مجله طب نظامی
سال دهم شماره 4 (پیاپی 34، زمستان 1387)

AIMS. Hospital emergency department has a critical role in human survival in accidents. Each one minute retardation in survival operation of emergency patient decrease 7-10% of the patient living chance. Aim of this study is to analyze effect of special educational courses on activity of emergency departments. METHODS. This study is a semi-experimental interventional research in one group pre- and posttest. Sampling done by census and simple method. According to, number of samples were estimated as 30 and 40 cases were Studeid. Satisfaction was evaluated by researcher-made questionnaire in each stages (preintervention, postintervention and follow-up). Patiant's transportation time was measured by chronometer. After establishing FOCUS-PDCA workshop in groups of 12 people, promotion classes were established and FOCUS-PDCA grades performed step by step. RESULTS. Average emergency patient expectation time was 428.65±69.12 seconds in preinventory stage, 250±25.7 in postinventory stage and 235±27.57 in follow-up (2 month later). Average satisfactory scores of process masters between receptions to consideration was 86.6±13.4 in preinventory stage, 116.9±9.4 in postinventory stage and 123.7±8.3 in follow-up. CONCLUSION. Implementation of FOCUS-PDCA have positive effect in emergency department activity and reduces emergency patients consideration time and also increase satisfactory rate of process masters from their transportation and consideration.

AIMS. Electromagnetic field is a consequence of electrical ion movement in a conductor material. It is known that ultra-violet & infra-red waves have side effect on human. Extremely low frequency (ELF) electromagnetic fields (EMF) has considered more by scientists and researchers these days. This research has intended to concentrate on anxiety disorder and headache in steel industry employees. METHODS. This research is a cross-sectional study. 103 people who work in energy department, energy transfer line & electric furnace units have selected as target group. 106 people who work in refinery part, hot & cold rolling press were selected as control group. People came to examination unit between 10 to 12 am and after a physical and psychological examination a questionnaire about psychological complaints & disorders filled by researcher. RESULTS. Target (7%) and control (11%) groups have not shown a significant difference in behavioral disorder amount (p> 0.05) but they have shown a significant difference in anxiety disorder (p<0.02) and headache occurrence (p<0.001). Headaches which needed medical cares have just seen in target group (4 cases) CONCLUSION. Anxiety and central nervous system problems such as headache are symptoms that were seen more in people who are exposed to high power magnetic fields for long time as comparison with a normal society. Employees who are exposed with high intensity ELF-EMF (more than 1.0 mili Tesla) are at more risk.Keywords:

AIMS. Treating uniforms with permethrin is registered as a useful technique to protect soldiers against biting. This study evaluates the effect of washing on endurance and persistency of permethrin and its contact toxicity in treated uniforms. METHODS. This is an intervention experimental study which done during 2003-2005 in two laboratories of Tehran university of medical sciences. Six different kind army uniforms fabrics, which commonly used in Iran military, impregnated with permethrin at 0.125 mg (AI)/cm2 (EC %10). Amount of permethrin residue was determined by High Performance Thin Layer Chromatography (HPTLC) technique using TLC-Scanner 3. Treated cloth patches were used in bioassay test against Anopheles stephensi. RESULTS. Washing uniforms result in meaningful decreasing of permethrin amount in impregnated clothes patches and also their insecticide ability. Hand washing of uniforms decreased 25-35% of residual permethrin and machine washing of them decreased 50-65% of residual permethrin amount. CONCLUSION. Washing the clothes is something inevitable which can reduce insecticide ability. Impregnation with normal formulation is appropriate for short-time purposes and for long-time purposes polymer-coating formulation or other durable long lasting formulations must be used.

