A 38-year-old emergency medical service Bell 214 male pilot with a dry cough, fever, anorexia, fatigue, and
sweating for the past 3 days; an oral temperature of 38°C; blood pressure of 105/65 mm Hg; heart rate of 94
beats/min; respiratory rate of 21 breaths/min; and pulse oximetry of 93% on room air was suspicious for coronavirus
disease 2019. Surprisingly, reverse transcription polymerase chain reaction was negative, but bilateral
hilar adenopathy was reported in his chest radiography as a new challenge. The pathologic report of the
adenopathy biopsy was noncaseating sarcoid-type granulomas. Serologic tests showed a serum angiotensinconverting
enzyme level of 58 nmol/mL/min. The bronchoalveolar lavage fluid CD4/CD8 ratio was 3.68. The
bronchoalveolar lavage findings provided an accurate sarcoidosis diagnosis, and a high-resolution computed
tomographic scan revealed stage 1 pulmonary involvement. Because of the pulmonary involvement, clinical
manifestations, use of inhaled fluticasone, and need for longer and accurate follow-up and to protect against
coronavirus disease 2019, he has been temporarily suspended until the final assignment.

Urinary Level of Heparin-Binding Protein in Pediatric Urinary Tract
Infection

The main purpose of this study is determining the difference between the incidence of ANA positivity
and its patterns in healthy children and children suffering from rheumatologic diseases such as: SLE,
JRA, etc in a tertiary pediatric center from 2013 to 2014.In this study we compared 100 healthy and 100
patient children by indirect Immunofluorescence antibody determining method. Then the positivity of
ANA and its patterns - if positive - compared between healthy and patient children suffering from
various rheumatologic diseases.From 100 patient children 3 had SLE and ANA was positive in 2 of them.
51 of the children had JRA that 35 had positive ANA results. There were 46 children suffering from other
rheumatologic diseases and ANA was positive in 34 of them. Among 100 healthy children 34 of them had
positive ANA test. The difference between ANA positivity and its patterns in children suffering from
SLE, JRA and other rheumatologic diseases and healthy children was meaningful. The difference between
incidence of ANA positivity in different ages was meaningful. The incidence of ANA positivity was 73.7
% in boys and 67.44% in girls.The difference between the incidence of ANA positivity and its patterns in
patient children and healthy ones was meaningful – as presumed earlier.
Keywords: Antinuclear Antibody, healthy children,rheumatologic disease ,SLE,JRA.

Objective: Regarding to the point that CVA is one of major reasons of mortality in aged people; and various
studies about role of CRP in the disease prognosis has been done, in the study we have tried to analyze
relation ship between CRP Level during bedridden period and disability rate of patient after a month.
Method: The research has been gained via studying on 50 patients (27 men.23 women), which by
ischemic Cerebral attack in middle cerebral artery pathway (upper branch) regarding to description, clinical
examination and cerebral C.T. Scan of Patient have been confirmed to bed. Age average of the patients is 60-
80 years old, which regarding to biochemical test of blood at the time of referral to hospital has been divided
into two groups: positive CRP (MI, infectious and inflammatory disease must be rule out) and negative CRP.
At the time of bedridden motor function examination, has been recorded in emergency; and after a month.
Motor function of patients has been recorded again, (by referring to their homes). It is clear that both groups
had a same treatment care during one month.
Findings: Muscular force in CVA patients, before treatment, which had positive CRP in comparison with
Muscle force patients before treatment with negative CRP had no meaningful difference (P<0.765). Muscular
force had no meaningful difference a month after treatment in patients with positive CRP in comparison
with negative CRP (P<0.262), but changes of muscular force before treatment and a month after treatment
was meaningful in patients with positive CRP (P<0.014), and muscular force improvement of negative CRP
patients was more obvious.
Conclusion: Regarding to the point that in the above research it is cleared those CVA patients. Who had
positive CRP in comparison with the patients who had negative CRP, had worse prognosis, and so it seems
that role of inflammatory elements in prognosis of CVA patients is considerable and analyzable. It is clear that
by Considering CRP factor, we may get new treatment strategies.
Keywords: CRP- CVA-muscle force

Background: according to the high prevalence of neonatal infection and reduce of NMR (neonatal
mortality rate) as one of the health and treatment program in our country, study about prevalence of blood
infection germs and predisposing factors seem necessary.
Material & Methods: in this cohort study, 118 neonat that admitted in neonatal ward and NICU of ghods
hospital along 3 month evaluated based on many items such as : BC(blood culture)/sex/age/admission date/
weight/type of birth/admission ward/clinical findings/predisposing factors.all of this informations acquired
frome patients profil.
Results: evalution results of 118 neonat that admitted along 3 month at ghods hospital neonatal ward and
NICU that shown 26 patient(%22) have positive BC and 92 patient (%78) have negative BC.
Conclusion: based on result of this study found that : %22 neonat have positive BC and %78 have
negative BC.responsible of %34.6 positive BC was staphylococcus cougulas negative and %65.4 was other
germs.most common predisposing factor was pretermity(%10.2) and most common clinical finding was
fever(%66.9).
Keywords: staphylococcus cougulas negative, blood culture, neonatal sepsis, clinical findings,
predisposing factors.

Background: First carpometacarpal (CMC) joint osteoarthritis is a painful and disabling disorder which
has variable sign and symptoms with complex x-ray findings. We try to show influence of ageing to get
radiographic changes with no symptoms.
Materials and methods: 74 hand radiographies were studied in asymptomatic persons for first (CMC)
joint osteoarthritis and marked for metaphyseal cyst, decreased joint line, osteophytes, and subchondral
sclerosis. The age groups were divided to under 20, 20-40, 40-60, and above 60 years old. Statistical analysis
were done with spss, and p-value <0.05.
Results: There were no radiographic signs of first CMC osteoarthritis at the age under 20. One case at
20-40; 3 mild and 1 sever at 40-60; and 3 mild, 4 sever at the age above 60 years old.
Conclusion: radiological signs of first CMC osteoarthritis increase by age (p<0.05) . No finding at fewer
than 20; 6% at 20-40; 30% at 40-60; and 35% at the age above 60 years old. It suggests that the first CMC
joint osteoarthritis is a natural ageing process and needs no further follow up in asymptomatic persons.
Keywords: carpometacarpal joint, radiography, pain

Background: the most important qualification of aviation at flight altitude over tenthousand feet and sub
aquatic seafaring (in all deeps) are the effective oxygen production instruments which have the worthwhile
role in prevention of hypoxia and hyperventilation. These systems were used invention inFirstWorld War and
greatly improved since this century. Informed about this systems and their introduction, function and probable
failures are very necessary.
Material & Methods: This study documents collected based on any books, articles and knowledge about
marine.
Results: Oxygen generator systems produce this gas as a shape of gas, liquid and chemical compounds.
All the oxygen generators consist of two major sources: main source and back up source which help on
emergency situations. Function of this system was based on two methods: automatic and manual operation.
Relative appurtenants such as connecting pips, regulators, air dilution systems and masks have accurate
points depend on their facilities. Best part of their functions are air dilution ability, generation of 100% oxygen,
positive pressure breathing and suitable oxygen temperature.
Conclusion: Progressive development of aviation and seafaring technology and up to date investigations
implicate enough flight and sea crew orientation about oxygen and its equipments for hypoxia and
hyperventilation prevention.
Keywords: Oxygen Production Instruments, Aviation, Seafaring, Hypoxia

Background: Optimal performance in spatial explorations depends on appropriate nutrition. Sufficient
nutrition is the basis of human physiologic activities. Zero gravity leads to physiological changes in astronaut’s
body. If the astronaut has no healthy situation, spatial mission will defeat.
Material & Methods: The article is a collection of data & knowledge regarding to earth atmosphere from
credible & scientific books & articles.
Results: Obtaining of macro & micro nutrition for astronauts is very important & if their foods (because of
anorexia) were not consumed, it has the adverse consequences. Many of reasons detected in association
with astronaut’s anorexia. Various researches show that no rapid stool defecation duo to decrease of energy
reception. Thus, accurate regulation of energy reception & consumption should be necessary.
Conclusion: Research results showed that total energy consumption in the earth & space are equal but
ratio of materials that generate this energy are variable & need to be calculation. This article presented in
aerospace nutrition conference.
Keywords: Nutrition, Energy Metabolism, Astronavigation, Astronauts

