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Journal Cover American Journal of PharmTech Research
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  This is an Open Access Journal Open Access journal
     ISSN (Online) 2249-3387
     Published by ScopeMed Homepage  [77 journals]
  • Mass casualty incidents after terrorist bombings

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Alexander Parashkevov, Ventsislav Mutafchiyski, Georgi Popivanov, Paulin Todorov.
      Introduction The frequent suicide terrorist attacks in the last years logically raise the question how prepared we are to cope with their consequences. In comparison to the other types of trauma, bomb explosions more frequently lead to mass casualty incidents (MCIs), generating a large number of casualties with multiple injuries within a short time frame. This number usually exceeds the capacity of the hospital, which tend to exhaust the hospital resources. Additionally, there are several important differences between combat and civilian MCIs. This reality, together with the unpredictability of these events, justifies their detailed analysis and discussion. Material and methods In the present work two suicide terrorist attacks led to MCI were analyzed. The first one occurred in a combat setting in Kerbala, Iraq, on 27 December 2003. The second occurred in a civilian setting at the International Airport in Bourgas, Bulgaria on 18 July, 2012. The following variables were analyzed and compared – a total number of the casualties, number of dead on scene (DOS), hospitalized victims and those who needed major surgery (MS), hospital mortality and returned to duty (RD) for the military personal. The severity of trauma was assessed by Injury Severity Score (ISS). Results Overall, there were an average 26 casualties per incident 52, 13.5% dead on scene and 62.5% hospitalized. The severely injured (ISS>16) were 12.5% (n=13), major surgery was performed in 12 of them (92.3%) or 11.5% of all (12/104). The overall mortality was 11.5%. It was higher after the bus explosion (17.9%) than those in Kerbala (7.7%). The bus explosion was also associated with a higher proportion of wounded – 78% vs. 50%, more immediate deaths – 15.4% vs. 6.2% and higher dead/wounded ratio – 1:5.6 vs 1:13. Conclusions The civilian terrorist attacks result in significantly more casualties and immediate fatalities, higher overall mortality and a higher dead/wounded ratio. Due to the unpredictability of these events, not only the largest trauma centers, but every hospital should have a contingency plan for MCIs. Every surgeon should be familiar with the art of triage and to develop ability for a judicious allocation of the precious hospital resources.

      PubDate: Tue, 30 Sep 2014 10:23:12 GMT
       
  • The response of mucosal immunity to stress faced by Lithuanian soldiers as
           a consequence of deployment to Afghanistan

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Raimonda Kvietkauskaite, Ramute Vaicaitiene, Irute Girkontaite, Danute Labeikyte.
      Objective: The responses of immune system to psychological stress are highly diverse. This study was designated to clarify the stress experienced by servicemen of the Provincial Reconstruction Team of Lithuanian Armed Forces as a response to changed job conditions (deployment to Afghanistan). Also we sought to determine the relationship between documented changes in salivary immunoglobulin (IgA, IgM and IgG) level and psychological stress. Methods: Special questionnaires covering state of health and strain experienced in association with deployment and psychotraumatic events were constructed using Symptom Check List SCL-90 and Peacekeepers Impact of Events Scale PIES-R. Quantitative detection of immunoglobulin was performed by sandwich ELISA. Nonparametric statistics were used to compare the distribution of immunoglobulin. Results: Secretory immunoglobulin A (S-IgA) was the only class of immunoglobulin sensitive to psychological stress associated with the deployment. Comparison of the medians before and after military mission demonstrated an increased amount of S-IgA after the deployment when general stress level was reduced. The amount of stress resistant individuals rose from 34% before the deployment to 77% after it. Chi-square test of independence indicated statistically significant relationship between the stress and S-IgA amount. Four separate psychotraumatic events experienced during the deployment was not associated with S-IgA distribution, but combined psychological variables revealed statistically significant (p>0.05) relationship with S-IgA distribution. Any relation between health parameters and stress experienced was not found. Conclusions: The mucosal immunity responds to stressful circumstances on the job (peacekeeping mission in Afghanistan) by variation in salivary S-IgA amount without manifestation of clinical symptoms. A deeper understanding of the response to stress can assist in finding strategies to overcome the inherent psychological challenges associated with specific professions.

      PubDate: Mon, 22 Sep 2014 05:54:15 GMT
       
  • Job satisfaction of military physicians in Turkey and Azerbaijan

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Necmettin Cihangiroglu, Bayram Sahin, Abdulkadir Teke, Fahreddin Agayev.
      Aim: This study is conducted to compare the job satisfaction of physicians working at military hospitals in Turkey and Azerbaijan, and determine physicians’ job satisfaction by their socio-demographic characteristics. Materials and Methods: Minnesota Satisfaction Questionnaire was used to measure the job satisfaction of physicians. 550 questionnaires were distributed in Ankara Gulhane Military Medical Academy Hospital, but 470 were collected. 159 questionnaires of 161 questionnaires distributed in Baku Military Medical Academy Hospital were analyzed since 2 were incomplete. Results: The study showed that both countries’ military physicians have “mild satisfaction”. Between the two countries, no significant differences were found in intrinsic, extrinsic, and overall job satisfaction levels of military physicians. Also, the results of Structural Equation Modeling showed that military physicians’ job satisfaction levels changed by duration of work and specialty area (p0.05). Conclusions: This study may present valuable information for the management of military health systems in understanding the factors that lead to job dissatisfaction of military physicians and identifying groups with low job satisfaction levels.

      PubDate: Thu, 04 Sep 2014 06:04:37 GMT
       
  • Caecal Polyp as a Rare Cause of Acute Abdomen: Case Report

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Zafer Kilbas, Yasar Subutay Peker, Ali Harlak, Nail Ersoz, Gokhan Yagci.
      Radiologic imaging is getting used more commonly in the evaluation of acute abdomen in our daily practice. Ultrasonography and computed tomography are worthwhile when clinical presentation is not concordant with appendicites. In this study, we aimed to present a rare case of caecal polyp causing acute appendicitis. 36-years-old male patient presented with right lower quadrant pain and nausea. On physical examination, rebound tenderness was obtained but there was no muscular rigidity. All blood tests including biochemistry and hemogram were within normal limits. Ultrasonography showed an enlarged, non-compressible appendix with 2-cm diameter and caecal edema. When a CT was performed to exclude a probable appendix tumor, a-25 mm diameter mass was obtained at posterior wall of caecum. As colonoscopy was applied, 2x3cm of sessile polyp located at caecum encircling appendical orifis was observed. Diagnostc biopsy was performed without polypectomy, due to its wide base. Histopathological diagnosis resulted adenomatous polyp with no malignancy. Appendectomy + partial caecal resection involving the polyp was performed. Histopathology confirmed the preoperative diagnosis ''mucinous neoplasm with tumor free margin''. Patient was discharged on postoperative fourth day without any complication Radiological imaging methods are beneficial for evaluating and confirming the diagnosis of acute abdomen. Negative laparatomies or second-step surgeries may be decreased by advanced radiological imaging, especially when there is discordance between clinical and laboratory findings.

