مجله طب نظامی
سال بیست و دوم شماره 11 (پیاپی 96، بهمن 1399)

Emerging and communicable infectious diseases are one of the major public health challenges that adherence to the principles of primary health care can prevent the rising of morbidity and mortality in communities. This study investigates the environmental health challenges of Iran in the Covid-19 epidemic as an emerging infectious disease.Insufficient readiness of the health system, delays in quarantine and social distancing, the unpreparedness of health instructions, lack of personal protective equipment and disinfectants, delays in starting necessary research activities, unnecessary disinfection of roads, unknown mechanisms of transmission, poor ventilation of hospitals, lack of attention to reduced contact, parallel work in the development of health instructions, improper management of corpses and the operation of the public transport system were among the major environmental health challenges of the Covid-19 epidemic in Iran.Despite the growth and development of medical technologies, it is necessary to pay serious attention to primary health care services with an emphasis on environmental health as a key strategy of the health system in combating the spread of diseases. In order to effectively deal with the long-term presence of the coronavirus, the authorities, while making policy, take comprehensive preventive and sustainable practical measures in providing and developing environmental health infrastructure, and the people should be seriously and consciously involved in the implementation of prevention programs.

In order to promote military nursing education in Iran, it is necessary to conduct comparative studies and use the strategies experienced in universities in other countries. The present study has a descriptive and comparative comparison of military nursing education programs in three countries: Iran, the United States and India.

A comparative and descriptive-analytical study was conducted in 2020. Data were collected by searching the Internet in military universities of Iran, USA and India, with the keywords of military nursing, nursing education, curriculum and reviewing the history and curriculum elements of these universities. Beredy model was used for comparative study and the educational systems were analyzed in four stages of description, interpretation, proximity and comparison.

Military nursing education systems in all three countries are based on the basic knowledge of the nursing profession and are presented with a military approach. Its main structure includes vision, mission, goals, admission criteria, training strategies and student evaluation. The mission of the educational program in India and Iran is based on providing humanitarian services in critical situations and the health of human societies, but in the United States it is based on global excellence and leadership. The predominant approach in the curriculum in the United States and India is to pay attention to cultural differences, teamwork and team-based training, providing optional units and flexibility of training units, but in Iran is the development of professional and Islamic ethics, individual-centered training, and development organizational capabilities. In the United States and India, specialization in military nursing is tailored to the needs of the air, naval, and ground forces, but in Iran, military nursing training is more general and more responsive to crisis and war situations.

Based on the findings, the military nursing training program in Iran has high quality and scientific validity in the theoretical dimension, but in terms of student admission, educational needs assessment, development of learner competency assessment tools, accreditation of educational content and specialization (appropriate to the needs of air, naval and ground units) needs to be revised, improved and upgraded.

COVID-19 is a new respiratory disease caused by SARS-Co-2. In 81% of patients, the symptoms are mild and improve at home, and treatment includes supportive care. One of the supportive care may be using the recommendations of Persian medicine.

In this study, the topics of pneumonia, salivation, shortness of breath, as well as colds and flu in Persian medical textbooks and search engines Google Scholar, PubMed and Web of Science were examined.

In general, in all diseases, including respiratory diseases, one of the important points in maintaining health and treatment in Persian medicine is to pay attention to diet and eliminate constipation, allergic rhinitis, sinusitis and recurrent colds to prevent their complications and also strengthen important organs include the heart, brain, liver, kidneys, stomach and lungs. In the early stages of the disease, the patient should reduce the volume and number of meals and avoid concentrated meats such as beef and veal at night.

Strengthening the organs with proper nutrition and taking advantage of the strengthening properties of plants helps to reduce the risk of people suffering from diseases and improve faster and less complication. These lifestyle instructions, along with strictly personal and social health recommendations, are helpful in preventing acute respiratory illness.

Numerous job stresses in military instructors damage their spiritual health and necessitate spiritual self-care. Considering the importance of teacher empowerment, the aim of the present study was to investigate the effect of spiritual empowerment with a multimedia method based on the sound heart model on the spiritual health of military teachers in an interventional study.

The present study was a randomized clinical trial, conducted in Tehran in 2019, on 98 military professors (49 in the experimental group and 49 in the control group). The samples were randomly divided into experimental and control groups. Intervention for the experimental group, a multimedia training based on a sound heart model with the aim of gaining trust, knowledge, communication development, motivation, by donating educational software and following the training in the virtual network, was implemented for 15 weeks. The control group did not receive any intervention. Before and immediately after the intervention, Pulotzin and Ellison spiritual health questionnaire was completed by both groups.

The difference between the two groups in terms of spiritual health index, after receiving the desired intervention and adjusting the effect of baseline values in the two groups was equal to 24.09 (22.69-25.49) and this difference was statistically significant (p<0.001). Also, after receiving the intervention, the difference between the two groups was significant in terms of religious health index 11.97 (11.11-12.83) and Existential health 11.90 (10.99-12.79) (p<0.001).

According to the results of the present study, it seems that the intervention based on a Sound Heart model has a significant effect on improving the mental health of military teachers.

