Journal of Archives in Military Medicine Journal of Archives in Military Medicine J Arch Mil Med http://www.jammonline.com 2345-5071 2345-5063 10.5812/jamm en jalali 2017 6 25 gregorian 2017 6 25 4 3
en 10.5812/jamm.40369 Sodium Hypochlorite-Induced Upper Extremity Chemical Burns: Case Series of Eight Patients and a Review of the Literature Sodium Hypochlorite-Induced Upper Extremity Chemical Burns: Case Series of Eight Patients and a Review of the Literature review-article review-article Conclusions

We recommend the use of tap water for high-volume, long-term lavage. We are against using neutralization chemicals in order to prevent more unforeseeable catastrophic effects, because it is difficult to determine the composition of exposure from NaClO-derived household chemicals. After emergency department evaluation, patients should be hospitalized for at least the first 24 - 48 hours, according to the plastic surgeon’s decision.

Background

Sodium hypochlorite (NaClO) is a chemical compound that is widely used in bleaching, stain removal, disinfection, deodorizing and water treatment. Sodium hypochlorite-induced chemical burns have been described and are reported as relatively rare. We report our experience with such cases to illustrate important points regarding management of these burns.

Methods

We retrospectively collected the data of NaClO-induced upper extremity chemical burn admissions at a military hospital during an eight-year period (2007 - 2015). Survey data included patient age, gender, burn area, burn depth, treatments and follow-up period.

Results

Eight patients were admitted to our emergency department with complaints of NaClO-induced chemical burns of the upper extremity of skin over an eight-year period. All of the patients were male, with a mean age of 21.25 (19 - 23) years. Four of the burns were diagnosed as second-degree deep dermal chemical burns and the other four were second-degree superficial dermal chemical burns. Two of the patients with second-degree deep dermal chemical burn underwent debridement and skin grafting. All of the patients were then followed for three to nine months.

Conclusions

We recommend the use of tap water for high-volume, long-term lavage. We are against using neutralization chemicals in order to prevent more unforeseeable catastrophic effects, because it is difficult to determine the composition of exposure from NaClO-derived household chemicals. After emergency department evaluation, patients should be hospitalized for at least the first 24 - 48 hours, according to the plastic surgeon’s decision.

Background

Sodium hypochlorite (NaClO) is a chemical compound that is widely used in bleaching, stain removal, disinfection, deodorizing and water treatment. Sodium hypochlorite-induced chemical burns have been described and are reported as relatively rare. We report our experience with such cases to illustrate important points regarding management of these burns.

Methods

We retrospectively collected the data of NaClO-induced upper extremity chemical burn admissions at a military hospital during an eight-year period (2007 - 2015). Survey data included patient age, gender, burn area, burn depth, treatments and follow-up period.

Results

Eight patients were admitted to our emergency department with complaints of NaClO-induced chemical burns of the upper extremity of skin over an eight-year period. All of the patients were male, with a mean age of 21.25 (19 - 23) years. Four of the burns were diagnosed as second-degree deep dermal chemical burns and the other four were second-degree superficial dermal chemical burns. Two of the patients with second-degree deep dermal chemical burn underwent debridement and skin grafting. All of the patients were then followed for three to nine months.

