Iranian Journal of War and Public Health

eISSN (English): 2980-969X
eISSN (Persian): 2008-2630
pISSN (Persian): 2008-2622
1.0
JMERC

About IJWPH

Iranian Journal of War & Public Health (IJWPH) have started to publish scholarly articles from 2008 and in these years, have tried to do its best in publishing good-quality articles with respect to research and publication ethics rules. IJWPH is supported by "Janbazan (Veterans) Medical and Engineering Research Center" (JMERC), as the first research center in the field of late onset complications and side effects of war on health in Iran, which have started studying in this field since 1989. Producing knowledge about the health consequences of war is one of the main missions of JMERC.
 
38.4 days
Submission to Final Review
51.0 days
Submission to Accept
77.3 days
Accept to Publish
39.2 %
Acceptance Rate
Editor-in-Chief
Rahmatollah Hafezi, MD, MPH
Associate Professor, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Scientific Supporters
Janbazan Medical & Engineering Research Center
Articles

Examining the Psychological Characteristics of the Psychosocial Crisis of Risk Perception Among Firefighters

H. Ojaghizadeh, A. Ghaemi , S. Basharpoor
Objective: First responders, particularly firefighters, are at the frontline of critical incident exposure and require psychometrically robust instruments to assess risk appraisal and related psychosocial consequences. The present study aimed to evaluate the psychometric properties and validate the Perceived Psychosocial Risk Scale (adapted from Altanlar et al., 2025) in a sample of firefighters.
Method: In this descriptive-correlational study, a sample of 200 firefighters was selected via purposive sampling. The data were analyzed using descriptive statistics, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and convergent validity in SPSS (Version 27) and AMOS (Version 24) using the maximum likelihood (ML) estimator.
Results: Prior to model estimation, univariate normality was confirmed, with skewness and kurtosis values for all items falling within ±2. The EFA and subsequent CFA supported a robust two-factor measurement model comprising 6 items: Disaster experience and its consequences and Preventive and coping measures. All standardized factor loadings were statistically significant (p<0.001). The measurement model demonstrated an optimal fit to the empirical data: χ2=14.80, χ2/df=1.85, RMSEA=0.065, NFI=0.96, CFI=0.98, IFI=0.98, GFI=0.97, and AGFI=0.92. Reliability assessment showed high internal consistency for the total scale, with Cronbach’s alpha (α=0.85) and McDonald’s omega (ω=0.86). Convergent validity and construct reliability were established for both dimensions: Disaster experience and its consequences (AVE=0.526, CR=0.788) and Preventive and coping measures (AVE=0.516, CR=0.780).
Conclusion: The 6-item, two-factor structure of the scale is a reliable, valid, and parsimonious instrument for evaluating psychosocial outcomes and disaster risk management among firefighters. Crisis management organizations and mental health practitioners can utilize this standardized measure for screening, risk assessment, and designing evidence-based preventive and resilience-building interventions.
 
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Machine Learning Classification of Lifetime Suicide Attempts Among Iranian Military Conscripts: A Gradient Boosting Approach

N. Goodarzi , M. Imani , H. Mohsenabadi , M.J. Shabani
Aims: This study evaluated the utility of machine learning, specifically a Gradient Boosting model (GBM), in classifying lifetime suicide attempts among Iranian military conscripts to overcome the limitations of traditional linear assessments.
Methods: In a cross-sectional study of 338 conscripts, psychological data were collected using the Beck Hopelessness Scale–Short Form, Suicide Capacity Scale–Version 3, Psychache Scale, Acquired Capability for Suicide Scale–Fearlessness About Death (ACSS-FAD), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Interpersonal Needs Questionnaire. A GBM was trained to classify participants based on lifetime suicide attempt history and benchmarked against Logistic Regression. Feature importance was interpreted using SHapley Additive exPlanations (SHAP) to ensure clinical transparency.
Findings: The GBM achieved high classification accuracy (AUC = 0.9344), outperforming the Logistic Regression model (AUC = 0.9180). SHAP analysis identified the ACSS-FAD and SBQ-R as the most significant features distinguishing attempters from non-attempters. Furthermore, intense psychological pain (Psychache) emerged as a key discriminative factor in identifying the high-risk group. The GBM effectively captured complex, non-linear risk patterns.
Conclusion: "Capacity" factors are central to the psychological profile of attempters. Integrating non-linear machine learning techniques with theory-driven tools like the ACSS-FAD provides a robust, data-driven approach for accurately distinguishing high-risk individuals and tailoring targeted military suicide prevention strategies.
 
