فهرست مطالب
Journal of Archives in Military Medicine
Volume:3 Issue: 2, May 2015
- تاریخ انتشار: 1394/03/15
- تعداد عناوین: 7
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Page 1BackgroundDespite the known risks of having high blood pressure, there is still a high prevalence of undiagnosed hypertension cases in society. A number of suggestions have been put forth over the years to counteract this issue. One suggestion was implementing a screening program; however, there was a high cost as well as a fear of low accessibility from lower socio-economic classes. Alternatively, there has been a suggestion to raise the degree of awareness about the risks of having high blood pressure..ObjectivesThe aim of this study was to determine the effectiveness of using nongovernmental organizations (NGOs) to promote awareness of hypertension and self-control management methods in families in Ardabil, Iran..Patients andMethodsIn 2007, a quasi-experimental study was completed with the collaboration of local volunteers in Ardabil. A total of 84 volunteers and 121 patients with hypertension were included in the study. Educational workshops were held for the volunteers by the NGO (Saman) and patients were educated by the volunteers. Thereafter, both groups were assessed for awareness by using self-administered questionnaires. The data was then statistically analyzed by paired t-test..ResultsApproximately half of the volunteers aged between 21 and 30 years, 94% of them were female and 68% of this cohort was single at the time of the study. Approximately 46% of the volunteers had an education level equivalent to a diploma. Paired-samples t test revealed that there was a statistically significant difference (P < 0.05) between the scores of awareness before and after education in both groups..ConclusionsHolding workshops by NGOs to train volunteers on hypertension is a helpful method to increase awareness about hypertension and control measures in patients with high blood pressure..Keywords: Organizations, Education, Hypertension, Volunteers, Iran
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Page 2Background
In 2001 the Council of Ministers of the Kingdom of Spain authorized the participation of Spanish military units in the International Security Assistance Force (ISAF) in support of the Afghan government. Four years later, Spain assumed control of the Forward Support Base in Herat (Afghanistan). Because of its capabilities, personnel, and equipment NATO considered it as the medical reference installation for the four provinces that form the western region of Afghanistan..
ObjectivesThe current report aimed to describe anesthesiology and surgical experiences of Role 2 Enhanced (Role 2E) in heart, Afghanistan, from March to May 2014.
Patients and MethodsAn observational, descriptive, retrospective study was conducted from March to May 2014. The civilians and military personnel wounded by firearm or explosive detonation in western Afghanistan, who were treated at the Role 2E in herat were included. There were no exclusion criteria..
ResultsSeven hundred and forty five patients including 181 Afghan civilians, 82 non-Afghan civilians, 24 Afghan police and military, and 458 military ISAF, were treated during the study period. There were 10 combat casualties among them. All patients were male and aged 25-30 years; seven had been injured by an explosive and three by firearm; five with head-neck wounds, two with wounds in the upper limbs, two in the abdomen, one in the thorax, and one in the lower limbs. The New Injury Severity Score (NISS) was one mild, five moderate and four severe. There were 14 surgical patients (seven wounded in combat and seven non-combat casualties, and 12 patients were admitted to the Intensive Care Unit (ICU). None of them died. A total of 12 general anesthesias, 11 regional anesthesias (three intradural anesthesias, three interscalene blocks, one axillary block and four femoral blocks) and six local anesthesias with sedation were performed..
ConclusionsDuring the study period, 745 patients were treated, including 10 combat casualties. Twelve general anesthesias, 11 regional anesthesias (three intradural anaesthesias, three interscalene blocks, one axillary block, four femoral blocks), and six local anaesthesias with sedation were performed. Twelve patients were admitted to the ICU. These anesthesiological and surgical experiences can be helpful in future military deployments..
