مجله علوم پیراپزشکی و بهداشت نظامی
سال هفدهم شماره 3 (پیاپی 45، پاییز 1401)

A Klebsiella pneumoniae bacterium, which is the most important species of the Klebsiella genus, mainly causes hospital infections. Moreover, it has a high resistance to most of the available antibiotics, which has caused concern among doctors all over the world. Therefore, the amount of antibiotic resistance and the effect of these antibiotics on Klebsiella pneumoniae isolates producing carbapenemase and ESBL enzymes with multi-drug resistance are investigated in this research.

Methods and Materials:

 Different strains of Klebsiella pneumoniae bacteria were identified and isolated from different clinical samples during 4 months (September 1400 to late December 1400) from hospitals and laboratories in Tehran. After determining the identity using biochemical tests, the isolates were investigated and re-identified by molecular method. Antibiotic resistance was determined by disk diffusion method. Then, the production of ESBL and carbapenemase were performed using the respective discs and checking the diameter of the inhibition zone. The ELISA test was repeated three times in order to investigate the creation of biofilm in strains with multiple resistances. Molecular testing was used again to identify fosA3, mcr1 and mcr2 genes. At the end, the results were evaluated using the software.

Out of 127 samples, 112 (88٪) isolates were of Klebsiella genus, and 80 (63٪) samples of Klebsiella pneumoniae were isolated using molecular tests.61 (76٪) samples had multidrug resistance. The lowest resistance was reported to amikacin (AN), gentamicin (GM) and meropenem (MEN) with 0, 1 and 3 resistant samples, respectively. Furthermore, the highest resistance to ampicillin (AM), piperacillin (PIP) and chloramphenicol (CL) were reported with 79, 66 and 67 resistant samples, respectively. By examining the diameter of the inhibition zone, among 80 Klebsiella pneumoniae strains, 51 (63.75٪) were beta-lactamaseproducing isolates and 29 (36.25٪) were carbapenemase-producing isolates.Out of 61 (76٪) samples with multiple resistance, 56 samples formed biofilm.The results of molecular tests for ESBL genes showed only the expression of mcr2 and the amplification of carbapenemase genes was only expressed for mcr2 and fosA3.

The frequency of Klebsiella pneumoniae isolates that produce biofilm, ESBL and carbapenemase with the expression of mcr-2 and fosA genes are increasing in hospitals.

Medial tibial stress syndrome is one of the most common musculoskeletal injuries among soldiers. However, there has not been a detailed report on the effect of risk-factors on its occurrence including the distribution of plantar pressure in military personnel and different communities. For this reason, the purpose of this study is to investigate the effect of plantar pressure distribution pattern on the incidence of medial tibial stress syndrome in military soldiers during military training.

Methods and Materials: 

The statistical population of this research is male military soldiers at Imam Hossein University (AS) during the 6 months of military training with an average age of (19.68 ± 0.99 years), height of (174 ± 0.04 cm) and body mass index of (23.32 ± 1.76 kg/m2). 116 of them were selected as the statistical sample of this study. At the beginning of the training course, in addition to investigate the prevalence of medial tibial stress syndrome using the Yates and White criteria and plantar-foot pressure distribution data, vertical fluctuations and the symmetry of the subjects’ plantar pressure were collected by the PT-scan plantar pressure distribution device (made by Mashhad Technologists in Iran). Then, the subjects started to do the exercises related to military training. Moreover, at the end of the 6-month period, the possible prevalence of medial tibial stress syndrome was evaluated by using the Yates and White criteria again. The chi-square test was used to check the prevalence of injury and the logistic regression test was used to check the effect of the independent variable on the dependent variable. All hypothesis tests were performed at a significance level equal to or smaller than 0.05.

The results of chi-square test showed that the prevalence rate of medial tibial stress syndrome in military soldiers was 29.3٪ at the end of the period. Furthermore, the results of the logistic regression showed that the plantar pressure distribution variables were able to explain between 71.6٪ and 96.6٪ of the changes in the incidence of medial tibial stress syndrome. Among these, the symmetry index variable (96.6٪) was a statistically more accurate predictor of injury than other variables. (p≥0.05). In other findings, the results of logistic regression to investigate the predicting role of body posture fluctuations in the incidence of injury showed that the model was able to predict 100٪ of the incidence of medial tibial stress syndrome injury (p=0.001).