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Assessment of MAPK4 and ERK5 as Novel diagnostic biochemical markers in systemic lupus erythematosus'

G.H. Abdulhadi
Background: Although anti-double-stranded DNA (dsDNA) antibodies is diagnostic markers for systemic lupus erythematosus (SLE), their limitations necessitate the identification of supplementary biologically relevant biomarkers to enhance diagnostic accuracy.
Objective: To evaluate serum levels of mitogen-activated protein kinase 4 (MAPK4) and extracellular signal-regulated kinase 5 (ERK5) in patients with active SLE and determine their individual and combined diagnostic performance relative to anti-dsDNA antibodies.
Patients and methods: This study involved 119 women with active SLE and 61 healthy female controls. Serum concentrations of MAPK4, ERK5 and the anti-dsDNA index were quantified using enzyme-linked immunosorbent assays (ELISA). Diagnostic performance was analyzed using receiver operating characteristic (ROC) curves, principal component analysis (PCA), and multivariate logistic regression.
Results: SLE patients showed a significant increase in MAPK4, ERK5 and anti-ds DNA levels compared with the controls (all P < 0.001). The ROC curves for all have AUCs of 0.99. PCA demonstrated that the three biomarkers loaded onto a single dominant component that explained most of the variance. A logistic model combining the three markers achieved classification accuracy of 99.4 %. The three biomarkers showed consistent behavior within the composite statistical model between them, suggesting that they are involved in a shared immunological pathway.
Conclusion: Serum MAPK4 and ERK5 levels were significantly elevated in active SLE, demonstrating exceptional diagnostic performance comparable to that of anti-dsDNA antibodies. Integrating these novel kinases into a multi-marker serological panel substantially enhances the diagnostic capability for SLE, particularly when conventional markers yield inconclusive results.
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Technology-Enabled Infection Risk Surveillance among Accidents-Affected Clients: The Mediating Role of Community Health Workers' Early Threat Detection Capacity

Al-Eqabi Q.A.K.
Background: Increased incidence of infectious diseases and disruptions of existing health systems are likely to occur among populations living in or affected by accident and disaster affected areas, where exposure risks may be elevated. This study aimed to examine the role of technology-enabled risk-surveillance in infection surveillance by assessing the mediating effect of early threat detection capacity.
Methods: A quantitative cross-sectional study was conducted among 250 Community Health Workers in Kut City; Iraq in 2026. Data where collected wsing established measures of technology enabled infection risk surveillance, early threat detection capacity, and infection risk surveillance. Pearson correlation, multiple linear regression, and Hayes PROCESS macro Model 4 with 5000 bootstrap samples were applied.
Results: Technology- enabled surveillance was positively and significantly associated with early threat detection capacity (r = .62, p < .001) and risk for detecting infections (r = .58, p < .001). There was also a strong association between the capacity for detecting potential threats early and infection risk surveillance (r = .65, p < .001). In the multiple linear regression model, technology-enabled surveillance was independently associated with infection risk surveillance ( B= .39, p < .001). Mediation analysis indicated a significant indirect effect (B = 0.30, 95% bootstrap CI: 0.20-0.42), supporting partial mediation.
Conclusion: Technology-enabled surveillance was associated with higher levels of infection risk surveillance, with early threat-detection capacity partially accounting for this association. The combination of digital surveillance technologies with training of health workers and emergency readiness could better support community-based infection surveillance.

 
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In Vitro Antimicrobial Activity of Date Seed Extract Against a Multidrug-Resistant Clinical Isolate of Helicobacter pylori

Qasim M.J.
Background: Helicobacter pylori remains one of the most prevalent human bacterial pathogens, colonizing approximately 30–70% of the global population and representing a major cause of chronic gastritis, peptic ulcer disease, and gastric adenocarcinoma. This study evaluated the in vitro antibacterial activity of date seed extract against a multidrug-resistant clinical isolate of H. pylor.
Methods: A multidrug-resistant clinical isolate of H. pylori was recovered from a gastric biopsy specimen obtained from a dyspeptic patient and identified by conventional microbiological tests and PCR amplification of the cagA virulence gene. Ethanolic date seed extract was prepared under standardized laboratory conditions. The phytochemical profile of the extract was characterized by GC–MS analysis. Antibacterial activity was evaluated using the agar well diffusion assay, while the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined using the resazurin microdilution assay and subsequent subculture, respectively. All experiments were performed in triplicate and expressed as mean ± standard deviation.
Results: Phytochemical profiling identified eighteen major bioactive compounds in the ethanolic extract of Phoenix dactylifera seeds, mainly proanthocyanidins, flavonoid glycosides, catechins, and hydroxycinnamic acid derivatives. Proanthocyanidin tetramer was the predominant constituent. The extract exhibited pronounced antibacterial activity against the multidrug-resistant H. pylori isolate, producing an inhibition zone of 32.0 ± 0.2 mm. The MIC and MBC values were 15.6 ± 0.5 μg/mL and 31.2 ± 0.3 μg/mL, respectively. The observed antimicrobial activity is likely attributable to the synergistic effects of the identified polyphenolic constituents, which may interfere with bacterial membrane integrity and essential cellular processes.
 
