Iranian Journal of War and Public Health
Volume:15 Issue: 61, Autumn 2023

Bronchial asthma is a chronic bronchospastic disease of the lung airway and one of the major causes of morbidity and mortality in childhood and adult age groups. This study aimed to investigate the role of antibiotics in managing acute asthmatic attacks in patients admitted to Al-Mawani General Hospital in Basrah, Iraq. 

This cross-sectional study was conducted on acute asthmatic patients admitted from January 2021 to January 2022 in Al-Mawani General Hospital in Basrah, Southern Iraq. Out of the patients, 70 subjects were selected by random sampling according to the Cochrane formula. The patient’s records were retrieved from AL-Mawani General Hospital. Data were analyzed using the Chi-square test through SPSS 18 software.

There was just a significant difference in the frequency of hypertension in comparing the goodness of fit between the subjects (p=0.045). There was an inverse relationship between the duration of hospitalization and single and combined medicine therapy by antibiotic. There was no significant association between the duration of asthma and single/combined medicine.

 Amoxicillin and ceftriaxone as an additional treatment to standard therapy of acute severe asthma effectively reduces hospitalization of asthmatic patients.

This study aimed to investigate the prevalence of musculoskeletal disorders and determine its correlation with the body posture of FARAJA employees.

This descriptive correlation study was conducted on 360 FARAJA employees in Yazd City in 2019, who were randomly selected from different ranks. The Nordic Musculoskeletal Questionnaire was used to collect the necessary information, and the Phi coefficient was used to determine the correlation level.

Among the 360 employees, 277 people had one or more musculoskeletal disorders (76.9%). Overweight had a weak correlation with the being in the Line or Staff (φ=0.20). Also, it correlated to the rank (φ=0.58). Neck disorder was correlated to the rank (φ=0.28). Neck, back and low back disorders had a weak correlation with overweight (φ=0.2). The bent position of the head and neck while working was correlated with musculoskeletal disorders of the neck, shoulder, back, and low back (φ=0.2). Observance of correct sitting was correlated to neck and back disorders (φ=0.20). There was a significant correlation between awareness of correct sitting and neck and knee disorders. Sitting percentage had a moderate correlation with the shoulder (φ=0.36) and knee (φ=0.41) disorders.

The prevalence of musculoskeletal disorders among FARAJA employees in Yazd city is 76.9%. The level of awareness of the correct body postures during work and their observance is correlated to the type of disorder, and there is a significant correlation between disorders with overweight and job rank.

Nowadays, infertility problems impose a heavy burden on many developing countries. Previous studies have shown that the testes are a target organ of cadmium poisoning, which may explain the decline in male fertility. On the other hand, many studies have shown protective and antioxidative properties of silymarin against adverse effects of chemotherapy medications and environmental toxins in sperms and oocytes. Therefore, the present study aimed to examine the protective effect of silymarin against cadmium nanoparticle-induced toxicity in the reproductive system of rats.

In this experimental study, 60 male rats weighing 190±10g, aged 90 days, were divided into six groups of 10 each. Rats of each group received cadmium (10mg/kg body weight) and silymarin (200 mg/kg body weight), for 14 and 28 days, according to the experimental protocol. After killing the male rats, blood tissue samples were collected, and their serum was separated. Then luteinizing hormone, follicle-stimulating hormone, and testosterone were evaluated by the ELISA method. Also, serum levels of antioxidants, including malondialdehyde, glutathione, and superoxide dismutase were investigated.

After nano-cadmium treatment, the levels of male sex hormones, including luteinizing hormone, follicle-stimulating hormone, and testosterone, as well as the levels of antioxidants, including malondialdehyde, glutathione, and superoxide dismutase, decreased. However, after a longer period of time (14 and 28 days, respectively), the levels of hormones and antioxidants improved significantly due to the effect of silymarin (p<0.05).

Silymarin significantly reduces cadmium-induced reproductive damage in rats.

Amis: 

Wound infections are one of the most important problems in human life. Continued use of antimicrobial agents against wound infections leads to the appearance of antibiotic-resistant bacteria strains. Flaxseed has important pharmacological properties against various diseases. This study aimed to determine the antibacterial activity of flaxseed extracts against different bacteria isolated from wound infections.

This experimental study used phytochemical screening for flaxseed extracts. Also, the agar well diffusion method was used to examine the antibacterial activity of aqueous, ethanolic extract, and flaxseed oil (200, 100, 50, and 25mg/ml) against gram-positive and gram-negative bacteria.

