Journal of Archives in Military Medicine

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In Collaboration with Aja University of Medical Sciences

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The “Journal of Archives in Military Medicine” (JAMM) is an international, peer-reviewed, open-access journal that focuses on basic and clinical studies in military medicine, including etiology, pathogenesis, epidemiology, diagnosis, screening, monitoring, treatment, rehabilitation and clinical practice guidelines for a better care of military forces, veterans and their families. The journal is characterized by the applied multidisciplinary research for improvement in the level of knowledge, practice, and technologies in military medicine, emergency care, disaster medicine, and related subjects. Furthermore, international experience in the “military health system” is of particular interest in this journal. Additionally, we encourage high quality and evidence-based research in variously armed forces health aspects including policy development, economic analysis, and system management as well as patients’ perspective about military health services. JAAM also welcomes articles in military medical education. The editorial board of the journal appreciates novel and innovative studies and offers special priority for these works.

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Now showing 1 - 20 of 267

Optimizing Emergency Department Resource Allocation Using Discrete Event Simulation and Machine Learning Techniques
(Brieflands, 2023-12-31) Sina Moosavi Kashani; Elham Yavari; Toktam Khatibi
Background: Optimizing resource allocation in emergency departments (ED) is challenging due to limited resources and high costs. Objectives: The objective of this study was to utilize data mining algorithms and simulation modeling to predict the length of stay (LOS) of patients and compare scenarios for increasing bed productivity. Methods: Data mining algorithms, including Random Forest (RF) regression and CatBoost (CB) regression models, were used to predict the LOS based on patient demographic information and vital signs. The process of admission to discharge in the ED was simulated, and different scenarios were compared to identify strategies for increasing bed productivity. Results: The combination of RF regression and CB regression models performed better than other methods in predicting the LOS of patients. Simulation modeling demonstrated that optimal resource allocation and increased bed productivity could be achieved using predicted LOS values. Conclusions: This study demonstrates that a combined approach of data mining and simulation can effectively manage ED resources and reduce congestion. The findings highlight the potential of advanced analytical techniques for improving healthcare service delivery and patient outcomes.
A Challenging in Diagnosis of Mucous Membrane Pemphigoid with Desquamative Gingivitis Presentation: A Case Report
(Brieflands, 2018-03-31) Maryam Koopaie
Desquamative gingivitis (DG) is a descriptive term, indicating inflamed and peeling gingiva. It is characterized by sloughing of the gingival epithelium as a result of formation and rupture of the vesicle. Consequently, the gingiva appears erythematous and often edematous. Desquamative gingivitis may represent an oral clinical manifestation of various systemic mucocutaneous diseases. This case report is on a 42-year-old female with chief complaint of burning sensation in the anterior maxillary gingiva. The patient did not have any other lesion at other sites of the oral cavity. The patient had been affected by asthma and her medications were salbutamol spray and tab cetirizine. Clinically, anterior gingiva appeared as the presentation of desquamative gingivitis. Therefore, an incisional biopsy of the affected area for histopathologic assessment and an incisional biopsy of clinically normal-appearing gingiva for direct immunofluorescence (DIF) study were performed. The histopathologic report was herpes simplex infection. However, this report was incompatible with the clinical view and the patient history. Therefore, a second biopsy was performed. The second histopathologic report was compatible with MMP. The treatment plan was local corticosteroid with follow-up. At the one-month examination visit, a significant improvement was observed in the clinical view of the gums.
Letter to the Editor: Cli/Lab 2018 Conference
(Brieflands, 2019-06-30) Saeed Soleiman-Meigooni
This article does not have an abstract.
The Status of Inflammatory Factors Involved in Coronary Artery Disease in Veteran Football Players
(Brieflands, 2019-11-09) Mohsen Jafari
Background: Homocysteine, C-reactive protein (CRP), fibrinogen, and lipoprotein (a) (LPA) are four novel cardiovascular risk factors. Objectives: The purpose of this study was to compare the serum levels of these substances in veteran football players and non-athletes. Methods: The subjects of this study were 16 male orthopedic veterans assigned to the two control and experimental groups. The age range was 40 to 50 years old. The athlete group was players of North Khorasan veterans’ team of futsal that trained regularly in the past six months. Trainings of the athlete group were three sessions per week that each session consisted of a warm-up, technical, tactical, and fitness trainings and cooling down. Non-athlete subjects had no regular trainings in the past six months. After 12 hours of fasting, serum levels of dependent variables were evaluated. Independent t-test was used for computing the mean differences of dependent variables between the two groups. Results: The findings showed that mean levels of homocysteine (P = 0.034), fibrinogen (P = 0.001) and LPA (P = 0.022) were lower in the experimental group compared to the control group (P ≤ 0.05). There was no significant difference between the two groups in terms of CRP mean levels (P = 0.072). Conclusions: Generally, orthopedic veterans can prevent cardiac events through regular futsal training because this type of training may reduce the levels of homocysteine, fibrinogen and LPA.
