مجله طب نظامی
سال دهم شماره 1 (پیاپی 31، بهار 1387)

Introduction. Toxins are produced by living organisms such as animals, plants, bacteria and fungi. These substances are poisonous to humans. The early and rapid detection of toxins is essential for appropriate management.Material and Methods. The aim of this study is to review the different methods for detection of toxins produced by living organisms. In this study, recently published reports on methods used for toxins detection were reviewed. The advantages and disadvantages of each method as well as their detection limit were also discussed. Conclusion. Elisa, mass spectrometry and chromatography based methods have been evaluated to have good capability for analysis of some toxins because of their high sensitivity, high selectivity, high specificity and capability to identify and quantify unknown agents simultaneously in a short time frame.

Introduction. Iran is faced with many natural disasters such as earthquake any year. Earthquake can damage food production and preservation centers. That is, following an earthquake, the situation of providing, producing, preservation and distribution of foods would dramatically be affected. Therefore, it is necessary to evaluate nutritional problems following an earthquake. The aim of this study is to evaluate of problems related to food supply, preservation and distribution status in the Bam’s earthquake.Materials and Methods. In this descriptive study, 271 questionnaires were completed by the study population. Questionnaire along with direct interview with the subjects and service providers were used to collect data. In addition, for collecting data regarding planning and preventive activities done by service providers, six specific questions were presented to responsible personsResults. The results showed that the most food problems reported by the population study was improper food distribution (98.9%), which is followed by absence of food variety (80.%), and low quality of food materials (77.8%). The major causes of the identified problems included, insufficient management (91%), late provision of food materials (85.7%), lack of nutrition experts in food distribution (79.7%), and insufficient food preservation equipments (60.2%). Conclusion. Prior to earthquake it is necessary to think about a sound planning regarding food supply and distribution and foundation of food storage. Following an earthquake, important activities include determination of the duties of governmental organizations, public education, use of army staff in the field, food habits of victims should be considered.

Introduction. A person who has suffered the total loss of a sensory system has, indirectly, suffered a brain lesion. Exact and fast visual information is critical for brain cognitive functions. The aim of this study is comparison of cognitive status of blinds veteran with normal sighted matched person. Materials and Methods. we compare 137 blinds and 124 sighted people in verbal fluency task. The test was mini mental state examination (MMSE). Independent T Test was used to comparing blind with sighted.Results. findings show significant difference between two groups in recall, language skills sub scales and total scores of MMSE. Result don’t show significant difference between two groups in orientation, information registration and attention subscales. Conclusion. based on this study blinds have lower performance in cognitive functions. We suggest immediately cognitive rehabilitation for prevention of cognitive deterioration in them.

Introduction. The paederus dermatitis is a dermatitis with vesicle and erithma that heals spontaneously. Its causes is a small insect of the rove beetles family with the name of pederasts in staphylinide.this disease is in the scattered of the word and in Iran we see in wet and warm area, specially in Gilan and Mazandaran and Khuzestan. We have problem in diagnosis of this disease because of variety in signs and symptoms, kinds of figure and area. In this study we want to show the signs and symptoms and the other specifications of this type of dermatitis.Material and Methods. This investigation is a cross sectional study. This study accomplished in 2000-2001 from the last month of summer till next two month. Sample study was 94 patients with paedrus dermatitis. The samples were chosen from the patients how they are coming for treatment the paedrus dermatitis to the clinics or hospitals of behshahr city. the patients visited by the dermatologist and the patients information including signs and symptoms, types, sizes, shapes and the location of the rash in different organs with dermographic information collected and analyzed. Results. According to this study the paedrus dermatitis is a multiple signs and symptoms diseases. The most common sign and symptom of this disease was the itching and burning twin pain. The most common clinical sign of this disease in this study was erithma and vesicle in location of rash (51%)that in some patients with postula.the most common location of rash was the neck and face(31%)and so hand(30%). The most common shape of the rash in paedrus dermatitis was linear (35%) and in single area (38%) with 2-6 cm in size.Conclusion. According to the finding of this study the most common sign in paedrus dermatitis in a northern city in Iran was burning and itching twin pain. The most common finding in patients is erithma and vesicle and in some patients with pustule. The rash of paedrus dermatitis was linear 2-6cm in size. This dermatitis in reason of the more contacts in Mehr and Sahrivar were the more prevalence that this clue can help the physicians to the diagnosis.