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Evaluation of Low-Level Laser Therapy (LLLT) on Skin Wound Healing and Inflammatory Biomarkers: A Clinical and Biophysical Study

Bushra Ghali Yousif, Selma Ahmed Jassim
Background: The process of healing wounds on the skin consists of various biological phenomena such as hemostasis, inflammation, proliferation, and remodeling. Nevertheless, the difficulty in healing wounds due to many factors has been the most challenging question in the clinic since persistent inflammation and the inability to regenerate tissues pose a threat to infection, make treatment lengthy, and decrease life quality.  Low-Level Laser Therapy (LLLT) also referred to as photobiomodulation, has emerged as a non-invasive procedure with the potential for enhancing tissue healing and regulating inflammation. This study investigated the impact of Low-Level Laser Therapy on the healing of wounds on the skin as well as the inflammatory biomarkers related to this process through both clinical and biophysical analysis.
Methods: In this group of 360 patients with either a superficial or partial thickness skin wound, a randomized clinical trial was done. The selection of the study participants resulted in 180 patients being treated for the clinical condition, while 180 received standard care alone. For 4 weeks, participants were treated with a 660-nm diode laser (100 mW, 4 J/cm²) 3 times in a week. The following clinical parameters were evaluated: percentage of wound closure, pain intensity, rate of complete healing, patient satisfaction and the number of adverse events. The following parameters were studied in the physical assessments: local skin temperature and tissue perfusion. Biochemical makers of inflammation like CRP, TNF-alpha, and IL-6 levels were measured before and after treatment to help assess the effectiveness of the treatment given. The significance of the study results was assessed using SPSS statistics p<0.05.
Results: Individuals treated with LLLT had significantly better wound closure, faster healing of the affected tissue, and better recovery from the disease compared to the group with no treatment. It was also noted that the levels of TNF-α, IL-6, and CRP tend to decrease considerably after the use of LLLT demonstrating decreased inflammation. Pain level was significantly lower and the healing and patient satisfaction rate were higher after LLLT treatment.
Conclusions: Low-Level Laser Therapy remarkably improved the healing process of wounds and decreased inflammation markers in combination with conventional wound care. A combination of results from laboratory, clinical, and biophysical studies and observations support the therapeutic role of photobiomodulation in tissue regeneration and the management of inflammation. Further large multicentric studies are suggested with a longer follow up period to determine efficacy of the treatment protocols and verify the results.



 
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CD35 as a Diagnostic Biomarker in Iraqi Hepatic Carcinoma

A.H. Jasim, B.A. Ali , M. Abdulbaqi
Aims: CD35, a gene encoding a key protein involved in inflammation and immune regulation, has been implicated in the development of several cancers. This study aimed to investigate the relationship between CD35 tag single-nucleotide polymorphisms and susceptibility to hepatic carcinoma, as well as their potential association with postoperative recurrence, thereby contributing to a better understanding of gene–environment interactions in hepatic carcinoma.
Materials & Methods: This hospital-based observational study included 120 Iraqi participants, comprising 56 patients with hepatic carcinoma and 64 healthy controls. The study investigated whether CD35 tag single-nucleotide polymorphisms were associated with susceptibility to hepatic carcinoma and, among patients who underwent surgery, with postoperative recurrence. Three CD35 tag single-nucleotide polymorphisms—rs2296160, rs3849266, and rs7525160—were selected using HaploView version 4.2 and genotyped using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS).
Findings: Among 56 patients with hepatic carcinoma and 64 controls, CD35 rs2296160 and rs3849266 showed no significant genotype differences between groups (p>0.05). In contrast, rs7525160 was associated with hepatic carcinoma.The rs7525160 C-allele association was more evident in patients with tumors >5cm, TNM stage III/IV disease, cirrhosis, portal vein thrombosis, or AFP >400ng/mL. There was an association between the CC/CG genotype and postoperative recurrence; however, the hazard ratio and 95% confidence interval should be added.
Conclusion: Among Iraqi participants younger than 65 years, the CD35 rs7525160 polymorphism increases hepatic carcinoma susceptibility and predicts poorer recurrence-free survival.
 
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Effect of Neurokinetic Therapy on Core Muscle Dysfunction among Subjects with Low Back Pain

K.T. Kumar, A.K. Kumaresan, S. Vishnuram, D.D. Vianni, S.S. Subramanian , N.B. Raj, I. Fatima , P. Arjunan, V. Thirunavukkarasu
Aims: Core muscle dysfunction is commonly identified as a contributing factor for low back pain. This study examined the effects of Neurokinetic Therapy on core muscle dysfunction in individuals with low back pain.
Materials & Methods: Sixty-six subjects aged 20-50 years with chronic nonspecific low back pain were randomized into two groups (NKT and Control). The NKT group received treatment for 8 weeks. Manual muscle testing of participants was conducted during this period, along with identifying dysfunctional movement patterns and biweekly neuromotor reprogramming sessions.
Findings: The primary outcome, core muscle endurance, improved significantly in the NKT group. Plank endurance time increased from a mean of 45.2±10.5 seconds at baseline to 61.0±12.4 seconds post-intervention, whereas the control group showed a smaller improvement. Side-bridge endurance times showed a greater increase in the NKT group (30.4±8.2 to 42.6±9.3) than in the control group (p<0.01).
Conclusion: Interventional techniques such as NKT should be incorporated into clinical practice for the treatment of chronic low back pain, especially when core dysfunction is involved.
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Resistance Training and Its Impact on Blood Glucose, Testosterone, FSH, and LH Levels in Men with Type 2 Diabetes