سابقه و هدف: بهره مندی از حداکثر کارایی در اکتشافات فضایی و تامین سلامت فضانوردان اساس سفرهای فضایی است. در
طول سفر وجود پرتو های یونیزان و امواج دارای فرکانس پایین الکترومغناطیسی که حتی با وجود پوشش های قوی سفینه به داخل
موجود در بدن آسیب می زند. DNA نفوذ می کند، موجب شکست آب و تولید رادیکال های آزاد شده که به چربی ها، پروتئین ها و
در پروازهای فضایی عوامل استرس زای متعدد دیگری نیز وجود دارد که سیستم دفاعی بدن را تحت تاثیر قرار می دهد.
مواد و روش ها: مطالعه حاضر مشتمل بر اطلاعات جمع آوری شده از مجموعه کتب و مقالات معتبر موجود در زمینه تغذیه
هوایی است.
یافته ها: استرس اکسیداتیو و تخریب اکسیداتیو در فضا یک مشکل با راه حل ساده نیست. مطالعات دانشمندان نشان داد در زمان
بازگشت به زمین پراکسیداسیون چربی در غشاء اریتروسیت ها افزایش می یابد و غلظت آنتی اکسیدان های خون کاهش می یابد که
حاصل افزایش استرس اکسیداتیو، تغییر دفاع آنزیماتیک و غیر آنزیماتیک بدن و کمبود دریافت انرژی در فضا است.
بحث و نتیجه گیری: با توجه به استرس های متعدد مکانیکی، شیمیایی، فیزیکی وغیره تغییرات گسترده ای در قسمت های مختلف
بدن از جمله افزایش استرس اکسیداتیو ها و تغییرات ایمونولوژیک رخ می دهد که در راستای کاهش اثرات زیان بار حاصله استفاده
از انواع آنتی اکسیدان ها در رژیم غذایی فضانوردان ضروری به نظر می رسد.
کلمات کلیدی: آنتی اکسیدان ها، استرس، سفر های فضایی، فضانوردان

Due to the increasing prevalence of air travel around the world, it is possible to spread contagious infectious diseases from endemic areas to other areas. Of course, this can be largely prevented by raising the level of public health and awareness. Also, with the ease of air travel and the aging of communities, the number of elderly travelers with concomitant illnesses will increase, which will increase the mortality and morbidity associated with the spread of communicable infectious diseases. Stricter hygiene protocols implemented on airlines and proper design of modern aircraft can greatly reduce the transmission of contagious diseases. Our purpose in presenting this article was to formulate appropriate guidelines for experts and authorities to inform and provide best practices when dealing with an influenza epidemic.
Keywords: Communicable Diseases, Aviation, Influenzas

Background: Since aerospace and oceans have been captured, the most important concerns were
unfamiliarity with hazards of entering into unknown environments. From anatomical and physiological point
of view, human body compatible with living on the earth. Thus human survival at other conditions necessitous
specific equipment’s. Identification of those hazards and how to prevent and cure was the purpose of this
article.
Materials and Methods: This review article is a collection of data and knowledge regard to earth
atmosphere from credible and scientific books and articles.
Results: Tooth pain following barometric pressure changes, named barodontalgia. Military air and naval
forces due to face agile maneuvers and special conditions are high-risk population. Three pathophysiological
hypotheses suggested: 1.Inflamatory, 2.Gas embolism, and 3.Trapped air. Pain often occur suddenly and
unpredictable. Patient profile, clinical examination and paraclinical procedures help to make net diagnosis.
Oral hygiene and periodical dental examinations of high-risk population are critical prevention methods.
Conclusions: Barodontalgia is rather rare but its emersion on complicated (critical) air and naval task
forces can lead to human and equipment hazards. Therefore, sufficient attention in prevention and creation
of optimal conditions for researches will be valuable.
Keywords: Aerospace medicine, Barotrauma, Toothache, Prevention & Control.

Background: Since 1850, as the first time, DCS have been detected in divers and pitmen .There were
no appropriate explanation for this Illness until 1930. Other names such as Bend, Aeropathy, Aeroembolism,
Dysbarism ، DCI/DCS were used. At the ascend to height, most of the problems which occur due to changing
the pressure of the body cavities. The goal of this presentation is collection of the abstract and sufficient
information for use our colleagues.
Results: The major adventures were happen in DCS is based on henry’s law and consist of any hazardous
would be occur in result of every soluble gas molecules egress the body’s fluid which nitrogen is one of the
most important of these gases. Obese individuals are more susceptible, because fat tissue have very amount
of nitrogen. DCS have different features and net diagnoses were possible by rule out of other diseases. The
etiology of this sickness is the sudden reduction in barometric pressure and the release of soluble gases in
body fluids.
The pathophysiology of this sickness is consist of three different mechanisms which result in tissue
damage: 1) destruction of tissue cells by released gases, 2) mechanical obstruction of blood vessels and
3) pressing effect of bubbles or emboli’s on adjacent vessels and nerves.
Conclusion: Because of the daily development of aviation and seafaring, inform about DCS and its
complications, prevention and treatment for all population especially aviators, divers and medical groups are
necessary.
Keywords: Decompression, Aviation, Decompression Sickness

مقدمه : واریسلا زوستر پاتوژن انحصاری انسان است ، عفونت اولیه بطور تی پیک در دوران کودکی رخ می دهد و باعث
واریسلا می گردد . همانند سایر اعضاء خانواده هرپس ویروس ها در دوره نهفتگی عفونی نیست، اما می تواند در مدت زمان
دیرتر فعال شود و از طریق آکسون ها به پوست مهاجرت نماید و از سلولی به سلول دیگر گسترش یافته و در اپیدرم نفوذ
نماید.
معرفی بیمار : در این مطالعه زنی 72 ساله با سابقه دیابت و هیپرتانسیون گزارش می شود که بعلت احتباس ادراری همراه با
ضعف پارستزی اندام تح تانی راست و اختلال حرکتی بستری م ی شود . مشکلات بیمار همراه با بروز ضایعات وزیکولر اولسره
با تشخیص رادیکوپاتی التهابی انجام شد که با L.P . یکطرفه درناحیه ساکرال بود که به کپل و قسمت خارجی واژن انتشار داشت
توجه به تشخیص مننژیت آسپتیک بیمار تحت درمان با آسیکلوویر و پردنیزولون قرار گرفت و با حال عمومی خوب و بر طرف
شدن کلیه علایم مرخص شد.
نتیجه نهایی : یکی از عوارض زوستر ضعف حرکتی در اعصاب غیر کرانیال است که تحت عنوان زوستر پارزی نامیده می شود
ضعف بطور ناگهانی در مدت 2 تا 3 هفته پس از شروع راش پیشرفت می کند و باعث درگیری انتهاها می گردد . در بیمار ما نیز
3 هفت ه پس از شروع راش عوارض عصبی بروز کرد . توصیه می شود در بیمارانی که با علایم پارزی همراه با احساس گزگز
(پارستزی) مراجعه می کنند معاینه از نظر ضایعات پوستی انجام گیرد.
کلید واژه ها : پارزی / دیابت شیرین / ویروس واریسلا زوستر

Background: The sea similar of other earth environments have very different animals that life in them and
any of that living beings have special characters. Notification about this special characters for all divers were
necessary. Perform successful operation depend on this important and intelligent awareness.
Material & Methods: This study collected based on any books, articles and knowledge be about marin.
Findings: Sea animals divided in two major group: poisonous and non poisonous .Poisonous sea animals
such as sea snake, stone fish, portuguese Man-O” War, chironex and etc use of their toxins for defence. Sign
and symptoms that produced by toxins are vary such erythema, endoration, pain or itching to anaphylactic
shock and death. Contamination by toxins occur on two forms: active and passive. Complete explanation of
this suggestion are reachable at this study.
Conclusions: With pay attention to importance of poisoning prevention and their harmful complications,
be awareness of sea animals characters for divers, swimmers and naval officers were seem necessary.
Keywords: sea animals, toxin, poisoning, divers