Keywords: Anesthesia, Surgery, Critical Care, Afghanistan -
Page 3BackgroundThe occurrence of neurologic complications in the intensive care units (ICUs) is one of the major risks in management of patients. These sequels may be caused by structural or metabolic disorders. The same phenomenon can be seen in the toxicology ICUs, although the toxicological effects of drugs and poisons may also cause the neurological complications..ObjectivesThis study aimed to determine the frequency of neurological sequels and their causes in patients hospitalized in the toxicology ICUs..Patients andMethodsIn this descriptive study, the data of patients admitted in toxicology ICU of Baharloo Hospital, Tehran, Iran, were investigated during a 2-year period (2010 ‒ 2011) and the patients with neurological sequels, based on neurological examination or brain computed tomography (CT) scan findings, were included. Data recorded in questionnaires were analyzed by means of SPSS software, with a significance level at P < 0.05..ResultsOut of 1571 patients admitted in toxicology ICU during this period, 56 patients (3.56%), with the mean ± SD age of 36 ± 13.01 years, were included. The most common finding in neurological examination was the Babinski sign (67.9%). Ischemic encephalopathy with brain edema was the most common finding on the brain CT scans of these patients (33.9%). The mortality rate was 58.9% (33 out of 56). Thirteen patients (23.2%) were discharged with vegetative state. The most common cause of neurological sequel, in this study, was hypoxia (64.3%).ConclusionsThis study, for the first time in Iran, investigated the frequency and cause of neurological sequels in toxicology ICUs. The findings can improve the prophylaxis and diagnostic programs for the patients in this field..Keywords: Sequels, Tomography, Hypoxia, Intensive Care Units, Toxicology
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Page 4BackgroundPseudomonas aeruginosa is an opportunistic human pathogen, which causes serious problems especially in people who have immunodeficiency. Recently, metallo-β-lactamase (MBLs) resistance in this bacterium has led to some difficulties in treating bacterial infections. The blaSPM-1 is one of the MBL gene families, which induces resistance to the carbapenem class antibiotics; this gene has not been previously assessed in Iran..ObjectivesDetection and quantification of blaSPM-1- metallo-β-lactamase gene among resistant Pseudomonas aeruginosa strains (imipenem), isolated from patients in Isfahan hospitals..Patients andMethodsA total of 180 samples were isolated from various nosocomial infections. These isolates were identified as Pseudomonas aeruginosa by using biochemical tests. In order to determine their bacterial drug resistance-pattern the Kirby-Bauer disk diffusion method was utilized. Presence of MBLs in imipenem isolates was detected using the combine disk technique (IMP-EDTA). Similarly, an E-test on Mueller-Hinton agar was used to determine the minimal inhibitory concentration (MIC) of imipenem isolates. The imipenem isolates were then subjected to polymerase chain reaction (PCR) to detect the blaSPM-1 gene. Data were analyzed using the SPSS software (version 16, SPSS Inc., Chicago, IL, USA)..ResultsIn total, 96 isolates of Pseudomonas aeruginosa were collected. Of all isolates, 34 (35.41%) were found to be imipenem-resistant P. aeruginosa. The MIC levels in all imipenem-resistant strains were MIC ≥ 32 μg/mL. Thirteen (38.23%) of the imipenem-resistant P. aeruginosa isolates were MBL positive. None of the isolates carried the blaSPM-1 gene, as indicated by the PCR assay..ConclusionsThe rate of imipenem resistance due to MBL has increased dramatically. Early detection and infection-control practices are the best antimicrobial strategy for this organism..Keywords: Pseudomonas aeruginosa, Imipenem, Nosocomial Infection, blaSPM, 1, Metallo, ?, Lactamase
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Page 5BackgroundStress causes various physiological, histological and behavioral changes..ObjectivesThe goal of the present study was to evaluate the effects of chronic immobilization stress on plasma ghrelin level, food intake and body weight in both male and female rats..Materials And MethodsTwenty male and 20 female rats were studied. These animals were divided to four groups (two control groups and two experimental groups). In the experimental groups, rats were exposed to immobilization stress for 14 days. On the fourteenth day serum ghrelin level was measured by the ELISA kit. Food consumption and body weight change during 14 days were also recorded. Student t-test was used to compare mean among the groups..ResultsIn male rats, immobilization stress significantly (P 0.0001) increased serum ghrelin level and decreased body weight as compared with the control group (P 0.0001). Food consumption significantly (P 0.0001) increased in stressed female and male rats..ConclusionsThe results of this study indicate that the effect of stress on serum ghrelin level and body weight is gender-depended..Keywords: Ghrelin, Food Intake, Body Weight
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Page 7Context: Platelet-rich plasma (PRP) is an autologous blood production that majorly contains high concentration of platelet and is known for its healing properties. The purpose of this paper was to assess the future application of PRP in military medicine.. Evidence Acquisition: In this review, the appropriate online databases including PubMed, Science Direct, and Wily were searched until January 15, 2015, using free text and MeSH. Only English papers were included such as systematic reviews, clinical trials, and randomized clinical trials (RCTs). Forty-nine papers were included in this study. Included studies were categorized based on topics related to regenerative characteristics of PRP, and considering at least one clinical output. Data from selected studies were reviewed based on year of publication, animal or human studies, and results. A total of 59 papers including RCTs, case control, and review studies were found among which 49 publications showed favorable outcomes with the use of PRP. The reviewed studies were separated into six groups as follows: Tendon injury, bone injury, wound healing, dermatology, rejuvenation, and hair growth..ResultsAccording to reviewed studies, use of PRP produced “inconsistent” but «promising» results in early trials. This study attempts to evaluate perspectives of PRP application in regenerative medicine as an efficient treatment and an innovative technology for military medicine through implementation of a review of literature..ConclusionsThis review represents an advantage of PRP application in healing quality such as improved regeneration for bone graft and an enhanced wound-healing rate; however, PRP therapy system has still remained controversial due to the lack of reliable studies..Keywords: Wound Healing, Military Medicine, Bone