AIMS. In many jobs, people must use protective clothes to avoid physical, chemical and environmental damages. Such clothes should cause the minimal physiological, mental and organic limitations on the body, beside their protective features. The aim of this study is to compare the Fire-fighting protective clothes with usual work clothes, in terms of their effects on aerobic capacity of the subjects. METHODS. This is an experimental study, in which 30 healthy male participants were chosen according to inclusion criteria. The physical activity has been done once by wearing fire-fighting protective clothes and the other time by wearing usual work clothes by random, based on Bruce protocol. After the physical activity, parameters such as activity time and the distance were measured. Aerobic capacity was also predicted by setting the activity time in the Bruce formula. RESULTS. Aerobic capacity (VO2max) was 44.25±6.42 ml/kg/min in participants with fire-fighting protective clothes, While it was 57.43±5.34 ml/kg/min for usual work clothes. This difference is statistically significant (p<0.001). These two sets of clothes are different in their effects on parameters such as activity (exhaustion), the distance and VO2max. The obtained values for common clothes are better than fire-fighting protective clothes. CONCLUSION. Fire-fighting protective clothes result in less tolerance time, because the aerobic capacity of these clothes is less than the usual work clothes.

AIMS. Over the last decade several changes occurred in the field of pretussis. B. pertussis infection and illnesses are common and endemic in adults and these infections are the reservoir for pertussis in susceptible children and infants. METHODS. In a case-control study, 50 patients more than 18 years old with paroxysmal cough lasting more than 2 weeks were compared with 50 controls without history of cough. Nasopharyngeal swab culture and IgG antibody titers to Boredetella pertussis antigens by ELASA methods were used. RESULTS. Anti-pertussis antibody was 12% positive, in control and 48% positive, in cases and this difference was statistically significant (P value < 0.001). Also the increase of mean antibody titer between acute and convalescent serum in cases after two weeks was statistically significant (P value=0.04). Patient’s culture was positive in 2% in cases and was not isolated from any of controls. CONCLUSION. Immunity after immunization and even infection is not life long. The frequent finding of asymptomatic antibody boosting in an immune person proves susceptibility for infection and probably active transmission despite protection from disease and supports of this hypothesis until pertussis in adults is universally prevented through immunization, clinicians must be on the alert of the clinical disease.

AIMS. Military personnel may sustain injuries in battlefield. In this case, performing primary life support measures by soldier can decrease morbidity and mortality of forces. In this study, scientific knowledge of a group of military personnel have been measured about self- and nonself aid. METHODS. This is a cross-sectional study performed during a maneuver included operational forces (no paramedic). A questionnaire which consisted of three parts (demographic data, knowledge about self- and nonself aid and contents of self bags) was used. 200 questionnaires under the supervision of accompanying physicians were filled. After collection of data, they were analyzed using statistics descriptive characters. RESULTS. The highest level of knowledge was seen associated with symptoms of external bleeding and opening obstructed airway (77.5%) and the least with disinfectation of water by clore (43%). There was a significant difference regarding knowledge between those who had participated in former classes and those who had not (p<0.005) in self- and nonself aid. Totally, 185 (79%) individuals were familiar with self bags, its contents and method of using them. CONCLUSION. The military personnel who had participated in training courses, showed a higher level of knowledge with regard to self- and nonself aid. They were able to perform life support in emergency situations better. These findings indicates the importance of performing self- and nonself aid training courses in regular intervals and with modern educational methods.

AIMS . Pain on lateral epicondyle and reduce of grip strength are the most common problems of lateral epicondylitis. One of the treating techniques for this disorder is taping. Aim of this study is to investigate the initial effect of taping technique on pain and grip strength of military patients with tennis elbow syndrome. METHODS. This study is Quasi-experimental and done on 25 patients (16 subjects in treatment group and 9 subjects in control group). Visual analog scale (VAS) used for assessment of pain and jammar dynamometer for measuring the grip strength. Subjects were selected randomly and data analyzed by SPSS. RESULTS. Mean of age was 23.6 years in treatment group and 24.1 in control group. In assessment of pain, average difference between two groups (P=0.004) was significant. But in studing the effect of taping technique on grip strength, average difference between two groups (P=0.09) was not significant CONCLUSION. Taping technique is effective for patients with lateral epicondylitis and reduces pain in lateral epicondyle but is not effective in initial improvement of grip strength. So, we could use this method for initial pain reducing of lateral epicondyle in rehabilitation clinics.