Since the prevalence of medial tibial stress syndrome in military soldiers is very high, specialists and medical staff of military soldiers in this field can be effective in identifying people prone to internal tibial pressure syndrome by considering the plantar pressure distribution pattern and foot movement patterns.

Academic failure of students is one of the major problems of higher education centers in the country, which causes a waste of time and running costs of these centers and it creates psychological, family and social issues and problems for students. In addition, people with a drop in education will not be efficient human resources in the future. The present study was conducted in order to investigate the
relationship between five major personality trait groups with academic performance and also the predictability of academic progress through these traits.

Methods and Materials:

 This correlational study was performed in AJA University of Medical Sciences. The studied population consisted of all students studying in the second semester of the year 2022. 287 students were selected as the research sample using Cochran’s formula and available sampling method. Moreover, they answered Costa and McCree’s NEO-FFI questionnaire (short form). The GPA of the previous
academic semester was used to measure educational performance. Data were analyzed through regression (enter method) using SPSS software version 26.

The results of the regression (enter method) indicated that the two variables of neuroticism and conscientiousness can be relatively good predictors for academic performance.

Since personality traits play an undeniable role in various dimensions of life especially academic performance, besides various measurements, the measurement of psychological and personality dimensions of students should be included in the selection of candidates to enter AJA University of Medical Sciences.

The profession-related activities of nurses and operating room staff have many ergonomic risk factors. A lack of knowledge about the correct performance of these activities can cause musculoskeletal problems. The aim of this study was to investigate the ergonomic status of working postures among nurses and operating room staff in Ilam.

Methods and Materials:

 This descriptive-analytical study was conducted on nurses and operating room staff of three educational hospitals in Ilam in 2021. The prevalence of musculoskeletal disorders was investigated using the Nordic questionnaire and working postures were evaluated by the REBA method. P< 0.05 was regarded as the significant level.

Out of 115 studied staff with a mean age of 32.73±6.93 years, 47 cases were male (41٪). 83 subjects were nurses and 32 of them were operating room staff. In the past year, the most reported complaints were low back pain. Its prevalence in female and male nurses was 51.9٪ and 48.4٪, respectively. For operating room staff, shoulder pain was (86.7٪) in women and neck pain was (70.6٪) in men. The results showed that 43.37٪ of the nurses needed to take necessary corrective measures and 62.5٪ of the operating room staff needed immediate corrective measures.

The results showed that there is not any acceptable ergonomic status among the studied occupations. There were not any high musculoskeletal complaints due to the youth of the staff at the time of the study. However, with the continuation of their profession-related activities in the current non-standard way, musculoskeletal problems will be observed for these medical staff in the near future. Evaluation of the working postures of the staff showed that some interventions such as appropriate staff training, work breaks, and exercises are necessary.

HTLV-1 virus is a human retrovirus and it causes several chronic diseases. So far, there is not any vaccine or satisfactory treatment that has been developed for infections caused by this virus. Moreover, the best way to control the infection is prevention and the best way to prevent it is education. Therefore, our study was conducted to investigate the knowledge and attitudes of laboratory science students of Mashhad University of Medical Sciences about HTLV-1 virus.

Methods and Materials: 

The present study was a descriptive-analytical study that was conducted in Mashhad School of Paramedical Sciences in 2016. The study population included all laboratory science students studying at the time of the study (n= 300). Participants were selected by census method. Data were collected by a researcher-made questionnaire and they were analyzed, using SPSS software version 11.0.

A total of 265 students answered the questionnaire (response rate: 85٪). The mean age of students was 5.7 ± 22.7. The majority of students (52.7٪) stated that the most important source of information for receiving HTLV-1 related information was the classroom (52.1٪) and the Internet (16.6٪). In general, students’ level of awareness about this infection is poor with an average score of 14.44 out of 40 points. The knowledge level of 2.6٪ of students was at the high level, 33.2٪ of them at the intermediate level and 64.2٪ of them at the low level. There was a significant relationship between students’ knowledge and variables of gender and year of university entrance (P = 0.001).

In general, the obtained results show that the knowledge of the target group was poor. Due to the endemic nature of the disease, we need to change the teaching method and educational program related to this virus in the curriculum of medical students in order to better prevent and deal with this infection. This is especially important for groups that are more closely associated with the virus and its associated diseases, such as students and laboratory science graduates.

