Annals of Military and Health Sciences Research

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Annals of Military and Health Sciences Research ( AMHSR) is a peer-reviewed middle-eastern medical journal publishing in all clinical and theoretical aspects of medicine scientific reports of original research in such areas as medical economic policy, medical ethics, and managing healthcare systems are also considered for publication. AMHSR is published quarterly and is the official journal of Aja University of Medical Sciences.
Its content includes original research, brief communication, expert and systematic reviews, case reports, case series, letter to the editor, and technical innovation with the aim of promoting new advances in the field and enhancing standards of professional practice. Also, reviews of newly published books and articles are welcomed. In addition, historical articles which discuss the remarkable history of medicine all over the world, especially the Persian and Egyptian medicine, are of special merit.

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1) Double-Blind Peer Review System

2) Open Peer Review (since Aug 2019), Show List of All Published Reviewers' Comments

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Now showing 1 - 20 of 368

Development and Validation of the Criminal Aptitude Inventory (Urdu): A Comprehensive Assessment Across Convicted Prisoners and the General Population
(Brieflands, 2024-06-30) Waqar Husain; Aqsa Murtaza; Muhammad Ahmad Husain; Farrukh Ijaz
Background: Criminal aptitude testing benefits police and other fields of law enforcement. Earlier literature lacked an Urdu-language scale for criminal aptitude. Objectives: The present study developed and validated a new scale to measure criminal aptitude in Urdu speakers. Methods: The development and validation of the Criminal Aptitude Inventory (CAI) unfolded across three distinct phases, involving a total of 1675 participants (51.34% women), including convicted prisoners (37.33%). In the initial phase, the CAI underwent development and preliminary validation through exploratory factor analysis (EFA). Subsequently, the second phase utilized Confirmatory Factor Analysis to further confirm the scale's validity. The third phase focused on analyzing the CAI's convergent and discriminant validity by investigating its relationship with antisocial personality disorder, morality, religiosity, and spirituality. Results: The results demonstrated high reliability and validity of the CAI, affirming its suitability for future applications. The final version of the scale comprises a single factor and consists of 36 items, each utilizing a 5-point Likert-type response format. Indicators such as Kaiser-Meyer-Olkin's values (0.984), Cronbach’s alpha (0.984), average item-total correlation (P < 0.001), comparative fit index (0.936), Tucker-Lewis Index (0.932), Goodness of Fit Index (GFI=.939), root mean square error of approximation (RMSEA = 0.043), convergent validity with antisocial personality disorder (r = 0.458; P < 0.01), and discriminant validity with morality (r = -0.396; P < 0.01), religiosity (r = -.318; P < 0.01), and spirituality (r = -.453; P < 0.01) established the reliability and validity of the CAI. Conclusions: The dual-source data collection strategy employed in this study, drawing from both convicted prisoners and the general population, enhances and operationalizes the scale. This approach ensures its applicability across diverse Urdu-speaking communities in Pakistan and India.
The Level of Satisfaction with Blended Learning via the Flipped Classroom Approach in the Epidemiology Course Among Nursing Students
(Brieflands, 2024-06-30) Zahra Farsi; Farzane Taghaee; Somayeh Azarmi; Abdolah Fathi Moghaddam
Background: The flipped classroom (FC) instructional strategy, as a blended learning approach, encourages students to take an active role in the learning process. Objectives: This study aimed to investigate the level of satisfaction with FC in the epidemiology course among nursing students. Methods: This descriptive-analytical study with a cross-sectional research design was conducted in 2022 at a school of nursing in Tehran, Iran. A total of 109 nursing students enrolled in the second semester of an undergraduate program were recruited via convenience sampling. These students were taught using the FC approach. The lecturer initially prepared teaching materials for each session in the form of multimedia files and uploaded them on the offline NAVID Virtual Education System. Subsequently, a series of questions related to the teaching materials were given to the students to answer in groups of 3 to 4 and discuss. The researcher facilitated the discussion to address any doubts among the students. After completing eight sessions, the Questionnaire for Satisfaction with Flipped Classroom (QSFC), with confirmed validity and reliability, was administered to evaluate the level of satisfaction among the students. Results: The majority of students expressed satisfaction with FC at moderate (48.6%) to high (47.7%) levels. Additionally, most male students (67.3%) reported being highly satisfied with FC, while 46% of female students showed a moderate level of satisfaction. The overall mean satisfaction score with FC was 55.36 ± 12.54, indicating a moderate level of satisfaction. This total score was not significantly correlated with students' age (P = 0.086), but the moderate level of satisfaction among male students was higher than that among females (P = 0.017). Conclusions: The study results suggest that FC, as a type of blended learning, is an appropriate teaching method in nursing education, as it enhances students' satisfaction levels. Improving the quality of virtual education infrastructure and facilities and enhancing teachers' capabilities in utilizing new teaching methods can enhance the quality of education, especially in critical situations.
