مجله طب نظامی
سال بیست و پنجم شماره 3 (پیاپی 121، امرداد و شهریور 1402)

Coronavirus disease 19 (COVID-19) is one of the deadliest viral diseases that has made serious problems in all aspects of human life since its emergence. The occurrence of neurological problems in the central nervous system (CNS) is one of the most dangerous and disturbing problems in patients with severe types of the disease, which can manifest in various forms including mental disorders, hemorrhagic and ischemic strokes, posterior reversible encephalopathy syndrome (PRES), cerebral venous sinus thrombosis (CVST), general disorders of the CNS (such as seizures, meningitis, encephalitis), peripheral neuropathies (Guillen Barre syndrome and cranial neuropathies), and many post-infection consequences (long-term COVID-19). New findings show that the neural invasion of the SARS-CoV-2 into the CNS can occur through different mechanisms, including entering the olfactory nerve, vascular endothelial contamination, and passing infected leukocytes through the blood-brain barrier (BBB). Better attention and recognition of these disorders can reduce the morbidity and mortality rates of the disease, as well as help in reducing the problems related to patients so that they can return to normal life as soon as possible. Emphasizing the importance of proper clinical management of these disorders in survival and improving the life quality of patients with this disease, the current study reviews the most important findings of studies related to neurological and CNS disorders from COVID-19.

With the spread of the coronavirus and considering the importance of sports activities in the physiological and psychological conditions of people, staying active during this period is of particular importance in preventing the spread of the coronavirus. Therefore, regular exercise has many benefits for health, including improving the performance of the respiratory and cardiovascular systems. In this study, the effect of sports activities on the respiratory and cardiovascular systems function during the coronavirus pandemic has been reviewed.

This study was review research. It was done by searching Persian and English articles available in SID, Magiran, CIVILICA, Google Scholar, Science Direct, and PubMed databases by using keywords Sports activities, Respiratory, Cardiovascular, Coronavirus, COVID-19, and their Persian equivalent without a time limit. Out of a total of 83 review articles, 57 articles that met the inclusion criteria were selected and investigated.

In December 2019, a virus called the 2019 coronavirus (COVID-19) was first identified in Wuhan, China, and quickly turned into a global pandemic. Respiratory and cardiovascular viral infections account for the highest mortality rate. Many patients with COVID-19 have severe respiratory failure. Also, COVID-19 causes extensive tissue damage in the heart and the infection caused in the heart muscle leads to acute heart attack, cardiovascular failure, and arrhythmia. Therefore, regular sports activity taking into account preventive health measures is considered one of the most important factors in dealing with coronavirus infections.

Based on the studies, it seems that doing regular sports activity of moderate intensity can strengthen the body's immune system and reduce the risk of viral infections in the respiratory and cardiovascular systems. However, sports activity of high intensity or for a long time causes harmful effects and weakens the body's immune system, and increases the risk of respiratory and cardiovascular infections during the coronavirus pandemic.

Chemical poisoning incidents are an important health problem with a long history all over the world and its occurrence in Iran's educational institutions in 2022 and the necessity of preventive, caused the authorities to pay special attention to the Issue. This study aimed to review the principles and requirements for the prevention and management of poisoning incidents in educational centers. The study was conducted by searching for keywords in national and international databases from 1994 to 2022. Due to the unavailability of related articles, several related books, guidelines, and authoritative websites were also reviewed. In intentional incidents, people are often exposed to poisoning by inhalation, eye contact, and skin contact. Children and Students are more sensitive and are the first to be at risk and show symptoms. The optimal management of the incidents requires the existence of preventive strategic plans to eliminate or reduce the risk severity. All the people present in the educational centers should be trained and gain sufficient knowledge about the preventive health tips for exposure to chemicals. In the event of an accident, timely preparation and response, especially the identification and recording of the initial clinical symptoms of the injured and the characteristics of the chemical agent, are essential to quickly identify the agent and speed up action in decision-making for the optimal management of the incident and preventing mass hysteria and disturbances in the psychological security of society. The results of this study show that creating motivation and teaching preventive strategies to perform health-promoting, safe behaviors, and reducing wrong behaviors have an effective role in reducing the occurrence of dangerous conditions and preventing poisonings, and helping in the event of an incident to provide the necessary services asap. It is expected that by informing and correctly implementing the requirements recommended in this article, an effective contribution will help to improve national stability against similar threats in the future, and by reducing the incidence and severity of poisoning, it will create the conditions for maintaining and improving the health of people and minimize the vulnerability of society, and prevent such incidents from reoccurring in the future.

Healthcare providers have a high workload due to different work shifts, so they are always exposed to increasing sleep disorders, decreasing resilience, and thus decreasing job satisfaction. The purpose of this study was to investigate the relationship between mental workload, job burnout, job satisfaction, resilience, and sleep disorders among nurses in 2021. Research tools included demographic information questionnaire, NASA-TLX questionnaire, Maslach job burnout questionnaire (MBI), Minnesota job satisfaction questionnaire (MSQ), Petersburg sleep quality questionnaire, and resilience questionnaire (CD. RSC). The data were analyzed using SPSS version 25 and AMOS version 24 software. In this study, 171 women (62.4%) and 103 men (37.6%) were examined. Based on the fit indices (χ2/df=1.650, RMSEA=0.049, TLI=0.906, CFI=0.912), a good fit was observed between the model and the data. The results indicate that mental workload has a positive and significant effect on job burnout (P<0.001, β=0.202). Also, the negative effect of mental workload on resilience (P<0.001, β=0.334) and job satisfaction (P<0.001, β=0.356) have been accepted. The results confirm the positive effect of mental workload on sleep disorders (β=0.166, P<0.05). In addition, the results showed that job burnout has a positive effect on sleep disorders (β=0.153, P<0.05). It is suggested that with proper planning, training, and management of the factors investigated in this study, it is possible to play an important role in increasing the health of nurses and consequently improving their services to patients.