Sodium Hypochlorite;Chemical Burns;Emergency Servic Sodium Hypochlorite;Chemical Burns;Emergency Servic http://www.jammonline.com/index.php?page=article&article_id=40369 Yakup Cil Yakup Cil Department of Plastic, Reconstructive and Aesthetic Surgery, Etimesgut Military Hospital, Ankara, Turkey Department of Plastic, Reconstructive and Aesthetic Surgery, Etimesgut Military Hospital, Ankara, Turkey Necati Salman Necati Salman Emergency Department, Etimesgut Military Hospital, Ankara, Turkey; Emergency Department, Etimesgut Military Hospital, Ankara, Turkey. Tel: +90-3123043507 Emergency Department, Etimesgut Military Hospital, Ankara, Turkey; Emergency Department, Etimesgut Military Hospital, Ankara, Turkey. Tel: +90-3123043507 Yahya Ayhan Acar Yahya Ayhan Acar Emergency Department, Etimesgut Military Hospital, Ankara, Turkey Emergency Department, Etimesgut Military Hospital, Ankara, Turkey Onur Tezel Onur Tezel Emergency Department, Etimesgut Military Hospital, Ankara, Turkey Emergency Department, Etimesgut Military Hospital, Ankara, Turkey Hakan Yesil Hakan Yesil Department of Dermatology, Etimesgut Military Hospital, Ankara, Turkey Department of Dermatology, Etimesgut Military Hospital, Ankara, Turkey
en 10.5812/jamm.37872 A Comparison Between Job Stress and Insulin Resistance Among the Hospital Medical Staff A Comparison Between Job Stress and Insulin Resistance Among the Hospital Medical Staff research-article research-article Background

One of the important risk factors for insulin resistance is stress and a major source of stress is job stress.

Objectives

The current study aimed to determine the relationship between job stress score and insulin resistance among medical staff of the Imam Reza hospital, Tehran, Iran

Methods

The current descriptive cross-sectional study was performed on 97 medical staff of Imam Reza hospital, Tehran, Iran. The Osipow questionnaire was used to assess the level of occupational stress. Insulin resistance was calculated according to the formula: fasting insulin (microU/L) × fasting glucose.

Results

There was no significant difference in insulin resistance among the hospital staff. Job stress was significantly higher in the intensive care unit staff than the staff of other departments (P < 0.01). There was a significant positive correlation between insulin resistance and age, but there was no significant correlation between insulin resistance with body mass index (BMI) and stress score.

Conclusions

The intensive care unit (ICU) staff was exposed to more stress than the staff of other departments. But there was no relationship between job stress and insulin resistance among hospital staff. Further studies are needed to evaluate the relationship between job stress and insulin resistance.

Background

One of the important risk factors for insulin resistance is stress and a major source of stress is job stress.

Objectives

The current study aimed to determine the relationship between job stress score and insulin resistance among medical staff of the Imam Reza hospital, Tehran, Iran

Methods

The current descriptive cross-sectional study was performed on 97 medical staff of Imam Reza hospital, Tehran, Iran. The Osipow questionnaire was used to assess the level of occupational stress. Insulin resistance was calculated according to the formula: fasting insulin (microU/L) × fasting glucose.

Results

There was no significant difference in insulin resistance among the hospital staff. Job stress was significantly higher in the intensive care unit staff than the staff of other departments (P < 0.01). There was a significant positive correlation between insulin resistance and age, but there was no significant correlation between insulin resistance with body mass index (BMI) and stress score.

Conclusions

The intensive care unit (ICU) staff was exposed to more stress than the staff of other departments. But there was no relationship between job stress and insulin resistance among hospital staff. Further studies are needed to evaluate the relationship between job stress and insulin resistance.

Stress;Insulin Resistance;Medical Staff Stress;Insulin Resistance;Medical Staff http://www.jammonline.com/index.php?page=article&article_id=37872 Parvin Zareian Parvin Zareian Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2144609936 Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran; Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2144609936 Fatemeh Ghasemi Fatemeh Ghasemi Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran Seyd Reza Abtahi Seyd Reza Abtahi Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran Department of Pharmacology, AJA University of Medical Sciences, Tehran, IR Iran Shahab Behzadi Shahab Behzadi Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran Department of Physiology, AJA University of Medical Sciences, Tehran, IR Iran
en 10.5812/jamm.38493 Calcitonin Injection and Functional Status of Females With Knee Osteoarthritis Calcitonin Injection and Functional Status of Females With Knee Osteoarthritis research-article research-article Conclusions

The study results showed that calcitonin can provide proper outcomes such as increased locomotor activity. Although WOMAC parameters increased in all age groups, it had great effect just on 55 - 60 years age group. Therefore, improvement of quality of life and proper rehabilitation, which are the main factors in osteoarthritis patients, were almost achieved in this study.