Introduction. Surveillance of natural occurrence of T-2 toxin in cereals intended for human consumption.Materials and Methods. Cereal samples obtained from nine cooking centers of Tehran. The samples were powdered and extracted by methanol-water solution (70:30) and the level of their T-2 toxin assayed using a competitive monoclonal antibody based ELISA.Results. All cereal samples contained T-2 toxin ranging from 7.9 to 65.4 (mean: 17.9±2.1) µg/kg. Wheat samples with mean of 42.4 µg/kg were the most contaminated cereals flowed by barley and rice with 18.3 and 12.5 µg/kg respectively. Conclusion. Although, a minority of cereal samples (13.9 %) was contaminated with levels higher than nation standard of Iran for T-2 toxin, extended contamination with the toxin reveals existence of favorable condition for natural occurrence of mycotoxins in agricultural products, and mentions the risk of chronic effects of the toxin exposure and necessity of foodstuffs mycotoxins assay.

Introduction.The subject of nutrition and its quality in armed Personnel is affected by many different factors. Knowledge & attitudes of necessity and importance of Nutrition by commanders in different administration Levels is one of those factors. Importance of nutrition in physical and mental health and its influence on efficacy of armed Personnel, make it more vital to the commanders. This point is very important that nutritional status of Personnel influences their activities and practices. Commanders’ knowledge of nutritional system has many influences on nutrition habits & nutritional behavior of soldiers. For instances, practical ration usually don’t have such sense quality and soldiers don’t like them. But, it is proved that, well-educated commanders can provide a very nice and positive attitudes toward those ration in official personnel both officers and soldiers. This role is supposed to be created in all commanders, even in small groups. This will even enable them to educate other officers & soldiers regarding water & energy. This means that the commanders pay attention to correct use of food & water as well as military practices & exercises. Many other researches conducted studies on knowledge & attitudes toward nutritional status of soldiers in other countries. Conducting these kinds of researches is important in our country too especially in armed forces. Results of these investigations can improve the nutritional conditions of armed forces.Materials and Methods. This is a descriptive study done through a cross-sectional method. Data has been collected through interview & questionnaires. The sample size was 277 and study population consisted of commanders was managers of the forces. The collected data was analyzed using Spss software.Results. Based on the results, 72% of the subjects has more than20 years work history.62% of the study population, the commanders, had good & excellent nutritional knowledge. With regard to formal education, more than 48% were well- educated, bachelor & higher degrees.Newspaper and journals (70.7%), planned courses (61%), mass- media (49.6%), healthy related pamphlets (47.6%) respectively, were information resources, reported by the study population.Conclusions. In general, knowledge level regarding the issue was reported excellent (8%), good (54%), moderate (36%) and weak (2%).Due to importance of education, it is recommended that health planners provide educational programs regarding nutrition for those commanders with moderate (36%) and weak (2%) levels of knowledge. These include generally, 38 percent of the subjects in one of the forces.

Introduction. Diver training is the process of developing skills and building physical and physiological performance in the use of diving equipment and techniques so that the diver is able to dive safely. Training armed forces divers, including combat divers or frogman, is far harder, longer, and more complicated than civilian sport scuba diver training, typically takes several weeks full-time, and the trainees must be at full armed forces fitness and discipline at the start. It needs much higher levels of fitness, and during the course there is often a high elimination rate of trainees who do not make the grade. VO2 max (also maximal oxygen consumption, maximal oxygen uptake or aerobic capacity) is the maximum capacity of an individual's body to transport and utilize oxygen during incremental exercise, which reflects the physical fitness of the individual. The aim of this study was to evaluate the effects of military diving training course on VO2 max, as one of indicators of physical fitness.Materials and Methods. According to inclusion criteria, and a quasi-experimental before-after one group design, 32 military personnel who were candidate to military diving training program, were selected. Their VO2 max before and after the 3-months training program was measured by Bruce protocol. Bruce protocol was done in two state, when subject was wore a diving suit and a current sport cloths. Results. The results showed a significantly (p<.001) deference between measured VO2 max within diving suit (65.99 +/-5.73) and sport cloths (60.5699 +/-6.37) subjects (n = 32 age = 24.31 +/- 4.47 yrs weight = 74.34 +/- 9.04 kg height = 173.84 +/- 5.87 cmBMI = 24.55+/-2.22). Measured VO2 max with either diving suit or sport cloths in compare to before the training program, was significantly (p<.001) differ, the mean of VO2 max was 68.50 +/-5.29 and 63.04 +/-5.74 respectively. Also, the results showed that the VO2 max was significantly (p<.001) increase after the diving training program. Conclusion. Although military diving training program significantly improved VO2 max, and VO2 max is widely accepted as the single best measure of cardiovascular fitness and maximal aerobic power in long term training program, we should be consider that the military diving training program is combination of some exercise activities and non exercise programs.

