محمود مومن زاده

Spinal cord injury (SCI) is a devastating condition associated with a sudden loss of sensory, motor, and autonomic function. Despite significant advances in medical and surgical care, there is no effective treatment for its neurological deficits, which can be partly due to the highly complex pathophysiological mechanisms involved in SCI. Inflammatory cascade and overproduction of reactive oxygen species (ROS) are secondary events of injury. Reducing the level of ROS with the help of antioxidants seems to be one of the alternative therapies to reduce oxidative stress. This study aims to review the effect of four natural and strong antioxidants (astaxanthin, saffron and its active ingredients, curcumin, and resveratrol) in spinal cord injuries research studies.

Methods and Materials: 

The present study was reviewed 77 scientific articles and the results were extracted from them. The articles have been searched in international databases using oxidative stress, antioxidant, herbal medicine, spinal cord injury, resveratrol, curcumin, saffron, and astaxanthin keywords, with an emphasis on neuroprotective mechanisms caused by them, mainly between the years of 2010 and 2022.

Oxidative stress and inflammation play an important role in the pathophysiology of SCI. Inhibition of oxidative invasion can significantly reduce the occurrence of inflammation, infection, apoptosis, and dysfunction. Therefore, it seems that adjunctive treatment with potent antioxidants can improve the outcome for spinal cord injury patients.

The use of natural antioxidants can be an important section of future research in the field of SCI treatment. Continuing studies on bioactive compounds with the capacity to inhibit ROS may lead to the development of effective methods based on antioxidant treatment in human studies of SCI.

In the Central Retinal Artery Occlusion (CRAO), the patient's vision usually disappears within a few seconds without pain. Recommended treatments include anterior chamber paracentesis (the removal of fluid from the anterior chamber), the intravenous injection of acetazolamide, breathing a mixture of oxygen as well as carbon dioxide, and direct injection of thrombolytic agents. Another treatment is the use of high pressure oxygen. In this review article, we will examine the effects of such treatment.

A review of articles and texts was done in Pubmed, Scopus, and Google scholar using key words, "central retinal artery occlusion" "sudden vision loss", "painless vision loss", and "hyperbaric oxygen therapy in CRAO".

Oxygen therapy showed beneficial effects in improving visual acuity in CRAO patients.

Oxygen therapy can be normobaric and hyperbaric. When patients do not respond well to 100% oxygen at normal pressure, Hyperbaric oxygen (pressure above 1.4 atmospheres) can be used to treat patients.

The use of hyperbaric oxygen therapy is one of the treatment methods to treat many diseases and injuries such as decompression sickness, wound healing, carbon monoxide poisoning, thermal burns, and nervous system injuries. This article aims to review the possible mechanisms of the effectiveness of this treatment in neurological injuries according to the available studies.

This review article has been performed by searching in international databases between 2000 and 2018 with keywords such as hyperbaric oxygen therapy, nerve injury, spinal cord injury, traumatic brain injury, neuropathic pain, emphasizing mechanisms of neuroprotection induced by the hyperbaric oxygen.

The beneficial effects of hyperbaric oxygen can be related to several biological activities, such as antioxidant, anti-inflammatory, anti-apoptotic effects. However, the mechanisms responsible for it have not been fully identified yet, and require further investigation.

Since neurological defects caused by injury to the nervous system are probably due to inflammation, oxidative stress, and apoptosis, it seems that hyperbaric oxygen can be considered as an effective treatment for nerve injuries.

Pilots are the most important asset of the aviation industry, and and their coronary artery disease endangers aviation safety. The aim of this study was to get acquainted with the conditions of pilots returning to flight status after coronary artery bypass graft surgery.

A comprehensive review of databases for the studies was conducted until the end of 2019. Also, a review of aviation medical regulations and of instructions of specialized books on aerospace medicine was performed.

Military pilots are rarely able to return to flight after coronary artery bypass graft surgery. On the otherhand, in the case of civilian pilots, at the end of six months of successful rehabilitation, those who were asymptomatic with ejection fraction≥50% in echocardiography, normal exercise tolerance test, no inducible ischemia in stress echocardiography or myocardial perfusion imaging, no arrhythmias in holter monitoring, and acceptable blood biochemistry tests, can return to the flight with a restriction of flighting with presence of more than one pilot with no medical restrictions as well as regular annual medical examinations. Otherwise, they will be unqualified forever from the flight.

From the age of 40, pilots have a higher incidence of asymptomatic coronary artery disease, sudden cardiac death from arrhythmias, and thromboembolic events than normal population. Young military pilots are in better conditions in personal and organizational health monitoring. But, unfortunately, if they had coronary artery bypass graft surgery, due to disability after surgery and side effects of prescribed drugs, they would have very little chancec of returing to the flight.

