ABSTRACT
BACKGROUND: In Western Himalayas, Indian Army soldiers take 11 days (6 days of acclimatization and 5 days of travel) on a sea-level to high altitude road (SH road) to reach a high altitude location (HAL) situated at an altitude of 11,500 feet from sea-level location (SLL) at an altitude of 1150 feet while following acclimatization schedule (AS). AS has an extra safety margin over the conventional 'mountaineering thumb rule' of not exceeding 500 m sleeping altitude above 3000 m altitude. We carried out this randomised field trial to study the feasibility of moving large number of troops rapidly from SLL to HAL on SH road in western Himalayas in 4 days under pharmaco-prophylaxis. METHODS: Based on the pharmaco-prophylaxis, at SLL 508 healthy lowland soldiers were divided into two groups: 'A' (n = 256) with Acetazolamide + Dexamethasone and 'B' (n = 252) with Acetazolamide + Placebo. They travelled rapidly by road to HAL in 4 days and prevalence of acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE) during the ascent was measured. RESULTS: Prevalence of AMS was found to be 1.56% and 1.59% in group 'A' and group 'B' respectively during the ascent with no cases of HAPE and HACE. CONCLUSION: At least on SH road, troops can be inducted rapidly to HAL from SLL in 4 days under pharmaco-prophylaxis with Acetazolamide with minimal occurrence of acute high altitude illnesses.
ABSTRACT
BACKGROUND: Military operations and training in hot environments present a special set of challenges to medical personnel who must support them. METHODS: Various meteorological parameters such as relative humidity (RH), ambient air temperature (Ta) and radiant temperature (Tg), were evaluated at training sites in a desert region. Development of a colour coded Heat Stress Prevention Decision Aid Tool was done using an existing guideline chart. RESULTS: Temperatures were being recorded routinely by ordinary meteorological instruments mounted within a Stevenson Screen. Onsite measurements with a USB datalogger was found to be relevant in making a decision on suitability of weather for conduct of training. Heat casualties occur when the stresses imposed by some combination of environment, work, and clothing combine to exceed individual tolerance limits. Personnel may encounter high environmental heat loads while working outdoors; during road marches; and while carrying loads or undertaking mechanical maintenance activities. Preventive strategies cannot be expected to eliminate heat stress but should minimize its impact on training while preserving the health of personnel to the extent possible. CONCLUSION: It is recommended that onsite measurement of meteorological parameters should be done, and a decision tool should be utilized for arriving at a spot decision by junior leaders.
ABSTRACT
Dengue, a viral disease transmitted by the Aedes mosquito has the potential to cause outbreaks in urban settings. Planned and coordinated actions including entomological surveillance need to be undertaken at the community level, through synergized efforts by all partners and stakeholders. The experience of conducting such a Task Force based action plan for prevention and control of dengue, in a desert township is highlighted in this study.
