مجله طب نظامی
سال چهارم شماره 4 (پیاپی 10، زمستان 1381)

In respect of disagreement among specialists about psychoJogical impacts of war, this study was performed for assessment of signs, syptoms and diagnosis of disease type in 52 psychological casualties of war by using demographic questionnaire and interviews. The analysis collected data showed that psychological symptoms accompanied by somatic are wide spread in addition most important psychological disorders and neurotic or reactive impairments and Post Traumatic stress Disorder (PTSD) which is the most common clinical feature. Based on this study we can say that, naturally, terrible stresses of war.impair the personality organization and with predisposing factors reduce to presentation of psychological impairments that in this study is PTSD, like many other studies, and is better to call this entity post war Stress Disorder.

This study was carried out in 1990 on 35 randomry selected pilots in the Revolutionary Guards, aimed at identifying the prevalence rate of psychological disorders and work fatigue. The stud1, was based on the SCL90 method. The required data was collected using the SCL90 test and the work fatigue test. This information was analyzed by spss. The result revealed that the overall indicator of the severity of the illness among the group under survey was higher than normal society. Generally, about 8.5% of them suffer from psychological disorders. The prevarence of the following symptoms was higher than the rest: obsession, paranoia, depression and anxiety. Furthermore, among 8.5% of the pilots, sever work fatigue was observed. This study also showed a significant reration between work Fatigue and the prevalence rate of psychological Disorders. This relation was mostly observed between work Fatigue and physical complaints, anxiety and depression. Based on these results, researchers made following suggestions: Modification and improvement in the recruiting system of the piloting students, use of accredited psychological toors in the recruiting system, providing consultations for reduction of stress in pilots, and arranging “how to encounter stress,, courses for pilots.

In spite of all attempts for safe blood transfusion, there are a variety of complications such as viral infections, alloimmunisation, hemolysis and immunosupression. Nowadays the main subject of blood transfusion services in the world is provision of safe blood, and one of the best ways is the patient's own blood or autologous blood. In this study, patients who were candidate for elective surgery consulted to Tehran blood transfusion center. With respect to the type of surgery and hematocrit more than 30%, abouI 10% of whole body blood (350-450cc) had been taken out. Collection of blood ceased 72 hour before surgery. After negative viral tests, the blood units, were preserved separately at2-6"C and handed over to hospital before operation. When it was not used, returned to blood transfusion center and with those units which had viral infections, autoclaved and then disoarded. Forthy six cases included in the study, of whom 36 (78.3%) were females. The patients had average 13-72 years of age and weighing 40-105 kg. 19 patients (41 3%) donated one unit of blood, 24 patients (52.2%) two units, 2 pattents (4.3%) three units and 1 patient (2.2%) four units. The only complication occurred in one patient was vasovagal reaction and resolved with sweet liquid diet. Ten patients (21.7%) needed no blood and in 31 patients (67.3%) allogen blood was not used. In plastic surgery- the most common type of surgical operations (41.3%)- ENT, general surgery, Gynea & obst and maxillo- fascillary operations, autologus blood provided i00% the need of the patients and no allogenic blood was used, But in ortlhopedic Surgery, 56.3% of necessary blood was provided with autolog blood. No blood transfusion complication was seen. Autologus blood as the safest blood, reduced necessity of allogenic blood by 70% and can be used more successfully by accurate planning and introduced to the patients who are candidate for elective surgery.

Vascular pooling has the responsibility of circulating blood throughout the body and feeding various tissues, any kind of disorder in this system threatens the vitality of the organ, thus this function is considered a vital system for the body. During the 8 years of the imposed war (Iran-Iraq) numerous casualties suffered from severe problems due to damages in the vascular system, such as hemorrhage, sever decrease in blood pressure (shock), loss of organs (amputation). Due to the lack of precise and informative data regarding the various cilculatory damages till the end of the war, and on the other hand abundance of radiology records in the Shahid Mustafa Khomeini hospital-one of the hospitals in which war casualties were admitted - we decided to study about 3000 radiographic films of the injuries registered in the hospital. Among them, the 157 angiographic films which were suspected to be caused by vasocirculatory disorders were separated and analyzed once again.

Accidents are increased among developing countries. To evaluate the severity ofsuch injuries (secendery prevention), many different scoring system have been devised so far. One of the most common system in this regard is injury Severity Scoring (ISS) which we used in our study to score traumatized patients reffered to emergency services aI Al Zahra medtcale center, Isfah, Iran. Prospectively, 380 traumatized patients were chosen for this study. All the cases involved were transfered to the emergency services of Al Zahra hospital which is an academic center affiliated to Isfahan University of Medical Sciences. Special sheets were already prepared to enlist patients required information such as age, sex, trauma type, literacy status, etc. The collected date were then analyzed with T test and regression test using spss software. P values of less than 0.05 were considered significant. As many as 83% of patients were men and 70% of all the cases were literate.Traumas were penetrating in 50.5% To of all. The age ofpatients ranged between 26.3 -14.15 years. The period of hospitalization varied from 7. 59 - 5.32 days.Those with blunt trauma stayed for 7.37 - 7.71 days while it was 3.2 to 6.9 days for penetrating ones. (P=0.0001) Blunt traumas occurred more frequently in women while men experienced penetrating traumas more. (P=0.03) Head traumas were more severe in woman (P=0.02) and also in blunt traumas (P=0.01) The ISS value varied from 8.9 to 12.63 and was usually higher in blunt traumas than in penetrating ones (P=0.003). No relations between age and ISS could be sought.The findings revealed that compared with penetrating traumas, trauma severity score is higher in blunt traumas. Besides, there were no significant relations between sex and trauma severity.