Results

Compared to baseline, significant improvement in WOMAC score was observed after five weeks of treatment. Pain, joint stiffness, functional activity and total score of WOMAC showed improvement of 80.6%, 25.3%, 41.9% and 47.91% respectively, which were statistically significant (P value < 0.001). Pain, activity and stiffness improved respectively according to the mean differences and confidence interval.

Methods

The current prospective cross sectional study, randomly recruited 28 eligible female participants aged 55 - 70 from outpatients referred to rehabilitation clinics. These patients were in stages II and III based on Kellgren-Lawrence grading scale. Patients were requested to fill out the multidimensional WOMAC questionnaire on the day of enrollment into the study (baseline examination) and five weeks after completion of their treatment with calcitonin. Paired T-test was used to assess mean differences of the questionnaire.

Background

Osteoarthritis (OA) is one of the most common diseases of both bone and cartilage. Since calcitonin may have positive effect on both of them.

Objectives

The current study aimed to evaluate the effect of weekly calcitonin injection on patients with knee osteoarthritis using Western Ontario and McMaster universities arthritis index (WOMAC) questionnaire.

Conclusions

The study results showed that calcitonin can provide proper outcomes such as increased locomotor activity. Although WOMAC parameters increased in all age groups, it had great effect just on 55 - 60 years age group. Therefore, improvement of quality of life and proper rehabilitation, which are the main factors in osteoarthritis patients, were almost achieved in this study.

Results

Compared to baseline, significant improvement in WOMAC score was observed after five weeks of treatment. Pain, joint stiffness, functional activity and total score of WOMAC showed improvement of 80.6%, 25.3%, 41.9% and 47.91% respectively, which were statistically significant (P value < 0.001). Pain, activity and stiffness improved respectively according to the mean differences and confidence interval.

Methods

The current prospective cross sectional study, randomly recruited 28 eligible female participants aged 55 - 70 from outpatients referred to rehabilitation clinics. These patients were in stages II and III based on Kellgren-Lawrence grading scale. Patients were requested to fill out the multidimensional WOMAC questionnaire on the day of enrollment into the study (baseline examination) and five weeks after completion of their treatment with calcitonin. Paired T-test was used to assess mean differences of the questionnaire.

Background

Osteoarthritis (OA) is one of the most common diseases of both bone and cartilage. Since calcitonin may have positive effect on both of them.

Objectives

The current study aimed to evaluate the effect of weekly calcitonin injection on patients with knee osteoarthritis using Western Ontario and McMaster universities arthritis index (WOMAC) questionnaire.

Knee Osteoarthritis;Calcitonin;Pain Assessment;Rehabilitation Knee Osteoarthritis;Calcitonin;Pain Assessment;Rehabilitation http://www.jammonline.com/index.php?page=article&article_id=38493 Attiyeh Vasaghi Attiyeh Vasaghi Department of Physical Medicine and Rehabilitation, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Physical Medicine and Rehabilitation, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran Mahdieh Karimizadeh Mahdieh Karimizadeh Department of Pediatrics, Shahid Beheshti Universuty of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Shahid Beheshti Universuty of Medical Sciences, Tehran, IR Iran Alireza Ashraf Alireza Ashraf Department of Physical Medicine and Rehabilitation, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Physical Medicine and Rehabilitation, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7132319040 Department of Physical Medicine and Rehabilitation, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Physical Medicine and Rehabilitation, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7132319040
en 10.5812/jamm.39480 Effects of Agility Training on Soldiers in a Warrior Transition Battalion: A Proof of Concept Study Effects of Agility Training on Soldiers in a Warrior Transition Battalion: A Proof of Concept Study research-article research-article Conclusions

This improvement in CV function, strength, agility and balance has the potential to result in better health and improved overall physical functioning.

Results

Results indicated significant improvements in the 6-minute walk test (P = 0.05), Illinois Agility test (P = 0.022), Up and Go test (P = 0.002), and single leg stance test (P = 0.027). Soldiers assigned to a WTB may see physical fitness improvements through participation in an individualized AP.