The Effect of Intra-Articular Injection of Hypertonic Saline Versus Dextrose Prolotherapy for Knee Osteoarthritis
(Brieflands, 2024-06-30) Zahra Rezasoltani; Ensieh Taftian; Seyed Morteza Tabatabaee; Sharif Najafi; Serous Azizi
Background: Knee osteoarthritis (OA) is the most common chronic arthritis worldwide, often causing knee stiffness, pain, and functional impairment. This study aims to compare the effects of Dextrose prolotherapy and Hypertonic saline prolotherapy on knee pain, stiffness, and function in patients with knee OA. Methods: The study was conducted as a randomized clinical trial. Patients meeting radiological and clinical criteria for knee OA were sequentially contacted and provided written informed consent. Participants were randomly assigned to receive injections of Hypertonic saline (n = 30) or dextrose prolotherapy (n = 33). The primary outcome measure was clinical manifestations assessed using the compound score of the Western Ontario and McMaster University Arthritis Index (WOMAC). Results: Within-group analysis revealed significant differences in outcome scores for both treatments after 6 months. Both Hypertonic saline and dextrose prolotherapy showed significant improvements in the Visual Analog Scale (VAS), WOMAC composite score, pain, stiffness, and function. In the first month, VAS scores were higher with hypertonic saline compared to dextrose. Additionally, stiffness decreased more with dextrose than with hypertonic saline. After 6 months of treatment, although not statistically significant, hypertonic saline showed better outcomes in the mean WOMAC composite score and pain sub-score compared to dextrose. Conclusions: Among patients with knee OA, Hypertonic saline prolotherapy administered by a trained specialist yields safe and significant improvements in knee pain, stiffness, and function. Our results suggest no significant difference in VAS and WOMAC scores between hypertonic saline and dextrose prolotherapy.
Changes in Serum Level of Vitamin D Four Years After Sleeve Gastrectomy in Patients with Morbid Obesity: A Single-Center Study
(Brieflands, 2024-06-30) Nasser Malekpour Alamdari; Maryam Abbasi; Iman Ansari; Maedeh Karimian; Elnaz Babakhani; Saman Ahmadi; Mohammadali Azizi Nadian
Background: Bariatric procedures are associated with various micronutrient and vitamin deficiencies, including vitamin D. Objectives: The aim of the study was to assess the effect of laparoscopic sleeve gastrectomy (LSG) on serum vitamin D levels in a 4-year follow-up of obese patients. Methods: All obese patients undergoing LSG at Modarres Hospital were included in this study. Patients were evaluated 4 years after surgery, and their serum levels of calcium, parathyroid hormone (PTH), and vitamin D were measured. Results: Analytical analysis demonstrated a statistically significant difference in vitamin D and calcium levels before and after LSG (P-value < 0.001 for both). However, the change in PTH levels before and after LSG was not statistically significant. Additionally, the analysis showed no statistically significant relationship between vitamin D levels and PTH levels. Conclusions: The results of the present study showed that, four years after LSG, vitamin D and calcium levels significantly increased in patients with morbid obesity, although the observed increase in PTH levels was not statistically significant.
