Dr Raghav Gupta
Jammu and Kashmir a hub of tourism with great avenues for Pilgrimage,trekking and adventure tourism also enjoys the credit of having the longest life survival in the valley of Hunza(Gilgit and Baltistan in POJ&K)in the World,which was disclosed by DrVinay Rampal during his lecture on High Altitude Mountain Medicine in the recently held APICON-2024 (79th International Conference of Association of Physicians of India held in New Delhi.
Every year around 140 million people visit high altitude (2500metres and above)as sportsmen,tourists,pilgrims,trekkers and defence and other services personnel in addition to about 100million who permanently reside there .Everyone wants to enjoy the pleasure of high altitude ,but it carries its disadvantages as well if the visitor is not properly conditioned/acclimatised to visit high altitude, because of low partial pressure of Oxygen there,resulting in various ailments ranging from High Altitude Mountain Sickness, a very benign and mild,reversible condition,which starts about 6 to 12 hrs after ascent to high altitude with onset of headache,nausea,vomitting and loss of appetite and loss of sleep and if not properly detected and treated and in persons with other co-morbidities like high blood pressure,diabetes, bronchial asthma, kidney or liver disease may further aggravate to other serious conditions like HACE (High Altitude Cerebral Edema) and HAPE(High Altitude Pulmonary Edema)
People at high altitude not only enjoy a peaceful healthy life,but also are the longest living people on the planet Earth, like those in Hunza valley (Gilgit and Baltistan in POJK now)part of our erstwhile Jammu and Kashmir state and Batalic in Ladakh and it proves that sojourn at high altitude increases the immunity of body and people enjoy a young and healthy life at 60 to 80years and often survive upto 150 years
To reach and enjoy high altitude it’s most important to condition the body by regular aerobic exercise and to administer a cheap medicine called Acetazolamde the night before ascent and continue it for 2to3days after stay there.While ascending it’s also important to follow the principle of “ascend high and sleep low “meaning thereby,if you ascend 2000 ft you must come down 1000ft to sleep and repeat again to prevent HACE and HAPE
Dr Rampal an ace Mountaineer and trekker also described from his own experience in Tibet and Ladakh that in addition to acetazolamide at times steroids and salmetrol inhalation will help in the prevention and management of HACE which starts with signs of high altitude mountain sickness and further aggravates with instability, involuntary movements, cranial nerve paralysis and coma and unless immediately shifted to low altitude may prove fatal. Dr Rampal also described in detail the prevention and management of HAPE with steroids and long acting Nifedipine and immideate shifting to low altitude in a pressuriser Gamow Bag or to a pressurised Chamber that are built in Ladakh and the great role of a cheap medicine acetazolamide in the prevention and management of high altitude related ailments for a successful and pleasurable sojourn at high altitude and invite “”1 the participants for visit to Jammu and Kashmir
This conference was inaugurated by His Excellency Jagdeep Dhankar the Vice-President of India in which more than 8000 Doctors participated.
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