A Study of High-Altitude-Associated conditions in soldiers less than 50 years of age admitted in the ICU of a tertiary care military hospital operating in a counter insurgency operation area

Introduction: Acute coronary syndrome (ACS) is common in serving personnel and requires prompt diagnosis and treatment. This retrospective study was done to see the profile of ACS in serving personnel presenting to a tertiary hospital without cardiac catheterization laboratory (CCL) facilities. Methods: ACS was diagnosed based on an electrocardiogram (ECG), clinical features, and cardiac biomarkers. History of comorbidities, risk factors, and preceding exertion was taken. Immediate medical management was done as per the standard guidelines, and follow-up angiography was done at a dependent cardiology center with CCL. Results: A total of 75 personnel reported with ACS. The mean age of personnel was 42.01 ± 8.59 years. Acute ST-elevation myocardial infarction (STEMI) was noted in 48% (36/75) of the patients, 32% (24/75) had non-STEMI, and 20% (15/75) had unstable angina (UA). Low ejection fraction was more common in patients with STEMI (P ≤ 0.001). History of preceding exertion was noted in 55 personnel. Eighteen patients with STEMI were thrombolysed. Angiographically significant lesions were noted only in 30.6% (23/75) individuals with ACS. Conclusion: ACS is common in deployed serving personnel. The most common precipitators were immediate preceding exertion and smoking. Morbidity and mortality due to ACS can be decreased by digital transmission of ECG, prehospital thrombolysis, graded physical exertion, and counseling about a healthy diet.

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Study of Clinical Spectrum, Laboratory Parameters, and Radiological Patterns in Cerebral Venous Thrombosis Cases Occurring at High Altitude

Naik¹,

Prasad²,

Singh³

et al. 2021

Journal of Marine Medical Society

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Context: The risk of cerebral venous thrombosis at particular locations and its association with high altitude is yet to be established completely. The relation between high altitude and venous thromboembolic events has been debated for many years. Cerebral venous thrombosis presenting with nonspecific symptoms like headache can be a tough challenge for primary care physicians deployed at high altitudes. Materials and Methods: Combatants going to wide areas of mountainous territories at varying altitudes presenting with persistent severe headache associated with nausea and vomiting were subjected into the study after evaluation at zonal and tertiary care hospital. Results: Over a period of 18 months from October 2018 to March 2020, 75 cases of headache were screened and evaluated. Eighteen of these patients were diagnosed to have cerebral venous thrombosis. Conclusion: The occurrence of chronic venous thrombosis in combatants who enter and remain at high altitude for the prolonged duration is very common and the gold standard for diagnosis is a clinical evaluation with radio imaging.

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A Study of High-Altitude-Associated conditions in soldiers less than 50 years of age admitted in the ICU of a tertiary care military hospital operating in a counter insurgency operation area

Cited by 3 publications

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M3: The military medicine module: A focussed competency-based program

M3: The military medicine module: A focussed competency-based program

Profile of Acute Coronary Syndromes in Serving Personnel Presenting to a Field Cardiology Center Without Cath Lab Facilities

Study of Clinical Spectrum, Laboratory Parameters, and Radiological Patterns in Cerebral Venous Thrombosis Cases Occurring at High Altitude

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