Background: Physiologic or behavioral cycles are generated by an internal pacemaker with an oscillatory
frequency of approximately 24. 2 hours which named Circadian Rhythm. This internal pacemaker is locate
at hypothalamus as suprachiasmatic nucleus and it Controls sleep/wake cycle, with wakefulness commonly
promoted during daylight hours and sleep promoted during evening hours. The Aim of This article is
providing a framework for understanding the biological basis of jet lag and for recommending management
strategies. Understanding jet lag can help us address the broader problem of circadian misalignment, which
has increasingly been associated with increased risk for cancer(Colorectal and Breast), metabolic disease,
cardiovascular dysfunction, mood disorders (Depression), and cognitive decline.
Results: Jet Lag usually experienced amongst individuals who traverse at least 2 time zones by
Intercontinental Flights. Symptoms and Signs Usually Occur During 1-2 Days After Arrival In Relation of
circadian system complication and Cause insomnia, sleepiness, general malaise, GI upset (Anorexia,
indigestion and defecation disorders), neural (fatigue, headaches, and irritability) And cognitive impairments
(concentration, judgment and memory disturbance) and …
Eastward travel requires a phase advance and These Persons often complain of initiating sleep at Early
Evening and Awaking at Early Morning. Thus, eastbound travelers have Difficult Adaptation and Worsen
Features rather Than Westbound Travelers. Incidence of Get Lag Often Does Not Reported and so the
Accurate Prevalence is uncertain.
Conclusion: Because Of the Progressive Development of Aviation and Intercontinental Travels, Aware
about Jet Lag and Its Complications, Prevention and Treatment for All Population Especially Aviators and
medical Groups are Necessary.
Keywords: Jet Lag Syndrome; Aviation; Circadian Rhythm

Background: Physiological or behavioral cycles are generated by an internal pacemaker with an oscillatory frequency of approximately
24.2 hours which are named as circadian rhythm. This internal pacemaker is located at hypothalamus as suprachiasmatic nucleus and
control sleep-wake cycle, with wakefulness commonly promoted during daylight hours and sleep promoted during evening hours. Objectives: The aim of this article is to provide a framework for understanding the biological basis of jet lag and recommend management
strategies. Understanding jet lag can help us to address the broader problem of circadian misalignment, which has increasingly been
associated with increased risk of cancer (colorectal and breast), metabolic diseases, cardiovascular dysfunction, mood disorders
(depression), and cognitive decline. Materials and Methods: The current study is a review article based on the literature in the field of aerospace medicine. It is hoped that
this presentation would days useful for those who are interested in aviation medicine. Results: Jet Lag usually experienced by individuals who cross at least 2 time zones by intercontinental flights. Symptoms and signs usually
reveal after 1-2 of arrival in relation with circadian system complication and cause insomnia, sleepiness, general malaise, gastrointestinal
upset (anorexia, indigestion and defecation disorders), neural (fatigue, headaches, and irritability) and cognitive impairments
(concentration, judgment and memory disturbance), etc.
Eastward travel requires an advance phase and these persons often complain about initiating sleep at early evening and being awake at
early morning. Thus, eastbound travelers have difficult adaptation and worsen features rather than westbound travelers. The incidence of
jet lag often has not been reported, so the accurate prevalence is uncertain. Conclusions: Due to the progressive development of aviation and intercontinental travels, the awareness about jet lag and its
complications, prevention and treatment for all population especially aviators and medical groups are necessary.
Keywords: Jet Lag Syndrome; Aviation; Cyrcadian Rhythm

Background: Varicella-zoster (VZV) is an exclusively human pathogen. The primary infection typically occurs during childhood and causes varicella. As other members of the herpes viruses’ family, VZV is noninfectious in its latent form but can reactivate at a later time to form intact virions in the involved sensory neurons. These virions then migrate to the skin through axons, spread from cell to cell, and penetrate the epidermis.
Patient: A 72-year old woman with history of diabetes mellitus and hypertension hospitalized because of urinary retention, weakness and parestesia in right leg complicated with vesiculoulcerative lesions in sacral area with distribution to right buttock and vagina. Lumbar puncture confirmed inflammatory radiculopathy and showed aseptic meningitis. Treatment was commenced with acyclovir and prednisolone. Patient enjoyed healthy life thereafter.
Conclusion: Motor weakness in non-cranial nerve is one of the zoster complications that known as zoster paresis. Weakness begins suddenly 2-3 weeks after rash and progress to extremities. In the present case nerve involvement was detected 3 weeks after rash.
Keywords: Varicella-zoster; Paresis; Diabetes mellitus.

Background: Crush injury of an extremity occurs when a limb is compressed between two hard surfaces,
to the point where vascular supply is impaired and vulnerable tissues undergo necrosis. Most commonly,
limbs are crushed during auto versus pedestrian accidents, motor vehicle crashes, and industrial accidents.
Result: However, during natural disasters such as earthquakes, building collapses, landslides, mine
cave-ins, and acts of war with mass civilian casualties, epidemics of limb crush injuries can occur. The large
number of casualties requiring specialized medical care can easily overwhelm medical systems, particularly
if medical facilities are simultaneously affected by the disaster.
Conclusion: This article reviews the acute management of vascular and soft tissue injuries in the
emergency department .
Keywords: crush injury,compartment syndrome, earthquakes,civilian casualties

Background: Since first human flight, unfamiliarity about atmosphere is the most important concern in
aerospace. Aerospace researchers scrounges cause finding some ambiguities in order to human space
arrival.
Material & Methods: This article is the apercu collection of available data and knowledge in aerospace
and diving medicine.
Results: Earth atmosphere contain five different layers: troposphere, stratosphere, mesosphere,
exosphere, that any of them, from temperature point of view, have specific characteristic. Diameter of
those layers of varies in polar shorter and in equator longer. With increase altitude, oxygen pressure and
concentration were decreased.
Conclusion: Armed forces(air force & navy) successful operations depending on practical knowledge
awareness in relation aerospace and diving medicine for physician, nurses, engineers, divers, athletics
and … . This Article Was Present At The Bandar Abbas Preventive Medicine And Marin Hygiene Congress.
Keywords: Atmosphere, Aviation, Space Research, Athletics

Objective: Diabet is one of the great problems in our age and important goal of cure it , is control of blood
sugar in order to decreas hyperglycemic long time advers effects.Also, lichen planus is a chronic skin disease
with only conservative and long term treatments that happens many cosmetic and pscychiatric problems in
patients.Thus, discover and research about control of diabets type 2 and lichen planus with modern methods
is will of the scientises in all the time.
Report: Patient is a 60 years old man with diabets type 2 and lichen planus that treat with antidiabet oral
drugs and routin lichen planus treatments.But blood sugar and lichen planus not controld.Also patient treated
with luvox 100mg and xanax 0.5 mg in order to anxity disorder and seen lichen planus and diabet controled.
Conclusion: Pay attention to results will hope that stress dependent disorders, such as diabets type 2
and lichen planus, improved by removing stress factor.
Keywords: dibets type 2 , lichen planus , stress , ssri

Background: The most important risk of aviation( in altitude over 10 thousand feet) and sub aquatic
seafaring (in depth exceed over 30 meters) is hyperventilation. The problems manifested itself at first and
especially second world war when pilots flew at altitude over 10 thousand feet. Those pilots had some signs
and symptoms while faced mental and physical stresses that eventuated in aircraft crash.
Material and Methods: This study collected related data from several books, articles and knowledge
about military and civil aviation.
Results: Etiology of hyperventilation is related to stressing (mental and physical problems) such as
ambient changes (temperature, pressure and, etc), face to emergency situations, physiological and mental
changes and, etc. Signs and symptoms were different in everyone this manifestations cause from motor
and sensory impairment, psychomotor, cognitive, neuromuscular, consciousness and death. These risks are
more important in military aviation due to highest performance and in seafaring because stresses in the work.
Conclusion: The astronauts, air crews, sea crews and athletics always have consciousness and higher
performance. Thus informing them about hyperventilation and its complications, prevention and treatment for
population are necessary.
Keywords: Hyperventilation, Aviation, Seafaring, Astronavigation

