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Biomedical subjects

B Basnyat

Publications and source records attributed to B Basnyat.

44 records · Page 3Linked to original sources

Medical problems of porters and trekkers in the Nepal Himalaya.

The purpose of this study was to assess the incidence of medical illness among members of trekking groups in the Nepal Himalaya. The design was a cohort study using interview and clinical examination by a single physician. The setting was the Manaslu area in the central Nepal Himalaya along a 22-day trekking route with elevations ranging from 487 m to 5100 m. Subjects were 155 members of commercial trekking groups: 102 Nepali porters, 31 Nepali trek staff, and 22 Western trekkers. We found that medical problems occurred in 45% of party members. The porter cohort contained the highest diversity and severity of illness. The relatively larger porter cohort experienced 77% of the medical problems recorded compared with 17% among Western trekkers and 6% among trek staff. The incidence of medical problems was not significantly different in the porter staff (52%) and Western trekkers (55%) and was significantly lower for the trek staff (13%). High-altitude pharyngitis/bronchitis was the most common illness in the party (12%) followed by acute mountain sickness (8%) and gastroenteritis (6%). Other conditions included anxiety (3%), cellulitis (3%), scabies (3%), snow blindness (3%), acute alcohol intoxication (2%), conjunctivitis (2%), fever (2%), lacerations (2%), and hemorrhoids (1%). Illness with infectious etiologies comprised 33% of the medical problems. The incidence of altitude illness was not significantly less in the Nepali porter staff than in the Western trekkers. Evacuation was required in 5% of party members, all from the porter group. This study should alert expedition medical providers and trip leaders of the need to be observant for and prepared to treat the frequent and diverse medical problems among the porter staff in their party, in addition to the Western members. Medical problems are common in remote mountainous areas, indicating that trip physicians should be experienced in primary care.

Altitude↗

Seizure and hemiparesis at high-altitude outside the setting of acute mountain sickness.

Neurologic problems at high altitudes are well known. What is probably less emphasized are neurologic problems at altitude outside the setting of high-altitude cerebral edema. Because neurologic symptoms for these kinds of problems at high altitude are often transient, neuroradiologic scanning for these problems is usually not done or reported. Furthermore, diagnostic testing facilities may be unavailable in these remote high-altitude settings. A patient is described here with transient seizure and right-sided hemiparesis at high altitude with no preceding symptoms of acute mountain sickness. Computed tomography of the head was obtained in a hospital at lower altitude where the patient was taken promptly. The findings of the scan revealed probable focal cerebral edema in the left parietal lobe in keeping with his temporary right-sided weakness. Possible treatment modalities on the mountain for this problem are also discussed.

Adult↗

The metabolic and ventilatory response to exercise in Tibetans born at low altitude.

The exercise response of 20 Tibetans (T) born and living in Kathmandu, Nepal (1300 m) was compared to that of 21 age- and sex-matched local lowlanders. The subjects carried out an incremental exercise protocol on a bicycle ergometer (30 watt steps every 4 min) until exhaustion. The kinetics of readjustment of VO2 measured as half time (t-on) upon a 90 watt constant load exercise was also determined. Breath-by-breath gas exchange, heart rate (HR) and blood lactate concentration ([La]) were measured at rest, at the end of each load and during recovery. The slope of the straight line relating VO2 to work load was 10.8 ml.watt-1 in both groups which corresponds to a mechanical efficiency of 0.26 (assuming a RQ of 0.89 and an energy equivalent of 20.9 kJ.L-1 O2). At submaximal loads T were characterized by higher VE (P < 0.05), VE.VO2(-1) (P < 0.01) and VCO2 levels (P < 0.001) than N. The found higher VE in T, resulting from a lower tidal volume coupled to a higher respiratory frequency, led to higher PETO2 (P < 0.001) and SaO2 (P < 0.001) at all work levels. Absolute VO2max in the two investigated groups were 1977 +/- 72 (T) and 2095 +/- 80 (N) ml.min-1 (NS). Specific (i.e. per kg body weight) VO2max were identical (37.0 +/- 1.1 [T] vs. 36.7 +/- 1.1 ml.kg-1.min-1 [N]). [La]max were 11.4 +/- 0.4 (T) vs. 12.3 +/- 0.4 (N) mM (NS). [La] accumulation in blood as a function of workload and its rate of disappearance during recovery were similar. t-on at 90 watt was 30.7 +/- 2.4 sec in T and 28.9 +/- 2.3 sec in N (NS). The corresponding average contracted O2 deficit were 971 ml for T and 994 ml for N (NS). In conclusion, Tibetans born at low altitude do not seem to differ from lowlanders with regard to their metabolic response whereas their ventilatory response to exercise is greater.

Adolescent↗

Pollen, mite and mould samplings by a personal collector at high altitude in Nepal.

The new personal portable sampler for detection of environmental biologic particles (Partrap FA52, Coppa, Biella, Italy) was used to evaluate both atmospheric and indoor biologic particles in bedding at high altitudes during two Italian scientific expeditions in Nepal, in 1994 and 1996 respectively. The sampling was performed outdoors and indoors at the following altitudes: Katmandu 1,330 meters (m), LuKla 2,800 m, Namche 3,500 m, Pericle 4,200 m and Piramide 5,050 m. In both expeditions each sample of outdoor and indoor air was obtained by sucking air into the sampler either against the wind during a 6-h period, from 9 am to 3 pm, or from bedding of inhabitants resident at the different altitudes for 5 min. The number of pollens, moulds and mites trapped in each sample were assessed. The statistical analysis of the results by Spearman correlation test revealed a significant inverse correlation (p < 0.02) between altitude and the number of the considered biologic particles for sampling carried out during both the 1994 and 1996 expeditions. Moreover, Wilcoxon paired test showed no significant difference between the biologic sampling obtained in the two expeditions. These results confirm the decrease of the environmental biologic charge in relation to the increase of altitude and prove the efficacy of Partrap FA52 in obtaining reproducible quantitative data.

Air Pollution↗