AIMS. War has different consequences. In human aspects, besides mortalities, it has high personal and social costs because of case morbidities. The aim of this study is assessment of various aspects of war injury distribution in one of the province centers of war injured data. METHODS. In this cross sectional study records of all injured millitant sent to war casualty headquarter of one of Iran provinces during 1987-1988 were assessed. Records were collected using a self- administrated checklist and Injured areas were considered as head-neck, upper and lower extremities, chest, abdomen, pelvis and vertebral column. Statistical qualitative tests were used analyzing data. RESULTS. Among all millitants 578 cases of injury were found. Lower extremities was the most common area of injury (57.6%). Upper limbs (30%) and head-neck area (15.7%) were in second and third place. The most common millitary reason of injuries was mortar explosion and hit of its Shrapnel. More than half of injuries had happened during antiattack operation. CONCLUSION. Non war etiologies have an important role in happening of injuries and also in most injured cases head and trunk areas are affected. So using appropriate personal protective devices have effective role in reduction of morbidity rate.

AIMS. Using health measures is one of the principles to protect human societies. Regarding the importance of hygiene in society and specially among military troops their health protection is necessary to protect the society, special attention to soldiers hygiene and keeping them healthy is essential to increase the defense power of country. In this study, hygiene status of soldiers and their hygienic knowledge level and attitude of duty personnel in hygienic problems were analyzed. METHODS. This is a cross sectional study done among 215 duty personnel in a military training center. Information is collected by a questionnaire. RESULTS. More than 85% of soldiers have vaccination records, 94.5% have received tetanus and diphtheria vaccine and 99% have received meningitis vaccine. Addiction to smoking was very low in the studied society and is about 1%. 96% of soldiers brushed their teeth at least once a day. However, personal health care like washing hands before eating and bathing were done in 87.3% and 86.9% respectively. Soldier's knowledge about AIDS transmission methods was very low. CONCLUSION. Vaccination coverage among duty personnel is higher than normality of society. Health status and knowledge level of duty personnel about personal and social health is not satisfied. Increasing soldier's hygienic knowledge level during military trainings must be of more attention.

AIMS. Victory in war requires the support of public opinion. The aggressive states are forced to use the psychological operations to grant legitimacy and acceptance to their performance the issue that in the minds of the majority of the thinkers, especially the Americans, has been more effective in the 2003 war. So the aim of this survey has been determining the effect of psychological operations at persuading Americans, regional states, the world and international organizations to support the war and ultimately isolating Saddam and demoralizing its military forces. METHODS. This research used content-analysis and trend analysis and after that analyzed the news agencies and media's messages by choosing purposeful sampling (from 11 September 2001 to 20 march2003) RESULTS. The results showed that: Question 1: the effect of psychological operations at persuading America’s public opinion has been ascending from 31 percent in 2001 to 75 percent at the threshold of war.Question 2 and 3: the effect of psychological operations at persuading regional states, the world and international organizations has led to the collapse of Arab states´ unity, coordination and cooperation of some of them with America and also direct coordination of some European countries, because of fear instillation of Saddam by different accusations. This effect finally imposed some kind of confusion to France and Russia, so that they couldn’t do anything especial for deterring the war. Finally the 1441 resolution of Security Council was approved against Iraq and paved the way for attacking to it. Question 4: the effect of psychological operations isolated Saddam at the threshold of war and demoralized its military forces completely. CONCLUSION. The results of the studies have shown the deep effect of psychological operations, especially at the persuasion context. The precise and coherent process at implementing keywords for instilling and persuading, especially Americans, governments and organizations, has extracted from two major routes i.e. central route and peripheral route. Methods such as communication source, communication nature and the characteristics of addressees have been produced by precise designing and organizing the psychological operations by Americans after 11 September and especially after the fall of Taliban.