The epidemic of COVID-19 and its associated acute respiratory syndrome has posed an unprecedented challenge in identifying effective drugs to prevent and treat it. Due to the high prevalence of this disease and the high number of people at risk, medical staff needs accurate evidence regarding effective drug treatments for this infection. There is currently no effective treatment for COVID-19. But the rapid development of knowledge about the virology of SARS-CoV-2 provides a significant number of potential pharmacological targets. Evidence suggests that the data provided on the efficacy of hydroxychloroquine is contradictory, but it seems that Remdesivir, although not yet approved by the US Food and Drug Administration, has strong laboratory activity against the virus is the most promising drug treatment. In addition to these results, some clinical trials have ruled out the effectiveness of Oseltamivir and limit the use of corticosteroids. Also, current clinical evidence does not support the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in patients with COVID-19.The COVID-19 epidemic is the largest global public health crisis of the present era since the outbreak of the flu pandemic in 1918. The speed and volume of clinical trials that have begun to examine potential treatments for COVID-19 indicate the urgent need to find the optimal treatment for this problem as soon as possible, which has not yet been conclusively effective.

Mental health of nurses working in Covid-19 wards may be at risk due to special conditions of the workplace and patients. Therefore, the present study was conducted to compare the mental health of nurses working in Covid-19 hospitals with other hospitals.

This descriptive-comparative study was performed on nurses working in the COVID-19 involved and non-involved wards of Sabzevar, Iran in May 2020. Using available sampling, 122 nurses (60 nurses in the Covid-19 ward and 62 nurses in other wards) enrolled. The online General Health Questionnaire (GHQ) was provided to nurses. Data were analyzed using SPSS software version 16.

The mean total mental health scores of nurses working in Covid-19 and other wards were 62.68 ± 11.71 and 65.84 ± 12.07, respectively. There was no statistically significant difference between the two groups (p-value = 0.20)

Mental health in nurses is very low in the epidemic of Covid-19. It is recommended promoting the mental health of nurses, which directly affects the quality of care and improves the health of the community, by appropriate planning such as psychotherapy counseling, holding fun and invigorating programs,‌ awarding incentives in various fields.

The outbreak of severe acute respiratory syndrome (SARS ‐ CoV-2) in December 2019 has led to the epidemic of Covid-19. Recent clinical studies have shown that parts of the nervous system; Cerebrospinal fluid (CSF) are involved in SARS-CoV-2 infection, which is associated with a variety of neurological manifestations such as headache, dizziness, and olfactory and gustatory disorders. This study provides an overview of the Pubmed, Google Scholar and Scopus databases; and the keywords SARS ‐ CoV-2, Covid-19, ACE2 and the nervous system were used to find articles related to the clinical data of SARS ‐ CoV-2 invasion of the nervous system. The published articles retrieved from 1992 to 2020. The findings suggest that coronaviruses invade the human nervous system and cause severe neurological changes. Therefore, given that the SARS-CoV-2 specific receptor; ACE2 is abundant in the central nervous system, and the neurological and invasive properties of other human coronaviruses have been widely reported, it is essential to identify possible complications of COVID-19 on the nervous system.

Patient safety is one of the basic principles of health care and the investigation of patient safety culture is a step towards providing safe conditions for patient care. The aim of this study was to evaluate the patient safety culture in nurses working in the care wards of patients with COVID-19 in Imam Khomeini Hospital in Ardabil, Iran.

The present descriptive-analytical study was performed on 150 nurses working in Imam Khomeini Hospital in Ardabil, Iran during the outbreak of COVID-19 disease. The tool used was the Hospital Survey of Patient Safety Culture Questionnaire (HSOPSC) consisting of 42 questions and 12 dimensions. The sampling method was the census. Data analysis was performed in SPSS software version 22.

The overall average percentage of positive responses to 12 dimensions of safety culture was 66.33%, the highest score was related to the field of "teamwork within the unit" (82%) and the lowest score was related to the areas of "Non-Punitive Response to Error" (20%) and "teamwork Across units" (20%). According to the independent t-test, there was a significant relationship between marriage and work shift and patient safety culture. Also, based on one-way analysis of variance, there was a significant relationship between age, employment status and work experience with patient safety culture.

The status of patient safety culture was moderate among the nurses. Improving the patientchr('39')s safety culture is essential to improving patient care indicators. Also, special attention should be paid to the dimensions with the low average in this study in order to improve and strengthen these dimensions.

COVID-19, which is caused by the SARS-Cov-2, begins with early symptoms of fever, cough, shortness of breath, myalgia, and fatigue, affecting the lungs with pneumonia and causing acute respiratory distress syndrome (ARDS). Also, the onset of the disease may with rapid progression, lead to organ dysfunction, such as acute kidney or liver damage, and even death in severe cases. Many scientific efforts are underway around the world to identify the appropriate treatment for this disease. Curcumin is a natural polyphenolic compound, which could be a potential treatment option for patients with Covid-19. In this study, we review some of the possible effects of curcumin, such as inhibiting virus entry into the cell, inhibiting virus replication and viral protease, as well as modulating some intracellular messenger pathways. To comprehensive literature review, information from an internet search of English language databases PubMed, Scopus, Web of Science and ScienceDirect as well as Persian language databases such as SID using related keywords based on MESH such as COVID-19, SARS-COV-2 , Curcumin and curcuminoid between January 2020 and January 2021 were collected. This review provides some possible effects of curcumin and its mechanisms for the treatment of COVID-19.