مجله طب نظامی
سال یازدهم شماره 4 (پیاپی 38، زمستان 1388)

Aims. Existence of HACCP system in nutrition department is one of the important factors for evaluation of health-treatment service providers. The aim of this study was to evaluate and compare the HACCP implementation requirements in nutrition departments of two military and non-military health -treatment centers. Methods. In this cross-sectional study for analyzing five main axes a researcher-made questionnaire was designed ant filled after confirming its reliability and validity by interview. Data was analyzed by SPSS 17 and Mann-Whitney test. Results. Military and non-military health-treatment centers had 77.8 and 70.8% of HACCP implementation requirements and the mean score of all five axes were 3.89 ± 1.4 and 3.54 ± 1.61, respectively. Among variables of study, only the amount of public health (from third axis) had a significant difference between two health-treatment centers (p<0.05). Conclusion. Implementation of HACCP system is necessary in health-treatment centers and it has positive impact to improve the health of staff and patients in both satisfaction and efficiency.

Aims. Sleep and respiratory disorders are common in addict persons. Anti-oxidant drugs improve sleep quality. The aim of this study was to evaluate the NAC effects on respiratory function and sleep quality in addict persons who are in treatment period. Methods. In this double blind clinical trial study, two drug (17 addicts) and placebo (15 addicts) groups were selected with systematic sampling method among the persons who referred for treatment of their opium addiction. 1200 mg/day drug and placebo were administered to drug and placebo groups, respectively, for 45 days. Sleep quality were evaluated with Pittsburgh Sleep Quality Index (PSQI) and respiratory function was evaluated with peak flowmetery, before and after drug administration. Finally, the results were analyzed with Fisher, Mann-Whitney and Wilcoxon. Results. PSQI total point mean, before intervention was 10.76 ± 4.64 in drug group and 10.07 ± 6.47 in placebo group and after intervention was 5.29 ± 2.62 in drug group and 4.40 ± 2.87 in placebo group. There was a significant relation between PSQI total points before the intervention, comparing with after the intervention in two groups. But there was no significant relation between PSQI total point before and after the study in drug group comparing to placebo group, before and after the study. NAC improved peak flowmetery results but there were no significant relation at the end of study between drug and placebo groups. Conclusion. NAC drug compared with placebo, does not significantly improve sleep quality and pulmonary function in morphine addicts.

Aims. Having a sufficient number of effective forces in all fields, including fields related to health is essential for any organization. After training, these forces must be properly distributed in geographical, type of profession, expertise and gender terms and be used by proper supervision to have the best effect. Due to the lack of information and documentation about the occupational activities of health-treatment services management graduates, this study was to determine their employment status. Methods. This cross-sectional study performed on 85 graduates of health-treatment services management field of one of the Tehran city medical universities who were selected through census sampling method. For data collection a researcher-made questionnaire was used which validity and reliability had been confirmed. Collected data was analyzed with SPSS 13 software using descriptive statistics and Chi-square test. Results. Access to graduates was 80%, mean age of graduates was 34.25±8.35 years and mean duration of service 3.92 years. 88.2% of samples had bachelor degree and 11.8% had master. Occupation of 72.9% of graduates suit their academic major and career of 75.3% graduates were related to their academic major. Chi-square test showed a significant relationship between the job title of graduates with their major (p=0.039). Conclusion. Health-treatment services management education course graduates have appropriate conditions according to fitness of the title and content of the course and professional needs of their jobs and work in posts commensurate with their field

Aims. Accidents and trauma take many victims all around the world each year. The mortality of trauma patients is unacceptably high in Iran. Therefore, a solution should be considered to reduce the mortality. These solutions are defined in the form of executive, training, research and operations control programs. The aim of this study was to examine the effect of education by field training and animal model on awareness of health staff. Methods. In this descriptive study that was performed at 2005 in one of medical universities, 144 physicians working in different fields, randomly selected and were divided in 6 groups. Resuscitation training was presented using animal model and multiple-choice tests, essay and practical was done before and after the workshop. Data was evaluated using statistical software SPSS 14 and paired T-test. Results. Qualitative knowledge level immediately after completion of the workshop increased from 26 to 58 and quantitative knowledge level from 44 to 65. Also individuals practical ability increased from 46 to75. Conclusion. Using animal model and field training have positive effects on improving the awareness of health staff in saving injures.

Aims. Stress is a phenomenon that has different density and rate according to demographic and geographic situation and increases in hard labor condition or bad climate places. The aim of this study was to rank stressors and determine the relation between demographic variables and stressors in a group of militants. Methods. This descriptive correlation study performed in a group of militants in one of the regions of Iran. 766 militants were selected by clustered based on proportion method. Instruments were researcher-made and demographic questionnaires. Data was analyzed by SPSS 11 software and correlation test, variance analysis and Scheffe test. aphic variables with stressors. The highest rankings in stressors were temperature and lack of expert physicians and appropriate clinics. The relation of stress rate with age and level of education was not significant but the relation between psychological stresses rate and work experience was significant. Conclusion. Geographic and demographic variables affect the stress rate of militants. Regional or problems related to geographical and climatic conditions are the most important stressors in militants.

