https://militarymedj.bmsu.ac.ir/ Journal of Military Medicine en daily 1 Sun, 10 May 2026 00:00:00 +0330 Sun, 10 May 2026 00:00:00 +0330 https://militarymedj.bmsu.ac.ir/article_1001369.html Attacks on healthcare infrastructure and medical personnel during armed conflicts represent a severe violation of international humanitarian law and ethical standards. Recent events in the Middle East, including the destruction of hospitals in Gaza and Iran, highlight a troubling pattern of selective silence by international institutions. This commentary reflects on the humanitarian, ethical, and psychological consequences of such attacks and calls for global accountability and consistent condemnation from international health and medical organizations.In the past two years, more than 30 hospitals in Gaza have reportedly been destroyed, with organizations such as Médecins Sans Frontières (Doctors Without Borders) documenting several of these incidents. The continued targeting of healthcare infrastructure in conflict zones is in clear violation of the Geneva Conventions, which explicitly prohibit attacks on medical facilities and personnel.Despite the scale of destruction, there has been a notable lack of explicit and consistent condemnation from leading international health bodies, particularly the World Health Organization (WHO). This silence not only undermines established humanitarian norms but also risks normalizing such actions. The consequences of this inaction became tragically evident during recent Israeli airstrikes on Iran, reportedly occurring while diplomatic negotiations with the United States were ongoing in Oman.As a result of these attacks, four hospitals and three emergency health centers in Iran were destroyed. One of the initial targets was a psychiatric hospital in Kermanshah, a region already grappling with a shortage of mental health resources. The strikes resulted in the deaths of six physicians, including a young pediatrician and mother of a four-year-old child, along with 14 staff from Iran’s medical and Red Crescent services. Additionally, a medical student lost their life in a residential area, and another suffered limb amputation due to a drone strike.These events raise a critical question: If similar attacks have occurred in Gaza, Lebanon, and now Iran, where will be next? Without a unified and decisive response from the international health community, such violations may become dangerously normalized.The psychological impact of these attacks extends beyond the immediate casualties. In Iran, the strikes coincided with national school and university entrance examinations. This timing exacerbated stress and trauma among students, with many reporting acute symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). The long-term health implications of this psychological trauma are deeply concerning and warrant international attention.As a former hospital director in Iran, I appeal to the global health and medical community to break its silence. Upholding humanitarian law and medical neutrality must not be selective or politically influenced. A consistent and principled stance is essential to preserve the sanctity of healthcare in conflict zones and protect the lives of those who dedicate themselves to healing others even amidst war.The erosion of protections for medical infrastructure in conflict must not go unchallenged. We urge international organizations, medical associations, and healthcare professionals worldwide to reaffirm their commitment to the principles of humanitarian law and to demand accountability for all violations, regardless of geography or politics. https://militarymedj.bmsu.ac.ir/article_1001368.html In the contemporary world, rapid scientific and technological advances, while creating unprecedented opportunities for human development, have also provided new capacities for structural violence. Recent wars and military conflicts have taken on broader dimensions of crime and violence by targeting scientific communities along with educational and research infrastructure. Meanwhile, the concept of "scientific terrorism" as one of the emerging forms of violence refers to a set of actions designed and implemented with the aim of weakening, destroying, or disrupting the scientific infrastructure, human capital, and knowledge capacities of a country. Focusing on the analysis of the recent United States (US) and Israeli attacks on the Iranian scientific community, especially tragedy the "Shajareh Tayyebeh" elementary school in Minab city, this article aims to explain the concept of "scientific genocide" as a more advanced and systematic stage of scientific terrorism. In this research, scientific genocide is defined as a targeted process for the gradual or sudden destruction of the science production cycle, through the physical removal of elites, the destruction of educational centers, and the creation of psychological insecurity in various scientific environments. On the first day of the Ramadan War (28th of February 2026), the attack on Minab School, a civilian educational center, by a Tomahawk cruise missile resulted in the martyrdom of 168 innocent