      PubDate: Tue, 02 Sep 2014 06:47:36 GMT
       
  • The Most Frequent Symptoms (Findings), Diagnoses, and Treatments Recorded
           At A Military Infirmary in Ankara

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Mustafa Alparslan Babayigit, Turker Turker, Suleyman Ceylan, Metin Hasde.
      Objective: This cross-sectional study aimed to assess retrospectively the most frequent diagnoses, treatments and examination results recorded at an infirmary of a military unit based in Ankara. Method: The study comprised the infirmary records (44,000 data) of a military unit based in Ankara, Turkey between January and December 2005. Using stratified and systematic sampling, 1000 infirmary records were examined between 12-15 May 2006. The data were collated and analysed using the International Classification of Diseases, version 10 (ICD-10) and SPSS software. Results: The mean age of the soldiers was 21.7±2.4 years with 67.3% aged 21 or below. According to the ICD-10, the most commonly seen disease diagnoses were related to the respiratory system (30.1%), the musculoskeletal system and connective tissue (16.4%) and skin and skin appendages (12.9%). The most common diseases were determined as acute upper respiratory tract infection, myalgia/back pain and dermatophytosis (22.4%, 10.8% and 6.1% respectively). While there was no statistically significant difference in the distribution of diseases according to age, a statistically significant difference was determined between the seasons (p

      PubDate: Tue, 02 Sep 2014 06:35:23 GMT
       
  • A non-syndromic case of co-existence of supernumerary and supplemental
           teeth

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Anusha Rangare Lakshman, Sham Kishor Kanneppady.
      Supernumerary teeth, is defined as teeth that exceed the normal dental formula, regardless of their location and morphology and can be found in almost any region of the dental arch both in the primary and permanent dentition. A Supplemental tooth is a type of supernumerary tooth that is so well formed that it mimics a fully formed tooth. Many individual cases of supernumerary and supplemental teeth have been reported earlier in the literature. Whenever these teeth are seen together, they will be associated with syndromes. We hereby present a rare non-syndromic case of co-occurrence of supplemental and supernumerary teeth in mandibular premolar region.

      PubDate: Tue, 02 Sep 2014 06:35:23 GMT
       
  • Factors affecting choices of the first-graders and newly graduates for
           Military Medical School in Turkey

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Unal Demirtas, Salim Ozenc, Gultekin Ozturk, Ertan Altayli, Yusuf Ziya Turk, Adem Parlak, Turan Fedai, Duran Tok.
      Background: The aim of the study is to find out the factors that make the first-graders and newly graduates on probation in 2012-2013 educational calendar to choose military medical faculty and to determine the precedence that they take into account in choosing a profession. Methods: After having necessary authorizations, this cross-sectional study was conducted in Gulhane Military Medical Academy in Turkey between March 2013 and April 2013. Ninetyfive students who completed their first year education and 58 newly graduated physicians joined the study. The form of survey had two parts. The first part deals with the socio-demographic features of participants and second part has questions that try to find the reasons of their preferences of medical science and military medical faculty and the reasons of not being chosen of military medical faculty and the questions related with their professional career. Results: When the factors that effects participants working life is examined, the rate of people who wants to work continuously in primary care centers is 9,2% (n=14). When first graders and new graduates are examined whether they want to work in other institutions different from Turkish Armed Forces (TAF), a significant difference is found (p

      PubDate: Tue, 02 Sep 2014 06:35:23 GMT
       
  • Work-Related Stressors in Healthcare Managers at the MMA - MHAT - Sofia

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Rositza Nikolova Doynovska, Ivanka Stambolova.
      Introduction:Occupational stress prevention is one of the priorities concerning health and safety on the workplace. Financial dimensions of the workplace stress consequences are significant for the employer - work absenteeism due to health problem in relation to the occupation, impaired concentration, fatigue and exhaustion. Health care managers as part of the clinic management often fulfill their duties under large pressure. Traditionally professions in the health care system are acknowledged as the most stressful. Aim: To investigate the health care managers' opinion about the most frequent causes of workplace stress. Materials and methods: A direct individual investigation among 44 senior nurses / laboratory technicians / midwives from MMA-MHAT-Sofia was held in December 2013. Results were statistically processed. Results: 39% of all respondents have experience as managers for up to 20 years and 36% - for more than 20 years. 70.4% have health care management master's degree. More than 54% of the respondents have pointed out the large amount of tasks that have to be done in short terms as a cause of stress. According to 52% another cause are the conflicted situations and for 34% - the personal relationships. Conclusions: According to the greater part of the respondents the existing stress causes are overwhelmed by work planning and re-organizing. Delegation of more authorities and responsibilities to the employees decreases the role stress. Family, employers and colleagues support decreases levels of the professional stress.

      PubDate: Mon, 01 Sep 2014 03:31:02 GMT
       
  • A Rare Case: Radial Shaft Fracture Seen at Torg-Winchester Syndrome

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Selim Turkkan, Burak Ahmet Bilekli, Yalcin Kulahci, Mustafa Kurklu, Arsen Arsenishvili, Harun Yasin Tuzun, Mustafa Basbozkurt.
      Torg-Winchester syndrome is an autosomal recessive inherited disease characterized by diffuse osteoporosis and osteolysis due to matrix metalloproteinase-2 (MMP2) enzyme deficiency. Flexion contractures at hand, wrist, feet, hip and knee joints occasionally accompany. In this paper, we aimed to present the conservative treatment of radial shaft fracture at a patient with Torg-Winchester Syndrome.

      PubDate: Wed, 09 Jul 2014 03:24:51 GMT
       
  • Waste management aproaches in hospital organizations and an example of
           practice

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Mehmet Nurullah Kurutkan, Esra Usta, Ismail Simsir, Fatih Orhan, Mehmet Bagis.
      Objective: Hospital managers in the World and Turkey are under pressure of decreasing excessive operational costs and improving healthcare quality. One of the interventions that will smooth of the severity of this pressure is to manage the waste in the healthcare services. The Hospital Inpatient Waste Identification Tool (HIWIT) is one of the best application tools, which will bridge the knowledge, practice and leadership gaps in this context. The main objective of this study is to examine THE waste in THE hospital inpatient settings in the context of HIWIT’s 5 modules. Methods: This study was conducted by using quantitative research methods. Research and Education Hospital of Duzce University was chosen as a sample center of this research. HIWIT, ward module, patient care module, diagnosis module, treatment module and patient module, was used to collect the data. Three healthcare personnel, June 15th, 2012 and December 31st 2012, carried out application of the modules. Results: 27 waste types were defined and their proportions were determined. Overall waste proportions of five modules were like followed: Word Module 11,11%, Patient Module 16,50%, Patient Care Module 2,52%, Diagnosis Module 44,20% and Treatment Module 25,29 %. The cost of determined using ward module only is 1.725.275 $. Healthcare-associated infections, delay in clinical care and flow delay were determined as the most important waste types in terms of clinical and patient safety for utilization of Social Security Institution (SGK). Conclusion: It is conferred in practice that HIWIT is a handy tool in definition of waste and costing. Reimbursement agencies are the ones, which will take the most advantage of defined waste types. Four components were intended to acquire through waste study: improving performance, diminishing operational costs, shortening operational cycles and improving patient safety. After identifying the main priority areas of waste types, a financial expert or team should be utilized in understanding the financial implications of them. Diagnosis, treatment and patient care modules particularly are expected to contribute more to patient safety which is one of the four intended output components.