Phytochemical screening for the crude aqueous and ethyl extracts of flaxseeds revealed alkaloids, terpenoids, tannins, flavonoids, glycosides, saponins, steroids, phenolic compounds proteins, and carbohydrates. Aqueous extract showed inhibition zones only for Staphylococcus aureus and Streptococcus faecalis at 50, 100, and 200mg/ml. All the concentrations of the ethanolic extract showed inhibitory effects against all tested bacteria. The maximum antibacterial effect of ethanol extract on aqueous extract was 200mg/ml. Also, 200mg/ml of flaxseed oil had the most powerful inhibitory effects on all tested bacteria

Flaxseed ethanolic extract and flaxseed oil have an inhibitory effect against different species of both gram-positive and gram-negative bacteria isolated from wound infections.

Iraq used chemical weapons in the war with Iran, in military and civilian areas. Due to the long-term effects of these weapons, Considering over 35 years after this eight-year war, the number of chemical warfare victims is increasing. This research aimed to investigate the spatial distribution of chemical warfare victims by province.
Instrument &

This descriptive-analytical research study was done using data obtained from the General Department of Statistics and Information Technology of the Martyr and Veteran Affairs Foundation. The data of chemical casualties includes the number; place of residence, gender, and type of injury in 2021 that were analyzed using SPSS 20 and ArcGIS software and Moran's test.

The total number of veterans in 2021 was 601330; 10.7% of them were chemical victims. Tehran (11%), Isfahan (9.67%), and Khorasan-Razavi (6.92%) provinces had the highest, and Hormozgan (0.39%), South-Khorasan (0.66%), and Sistan & Baluchistan (0.77% provinces) had the lowest. The spatial distribution of chemical warfare victims showed a cluster pattern.

The consequences of Iraq's use of chemical weapons can be seen in all of Iran’s provinces, and all provinces have chemical victims. Tehran, Isfahan, Khorasan Razavi, Kerman, West-Azerbaijan, and Khuzestan have more chemical victims than other provinces.

Assessment of cardio-protective potential of celastrol against sepsis-induced cardiac injury in mice.

A twenty- four Swiss albino mice aged between 6-8 wks., weighted between 20-30 g were included in this study. They were randomly divided into 4 groups, each of 6:Sham group: laparotomy without cecal ligation and puncture( CLP), Sepsis group: (laparotomy with CLP), Vehicle group: Treated with equivalent volume of DMSO i.p. 1 hr. before CLP, Celastrol treated group: treated with 2 mg/kg  i.p. 1 hr before CLP. Animals were sacrificed after 24 hrs. Blood samples then aspirated for assessment of cardiac troponin and CK-MB by spectrophotometric assay. Part of cardiac tissue was used for assessment of the levels of TNF, IL6, IL10, F2-Isoprostane, and TLR4 by ELISA method, another part was used  for assessment of the degree of cardiac tissue damage by histo-pathological analysis.

Significant cardiac damage was noticed in sepsis group (P≤ 0.05) as compared with sham group manifested by significant elevation in inflammatory markers( TNF, IL6, TLR4) and oxidative stress marker( F2-Isoprostane) as well as cardiac troponin and CK-MB, with significant reduction in IL10.
Pretreatment with celastrol was resulted in significant reduction in TNF,IL6, TLR4,  F2-Isoprostane, troponin,  and CK-MB with significant elevation in IL10 as compared to sepsis group.
In the same manner significant histological damage was encountered in sepsis group as compared to sham, while celastrol treated group exhibit minor histological damage as compared to sepsis group.

Celastrol have a cardio-protective effects against cardiac injury induced by endotoxemia.

Teamwork is an essential necessity for triage in war by healthcare science students and providers. The aim of this study was to evaluate the effects Online Micro Learning Interdisciplinary Education (OMIDE) about war victim triage on triage-related knowledge and practice of healthcare science students.

This quasi-experimental study was conducted in 2021 with a single-group pretest-posttest design. Participants were eighty male medical, nursing, and medical emergency students. They were purposively selected from a medical sciences university in Tehran, Iran, and randomly allocated to ten interdisciplinary WhatsApp groups. The intervention of the study was online micro learning video-based education about war victim triage provided through the ten WhatsApp groups. Participants’ knowledge and practice respecting war victim triage were assessed before, immediately after, and one month after the intervention using a war victim triage knowledge questionnaire and six scenarios about war victim triage practice, respectively. The SPSS software (v. 22.0) was used to analyze the data through the repeated measures analysis of variance.