M. Parastesh, B. Aria, E. Hashemi Beni, A. Saremi
Aims: Research has demonstrated a negative association between type 2 diabetes mellitus and male gonadal function, with reductions observed in serum levels of testosterone, follicle-stimulating hormone, and luteinizing hormone. Conversely, resistance training has been shown to positively influence these hormones in healthy men. This study aimed to investigate the effect of resistance training on blood glucose, testosterone, follicle-stimulating hormone, and luteinizing hormone levels in men with type 2 diabetes.
Materials & Methods: This semi-experimental study included 20 men with type 2 diabetes (aged 45-60 years) who were randomly assigned to the resistance training or the control groups (n=10 per group). The training group participated in an eight-week supervised program targeting major muscle groups. Blood samples were collected pre- and post-intervention to measure blood glucose, testosterone, luteinizing hormone, and follicle-stimulating hormone levels. Data were analyzed by SPSS 26 using the mixed ANOVA and an independent t-test.
Findings: The resistance training group demonstrated significant improvements (p<0.05) in blood glucose, testosterone, and luteinizing hormone levels compared to the control group and baseline measurements. No significant changes were observed in follicle-stimulating hormone (p>0.05).
Conclusion: Eight weeks of resistance training enhance blood glucose control and gonadal function in men with type 2 diabetes.
 
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A Scientific Evaluation for Military Medical Services in the Russia-Ukraine War

O. Özmen , P. Özmen
Aims: 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 & Methods: 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.
Findings: 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.
Conclusion: 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".
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Effect of Emergency Nurses’ Work Stress, Workload, and Motivation on Emergency Severity Index Implementation

S.D.M. Riu, N. Nursalam, T. Nusi, I.M. Yahya, N.H. Rahil, Y.M. Taplo
Aims: This study aimed to identify the relationship between emergency room nurses’ work stress, workload, and motivation with implementing the Emergency Severity Index triage system.
Instrument & Methods: This cross-sectional study was conducted at the X Regional General Hospital with a sample of 72 emergency room nurses. The questionnaires were validated to assess work stress, workload, motivation, and Emergency Severity Index implementation. Data were analyzed through descriptive statistics and multiple linear regression to ascertain the relationship between the explanatory variables (including work stress, workload, and motivation) and the dependent variable (Emergency Severity Index implementation).
Findings: All three independent variables and Emergency Severity Index implementation had statistically significant positive relationships. The final model revealed workload as the strongest variable (B=0.14; p=0.002), followed by work stress (B=0.24; p=0.015) and motivation (B=0.1; p=0.046). The regression model accounted for 27% of the variability in Emergency Severity Index implementation (adjusted R2=0.27).
Conclusion: Workload is the most significant factor affecting Emergency Severity Index implementation, followed by work stress and motivation.
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Risk Factors Predicting Hypertension in the Elderly

A. Sutriyawan, F. Fardhoni, A.A. Yusuff, H. Akbar, M. Sangaji
Aims: West Java has the second highest incidence of hypertension in the country, with a prevalence of 36.79% in the city of Bandung. The elderly have the highest rate of hypertension among all age groups. This study aimed to investigate non-modifiable and modifiable risk factors, as well as the most common risk factors related to hypertension in the elderly.
Instrument & Methods: In this cross-sectional, all patients who visited and received treatment at the general polyclinic and were registered in the Neglasari Health Centre’s report registration were investigated. There were 245 respondents in this survey. A basic random strategy was used to collect samples. Data were collected using questionnaires and observation sheets and analyzed by Chi-square test and multiple logistic regression.
Findings: Age (p=0.000), family history (p=0.015), obesity (p=0.0001), physical activity (p=0.003), stress (p=0.000), excessive salt consumption (p=0.007), alcohol drinking (p=0.0001), and inadequate fiber consumption (p=0.0001) were risk factors for hypertension in the elderly. The degree of stress was the most important risk factor for the occurrence of hypertension in the elderly (OR=4.2).
Conclusion: Both non-modifiable (age and family history) and modifiable (obesity, physical activity, stress, excessive salt consumption, alcohol consumption, and low fiber consumption) factors can influence the occurrence of hypertension. Stress is the most significant factor linked to hypertension.
 
