Iranian Journal of War and Public Health
Volume:15 Issue: 58, Winter 2023

People with diabetes mellitus (DM) represent a population group that is at high risk of developing a poor prognosis for Covid-19. Having diabetes increases the risk of serious illness, ICU stay, and death from Covid-19. The present study aimed to determine RETN gene polymorphisms as a risk factor in diabetic patients with Covid-19 infection.
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The current study included 150 participants with diabetes, 100 patients of whom had Covid-19 (46 male, 54 female), and 50 had diabetes only (28 male, 22 female). Five ml of venous blood was collected from participants, then used for examining the blood sugar and HbA1c levels and molecular study.

There was a significant increase in random blood sugar and HbA1C concentrations in diabetic patients infected with Covid-19 compared to diabetic patients only. Regarding the molecular study of the gene encoding the protein resistin, diabetic patients with Covid-19 had a high frequency of single nucleotide polymorphisms compared to diabetic patients only. Polymorphisms of X494T.C, X663A.C, X494T.C, and X663A.C recorded significant differences, while the polymorphisms of rs3219177, X542A.C, and rs3745367 did not show a significant difference.

Diabetic parameters increase in diabetic patients with covid-19 compared to diabetic patients without Covid-19. In addition, diabetic patients with Covid-19 have a high frequency of single nucleotide polymorphisms of the RETN gene.

Medical evidence shows that Visfatin and Leptin are related to multiple metabolic Problems, including obesity, type 2 diabetes, and cardiovascular disease. The present study aimed to assess Visfatin and Leptin levels in type 2 diabetic patients with and without atherosclerosis.
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This descriptive study was conducted on 30 diabetic patients, 30 patients with diabetes mellitus and atherosclerosis, and 30 seemingly healthy persons (as a control group) in Babylon Province, Iraq, and their serum Visfatin and Leptin levels were assessed by ELISA procedure. The statistical analysis was done with SPSS 21 software.

In diabetic patients and patients with diabetes and atherosclerosis, the level of Visfatin was significantly higher than in the control group (p=0.0001). There was a significant increase in Leptin level in diabetic patients compared to the control group (p=0.0001), while Leptin level showed a significant decrease in patients with diabetes and atherosclerosis than in the control group (p=0.0001). Also, the mean body mass index in diabetic patients and patients with diabetes and atherosclerosis was significantly higher than in the control group (p=0.0001).

Visfatin serum levels are significantly higher in atherosclerosis patients compared to healthy people, while low Leptin and high Visfatin expression are seen in patients with diabetes.

Amputation makes a person susceptible to postural deviation and compensatory movements and causes reduced performance, biocompatibility, pain, and dissatisfaction. This study aimed to investigate the effect of eight weeks of a comprehensive rehabilitation protocol on indicators of postural control, back pain, quality of life, and gait speed in adults with unilateral lower limb amputation.
Materials &

This Quasi-experimental study was carried out on 23 subjects with transtibial amputations at K2 level and above who could walk with the help of a prosthesis. The subjects were selected by purposive sampling and were assigned into training and control groups. The training group received proper posture, correcting daily life activities, teaching the correct use of prosthesis, and mirror therapy for eight weeks. However, the control group followed their routine daily life activities. A dynamic computer posturography machine was used to evaluate the postural control indicators. Low back pain was measured by a visual analog scale. The quality of life was evaluated using TAPES and CLASS questionnaires. And the gait speed was checked by a 2-minute gait test.

Eight weeks of the comprehensive corrective protocol had a significant effect on the indicators of postural control, low back pain, quality of life, and gait speed, in the training group (p≤0.05).

Implementing a comprehensive program of correctional protocol leads to improvement of balance and postural control indicators, quality of life and gait speed, and reduction of low back pain intensity in unilateral lower limb amputees.

Amputation is a procedure in which an unhealthy limb or a part of it is cut because it is dangerous, or useless or disrupts life. This procedure in itself is considered a crippling procedure, yet it is also a life-saving procedure. This study aimed to compare the causes of amputation in Iraqi subjects for five years (2016-2020).
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In this retrospective cross-sectional study, 758 amputated patients were investigated from 1st day of 2016 to the last day of 2020 at Al-Hariri Hospital for Surgical Specialty.