Electromagnetic field treatment exerts its lethal effect primarily by producing pores in the cytoplasm membrane. And different antibiotics affect on bacteria are dissimilarly and their mechanism of action is different from each other. Researchers have shown that electromagnetic field treatment enhances wound healing. In the present work at first the effect of gentamicin, tetracycline, erythromycin and vancomycin on Staphylococcus oureus, has been studied by disk diffusion test. This bacterium causes a wide variety of suppurative disease in humans, including superficial and deep abscesses and wound infections. Gentamicin, tetracycline and erythromycin inhibit the protein synthesis and vancomycin inhibits the cell wall synthesis of sensitive bacteria. S. aureus was resistant to gentamicin, tetraciclin and erythromycin and susceptible to vancomycin.Then combined effect of electromagnetic fields of 12 G and the above-mentioned antibiotics on the growth of Staphylococcus aureus was studied. The result of analysis of sensitivity of S. aureus to the studied antibiotics after exposing to electromagnetic fields for different periods of time shows that these fields have no significant effect on the susceptibility of the bacterium against tetracycline, erythromycin, and vancomycin but affect the susceptibility pattern of the bacterium against gentamicin. Probably the combined effect of some antibiotics and electromagnetic fields can increase the wound healing.

War, as an unpleasant and stressful phenomenon is able to precipitate all psychiatric disorders. For the first time during the US civil war (1861 to1865) in a documentary and formal study, physicians noticed a kind of neurotic disorder among the soldiers active in war and named it Nostalgia. Later on, other names and terms such as Fright Neurosis, and Effort syndrome were used. Therefor, since an eight-year war was imposed on our country and numerous young people took part voluntarily in this war, psychological analysis of soldiers is of great importance. Rendering medical service to these courageous devoted soldiers would be possible, if their psychological problems caused by this imposed war are thoroughly and precisely studied. Thus the purpose of this study is to determine psychological disorders in soldiers of the holy defense.

Recenty crimean congo heamonhagic fever has been spread across the world including:Kosovo, Afghanestan, Pakestan, Iraq and Cuba. The mechanisms of transmission is not well understood. Perhaps, many socio- economical factors may be involved. Crimean congo haemorrhogic fever has been increased since l999 in lran.The disease can be Transmitted to human either by the contact with contaminated human and animal blood or by specific ticks bite (Hyaloma spp). However, it has to be said that the disease was present in the past as endemic form in north west of Iran. This article is going to explain 8 cases of CCHF who are infected with the virus in South Africa. In a few cases, mode of transmission was considered either nosocomial or airborne infection. It should be said, that the CCHF virus was weapnized by some super power countries which Poses a great threat totheWorld. Therefore, considerable attention should be paid to this issue.

The global outbreak of severe acute respiralory syndrome (SARS) originated in Foshan, Guangdong province of China, as early as 16 November 2002, has infected more than 4000 people in 30 countries.The agent that causes SARS has now been conclusively identified by who colaborative researches. The SARS virus is a new coronavirus unlike any other known human or animal virus in the coronavirus family. The virus is transmited by close contact with patients and there are evidences that it can be transmited via feces. The incubation period of SARS is usually 2-7 days but may be as long as l0 days. All patients presented with fever (temperature higher than 38 oC for over 24 hours), and most presented with rigor, dry cough, dyspnea, malaise, headache, and hypoxemia. A few patients have reported diarrhoea during the febrile prodrome. Pulmonary infiltrates appeared in chest radiographs early, even before the start of dyspnoea. Early in the course of disease, the absolute lymphocyte count is often decreased. overall white cell counts have generally been normal or decreased. At the peak of the resptratory illness, up to half of patients have leukopenia and thrombocytopenia or low normal platelet counts. Early in the respiratory phase, elevated creatine phosphokinase levels and hepatic transaminases have been noted. Renal function has remained normal in the majority of patients. Scientists have completed full sequencing of the genome of the SARS coronavirus and it seems that viruse has been originated from domestic animals. Molecular tests like RT-PCR can be used to detect genetic material of virus in various specimens (blood, stool or respiratory secretions) 96% of persons developing SARS recover spontaneously. Treatment includes a variety of antibiotics and antiviral agents such as ribavirin. Steroids have Also been given. Mortality rate is around 5%. Majour Precoution for Prevention and control of SARS includes not to travele to infected countries and Sulvilanse. Health care personrrel should apply appropriate infection control precautions for any contact with patients with suspected SARS.

Bioterrorism events have been rare until recently. Many clinical laboratories may not be familiar with handling specimens from a possible bioterrorism attack. Therefore, they should be aware of their own responsibilities and limitations in the handling and treatment of such specimens, and what to do if they are requested to process clinical samples. The Centers for Disease Control and Prevention has developed the Laboratory Response Network to provide an organized response system for the detection and diagnosis of biological warfare agents based on laboratory testing abilities and facilities.There are potentially many biological warfare agents, but plobably a limited number of agents would be encountered in case of an attack, and their identification and identification and laboratory safety will be discussed.