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Review of therapeutic effect of trans cranial magnetic stimulation in psychological disorders

V. nejati

Human brain can be stimulated safely and non invasively by powerful magnetic field. This magnetic field causes a current in stimulated tissue, which stimulates the brain neurons. In psychological disorders, focal brain activity is observed in clinical syndromes. Application of trans-cranial magnetic stimulation as a therapeutic technique proposes to change the selective brain activities. Low frequency repetitive trans-cranial magnetic stimulation (rTMS) is a new method in evaluation and treatment of hyper excitability brain syndromes, which changes brain plasticity. In this review article, therapeutic effect of rTMS in some psychological disease such as depression, post traumatic stress disorder, epilepsy, obsessive compulsive disorder and schizophrenia is discussed.

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Examining the effects of ’bad’ and ‘good’ fitting conditions supracondylar PTB socket on interface pressure and comfort of unilateral transtibial amputees: Case Study

N. Tafti, M.R. Safari, Gh. Aminian, P. Rezasoltani

Background: Changes in the volume and shape of the stump causes difficulties in maintaining A comfortable and exact fit. Improper fit causes pain, discomfort and movement between stump and socket. There is not enough document to identify how much volume fluctuation causes fitting problem . To identify and understand the relationship between the changes of interface pressure between stump and socket with mentally feeling of amputees in "good" and "bad" fitting conditions.

Method and Material: The study was conducted on two below knee amputees. The method has 2similar stages, SCS was evaluated at both stages with the difference that one was done in bad and other in good fitting condition. To examine stump-socket interface pressure at each stage,static tests with applying half and full body weight to the artifical limb and walking tests were done.

Results: With volume reduction, it seems adding several sock layers to improve fitting condition (force couple correction)imposes high interface pressure to patellar tendon and fibular head which lowers amputees feeling of comfort. Without adding sock layers,stump movement to distal causes unbearable pressure to the distal of tibia.

Conclusion: In static tests, interface pressure increased in good fitting condition at patellar tendon and popliteal region. Walking tests in good fitting condition showed less movement between stump and socket and less improper pressure. Using too many layers of socks to improve fitting causes intolareable interface pressure at regions such as petellar tendon and fibular head.

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Tactile and Force Feedback Gloves for Virtual Reality and Telecontrol of Anthropomorphic Manipulators; an Analytic Review

I. Krechetov, A.A. Skvortsov, I.A. Poselsky
Introduction: Devices that allow using the functionality of natural hand movements are of the greatest interest. The purpose of this study was to select areas of research at the intersection of several fields of science – biomechanics and cybernetics to develop scientific and technical approaches to track the movements of the operator's fingers and form feedback tactile and force communication received from the control object to achieve a new level of accuracy in work with virtual and with real objects by converting virtual contact action into physical. Methods of force feedback were implemented according which they can be divided into two groups: active and passive feedback. The main technologies used to implement various functionalities of the virtual reality glove were identified: measuring hand positions and feedback generation. The main advantages of the planned development were also identified: the ability to digitize up to 16 finger joints, tactile and force feedback, and moderate cost, a benchmark for the mass market.
Conclusion: The development of the design of the glove will be implemented using a kinematic scheme based on the kinematics of the human hand, considering the requirements of aesthetics and ergonomics of the solution. As a sensor system, it is planned to use digital Hall sensors with a capacity of up to 14 bits, high speed and, at the same time, small dimensions, allowing them to be installed directly inside the swivel joints.
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Frequency of Phantom Pain among patients with Spinal Cord Injury

Hadi Shojaei, Alireza Jafari, Shohre Valaei

Summary: Background: Patients with spinal cord injury (SCI) usually have permanent and often devastating neurologic deficits and disability and pain (1). According to the National Institutes of Health, "among neurological disorders, the cost to society of automotive SCI is exceeded only by the cost of mental retardation"(2). Neurogenic pain constitutes one of the enigmatic clinical syndromes faced by patients, clinicians, and researchers (3). Materials and Methods: Current observational descriptive cross-sectional survey is performed among 270 patients with spinal cord injuries including veterans and non-veteran disabled subjects in Tehran-City during 2005. Results: Mean age of the subjects was 37.8±12.2 years. 26.3% were female and 73.7% were male. 17.4% had spinal cord injury in cervical level, 41.5% thoracic, 38.1% lumbar, and 3% Quada Equina level. 76.3% had complete and 23.7% incomplete injuries. 19.3% had injury duration of less than 5 years, 11.9% between 5 to 10 years, and 68.9% upper than 10 years. Phantom pain below the lesion level was present in 89 patients (33%) that included 26% of veterans and 37% of non-veterans. There was a statistically significant association between age, marital status, and injury duration with having phantom pain (P< 0.05). Conclusion: it is concluded that frequency of phantom pain in current study is less than all of previous studies and our patients were totally resistant to analgesic treatments which may be due to physiopathologic basis of such pains in comparison with other pains due to spinal cord injuries.

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Localization of Hemoxigenase in the epithelium of human air way wall induced by sulfur mustard

M.R. nourani, L. Mirbagheri, M. Habibi Rodkenar, M. Ebrahimi, S. Yazdani, A.A. Imani Fouladi

Introduction: Sulfur mustard (SM) as an effective chemical agent was used recently in the Iraq war against Iran. Currently more than 40,000 chemical casualty of war left with lung lesions caused by mustard gas.

