فهرست مطالب

Archives in Military Medicine - Volume:6 Issue: 4, Dec 2018

Journal of Archives in Military Medicine
Volume:6 Issue: 4, Dec 2018

  • تاریخ انتشار: 1397/09/11
  • تعداد عناوین: 8
|
  • Soheil Mehrdadi * Page 1
    Context
    Military personnel and recruits are generally a high-risk group for meningococcal disease, with a reported incidence of four to ten times greater than that of the general population. Unlike progresses in medicine, bacterial meningitis is still recognized as a medical emergency, which necessitates immediate actions for the definitive diagnosis and subsequently proper antimicrobial regimen. The mortality and morbidity rate are still high even with proper therapeutics and diagnosed cases, if left unattended, can reach 100% mortality. Epidemics with certain pathogens, especially N. meningitidis, might result in grave situations in public health levels in crowded places, namely military bases and camps, and this necessitates proper precautionary actions. Various vaccines have been introduced to control outbreaks in the public health context.
    Evidence Acquisition
    In this review article, 45 related literatures regarding the “acute bacterial meningitis” were studied searching the Internet using Medical data bases such as PubMed and Google Scholar, using the keyword of acute bacterial meningitis.
    Results
    Due to high morbidity and mortality rate, providing accurate, detailed, and citable information is vital, especially, concerning the etiology and persons at highest risk to guarantee and ensure public health and appropriate management.
    Conclusions
    Despite a decrease in morbidity and mortality in the recent years, it is still one of the fatal diseases of the world. However, a definitive diagnosis, prompt therapeutic strategy, decent adjunctive treatment, and vaccinations can all have positive influences in the context of the best patient care.
    Keywords: Military Personnel, Recruits, Military Medicine, Meningococcal Disease, Bacterial Meningitis, Diagnosis, Prevention, Control, Mortality, Morbidity
  • Masued Behshad , Alireza Shamsoddini * Page 2
    Background
    Unilateral below knee amputation is a permanent surgical procedure that can influence the quality of life (QOL) of the person with amputation. The aim of this study was to assess the effects of ankle turner unit on the quality of life of unilateral below knee amputees.
    Methods
    In a cross-sectional study, a total of twenty unilateral below-knee amputee patients were selected by simple random sampling. Quality of life of subjects was assessed with Trinity Amputation and Prosthesis Experience Scales (TAPES) questionnaire baseline and after 30 minute of using the unit. The participants were evaluated by five major criteria including: total TAPES score, conformity of movement restrictions, level of athletic activities, level of daily routine activities, and social activities, which were part of the TAPES survey.
    Results
    In this study, 20 below-knee amputee male patients with average age of 47.7 years participated. Total index of TAPES with P = 0.01, matching of athletic restrictions with P = 0.04, athletic activity level with P = 0.006, and social activity level with P = 0.04 showed a significant difference compared to before using the unit. The difference in the level of daily routine activities, despite 5.15% increase in respect to before using the unit, was not significant (P = 0.2).
    Conclusions
    The results implied that this unit can effectively improve the quality of life in amputees. In a detailed review of the study, it was proven that his unit resulted in an increase of the conformity with restrictions, and reduction of restrictions in athletic and social activities while it did not provide a positive effect on functional restrictions.
    Keywords: Ankle Turner Prosthesis, Quality of Life, Limb Loss, Below-Knee Prosthesis
  • Younes Khademi*, Seyed Ali Hosseini , Fatemeh Dana , Azar Hamidi , Majid Azadmanesh , Mehdi Pirouz Page 3
    Background
    Inflammation plays an important role in the development of atherosclerosis. Interleukin-1 beta (IL-1β) and lipocalin-2 (LCN-2) are important inflammatory markers in the pathogenesis of atherosclerosis.
    Objectives
    This study aimed to investigate the interactive effects of high intensity interval exercises (HIIT) with flaxseed oil consumption on IL-1β and LCN-2 gene expressions in the heart tissue of rats.
    Methods
    In this experimental study, 20 adult male Wistar rats were randomly selected and divided into four groups of five rats: (1) Control, (2) HIIT, (3) 20 mg/kg of flaxseed oil, and (4) HIIT with mg/kg 20 flaxseed oil. Groups 2 and 4 ran on a treadmill for 10 weeks and five weeks each, with 90% to 95% intensity of VO2max. For analysis of the research findings, Kolmogorov-Smirnov statistical analysis and two-way ANOVA were used (P ≤ 0.05).
    Results
    Ten weeks of HIIT (P = 0.001) and flaxseed oil consumption (P = 0.03) had a significant effect on reducing the LCN-2 gene expression in the heart tissue of rats. However, 10 weeks of HIIT (P = 0.19) and flaxseed oil consumption (P = 0.19) had no significant effect on IL-1β gene expression in the heart tissue of rats. In addition, 10 weeks of HIIT with flaxseed oil has no interactive effects on IL-1β (P = 0.91) and LCN-2 (P = 0.99) in the heart tissue of rats.