Investigating the Coefficient of Performance of Hospitals in Meeting the Needs of Nurses
(Brieflands, 2022-12-31) Fatemeh Mirparsa; Abasat Mirzaei
Background: Two of the most important problems of the nursing profession are the job uncertainty experienced by those working in the field and the profession’s status in society. The nurses’ needs have not been adequately addressed by policymakers of the health care system in Iran. Objectives: The present study, conducted in selected hospitals in Iran from March to August, aimed to evaluate the performance of hospitals in meeting the needs of nurses. Methods: The statistical population included 683 nurses from the selected hospitals. Data were collected using a researcher-made questionnaire containing four items with 40 criteria. Results: Hospitals meeting the needs of nurses were classified according to the importance coefficient and in order of importance as follows: job promotion (0.63), spiritual factors (0.62), material factors, (0.57), and job status (0.52). Conclusions: It was recommended that the corrective measures regarding job promotion, spiritual factors, material factors, and job status of the nurses should be designed and implemented by health system policymakers and hospitals’ managers.
Recent Epidemiological Profile of Cutaneous Leishmaniasis in Iranian Military Personnel
(Brieflands, 2014-02-01) Elnaz Tabibian; Seyyed Javad Hosseini Shokouh; Shahram Rahimi Dehgolan; Arasb Dabbagh Moghaddam; Mohsen Tootoonchian; Mahtab Noorifard
Background: Leishmaniasis is one of the zoonotic diseases caused by protozoa of trypanosomatidae family. The cutaneous type with various manifestations is endemic in Iran and affects people of many provinces. Outbreaks may occur in military personnel who deploy these endemic areas. Objectives: The main objective of this study was to evaluate the most important epidemiologic features of leishmaniasis in Iranian military personnel from 2005-2010. Patients and Methods: This was a cross-sectional study. Data was gathered from the regional passive surveillance system of the Iranian army and double checked by the Deputy of Health of Aja University of Medical Sciences. Analysis was performed by the STATA Software using appropriate statistical functions. Results: During the 6 years of study, 3767 cases of cutaneous leishmaniasis were reported, 15% of the total reported infectious diseases (excluding upper respiratory infections, which were not included in this study). Cutaneous leishmaniasis was the third most prevalent infectious disease. Sixty nine percent of cases were reported in autumn. Most were related to three provinces: Isfahan, Khuzestan and Bushehr. Two thirds of the reports were from the Air Force. Conclusions: There has been a decline in the overall trend of cutaneous leishmaniasis in the recent years, but there are still peaks in some provinces particularly during autumn. Army health commanders must do their best to prevent the disease and control its cycle, especially in high endemic areas.
Comparison of the Lumbosacral Manipulation Method Versus Knee Exercises Alone in Patients with Patellofemoral Pain Syndrome
(Brieflands, 2020-09-30) Sirous Azizi; Zahra Rezasoltani; Elaheh Shirzadi; Afsaneh Dadarkhah; Morvarid Elahi
Background: Patellofemoral Pain Syndrome (PFPS) is one of the most common diagnoses made for patients referred to physical/rehabilitation and orthopedic clinics. The most common symptom of PFPS is a diffuse pain in front of either one or both knees exacerbated by intense activity, kneeling, squatting, climbing, and weakness of quadriceps muscle. Lumbosacral manipulation and knee exercises are the most commonly used methods in physical medicine with no major side effects. Objectives: The current study aimed to compare the efficacy of the lumbosacral manipulation technique with knee exercises versus sole knee exercises in patients with PFPS. Study Design was Randomized Controlled Clinical Trial. Methods: In this randomized controlled clinical trial, 30 patients (18 females and 12 males) diagnosed with PFPS were divided into two groups of study and control, each with 15 subjects. Those in the intervention group received a single bilateral lumbosacral manipulation after ruling out any contraindication for lumbosacral manipulation by lumbosacral radiography. Quality of life, gait, quadriceps muscle strength, keen pain improvement, and range of motion were evaluated at the beginning and four weeks following the knee strengthening exercises for all participants. Results: The mean age of participants was 34 ± 5 years. The difference between the groups concerning the swing phase of walking and quadriceps muscle strength was in both groups was investigated following providing interventions. Conclusions: The manipulation technique had a greater effect on improving the function of patients with PFPS compared to therapeutic knee exercises.