This combination induce the production of oxygen free radicals are molecules that activate inflammatory processes. Heme Oxigenase is one of the important proteins that decrease the harmful effects of free radicals and involved in many cellular functions such as oxidant/antioxidant system balance in respiratory system.

Methods: 12 biopsy samples of the airway wall (8 chemical samples and 4 control samples) obtain by bronchoscopy. After fixation in Parafrmaldehyd 4%, 20 microns slices were prepared by Cryostat. The expression of HO1, a polymorphism of HO, by immunohistochemistry method in samples of veterans and control groups analysed and were compared.

Results: SM exposed samples were immunonegative for HO1 antibodies in compare to unexposed patients, while Normal ones expressed in high intensity in epithelium as a basal expression.

Conclusion: These findings indicate that this molecule play an important role in protecting cells against oxidative stress, including the poisoning of SM. So it concluded that the absence of this protective factor may be cause for chronic obstructive pulmonary disease and continuity of problem.

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Effectiveness of Emotional Schema Therapy on Cognitive Emotion Regulation Strategies of Combat-Related Post Traumatic Stress Disorder Veterans

Y. Naderi , A.R. Moradi , J. Hasani , S. Noohi

Introduction: This study aims to examine the effectiveness of Emotional Schema Therapy on The Emotional Schema & Cognitive Emotion Regulation Strategies of patients suffering from Post-Traumatic Stress Disorder (PTSD).

Method: 6 patients from the clients of psychiatric clinic of Baqiyatallah hospital, were selected through available sampling, matched together and then divided into 3 groups (Emotional Schema Therapy combined with Medications, Cognitive Behavioral Therapy combined with Medications & Medications) Patients were examined 5 & 3 times by Leahy Emotional Schema Scale (LESS) and the Short Form of Cognitive Emotion Regulation Questionnaire (CERQ-18) and The Persian versions of the Impact of Event Scale-Revise (IES-R). To analyze the data, indexes of effect size, cohen’s d, process changes, slope and interpretation of ups & downs in charts were employed.

Result:  After treatment, scores of patients who Emotional Schema Therapy received showed decrease in Negative Emotional Schema(Rumination, guilt, uncontrollability) & Maladaptive Cognitive Emotion Regulation strategies (Self-blaming, Rumination, Catastrophizing) additionally, in some Adaptive Cognitive Emotion Regulation strategies (Positive refocusing, Refocusing on planning, Positive Reappraisal)and Adaptive Emotional Schema (higher values, acceptance, consensus, Comprehensibility) an increase was observed.

Conclusion: Emotional Schema Therapy via targeting directly mechanisms of pathological Emotional Schemas & Maladaptive Cognitive Emotion Regulation strategies. can be appropriate choice for treatment of Post-Traumatic Stress Disorder (PTSD).

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Social Support and Social Health

T. Hassanpour , S. Mehrabi , A. Poursamad , K. ZandiGhashghaie, M. Sharifi
Aims: Social health is the part of a person's health that emerges in the community. We consider a person to have social health who can express his/her social activities and roles normally and feel connected to society and social norms. This study was aimed to determine a relationship between social support and social health among the people of Yasouj, Iran.
Instrument & Methods: This descriptive study was a cross-sectional survey conducted on people of Yasuj in 2016. Four hundred people were selected using the cluster sampling method. A standardized questionnaire for the social support variables was used. The information was coded and entered into SPSS 22 software. Kendall's tau-c test was used to analyze the relationships between variables.
Findings: There were significant relationships between social health and social, family, friends, and others' support (p<0.05).
Conclusion: Social support (family, friends, and others) can help increase the social health of individuals, and it can reduce social harm.
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survey of relationship between abnormalities of the spine and spirometric indices of spinal cord injury veterans

M. Saberi, A. Ebrahimi atri, S.A. Hashemi Javaheri, M. Mosaferi Ziaaldini, M. khodaei

Background & Purpose:   In addition to any disability, especially spinal cord injury level of sensory and motor performance of shows, other serious complications in other parts of the body, leaving lasting. . One of these complications, the spine is deformed. Many of the deformation of the spine, opening the chest to reduce this mode reduces the vital capacity and respiratory disorders, negative effects on the cardiovascular system and ultimately cause a change in the amount of their lung capacity is. The objective of this study, survey of relationship is between abnormalities of the spine (Lordosis, Kyphosis, scoliosis) and spirometric parameters (FEV1/FVC, FVC, FEV1, FEF75, PEF).

Materials & Methods:For this purpose, the present study was performed on 60 cases of spinal cord injury veterans And spirometric indices including FEV1/FVC, FVC, FEV1, FEF75, PEF was assessed using spirometry. For data analysis descriptive statistics were used and the test of Pearson inferential statistics were used.

Results: Based on survey results, a relation between Lordosis, scoliosis Kyphosis and spirometric indices, the rate and Kyphosis and  Lordosis abnormalities was significant
(P<0.05). But there is no significant difference in the rate of scoliosis (P>0.05).