The Effect of Endurance Training with Crocin Consumption on the Levels of AMPK and NRF1 Gene Expression in the Soleus Muscles of Diabetic Rats
(Brieflands, 2021-06-30) Abdolnabi Peyravi; Hashem Nayeri; Nasrin Yazdanpanahi; Seyed Ali Hosseini
Background: Exercise training and crocin, as a herbal antioxidant, help improve metabolism and insulin sensitivity in type 2 diabetes mellitus (T2D). AMP-activated protein kinase (AMPK) and nuclear respiratory factor 1 (NRF1) involve in the mitochondrial biogenesis pathway and diabetes control. Objective: This study aimed to investigate the effects of high-intensity interval training (HIIT), and low intensity continued training (LICT) in combination with crocin consumption on AMPK and NRF1 gene expression in the muscle tissue of diabetic rats. Methods: In this experimental study, 56 adult rats were divided into eight groups (n = 7), including diabetic (crocin utilization, HIIT, LICT, HIIT with crocin, LICT with crocin, control, sham groups) and healthy control group. The HIIT and LICT groups performed five sessions of training per week for eight weeks, and the crocin consumption groups received 25 mg/kg of crocin daily for eight weeks. Moreover, AMPK and NRF1 genes expression levels were evaluated in different groups using real-time polymerase chain reaction (RT-PCR). Results: According to our results, while induction of diabetes significantly decreased the levels of NRF1 and AMPK gene expression (P ≤ 0.05), training and crocin consumption significantly increased the levels of AMPK and NRF1 gene expression (P ≤ 0.05). Conclusions: It appears that crocin consumption along with HIIT improves diabetes symptoms through AMPK and NRF1 mechanism in diabetic rats.
Effectiveness of Metacognitive Therapy in Reducing psychological and MetaCognitive factors in Patients with Major Depressive Disorder in a Military Hospital
(Brieflands, 2015-08-31) Shahram Mami; Maisam Sharifi; Azadeh Mahdavi
The assessment of epidemiologic aspects of scabies in Iran’s Army during 2004 to 2010
(Brieflands, 2014-12-31) Seyed Javad Hosseini-Shokouh; Shahram Rahimi-Dehgolan; Mahtab Noorifard; Arasb Dabbagh-Moghaddam; Mohammad Barati; Elnaz Tabibian
Purpose: Scabies is a parasitic disease with nocturnal itching and cutaneous lesions. It spreads by physical contact and it occurs mostly in crowded places. Because of their occupation, military personnel have to live in garrisons and camps. So the prevalence of scabies is higher in military systems. Hence, this study evaluated the epidemiology of scabies in Iran’s Army.
Effects of four weeks supplementation of vitamin C on total antioxidant capacity and malondialdehyde among inactive men after an eccentric exercise
(Brieflands, 2014-12-31) Mandana Gholami; Mehdi Hedayati; Mina Mabani; Masoud Mabani
Materials and Methods: Twenty non-athletic healthy volunteer men (24 ± 1.6 years old,
The effect of selenase on the disease process of patients with septic shock admitted to the intensive care unit: A clinical trial in Tehran
(Brieflands, 2015-02-28) Ebrahim Hazrati; Mohammad Reza Rafii Rafii; behzad kazemi haki; Babak Shekarchi; Seyed Javad Hosseini-Shokouh
Materials and Methods: This double-blind clinical trial was done on 80 participants (40 case and 40 control) who were admitted to the ICU with septic shock. Every participant in the case group was administered 500 μg selenase twice daily for 10 days. In contrast, each participant of the control group was treated with placebo (normal saline). Data were collected by observation and recorded in a questionnaire. Chi-square and Student’s t-test were used for data analysis. Results: In this study 34 participants (42.5%) were men and 46 (57.5%) were women. The duration stay in the ICU in treatment group was less than in the observation group which was statistically significant (P = .01). There was also a significant difference regarding the frequency of morbidity and mortality rates between the two groups (P = .03 and P = .02, respectively). Conclusion: Selenium at a dosage of 500 μg (twice daily) is effective in those who have suffered from septic shock. Still, more studies are needed to determine the best dosage and administration method of this drug.