The rate of amputation in 2020, 2019, 2018, 2017, and 2016 was 6%, 6%, 4%, 3%, and 2% of total admitted cases, respectively. The highest cause of amputation in 2020 was diabetes mellitus (18%) and mostly in males. Diabetes mellitus and vascular ischemia in both sexes were 18% of total amputated cases in 2019. Trauma was 23% of total amputated cases in 2018, 57% in 2017, and 64% in 2016.

The rate of amputation is not so high. There is a significant association between amputation and gender, age, occupation, and the cause of amputation. There is no significant relationship between amputation and the hospital stay, the parts are either lower or upper, and the side is either left or right. Regarding the indications of amputation, the highest cause of amputations changes every year.

Endotoxemia is the most common condition in patients treated in critical care units. This study aimed to investigate if dulaglutide may help to protect the lungs during endotoxemia by modulating the inflammatory and oxidative stress pathways. This study is self-funded. All authors contributed to the costs.
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20 adult male Swiss-albino mice aged 9–12 weeks, weighted 25–35g, were randomized into four equal groups (n=5), sham group (laparotomy without Cecal Ligation and Puncture (CLP), CLP group (laparotomy with CLP), vehicle group (normal saline 2 weeks before CLP), and dulaglutide group (0.6mg/kg twice weekly S.C for 2 weeks before CLP). After 24 hrs of sepsis, lung tissue was harvested and used to assess IL-6, Interleukin-IL-1β, TNF-α, MIF, TLR4, and 8-isoPGF2α, as well as histological examination.

Lung tissue levels of IL-6, IL-1β, TNF-α, MIF, TLR4, and F2-isoprostane were significantly higher in the sepsis group compared to the sham group (p<0.05), while dulaglutide group showed significantly lower level in these inflammatory mediators and oxidative stress compared to sepsis group (p<0.05). Histologically, all mice in the sepsis group showed a significant lung tissue injury (p<0.05), but this injury was significantly reduced in the dulaglutide pre-treated group (p<0.05).

Dulaglutide can attenuate acute lung injury during CLP-induced endotoxemia in mice through its modulating effects on TLR4 and oxidative stress, downstream signaling pathways, and subsequently decreased lung tissue levels of pro-inflammatory mediators.

In recent years, the global incidence of infections caused by gram-negative bacteria resistant to antibiotics has increased. This study aimed to investigate the presence and frequency of coagulase-negative Staphylococci in contact between animals and people and determine the phenotypic antimicrobial resistance profiles of coagulase-negative Staphylococci isolates from these sources.
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80 samples were collected from humans in different areas of Basrah Province, including 40 samples from human hand swabs and 40 from nasal swabs. The samples were inoculated onto mannitol salt agar and blood agar and then incubated at 37ºC for 24 hrs. Antibiotic susceptibility testing was performed using the disc diffusion method. A molecular study was done using the PCR technique.

37 samples (46.25%) were positive for staphylococcal infection. Five species, including S. sciuri, S. lentus, S. gallinarum, S. chromogen, and S. haemolyticus were identified, according to Vitek 2 kit. Staphylococci were resistant to several different antibiotics. Out of 20 amplification samples, only 12 positive samples were purified for the ermA gene region with a PCR product of 190 bp. The results also showed the presence of an ermC band with a size of 299 bp, which represents the correct expected band in 8 isolates out of all isolates.

Gram-positive organisms are increasingly identified as the source of acute clinical infection in animals and humans. Some isolates are resistant to several different antibiotics. The ermC gene, ermA gene, and both ermA and ermC genes are present in the genome of these bacteria.

Post-traumatic epilepsy is one of the most common and disabling sequels of traumatic brain injury and is defined as repeated unprovoked seizures seven days after traumatic brain injury. The present study aimed to determine the late consequences of epilepsy in veterans with traumatic brain injury during the imposed Iran-Iraq war.
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This study was observational cohort research in 2022. The sample of the study included all living veterans with a history of Post-traumatic epilepsy who were covered by the services of the "Veterans Affairs Foundation" of Isfahan, Iran. 218 veterans with epilepsy, who were available, were identified, 100 of them had a traumatic brain injury, and 118 did not have any traumatic brain injury. Data were collected using the Mini Mental State Examination (MMSE) and Instrumental Activities of Daily Living and Physical Self-Maintenance Scale (IADL-PSMS).