Extracorporeal Membrane Oxygenation (ECMO) for COVID-19: Yes or No?
(Brieflands, 2020-09-30) Banafsheh Ghorbani; Fatemeh Bahramnezhad
This article does not have an abstract.
Effect of Cognitive-Behavioral Group Therapy on the Anxiety and Depression of War-Handicapped
(Brieflands, 2021-03-31) Mehryar Anasseri
Background: Depression and anxiety as the most common psychiatric problems in survivors of traumatic events pose a significant burden on health systems and families. Objectives: This study was conducted to determine the impact of group cognitive-behavioral therapy on the anxiety and depression of war veterans. Methods: This was a quasi-experimental study with pre-test and post-test and a control group. The statistical population included all men with war disabilities who visited Sadra Psychiatric Hospital in Tehran. By convenience and purposive sampling, 116 people were selected and randomly assigned to two groups. Therapeutic interventions (group cognitive-behavioral therapy and Jacobsen's progressive muscle relaxation technique) were applied to each group for 12 sessions, 2 sessions per week and 2 sessions each. Beck’s Depression Scale (Beck, 1961) and Spielberger’s Anxiety Scale (Spielberger, 1970) were used to collect the data. Data was analyzed using analysis of covariance. Results: The mean scores of anxiety and depression in the post-test phase decreased compared to the pre-test phase (P < 0.05). Therefore, group cognitive-behavioral therapy improved the psychological symptoms of the participants. Conclusions: Cognitive-behavioral therapy improved cognitive flexibility and diminished anxiety-depression symptoms in war veterans; thus, it can be considered a useful treatment strategy to improve the psychological status of war veterans.
VIM, NDM, IMP, GES, SPM, GIM, SIM Metallobetalactamases in Carbapenem-Resistant Pseudomonas aeruginosa Isolates from a Turkish University Hospital
(Brieflands, 2022-03-31) Yeliz Tanriverdi Cayci; İlknur Biyik; Asuman Birinci
Background: Pseudomonas aeruginosa is an important opportunistic pathogen, and carbapenem resistance is an emerging problem. The determination of resistance genes is vital for epidemiological purposes, and the early determination of carbapenemase production methods is also recommended. Objectives: The present study aimed to investigate the presence of VIM, NDM, IMP, GES, SPM, GIM, and SIM genes in P. aeruginosa isolates. Methods: In this study, 200 carbapenem-resistant P. aeruginosa isolates were included. The DNA extraction of the carbapenem-resistant isolates was performed using the boiling method. Following the DNA extraction, optimization was conducted using the original primers. After optimization, the VIM, NDM, IMP, GES, SPM, GIM, and SIM genes were examined using the polymerase chain reaction (PCR) method. Results: The isolates were mainly identified from the tracheal aspirate cultures (34.5%). The PCR method revealed the presence of VIM in one of the P. aeruginosa isolates, and the NDM gene in one isolate using. None of the isolates was positive in terms of the IMP, GES, SPM, GIM, and SIM genes. Conclusions: In our study, two carbapenemase genes (VIM and NDM) were detected in the P. aeruginosa isolates.