Effects of oral vitamin C supplement on the serum lipid profile
(Brieflands, 2015-02-28) Mojgan Mohajeri-Iravani; Ebrahim Hazrati; Shahram Firuz-Marani Firuz-Marani
Purpose: Ascorbic acid has protective effects against coronary heart disease. These effects are attributed to its antioxidant properties and its relation to plasma lipids. This study investigated the effects of supplementing one gram of vitamin C per day on the serum serum lipoproteins of healthy 18 to 55 years old individuals in Iran.
A survey of triage systems in combat casualty care for providing a revised system
(Brieflands, 2014-12-31) Seyed Omid Khalilifar; Ali Reza Khoshdel; Ameneh Valadkhani; Abbas Akbari; Bayram Nejati-Zarnaqi
Methodology: In this review, two methods of field and library research were used. The data were collected through related books and papers. Then interviews were done to validate the collected data.
Evaluation of Levofloxacin Prescription Pattern Based on International Standards in a Tertiary Hospital in Iran
(Brieflands, 2023-12-31) Mahgol Moaref; Mandana Izadpanah; Leila Kouti
Background: The emergence of antibiotic-resistant bacteria poses a significant global concern. The improper use of antibiotics, identified as a leading contributor to this problem, is a widespread issue in medical centers worldwide. Objectives: This study aimed to investigate the utilization pattern of levofloxacin, a commonly prescribed antibiotic. Methods: We conducted a retrospective descriptive study in Ahvaz, Iran, focusing on patients who had received levofloxacin over a 6-month period. Data collection involved a questionnaire comprising patient demographic details, diagnosis information, details concerning levofloxacin administration, and outcomes, all extracted from the patients' medical records. During the assessment, we considered factors such as the correct dosage, frequency of administration, potential drug interactions, and adverse effects. Data analysis was performed using SPSS v. 20. Results: A total of 35 patients, with a mean age of 55.17 ± 20.36 years, received levofloxacin during the study period, and 48.6% of them were women. On average, each patient received 3.20 ± 2.85 grams of levofloxacin, with a minimum dose of 0.500 grams and a maximum of 11.50 grams. The average treatment duration was 3.813 ± 4.26 days. In only 8.6% of cases, the prescribed dosage was deemed inappropriate, while in 40% of cases, the duration of antibiotic use was found to be inadequate. Conclusions: The utilization of levofloxacin was deemed irrational in 40% of cases. Although the prescribed dosage for the respective diagnoses was generally accurate, the treatment duration was often incorrect, potentially contributing to antibiotic resistance.
Mental health screening of Iranian conscripts during basic military training in Guilan province
(Brieflands, 2014-09-30) ehsan kivehee; Hamid Jalali
Materials and Methods: In this descriptive cross-sectional study, the mental health of 930 conscripts (mean age of 19.78 ± 1.57 years old) was assessed using a 28-item general health questionnaire (GHQ-28), during basic military training. Acquired data were analyzed using the chi-squared test (α = 0.01).
Evaluation of Health-related Quality of Life in Active and Inactive Adolescents in the COVID-19 Pandemic
(Brieflands, 2022-12-31) Abdossaleh Zar; Hamid Reza Sadeghipour; Sara Zare Karizak
Background: The coronavirus disease 2019 (COVID-19) is a problem that has breakout worldwide recently and has led to physical, psychological, and social issues, especially in adolescents. Objectives: The current study aimed to evaluate the health dimension of life quality in active and inactive adolescents during the COVID-19 pandemic. Methods: A total of 350 students from the high schools of Shiraz (175 active + 175 inactive) participated in this study as volunteers. The Health-related Quality of Life Questionnaire was used to collect information. Furthermore, the Kolmogorov-Smirnov test and independent t-test were used for data analysis using SPSS 18 software (α = 0.05). Results: There were significant differences in the level of quality of life (P = 0.001), the overall psychological health (P = 0.002), and the overall physical health (P = 0.001) of active and inactive students. There was a significant difference between boy and girl students only on the mental health scale (P = 0.038). Conclusions: It seems that during the epidemic of COVID-19, active adolescent students have had a higher quality of life, which can refer to the importance of exercise and physical activity during the epidemics and an important issue in preventing the educational decline of adolescent students.