Introduction: Dysbaric accidents (DA) are usually referred to continuous air-supplied dives. Nonetheless, diving accidents are known to occur also among breath-hold (BH) divers. BH diving accidents include the rare Taravana syndrome (TS) which firstly described by Cross in 1965. He reported professional BH pearl divers in the Tuamoto Archipelago, in the South Pacific. Paulev also Found TS in Danish military personnel previously exposed to pressure during submarine escape training. In the same year, using the U.S Navy no-decompression limits Lanphier calculated the likelihood of developing decompression sickness after repetitive breath-hold dives using specific parameters such as average diving time, depth and surface intervals.
Methods: This article is a review Article, According to all articles, textbooks, guidelines and documentation about Challenges in Military Breath-Hold Diving.
Results: Often called "Taravana" it presents as a complex clinical picture characterized by different combinations of complete or partial neurological disorders as nausea, euphoria, hemiparesis, visual problems, hearing impairment, dysarthria, crossed sensory numbness and minor symptoms such as nausea, dizziness, vertigo, headache and unconsciousness, and even sudden death, after repetitive BH dives with short surface intervals. In some cases the symptoms were sudden, occurring as the divers left the water, whereas in other cases they appeared 1-2 h later, depending on the dive profile. Its predisposing factors are unclear. Although some cases have been reported in the literature, the pathophysiology and the predisposing factors of this syndrome are still unclear. Even if the genesis of these particular TS cases is still doubtful, the inert gas accumulation cannot be excluded. Hyperbaric Oxygen Therapy is the choice treatment for TS.
Conclusion: TS is the critical threat in military BH divers with repetitive shallow water diving during Marine environment conflicts. So, havingenough information and skills for prevention, approach and treatment of TS are mandatory in military divers, military and civil medical crew.
Keywords: Military, Breath-Hold Diving, Taravana Syndrome

Purpose: Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a pressurized chamber or tube. HBOT is a well-established treatment for several diseases such as serious infections, chronic diabetic foot ulcer, radiation injury and hidradenitis suppurativa. There are various troublesome diseases that decrease the quality of life (QOL) in patients. HBOT has excellent effects in improving QOL in patients with the acute and chronic disease. The aim of our study is evaluating the researches, focusing on improving the QOL after HBOT treatments. Methods: Systematic search was conducted for finding English papers (clinical trials) that Published before April 2017. We searched PubMed, Institute of Scientific Information (ISI), SCOPUS, Web of Science, Ovid, Science direct, ProQuest, Wiley, Cochran, Ebsco host, Google Scholar. The JAMA users guide assessment scales for clinical trials was used to evaluate the quality of included articles. Inclusion Criteria and Exclusion Criteria extracted according to the scientific criteria. The sample size was 806 patients.Results: Finally, 15 published articles extracted. Mean age in HBOT group was 41.88 with male/female 1.52. Mean age in the control group was 38.29 with male/female 2.14. The most frequent clinical trials were for treatment of diabetic foot ulcer (20%), post-concussion syndrome
(13.3%), and pelvic radiotherapy (13.3%), chronic arm lymphedema after radiotherapy (13.3%). The most QOL questionnaires used were SF-36 (21.4%), EORTC (European Organization for Research and Treatment of Cancer) QLQ-C30, Head & Neck Cancer Module (H&N35) and Performance Status Scale (PSS).Conclusions: There was dramatically effect of HBOT in improvement QOL in symptoms and patients' outcomes compared with control groups. We found improved QOL in patients with a diabetic foot ulcer, post-concussion syndrome, pelvic radiotherapy, post-stroke, hidradenitis suppurativa, tonsillar fossa tumour radiotherapy, jaw osteonecrosis and Fibromyalgia syndrome. We suggest that HBOT must accompany as an adjuvant to conventional treatment of these patients.
Keywords: Hyperbaric Oxygen Therapy, Quality of life, Clinical trial

Purpose: Microgravity causes major changes in various systems of the body in space, such as a shift in cerebrospinal fluid, decreased red blood cells count, and electrolyte loss. These complications are very important in space and we should find new approaches to prevent the side effects of microgravity in astronauts.
Materials and Methods: This experimental study was conducted on 21 adult male rats in three groups: control, Hind-limb unloaded, Hind-limb unloaded plus Erythropoietin. SPSS software was used for data analysis. RBC indices were assessed in the first, third and fourteenth day in different groups.
Results: The highest mean of haemoglobin was 17.98 ± .35 in the Hind-limb unloaded plus Erythropoietin group (on the 3rd day) and the lowest amount was 13.52 ± 1.22 in the Hind-limb unloaded group (on the 14th day). The P value to compare RBC and reticulocyte count in Hindlimb unloaded group with those in Hind-limb unloaded plus Erythropoietin group was .017 (on the3rd day), to compare hemoglobin in Hind-limb unloaded group with that in Hind-limb unloaded plus Erythropoietin group was 0.004 (on the 3rd day), and to compare reticulocyte values in Hind-limb unloaded group with those of Hind-limb unloaded plus Erythropoietin group was 0.036 (on the 14th day).
Conclusion: The lowest amount of RBC indices was in the Hind-limb unloaded group (on the 14th day). RBC indices were significantly higher in Hind-limb unloaded plus Erythropoietin group than those on the 1st day. Erythropoietin injection induced significant improvement in RBCindices in rats under microgravity condition. Erythropoietin is very useful to prevent space anemia and its highest effect occurs on the 3rd day after injection. This is as an innovative method to prevent space anemia.
Keywords: microgravity, anemia, erythropoietin.

Introduction: These days, dentistry experiences accelerate and extraordinary evolution, especially in aviation field. It has two significant roles in aerospace medicine. First, a careful periodic examination of the oral cavity and, if necessary, a proper treatment is very important for the oral health and so the overall wellness of military aircrew. Second, aviation regulations in the field of dentistry often are the guidelines in identification of pilot’s bodies and other fatalities after air accidents. We want to introduce aviation dentistry to young flight physicians. Methods: This article is resulted from the review of references, aviation regulations and reliable scientific articles regarding to the role of dentistry in aerospace medicine.
Results: Various military and civil references and authorities have pointed to the key role of oral health in military aircrew. Providing a precise dental record (at least one OPG) is important in appropriate oral diagnosis, treatment planning and communication between dentists, aerospace physicians and forensic physicians. Dental materials used for these people should have minimum changes against atmospheric pressure fluctuations and sustained gravitational forces, otherwise, they may encounter different complications including barodontalgia. It is also important to observe the interval between dental procedures and flight to prevent possible problems. Due to their occupational sensitivity, the possibility of developing stress-related problems such as bruxism and some oral lesions including recurrent aphthous stomatitis and herpetic infection is increased. Forensic dentistry in identification of aircrew bodies is a fraction of the cost and also much faster compared to DNA identification.
Conclusion: Dentistry can play a substantial role in modern military aviation. It is very important to pay attention to oral health of military aircrew because of their occupational sensitivity. Therefore, close relationship between dentists and aerospace medicine physicians and making necessary consultations is essential.Keywords: Barodontalgia, Bruxism, Dentistry, Herpetic Infection, Military Aircrew, Recurrent Aphthous Stomatitis

Introduction: Telehealth can be used to telecommunication technologies to provide health-related information and information for support of patient care, office activities and health education, which today is a key component of multimodal strategies to improve health services delivery in developed countries. Telehealth is considered as a means to improve access to care by reducing transportation costs and increasing patient comfort in obtaining care. These points have particular importance in the modern wars.
Methods: This article is based on Internet search using the term telehealth, modern Wars, new threats, and related phrases.
Findings: The main importance of telehealth is to improve patient health and reduce mortality. Military forces must be rehabilitated as quickly as possible and regain their efficiency and, in the course of such a process, incur less harm, especially physically. When they are able to have access to better medical care, they can receive medical care and treatment before they become critical in their acute conditions and in the wake of modern wars and manage them with a better health care. This method is an appropriate option to support people under their supervision in the event of sudden occurrences. Telehealth can help care for injuries in accident areas, even in the long run.
Discussion and Conclusion: There is good evidence of telehealth assistance as an effective clinical intervention for some conditions, including patients with COPD, diabetes and heart failure. Telehealth in modern wars can improve the quality of life and care of injured people. This method can be effective in the early diagnosis of medical problems and early onset of therapeutic interventions within a short time after the occurrence of an accident. Telehealth may potentially improve treatment outcomes in such cases and reduce the cost of treatment. It seems that telehealth for many physicians and authorities is acceptable.
Keywords: Telehealth, Modern Wars, Health, New Threats

