مجله طب نظامی
سال پنجم شماره 1 (پیاپی 11، بهار 1382)

After Iraq -Iran imposed war; volunteers with spinal cord injudes have been facing lots of problems and complications, which are consequences of relative inactivity. To manage these problems we should use rehabilitative teamwork in addition to treatment and nursing personnel. Rehabilitation efforts can be directed to the entire spectrum of abilities, from directing only one's self care performed by others to being totally independent. The functional program should be accompanied by an educational program for the injured persons, their families, and their caregivers. Instruction is given in the recognition, prevention, and treatment of secondary complications of spinal cord injury.Adapting skills learned in the protective environment of the hospital to the home situation. Help the patient to gain a more realistic correspondence of barriers in the outside environment. It is important to reach a balance in these areas to prevent unnecessarily prolonging rehabilitation toobtain functional skills that are not obtainable or not needed.During this cross-sectional, descriptive study, we determine incidences of pressure sores, urinary calculus, urinary tract infections, spasticity, joint contractures around hip, knee and ankle joints, heterotopic bone ossification, and osteoporosis in thirty five available war induced spinal cord injuries in Khoozestan province, and finally suggest primary rehabilitative instructions to decrease secondary complications.

Spinal cord injuries are one of the chronic disorders which has the long lasting destructive results on individuals. The present study is to estimate the physical effects caused by spinal cord injuries among the war casualties with spinal cord injuries in lorestan province in 1377. The data for the study were collected through cheek list, clinical examination, paraclinic and lab Iests. The results showed that among a1l participants 65% urine disorders, 57.5% sexual problems,27.5% bed sore, 82.5% myalgia, 75o/o muscle spasm, 45% backbone deformity, 85% joint movement limitation, 87.5% muscle atrophy, 80% digestion problems, 37.5% constipation, 72.5Yo abdominal distension, 5% anorexia, 27.5% heart burn. In this study other variables, such as age, sex, job, hemoglobin, hematocrit, blood sugar, triglyceride, cholesterol, creatinine, urine infection were considered. The results of this kind of studies make it possible for us, based on the participant need, to give better services to them and to make better educational, prevention, and clinical programs for improving their life situation.

In most developing countries trauma is a leading cause of death among older children and young adults.It is also a leading cause of disability and health related economic losses in most of these countries.Focusing on hospitalized. trauma patients from epidemiological view, this study sought to provide backgrounds needed for improving trauma care based on identifying common trauma mechanisms and major groups at risk. In this prospective research, 1393 trauma hospitalized patients were studied based on a questionnaire including all demographic, injury-related and diagnostic-therapeutic intervention data.Results of this study shows that young men were the major group at risk' Road traffic Accidentswith 37% and falls with 35% were the more common mechanisms of trauma while lacerations, struck by falling objects and gon-shot wounds were following mechanisms, In road traffic accidents motorcycle riders, car occupants and pedestrians incluad the most ofttauma victims by 42.1%, 28.1% and25.6% respectively.75.6% of patients had minor injuries while the moderate injuries was 18.2% and only 6.2% of patients had major injuries improving hospital caresbesides development in preventive programs and pre-hospital cares, focussed on trauma Registry,and is one at the priorities in approaching to trauma problem.

valfajr 4 operations took place in 1983 on two operative axes in the northwestern regions of the country in mountainous areas with the involvement of Sepah forces in collaboration with the lslamic Republic Of Iran's Army. In this article hygiene section in various fields is being discussed: Food hygiene, environmental hygiene and hygienic training, psychological health and preventive health before, during and after the operations. In this discussion weak points and expediencies are assessed and finally some proposals for improving the hygiene section of forces in operations are made.

Amebiasis caused by Entamoeba histolytica is cosmopolitan in distribution.Aproximately 80% of the morbidity population are without any signs.A recent estimate is that there are about 500 million infected individuals worldwide,with an annual mortality rate of 75000 to 110000. It is caused the third mortality after Malaria and Schistosomiasis in the world. In this research, we will be determining prevalence rate (PR) of intestinal amoebiasis (IA) and related factors such as age and sex in villages of Sarakhs. The type of study was cross-sectional. PR of disease was determined by 250 samples of stool from three villages (one located in flat, the other in slope and tertiary located in mountain area (Total 250 persons were srudied in three villages. (100 in flat area, 88 in slope and 62 in mountain area). In this study, no acute amoebiasis was seen. PR of IA was 7.2 percent. Because all of cysts positive were in flat area, hence PR of IA in this village was 18 percent. Proportion of infected in male was 11.9 percent and in female 22.4 petcent. Sex differences of infected persons were not statistically significant. (P>0.05) The highest proportion of infected age gloup was 5-9 year. Mean of age of irrfected persons was 22.7 years (standard deviation:17.3) and in other was 24.1 years (standard deviation=28.1). Differences of mean of agewere not statistically significant.(P>0.05) occurrence of Amebiasis is worldwide. The most infected areas in the world were Asia and Africa. PR of amebiasis in cities of Iran is 6-8percent and in rural areas 5 to over 30 percent Total PR of IA was 7.2percent. Lack of infected person in later villages for many reasons especially sanitary water availability in these areas. Differences of Proportion in male and fema1e groups were not statistically significant.(P>0.05)This result is consistent with other studies. In this Study, most of cases were seen in 5-9 year age group. Whereas other studies showed that, most of cases occur in 20-40 years. As a result, for control ot the disease, water sources and other public finances must be care intensively.