children and school staff and the injury of 96 others, which is not only an example of a violation of the principle of separation and proportionality from the perspective of international humanitarian law, but also, from a conceptual perspective, represents the transition from scientific terrorism to scientific genocide. This event can be analyzed as a chain of actions including the assassination of scientists, attacks on universities, and targeting students. It indicates the formation of a macro strategy to weaken the scientific and technological foundations of a country. The lack of a clear definition of "scientific terrorism" and "scientific genocide", along with political and structural challenges, has caused relative inefficiency in the pursuit and prevention of these types of crimes. On the other hand, the international scientific community, despite having significant capacities in documenting, raising awareness, and creating international pressure, has not yet been able to play a coordinated and effective role in dealing with this phenomenon. Dealing with scientific terrorism and scientific genocide requires a multi-level and interdisciplinary approach that includes redefining legal concepts, strengthening multilateral regulatory mechanisms, institutionalizing ethics in scientific research, and developing international cooperation in support of the scientific community. It is suggested that future research be conducted with the aim of focusing on the analysis of experimental data and evaluating the long-term effects of this phenomenon on scientific development indicators, deepening the understanding of this concept and providing practical solutions for its prevention. https://militarymedj.bmsu.ac.ir/article_1001370.html The colloquial term "Kickbacks" is usually considered synonymous with "bribe"; however, bribe encompasses a broader range of definitions according to established legal and judicial standards. It refers to a series of actions that result in the payment and acceptance of illicit property, for which the offenders may face legal penalties based on applicable laws and regulations. In this editorial, I do not intend to delve into this specific category, as numerous scholarly articles already examine it in depth. Instead, I aim to emphasize, from a sense of responsibility, the importance and reminder of fulfilling the duty to "enjoining right and rorbidding wrong." https://militarymedj.bmsu.ac.ir/article_1001371.html Traditional drug delivery methods, like immediate-release tablets and coventinal injections, have always faced limitations such as poor drug solubility, poor biocompatibility, rapid clearance from the body, and inability to control the time and location of release. These challenges often reduce the therapeutic effectiveness and increase the fluctuations of drug concentration in the body. Recently, advances in materials technology, nanotechnology, bioengineering, and computational modeling have opened a new path in the design of drug delivery systems. In this study, different types of drug delivery, including polymeric nanoparticles, micelles, liposomes, injectable hydrogels, slow-release implants, osmotic systems, nanogels, and dendrimers, were investigated and compared. The methodology was designed based on a literature review of reliable scientific sources, research articles, clinical and laboratory findings, and patents submitted between 2000 and 2025 by searching multidisciplinary databases including PubMed, Scopus, and Web of Science. Upon the reviewed refrences, combining smart materials with programmable platforms such as implants and stimulus-responsive systems (such as pH, temperature, enzyme, magnetic field, etc.) can significantly improve targeted and timed drug release. Also, systems such as drug-coated vascular scaffolds, implantable pumps, and tunable microchips were able to enable sustained release in chronic applications such as diabetes, cancer, and neuropathic pain. In summary, by compiling existing research achievements and critically analyzing emerging technologies, a strategic framework for designing next-generation drug delivery systems has been presented, and the results of this study will pave the way for the development of precise, personalized, and long-term effective treatments in various medical fields. https://militarymedj.bmsu.ac.ir/article_1001372.html Background and Aim: Breast cancer, the most common malignancy in women and the second leading cause of cancer-related mortality, continues to demand more effective therapeutic strategies. Current treatments, including surgery, radiotherapy, and chemotherapy, are often limited by drug resistance, high toxicity, and substantial costs. Consequently, the development of novel and alternative therapeutic approaches is of significant importance. This study aimed to investigate the effects of chitosan nanoparticles coated with Allium ursinum (A. ursinum) extract on the proliferation of 4T1 breast cancer cells.Methods: Chitosan/A. ursinum nanoparticles were synthesized by loading A. ursinum extract onto chitosan. The physicochemical properties of the nanoparticles were characterized