The most important challenge in aviation is to provide the health of passengers and flight crew. The spread of infectious agents, especially respiratory viruses, is always a major concern when human are gathered in a closed space and can lead to become disablility or death.

A comprehensive review on pandemic SARS-CoV-2 (Covid-19) and other respiratory-transmitted viruses in air travels was conducted using databases, speicialized books on aerospace medicine, travel medicine, national and international references for medical advice, medical regulations and guidelines.

The first step is to classify the intensity of flight hazard into low, medium, and high levels. Effective screening is necessary before boarding a plane to check for signs of infections in passengers and flight crew, and then measuring body temperature and regular measurements of it in flights over four hours. If the infection is confirmed, a report to health authorities, a 14- day quarantine for everyone until complete recovery, and the use of personal protective methods and observance of principles and hygiene recommendations in flight is necessary. Infection control measures and up-to-date principles of disinfection of aircraft equipment and devices are also important points in maintaining health in aviation.

With the expansion of international air travels, most viral respiratory infections, especially from asymptomatic carriers, occur during flight,  and consequently the plane will not be a clean and safe place. Despite regulations, recommendations, and numerous guidelines in aviation medicine, close cooperation and interaction between medical communities and the aviation industry can successfully eradicate COVID-19 transmission chain.

Due to the increasing prevalence of air travel around the world, it is possible to spread contagious infectious diseases from endemic areas to other areas. Of course, this can be largely prevented by raising the level of public health and awareness. Also, with the ease of air travel and the aging of communities, the number of elderly travelers with concomitant illnesses will increase, which will increase the mortality and morbidity associated with the spread of communicable infectious diseases. Stricter hygiene protocols implemented on airlines and proper design of modern aircraft can greatly reduce the transmission of contagious diseases. Our purpose in presenting this article was to formulate appropriate guidelines for experts and authorities to inform and provide best practices when dealing with an influenza epidemic.

Ankylosing spondylitis or Marie Strümpell disease، the most common form of the spondyloarthritides، is a chronic inflammatory disease principally involves the hips and axial skeleton and peripheral joints. In addition، in severe forms of disease، systemic involvements such as uveitis، pulmonary fibrosis and aortic insufficiency can be seen. Its onset is insidious، can have extra-articular manifestations، and is diagnosed by clinical suspicion supported by imaging techniques and associated human leukocyte antigen HLA B27. The disease may present with nonspecific symptoms such as low fever، fatigue and weight loss. The illness commonly affects young adults with a peak of the third decade of life. The male to female ratio is approximately 2 to 3:1. In the aviators، medical problems may induce a large impact on the ability of aircrew،s safety and their duties. Musculoskeletal diseases that affect the joints and range of motion are important when conside aviators as waiver for aircrew members. Non-specific symptoms such as fatigue may decrease tolerance to acceleration forces in military aviators. So flight surgeons must consider severity of disease and adverse reaction of drugs on the flight safety and its impact on health،s aviator. In this paper we report a jet pilot with ankylosing spondylitis disease with a good response to treatment with etanercept.

and is a frequently encountered clinical problem in the aircrew population. Arterial systolic and diastolic Hypertension is the most prevalent risk factor for arterial disease in the industrialized world blood pressures are continuously varying quantities، influenced by a host of extraneous factors. Aviators with hypertension responsive to life-style modifications should have serial BP rechecks quarterly to semi-annually during the first year to assure success of the lifestyle modifications. Failure to achieve blood pressure control with lifestyle modifications، or an initial blood pressure average exceeding 160 mmHg systolic or 100 mmHg diastolic، requires initiation of pharmacotherapy. In this study we evaluate books، magazines، articles، guidelines and reliable websites related to aeromedical concerns and waiver considerations in aircrew with hypertension. by suppressed renin activity and sensitivity to dietary sodium، the other by high renin activity and a lack of response to sodium intake. Thiazide diuretics are certainly the initial therapy of choice، particularly for older subjects. Aircrew with blood pressure that is controlled adequately with thiazides، with no other uncontrolled Two major “types” of essential hypertension are generally recognized. One is characterized cardiovascular risk factors، and with no evidence of end-organ damage، are usually fit to return to unrestricted flying in military and civilian spheres. ACE inhibitors are an alternative initial choice in younger aviators، are positively indicated in patients with type 2 diabetes، and have no adverse effects on serum lipids. Hydrochlorothiazide (hctz)، with or without triamterene or potassium replacementt، can be used as a first line agent for treatment of hypertension in designated personnel. ACE inhibitors might have an adverse effect on G-tolerance have not been borne out by experience in either the US Air Force or the Royal Air Force (RAF)، and the US Navy accepts these agents for unrestricted flying without G tolerance testing.