Aims. Regarding to the epileptogenic properties of diazinon (DZ) and its widespread usages, prevention and conflict against these effects is indispensable. The this study was to evaluate the protective effect of guanosine against DZ toxic effects after discharge threshold and kindling acquisition in male rats. Methods. At first, intact Wistar male rats (250-300g) were stereotaxicaly implanted with a tripolar and two monopolar electrodes in the amygdale and dura, respectively. After recovery, after discharge (AD) threshold was determined in each animal for 10 days. Then, the animals received either olive oil (control), oral guanosine (0.5mg/kg), DZ (30mg/kg) intraperitomeally, or both. AD threshold, after discharge duration (ADD) and number of trials for kindling acquisition were determined daily, 30 minutes post injections. Results. The AD threshold was significantly reduced by DZ and increased by guanosine after 30 minutes compared to control group. Guanosine pretreatment partially and post-treatment completely inhibited the AD threshold reduction induced by DZ. Also, DZ could significantly increase the daily recorded ADD and also, cumulative ADDs which was inhibited with either pre- or post-treatment by guanosine. The number of trials (stimulations) for fully kindling acquisition was reduced significantly by DZ treatment which was blocked by gounosine post-treatment and guanosine. Conclusion. While guanosine alone probably has antiepileptic effects, it can share a suitable protective effect against DZ induced epileptogenesis.

Aims. Aerodynamic measurements are useful and conventional methods for acquiring clinical information about phonetic function. The purpose of this study was to analyze the aerodynamics of speech subsequent to respiratory exposure to mustard gas and compare it with normal people. Methods. This case-control research was done in 2007. 19 chemical injured male patients by mustard gas as case group and 20 normal male as control group were selected by achievable sampling method. Aerodynamic analyses were performed by ST1 Dysphonia (manufactured by G.M. Instruments Ltd). Vital capacity, phonation time, phonation volume, mean flow rate and total expired volume were measured. Vocal velocity index and phonation quotient were also calculated. The correlation between variables in two groups was studied. Data was analyzed by SPSS 11 software using independent T-test and Pearson correlation coefficient. Results. In all variables except \"mean flow rate\" a statistically significant difference was seen in compare of two groups (p<0.05). There were a significant correlation between phonation time and vital capacity and also phonation volume and phonation time, while this correlation did not exist in control group. Conclusion. Chemical injuries have failures in vital capacity, phonation time, phonation volume, vocal velocity index, total expired volume and phonation quotient.

Aims. Preventive actions such as training and improving preventive knowledge and skills is one of the most important strategies is cutaneous leishmaniasis control program for personal protection in endemic areas. The aim of this study was to examine the effect of health education based on health belief model (HBM) in promoting preventive behaviors of cutaneous leishmaniasis. Methods. In this quasi-experimental study that was performed in 2008, 450 people from the statistical community which was the guidance and high school students of one of the areas of Isfahan province were selected by census method. Three educational sessions and a questionnaire were designed based on the health belief model. Demographic information questionnaire had questions related to knowledge, perceived susceptibility, perceived threat, perceived benefits and barriers, action guide and action performing which was completed before training and 2 months after training by interview. Data was analyzed using SPSS 15 software and paired T-test. Results. There was a significant correlation between sex and the knowledge score and whole HBM famale students\' got higher scores than males. Those students who infected before with coetaneous leishmaniasis were gotten higher scores in whole variable of HBM but the knowledge score was not different with those who weren’t infected. There were significant differences between all score of HBM components before and after educational intervention. Conclusion. Educational program based on HBM can promote preventive coetaneous leishmaniasis behavior among students.

Aims. The role of group cohesion in improving morale and performance of military forces has confirmed in investigations. On the other hand, aggression and suicide are common problems of these forces, especially in conscript soldiers due to their armed. Of course, aggression and suicide are not moment events and have been started of thought and followed to design and implement. In order to prevent the aggression and suicide ideation, must first the factors of their inhibition and facilitates be studied. The aim of this study was to evaluate the factors of group cohesion and their relation with aggression and suicidal ideation in conscript soldiers. Methods. This survey and applied research was performed in all conscript soldiers of one of the military forces and 237 soldiers were selected by categorized sampling method. The instruments were Siebold & Kelly group cohesion questionnaire, Huesmann, Miller & Zelli aggression questionnaire (revised version), Beck scale for suicide ideation (BSSI) and the researcher-made demographic questionnaire. Data was analyzed by Pearson correlation coefficient and multiple regressions. Results. There was a significant correlation among group cohesion’s factors, aggression and suicide ideation, but they were not valid for predicting. Therefore, linear model had not a good fitness in multiple regressions. Conclusion. Group cohesion’s factors are not determinants in control of aggression and suicidal ideation.

Aims. This study was to estimate the demographic and psychological predictors of substances and drug abuse (SDA) in disabled veterans (DV). Methods. This correlation study performed in DVs population in 2007. 452 DVs with severity of disability from 25 to 70% were selected by systematic categorical random sampling. Data were collected by Drug Abuse Screening Test (DAST), Addiction Severity Index (ASI), Automatic Thoughts Scale (ATS), Brief COPE, Chronic Stress Symptoms Checklist (CSSC), Post-Traumatic Symptom Scale-10 items (PTSS-10), Personal Well-being Index (PWI) and demographic questionnaire. Data was analyzed by SPSS 11 and Pearson correlation test, partial correlation tees and multivariate linear regression analysis using stepwise. Results. SDA correlated with behavior disengagement, ATS, ASI, CSSC and PTSD (PTSS) scores, but no correlation was seen with PWI scores. Regression analysis by all demographic and psychological variables showed that refuge to substances and drug against stress, cigarettes and hookah addiction, withdrawal, ATS, dissatisfaction by healthy status, disability time, home hours spending during day and group membership satisfaction explained 62% of SDA variances. Conclusion. SDA correlates with PTSS, DAST, ASI, ATS, Brief COPE, PWI and CSSC scores.