Introduction: Stress is a term that is widely used in everyday life. Work-related stress is recognized globally as a major challenge to workers’ health and the health of an organization. Stress at work has become a serious problem affecting many people of different professions, life situation and age groups. The healthcare profession has been depicted as one of the most stressful occupations across the globe. Objective: To assess the extent of occupational stress among health professionals of Combined Military Hospitals and to explore its association with work-related factors and family-work interference. Materials and Methods: A total of 574 respondents were selected from five Combined Military Hospitals using simple random sampling considering doctors, nurses, paramedic medical assistants and technologists as the study population. Occupational stress was determined by Health Professions Stress Inventory (HPSI). Results: Stress of health professionals was reassessed through HPSI and 1.0%, 77.6%, 20.7% and 0.8% were found to be mild, moderate, very and extremely stressful respectively. About one fifth (21.4%) were found to be in high stress. High stress was more prevalent among Paramedic Medical Assistants (PMAs) (24.5%), Paramedic Medical Technologists (PMTs) (23.2%) and nurses (21.9%) on contrary to doctors (11.7%). Their mean stress scores were 55.70±13.75, 55.44±13.53, 56.18±10.55 and 50.92±10.93 respectively (p<0.05) out of 124. Highest stress was in CMH Dhaka (56.50±14.27) followed by CMH, Rangpur (53.43±11.65) (p<0.05). The mean work hour per week for doctors, nurses, PMAs and PMTs were 63.25(±18.95), 55.70(±9.72), 89.58 (±17.44) and 80.58 (±16.12) hours respectively (p<0.05). Working for long/unsociable or unpredictable hours, financial and job insecurity were found to be related to the greater prevalence of high stress (p<0.05). The parameters of pressures at work, job satisfaction and support from colleagues/superior were found to be associated with high stress (p<0.05). Higher prevalence of family-work interference was found to be a predictor of high stress (p<0.05). Conclusion: A large proportion health professional of Combined Military Hospitals were in high stress due to the prime stressors. Measures like workload-management, job-redesign, employee motivation and training should be taken to alleviate these stressors. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 37-41

Introduction: Middle ear barotrauma is a common medical problem related to aviation; because the aviation environment exposes the aviator to a rapidly changing ambient pressure. Middle ear barotrauma occurs when the Eustachian tube failed to equalize middle ear pressure with ambient pressure during flight. Objective: To determine the prevalence of middle ear barotraumas among aircrew on Bangladesh Air Force (BAF) and to find the risk factors of middle ear barotrauma. Materials and Methods: This cross-sectional study was carried out on middle ear barotrauma in aircrew of BAF from February 2018 to January 2019. Aircrew who experienced fullness in the ear or ear pain during flight and visited the flight surgeon was enrolled in this study. Modified TEED scale used for grading of middle ear barotrauma. Results: The study revealed middle ear barotrauma in the aircrew was 12.0% with a higher prevalence among the student pilots (14.2%) compared with trained pilots (5.9%), the mean age of aircrew was 23.2 ± 3.6 years. The right ear (43.5%) was affected in most of the cases than the left ear (34.8%). Most of the symptoms developed at a stage of descending (60.9%). The duration (mean± SD) of sickness was 7.6±3.7 days. Conclusion: Middle ear barotrauma or ear block is common in trainee aircrew but it is also seen in the experienced pilots who fly with upper respiratory tract infection (URTI) or a common cold. Appropriate training on ear physiology related to pressure changes inside the hypobaric altitude chamber can prevent the incidence of middle ear barotrauma. JAFMC Bangladesh. Vol 17, No 1 (June) 2021: 14-17