      PubDate: Wed, 09 Jul 2014 03:22:33 GMT
       
  • Disease and nonbattle injuries sustained by Bulgarian military personnel
           during missions abroad, 2008-2012

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Ivan Popivanov, Assen Petkov.
      The aim of the study is to analyze the structure and dynamics of disease and non battle injuries (DNBI) sustained by Bulgarian military personnel, participating in missions abroad during the period 2008-2012. This survey was based on data from the annual reports for the health condition of Bulgarian armed forces (BAF) personnel. The spread of DNBI amongst military personnel was analyzed by determining indicators for incidence rate (per 1,000 combat-years) and distribution. Regression analysis was carried out for determining the trend of the DNBI incidence rate. Data for the military personnel deployed abroad were compared with the analogous for the BAF personnel in the country. A total of 8,593 cases of DNBI amongst personnel deployed abroad were registered for the period. The overall DNBI incidence varied between 1514 ‰ and 870.4 ‰ and exceeded registered in military units in the country. Statistically significant trend for its reduction (y= - 118.1x+1483; R²=0.565) was established, which followed the downward trend for the DNBI incidence in BAF for the period (y= - 44.47x + 1063; R² = 0.585). The fatality rate was 0 % (0 deaths). The diseases of respiratory system dominated the structure of DNBI with 39.09 % (mainly acute upper respiratory infections), followed by the diseases of digestive system with 17.51 % (mainly dental diseases), diseases of the skin and subcutaneous tissue – 11.96 %, non battle injuries - 6.25 % etc. The established higher levels of DNBI incidence among deployed forces require additional efforts and approaches of medical service to minimize it.

      PubDate: Wed, 09 Jul 2014 03:20:02 GMT
       
  • An Interesting Cardiac Syncope Adventure: case report

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Umit Kaldirim, Ibrahim Arziman, Yusuf Emrah Eyi, Murat Unlu, Salim Kemal Tuncer, Ali Osman Yildirim.
      Abstract: The ame of this article is to demonstrate a case finally diagnosed aortic dissection presented with syncope and afterward transported via air ambulance system from Kabul/Afghanistan to Turkey. Drainage catheter was inserted into pericardial space with the intend to prevent repetitive shock and tamponade during transportation. He underwent surgery and was discharged home without any complication in Turkey.

      PubDate: Sat, 28 Jun 2014 22:54:12 GMT
       
  • Cutaneous Anthrax – Contemporary Clinical And Epidemiological
           Aspects

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Tanya Petkova, Ivan Popivanov, Tzetza Doichinova, Galya Gancheva, Kalin Kanev, Dimitar Shalamanov.
      Anthrax in humans is sporadic disease in Bulgaria, but for many countries it is an important health and economic concern. For military medicine the disease is a matter of special interest because of the leading position of Bacillus anthracis in the list of potential BW agents. The aim of this paper is to present cutaneous form of anthrax infection from clinical and epidemiological point of view. Diagnosis, clinical features and treatment of case of human cutaneous anthrax – a 32-year-old male from Pleven district, are presented by using clinical, microbiological and laboratory methods. The epidemiological peculiarities of this clinical form are examined using epidemiological method, medico-geographical research and document analysis.

      PubDate: Mon, 19 May 2014 04:52:56 GMT
       
  • Hydrotherapy in Ancient Greece

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Nikolaos TSITSIS, Georgios POLKAS, Andreas DAOUTIS, Evanthia PROKOPIOU, Lambrini KOURKOUTA.
      Water is the basic element of the human body. It also plays an important role in philosophy, the legislation regarding hygiene and the therapeutic practice. Ancient Egyptians regarded water as the basic element in practicing hygiene, but only of priests. Also, according to Hebrew sanitary legislation, water was important in the hygiene of all people. Medicine in Ancient Greece is interrelated with medicine and philosophy of the people in the eastern Mediterranean. Thus, Thales regards water as the basis for everything in the world and Plato perceives water as one of four of the body humors. The treatment in the temples of Asclepius included bathing. Hippocrates, in his book “on airs, waters and places” examines the effects of water on the body and its health.

      PubDate: Sat, 17 May 2014 15:14:24 GMT
       
  • The Therapeutic Use of Honey from Greek Antiquity until Today

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Lambrini KOURKOUTA, Aikaterini RARRA, Evangelos FRADELOS, Christos ILIADIS.
      The following historical study presents honey as therapeutic means. The ancient Greeks knew the therapeutic and healing properties of honey and that is why it was used widely in the treatment of skin ulcers and pressure ulcers. Those observations, although empirical, revealed the beneficial effects that honey had, especially in leg ulcers. A systematic study of the subject is suggested.

      PubDate: Sat, 17 May 2014 15:12:10 GMT
       
  • Medical Views of Solon of Athens (638-558 B.C.)

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Emmanouil MAGIORKINIS, Kalliopi SIDIROPOULOU, Aristidis DIAMANTIS.
      Solon of Athens (638-555 BC) is considered one of the emblematic personalities of Ancient Greece who lived before the Golden Age of Pericles. He is mostly remembered for his efforts to legislate against political, economic and moral decline of Athens and for his reforms, which set the basis of the Athenian democracy. The purpose of this article is to review his less well known views on Medicine and on human health. Solon is an ardent supporter of “all in good measure” (παν μέτρον άριστον) and the balance between the human body and the spirit. However, like all his contemporaries, he mixes magical and theurgical views as far as the cause of diseases and their cure is concerned. Overall, his views recapitulate the holistic approach of human health that prevailed in Medicine during his time.

      PubDate: Sat, 17 May 2014 15:05:27 GMT
       
  • Contemporary Role of Transrectal Ultrasound - Guided Prostate Biopsy

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Ioannis GALANAKIS, Eleftherios AGIANNIOTAKIS, Stylianos MEGREMIS, Georgios DELIMPASIS, Konstantinos PSARAS, Anastasios GIFTOPOULOS, Konstantinos PSILLAKIS, Ioannis PETINARAKIS, Ilias PALAIODIMOS, Christos BISSIAS.
      Prostate cancer is by far the most common solid neoplasm in male population, in Europe and USA, nowadays. The only accurate method to establish the diagnosis is the biopsy of the prostate or the presence of cancer in prostatectomy specimen. Prostate biopsy is usually performed using transrectal ultrasound (TRUS) which has gone through various modifications over the years and is considered now as the gold standard for prostate biopsy. However, a lot of unnecessary biopsies are performed and a lot of insignificant cancers are identified every day. "When to biopsy" is a rather puzzling issue. This article aims to review the current indications and techniques of TRUS - guided prostate biopsy.