using Fourier-transform infrared spectroscopy (FTIR), dynamic light scattering (DLS), and field emission scanning electron microscopy (FESEM). Subsequently, 4T1 cells were cultured in RPMI 1640 medium, and the effects of the nanocomposite on cell viability were assessed using the MTT assay.Results: The synthesized nanoparticles had an average size of 145 nm with a polydispersity index (PDI) of 0.28, indicating a relatively uniform particle distribution. FTIR analysis confirmed the successful loading of A. ursinum extract onto chitosan, as evidenced by the presence of characteristic peaks corresponding to functional groups of both components. The chitosan/A. ursinum nanoparticles demonstrated dose-dependent inhibitory effects on 4T1 cells. The IC50 of the nanocomposite was 0.64 µg/mL, significantly lower than that of chitosan or A. ursinum extract alone.Conclusion: Chitosan/A. ursinum nanoparticles effectively inhibited the proliferation of 4T1 breast cancer cells without exerting cytotoxic effects on normal cells. This nanostructure may serve as a promising therapeutic candidate for further preclinical and clinical investigations. https://militarymedj.bmsu.ac.ir/article_1001373.html Background and Aim: Mucoadhesive drug delivery systems are a type of novel drug delivery system predominantly available in the form of polymeric films. These films extend the drug release time and create a high concentration gradient for drug penetration, leading to enhanced drug absorption. The aim of this study was to prepare and evaluate polymeric films containing eugenol for the improvement of mild to moderate oral cavity wounds and inflammation.Methods: In this experimental study, mucoadhesive films containing eugenol were prepared using the Solvent Casting method, employing ingredients such as HPMC (Hydroxy propyl methyl cellulose) powder as the film-forming polymer and glycerin as a plasticizer. The films were evaluated for their physical and pharmaceutical properties, including weight, thickness, disintegration time, drug release, and release profile.Results: The results indicated that formulations with higher eugenol concentrations, such as F5, exhibited higher absorption, suggesting stronger therapeutic effects. Cumulative release profiles showed that this formulation, with a faster release rate (95.5% in 60 minutes), is suitable for quicker treatments compared to other formulations.Conclusion: Parameters from the Korsmeyer-Peppas equation indicated that formulations with n values close to 1, utilizing both diffusion and swelling processes, exhibited faster drug release. Formulations with higher glycerin content, including F5, demonstrated a higher release rate, making them suitable for rapid treatments. Overall, these formulations can be designed for treatments with specific needs, such as rapid or controlled therapies. https://militarymedj.bmsu.ac.ir/article_1001374.html Background and Aim: In the 21st century, the increase in natural and man-made disasters has created serious challenges for public health. Biological hazards, with their characteristics such as high spread rate and genetic changes, require a rapid and coordinated response, but the lack of specialized resources, the lack of clear definition of organizational roles, and the dissemination of incorrect information complicate the management of these events. In the meantime, the preparedness of hospitals is considered as a key factor in reducing the casualties of these events and maintaining the performance of the health system. Given that some studies show that hospitals in Iran, despite some strengths in human resources, are still not prepared in terms of the prerequisites for response, this study was conducted with the aim of accurately assessing the level of preparedness of these hospitals against biological disaster.Methods: This descriptive, analytical, cross-sectional study was conducted in 1404 using a standard questionnaire to assess bio-preparedness across eight main dimensions: development of management structures, capacity building, education and training, information and communication management, care and laboratory systems, safety and security, patient management, and resilience. The statistical population consisted of university-affiliated educational and medical centers, specifically 11 hospitals. The average of the data was then calculated to determine the percentage of hospital preparedness.Results: The findings showed that large public centers performed well in most dimensions of biopreparedness, with an average score of 75%, and were able to offer a model of organizational resilience and biological incident management. More than half of the centers were at an average level, scoring 54%, which indicates limited resources and the need to strengthen management structures, training, and practice. Some Single-specialty centers performed poorly in the dimensions of patient management, triage, and resilience, scoring 30%, highlighting their supportive role in the biological response network and the need for improvement.Conclusion: The research results emphasize that biopreparedness depends not only on physical