مقدمه: از زمان تسخیر هوا، فضا و دریا ها، یکی از مهم ترین نگرانیها عدم آشنایی با مخاطرات ورود به محیطهای نامتعارف بوده
است. بدن انسان از نظر آناتومی و فیزیولوژی، جهت زیست در خشکیهای سطح زمین تطابق یافته است و ادامه حیات در سایر محیطها
نیازمند ایجاد تغییرات و استفاده از امکانات ویژه ای می باشد. شناخت این مخاطرات و چگونگی مقابله و پیشگیری از آن، از ابتدای قرن
گذشته سرلوحه تحقیقات پژوهشگران قرار گرفته است.
روش بررسی: مقاله حاضر حاصل مجموعه اطلاعات و داده های گردآوری شده در خصوص جو کره زمین از کتب و مقالات علمی
معتبر موجود در این زمینه می باشد.
یافته ها: درد و حساسیت دندانی به دنبال تغییر فشار بارومتریک را "بارودنتالژیا" می نامند. پرسنل هوایی و دریایی نظامی به دلیل
مواجهه با مانورهای سریع، وضعیتهای خاص و شرایط نامتعارف، گروه پرخطر محسوب می شوند. سه تئوری در توجیه پاتوفیزیولوژی
این بیماری ارائه گردیده است: تئوری التهابی، آمبولی گازی و هوای محبوس. درد اغلب به صورت ناگهانی شروع شده و شدت آن قابل
پیش بینی نیست. اخذ تاریخچه بیماری، معاینات بالینی واستفاده از روشهای پاراکلینیک به تثبیت تشخیص کمک می نماید. حفظ
بهداشت دهان و معاینات مکرر دندانپزشکی گروه پرخطر در پیشگیری از این بیماری، بسیار مهم است.
بحث و نتیجه گیری: بارودنتالژیا نسبتا نادر است اما وقوع آن طی ماموریتهای حساس و پیچیده می تواند موجب به خطر افتادن
سلامت پرسنل پروازی و دریایی و در نتیجه انهدام تجهیزات و شکست عملیات شود. لذا دقت کافی در پیشگیری و ایجاد شرایط
مطلوب و بستر مناسب جهت انجام تحقیقات در این زمینه بسیار ارزشمند خواهد بود.
کلمات کلیدی: بارودنتالژیا، هوانوردی، فضانوردی، دریانوردی

سابقه و هدف: بهره مندی از حداکثر کارایی در اکتشافات فضایی و تامین سلامت فضانوردان اساس سفرهای فضایی است. در
طول سفر وجود پرتو های یونیزان و امواج دارای فرکانس پایین الکترومغناطیسی که حتی با وجود پوشش های قوی سفینه بداخل
نفوذ می کند، موجب شکست آب و تولید رادیکال های آزاد شده که به چربی ها، پروتئی نها و DNA موجود در بدن آسیب می زند. در
پروازهای فضایی عوامل استرس زای متعدد دیگری نیز وجود دارد که سیستم دفاعی بدن را تحت تاثیر قرار م یدهد.
روش بررسی: مطالعه حاضر مشتمل بر اطلاعات جمع آوری شده از مجموعه کتب و مقالات معتبر موجود در زمینه تغذیه هوایی است.
یافته ها: استرس اکسیداتیو و تخریب اکسیداتیو در فضا یک مشگل با راه حل ساده نیست. مطالعات دانشمندان نشان داد در زمان
بازگشت به زمین پراکسیداسیون چربی در غشاء اریتروسی تها افزایش می یابد و غلظت آنتی اکسیدا نهای خون کاهش می یابد که
حاصل افزایش استرس اکسیداتیو، تغییر دفاع آنزیماتیک و غیر آنزیماتیک بدن و کمبود دریافت انرژی در فضا است.
بحث و نتیجه گیری: نتایج بررسی های صورت گرفته در زمینه اهمیت دریافت آنتی اکسیدا نها در سفرهای فضایی نشان داد که با
توجه به استر سهای متعدد مکانیکی، شیمیایی، فیزیکی و... تغییرات گسترده ای در قسم تهای مختلف بدن از جمله افزایش استرس
اکسیداتی وها و تغییرات ایمونولوژیک رخ م یدهد که در راستای کاهش اثرات زیان بار حاصله استفاده از انواع آنتی اکسیدا نها در رژیم
غذایی فضانوردان ضروری به نظر می رسد.
کلمات کلیدی: آنتی اکسیدان ها، استرس، سفر های فضایی، فضانوردان

سابقه و هدف: حداکثر کارایی در اکتشافات فضایی به تغذیه مناسب وابسته است.تغذیه مناسب پایه حفظ کلیه فعالیت های
فیزیولوژیک بدن است. ب یوزنی موجب تغییرات فیزیولوژیک در بدن فضانورد م یشود به علاوه باید دانست شرایط محیطی موجود
در فضا از قبیل تشعشعات، مخاطراتی را برای بدن فضانورد بوجود می آورد.در صورتی که فضانوردان در شرایط سلامت کامل نباشند
موفقیت سفر به مخاطره م یافتد و توانایی برای تحمل فضای خارج از جو کاهش می یابد.
روش بررسی: مطالعه حاضر مشتمل بر اطلاعات جمع آوری شده از مجموعه کتب و مقالات معتبر موجود در زمینه تغذیه هوایی است.
یافته ها: فراهم آوردن درشت مغذ یها و ریز مغذی های مورد نیاز فضانوردان در مواد غذایی مصرفی آنها نکته مهمی است و اگر
غذای تهیه شده برای فضانورد بدلیل بی اشتهایی و آنورکسیامصرف نشود عواقب نامطلوبی بدنبال دارد که توجه کافی برای رفع آن
ضروری است. عوامل متعددی زمینه ساز وضعیت بی اشتهایی در فضا است. تحقیقات روشن ساخته است، کاهش دریافت در اکتشافات
فضایی بدلیل عدم تخلیه سریع مواد دفعی حاصل شده از فعالیت فیزیکی از بدن افراد است. از این رو تنظیم دقیق دریافت و مصرف
انرژی فضانوردان بسیار اهمیت دارد.
بحث و نتیجه گیری: نتایج بررسی های صورت گرفته در زمینه مقایسه انرژی مصرفی در زمین و فضا و تعیین انرژی مورد نیاز
فضانوردان نشان داد که میزان انرژی مصرفی کل پیش از سفر و در طول سفر تفاوت چندانی ندارد ولی نسبت مواد اولیه تولید کننده
انرژی در بدن و انرژی صرف شده در فعالیت های فیزیکی با شرایط زمین متفاوت است و نیازمند محاسبه دقیق است.
کلمات کلیدی: تغذیه، متابولیسم انرژی، سفر فضایی، فضانوردان.