      PubDate: Sat, 17 May 2014 15:02:52 GMT
       
  • To Risk or not to Risk' The Case of Removing Metalwork (or not)

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Christos BISSIAS, Ilias BISBINAS, Dimitrios GEORGIANNOS, Eleftherios AGIANNIOTAKIS.
      Orthopaedics has always been interconnected with implantation of fixation devices for the operative treatment of fractures; the indications have changed over the decades and orthopaedic surgeons tend, nowadays, to be more aggressive, favouring surgery to conservative treatment. In general, there exists a consensus in relation to the need for “putting in” the devices;; however, their routine removal after fracture healing has always been -and remains- a debatable issue

      PubDate: Sat, 17 May 2014 15:00:44 GMT
       
  • Pulmonary Embolism Presenting as Syncope

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Michail PITAROKOILIS, Despoina AGIANNIOTAKI, Panagiotis IOANNIDIS, Michail KARAVELAKIS, Emmanouil ROGDAKIS, Alkiviadis DERMITZAKIS, Emmanouil KOYNELAKIS, Georgios PROTOGERAKIS, Eleftherios AGIANNIOTAKIS.
      Pulmonary Embolism is a lifethreatening disease which refers to an obstruction of the pulmonary artery or one of its branches. The classic presentation of this disease (pleuritic chest pain, dyspnea and haemoptysis) is not often displayed which may make the diagnosis difficult. Most of the times symptoms are variable and non-specific. We present the case of an 83-year-old male who was diagnosed with Pulmonary Embolism after his admission to the Emergency Department due to syncope.

      PubDate: Sat, 17 May 2014 14:57:37 GMT
       
  • A Case of Metastatic Carcinoid Tumor of the Coccyx

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Christos S. BASAGIANNIS, Charalampos D. KALANTZIS, George S. PANAGOULIAS.
      Introduction: A report of a 67-year-old patient with a metastatic carcinoid tumor of the coccyx. Aim: To describe the clinical presentation, diagnosis and treatment of a patient with carcinoid tumor of the coccyx with liver metastases, discuss about neuroendocrine tumors and review relevant medical literature in English. Materials and Methods: Clinical history, laboratory tests, magnetic resonance imaging studies and light microscope micrographs are reviewed. Results: A coccygeal mass was detected in a 67-year-old woman with fever and coccygeal pain. She was treated with a somatostatin analogue with regression of her symptoms. Conclusions: Coccygeal carcinoid tumors are extremely rare tumors. Somatostatin analogues offer an effective treatment option in cases where surgery is not indicated.

      PubDate: Sat, 17 May 2014 14:55:00 GMT
       
  • Specificity of the Management of Blast Burns in a Field Setting

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Alexander B. PARASHKEVOV, Georgi I. POPIVANOV, Ventsislav M. MUTAFCHIYSKI, Simon AJDERIAN, Georgi L. KOUTIN, Kirien T. KJOSSEV.
      Burns are accountable for approximately 10% of all injuries in the present conflict in Afghanistan. Due to the high frequency of the penetrating injuries (60-90%) they tend to be underestimated and deployed medical teams are relatively unprepared for them. A small series of 12 blast and 6 conventional burns in Afghans is presented, who were treated by the authors as a forward surgical team in the field hospital in Herat from June to December, 2004. The comparison between blast and civil burns revealed a higher incidence of inhalation (5/12 vs 0) and multiple non-burn injuries (9/12 vs 0), reflected in higher Injury Severity Score (12.2 vs 5.7). The face was most frequently affected in blast burns (8/12) versus the extremities in civil ones (5/6); the affected body surface area was 18.7% vs 15.9% respectively. The specificity of the blast burns and burn care in a field setting require good judgement and special training for all deployed surgeons.

      PubDate: Sat, 17 May 2014 14:52:21 GMT
       
  • Training Protocol for Non-Medical Staff in Providing First Aid

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Georgios GIANTSIDIS, Maria KIAKOU, Nikolaos TSETSOS, Alexandros MAUROMATIS, Dimitra TZAKRI.
      Objective: The purpose is to illustrate how our hospital trains unskilled personnel in providing first aid, in an outpatient setting, until the arrival of specialized assistance (ambulance). Materials and Methods: The training includes a theoretical and a practical part. The theoretical part consists of a main body of a lecture-demonstration that emphasizes in ABC algorithm. This part is also enriched with a flexible body of subjects that are suitable for the audience being trained, every time. In regards to the practical part, during this section the trainees have the opportunity to consolidate their knowledge gained from the theoretical lectures, practicing on specially organized hands-on stations consisting of volunteers and medical mannequins. Results: Over the last two years, eight educational series have been trained, each time consisting of different, unskilled personnel. The performance of the trainees on practical skills and training scenarios indicates that they adequately understand the issues raised and the range of their abilities and weaknesses. Conclusion: The non-medical personnel, if trained properly, are capable of assessing situations, taking initiative and providing basic first aid, without overestimating its features. What is needed is a stable protocol, which is followed by the individual as an indisputable reference point.

      PubDate: Sat, 17 May 2014 14:49:47 GMT
       
  • Dermatomycosis in Military School Cadets: Prevalence, Risk Factors and
           Countermeasures

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Maria KALOGEROPOULOU, Athanasios KALOGEROPOULOS, Evanthia PAPASPYROU, Eleni THEODOSOPOULOU, Theodoros LOUTAS.
      Background: Dermatomycosis poses a frequent problem in military populations. This is the first study of its kind with participants representing Military Schools for Officers and Petty Officers of all branches of the Greek Armed Forces. Purpose: The aims of our study were to: 1) investigate the appearance and prevalence of dermatomycosis (fungal skin infection) in Military School cadets, 2) relate this infection to various risk factors in these groups of military personnel, and 3) suggest measures that could minimize the prevalence of fungal skin infections in Military cadets. Materials and methods: A special questionnaire was prepared, containing 46 items pertaining to clinical and demographic data. A total of 890 completed questionnaires, representing a response rate of about 35% of the target population, were collected between October 2012 and January 2013. The participants (73.4% male, 26.6% female) were aged between 18-24 years. Statistical analysis was done using SPSS v.18. Descriptive statistics and correlation analyses were conducted; the Fisher exact test and odds ratios were calculated. Results: A 23.7% of the responders had had at least one past incident of dermatomycosis; the foot digits-nails and interdigital areas were affected in 7.7%, with the rest of the foot being the most frequently affected area with a percentage of 9.1%. For the majority (22.1%) the problem originally presented during their first cadet year. Generally, the survey shows that 15.3% of cadets use objects owned by others; females do that in significantly higher percentage than males (26.6 % against 11.1%, p

      PubDate: Sat, 17 May 2014 14:48:03 GMT
       
  • The Origins of Healing: How did ‘Medicine’ Evolve'

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Christos BISSIAS, Ilias BISBINAS, Eleftherios AGIANNIOTAKIS.
      Where does the word medicine come from' What are its primary roots and which have been the linguistic and grammatical transformations that have lead to its current meaning and usage'

      PubDate: Sat, 17 May 2014 14:41:19 GMT
       
  • A Case of Sudden Death Due to Ruputre of A Hydatid Cyst

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      MEHMET TOYGAR, İSMAİL ÖZGÜR CAN, YILDIRIM KARSLIOĞLU, ABDULLAH KILIÇ, HARUN TUĞCU, MÜKERREM SAFALI.
      Deaths due to rupture of hydatid cysts caused by Echinococcus granulosus encountered rarely, mostly in endemic areas. We report a 29-year-old man who died suddenly. A forensic autopsy was performed. The postmortem examination confirmed a ruptured cyst in the liver and a decision was made that death must have been caused by the anaphylactic shock due to rupture of this cyst. This case was presented in order to emphasize the medico-legal issues related to the diagnoses and treatments of the entities which cause sudden death encountered in primary health care services, and to document of the postmortem findings of a sudden death case due to a ruptured hydatid cyst which is rarely occured.