resources, but also on the development of a management structure, continuous training and practice, information and communication management, diagnostic infrastructure, safety protocols, patient management, and organizational resilience. https://militarymedj.bmsu.ac.ir/article_1001376.html Background and Aim: Hospital-based cancer registries provide detailed clinical and pathological information that is often absent from population-based registries. This study describes the design and implementation of a structured breast cancer registry at Baqiyatallah Hospital and presents an initial profile of the data recorded.Methods: This retrospective registry-based study included 185 patients with primary invasive breast cancer. Demographic, histopathological, and molecular variables, including tumor grade, estrogen and progesterone receptor (ER/PR) status, HER2 expression, Ki‑67 index, lymphovascular invasion (LVI), and perineural invasion (PNI), were extracted from the hospital’s electronic registry. Descriptive statistics and chi-square tests were used.Results: Grade 2 was the most common histological grade (65.9%). ER and PR positivity were observed in 75.1% and 71.4% of patients, respectively. HER2 overexpression (3+) was present in 16.2% of cases, and Ki‑67 <20% in 87.6%. LVI and PNI were detected in 72.4% and 36.2% of tumors. Higher tumor grade was significantly associated with lower PR positivity and higher PNI frequency (P=0.040 and P=0.044).Conclusion: The Baqiyatallah breast cancer registry successfully enabled structured and complete documentation of key clinical and pathological variables. The observed patterns align with national and international reports, while the high prevalence of LVI and PNI highlights the need for further investigation. Expansion of similar registries across Iran can strengthen data-driven planning and improve breast cancer control strategies. https://militarymedj.bmsu.ac.ir/article_1001377.html Background and Aim: Motor disorders of the upper limbs in children with cerebral palsy cause limitations in performing their daily activities. Neuromuscular exercises are innovative approaches used in the rehabilitation of central nervous system injuries. The aim of our study is to investigate the effect of neuromuscular training on muscle stiffness, range of motion, and gross manual dexterity in children with hemiplegic cerebral palsy.Methods: In an experimental study with a pretest-posttest design, 18 children with spastic hemiplegic cerebral palsy aged 4 to 11 years were selected by convenience sampling. The range of motion for wrist extension and forearm supination was measured using goniometry; muscle spasticity of the wrist flexors and forearm pronators was evaluated using the modified Ashworth scale; and gross manual dexterity of the children’s hands was assessed by the Box and Block test at the beginning and end of the study. The neuromuscular exercise protocol was conducted for 8 weeks, with 3 sessions per week and each session lasting 45 minutes. In this study, the unaffected upper limb of the children was considered as the control group, and all assessments performed on the affected side were also conducted on the unaffected side.Results: According to the results obtained, a significant increase was observed in the mean scores of wrist extension range of motion and forearm supination in the affected limb (P<0.001). The results also show that the neuromuscular exercise intervention on the affected limb caused a significant reduction in the stiffness of the forearm pronator muscles and wrist flexion (P<0.001). However, our intervention did not have a significant effect on the dexterity of the affected hand in children with hemiplegic cerebral palsy (P=0.39).Conclusion: It appears that the neuromuscular protocol used in this study can increase the range of motion of restricted joints and reduce the spasticity of the affected muscles in the forearm and wrist of children with hemiplegic cerebral palsy. https://militarymedj.bmsu.ac.ir/article_1001375.html Background and Aim: This study aimed to analyze the strengths, weaknesses, opportunities, and threats (SWOT) of athletic sports in the armed forces of the Islamic Republic of Iran in 2025.Methods: This was a mixed-method (qualitative-quantitative), survey-based, cross-sectional study.  Data were collected through semi-structured interviews with 15 purposefully selected experts. Analytical tools included Internal Factor Evaluation (IFE), External Factor Evaluation (EFE) matrices, and Friedman’s test.Results: The findings indicated that documented regulations, specialized experts, and experience in organizing competitions were the main strengths, while the lack of long-term planning and insufficient financial resources were key weaknesses. Opportunities included participation in international CISM competitions and collaboration with sports organizations, whereas threats comprised the absence of cultural-spiritual policies and equipment shortages.Conclusion: These findings provide strategies for developing strategic plans to enhance physical fitness, mental health, and success in international events.