سابقه و هدف: دریا همچون سایر زیستگاه های کره زمین ماءمن طیف وسیعی از جانداران با خصوصیات و ویژگ یهای منحصر بفرد
می باشد.آشنایی با این خصائص از اصول اولیه فعالیت گروههای دریایی بویژه غواصان است.ضمن ورود به محدوده زیست هر جاندار
آگاهی از مشکلات احتمالی حائز اهمیت بوده و نقش مهمی در اجرای موفق ماموریت های محوله و حفظ سلامت نیروها ایفا می نماید.
روش بررسی: مطالعه حاضر مشتمل بر اطلاعات جمع آوری شده از مجموعه کتب و مقالات معتبر موجود در زمینه علوم دریایی است.
یافته ها: جانداران دریایی به دو دسته عمده سمی و غیرسمی تقسیم م یگردند.جانداران سمی مانند مار دریایی، سفره ماهی،
سنگ ماهی، کیسه تنان همچون عروس دریایی و فیسالیافیسالیس )جنگجوی پرتقالی(، چیرونکس )زنبور دریایی(، صدف مخروطی،
توتیا و اختاپوس حلقه آبی برای دفاع در برابر دشمنان خود از توکسین های منحصر بفردی استفاده م یکنند که با توجه به ماهیت،
میزان، ترکیب شیمیایی و مکانیسم عمل توکسین در بدن انسان و وضعیت فیزیولوژیکی قربانی علائم بسیار متنوعی ایجاد م یکنند.
نشانه ها و علائم طیف وسیعی داشته و می تواند بصورت یک واکنش آلرژیک ساده با تابلوی بالینی اریتم، التهاب، اندوراسیون، سوزش
و خارش تا واکنش آنافیلاکتیک و مرگ باشد.آلودگی قربانی با توکسین می تواند بصورت فعال )در قالب واکنش تهاجمی جاندار( یا
بصورت غیر فعال )تصادفی( باشد.اکثر موارد تصادفی بدلیل عدم شناخت کافی فرد از مخاطرات جاندار دریایی حادث م یگردد.پس
لازم است راه های پیشگیری و درمان موارد احتمالی مسمومیت همواره مد نظر پرسنل درمانی باشد.شرح مبثوت مطالب فوق الذکر
در مقاله قابل دسترسی می باشد.
بحث و نتیجه گیری: با عنایت به اهمیت پیشگیری از مسمومی تهای ناشی از گزیدگی فعال و غیر فعال جانداران آبزی و عواقب
خطرناک آن، اطلاع از ویژگ یهای زیستی آنان و بکارگیری دستورالعمل های حفاظتی و بهداشتی برای گرو ههای دریانوردی خصوصا
غواصان ضرورری بنظر می رسد. همچنین آگاهی از ماهیت توکسین ها، مکانیسم عمل آنها در بدن انسان، فیزیولوژی زیرسطحی،
پیشگیری و درمان مصدومین از اهم مطالبی است که باید مد نظر کادر بهداشت و درمان نیروی دریایی )پزشکان، پرستاران و پزشکیاران
و...( قرار گیرد.
کلمات کلیدی: جانداران دریایی، توکسین، مسمومیت، غواصان

سابقه و هدف: از زمان اولین پرواز بشر یکی از مهم ترین نگرانی ها در زمینه هوا و فضا نوردی نا آشنایی با ماهیت جو پوشاننده
اطراف کره زمین بوده است. تلا شهای ب یبدیل و خستگی ناپذیر محققین علوم هوایی و فضایی سبب شد تا ابهامات موجود در این
خصوص به شکل چشمگیری مرتفع شود، چرا که ورود انسان در یک محیط ناشناخته و پر مخاطره واجد چنین آگاهی هایی می باشد.
روش بررسی: مقاله حاضر حاصل مجموعه اطلاعات و داده های گرد آوری شده در خصوص جو کره زمین از کتب معتبر موجود
در این زمینه می باشد.
یافته ها: اتمسفر زمین از مجموع 5 لایه مختلف تشکیل شده که هر لایه دارای ویژگی های خاصی بوده و بر اساس پارامتر دما به
ترتیب )از سطح دریا( شامل تروپوسفر، استراتوسفر )ازنسفر(، مزوسفر، ترموسفر )یونسفر( و اگزوسفر می باشد.این لایه های فرضی از
نظر دما، فشار، میزان بخار آب و... تفاوت دارند.ضخامت اتمسفر )بدلیل اختلاف دما( در نقاط مختلف کره زمین متفاوت است.با صعود
به ارتفاع کاهش رقت، فشار و غلظت اکسیژن رخ م یدهد.در استوا ضخیمتر و در قطبین نازکتر است.
بحث و نتیجه گیری: فعالیت همزمان و هماهنگ نیروی هوایی و بخش هوایی نیروی دریایی در کنار نیروهای سطحی و زیرسطحی
جهت انجام موفق کلیه عملیات های محوله نیروی دریایی ضروری است. لذا اطلاع کافی از ویژگی های مهم اتمسفر برای خلبانان،
ملوانان، مهندسین و پزشکان هوا فضا و زیر سطحی، پرستاران و امداد گران هوایی و دریایی و ورزشکاران ضروری بنظر می رسد.
کلمات کلیدی: اتمسفر، هوانوردی، فضا نوردی، ورزشکاران.

سابقه و هدف: گاز اکسیژن در نیمه دوم قرن هجدهم توسط "لاوازیه" کشف شد و اولین بار "پریستلی" در سال 1775 میلادی
مطرح کرد که ممکن است دارای عوارض جانبی باشد. "پل برت" در کتاب خود عنوان کرد که این گاز در فشار های بالا کشنده است.
عوارض عصبی مرتبط با مسمومیت اکسیژن تحت عنوان "اثر پل برت" نام گرفت.
در سال 1889 میلادی "لورین اسمیت" دریافت که موش قرار گرفته در معرض اکسیژن 75 درصد دچار پنومونی گشته )عوارض
ریوی( و تلف شده است. لذا عوارض ریوی مرتبط با اکسیژن "اثر لورین اسمیت" خوانده شد.
روش بررسی: این مقاله حاصل مجموعه اطلاعات مدون در زمینه هیپرونتیلاسیون ماهیت و چگونگی ایجاد، پیشگیری و مقابله
با آن و اثرات مخرب آن از کتب معتبر موجود در این زمینه می باشد.
یافته ها: اتیولوژی مسمومیت با اکسیژن به طور قطعی مشخص نیست اما بیماری به دلیل تنفس اکسیژن با فشار قسمتی بالا
ایجاد می شود.در خصوص مسمومیت با دی اکسیدکربن علت افزایش میزان گاز CO2 در مخلوط تنفسی است.در مورد فیزیوپاتولوژی
مسمومیت با اکسیژن دو فرضیه قابل قبول در زمینه آسیب سلولی/بافتی در بدن مطرح شده است: 1- فشار اکسیژن خون شریانی
افزایش یافته و ضمن واکنش با برخی فلزات و تشکیل سوپراکسید به باندهای دوگانه که در بسیاری از سیستم های آلی مانند اسید های
غیر اشباع وجود دارد حمله ور می شوند. 2- با افزایش محتوای اکسیژن خون میزان رادیکال های آزاد افزایش یافته و به ساختار های
سلولی چون DNA صدمه وارد م یکنند.
بحث و نتیجه گیری: بر خلاف تصور همگانی گاز اکسیژن یک ماده کامل ب یضرر نبوده و مسمومیت با آن عواقب سوءی به دنبال
دارد. به دلیل گسترش روز افزون دریانوردی )غواصی( نظامی و غیرنظامی لزوم اطلاع کافی در خصوص علائم، تشخیص سریع، برخورد
لازم و پیشگیری مناسب این بیماری برای کلیه گروه ها خصوصا دریانوردان، غواصان و گروه پزشکی و درمانی ضروری به نظر می رسد.
کلمات کلیدی: هیپرونتیلاسیون، هوانوردی، دریانوردی، فضانوردی.

متر( هایپرونتیلاسیون است که منجر به مشکلات و خطرات جدی م یشود.اولین مشکلات زمانی حادث شد که طی جن گهای
جهانی اول و خصوصا دوم هنگامی که خلبانان در ارتفاع بالاتر از 10 هزار پا پرواز م یکردند ضمن برخورد با استر سهای جسمی و
روانی دچار عوارض و نشانه هایی شدند که گاهی منجر به سقوط پرنده و مرگ آنان می شد.
روش بررسی: این مقاله حاصل مجموعه اطلاعات مدون در زمینه هایپرونتیلاسیون ماهیت و چگونگی ایجاد، پیشگیری و مقابله
با آن و اثرات مخرب آن از کتب معتبر موجود در این زمینه می باشد.
یافته ها: علت ایجاد هایپرونتیلاسیون ایجاد هر نوع استرس اعم از جسمی و روانی است که از آن جمله م یتوان به تغییرات محیطی
)دما، فشار و...(، برخورد با شرایط اضطراری، تغییرات فیزیولوژیکی، تغییرات سایکولوژیکی و غیره اشاره نمود.علائم و نشانه های آن
به اشکال مختلفی ظاهر م یشود که در تمام افراد متفاوت است.این علائم شامل اختلالات حسی و حرکتی، سایکوموتور، شناختی،
نورو ماسکولار، هوشیاری و مرگ می باشد.مخاطرات مذکور در هوانوردی نظامی بدلیل عملکرد اجرایی بالاتر و دریانوردی سطحی،
زیرسطحی بدلیل استرسورهای متنوع دارای اهمیت است.
بحث و نتیجه گیری: آنجا که گرو ههای فضایی )فضانوردان(، گروه های پروازی )خلبانان(، گروه های دریایی )غواصان( و ورزشکاران
همواره باید در طول فعالیت خود واجد هوشیاری و کارکرد کامل باشند )خصوصا در حیطه نظامی(. لذا شناخت هایپرونتیلاسیون، عوارض،
پیشگیری و درمان آن برای جمعیت هدف حائز اهمیت انکار ناپذیری است که ضامن اجرای امن و موفق هر فعالیت یا عملیات می باشد.
کلمات کلیدی: هایپرونتیلاسیون، هوانوردی، دریانوردی، فضانوردی.