There was a significant difference between veterans with and without traumatic brain injuries in the age at post-traumatic epilepsy debut (p<0.05). Epilepsy characteristics were not significantly different between the two groups (p>0.05). The mean score of MMSE in veterans with and without traumatic brain injuries was significantly different (p<0.05). The Recall and Registration subscales were significantly different in veterans with/without traumatic brain injuries (p<0.05).

The ability to perform daily activities and cognitive function are lower in veterans with epilepsy with traumatic brain injuries compared to veterans with epilepsy without traumatic brain injuries.

Chemically injured veterans are very vulnerable because of their special situation, and they may confront numerous difficulties. Body composition is one of the effective factors in mental health in adults. So, this study aimed to survey the correlation between body composition and body mass index with mental health and sleepiness in chemically injured veterans.
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This cross-sectional study was conducted on chemical veterans referred to the rheumatology ward in Karaj province. 131 patients were selected through the available sampling method. The body composition and body mass index of veterans were determined, and General Health Questionnaire and Epworth Sleepiness Scale were answered. Data were analyzed using the Pearson correlation coefficient by SPSS 19 software.

There was a significant correlation between body fat percent and fat mass with total general health (p=0.004). The correlation between body composition and sleepiness was not significant (p>0.05). There was no significant correlation between body mass index with mental health and sleepiness (p>0.05).

Body composition, particularly fat percent and fat mass, is associated with general health in chemically injured veterans.

Due to the prevalence of COVID-19 and its adverse effects on the mental health of healthcare workers, the present study aimed to investigate the prevalence of post-traumatic stress disorder among healthcare workers involved with COVID-19 treatment and its factors in military hospitals of Iran, Tehran within the first two months of 2021 (fourth peak).
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This study is a descriptive cross-sectional study, which was performed within the first two months of 2021 (fourth peak). A total of 356 samples were selected among the healthcare workers in three hospitals in Iran, including Imam Reza (501), Family, and Hajar (503) hospitals, using cluster random sampling method. All samples were interviewed in person. To collect data, a researcher-made demographic information questionnaire, and PTSD Symptom Scale – Interview for DSM-5 (PSS-I-5) were used. Data analysis was performed using SPSS 26 software.

85.4% of the healthcare workers had no PTSD, and 14.6% had PTSD. 12.4% of the healthcare workers had intrusion, 14% had avoidance, 21.6% had negative changes in cognition and mood, and 13.2% had arousal.

COVID-19 disease can lead to psychological problems in the frontline HCWs. Therefore, it is necessary that planners and community mental health professionals pay special attention to planning and providing mental health interventions, especially in the field of resilience, to the HCWs of military hospitals and centers that are involved with COVID-19 treatment.

Endotoxemic shock is characterized by multiple organ dysfunction, acute Lung Injury, acute respiratory distress syndrome, and high mortality. This study aimed to investigate the protective effect of ertugliflozin against acute lung injury during endotoxemia.
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Twenty adult Swiss-albino male mice, 9–13 weeks old, weighing 20–35 g, were divided into four groups (n=5) at random: the sham group (laparotomy without Cecal Ligation Puncture, CLP), the sepsis group (CLP), the vehicle group (DMSO for one week), and the ertugliflozin group (20 mg/kg/day orally for one week before CLP). After 24 hours of CLP, the lung tissue was removed and used for histological analysis. The inflammatory cytokines, including IL-1β, IL-6, TNF-alpha, TLR4, MIF, oxidative stress marker, and 8-isoPGF2-alpha, were measured.

In sepsis group, lung tissue levels of IL-6, IL-1, TNF-, MIF, TLR4 and F2-isoprostane were substantially greater than those in the sham group. In comparison to the sepsis group, the ertugliflozin treated mice exhibited significantly lower levels of inflammatory cytokines. Histologically, all of the mice in the sepsis group had considerable lung tissue injury, but in the ertugliflozin pre-treated group, there was a significant reduction in lung tissue injury.

Ertugliflozin attenuates lung dysfunction during endotoxemia in male mice via downstream inflammatory and oxidative stress signaling pathways.

