نشریه بهداری رزمی دفاع مقدس و مقاومت
سال سوم شماره 1 (پیاپی 5، بهار و تابستان 1399)

One of the rich resources and supports of the culture of our society is the culture of self-sacrifice and martyrdom that has flowed from Islam. This culture extends to all aspects of society. The healthcare system also has a high level of culture and a high capacity for self-sacrifice and martyrdom. This part of the study deals with semantics and thematics by combining selected opinions of experts and combining them with a selection of authoritative local sources. Topics are categorized and presented in three groups: major, detailed and specific. The results of this part of the study will be the basis for detailed reports.

The study method is descriptive, field, survey, and applied. This part of the study has been done with a focused group discussion with elites and experts, as well as by literature review and with reference to reliable local sources.

The results of the study are presented in 12 major issues and in each issue, a conceptual definition and a list of general and specific topics are presented: "concepts and thematics", "principles and indicators", "harms and threats", "valid and inspiring models" "Individual and family dimensions", "Social dimensions", "Spiritual dimensions", "Cultural and promotional dimensions", "Examples", "Sacrifice and martyrdom in describing witnesses", "Ideals and symbols and ceremonies", and "Relationship of the culture of self-sacrifice and martyrdom with the culture of resistance".

The valid components of the culture of self-sacrifice and martyrdom, derived from Islamic teachings and experiences of revolution and holy defense, are numerous and extensive. This study has identified and described 12 major issues and in each major issue, a list of the most important general and specific topics (related to health) has provided.

The development of biological sciences, microbiology, biotechnology and genetic engineering, industrial applications of microorganisms, has posed a terrorist threat. Along with the production, development and use of biological weapons for military, bioterrorist, agro-terrorist (against plant resources), and ecotourism (against economic resources) purposes, the epidemic of some infectious diseases has endangered human security. The subject of this study is to survey biological threats to the health of individuals and society and the phenomenon of bioterrorism, its relationship with national security and ways to deal with it by the passive defense approach.

This study was conducted by descriptive-analytical method, using literature review and cyberspace and using the experiences of authors and experts.

Threats of infectious diseases (AIDS, SARS, Corona, influenza, typhoid, leishmaniasis, etc.), biological terrorist attacks and bioterrorism are considered security issues. These health threats, which have national, regional and international security dimensions, and ways to deal with them, before, during and after incidents, have been studied with a passive defense approach. Measures taken before the biological attack, consolidation of infrastructure, enhancement of threat response capabilities, lead to resilience and reduction of vulnerability to biological threats. The passive defense as a peaceful and preventive method without the use of weapons by using new techniques and methods of detection, protection and safety, elimination and repulsion of pollution, is the best way to reduce vulnerability to biological threats. Along with Passive defense, the protection and security organizations before, during and after a bioterrorist attack, play a constructive and undeniable role in controlling, inhibiting and countering biological threats.

Preparedness, forecasting, prevention, the resilience of manpower and endangered structures, detection, protection and safety, elimination, and disposal of pollution are strategies to reduce vulnerability to biological threats. Preventing bioterrorist operations is more important and better than dealing with them after the operation. Dealing with the spread of a bioterrorist agent requires spending time and budget, the equipment, and facilities. Passive defense is the most effective and efficient approach to dealing with biological threats and protecting national security. The key and pivotal role in the country's biological defense is played by the country's passive defense organization. In this organization, it is necessary to integrate human and veterinary public health monitoring, as well as the coordination of scientists and health service providers.

Ensuring environmental health is a necessary requirement in any circumstances. In the context of the imposed war, the dangers of the war led health officials to take special care to ensure the health of the environment. Among the measures taken is the issue of water hygiene, which will be addressed in this article, and the process of how to provide safe and hygienic water is presented.

Coronavirus disease 2019 (COVID-19) is caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its common symptoms are similar to other respiratory viral diseases such as loss of smell, fatigue and myalgia, cough and fever. In these patients, the symptoms of the runny nose are less than other respiratory viral diseases. Also, the distance between infection and the onset of symptoms is relatively longer than other respiratory viral diseases, and its contagious rate is very high.

This is a short review and the authors have used some of their personal experiences to analyze the data and findings.