Conclusion: Due to the complications of spinal deformity and subsequent loss of lung volume in the injured spinal cord injury, for deformity correction protocols and a regular exercise program continued to increase indicators lung is recommended.

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Relation between perceived social support and health promotion behaviors in chemical veterans in Ilam province on 2012-13

R. Chenary, A. Noroozi, R. Noroozi

Background & Purpose: Chemical attacks in war can make short term and long term personal, family and social damages and limited social relationships of victims as compared to ordinary people. The aim of this study was to investigate the relationship between social support and health promoting behaviors in chemical veteran in Ilam province 2012-13.

Methods & Materials: This cross-sectional study was performed in the entire moderate and severs chemical veterans, who they were covered by the Department of Veterans and Martyrs of Ilam province. Information was collected by using standard questionnaires for health-promoting behavior and Multidimensional scale of perceived social support (family, friends, and important people). The reliability and validity of these instruments was desirable. Inclusion criteria were percentage of disability with moderate and sever levels and enough physical strength to answer questions, and exclusion criteria were also lack of cooperation and have no permanent residence in Ilam province. After data collection, all data were analyzed by SPSS statistical soft ware and Pearson correlation coefficient and linear regression.

Results: All of 239 veterans indicated that all of them were men with mean and standard deviation age 51.17± 8.87 years and there is a significant relation between all subscales of social support and health-promotion behavior subscales (p<0.05). Among the subscales of social support, friend support had the highest correlation with health-promoting behaviors (r= 0.391), and support from important people showed the lowest correlation (r= 0.367). The all regression models of health promotion behavior and its subscales were significant.

Conclusion: There is a relation between perceived social support especially friend support and health-promotion behaviors, therefore suggest that the friend as a resource support was used in design of educational programs.

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The effect of lateral wedge insole with and without subtalar strap on vertical component of ground reaction force in knee osteoarthritis

E. Esfandiari, M. Kamyab, H. Yazdi, N. Foroughi, F. Navab Motlagh

Objective: The effects of lateral wedge insoles with and without subtalar strap on vertical component of ground reaction force were compared. Methods: Twenty five patients aged over 40 years with grades I or II of medial compartment knee osteoarthritis based on Kellgrene and Lawrence grading system were participated in this study. They were tested in 3 conditions while walking in a 3-meter walkway: bare foot, lateral wedge insole and lateral wedge insole with subtalar strap. Three successful trials were recorded in each condition. Gait analysis was performed to compare the immediate effect of lateral wedge insole with and without subtalar strap on vertical component of ground reaction force.

Results: There was significant effect of lateral wedge insole with subtalar strap on second peak of vertical ground reaction force related to lateral wedge insole and without insole conditions. But no significant effect of lateral wedge insole with and without subtalar strap was found on first peak of vertical ground reaction force and walking speed.

Conclusion: The results of this study suggest that lateral wedge insole can reduce second peak of vertical ground reaction force. Also it was understood lateral wedge insole with subtalar strap might be more efficacious than lateral wedge insole in mild knee osteoarthritis patients.

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Splinting in Congenital Hand Anomalies; A Systematic Review

M. Pashmdarfard, M. Kalantari
Aims: Congenital hand anomalies are abnormal conditions presented at birth regardless of their cause. These abnormalities may lead to structural or functional disorders in children. The treatment of pediatric hand anomalies has been controversial, and the agreement on the gold standard for the treatment of this malformation in children has yet to be ambiguous.
Information & Methods: The aim of the present study was to review studies on splinting in congenital hand anomalies using ProQuest, PubMed, Scopus, and EMBASE databases published from 1990 to 2023.
Findings: A total of 344 articles were found and finally, 13 articles were reviewed, of which six cases were at evidence level I (one randomized controlled trial (RCT) and five reviews), two cases were at evidence level II,  two cases were at evidence level III, one study was at evidence level IV, and two cases were at evidence level V. The methodological quality assessment of the one and five included RCTs and systematic review studies showed the moderate-to-high quality of the studies based on the scores≥5 using the Physiotherapy Evidence Database (PEDro) and Assessment of Multiple Systematic Reviews (AMSTAR) scales.
Conclusion: The use of a splint alone in the function of the upper limbs of children suffering from congenital hand abnormalities cannot be presented as an effective solution.. The use of splints as the first line of congenital hand anomalies in children can be useful if prescribed during infancy and in some congenital anomalies, such as thumb and radial hand. The best treatment process for children with other hand anomalies is surgery and timely prescription of a splint.
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Validation of a Device for Registering Orthotic Wearing Time during the Laboratory Climate Tests on Normal Volunteers