The mean of participants’ age was 23.07±1.51 years. The mean scores of knowledges and practice respecting war victim triage significantly improved across the three measurement time points (P < 0.001).

Web-based OMIDE is effective in significantly improving healthcare science students’ knowledge and practice respecting war victim triage.

The incidence of mental disorders continues to rise annually, a trend that is exacerbated by the inability to detect early mental health issues in the community and the inadequate reporting of such conditions. The purpose of this study is to assess the efficacy of interventions that distribute culture-based cadre empowerment modules in order to improve cadres' early awareness of mental health issues.

In this experimental study, 102 mental health personnel were divided into an intervention group (n=51) and a control group (n=51). Culture-based cadre empowerment training via discussion forums and modules constituted the intervention. The participants were evaluated by independent assessors both prior to randomization (T0) and in a posttest following eight weeks of intervention (T1).

The posttest findings and follow-up assessments, which were analysed statistically, indicate a significant improvement in the cadres' capacity to identify, oversee, mobilise, and document mental health issues in the community. The p-value was found to be less than 0.05. In contrast to the control group, there is typically no observed increase.

Culturally based cadre empowerment is an effective intervention to increase mental health cadres' ability to detect mental health in the community. Culture-based cadre empowerment is a short, easy-to-use, group-based intervention and is easy to implement in various environments.

Garden cress (Lepidium sativum L.), a member of the Cruciferae family, is widely planted worldwide, especially in India, Europe, and the United States. One of the most common mosquito species that carries Plasmodium falciparum is the Anopheles gambiae sensu lato, which may be combated by sprinkling fields with Lepidium sativum seeds. This study aimed to test the Lepidium sativum Linn. seeds extract as an antimicrobial agent against food pathogens.
Materials &

The active components were extracted from the powdered dry seeds using chloroform, ethyl acetate, methanol, and dichloromethane. The antibacterial activity of various doses of the extracts was evaluated using agar well diffusion. The MIC and MBC for the most effective extract were estimated using tube dilution and subculturing methods.

Staphylococcus aureus had an MIC of 1.56mg/ml and a minimum inhibitory concentration (MBC) of 6.52mg/ml, while Salmonella typhi had an MIC of 25mg/ml. At a concentration of 10% L. sativum, the half-life (KDT50) was determined to be 7.34 minutes. Conversely, the half-life of L. sativum oil was only 10.05 minutes when used at the same concentration. Compared to the L. sativum concentrations that resulted in the KDT50 (50 and 10%, respectively), the bendiocarb 0.1% impregnated filter paper performed poorly.

L. sativum essential oil effectively kills Anopheles gambiae.

The study aimed to evaluate military medical services, identify problems, and develop suggestions, evaluating medical services in the Russia-Ukraine War as hybrid warfare.
Information &

This systematic review was conducted by examining scientific articles published between 2021 and 2023, obtained by searching the sentences "Military Health Services in the Russia-Ukraine War" and "War Casualties in the Russia-Ukraine War." Additionally, military medical literature and military medical news from China, Iran, the United Kingdom, Belarus, and the United States were examined and interpreted.

The Russia-Ukraine war differs from conventional wars and counterterrorism operations regarding military healthcare. Diversity of front depth, frequency of mass and polytrauma, difficulties in medevac, and the loss of medical personnel were found to be noteworthy as the main problems for both Russia and Ukraine in this expanding hybrid war. Attacks on health facilities and medical personnel were also one of the basic attack strategies in this war, as in all wars.

Medical examination and vaccination for attending to the army, medevac distances, the safety of medevac routes, loss of medical facilities and medical personnel, lack of communication between medical units, the load of medical facilities deployed in route migration mandatorily, non-standardized first aid applying and absence of medical intelligence are main problem areas about medical services in Russia -Ukraine War. It has been stated that the military medical system is an important power protector and "Force Multiplier".

The present study aimed to determine veterans' mental health indicators based on the Item Response Theory.
Information &

474 veterans participated in this instrumental-psychometric study. The quality of life (SF-12), mental disorders checklist (SCL-90), and daily activities (Bartel) tools were used for data gathering. The data was analyzed using the DETECT method and multivalued Item response theory models. Likelihood indicators and Akaike’s information criterion were used to model data fit.