      PubDate: Tue, 29 Apr 2014 12:21:48 GMT
       
  • “A Bullet That Cannot Be Taken Out Of The Body Because Of Medical
           Reasons And Three Suspicious Guns: Case Report”

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Mustafa TANRISEVEN, Ibrahim ARZIMAN, Mehmet TOYGAR, Zafer KILBAS, Murat DURUSU.
      It is important to obtain the material which serves as evidence of an event for clarifying in forensic cases. We aimed to share an unresolved criminal case because of a bullet that cannot be taken out of the body due to medical reasons.

      PubDate: Sun, 27 Apr 2014 13:50:37 GMT
       
  • Posterior Interosseous Nerve Lesion Due to Thrombosis in a Newborn: A Case
           Report

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Muzaffer DURMUŞ, Selim TÜRKKAN, Harun Yasin TÜZÜN, Alparslan Bayram ÇARLI, Arsen ARSENISHVILI, Yalcın KÜLAHÇI, Mustafa KÜRKLÜ.
      Thrombosis in the newborn is a severe condition that may cause mortality and/or serious morbidity. Although the most frequently cause of the newborn thrombosis is catheters, spontaneous cases may also be seen. Arterial thrombosis is very seldom and it is responsible for the half of the thrombotic conditions in the newborn. Genetic prothrombotic risk factors influence the formation of thrombosis. In our case, skin necrosis due to thrombosis following circulation insufficiency in the dorsolateral region of the left forearm was detected. Plasma homocysteine levels and other prothrombotic components were elevated. Soft tissue debridement was applied and it was followed up for secondary healing. In the follow up period, lesion in the posterior interosseous branch of the radial nerve was determined. It was considered that this lesion was either due to the thrombosis or the surgical debridement. Newborns that have increased levels of plasma homocysteine levels and medical history of congenital arterial thrombosis should be investigated for MTHFR gene C677T and A1298C polymorphism with genetic analyses. In this study, we reported a premature newborn with thrombosis in the left forearm and lesion in the posterior interosseous branch of the radial nerve associated with methylene tetrahidrofolate reductase (MTHFR) gene A1298C polymorphism heterozygotism.

      PubDate: Wed, 23 Apr 2014 13:39:31 GMT
       
  • Pulmonary embolism associated with carbamazepime medication: An
           interesting clinical case

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Konstantinos Sgouros, Ioannis Kyriazis, Maria Rekleiti, Emmanouil Beliotis, Maria Saridi.
      The aim of the study was to present the case of a 65 year old woman with a final diagnosis of pulmonary embolism in relation to carbamazepime consumption. A 65 year old woman is admitted at the Emergency Room for mild progressive dyspnoea and very light right side thoracic pain, with a final diagnosis of pulmonary embolism that was possibly explained as a side effect of carbamazepime consumption as a treatment for trigeminal neuralgia. The absence of major risk factors and the tacit symptoms can leave this condition go undiagnosed, thus compromising the patients’ lives.

      PubDate: Sat, 19 Apr 2014 13:23:37 GMT
       
  • Glioblastomamultiforme with exophytic growth in young adult: a case report

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Passos ID., Pliakou E., Triantafyllidis A., Plakas S., Mitsos A., Nakos G., Sambaziotis D., Samelis A.,Mironidou- Tzouveleki Maria.
      Glioblastomamultiforme is a highly malignant neuroepithelial tumor which grows usually in the white matter of the brain hemispheres, with an average age of diagnosis at 45 years. Gliomas of the cerebral hemispheres are locally invasive tumors that extremely rarely grow and extend exophytically as an extra- axial lesion. We present the case of a 25- year old male who was admitted to the neurosurgery department with a two- month history of severe headaches located in the right temporal lobe. The patient had no other neurological deficit. The imaging exams revealed a malignant space- occupying lesion in the right temporal lobe. During the surgical resection, it was revealed as an extra- axial, exophytic mass which was infiltrating the surrounding structures, with a non well- defined transition zone. The histology examination was diagnostic of an astroglial neoplasm, grade IV. There are no reports in the international literature about exophytic malignant gliomas in young adults so far.

      PubDate: Sat, 19 Apr 2014 12:59:45 GMT
       
  • Conversion Disorder; an unusual etiology of wrist drop: Report of a case
           and review of literature

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Saeed Bin Ayaz, Atif Ahmed Khan, Sumeera Matee, Zaheer Ahmed Gill.
      Wrist drop is commonly a consequence of Radial Nerve injury and infrequently due to C7/C8 radiculopathy, brachial plexus lesion or central causes. We present here a rare case of wrist drop due to conversion disorder. He was a 31-year-old soldier who presented with left sided wrist drop and numbness over dorsal aspect of left hand following gunshot injury to the left forearm. His repeated electrophysiological evaluation revealed injury to the sensory branch of left Radial Nerve. Magnetic resonance imaging of brain, muscle enzymes and routine laboratory investigations were normal. After getting treatment as a case of radial nerve injury, focal dystonia and adjustment disorder he was finally diagnosed as a case of conversion disorder. Motor point blocks, orthotic support, electrical muscle stimulation, cognitive behavioral therapy and biofeedback were tried but did not prove effective. Patient ultimately landed up with the psychiatrist and is still under his treatment. Conversion disorder may be considered in a patient presenting with wrist drop when no organic cause can be found. Early opinion of a psychiatrist is needed to be sought in suspicious cases after providing relevant clinical findings and investigations.

      PubDate: Thu, 17 Apr 2014 10:54:51 GMT
       
  • Acute Complications of Diabetes Due to Schizophrenia and New Generation
           Antipsychotics: Relationship Between Egg-Chicken'

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Erol Arslan, Mustafa Çakar, Şeref Demirbaş, Şirzat Yeşilkaya, Mehmet İnce, Salim Özenç, Ali Kılınç, Kenan Sağlam.
      A number of patients with schizophrenia have diabetes mellitus in higher rates than the general population due to some pathophysiologic and genetic mechanisms and effects of antipsychotic drugs. Hyperosmolar hyperglycemic state is an acute metabolic complication of diabetes and an important process up to coma. Here, we describe two cases who developed a mild hyperosmolar hyperglycemic state associated with the use of new-generation antipsychotic drugs, presented in emergency department and treated as inpatients.