Methods

A pre-post design was used that assessed four fitness domains (cardiovascular function, agility, mobility and balance) before and after six weeks of two days per week training. Cardiovascular (CV) function was measured by the 6-Minute Walk test, agility by the Illinois Agility test, mobility with the Up and Go test, and balance by Single Leg Stance test. Modifications for the AP were individualized for each participant based on their medical history and current health status.

Objectives

This proof of concept study evaluated the impact of an individualized Agility Program (AP) on the physical functioning of 11 Soldiers assigned to a WTB at a Midwest military base.

Background

Soldiers are returning from military service with physical and/or emotional injuries that impair health and overall physical functioning. To address this limitation these Soldiers are assigned to Warrior Transition Battalions (WTB).

Conclusions

This improvement in CV function, strength, agility and balance has the potential to result in better health and improved overall physical functioning.

Results

Results indicated significant improvements in the 6-minute walk test (P = 0.05), Illinois Agility test (P = 0.022), Up and Go test (P = 0.002), and single leg stance test (P = 0.027). Soldiers assigned to a WTB may see physical fitness improvements through participation in an individualized AP.

Methods

A pre-post design was used that assessed four fitness domains (cardiovascular function, agility, mobility and balance) before and after six weeks of two days per week training. Cardiovascular (CV) function was measured by the 6-Minute Walk test, agility by the Illinois Agility test, mobility with the Up and Go test, and balance by Single Leg Stance test. Modifications for the AP were individualized for each participant based on their medical history and current health status.

Objectives

This proof of concept study evaluated the impact of an individualized Agility Program (AP) on the physical functioning of 11 Soldiers assigned to a WTB at a Midwest military base.

Background

Soldiers are returning from military service with physical and/or emotional injuries that impair health and overall physical functioning. To address this limitation these Soldiers are assigned to Warrior Transition Battalions (WTB).

Physical Fitness;Warrior Transition Battalion;Soldier Training Physical Fitness;Warrior Transition Battalion;Soldier Training http://www.jammonline.com/index.php?page=article&article_id=39480 Kathleen Carter Kathleen Carter Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA Chelsey Erbaugh Franz Chelsey Erbaugh Franz Exercise Sciences Department, Bellarmine University, Louisville, Kentucky, USA Exercise Sciences Department, Bellarmine University, Louisville, Kentucky, USA Megan Saprano Megan Saprano Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA Dylan Shepard Dylan Shepard Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA Ann Swank Ann Swank Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA; Human Performance Lab, Crawford Gym Rm 2, University of Louisville, Louisville, USA. Tel: +1-5028528351, Fax: +1-502852-6683 Health and Sport Sciences Department, University of Louisville, Louisville, Kentucky, USA; Human Performance Lab, Crawford Gym Rm 2, University of Louisville, Louisville, USA. Tel: +1-5028528351, Fax: +1-502852-6683
en 10.5812/jamm.42039 A New Innovative Home Exercise for Chronic Non-Specific Low Back Pain: A Twelve-Week Clinical Trial A New Innovative Home Exercise for Chronic Non-Specific Low Back Pain: A Twelve-Week Clinical Trial research-article research-article Conclusions

Study strengths included controlling for co-interventions, rigorous inclusion criteria, assessment of compliance, plans for limiting dropout, identical assessment methods and timing.

Results

The primary outcome measure was the Oswestry disability index. Secondary measures included visual analog scale (VAS) pain score. Outcome measures were assessed at baseline (0), fourth, eighth, and twelfth week. Treatment failure was defined if the patient terminated treatment for non-efficacy or underwent invasive procedure or other excluded co-interventions.

Methods

Patients: The cases included chronic non-specific low back pain patients aged between 19 and 64 years, with pain of at least three months in duration. Patients had no significant signs or symptoms of lumbosacral nerve impingement, malignancy, spinal stenosis, or mood disorders. The study design involved CT with 113 subjects. Samples were stratified by workers compensation claim (yes vs. no), and use of opioids. The null hypothesis of this study was “no statistically significant improvement in function of patients during and at the end of the 12-week treatment period”. Data collection: subjective data were collected using database management collection tools. Objective data were obtained through functional assessments. Data were collected at enrollment (baseline) and on the fourth, eighth, and twelfth week for each participant by a blinded assessor. Intervention: A new home exercise was designed by the author (Farshad exercise). Each patient had identical numbers of visits (4) and researcher contact time (approximately 15 hours).