Oral Delivery of Insulin from Trimethyl Chitosan/Tragacanth: In Vitro, MTT, and In Vivo Bioactivity Tests
(Brieflands, 2023-03-31) Alireza Khajeh-Amiri; Ali Maghsoudi
Insulin-loaded Trimethyl Chitosan (TMC)/tragacanth microspheres were prepared by microemulsion dispersion and triggered in situ gelation. Microspheres were characterized by their mean size and distribution by laser diffraction spectroscopy and Brunauer-Emmet-Teller theory. Insulin encapsulation efficiency and in vitro release were determined by Bradford protein assay, and bioactivity was assessed in vitro using an enzyme-linked immunoassay diagnostic kit and in vivo using Wistar diabetic rats. TMC/tragacanth particles suppressed insulin release in acidic media and promoted a sustained release at near-neutral conditions. Micro-capsulated insulin was bioactive, demonstrated by both in vivo and in vitro bioassays.
Reviewing the Physiology of Cutaneous Wound Healing and Evaluating the Effect of Exercise on It: A Narrative Review Article
(Brieflands, 2021-09-30) Fatima Riyahi; Simin Riahy; Mitra Yousefpour
Context: The skin is the most important organ of the body, and maintaining its integrity is important for health. Severe skin damage is life-threatening, and wound healing restores its integrity. One of the main health problems is impaired cutaneous wound healing. According to the importance of wound healing and the fact that unrepaired skin decreases the quality of life, many studies have investigated the effect of some natural and chemical substances on the length and quality of wound healing to find beneficial interventions for rapid and economical treatment. Objectives: This review was conducted to describe the physiology of cutaneous wound healing and some positive and negative factors affecting it with a focus on exercise. Evidence Acquisition: An electronic search without any time limitation was performed on the PubMed, Google Scholar, and Web of Science databases. The keywords were ‘wound’, ‘healing’, and ‘exercise’. Finally, according to the similarities or differences between the results and the relationship with the subject, 53 papers were selected and reviewed. Results: Wound healing is a complex physiological process with four overlapping processes. It seems that disturbance in the inflammatory phase of wound healing is the main factor in the impairment of healing. Traditionally, many chemical and herbal medicines and compounds have been used to speed up wound recovery due to their anti-inflammatory and antioxidative properties. Many studies have evaluated the effect of exercise, as complementary medicine, on wound healing, and they have examined the effect of different protocols of exercise on the speed of wound healing. According to the results of these studies, aerobic exercise, due to its anti-inflammatory and antioxidative effects, is a beneficial method in shortening the length of healing, especially in aged, obese, and diabetic individuals. Conclusions: Exercise as a low-cost intervention is a good strategy in the treatment of impaired and chronic wounds.
Medium-Term Clinical Outcome of the Arthroscopic Repair of Isolated Subscapularis Tendon Tear
(Brieflands, 2021-12-31) Hossein Saremi; Shervin Bashiri; Abbas Moradi
Background: There have been many studies on arthroscopic rotator cuff surgery outcomes. However, few studies have investigated the outcomes of the arthroscopic repair of isolated subscapularis tendon tear. Objectives: This study aimed to evaluate the medium-term clinical outcomes of the arthroscopic repair of an isolated subscapularis tendon tear in a four-year follow-up. Methods: This prospective cohort study was performed on all patients with shoulder pain who had isolated subscapularis tendon on magnetic resonance imaging and underwent arthroscopic evaluation and repair at Besat Hospital, Hamadan, Iran, during 2011 - 2017. The mean follow-up time was 4 years. The modified UCLA, Quick DASH, and visual analogue scale (VAS) were measured, and the belly-press test and lift-off test were completed in the examination. Data were analyzed by the SPSS software version 24. Results: Out of 11 patients, three were female (27.3%), and seven were male (72.7%). The mean age of patients was 59.42 ± 8.12 years. Nine patients were completely satisfied with the surgery outcome, and one was relatively satisfied. The mean UCLA score 2 years after the surgery increased significantly (33.28 ± 2.92 vs. 10.71 ± 3.4, P < 0.001). The mean Quick DASH reached from 38.26 ± 27.94 before surgery to 7.56 ± 16.43 (P = 0.003). Moreover, the mean VAS score significantly reduced (0.57 ± 1.51 post-intervention compared to 4.57 ± 1.21 pre-intervention, P < 0.001). Conclusions: The medium-term results of the arthroscopic repair of subscapular tendon tear were satisfactory. Therefore, it can be a reliable alternative method for open subscapularis tendon repair.
