فصلنامه ابن سینا
سال دهم شماره 1 (پیاپی 25، بهار 1386)

Varicocel is known as one of the most common causes for male infertility which occurs by means of different mechanisms. In particular immunological reasons such as anti sperm antibody (ASA) may have role such infertility. Although varicocelectomy is identified as a risk factor producing ASA، its role is not fully understood، while the impact of some other surgeries including vasectomy، orchiopexy and testis biopsy and infection on the production of ASA have already been well recognized. Upon clinical examination، 65. Varicocel patients، whose were candidate for varicocelectomy surgery، were selected. A prospective study for an assessment of ASA level in semen and serum pre and post surgery was conducted. The level of ASA was measured by direct and indirect sperm-MAR-test. Over 15% ASA level was considered as positive result. 60 patients with the mean age of 24 (18-33) completed the study. The semen analysis after surgery showed recovery regarding all three parameters including sperm count، motility and morphology، where changes in count and motility revealed significant (p<0. 05) differences. 29 % of patients before surgery showed positive level of ASA (20-40%)، whose ASA level 3-month after surgery yielded 53 %، and serum level of ASA before and after surgery displayed significant (P=O. 03l) differences. In semen، however، the level of ASA did not show any differences (p=0. 772). After surgery، semen parameters were compared within ASA positive and negative patients and significant (p= 0. 035) differences were observed in terms of motility. Within patients with negative ASA before surgery، 48 patients showed ASA level about 5-15% with no effect on semen parameters. Based on our findings، it can be concluded that varicocelectomy may cause positive ASA levels in serum of patients after surgery. However، in comparison with patient with negative ASA after surgery، no fluctuation in the semen parameters can be seen except reduction in motility. Since varicocelectomy displayed no effect on semen ASA، thus varicocelectomy do not trigger unfavorable effects، even if it initiates some increase in serum ASA.

Ovarian cancer is the second most common cancer in gynecology. The most important prognostic factor is the diagnosis of the cancer in early stages; therefore، we tried to evaluate ultrasonography as a non invasive method in the work up ovarian masses. The study was retrospective. It involved 100 patients with ovarian mass that had an abdominal ultrasonography 1 week before surgery in that center. All of 100 patients had laparoscopy. After the procedure، we compared pathology and sonography reports. Age of patient''s ranged from 12-78 years. sonographic findings in benign tumors included، 80% benign، 14% malignant، 4% normal and 2% suspicious. There fore، the sensitivity of this method in benign tumors is 92%، specificity is 80% and accuracy is 0. 85. Sonographic findings in malignant tumors included، 73% benign، 63. 4% malignant، 2. 4% normal، and 26. 8% suspicious. Consequently، the sensitivity of abdominal sonography in malignant tumors is 63%، specificity is 80% and accuracy is 0. 7. Abdominal ultrasonography is very sensitive and specific in benign tumors. It also has good specificity and accuracy in malignant tumors; as a result it can used as the first step in management of ovarian masses.

Piloting is one of the most critical and stressful professions in any society and may be considered as one of the most important military and defensive occupations. The closer a pilot to physical and mental health the higher is his performance. Thus، anxiety، being an important factor influencing behavior and performance، deserves close attention and careful study. The purpose of this study was to assess anxiety in pilots and to compare results with office workers. We conducted an ex post facto study to find the underlying factors affecting a behavior (anxiety). To do this، we compared subjects demonstrating this behavior (pilots) with others who lack such a behavior (office workers). A total of 68 pilots were randomly selected from all pilots residing in military air bases and compared with 68 office workers in terms of anxiety. We used the ketel test to assess anxiety. 20. 6% were fighter and 79. 4% were transport pilots. 39. 7% had participated in military operations and 14. 7% had experienced air accident. The average anxiety score did not show meaning ful difference among pilots and office workers، pilots participating in military operations versus non participators، and transport and fighter pilots. (p>0. 05) The average anxiety score was significantly different between pilots who had experienced air accident and others who lacked such experience. (p<0. 05) Our study showed no significant difference in anxiety between pilots and office worker at 0. 05 level. The failure to confirm other hypotheses may be due to the paucity of samples. Furthur research in different bases is recommended.

Dermatitis is a common problem both in the workplace and in the general community. Airline personnel represent a novel occupational group as they are also exposed to a wide range of potential chemical irritants and other aggravating factors. Such as low relative humidity and airborne pollutants. Common skin irritants include dielectric fluids from electrodischarge machining، ‘pre-preg’ materials and sealants in aircraft manufacture، kerosene and various jet-fuel components. Commercial jet fuel is a complex mixture of aliphatic and aromatic compounds، and there is potential for dermal exposure among refueling and maintenance crew. Low relative humidity appears to exacerbate dermatitis amongst aircrew، especially on longer flight durations. Pilots may also be exposed to additional skin irritants outside of the cabin environment، such as ethylene glycol، hydraulic fluid or jet fuel، all of which may be encountered during routine inspections of aircraft before and after flight. Given these factors، preventive measures must carefully consider the undoubted potential for contact with irritants and allergens، which may lead to dermatitis in airline personnel.

Popularly and expansion of air transport and its convenience and ease has made the issue of airborne، food borne and zoonotic disease transmission during air travel to a critical public health problem. The immense fear of bioterrorism draws attention toward the potential of spread of these agents through air travel. The incidence of SARS in 2002 showed the serious role of air transport in rapid dissemination and potential risk of pandemy of such disease. In addition to air crew، public health officials and care providers have a major role in defection and control of infection during air travel and must have of knowledge of the local and international guidelines.

Calcium is an essential mineral with different vital actions. It is the main constituent of bones and teeth and also plays a mjor role in neural conduction، muscle contraction، control of heart rate، coagulation، energy production، endocrine function، and finally، immune function. There is solid evidence to support the beneficial effects of calcium intake on behavioral performrmance of soldiers. Calcium deficiency in soldiers is usually due to inadequate dietry intake or excessive loss in urine or sweat، strenuous exercise can make up for this dietry inadequacy by increasing the bone mass; however، weight loss may decrease bone mass in soldiers. Studies about the role of calcium in preventing fractures in soldiers are under way. It seems that the stress caused by military training increases calcium needs in soldiers، whereas the increase in bone mass، resulting from exercise، may itself make up for this increased need. The institute of medicine recommends the adequate intake (AI) and Military Dietry Reference Intakes (MDRI) to be 1000mg/day for men and women during military training and 750-1000mg/day during military operations.

Fungal Infections are common and can be local or systemic. Due to their resistance to common antibiotics there are few drugs for systemic fungal infections. A complete knowledge of antifungal medications is necessary regarding the critical conditions of flight. In the military section: The Canadian Air force allows the use of oral antifungals like terbinafin and flucconazole for non pilots if no adverse reactions occur after being grounded for one week. Pilots who use these drugs don’t receive the permission for flight even as copilot or with copilot assistance. In the civil section: FAA allows the use of oral antifungals like terbinafin، grisefulvin and itraconazol for the treatment of chronic onycomycoses in the absence of adverse effects. It is noteworthy that in the presence of systemic fungal infections which are potentially life threatening، the decision about the flight status depends firstly on the severity of the disease and secondly on the type of medication; and is the duty of the flight surgeon.