      PubDate: Thu, 17 Apr 2014 10:51:57 GMT
       
  • The Relationship between Family Structure and Eating Attitudes of People
           Registered to the Family Mediciners

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Salim Ozenc, Sirzat Yesilkaya, Dursun Karaman, Nuri Yildiran, Erdal Pan, Mehmet Ince, Erol Arslan.
      Introduction: There are many causes of eating behavior disorders. Family factor is also one of them. In this study, we aimed that to determine whether there is a relationship between family structure and eating attitudes by young people, who have registered to the family doctors, between the ages of 14 to 24 that is registered with their family doctors. Material and methods: People registered with to the family doctors, between the ages of 14 to 24, and who have applied to the family health center from June 2012 to October 2012 were included in the study. From the registered 180 people of 149 of them, who agreed to participate in the study and filled out the questionnaire completely, were evaluated. The semi-structured interview form for sociodemographic characteristics, Eating Attitudes Test (EAT), and the Family Assessment Scale (FAS) were used for data collection. Results: Between sexes, there were no statistically significant difference observed in terms of the sub-groups of FAS and the EAT scores (p> 0.05). There were no statistically significant correlation observed between the sub-groups of FAS scores and the EAT scores (p> 0.05). A statistically significant elevation in terms of contact points have been identified in women than in men (p = 0.040). Discussion: In our study, there was no relationship found between eating attitudes and family structures was not found within the people, who have registered to the family doctors, between the ages of 14 to 24. Corresponding to this, the results of our study is compatible with studies showing that there is no relationship between family functioning and eating attitudes. However, it is imperative to perform longitudinal studies analyzing possible causes and related effects of this issue.

      PubDate: Thu, 17 Apr 2014 10:51:19 GMT
       
  • BENEFITS OF HYPERBARIC OXYGEN THERAPY IN A PATIENT WITH MULTIFOCAL
           OSTEONECROSIS MIMICKING SEPTIC ARTHRITIS.

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Şeref Demirbaş, Mehmet İnce, Erol Arslan, Kemal Şimşek, Salim Özenç, Seyit Ahmet Ay, Murat Karaman, Sebahattin Sarı, Bayram Koç.
      Osteonecrosis is a progressive disease characterized with bone damage. Glucocorticosteroids, which are used in treatment of many diseases, are believed to be the most important reason for development of non-traumatic osteonecrosis. Osteonecrosis(ON) generally does not affect multiple joints simultaneously and mimic septic arthritis. In this article, we reported a 48-year-old woman with osteonecrosis who received glucocorticosteroids due to autoimmune hepatitis. The onset of the osteonecrosis was mimicking septic arthritis with multiple joint involvements after corticosteroid therapy. Physical examination; there was mild erythema, effusion, warmth, and diffuse tenderness on palpation in bilateral ankles and knees. Significantly intensity changes were compatible with ON in the femur and the tibia, increased fluid in the knee joint and edema in muscle groups and fatty tissue that are around the knee joint were seen on MRI. Other tests were negative for artiritis.Hyperbaric oxygen treatment was used effectively for the treatment of the patient. Patient's complaint of pain was ceased acoording to Visual Analogue Scale and she did no need to much painkiller. The main purpose of the treatment of ON is intended to protect the patient's natural joint structure. HBO and other medical approaches were provided benefit to patients with ON. Because HBO restores tissue oxygenation, reduces oedema, and induces angioneogenesis. By reducing the intraosseous pressure, venous drainage is restored, and the microcirculation is improved.

      PubDate: Thu, 17 Apr 2014 10:50:15 GMT
       
  • Perforation of Ascending Colon Tumor Mimicking Acute Appendicitis: A case
           report

    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Mehmet Ince, Erol Arslan, Ali Kılınç, Mustafa Cakar, Sebahattin Sari, Ali Osman Yildirim, Kenan Sağlam.
      Acute abdomen may result from several diseases such as infection, ischemia, obstruction, and perforation. Less frequently, diverticulitis, tumor perforation may be the reason. Ruling out acute appendicitis is mandatory in patients presenting with right lower quadrant abdominal pain. We report a 43-year-old male, suffering from right lower quadrant pain lasting for 2 days resembling acute appendicitis, which has been subsequently diagnosed perforation of ascending colon with tumor via advanced images modality that had been operated emergently. Histological findings revealed poorly differentiated adenocarcinomas for ascending colon mass and liver metastasis. If young patients with acute abdomen admitted to emergency service; appendicitis and other inflammatory diseases should be recognized as initial diagnosis. However, perforation or obstructions of malign colon tumors should be kept in mind.

      PubDate: Thu, 17 Apr 2014 10:49:26 GMT
       
  • 18th CONGRESS OF BALKAN MILITARY MEDICAL COMMITTEE

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      .
      18th CONGRESS OF BALKAN MILITARY MEDICAL COMMITTEE ISTANBUL, TURKEY May 22-26, 2013

      PubDate: Tue, 15 Apr 2014 09:51:23 GMT
       
  • Factors Associated with Chronic Post-Thoracotomy Pain

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Sara Eleni AMPRACHIM, Ioannis D. GKEGKES, Ioanna V. PAPATHANASIOU, Labrini KOURKOUTA.
      Thoracotomy is one of the surgical procedures that present with increased incidence of chronic postoperative pain and discomfort. The related pain after thoracotomy can provoke considerable peri-operative as well as long-term morbidity of notable intensity and duration. Post-thoracotomy pain is considered to be a result of the thoracic structure damage, including damage to ribs, muscles, peripheral nerves and pleura. The surgical incision, the rib retraction, the discontinuity of costal pleura, trocar placement and suturing are the possible pathogenic causes of chronic post-thoracotomy pain. Various techniques and prevention strategies have been proposed in order to offer satisfactory analgesia to postoperative thoracotomy pain. Nevertheless, both acute and chronic pain related to thoracotomy continue to represent a challenge for thoracic surgeons. Recommenda tions can only be established in this regard based on unique studies, with a higher or lower level of evidence depending on their design. Well designed randomized prospective studies are required to evaluate the diverse technical variation for the performance of thoracotomy and their association with post-thoracotomy pain.

      PubDate: Sun, 13 Apr 2014 03:36:28 GMT
       
  • Duties of the Head Nurse for the Organization of Prevention and Control of
           Nosocomial Infections in MHAT Hospital/Military Medical Academy, Sofia,
           Bulgaria

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Rositza DOYNOVSKA, Angel D. ANGELOV, Georgi POPOV.
      Prevention and control of medical-care related nosocomial infections are of the top priorities in every medical facility. The problem of nosocomial infections goes along with medical activities, posing health and financial consequences of various dimensions. Current regulations, orders and recommendations of the President of Military Medical Academy (MMA) define the methods and means of control, together with the personnel in charge. One of the basic duties of every Head Nurse in Multiprofile Hospital for Active Treatment (MHAT) Sofia, MMA, is the active participation in the prevention and control of the nosocomial infections while respecting hierarchy subordination, during onset, registration and taking of measures according to the current hospital program. Preventive measures ensure high level of protection for patients, staff and visitors. Training of nurses and hospital attendants is a basic duty of the Head Nurse. Due to the severity of the problem posed by the nosocomial infections, constant work is required in order to match administrative measures and personal responsibility of the hospital employees.

      PubDate: Sun, 13 Apr 2014 03:34:04 GMT
       
  • The Concept of Health in Ancient Greek Medicine

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Emmanouil MAGIORKINIS, Nikolaos PETROGIANNIS, Christos BISSIAS, Aristidis DIAMANTIS.
      The purpose of this article is to summarize the views on Health in Ancient Greek Medicine. We studied mainly the Hippocratic and Galenic Corpus as well as the views of contemporary scholars on the subject. Important aspects on human health include the “four humors theory”, the strict connection of human physiology with the laws of Nature and the interconnection between the functions of human body and the way of life and habits of the patient. The humoral theories provided the basis for treatment strategies in Hippocratic medicine which was strictly individualized and case restricted. Hippocrates, on the basis of those theories, also suggested a set of rules for everyday life in his “Regimen” suggesting a direct association between health and life style. In all aspects of human life, the golden mean is considered to be the optimum way, according to the writer of the Hippocratic texts, in order to restore the balance between opposing powers that tend to disturb the homeostasis of human health.