Laboratory tests such as Reverse-Transcription Polymerase Chain Reaction (RT-PCR) have an accuracy of approximately 71% for the detection of COVID-19. CT scan is a very accurate tool for this purpose, its accuracy according to initial reports is about 98%. So far, no effective vaccine has been found for this disease, although some vaccines have been introduced.

In patients hospitalized with the possibility of developing COVID-19 in the hospital, CT scan is a more sensitive and faster alternative to RT-PCR.

Throughout history and from birth to death, human has faced three wars (with nature, with the man, and with ego) and if he/she wants to have a good life, it is inevitable to resist and defend against these attacks. One of the most obvious human-to-human wars in recent years is the aggression of the ruling regime in Iraq against the Islamic Republic of Iran on September 22, 1980. Although to some extent in this eight-year war, specialists and university professors orally passed on health experiences (health, treatment, and health management) to the next generation, they were not written as they should have been. What can be written when it can convey the message of oppression and self-sacrifice of that time to today's young generation that can also play a role in solving current problems. One of the applications of these experiences is comparing immunopathological studies of chemically injured lungs with lungs of COVID-19 patients. Coronaviruses commonly cause pulmonary and internal infections in humans and animals, and in China in 2002 and 2003, they were considered almost benign viruses before the discovery of the potential for the acute respiratory syndrome (SARS-CoV). A decade later, the Middle East Respiratory Syndrome Virus (MERS-CoV), which had clinical manifestations similar to SARS, was identified in patients with pneumonia. SARS-CoV-2, SARS and MERS are of animal origin and have evolved into a form that can cause infection and fatal disease in humans. Genome sequencing showed 79% similarity of SARS-CoV-2 to SARS and 50% to MERS. Also, amino acid sequencing of some proteins indicates 68% similarity of SARS-CoV-2 proteins to SARS. Clinical symptoms of COVID-19 similar to SARS and MERS include fever, fatigue, and pulmonary symptoms such as cough, and shortness of breath. Radiological findings showed involvement of both lungs in most patients (81%) with COVID-19 with manifestations such as ground-glass opacity, crazy-paving pattern, and consolidation lesions. Laboratory findings also indicate lymphopenia and increased levels of acute-phase protein (C-reactive protein). In this disease, a portion of patients suffer from acute respiratory distress and require hospitalization in special conditions (ICU), and unfortunately, some have found a critical condition that can lead to death.

In today's modern world, despite numerous advances in medicine, the hemorrhagic shock is still the leading cause of death on the battlefield and the second most common cause of death in civilian trauma. Hemostatic agents can play a key role in establishing hemostasis in the prehospital setting and preventing hemorrhage-associated death. In this regard, the purpose of this article is to investigate the various aspects of known hemostatic factors.

A comprehensive search of academic scientific databases for related keywords was performed. Related articles were evaluated.

Hemostatic agents can cause hemostasis by different mechanisms, including concentrating coagulation factors, adhesion to the tissues in which traumatic hemorrhage occurred, and delivering procoagulant factors to the hemorrhage site. At present, these hemostatics have been significantly improved with regard to efficacy and adverse consequences resulting from their use. Several hemostatic dressings have been developed to receive FDA approval and are being used practically on the battlefield. In addition, there are currently several reports on the use of such hemostatics in the hospital setting, in conditions where commonly known approaches fail to stop life-threatening bleeding.

The use of hemostatic dressings and agents is one of the main advancements achieved in recent decades. However, it can be claimed that the ideal hemostatic has not been recognized yet; therefore, this topic needs to be brought into focus and further addressed.

War trauma is different from civilian trauma in diverse aspects. In fact, the mechanism of war trauma is generally more severe than civilian injuries; therefore, the type of treatment and management of war trauma is completely different. In this article, we address the challenges of dealing with war casualties with facial and oral trauma and how to treat a patient based on evidence-based military medicine.

Case Report:

 A 25-year-old man was hit by shrapnel after an explosion. On initial examination, there was a wound on the face in the area of the left cheek that opened into the mouth and had several teeth crushed. Severe bleeding from the gums and tongue was evident, and the tongue was cut in half by shrapnel from the base.