Vaccination in the Yugoslav National Army: A Significant Risk Factor for Acquiring Chronic Hepatitis B Virus Infection During Army Service in the Former Yugoslavia
(Brieflands, 2020-12-31) Nina Grasselli Kmet; Mario Poljak; Mojca Rajter; Tanja Selič; Zvonko Baklan; Emil Pal; Mojca Matičič
Background: To prevent the spread of infectious diseases, several state armies implemented obligatory vaccination programs also practiced in the former Yugoslav National Army (YNA). Iatrogenic hepatitis B virus (HBV) transmissions during vaccinations in the armies were well documented, but to the best of our knowledge, no such study has been performed in the former Yugoslavia. Objectives: In the present study, we determined risk factors for acquiring chronic hepatitis B (CHB) infection in patients in Slovenia. This study focused on the detection of a statistically significant risk factor in males, namely “vaccination in the YNA”. Methods: One thousand seven hundred and twenty-nine patients from all Slovenian regions who tested positive for HBV surface antigen (HBsAg) at the national referential laboratory for viral hepatitis diagnostics between January 1997 and December 2010 were included retrospectively. Accordingly, demographic, epidemiological, virological, and clinical data were extracted from the medical documentation and were statistically analyzed. Results: For 1,122 (64.9%) out of 1,729 patients, data regarding risk factors for acquiring HBV infection were available. The risk factor for infection of almost 60% of HBV chronically infected individuals with available data, followed by “HBV infection in the family” (19.8%) and “blood/blood products transfusion before the nineties” (8%) was unknown. Seven males (0.6%) (mean age ± SD, 53.7 ± 4.50 years) reported “vaccination in the YNA” as a risk factor for acquiring chronic HBV infection. “Vaccination in the YNA” was a significant risk factor for CHB infection in men over 46 years of age (P = 0.006). Conclusions: A significant risk factor for infection in Slovenian men over 46 years of age was identified as “vaccination in the YNA”, which is specific to this geographic region and, to the best of our knowledge, has not been previously described in the peer-reviewed literature.
Effects of Six-Week Endurance Training in Liver Enzymes, Lipid Profile, Interleukin-6 and High-Sensitivity C-Reactive Protein (hs-CRP) Responses in People with a Family History of Coronary Artery Disease
(Brieflands, 2021-06-30) Farzad Shiri; Amirabbas Monazzami; Mohammad Azizi
Background: Research on the effects of moderate-intensity endurance training on inflammatory indices and cardiovascular risk factors is limited. Objectives: The aim of this study was to determine the effects of six weeks of endurance training on liver enzymes, body composition, lipid profile, interleukin-6, and C-reactive protein responses in people with a family history of coronary artery disease (CAD). Methods: Thirty men (30 - 45years) participated in this study who were divided into two groups, including the control group (n = 10) and training group (n = 20) systematically. The training group program consisted of running on a treadmill for 30 minutes with an intensity of 55 to 60% of maximum heart rate. These training programs were continued three times a week for six weeks. The control group did not perform any exercise program. ELISA technique was used to measure lipid profile, liver enzymes, interlukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP), respectively. Results: The results showed that the variables of weight, liver enzymes, lipid profile, IL-6, and hs-CRP were significantly different from the pre-test (P < 0.05). Also, in between-group comparison, the results showed that except for the variables of fat percentage and BMI in the other variables of the study, a significant difference was observed (P < 0.05). Conclusions: The results of this study suggest that moderate-intensity endurance training could be used as a useful way to reduce weight, levels of inflammatory markers, liver enzymes and cardiovascular risk factors in people with a family history of CAD.
Reverse Transcription Polymerase Chain Reaction (RT-PCR) as a Tool for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Surveillance in the Military
(Brieflands, 2021-03-31) Idris Zubairu Sadiq
Context: Military organizations like civilian communities are under considerable threat due to COVID-19 and other re-emerging infectious diseases, which may impair their operations and training. The aim of this review was to discuss the application of RT-PCR technology for detecting and surveillance of SARS-CoV-2 among armed forces to successfully halt COVID-19 transmission. Evidence Acquisition: Relevant literature was collected from PubMed, Science Direct, and Google Scholar Results: By combining both detection and quantification of pathogens, RT-PCR provides a reliable and sensitive method for detecting SARS-CoV-2 via targeting the viral ORF1ab, E, and N genes. Military surveillance plays an important role in the early detection and identification of positive cases, isolating infected patients, contact tracing, and quarantine to contain the spread of the disease among personnel. This technology emerges as a suitable tool for disease surveillance in the military and early detection and control of diseases. Conclusions: The COVID-19 disease has spread into different parts of the world and may affect military training and operations. So, there is a need for active disease surveillance and preparedness plans in the military. Accordingly, RT-PCR, as a standard tool for SARS-CoV-2 detection, can be used for the surveillance and monitoring of military personnel to successfully curtail COVID-19.
Military Personals Should Be Vaccinated Against Hepatitis B Infection
(Brieflands, 2014-02-01) Seyed Moayed Alavian
This article does not have an abstract.