Background

Exercise therapy is commonly used for treatment of chronic low back pain. Evidence for efficacy of most exercise therapy modalities is weak or lacking. This study aimed to execute a high-quality, clinical trial of a single innovative new home exercise (“Farshad exercise”) to determine the efficacy for treatment of chronic non-specific low back pain patients.

Conclusions

Study strengths included controlling for co-interventions, rigorous inclusion criteria, assessment of compliance, plans for limiting dropout, identical assessment methods and timing.

Results

The primary outcome measure was the Oswestry disability index. Secondary measures included visual analog scale (VAS) pain score. Outcome measures were assessed at baseline (0), fourth, eighth, and twelfth week. Treatment failure was defined if the patient terminated treatment for non-efficacy or underwent invasive procedure or other excluded co-interventions.

Methods

Patients: The cases included chronic non-specific low back pain patients aged between 19 and 64 years, with pain of at least three months in duration. Patients had no significant signs or symptoms of lumbosacral nerve impingement, malignancy, spinal stenosis, or mood disorders. The study design involved CT with 113 subjects. Samples were stratified by workers compensation claim (yes vs. no), and use of opioids. The null hypothesis of this study was “no statistically significant improvement in function of patients during and at the end of the 12-week treatment period”. Data collection: subjective data were collected using database management collection tools. Objective data were obtained through functional assessments. Data were collected at enrollment (baseline) and on the fourth, eighth, and twelfth week for each participant by a blinded assessor. Intervention: A new home exercise was designed by the author (Farshad exercise). Each patient had identical numbers of visits (4) and researcher contact time (approximately 15 hours).

Background

Exercise therapy is commonly used for treatment of chronic low back pain. Evidence for efficacy of most exercise therapy modalities is weak or lacking. This study aimed to execute a high-quality, clinical trial of a single innovative new home exercise (“Farshad exercise”) to determine the efficacy for treatment of chronic non-specific low back pain patients.

Chronic Low Back Pain;Exercise Therapy;Home Exercise Chronic Low Back Pain;Exercise Therapy;Home Exercise http://www.jammonline.com/index.php?page=article&article_id=42039 Farshad Najafipour Farshad Najafipour Epidemiology Research Centre, AJA University of Medical Sciences, Tehran, IR Iran; Epidemiology Research Centre, AJA University of Medical Sciences, Tehran, IR Iran Epidemiology Research Centre, AJA University of Medical Sciences, Tehran, IR Iran; Epidemiology Research Centre, AJA University of Medical Sciences, Tehran, IR Iran Farzad Najafipour Farzad Najafipour Allameh Tabataba'i university, Department of physicaleducation and sport Sciences, Mac in Sport Injury and Corrective Exercises, Tehran, IR Iran Allameh Tabataba'i university, Department of physicaleducation and sport Sciences, Mac in Sport Injury and Corrective Exercises, Tehran, IR Iran Alireza Khoshdel Alireza Khoshdel Epidemiology Research Centre, AJA University of Medical Sciences, Tehran, IR Iran Epidemiology Research Centre, AJA University of Medical Sciences, Tehran, IR Iran
en 10.5812/jamm.41553 Zika Virus Infection in Military Camps Zika Virus Infection in Military Camps letter letter Zika;Military;Medicine Zika;Military;Medicine http://www.jammonline.com/index.php?page=article&article_id=41553 Viroj Wiwanitkit Viroj Wiwanitkit Surindra Rajabhat University, Surin, Thailand; Surindra Rajabhat University, Surin, Thailand. Tel: +66-24132436 Surindra Rajabhat University, Surin, Thailand; Surindra Rajabhat University, Surin, Thailand. Tel: +66-24132436