مدت زمان اندکی تا فارغ التحصیلی اولین گروه از دستیاران باقی مانده است. جامعه با متخصصینی روبرو خواهد شد که آشنایی
چندانی با تواناییهای آنها ندارد و در پاره ای موارد حتی نامانوس به نظر می رسد. پیامدهای مورد انتظار از دانش آموختگان این رشته
می توانند موارد ذیل باشند:
اقدام برابر موازین پزشکی در انتخاب افراد واجد شرایط برای انجام خدمت در محیطهای خاص )با توجه به معلومات کسب شده(.
برقراری ارتباط مناسب با نیروهای مسلح که در محیطهای غیرعادی قرار م یگیرند )همچنین با افراد تیم سلامت(.
گردآوری و ثبت اطلاعات بالینی لازم با اخذ شرح حال تخصصی، ارزیابی و معاینه خدمت گیرندگان.
تکمیل و ثبت اطلاعات بالینی مددجویان با در خواست یا انجام آزمایشهای پاراکلینیکی و پروسیجرهای تشخیصی.
تشخیص بیماری، اختلال و یا حالت غیرطبیعی در مددجویان با تفسیر آزمایشات، ادغام و تجزیه و تحلیل یافته ها، پس از استدلال
بالینی.
انتخاب رویکرد مناسب و انجام اقدامات درمانی لازم )اعم از درمانهای طبی، جراحی )در شرایط خاص( تسکینی و یا حمایتی برای
مددجویان.
آموزش افراد در تمام سطوح )در حیطه تخصصی(.
ارایه مشاوره در صورت نیاز در مورد درخواستی و انجام وظیفه به عنوان مشاور درمانی و بازتوانی.
پایش و نظارت سلامت کارکنان شاغل در حرف ذکر شده و خانواده های ذیربط با استفاده از شیو ههای علمی.
هدایت و نظارت مقابله با بحرانهای رزمی و غیررزمی و بلایای عمومی طبق هماهنگی با ارگانهای ذیربط.
ارزیابی حرفه ای سوانح و حوادث هوایی و دریایی.
تلاش در زمینه به روز نگه داشتن دانش و مهارت در علوم طب هوا و فضا و دریا.
کلمات کلیدی: طب هوافضا و زیرسطحی، متخصص، پیامد.

مقدمه: مسئولیت های شغلی ارتباط مستقیمی با استرس دارد. هنگام وارد شدن استرس، بدن واکنش هایی از خود نشان م یدهد
تا تعادل از دست رفته را باز گرداند. بسیاری از شغل های امروزی فشار روانی را با خود دارد.
روش بررسی: هدف از این مطالعه بررسی میان مسئولیت های شغلی و بیماری های قلبی بر اساس آخرین مطالعات 13 موسسه
تحقیقاتی اروپایی که بر روی 200000 نفر انجام شده است. بر اساس این مطالعه افراد به دو گروه دارای استرس و بدون استرس شغلی
تقسیم شدند. نتایج نشان داد استرس شغلی ارتباط مستقیمی با حمله قلبی دارد. کسانی که مشاغل پرمسئولیت دارند 23 % بیش از
سایرین دچار سکته قلبی می شوند و درصد ابتلای آنها به بیماریهای قلبی هم افزایش می یابد. البته خطر شغل پرمسئولیت به اندازه
خطرات ناشی از سیگار کشیدن و ورزش نکردن نیست. کسانی که به مشاغل حرفه ای و تخصصی مشغولند بیش از سایرین در معرض
خطر هستند؛ در این میان کسانی که رده شغلی پایین تر دارنودر تصمیم گیری ها دستشان باز نیست و اختیار چندانی ندارند بیشتر
در معرض خطر هستند.آزادی عمل و قدرت تصمیم گیری در کاهش بیماری های قلبی موثر است.
بحث و نتیجه گیری: به نظر می رسد نظامیان با توجه به مسئولیت سنگین و در رده های پایین تر عدم اختیار در تصمیم گیری
بیش از سایرین در معرض بیمار یهای قلبی باشند که نیازمند مطالعه است.رژیم غذایی درست، ورزش کردن وترک سیگار می تواند
سپر دفاعی خوبی در برابر استر سهای شغلی باشد.
کلمات کلیدی: مسئولیت شغلی - استرس – بیماری های قلبی

Introduction: Decompression Sickness Was Found
on 1850 in Mine Workers & Divers Who Worked by
Compressed Air. It Named Dysbarism, Aeroembolism,
Aeropathy, Bends & DCS/DCI. The Major Problem
During Ascent is About Gas Volume Changes in
Body Chambers After Ambient Pressure Changes.
Methods: This is a Review Article Based on The
Information Have Been Collected as The Complex
of Text Books & Articles in About Marine Sciences.
We Try to Introduce & Display Critical & Clinical
Information with Trust sheep & Affiliation.
Findings: Doppler Sonographic & Echocardiography
Are Good Devices for Bobble Formation Assessment
after Exposure to High Ambient Pressure & Can be
Useful in Evaluation of DCS Happen. However, this
is Necessary That Methods & Time Intervals Should
be Standardized Due to Their Findings Would be
Comparable. These Days Medical Stuffs Want toReduce The Assessment Numbers Which Caused to
Missed Some Cases.
In This 15 Years Research, The Data of Many
Doppler Assessments, 30 & 60 Minutes After Diving,
Were Collected & Their Impresses on Diagnosis of
VGE Incidence & Peak Time Were Assessed. VGE
Development is Very Vary in These Divers & Dives.
Discussion & Conclusion: Due to Daily Improvement
of Seafaring & Diving, Sufficient Warns in About VGE
Assessment Will be Necessary for Medical Teams.
Based on The Ultrasonic Assessment, This Appear
That Doppler Assessments at 30, 60 & 90 Minutes
After Diving Will Not Express a Good Explanation in
About VGA Progression. So, Propose That the Times
& Intervals of Assessments Would be Increased.
Keywords: Decompression, Diving, VGE, Doppler

Introduction: Cortisol is one of The Stress Hormones
& Secrets in Critical Condition, Such as Survival in
Unusual Circumstances, in Paralleled of Sympathic
Stimulation in Fasiculata Area from Cortex of Adrenal
Gland. More ever, This Hormone is Insulin Contour
Regulator & Has Important Role in Plasma Glucose
Regulation.
Material & Methods: This is a Review Article Based
on The Information Have Been Collected as The
Complex of Text Books & Articles in About Marine
Sciences. We Try to Introduce & Display Critical &
Clinical Information with Trust sheep & Affiliation.
Findings: Hypercortisolism is a Chronic Condition
That Occur Due to Disorder in Maintenance of
Physiological Level of Plasma Cortisol. Chronic
Stresses & Disomnia Are The 2 Important Reasons
Which Produce This Condition & Both of Them AreFind Plentifully on Underwater Buoyant Vehicles.
This Condition is Usually Undetected & With Slow
Progression in Personnel Provides a Complex of
Psychosomatic Features For Them, Such as Over
Weight, Weakness, Malaise, Decrease of Libido,
Osteoprosis, Depression & … .
Discussion & Conclusion: Due to Daily Progression
on Seafaring & Diving, Adequate Awareness about
Job Hazards on Underwater Buoyant Vehicles is
Necessary for Medical Groups. For Many Years,
Health Strategy is based on Prevention, So in Order
to Prevention of Mental & Physical Disorder Caused
by Increase in Plasma Cortisol, Target Population
Should be Assessed Periodically & in Parallel Increase
Should be Avoided.
Keywords: Cortisol, Stress, Depression, Disomnia