Effects of Agility Training on Soldiers in a Warrior Transition Battalion: A Proof of Concept Study
(Brieflands, 2016-08-01) Kathleen Carter; Chelsey Erbaugh Franz; Megan Saprano; Dylan Shepard; Ann Swank
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). 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. 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. 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. Conclusions: This improvement in CV function, strength, agility and balance has the potential to result in better health and improved overall physical functioning.
An Efficient Two-step Selective Synthesis of 7-Methyl-8-nitroquinoline From m-Toluidine as a Key Starting Material in Medicinal Chemistry
(Brieflands, 2014-02-15) Ramin Zibaseresht; Mohamad Reza Amirlou; Parto Karimi
Background: A major problem in the development of required chemical compounds in a variety of industries such as pharmaceutical, agricultural, paint and polymer industries is to easily access the chemical starting materials. One class of these materials is quinoline derivatives. Synthesis of these compounds, despite their simple chemical structures is relatively complicated and their synthesis design and purification are challenging. Quinoline derivatives were synthesized and explored for their anticancer, antitinephritic, antitumor, anti-inflammatory and analgesic activity, as antiallergetic agents for treating Alzheimer’s disease (AD). Possible formation of 5- and 7-substituted quinolines during the Skraup reaction using m-substituted anilines is well understood. However, there are conflicting reports on the composition of the products from certain reactions. Objectives: As part of our research, we are interested in the development of synthetic strategies for preparation of 7-methyl-8-nitroquinoline selectively from a prepared mixture of 5- and 7-methyl quinoline as a key material to study its biological activities as well as to develop other corresponding quinoline derivatives for our research purpose. Materials and Methods: Synthesis and characterization of 7-methylquinoline using the Skraup methodology was reported. A subsequent nitration reaction was also carried out using a mixture of 5- and 7-methylquinoline to obtain pure 7-methyl-8-nitroquinoline selectively. In this project, in the first step, a mixture of 7-methylquinolin and 5-methylquinolin was prepared from the reaction of m-toluidine and glycerol. In the next step, 7-methyl-8-nitroquinoline was selectively synthesized and subsequently characterized using conventional methods such as NMR, IR, GC-MS and elemental analysis. Results: The compound 7-methyl-8-nitroquinolin was selectively synthesized in a two-step reaction with an excellent yield. Conclusions: 7-methyl-8-nitroquinolin as a key starting material was obtained through a two-step synthesis from m-toluidine. Skraup synthesis was employed to produce a mixture of 7- and 5-methylquinoline in a 2:1 ratio, which was then used for a nitration reaction using nitric acid and sulfuric acid without further purification. The final reaction selectively produced 7-methyl-8-nitroquinolin with an excellent yield.
Serum Aminotransferase Alteration Following Altitude Chamber Experience in Military Aircrew
(Brieflands, 2014-02-01) Iraj Mirzaii-Dizgah; Mahmud Mominzadeh
Background: Hypoxia is a serious threat in aviation. Aviators are trained in a type of hypobaric chamber (altitude chamber) in order to become familiar with the symptoms of hypoxia. This chamber simulates an altitude of 25,000 feet or more. Hypoxia could have an effect on various organs of the body, such as the liver. Objectives: The purpose of this study was to investigate alanine aminotransferase and aspartate aminotransferase alterations, as tissue damage markers, in aviators following altitude chamber experience. Patients and Methods: A cross-sectional study was carried out in 37 normal healthy male military aviators (age 22-43 years, height 165-192 cm and weight 63-105 kg) conducted in a hypobaric chamber. Total alanine aminotransferase and aspartate aminotransferase activities were assayed in their serum, before and after altitude chamber experience, by the international federation of clinical chemistry (IFCC) method. Statistical analysis of a paired Student’s t-test was performed. Results: The mean serum activities of aspartate aminotransferase (P = 0.001) and alanine aminotransferase (P = 0.014) were significantly increased following altitude chamber experience. Conclusions: Results suggest that subsequent to altitude chamber experience, there is a rise in the serum activities of aminotransferase.
The Value of Exercise Stress Testing for Renal-Cardiac Risk Assessment in Military Personnel: Exploring the Hidden Half!