In a field hospital, due to a large number of injured, we generally face critical conditions, which means that there is a real need for triage of the injured, but like the civilian crisis, color triage does not make sense, but triage is based on the injured person's need for urgent surgery that should be considered in military medicine. Due to the simultaneous facial injury and the possibility of a chest injury, the main focus was on the airway and breathing of the case, and in the next stage, the tongue was repaired.

Influenza is a contagious viral disease whose causative virus belongs to the orthomyxoviridae family. The genome of this virus contains RNA, the various types of which can infect humans, birds and many mammals and cause various symptoms and disorders in their bodies. The first documented report of the epidemic and the widespread outbreak of the disease in human society is considered having started after the First World War. The use of scientific resources and therapeutic experiences in dealing with this epidemic can be helpful in choosing therapeutic approaches and fighting various infectious diseases, including influenza in the present time.

This article has been conducted by literature review in national and international reliable scientific online databases.

Influenza virus causes infection in the respiratory system, which after a latency period of 2-3 days causes symptoms such as fever, myalgia, muscle pain, shortness of breath, cough, etc. The disease can be dangerous in people with underlying diseases such as cardiovascular, respiratory, diabetic and cancer patients and cause the highest mortality rate in them. There are three types of influenza virus: type A, which causes disease in humans and animals, type B, which causes disease in humans and mammals, and type C, which only affects humans. So far, there have been four pandemics of influenza in 1918-1919, 1958-1957, 1968 and 2009, regardless of the type of virus that causes it, in terms of the incidence and mortality, the first pandemic 1918-1919, closely after World War I (1914-1918), stands on the top.

Influenza has become epidemic, both seasonal and epidemic, as well as pandemics, killing millions and causing irreparable damage, as well as financial costs and damage to the global economy. Although the current conditions of medical knowledge and the facilities and equipment required in each historical period are different from each other and sometimes incomparable with the present, basic principles such as improving knowledge and level of public health literacy, personal hygiene and strict implementation of social guidelines, access Vaccination and immunization of people in the community, as well as access to effective drugs for viral infections, have been among the most important foundations and essential achievements in the fight against the spread of influenza in human societies.

The beginning of the imposed war and the massive invasion of the Ba'athist enemy to the borders of Iran and along with the national defense of soil with the progressive cohesion of combat forces, the presence and activity of medical service units in all areas was necessary. One of the important parts of this specialized health unit, which is known as the combat health unit, was the part of pharmaceutical services. Recognition of this key part and how it communicates and cooperates with other specialized pharmaceutical systems of the country with the aim of rapid supply of essential drugs and sustainable support for permanent access to the daily needs of the battlefields is the aim of this study. In order to conduct this research, in addition to studying libraries, searching for national and international online scientific databases, as well as conducting oral interviews with all stakeholders and officials of pharmaceutical services during the holy defense period have been used. The pillars of drug supply management during the eight years of the Holy Defense included the then Ministry of Health (and since 1985 the Ministry of Health, Treatment and Medical Education) and the Army and IRGC Combat Health Unit, and also the Red Crescent Organization, pharmaceutical factories, drug distribution companies, schools of pharmacy, and research centers of medical universities. The responsibility of the management of this complex, as a supply chain for the pharmacy needs of the battlefields, is by the Central Coordination Headquarters, which use all the potential and actual capacities in the country, even in the conditions of the oppressive sanctions of global arrogance. The establishment of the Central Coordination Headquarters played a vital role in meeting the immediate pharmacy needs of the battlefields. In this regard, by starting a generic project in the pharmaceutical system, using the power of committed specialists and professors of pharmacy schools, establishing university pharmaceutical research centers, creating a spirit of self-confidence and relying on our national slogan, we can create a role in the pharmaceutical industry, activitis of the Red Crescent Organization, the presence of pharmacists and pharmacy students on the battlefields, gaining opportunities from arrogant threats, etc., and most importantly; national belief in the culture of self-sacrifice and resistance in addition to pure obedience to the Leader added another leaf of pride to the pages of the glorious history of the Islamic regime in the field of providing medical services during the holy defense. On the other hand, this dynamic and leading management chain will be a very valuable experience for current and future generations of those in charge of the country health system in providing the best services with a resilient economic approach that is an urgent and undeniable need of the country even in the absence of sanctions.