Various treatments have been proposed to improve the pulmonary function of patients with COVID-19. The current study aimed to evaluate the effects of diaphragmatic breathing and aerobics exercises on the pulmonary function of patients recovered from COVID-19. This study was a semi-experimental with two exercise groups and one control group of recovered women from COVID-19 who attended to the pulmonary ward of Zabol healthcare centers in 2022. Thirty people (25-40 years) with 20 to 40% involvement were purposefully selected and randomly categorized into three groups diaphragmatic breathing training (n=10), aerobics exercise training (n=10), and control (n=10). The Shuttle test was applied to measure Vo2max and the spirometry was applied to measure pulmonary function indexes. The program of the training groups consisted of 3 sessions/week for eight weeks. The intra-group difference was studied using paired sample t-test method and the inter-group difference was evaluated based on one-way variance ANOVA analysis by SPSS software. Paired sample t-test results showed that values of Vo2max and pulmonary function indexes increased in the aerobics exercise group (PFEF<0.001), PFEV<0.001, PFVC<0.001, PVo2max<0.001) and diaphragmatic breathing group (PFEF=0.002, PFEV=0.001, PFVC<0.001, PVo2max<0.001), while the mean FEV1/FVC index following intervention did not change (Paerobics=0.92, Pdiaphragmatic=0.77). Results of one-way ANOVA showed an increase in Vo2max (P=0.001) and pulmonary function (PFEF=0.002, PFEV=0.002, PFVC=0.003) following aerobics exercise training more than diaphragmatic breathing. Both diaphragmatic breathing and aerobic exercise were effective in improving the pulmonary function of patients who recovered from COVID-19. However, the effects of aerobics exercise were more evident than diaphragmatic breathing.

Insulin resistance is a metabolic disorder marked by insufficient tissue response to insulin secretion and hyperinsulinemia. This metabolic abnormality plays a crucial role in the pathogenesis of many diseases. It appears that changes in lifestyle, such as participating in exercise activity and consumption of non-medicinal supplements, will ameliorate this condition; therefore, the present study aims to investigate the effects of aerobic exercise and vanadium-zinc supplementation on body composition, lipid profile, and insulin resistance index in fructose-fed rats. In this experimental study, 56 male wistar rats were randomly assigned to one of seven groups (eight rats per group); 1) Normal control (NC), 2) Fructose control (FC), 3) Fructose + Moderate-intensity continuous training (FIT), 4) Fructose + High-intensity interval training (FCT), 5) Vanadium-zinc supplement (FS), 6) Moderate-intensity continuous training + Vanadium-zinc supplement (FSIT), and 7) High-intensity interval training + Vanadium-zinc supplement (FSCT). The protocol of moderate intensity continuous training consisted of running for 12 to 54 min at a velocity of 12 to 20 m/min on a motorized treadmill with a 5% to 15% incline (weeks 1 to 8); also High-intensity interval training performed 3 min bouts at 40 m/min, interspersed by 3 min active recovery at a running velocity of 20 m/min on a motorized treadmill with a 5% to 15% incline. Supplement groups received 10 mg/kg/day of vanadium-zinc through oral gavage. Body composition and serum levels of lipid profile, glucose, insulin, and HOMA-IR index were measured before and 48 hours after the final session of the training program in a fast state. Eight weeks of aerobic exercise and vanadium-zinc supplementation significantly improved body composition (P=0.0001), insulin resistance (P=0.0001), and lipid profile indices (P≤0.05). Aerobic exercise combined with vanadium-zinc supplementation has the most significant impact on the modulation of serum insulin resistance, lipid profile, and, inguinal and retroperitoneal fat tissue (P≤0.05). Findings suggest that vanadium-zinc supplementation combined with aerobic exercise can be effective in improving metabolic conditions and body composition.

The prevalence of metabolic syndrome (MetS) is increasing in the world and also in Iran. MetS is associated with an increased risk of cardiovascular diseases and diabetes. There is no study on the prevalence of MetS in families of military personnel. The present study aimed to determine the prevalence of MetS and its components in a military town in Tehran. This cross-sectional study was conducted on 384 participants who were referred to the health center in Shahrak-e- Fajr. MetS components including waist circumference, blood pressure, fasting blood sugar, triglycerides, and high-density lipoprotein-cholesterol (HDL-C) were measured. MetS was diagnosed according to the Iranian National Committee of Obesity criteria. The overall prevalence of MetS was 36.45% (95% CI=31.62%-41.29%); 37.5% and 62.5%% were males and females, respectively. Only 6.25% of the participants did not have any MetS components. The most frequent components were low HDL-C levels (62.23%), and abdominal obesity (49.73%), respectively. Female gender (OR=1.35, 95% CI=0.83–2.19) and age (OR=1.17, 95% CI=1.12–1.22) were associated with increased risk of MetS. According to the results of the present study, the prevalence of MetS and its components is high in Shahrak-e- Fajr, Tehran. It needs to implement MetS prevention programs for the families of military personnel.