The current reseatch is a cross - sectional study stress with purpose of, determining.the relation between nursing managers’ and efficiency in the offiliated of hospital Baghiyatollah (a.s) and Army universities. of medical. sciences. In this study 90 headnurses were selected.through census. Data collection tools included filled general questionnaire: and stressor variable tests, also manager’s efficiency assessment inventory with likert scoring scale. The datas were analyzed by descriptive and inferential statistical methods.In this study 38.8% of nursing.managers had mild, 35.6% moderate and,25.6 severe stress. Also 7% of nursing managers had very low 9.7%, 27.7%. moderate, 32%high, 23.6% very high efficiency Also there was significant correlation between stress and efficiency in headnurses. (P = 0.001) There was significant.correlation between severity, of stress and efficiency.in headnurses. (P = 0.01) According to the findings of this study, there was no statistical significant corelation between headnurses employee in affiliated hospitals of Baghiyatollah (a.s)and Army universities.

Typhoid fever is a global health problem, that12 -23 miliion cases occurring worldwide each year.In endemic countries the incidence of infection is highest in children but in epidemic event infection can involvement and result high and mortality in adult age. This is a retrospective study in a admitted patients with typhoicl fever. Patient’s recurite to this study when first diagnosis typhoid fever. Total cases are 54 person of a militaty unit, that all cases is men and age between 19 - 21 years, 39 patients (72/2%) have clinical diagnosis, 2 patients (3/7%) have microorganism diagnosis, 13 patients (34%) have serologic diagnosis with Widal test. All patient’s treated imiprical with combination antibiotic with ceftriaxone lgr/Bid pluse Ciprofloxacin 500 mg/Bid. Two patients (3/7%) have antibiogram test that found sensitive to Chloramphenicol, Ampicillin, cotrimoxasol. Six patients (11/1%) have a bad condition and Complication of typhoid fever and suspected to DlC that referred to center hospital. Two patients (3/7%)have intestinal perforation and give surgical treatment and one patient (1/8%) was expired. The source of epidemic was water borne and 40patient's (74%) had consumption water from container and 14 patients (25/9%) from tap water. The epidemic control needed to complete management and the cause of epidemic should be rapidly diagnosed. Epidemic should be treated with the best and cost effective drugs. The sourcsof Epidemic should be controlled and eradicated as soon as possible. Drinking water should be sanitized and chlorinating for military.

By use of biological weapons in recent war we are faced with new diseases that their pathogens are not clear and the military personal and civilians are not vaccinated for these new diseases. For diagnosis and treatment of such infections we must evacuatwig a limited number of patients to special Hospital with containtent laboratories. Air evacuation is the best way for transpolting these patients. this article we speak. Abut. How miymising the risk for transmission of infectious diseases to.Air crews Caregivers and civilians.

After a nuclear attack or a similar accident, radioactive pollution is distributed in the environment This contamination enters different elements of the environment such as atmosphere, aquasphere, geosphere and also animals and vegetables. Man as the most important element of the environment can be exposed to chemotoxicity and radiotoxicity of radioactive contamination from physical elements of the environment, herbal and animal sources. Meanwhile, vegetables as the main and basic source of human foodstuff which are consumed after processing or directly considered important. So these parameters absorbable radioactive contamination in the herbal environment important Radionuclides, quality and quantity of their adsorption in different vegetables, effective in adsorption, radionuclide accumulation in the plant, velocity and quality of contamination transfer to animals, animal products, and the man specially by vegetable foods. Recognizing the quality and quantity of these cases as a whole to the people in general and specially organizations in charge of decision making gives the ability to determine our strategy against herbal Sources which have important effects in different aspects of human life in a nuclear war, and will Determine how use these sources in short and long term.

When Nuclear accidents occur in many types such as, bombing in nuclear power plant and non intentional leakage of nuclear agents or applied radioactive weapons, number of people and personal may be contaminated. Thus in this time essential efforts are: - Save of victims and injured patients by CPR - Contamination Detection in all victims and patients - At the end, decontamination of injured patients Skin external contamination include: Body orifice, Eyes, Ears, Nose, Mouth, Hair, Nails. In the most of nuclear disasters, essential activity is remove any radioactive material from skin. 4 kinds of radio nuclide effects against skin or skin reaction in low and high radiation dose(<3 Gy), (3 -5 Gy), (<5 Gy) include: Erythema, linear structural changes in skin dermis, finger trip disappearing, basal layer damage, skin scaling and the end ulcer and necrosis. Washing and local cleaning of intact skin is enough in Nuclear disasters and in wonder injured skin we must covered all clean skin areas with waterproof covers. Of course, contaminated area must be washed softly with soft brush and warm water or detergent agents near to center of contaminated areas to reduce contamination releasing. Use of antiseptic agents and abrasive material example adhesive tapes and particular solution as a decontamination agents, can be damaged to horny layer of skin.