Study of Effective Factors in the Tendency of Young People to Smoke Hookah in Teahouses in Deprived Areas of Zahedan in 2018 - 2019
(Brieflands, 2021-12-31) Khaled Badpa; Mohammad Ali Fardin
Background: Given the increasing trend of hookah use among youth in deprived areas and the increasing number of traditional teahouses serving hookahs, it is critical to investigate the reasons for this issue. Objectives: The aim was to determine the factors affecting the tendency to use hookahs. Methods: This study was conducted in Zahedan City, the capital of Sistan and Baluchestan Province. The sampling method in this study was cluster sampling, such that among 15 traditional teahouses, 4 teahouses were randomly chosen. After referring to each of these teahouses, 1385 questionnaire forms were distributed among all youth, and 300 questionnaire forms were returned. The structured questionnaire consisted of a series of questions about demographic data, favorite flavor, duration of using a hookah, the main reason for hookah smoking, etc. The analysis of the data involved both descriptive and inferential statistics, including mean, SD, and linear regression. The obtained data were analyzed using SPSS version 23. Results: The results of linear regression showed that the duration of smoking (B = 0.30; 95% CI, 0.22-0.37) and reason for smoking were significantly associated with the rate of hookah smoking (B = 0/56; 95% CI, 0.45 - 0.68). Conclusions: As a result, there is a strong association between smoking duration and the atmosphere of traditional teahouses with the rate of hookah smoking. Thus, other places with a healthy atmosphere (such as gyms and sports clubs) should be made for youths to spend their time.
Chemical Safety Concerns of Sulfur Mustard Analog, 2-Chloroethyl Ethyl Sulfide, in Laboratory Study
(Brieflands, 2021-12-31) Feng Ye; Yan Sai; Zhongmin Zou
Sulfur mustard (SM), a classic chemical weapon in the vesicant category, can induce severe damage, for which the therapy is still limited even today. Laboratory work is essential in unveiling toxicological effects and developing medical countermeasures. Sulfur mustard analog 2-chloroethyl ethyl sulfide (CEES), is employed in the lab for less toxicity. However, due to its similar characteristics to SM (being oily, hydrophobic, and volatile), the manipulation of CEES still needs special attention to avoid personnel injury and laboratory pollution. Here, to clear the chemical safety concerns in the laboratory study of CEES, the working procedure and experimental data are summarized, which might help educate new researchers to be skilled and professional.
A Team-Based E-Learning Method for Clinical Education in the COVID-19 Pandemic
(Brieflands, 2021-09-30) Sedighe Sadat Hashemikamangar; Mehrzad Gholampourdehaki
Background: Following the emergence of the new coronavirus pandemic, e-learning seemed to be the first and best alternative to classroom-based medical education. The Learning Management System (LMS) is a key infrastructure requirement for the provision and progression of e-learning. Objectives: This brief report is about a team-based e-learning method for clinical education in the COVID-19 pandemic. Methods: A novel e-learning protocol was implemented for the instruction of knowledge-based part of practical operative dentistry course to third- and fourth-year dental students in NAVID LMS, and their satisfaction levels were evaluated. Results: More than 90% of the students mentioned that the method encouraged them to learn new topics and created a joyful learning experience for them. More than 80% reported that the method decreased their anxiety for learning practical topics during the COVID-19 pandemic. Conclusions: Implementation of such a team-based e-learning method can greatly help in the instruction of clinical topics.

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