Introduction: Oral and dental diseases are those cases
that can be problematic for submarine personnel and
divers (especially scuba divers). Numerous studies
have been conducted on oral and dental problems in
these people in which, the cases such as barodontalgia,
tooth fractures, decrease of denture retention, …
caused by changes in barometric pressure have been
mentioned.
Due to the job sensitivity of submarine personneland divers, it is very important to pay attention
to effective tips in the prevention of their oral and
dental potential problems. The objective of this study
is to assess these problems and the approaches of
prevention.
Methodology: The study is the review of existent
reliable research on oral and dental problems
in submarine personnel and divers in different
communities and strategies for prevention of these
problems.
Results: Despite the careful oral hygiene and also,
apparently teeth health in submarine personnel and
divers, sometimes pain in the oral cavity can be seen
during the mission. Researchers have been proposed
several hypotheses to explain the cause of orofacial
pain caused by changes in ambient pressure. In
addition to pain, they may experience some problems
such as tooth and restorative material fractures,
decrease of denture retention, implant failure, etc.
With periodically oral examinations and review the
status of dental caries, fillings, root canal treatment
and crowns, and if necessary, appropriate treatment
can be largely prevented the occurrence of oral
problems during diving.
Conclusion: Considering the importance of oral and
dental problems in diving, oral hygiene maintenance
and regular dental checkups are necessary to prevent
these problems. Lack of attention to this issue,
especially in military missions can in addition to
endangering the health of the diver, fail the mission.
So careful oral hygiene in these people and paying
special attention to all of their oral problems is very
important.

Introduction: From The Past, One of the Importance in
About Entrance to Seas & Oceans Was the Possibility
of Interfere With Aquatic Animals. Actually, Human
Entrance in to Their Territory Lead to Their Innate
Reactions Which Are in Order to Protection of Their
Territory, Childs, Fear & … Tens During Their
Intercourse Season.
Material & Methods: This is a Review Article Based
on The Information Have Been Collected as The
Complex of Text Books & Articles in About Marine
Sciences. We Try to Introduce & Display Critical &
Clinical Information with Trust sheep & Affiliation.
Findings:
Sea Snake
Attack to Human Occur When The Diver Try to Touchor Keep The Animal. Rapid Moving Things, Such as a
Diver Which Takes on Board is Yummy from Animal
Point of View. The Toxin Target Are Post Synaptic
Membrane & End Plate Motor Neuron of Skeletal
Muscle That Prevents of Acetylcholine Effect. More
ever, it Causes Arial Necrosis of Skeletal Muscles &
ATN if Takes Longer than 48 Hours.
Stingray
Stingray Hides Under the Sands of Ooze &it Possible
That When a Diver is Walking, Pressed it. The Animal
Moves its Tail up & Forward & with Entrance of the
Hook into the Victims Body, Toxin Case is Broken
& Toxin Enters Into the Wound Via a Downpipe.
Entrance of Little Toxin into the Body Caused the
Increase of PR-Intervals in EKG, Heart Block Type
1 & Low Decrease of Blood Pressure.In High Doses,
Heart Block Type 2&3, Respiratory Depression &
Convulsion Will Happen.
Stone Fish
It Has 30 Centimeter Length & Lives under the Mud,
Sands & Rocks on the Ooze & This is Detected Hardly.
It Has 13 Poisonous Back Thorns on the Loose Skin
& When They Enter into the Victims Body, Toxin
Go into the Tissues From 2 Bags. This Myotoxin is
an Unstable Protein with High Molecular Weight &
Causes Rapid Contraction & Paralysis of Skeletal,
Smooth & Heart Muscle.Discussion & Conclusion: Due to Possibility of
Aquatic Animal Exposure by Human on Military
& Civil Operations & Sea tours, Recognition of
These Animals, Especially Sea Wasp & Biting Fish
is Necessary for Target Population. Thus, This
Information Are Assurance For Successful Operations
& Healthy Personnel.
Keywords: Sea Snake, Stingray, Stone Fish

Introduction: From The Past, One of the Importance in
About Entrance to Seas & Oceans Was the Possibility
of Interfere With Aquatic Animals. Actually, Human
Entrance in to Their Territory Lead to Their Innate
Reactions Which Are in Order to Protection of
Their Territory, Childs, Fear &… Tens During Their
Intercourse Season.
Material & Methods: This is a Review Article Based
on The Information Have Been Collected as The
Complex of Text Books & Articles in About Marine
Sciences. We Try to Introduce & Display Critical &
Clinical Information with Trust sheep & Affiliation.
Findings:
Crocodiles
Nowadays Mortality of Shark Attacks & Crocodile
Attacks Are Almost Equal. The Reason of Crocodiles
Protection is The Prevention of Shark Attacks. During
Reproduction Seasons, Especially When Their Babies
Come Out From The Egg, They Demonstrate More
Aggressive Behavior. Their Maneuverability & Agility
are increase in Water & in Compare with Human.
They Usually Waiting for Their Victims, Which
Often are live stock, at Beach While Their Nostrils
are Out of The Water. They May Storage Their Food
for Future That This Matter is Very Important in
Searching Victims Remains.
Killer WhaleThis Animal is The Greatest Type of Dolfins Family
& Live as Teams. They Keep Their Victims into Deep
Water & Drown Them. Until Now at least One Case
of Human Attack Was Reported.
Leopard Seal
This Animal Lives in Polar Seas & Their Near Waters
Lonely & Feeding of Penguins, Other Seals & Human
When They Come From Water Surface. If This
Animal have been Saw at Sea Area, Diving Will be
Unreasonable. Divers Which See This Animal Should
Not Go On Water Surface, But Should Reach The
Beach Via Ooze. In Order to Avoid of Exposure with
This Animal Use of Protective Clothes & Swimming
at Safe Area are Useful.
Conclusion: Due to Possibility of Aquatic Animal
Exposure by Human on Military & Civil Operations
& Sea tours, Recognition of These Animals, Especially
Sea Wasp & Biting Fish is Necessary for Target
Population. Thus, This Information Are Assurance
For Successful Operations & Healthy Personnel.
Keywords: Crocodile, Killer Whale, Leopard Seal

Introduction: From The Past, One of the Importance in
About Entrance to Seas & Oceans Was the Possibility
of Interfere With Aquatic Animals. Actually, Human
Entrance in to Their Territory Lead to Their Innate
Reactions Which are in Order to Protection of Their
Territory, Childs, Fear & … Tens During Their
Intercourse Season. Up to Now, There Were Many
Efforts in Order to Recognition of Aquatic Animals
& Prevention of Their Conflict by Human & Their
Bad Effects.
Material & Methods: This is a Review Article Based
on The Information Have Been Collected as The
Complex of Text Books & Articles in About Marine
Sciences. We Try to Introduce & Display Critical &
Clinical Information with Trust sheep & Affiliation.
Findings: The Name of This Syndrome Was Came
From a Caste in Australia That Invented With Doctor
Flecker. A Living Being Which Caused This Syndrome
is a jelly Fish Which Called Carsia Barenz. Biting is
Usually Happen in Calm Warm & Shallow Waters
& Often Victims Can Not See the Biting Agent.
Firstly, Local Features Occur & after 5 to120 Minutes
General Features Are happen Too. Late Features as
Pulmonary Oedema, Paraesthesia, Itching, Sneez,
Epiphora, Artralgia, Tachycardia, Weakness, Malase
& Dry Mouth Will Happen Later.Use of Vinegar for Washing & Prevention of
Nematocite Release at First of Report Time is
Recommended. If General Features Were Presented,
Water & Electrolytes Correction With Vital Sign
Control are Necessary. In Acute Phase, Intravenous
Petedin 0/5mg/kg Within 5 Minutes & Repeted
doses are Needed. Promethezin 0/25mg/kg up to
25mg as Intravenous Injection Should be Added.
Alfa Blockers, Phentolamine 1to5mg State & Then5-10mg/h or Hydralazine Should be Prescribed.Other
Drugs are Diazepam, Anti-histamine & Anesthetics.
Conclusion: Due to Possibility of Aquatic Animal
Exposure by Human on Military & Civil Operations
& Sea tours, Recognition of These Animals, Especially
Sea Wasp & Biting Fish is Necessary for Target
Population. Thus, This Information Are Assurance
For Successful Operations & Healthy Personnel.
Keywords: Irukandgi Syndrome, Carsia Barenz,
Jelly fish