Introduction. It is estimated that fever is the primary complaint for 30% of patients seen by paediatricians. Fever is on of the most common reasons that parents seek medical attention for their children, for most parents fever is a disease rather a symptom or sign of an illness. The parent’s anxious response to the fever named “fever phobia“..The aim of study was to assessment of mother’s knowledge and attitude toward management of fever in their child.Materials and Methods. A cross sectional study was done between Jan to Apr 2004 in baqyiatallah hospital paediatric clinic with 15 item questionnaire to determine maternal attitude of military families about their children fever. The questionnaire was administered before either health maintenance or acute care visits.Results. A total number of 180 mothers were interviewed. Of those who were interviewed 83.9% considered 38oc and less as a high fever. Nine percent of mothers believed that temperature could rise to>/=41°c if left untreated and 87.8% of mothers be lived that temperature could cause harmful effects such as convulsion (72.2%), dehydration (3.9%), delirium (2.8%), brain damage (2.8%). Fifty two percent believed that complications occur in temperature 40°c.Forty one percent gave Acetaminophen (98.3%) and Ibuprofen (1.7%). Fifty percent gave drugs with correct dosage. Most of the parents (89.4%) were very worried about their children fever and 88.3% awaken their children to give antipyretics. Of theses 84.4% used wet sponge and 56.2% used sponge in temperature less than 38.5 oc. Fifty three percent used alcohol and salt for sponge. Sixty four of mothers listed doctors and nurses as their primary resource of their fever information, and 75% of children were visited by paediatricians.Conclusion. Fear of fever and about the definition is a major problem. It seems that mothers still need education about the definition and significances of fever, the correct way to use thermometer and antipyretics for fever home management.

Introduction. chronic osteomyelitis is the infection of the bone caused by pyogenic bacteria and mycobacteria. Regarding to the prolonged clinical progression, frequent recurrences and severe complications, treatment could be so complicated and the cost of treatment would be very high. considering the large amount of war handicapped patients suffer from the chronic infection of the bone, the aim of this study is to investigate clinical and paraclinical presentations of war handicapped patients infected to chronic osteomyelitis.Materials and Methods. This cross sectional study was performed in 40 war handicapped patients hospitalized in osteomyelitis center of Sasan Hospital from 1385 to 1387. all data including demographic properties, clinical and paraclinical findings with underlying diseases were extracted from medical records of each patient’s profile. Obtained data was analyzed by spss (Ver.14) software, in addition, chi-Square test was used to study the relation between pre-treatment ESR and the result of culture.Results. All 40 studied patients were male. The average age was 42.78+6.28 (X+S.D.) and the average duration of infection was 18.80+7.31. The most prevalent clinical presentations were discharge (90%) and pain (10%) as well. The most sites of infection were tibia (45%) and femor (25%) respectively. 15% of cases had diabetes mellitus and 40% were smokers. Anemia was seen in 72.5% of cases and Erythrocyte sedimentation rate (ESR) was found to be greater than 20mm in the first hour in 50% of patients.In addition, No significant difference was found between ESR pre-treatment and the result of culture (p Value = 0.24).67.5% of patients had positive culture of which 51.9% were Staphylococcus aureus and E.coli (33.3%), Pseudomonas aeruginosa (7.4%) and klebsiella spp (7.4%) were the next prevalent organisms. Conclusion. Regarding to the recent results, the most prevalent clinical sign of chronic osteomyelitis was Discharge especially in large bones. Anemia was found as a prevalent complication in these patients. In this study, The most common grown organisms were staphylococcus aureus and E.coli. Based on the results of this study, one can determine the best antibiotical coverage in empiric therapy.

Introduction. The first anthropometric studies have been performed on militaries in the world. These days, different kinds of foot anthropometric studies are done for the purpose of medical goals and design of boots. But there is not any background of foot anthropometry in Iran as widespread and specially. Determination of the foot anthropometric data's for a sample of Iranian men and detection the importance of applying these studies in design of boots. Materials and Methods. In this study, the foot images of 160 Iranian men, with ages ranging from 18 to 25 years old were taken by a digital camera and the values of 8 dimensions of the foot were extracted with Photo Anthropometry software. Finally the results were analyzed by SPSS.Results. The average values, standard deviation, the smallest and largest values, the5th, 50th and 95th percentiles of the 8 dimensions were calculated. For example M± SD for length, width and Biomlleolar Breadth of the foot were obtained 264.66±13.10, 106.84±5.64 and 74.47±4.11 millimeter. The correlation coefficients were found between different dimensions. It was determined that there is significant correlation between 85% of foot dimensions (p<0.05). Conclusion. In this study, the values of important foot dimensions for a sample of Iranian men were obtained that would be useful for design and sizing of the boots in the future. It is recommended that similar studies to be done with considering race, life style and job for the purpose of medical goals and ergonomic designs for militaries.