    Conclusions
    Although it seems that the simultaneous use of flaxseed oil with HIIT does not have interactive effects on IL-1β and LCN-2 gene expressions in the heart tissue of rats, the use of flaxseed oil and HIIT alone results in improved LCN-2 gene expression in the heart tissue of rats.
    Keywords: Training, Flaxseed Oil, Heart, IL-1?, LCN-2
  • Rodrigue Nomeharisoa Hasiniatsy*, Valery Refeno , Voahary Nasandratriniavo Ramahandrisoa , Fanomezantsoa Andriamparany Rakoto , Olivat Aimée Rakoto Alson , Florine Rafaramino Page 4
    Background
    Currently, the prognosis of hematological malignancies continues to improve in developed countries. In developing countries, such as Madagascar, data on hematological malignancies treatment and outcome are often rare, incomplete, or nonexistent. Until 2011, there was only one cancer center in Madagascar. The Medical Oncology Unit of the Military Hospital of Antananarivo, Madagascar, managed hematological malignancies since December 2012. This pathology represents there the fourth most frequent cancer.
    Objectives
    We aimed to describe the therapeutic aspects and outcome of hematological malignancies managed at this center.
    Methods
    This was a longitudinal study (descriptive and analytic) carried out from December 1, 2012 to August 31, 2015 (33 months). We included all patients followed, then, excluded those without pathologic evidence, cases of monoclonal gammopathy of unknown significance, and cases of solid cancers.
    Results
    We followed up 57 cases of hematological malignancies. The mean age was 49.4 ± 15.5 years and sex ratio (male/female) was 1.71. A total of 34 patients (60%) received specific treatment and 40% of the patients undertook only symptomatic treatment. The median follow-up time was 60 days and mean survival time was estimated at 410 ± 61 days for all patients combined. The mean survival time varied significantly according to the nosological subgroup and to the type of treatment received (P = 0.004). At the end of the study 20 patients (35.1%) died and 17 patients (29.8%) were lost to follow-up.
    Conclusions
    Our results are globally similar to the results found in other African studies. Improving diagnosis, establishing a hematopoietic stem cell transplant center, and improving access to specific therapies should improve the prognosis of our patients.
    Keywords: Drug Therapy, Epidemiology, Hematologic Neoplasms, Madagascar, Signs, Symptoms
  • Asiye Seyyed , Siroos Farsi*, Seyed Ali Hosseini , Gholamreza Kaka Page 5
    Background
    Regarding the effects of excessive alcohol use on the heart tissue, the present study aimed at investigating the effect of swimming training and curcumin consumption on the levels of superoxide dismutase (SOD) and glutathione peroxidase (GPX) proteins in the heart tissue of rats after withdrawal of binge alcohol consumption.
    Methods
    Forty rats were selected to receive alcohol (25 w/v% ethanol) every eight hours for four days through intragastric gavage. Then, they left the alcohol consumption for seven days to be divided into five groups of eight including (1) control (C), (2) curcumin (CU), (3) swimming training (ST), (4) swimming training with curcumin (STC), and (5) sham (S). Groups 3 and 4 performed swimming exercises five sessions per week for two weeks and groups 2 and 4 received 50 mg/kg intraperitoneal curcumin five times per week for two weeks.
    Results
    CU, ST, and STCU had no significant effects on the increase of SOD protein levels in rats after excessive consumption of alcohol (P ≥ 0.05). However, CU, ST, and STCU significantly increased the GPX protein levels of rats after excessive consumption of alcohol (P ≤ 0.05).
    Conclusions
    It seems that swimming training and curcumin consumption can be simultaneously used during withdrawal of binge alcohol abuse in order to improve GPX protein levels.
    Keywords: Training, Curcumin, Alcohol, Superoxide Dismutase, Glutathione Peroxidase
  • Sharif Najafi , Zahra Rezasoltani , Masoumeh Abedi * Page 6
    Background
    Mechanical low back pain is one of the most common complaints of people, which may interfere with some aspects of daily living activity such as walking.
    Objectives
    The aim of the present study was to objectively assess the effects of mechanical low back pain on the gait pattern.
    Methods
    Thirty mechanical low back pain patients and 30 healthy subjects were recruited randomly (age 18 - 60). The spatiotemporal parameters of gait were assessed and recorded as subjects walked on a two-meter platform three times at their normal walking speed. Descriptive statistical methods were used to evaluate demographic characteristics. The independent samples t-test was used to compare the groups for the gait parameters.
    Results
    No significant differences were found between controls and patients in demographic variables. Significant differences were obtained between patients and healthy subjects in step length (P < 0.04), step time (0.009), single support time (0.04), stride length (0.04), stride time (0.01), velocity (0.03), and cadence (0.009).