Problem-based learning (PBL) and outcome-based learning (OBL) are two new educational methods of learning. Considering the importance of clinical education in nursing students and the lack of use of modern educational methods in the clinical education of nursing students, this study was aimed to investigate the students’ satisfaction with two educational methods of PBL and OBE in nursing students of intensive care units.

Methods and Materials:

 This study was a semi-experimental study with a two-group design. The samples were selected by census method and they included 45 nursing students of Jahrom faculty of Nursing and Paramedicine who were interns in the special care department in the second semester of the academic years of 2016-2017.The samples were divided into two test groups. Training was performed by problemsolving based method in one group and it was done through result-based method in the other group by a trained instructor in the field of result-oriented and problem-solving based training methods. After the completion of the course, the students’ satisfaction with the two teaching methods was checked using a researcher-made questionnaire. After completing the questionnaires by the research units, data were analyzed using SPSS software version 22.

45 nursing students with an average age of 20 years and an average GPA of 16.54 were studied in this research. The findings show that the average level of satisfaction with problem-solving-based training was 47.25±94.94 and the satisfaction with result-oriented training was 41.65±8.60.The results of the independent t-test comparing the satisfaction in the two educational groups showed that there was a significant difference between the satisfactions of the nursing students with the two educational methods used. Therefore, the satisfaction with the method based on problem solving was significantly higher than another one (p=0.009).

The use of new educational methods, especially in clinical education in nursing students, can increase the satisfaction and interest of students. Moreover, it leads to effective learning and improvement of clinical skills in students.

The outbreak of the Corona disease in 2019 deeply affected the world community in all dimensions. Moreover, based on the recommendation of the World Health Organization, most countries decided to control the spread of Covid-19 by leading people to quarantine and regarding social distance. The main problem of this universal solution was the lack of attention to the mental health of people especially the elderly. The purpose of this article is to review and summarize the findings of studies that examine the impact of covid-19 on the social isolation of the elderly. Furthermore, this study provides strategies to reduce mental and physical harm and it improves the quality of life of the elderly.

Methods and Materials: 

The studies conducted in the field of the impact of social isolation caused by Corona virus pneumonia on the elderly using corona virus, social isolation, mental health, covid-19, epidemic and the elderly keywords in Pubmed, Science direct, Scopus, Google Scholar and Iranian databases such as SID, Iranmedax and Magiran.

The results show that the impact of Covid-19 on mental health is moderate to severe. On the other hand, social isolation in the elderly can lead to increased depression and tendency to suicide, decreased immune response to viral infections, and increased risk of stroke, cardiovascular diseases, and brain deterioration. Therefore, it is important to provide a systemic approach to improve the quality of communication in all individual and social dimensions. In addition, providing these solutions can reduce the stress and anxiety caused by social isolation in the elderly with social supports such as emotional and practical support. Furthermore, educational interventions, maintaining the dignity and respect of the elderly, encouraging the use of Virtual network, and sports are among other things that improve the mental and social health of the elderly in the era of Corona.

Although social isolation is one of the most important measures to deal with the Corona virus, paying attention to mental health and implementing quality and acceptable services in times of crisis is essential especially for the elderly. This issue requires an integrated and interdisciplinary assessment of geriatric specialists. , psychiatrists and physiotherapists in improving the conditions of the elderly.

Acinetobacter baumannii is a gram negative and it is one of the most important and drugresistance infections in hospitals.After Staphylococcus aureus and Pseudomonas aeruginosa, Acinetobacter baumannii is one of the included multidrug resistance infectious bacteria. The aim of this study is to review of pathogenesis and drug-resistance mechanisms in Acinetobacter baumannii.

Methods and Materials:

 International scientific databases including PubMed, Scopus and google scholar were used to review the articles. Out of the 150 articles obtained, only 105 of them with full text have been used in the study. Moreover, articles with abstracts and those received money were excluded from the study.

The rate of drug resistance is growing by examining the scientific papers in most countries of the world. This bacterium gained a specific mechanism of resistance which is a cause of global concern for this organism. Beta-lactamase enzyme producing genes such as OXA, TEM and others are widespread.

In less developed countries, with the indiscriminate use of antibiotics in the society and, in most cases, without the cultivation of pathogenic agents, it causes the emergence and acquisition of resistance genes by the organism. It is recommended that doctors in the hospital request microbial culture from infected samples before treating hospitalized patients in order to prevent resistance as much as possible.