The mean age of the veterans was 53.4±35.2 years. 266 veterans had physical injuries, and 208 (43.9%) had mental health problems in addition to physical injuries. The mean of items was 3.92 to 2.30. The highest experimental reliability was related to the Neuroticism dimension (0.91). The levels of dimension information were 3±, and the neuroticism dimension had the best level of information compared to other dimensions.

The questionnaire on mental health indicators has four dimensions, and the questionnaire items, with adequate experimental reliability, can give information at all levels of ability.

Methicillin-resistant Staphylococcus aureus frequently causes infection of diabetic foot ulcers. However, no investigations have investigated the connection between methicillin-resistant A, perivascular tissue neoplasia, and delayed healing of diabetic foot ulcers. The purpose of this study was to genetically isolate methicillin-resistant from diabetic foot ulcer patients and define its function in the development of chronic ulcer lesions, the course of the disease, and antibiotic resistance.
Materials &

This experimental study was conducted on patients referred to the Diabetes Endocrinology Center in Al-Basrah, Southern Iraq, from 2019 to 2020. Only 31 isolates were found in the 80 samples of diabetic foot ulcer patients; 12 Staphylococcus aureus (38.7%) and 19 other Staphylococcus spp. (61.3%). All 12 samples of Staphylococcus aureus strains were confirmed by amplifying the universal 16SrRNA gene for pak2, MR30, CFSAN007896, and ST4.

The mecA gene was 100% positive for the icaA gene (involved in biofilm formation) and 75% positive for the pol gene (involved in the manufacture of cytotoxins), revealing that all 12 Staphylococcus aureus isolates were methicillin-resistant.

Panton-valentine leukocidin has a high prevalence among MRSA strains isolated from diabetic foot ulcer patients that form biofilms, causing patients to have significant inflammation, illness progression, and challenging wound healing, which may result in lower limb amputations.

Emergence agitation is an acute confusion state during recovery from anesthesia, a common side effect of sevoflurane anesthesia. Small doses of ketamine or fentanyl appear to decrease the incidence and severity of emergency agitation. The effect of IV ketamine and IV fentanyl on the emergence agitation score in patients undergoing tonsillectomy with or without adenoidectomy under sevoflurane general anesthesia was compared.
Materials &

Sixty patients in this study are divided randomly into three groups, each comprising 20 patients. So, the first group received IV ketamine, the second group received IV fentanyl, and the third group, the control group, received nothing. Children who were selected were prepared to undergo tonsillectomy with or without adenoidectomy under sevoflurane general anesthesia. Patients were monitored by standard monitoring techniques and mechanically ventilated until the end of the surgery, where they were extubated and transported to the Post Anesthesia Care Unit, where the incidence of emergency delirium was assessed using the Pediatric Anesthesia Emergence Delirium scale.

Emergence delirium was significantly lower in patients receiving ketamine and fentanyl than in the control group (p=0.001). No significant correlation was found between the Pediatric Anesthesia Emergence Delirium score and other variables among both studied groups, indicating that ketamine and fentanyl had a good ameliorating effect of reducing the incidence of emergence delirium.

The intravenous administration of either ketamine or fentanyl before the end of surgery in sevoflurane-anesthetized children undergoing tonsillectomy with or without adenoidectomy reduces the incidence of postoperative agitation.

The present work seeks to ascertain immunological and biochemical characteristics in thalassemic individuals who have contracted giardiasis.
Materials &

This experimental study was conducted at the Thalassemia Center in Thi-Qar province, Iraq, in 2022. Fifty patients (21 males and 29 females) and 20 healthy controls were investigated. Of the patients’ group, twenty-five were thalassemic and had giardiasis. The other 14 patients were thalassemic and free of giardia infection, and the remaining 11 patients were non-thalassemic but had giardia infection. Five ml of venous blood from each participant was withdrawn to determine WBCs, neutrophil activity, and levels of IL-6, iron, ferritin, and transferrin.

The levels of interleukin-6 in the three patient groups (28.20, 23.29, and 30.94pg/ml) were considerably higher than those in healthy controls (16.09pg/ml). In patient groups, there was a notable rise in WBCs but a notable fall in neutrophil activity. Additionally, a substantial increase in iron and ferritin was found, although transferrin was lower in the patients than in the control group.

The thalassemia and giardia patients have greater iron and ferritin levels but much lower transferrin levels than the healthy individuals.