      PubDate: Sun, 13 Apr 2014 03:32:11 GMT
       
  • Professional Identity Statuses of First-year College Students in General
           Practice Nursing Programmes: the Case of Lithuania

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Ramute RIMKIEN&#;, Vilma &#;YD&#;I&#;NAIT&#;.
      Introduction: What is nowadays called “globalization” enforces social, economic and political changes which make collegial higher education institutions search for the best possible means to more effectively adapt to the fast changing environment and prepare competitive professionals for the market. Professional identity is the important factor, which increases competitiveness of a young specialist in the labor market. Person’s professional identity forms whilst training in a higher education institution– the development of person’s knowledge, abilities, skills, approaches, values and beliefs, which takes place during theoretical and practical studies. According to most scientists’ opinion, professional identity forms from the first year of study by acquiring deeper professional understanding, developing professional values and approaches. When analyzing the peculiarities of professional identity development, some scientists apply the concept of the Marcia identity research, which functions in the context of problem solution. Marcia distinguishes four statuses of identity according to alternative exploration level and decision-making crisis as well as the commitment to certain field: the lowest – Identity diffusion, higher – Foreclosure, still higher – Identity Moratorium, the highest – Identity Achievement. The article analyzes the levels of the professional identity statuses of first-year students’ in the General Practice Nursing programmes in Lithuanian colleges. The research was performed in March – April 2012 when the first-year students in the General Practice Nursing programme followed theoretical subjects and passed clinical practice work tasks. The research involved 251 first-year Nursing students, whose age was from 18 to 49 years. The research results have shown that half of the first-year students-respondents are in the ‘strong status’ level of the acquired professional identity; and the respondents-students in the group of over 20 years old are well aware of their professional goals, are more autonomous, have stronger commitment to their professional choice than the respondents-students of the 18-20-yearold group.

      PubDate: Sun, 13 Apr 2014 03:29:17 GMT
       
  • Experiences from Post-Graduate Courses organized by the NATO International
           Security and Assistance Force (ISAF) in Support of the Afghan Health
           System

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Murat DURUSU, Umit KALDIRIM, Ibrahim ARZIMAN, Engin Ilker CICEK, Mehmet ERYILMAZ, Oguz KILICKAYA, Yusuf Emrah EYI, Ali Osman YILDIRIM, Salim Kemal TUNCER, Selahattin OZYUREK, Ramazan AKYILDIZ.
      Introduction: This article aims to share the experience and ‘evaluations for the future’ gained from the "Emergency Care for Trauma" course on 14-15 April 2010 and "Emergency Care, echocardiography, anesthetical applica tions, blood bank management, and medical technician course" on 18-21 December 2010 performed with the attendance of Afghan medical personnel were to be shared. Method: The courses were evaluated retrospectively under the titles including; course curriculum, training instructors, participant characteristics, participant evaluations and course of events, preparation, execution and results. Results: 13 hours of theoretical training, 6 hours of practical stations with a total of 19 training hours of the course were scheduled for execution in two days. An organization committee composed including one president, two secretaries, six trainers and six assistant trainers. Moreover, three interpreters assisted for the simultaneous translation. A total of 24 and 25 medical personnel attended the two courses, respectively. Pre-test and post-test were administered to course participants before and after the course in order to evaluate the effectiveness of the first course. Darish simultaneous translation was done during all training sessions. At the end of each course, reviews from participants were discussed. Discussion and conclusion: The experience gained from the course and direction of the participants revealed that it needs to be repeated every six months. More time was decided to be offered for the practical part of the course. Educational training course has been planned after 4-5 periods of courses for the Afghan health workers. In this way, the course was planned to get integrated into the Afghan health system. Post-graduate courses are important components of modern health care systems. In many developed countries, these kind of courses have become compulsory and are performed regularly. However, standardized and regularly performed courses in developing countries are currently not ‘the norm’ and should be supported.

      PubDate: Sun, 13 Apr 2014 03:27:35 GMT
       
  • Adaptation of Temperament and Character Inventory (TCI) –
           Cloninger’s in a Specific Population - The Bulgarian Military Man

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Milena DIMITROVA, Toni DONCHEV.
      The author of the Temperament and Character Inventory (TCI) is Dr. C. Robert Cloninger, working at Washington University in St. Louis, USA. His questionnaire includes four temperament dimensions and three personality (character) dimensions. The Bulgarian version of the questionnaire was adapted in 2003-2004. TCI consists of 240 dichotomous items, completed independently. The questionnaire provi des information on temperament, character, adaptive capacity and emotional stability of the subjects, so it is especially important as a diagnostic and prognostic test method. Considered in the clinical aspect, Cloninger’s model can serve as a useful instrument for clinical diagnosis and prediction of personality disorders. From personality (character) traits depends on whether the person is abnormal at all, while temperament depends on the type of personality abnormality and vulnerability (susceptibility) to affective disorders

      PubDate: Sun, 13 Apr 2014 03:25:25 GMT
       
  • Cardiorespiratory Changes during Colonoscopy in Young Patients with no
           Known Diseases

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Ivaylo VAZHAROV, Yolanda ZAYAKOVA.
      Introduction: Like every invasive procedure colonoscopy carries risks for complications, mainly cardiorespiratory. Aim: The purpose of this study is to investigate cardiorespiratory changes during colonoscopy in young patients with no known diseases. Materials and Methods: Between March 2010 – March 2013, 41 young patients - 31 men and 10 women underwent colonoscopy (“Olympus”) by two experienced endoscopy specialists. The patients were free of signs and symptoms of any heart and pulmonary diseases. During endoscopic examination each patient was monitored with Holter (“Hewlett-Packard”) and pulse oximeter. The blood pressure was measured before, during and after the procedure. Results: During colonoscopy 17 patients (41.46%) manifested rhythm disorders. In 9 patients (21.95%) sinus tachycardia occurred. In 3 patients (7.32%) supraventricular extra systoles were observed and in 2 patients (4.87%) - ventricular extra systoles. No ST-T changes were found. The highest blood pressure values were measured before and during endoscopy, but they did not exceed 165/105 mmHg. In 5 patients (12.2%) a hypotensive reaction was observed, but the values were not lower than 80/50 mmHg. In 3 patients (7.32%) there was a short bradycardia with a heart frequency of 50-55 /min. Conclusions: Our results showed that the rhythm disorders during lower colonoscopy occur in almost half of the examined patients, there is an increase or decrease of the blood pressure in some patients, but that did not require physician’s aid and the examination could be carried out safely without monitoring.