Amoxiclav antibiotic is a commonly prescribed medication for many medical situations. One of the side effects of amoxiclav is hepatotoxicity. Coenzyme Q10, as a potent anti-oxidant, can play a beneficial role in reducing various drug-induced hepatotoxicity. The present study aimed to evaluate the hepatoprotective effects of coenzyme Q10 against amoxiclav-induced hepatotoxicity in the rat model.
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24 male albino rats weighing 150-250g were randomly divided into four groups of six animals. The control group was given normal saline; the amoxiclav group was given 30mg/Kg/day of amoxiclav orally for 30 days; In the amoxiclav and CoQ10 group, each animal was given orally 30mg/Kg of amoxiclav, and 100mg/Kg CoQ10 orally daily for 30 days; In CoQ10 group, each rat was given 100mg/Kg CoQ10 orally daily for 30 days. At the end of the experiment, the animals were anesthetized and then scarified to assess the serum liver enzymes, as well as liver tissue samples were obtained for histopathological study.

Liver function parameters were significantly elevated in the animal group treated with amoxiclav, and hepatocellular necrosis and congestion were observed in histopathological examination. Concomitant treatment with CoQ10 and amoxiclav significantly reduced the liver enzymes and improved hepatocellular congestion and inflammation.

CoQ10 is a potent anti-inflammatory and anti-oxidant agent that can be used to reduce amoxiclav-induced hepatotoxicity.

Military personnel are likely to encounter mental health problems due to high-risk occupations associated with significant levels of psychological distress. The present study aimed to determine the factors that caused psychological distress in Iranian military staff members.
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This qualitative research was done in two steps on psychological distress among military personnel. The first stage was a brief review. We studied texts related to psychological distress in the military, then we extracted the factors affecting psychological distress. The second stage was the interview with 15 experts. Purposeful sampling was used to select participants and continued until data saturation was reached. Data were collected using semi-structured interviews and analyzed through direct content analysis. The results were presented as codes, subcategories, and categories using an inductive approach.

In the first stage, 25 studies were found, and in the second stage, 395 primary codes and two main categories, including demands and resources, were developed based on the opinion of experts.

Different factors affect the military members’ psychological distress, which are divided into two categories and six subcategories: Demands (military related demands, occupational-organizational demands, individual-occupational demands, and personal demands) and Resources (personal resources and job resources).

Due to the special economic and social situation of the rural environment, the rural elderly are at risk of reducing their quality of life compared to the urban elderly. This study aimed to investigate the quality of life and its determining factors among rural elderly in the southern counties of Fars province.
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In this survey research, 825 people were selected by cluster sampling method among the elderly population of Lamard and Mehr cities in the south of Fars province in 2021. Data were collected using a questionnaire that measured the different dimensions of quality of life, as well as its determinants and then were analyzed by the step-by-step regression method.

Children and spouses were the most important sponsors of rural elderly. About 80% of the elderly felt lonely, and about three-quarters felt satisfied with their health. About 45% in physical health and mental psychological health, and about 48% in social-environmental status, have a high quality of life.

Feeling of loneliness and cost of living are two important factors in reducing the quality of life and health of rural elderly. Also, the financial support of children and the acquisition of housing plays an important role in increasing the quality of life of the rural elderly.

Tonsillitis is inflammation of the tonsils, a common clinical state caused by bacterial or viral infections. There are different types of tonsillitis; acute, sub-acute, chronic, and recurrent. The aim of this study was the isolation and identification of Klebsiella oxytoca isolated from tonsillitis based on conventional standard bacteriological methods and confirmed by VITEK-2 compact system.
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A polymerase chain reaction was performed to detect blaCTX-M and blaTEM genes.

A total of 50 specimens were recovered from tonsillitis using swab sampling, which contained 35 bacterial growths. Onto the MacConkey agar, 15 isolates were confirmed as K. oxytoca using IMVIC test and VITEK-2 compact system. In the genotypic test, K. oxytoca isolates contained 11 (73.3%) blaCTX-M and 10 (66.6%) blaTEM genes.

The use of the VITEK-2 system is necessary to confirm the precise identification of K. oxytoca nosocomial pathogens from tonsillitis. The existence of blaTEM and blaCTX-M gene in half of K. oxytoca isolates is a concern that needs control strategies.