(Brieflands, 2014-03-01) Ali Reza Khoshdel; Habib Mirzababaie; Hooman Angoorani
For decades, the exercise stress test (EST) has been known as a well-established non-invasive diagnostic test in patients with suspected or known cardiovascular disease (CVD). However, EST is also used for several other purposes in the armed forces including fitness assessment and adjustment training in simulated non-conventional environments such as altitude chambers. While exercise stress test is a part of periodic health check-up in specific groups of the military forces such as aviators, divers, and commanders, its diagnostic value for cardiovascular disease (CVD) detection is unclear in asymptomatic healthy subjects with low and intermediate cardiovascular risk according to the current clinical practice guidelines. Furthermore, it is demonstrated that it has a modest sensitivity and specificity for the diagnosis of coronary artery disease (67-72% and 69-90% respectively) in symptomatic patients. Hence, the hidden half of the test including non-electrical variations such as hemodynamic changes would be taken into the account or results of other tests such as arterial evaluations would be combined to provide a diagnostic battery. Meanwhile, its performance is also related to the CVD pre-test probability and the prevalence of the disease in the target population. On the other hand, not only the heart, but also vessels and kidneys can be evaluated by EST. Current evidence demonstrates that the hemodynamic response to exercise and exercise-induced micro-albuminuria are associated with cardiac, renal, and arterial functional status. In addition, impaired hemodynamic response to exercise predicts the development of renal dysfunction in the future.
Factors Associated With Renal and Urological Complications in Patients Suffering From Spinal Cord Injuries During Subsequent Years of Post-Injury
(Brieflands, 2013-10-21) Banafshe Dormanesh; Mohammad Khak; Vafa Rahimimovaghar
Background: Renal and urological complications are the main causes of mortality and morbidity associated with spinal cord injury (SCI). Besides clinical risk factors, there are environmental predisposing factors making a patient prone to develop any complications. Objectives: The present study aimed to evaluate the risk factors of developing nephrolithiasis, urinary tract infection, hydronephrosis and renal failure, as the main renal and urological complications in the SCI patients. Materials and Methods: The database of SCI patients of State Welfare Organization of Iran (SWOI) was used for data gathering. The data were collected between 2008 and 2010 by 222 separate teams consisting of 6 mobile rehabilitation team members. The independent risk factors of developing nephrolithiasis, urinary tract infection, hydronephrosis and renal failure were recognized by controlling the confounders after entering all biologically plausible variables in multivariate regression models. Results: Complete information was available for 5901 (72.59%) of the patients. Urologic and renal complications were reported in 2358 (40%) of the patients among which 286 (4.8%) had chronic renal failure, 127 (2.2%) from hydronephrosis, 307 (5.2%) from nephrolithiasis and 2138 (36.2%) from urinary tract infection. Generally, renal and urological complications associated with old age, and more time since SCI; however, lumbar level of injury and living in rural area negatively correlated with renal and urological complications. Conclusions: SCI patients with and without renal and urological complications are different regarding demographic and environmental factors; hence, it is necessary to determine the modifiable risk factors in patients' life-style to design preventive programs.
Effects of Substrate and Electrodeposition Parameters on the Microstructure of Hydroxyapatite Coating
(Brieflands, 2016-05-01) Mostafa Shahrezaei; Elnaz Mirtaheri; Hamed Miryousefi; Mohsen Saremi
Background: Hydroxyapatite (HA) has been widely used in hard-tissue repair applications, such as implant coatings and bone substitutes, because of its stability under in vivo conditions and its osteoconductivity. Objectives: The aim of this study was to investigate the effects of HA coating applied on two different metallic materials that are used as implants, with regard to the substrate and electrochemical parameters of their microstructure. Materials and Methods: HA coating was applied on AZ31 magnesium alloy and stainless steel 304, metallic materials used as implants, and the effects of the substrate and electrochemical parameters on their microstructure were investigated. Results: It was observed that at 2 V potential and 85°C for AZ31 and steel 304, the coatings did not have proper coverage and the grains were coarse. By hindering the grain growth, complete coverage with a uniform and fine structure will be achieved. There was a difference in morphology that was probably due to the different open circuit potentials of these two alloys. Magnesium alloys have more negative potential, in which H2 formation can hinder growth of HA flakes, but in Ti base alloys, the formation of H2 gas does not easily form in the working potential, so the HA coating can grow easily. Conclusions: Nanosized HA coating can be obtained on stainless steel 304, AZ31 magnesium alloy, and Ti-6Al-4V by cathodic deposition using pulse and direct cathodic electrodeposition from a proper electrolyte solution, regardless of the substrate material.

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