Introduction: When there is a difference of patient's blood pressure (BP) which is measured in a physician's office and patient’s home, it is said to have White Coat Hypertension (WCH). Prevalence of WCH is very much common among aircrew, because they need to face everyday preflight medical checkup. Objective: To find out the incidence of WCH among the aircrew of Bangladesh Air Force (BAF) as well as to ascertain the long-term clinical implications of WCH. Materials and Methods: This cross-sectional observational study was conducted among 150 aircrew, reported to Central Medical Board (CMB), Bangladesh Air Force (BAF) for periodical medical evaluation, during the period January 2014 to December 2018. Study subjects were selected purposively with age range 25-50 years; those who did not have any history of hypertension or received any anti-hypertensive medication but were detected elevated BP having clinical recording of BP ≥ 140/90 mm of Hg. Ambulatory blood pressure monitoring (ABPM) was performed on them for 24 hours in order to distinguish between those who were truly hypertensive and those who were suffering from WCH. To exclude secondary causes of hypertension as well as to assess for evidence of target organ damage (TOD), a thorough clinical and laboratory examination as well as regular follow-up were also performed. Results: White Coat Hypertension was observed in 26.7% of the aircrew. There was no evidence of target organ involvement, such as left ventricular dysfunction, left ventricular hypertrophy, hypertensive retinopathy or renal involvement. Conclusion: WCH is comparatively common among the aircrew. This highlights the importance of the requirement for regular follow up of all cases of WCH, over the normotensive subjects with a view to identify early organ involvement and therapeutic intervention are often initiated as and once needed. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 14-17

subjected to atmospheric pressure changes and have an influence on flights. Barodontalgia is caused whenever the pulp is exposed to differential pressure gradient. Objective:  To see the barodontalgia among aircrew of Bangladesh Air Force. Methodology: A cross-sectional study was carried out in Dental wing medical squadron BAF base Basher Dhaka. The study participants were recruited during one year among all the pilots and crewmembers attending departments specializing in medical follow-up at the study period from the Bangladesh Air Force. Results: Among the 50 barodontalgia group, most 39(78%) of the respondents were found technical and military flying whereas 50 without barodontalgia group 38(76%) specifically in military flying. In barodontalgia, 62% respondents were found in moderate pain (4-6), 26% in mild pain (1-3) and 32% in severe pain (7-10). In barodontalgia, 50% respondents were descent of barodontalgia, 52% were altitude where barodontalgia was reported to appear during the flight was <4000 meters and 70% were flight speed was 500-1000 km/h. Most of the respondents were found specifically in commercial flights in patients with barodontalgia. Majority pain intensity was found moderately in barodontalgia JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 186-188

Introduction: Fighter flying is one of the most hazardous occupations known to man. Emergency escape from the aircraft is an important issue to ensure the safety and survivability of aircrew. In spite of advancement of ejection system, both rate and severity of injuries sustained during ejection remain a cause for concern. Objectives: The purpose of this study was to assess the number of survivability, causes of death in fatal cases, patterns of ejection injuries among the aircrews of Bangladesh Air Force (BAF) and to find out the ways to minimize the fatality and injuries during escape from disabled aircraft. Methods: This descriptive case series study was conducted at the BAF flight safety directorate and Combined Military Hospital (CMH), Dhaka among the aircrews of Bangladesh Air Force fighter planes which were crashed during the period of 1982 to 2012. The records of injuries, medical documents during admission at hospital, radiological and laboratory investigations reports, clinical analysis of pilots were utilized for this paper. Post mortem reports of fatal cases were also carefully considered. Results: Out of 23 ejection cases 10(43.48 %) were fatal and 13(56.52%) cases were non fatal. All the pilots (100%) had multiple abrasions, bruises, lacerations in their body. Penetrating injury was observed in one case (10%), one (10%) body was totally mutilated and 06(60%) showed burn injury. All the pilots had thoracic spine compression fracture (100%), 8(80%) had cervical hangman’s fracture and lumbar spine fracture. Seven victims (70%) had ruptured diaphragm, 6(60%) had ruptured liver, 5(50%) had ruptured spleen, 2(20%) pilots had ruptured kidneys and urinary bladder. All the pilots (100%) had fracture of lower limbs, 8(80%) had fractured upper limbs. Among the non fatal cases all the pilots (100%) had multiple abrasions, bruises, 6 (46.15%) had laceration, 01 (7.69%) each sustained anterior cruciate ligament tear of knee joint (Lt) and fracture middle of the shaft of the humerus (Lt). The mean age of the pilots was 31yrs (24 – 41 yrs). Conclusion: Protective measures and training among aircrews should be updated, so that less injury occurs in survivors. Thorough medical diagnosis and psychological treatment are required for the injured aircrews.DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21861 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013