N. Fallahian, F. Tabatabaei, M. Rahgozar , R. VahabKashani , M. Bahrami

Laboratory instrumentation of orthoses and prostheses can be used to objectively gain accurate information. In this study the measurement of orthosis wearing time during laboratory climate tests with normal volunteers were accomplished to determine the validity and reliability of the device for registering orthotic wearing time that was designed and fabricated in Iran. Orthosis wearing time is an important factor in orthotic treatment for spine disorders. A reliable and objective System for measuring orthosis wearing time currently is still lacking in Iran. After Developing such a device, our objective was to test the accuracy and validity of the device, Made in Iran which was designed to register spinal orthosis wearing time. The device had a force sensor mounted on a thoracolumbosacral orthosis pad to recorded orthosis wearing time. In an interval of 1 hour 5 Normal volunteers tested the device using a CASH orthosis. They donned the orthosis for a few minutes and doffed it meanwhile they recorded the time using a standard chronometer into the "Orthotic Wearing" form. After gaining the data one sample t-test was performed on all orthosis wearing-time intervals as recorded by the system and by the time tables filled by each of the 5 testers using a chronometer. The tests yielded 100 sensor trigger-events that is 50 times of orthotic wear (t=2.21, P=0.032). As indicated by the t-test analysis, the device for registering orthotic wearing time had accurately quantified the orthosis wearing-time intervals during the laboratory climate tests with normal volunteers.

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The relationship between basic need satisfaction and general healthof veteransofIsfahan’s AmiralmomeninHosptital

H. Salehi, A. Ghamarani, Z. Salehi

Background& Purpose: The onlyforcethat hastargetedhealth,physicalandmental. Satisfythebasicneedsrequiredto grow theconsistency,specificityandprovidepsychological well-being. The present study aims at analyzing the efficiency of basic need satisfaction in general in predicting the veterans’ general health at Isfahan’s AmiralmomeninHosptital.

Methods&Material:132 veterans were chosen randomly at AmiralmomeninHospital. They answered the questionnaires of the Basic Need Satisfaction (Basic Needs Satisfaction) and General Health (General Health Questioner ). In order to analyze the data, multivariate (step by step) regression analysis was used.

Result: The results indicated that satisfying the basic need satisfaction has correlation with the veterans’ general health (p<0.001) and also, the results indicated that among the psychological needs, satisfying the autonomy need and general health are predicted significantly (p<0.001).

Conclusion: To sum up, the results of the present study confirmed the efficiency of the basic needs satisfaction in predicting general health.

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The Comparison of the quality of life of the war veterans families with/without Post traumatic Stress Disorder

M. najafy, M.A. mohammadyfar, S. dabiri, N. erfani, A.A. Kamary

Introduction: The aim of current study was comparison of the quality of life of the war veteran’s families with/without PTSD.

Method: In this purpose 300 war veterans' families were selected by clustering random sampling in Hamedan province. The measures of this research were quality of life questionnaire 28 items and demographic inventory.

Results: The results of independent samples t-test have shown the war veterans with PTSD reported lower scores on Physical Function, Bodily Pain, General Health, Vitality, Social Functioning, and mental health in comparison of the war veterans without PTSD. The spouses of the war veterans with PTSD also have reported lower quality of life in all subscales in comparison of the spouses of war veterans without PTSD. The children of the war veterans with PTSD have reported lower scores only on general health in comparison of the children of the war veterans without PTSD.

Conclusion: In respect to results, it appears that consideration of family's health in war veterans' families is necessary with special attention to war veterans with PTSD. However, planning, and instructional, therapeutic policies can be useful

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Psychological- social consequences chemical bombardment of the Sardasht victims (a qualitative study)

B. Malkari, N. Karimian

Purpose: Aim of the present research is study of psychic and social consequences of chemical bombarding on the victims of Sardasht City by qualitative method. 

Material & Method: 15 men and 15 women of Sardasht City victims were selected as available sampling and they were interviewed in semi-structured manner. Method of qualitative research is interpretive. Results of the interviews were divided into several categories. 

Results: Results show that psychic and social consequences of chemical bombarding on the victims include complaints such as social complaints, psychic complaints, exhaustion problems, economical complaints, characteristic complaints, anger, no safety sensation, emotional interdependent, decrease of social interaction exist in victims. 

Conclusion: Results of the research demonstrate social and psychological problems have higher role in psychic- social consequences of chemical bombarding in ratio with other psychic- social consequences. Finally, we involved in limitations and providing several recommendations

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Correlation between mindfulness and executive functions in blinds veterans

V. Nejati

  Background and Aim : Mindfulness is ability of self regulating attention and direct it for task. The purpose of present study is evaluation of correlation between mindfulness and executive function in blind veterans.

  Materials & Methods : we evaluate 93 blind veterans with Dys executive function and mindfulness questionnaire. Pearson Correlation Test was used to evaluation.

  Results : findings show significant correlation between mindfulness and executive function specially inhibition and memory (P<0.01) and arousal (P<0.01) subscale. No correlation found in intentionality and hyperactivity subscale (P>0.05).

  Conclusion : Cause of correlation between mindfulness and inhibition, arousal and memory is common structural and functional overlap. Mindfulness can be used as a proper predictor of this subscale of executive functions.

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