      PubDate: Sun, 13 Apr 2014 03:23:29 GMT
       
  • Acute Barotitis Media in Flight: Pathophysiology, Symptoms, Prevention,
           Treatment

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Ourania FYNTANAKI, George ALEVITSOVITIS, Leonidas ANGELAKIS, Vasileios MOUTEVELIS.
      Acute barotitis media or aerotitis media is one of the most prevalent medical issues caused during flight. This is the reason that the incidence of aerotitis media increases not only among aviation crews but among common travelers due to the increasing airplane transportation. Its pathophysiology is completely explained by Βoyle’s law, since the gas volumes in our body and in the airplane cabin change during the flight. In fact, the problem is caused by the dysfunction of equilibrium between the air in the middle ear and the surrounding environment. The main symptoms are severe otic pain and partial hearing loss, mainly during the descent. There are many predisposing factors for this medical condition such as a concomitant upper respiratory infection. Many preventive measures can be used to avoid otic barotrauma, like the Valsalva maneuver. The treatment is generally symptomatic, but there are also ongoing relevant research projects.

      PubDate: Sun, 13 Apr 2014 03:20:02 GMT
       
  • Complex Segmental Fractures of the Radius and Ulna without Associated
           Dislocation or Ligamentous Injury: A Case Report

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Demetrios KAPOUTSIS, Miltiades ZIOGAS, Ioannis LACHANAS, Konstantinos GARTSIOUDIS, Ioannis ZAGAS, Konstantinos KARLIAFTIS.
      Isolated complex segmental fractures of the forearm bones are rare injuries that result from significant force and warrant challenging operative treatment. We present one such case where, despite the severity of the bone injury there were no associated dislocation or ligamentous injuries at the proximal or distal radioulnar joints. The patient was treated with open reduction and internal fixation with very satisfactory clinical and radiological outcome after a six-month follow-up.

      PubDate: Sun, 13 Apr 2014 03:18:11 GMT
       
  • Injury of Tank Personnel due to Kickback: A Case Report

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Yusuf Emrah EYI, Sukru ARDIC, Ibrahim ARZIMAN, Cengiz KAYA, Murat DURUSU, Mehmet ERYILMAZ.
      Kickback is the backward momentum of a gun when it is discharged. In this paper, it is aimed to share a case of splenic injury and mandibular fractu re due to a kickback during throwing of Leopard 2 tankball.

      PubDate: Sun, 13 Apr 2014 03:16:13 GMT
       
  • Symptomatic Hypocalcaemia in a Patient with Bone Metastatic Prostate
           Cancer

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Apostolos PAPPAS, Nikolaos KONTORAVDIS, Athanasios PANOUTSOPOULOS, Nikolaos KORONAKIS, Emmanouil LAGOUDIANAKIS, George KARANIKAS, George MIHALOPOULOS, George SIOZOS, George ANDRIANOPOULOS.
      Symptomatic hypocalcaemia has rarely been reported in bone metastatic prostate cancer patients. The use of bisphosphonates as part of palliative treatment in patients with concurrent medical conditions is among the most common causes of hypocalcaemia. We present the case of a patient with bone metastatic prostate cancer who experienced severe hypocalcaemia while being treated with zoledronic acid.

      PubDate: Sun, 13 Apr 2014 03:13:28 GMT
       
  • Patients’ Satisfaction with their Post-operative Pain Management in
           Armed Forces’ Hospitals of Athens, Greece

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Maria MITSIOU.
      The purpose of this study was to investigate patients’ satisfaction with their post-operative pain management, identify the characteristics of their pain and explore any possible gaps in postoperative pain management in Armed Forces’ Hospitals in Athens. A total of 150 consecutive patients on their 2nd post-operative day, selected from different wards of the surgical sector of the three tertiary care Armed Forces’ hospitals in Athens, Greece, were included in the study. Data was collected using “The American Pain Society/Patient Outcome Questionnaire” For the 2nd post-operative day, 26.7% of the patients reported the level of their pain as 5 in the 0-10 VAS (mean = 3.15 2.14). A 90.7% of the respondents were generally satisfied with the management of their post-operative pain, whereas 53.3% of them were very satisfied with the response of nurses and 45.3% were very satisfied with doctors’ response when they were complaining of pain. The time for administration of a medication on demand was

      PubDate: Sun, 13 Apr 2014 03:11:30 GMT
       
  • Diagnosing Personality Disorders in Temperament and Character Inventory
           (TCI), Cloninger’s Questionnaire

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Milena DIMITROVA, Toni DONCHEV.
      Personality disorders are very impor tant and quite often remain occult during the first psychological selection for military personnel. Personality disorders are difficult in their diagnosis even when the person has already demonstrated emotional and behavioral symptoms of disadaptation. We present our experience in diagnosing personality disorders with the adaptation of a psychological test for the Bulgarian population: Temperament and Chara cter Inventory (TCI), Cloninger’s. It is a new psychological test of good proven effectiveness, extremely useful when making the first psychological selection for entry in the military service, participation in military missions and training abroad and for objectification of military medical expertise. The study, conducted on 534 servicemen, suggests that determining the type of temperament allows the prediction of the occurrence of certain types of personality disorder. The features which invariably recur and are especially important for the formation of almost all types of abnormal personality peculiarities are: Coopera tiveness (C), Self-transcendence (ST) and Harm avoidance (HA). A chara cteristic with less importance is Selfdirectedness (S).

      PubDate: Sun, 13 Apr 2014 03:09:17 GMT
       
  • How Cost-worthy is the Hellenic AirForce’s Investment on Health
           Disorders Prevention: Policy Comparison between Flying-non Flying
           Personnel

    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Georgios ALEVETSOVITIS, Ioanna KATSOU, Vasileios MOUTEVELIS, Ourania FYNTANAKI, Panagiotis PREZERAKOS.
      Introduction: The main interest of this study is focused on the level of interaction between the perceived health level and the degree of health prevention policy applied by the Hellenic AirForce which compels the flying personnel in an annual health examination, whereas the ground personnel attends a similar examination every two years. Objective: Statistical analysis of crosscorrelation between health status and the degree of prevention (by the means of health services consumption) in a sample of the Hellenic Air Force personnel. Materials – Methods: Calculation of cardiovascular risk score (Hellenic Score) and Body Mass Index in a sample of 190 individuals (92 pilots and 98 individuals from technical/maintenance – air traffic control sectors) from 120 Flight Training Wing and statistical analysis of the level of correlation between health status and the intensity of medical prevention policy. Results: The level of cardiovascular risk depends positively upon the BMI value (p=0.009). The BMI value-overweight and obese is in statistically significant relation to the type of profession (ground personnel p= 0.004). However, the cardiovascular risk score does not seem to depend strongly upon the type of profession. Conclusions: In general, Hellenic Air Force pilots seem to keep a higher level of quality Health status and the interpretation of this result lies upon the policy of Health Prevention measures.

      PubDate: Sun, 13 Apr 2014 03:07:02 GMT
       
  • Pregnancy after renal transplantation and management: a case report and
           review of the literature

    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Gezginc K, Celik C, Karatayli R, Colakoglu MC.
      It is well known that conception rates in dialysis patients with chronic renal failure are low. However, renal transplantation restores fertility and increases conception rates in women at reproductive age. In those who have conceived, pregnancy cannot be anticipated without risks, and mother, fetus and allograft should be closely monitored. Here we report a pregnancy following renal transplantation and review the current literature in terms of proper management.

      PubDate: Sun, 13 Apr 2014 02:21:54 GMT
       
 
 
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