    Conclusions
    The results of this study showed mechanical low back pain has a great influence on the spatiotemporal parameters of gait. The findings can be used in selecting better rehabilitation procedures.
    Keywords: Low Back Pain, Gait, Walking
  • Diego Ribeiro de Souza*, Edenilson Pinto da Silva Junior , Jose Roberto de Moura , Jose Ribeiro Lemos Junior , Adriana Cristina Levada Pires , Rui Curi , Tania Cristina Pithon, Curi Page 7
    The health promotion efficacy of a dietary regimen and physical activity guidance program applied to the São Paulo state military ppre-obese policemen exhibitedolice working in São Paulo city was investigated. The guidance program consisted of the delivery of a 10-minute talk on healthy nutritional habits and the beneficial effects of a regular physical activity practice for each volunteer personally. The physical fitness parameters related to the health of the volunteers were evaluated before and eight weeks after the interventional program. The study included 58 policemen working in São Paulo city, aged 34.9 ± 0.8 years (mean ± SEM). The application of the guidance program could decrease body fat percentage (BFP) (by 5.7%), abdominal circumference (ABC) (by 1.1%), and systolic blood pressure (SBP) (by 2.4%), and increase flexibility (FLEX) (by 8.8%) and abdominal resistance (ABR) (by 5.2%). A change in physical activity behavior was also reported. Increases in the number of volunteers in very active (VA) (3.45%), active (ACT) (10.35%), and irregular active A (IRA) (5.17%) groups, and reductions in irregular active B (IRB) (13.79%) and sedentary (SED) (5.17%) groups were found. The policemen were classified (before-after) as obese (29.3% - 24.1%) and pre-obese (39.7% - 43.1%). Foty-three percent of pre-obese policemen exhibited more daily physical activity after the guidance program implementation. The guidance program was effective in increasing the adherence of pre-obese policemen to the physical activity practice, reduced the percentage of body fat and abdominal circumference, and improved lower limbs flexibility and abdominal muscle resistance.
    Keywords: Fitness, Body Mass Index, Nutritional Guidance, Exercise
  • Suresh Antony*, Joya Singh , Mikhail Dejesus Page 8
    Background
    Historically, the US Military has made significant contributions toward the treatment and prevention of common sexually transmitted infections (STI) including syphilis, gonorrhea, and human immunodeficiency virus. Although there have been numerous studies evaluating the prevalence of STIs among service members, there is a lack in studies that evaluate the prevalence of STIs acquired by U.S. military personnel during the deployment period.
    Objectives
    The objective of this study is to evaluate the rates of sexually transmitted infections (STI) among U.S. military personnel within the deployment period to determine if further studies are needed to evaluate its significance on public health.
    Data Sources
    We retrospectively collected data published between the years 2005 to 2018 of US military active duty members who tested positive for human immunodeficiency virus (HIV), human papillomavirus (HPV), herpes simplex virus I (HSV I), herpes simplex virus II (HSV II), Chlamydia trachomatis (CT), Neisseria gonorrhoeae, and Syphilis. We performed a literature review using Medline, PubMed, and Google Scholar to collect data from publications related to sexually transmitted infections among U.S. military servicemen published between the years 2005 - 2018.
    Study Eligibility Criteria
    Inclusion criteria for post-deployment group included those who tested positive for a given STI during deployment (time spent during active duty) and those who tested positive in the period up 180 days upon returning from deployment.
    Results
    The total sample size from our study included 4984014 active duty military personnel, of which 1321706 (27%) individuals had a prior history of deployment. From the total sample size, 265886 (5.3%) of service members had a positive STI diagnosis. Among those with a positive STI diagnosis, 9083 (1.7%) were diagnosed while they were deployed, whereas 14121 (2.7%) were diagnosed in within 180 days of returning home.
    Conclusions
    Although there is insufficient data regarding pre-deployment versus post-deployment rates of sexually transmitted infections, the available data we analyzed regarding post-deployment STI suggests that it may be beneficial to screen service members for common STIs immediately upon return from deployment. Individuals who are predisposed to participating in high risk sexual behavior pose a higher risk of returning home with a sexually transmitted infection. Therefore, a screening questionnaire administered upon return from deployment to stratify high risk sexual behavior would be beneficial in identifying individuals that need to be tested for STIs. Deployed soldiers returning home with STIs have the potential to infect their spouses/significant others. In addition, the risk of untreated STIs has the potential to pose a public health issue, especially when considering that overseas deployed soldiers may contract strains of viruses or bacteria that have the potential to develop resistance to current standard of treatment within the United States. Additional studies are needed to further evaluate the prevalence of sexually transmitted infections among the post-deployment group.
    Keywords: Sexually Transmitted Diseases, United States, Military Personnel, Deployed, HIV, Neisseria, Gonorrhea, Syphilis, Chlamydia