There are controversies about the expenditures imposed on surveillance in the treatment of elderly patients and patients with end-stage disease. The present health economic evaluation study was performed to find the cost-effectiveness of hospitalization and antiviral treatment of COVID-19 in elderly patients.
Instrument &

A health economic evaluation as a single-center primary study with a cross-sectional design was performed in Firoozgar Hospital, Tehran, Iran, in 2022. All the hospitalized cases of COVID-19 at 65 years of age and more were eligible for the study. The health outcomes were the length of stay and death. Cost-effectiveness was calculated using the incremental cost-effectiveness ratio. Stata14 was used for data analysis.

Of the admitted patients, 347 cases over 65 were selected for the study. 173 patients (49.86%) were in the age range of 65-74, 69 patients (31.41%) were in the age range of 75-84, and 65 patients (18.73%) were 85 and more. One hundred ninety-nine patients (57.35%) survived, and 148 patients (42.65%) died. The mean of LoS was 11.40±7.01 days, with the mean at the ward being 5.24±5.44 days and at the ICU 6.15±6.94 days. The mean cost of a bed day was 35.41±32.03 dollars, with a right-skewed distribution.

A mean cost of 88.711$ is needed for the survival of one patient, assuming that all the ICU-needed patients would die if there was a lack of hospital admission. Considering all ward and ICU admitted patients, 44.854$ is needed to save one old patient's life, assuming this logic.

The current study aimed to determine the influence of COVID-19 infection on kidney function and the levels of some related hormones.
Instrument &

In this experimental study, some severe patients were admitted to the Ibn Al-Khatib Hospital in Baghdad City, Iraq, from May to October 2021, at the end stage of the pandemic. All positive cases (n=60) were entered into the study, and a sample of 31 healthy individuals was also selected as the control group. Urea, uric acid, creatinine, and ADH, EPO were estimated in patients’ serum samples with severe COVID-19. The Independent T-test and Pearson correlation coefficient were used for the analysis.

There were significant differences between the patient and control groups in the total levels of urea (p=0.04), creatinine (p=0.009), uric acid (p=0.009), erythropoietin (p=0.0001), and antidiuretic hormone (p=0.0001) except calcium (p=0.085). Female patients and controls significantly differed in uric acid levels and the other two hormones. Male patients and controls revealed significant differences in Creatinine and both hormones. Calcium and urea represented a significantly higher elevation in male than female patients.

Recombinant human erythropoietin weakens distress syndrome of the respiratory system and opposes SARS-COV-2.

Although vaccines have been developed for COVID-19, the virus continues to present problems to the health sector. The current study assessed thyroid function in all hospitalized patients diagnosed with the virus to ascertain whether COVID-19 infection was linked to thyroid function abnormalities.
Instrument &

An observational cohort study was conducted on all COVID-19-positive patients hospitalized in the Al-Fourat Al-Awsat Hospital in Al-Kufa, Iraq, between September 2021 and April 2022. 208 potential patients were tested during this period, and 150 COVID-19 patients and 50 COVID-19-negative individuals were selected. A sample of blood was collected during hospitalization. A serum was used to determine the thyroid-stimulating hormone.

Hypertension, shortness of breath, diabetes, liver dysfunction, and cardiac and pro-inflammatory diseases were the most frequent comorbidities in COVID-19 patients. The association between COVID-19 and Control groups indicated a significant difference in age, body mass index, gender, systolic- and diastolic blood pressure, fasting blood sugar, HbA1C, alanine aminotransferase, and aspartate aminotransferase. Also, the analysis indicated a significant (p<0.001) difference between COVID-19 patients and the control group in the level of TSH.

Thyroid impairment is frequent in most individuals admitted to the hospital with a COVID-19 infection. Low thyroid-stimulating hormone level is a reliable indicator of poor prognosis in COVID-19-infected individuals.

Evidence suggests that the COVID-19 pandemic has been identified as a stressor. Perceived social support can protect against negative mental health impacts from COVID-19. The study aimed to identify the dimensions of perceived social support from the perspective of the people of Iran during the COVID-19 pandemic.
Participants &

This qualitative content analysis was conducted from September to December 2022 in the Hamadan province; 42 in-depth semi-structured interviews were completed with male and female residents. Eligible participants were adults over 18 and heads of household. The data were analyzed using MAXQDA 10 software.

The family was recognized as the main source of emotional support. Informational support was reported through formal (e.g., media) and informal sources (e.g., friends and neighbors), instrumental support from the two areas of relatives and the government, and feedback from others as appraisal support.

The coronavirus pandemic has illuminated global crises' irrefutable mental and social health repercussions. Crucially, this pandemic highlighted the detrimental impact on households' jobs and incomes.