected and analyzed.

On average, the hospital consumes 80.79 kWh of electricity and 12.12 m3 of gas at a cost of 25861 Rials and 10808 Rials per active day bed, respectively. This statistic is active for 1124 liters of water consumption at a cost of 16,993 Rials per day bed. Waste production was on average 3.67 kg per active day bed, of which 42% was infectious waste.

The results showed that water and electricity consumption were 2.20 and 10.1 times the existing standards, respectively. The average production of total waste was 2.5 to 3.7 times and infectious waste was estimated to be 27% higher than international standards. It is recommended that hospitals adopt environmental protection strategies, hold training courses, manage waste, and allocate the necessary funds. In the macro dimension, the binding of these measures and the development of local indicators will be a useful solution. The lack of mandatory standards for measuring and reducing the studied indicators is a national challenge and it is suggested that the hospital reduces the statistics.