Title: Pen Paper & A Pulse Oxymeter: Prospective Study of the Effect Acetazolamide Have in Quick Trans-Himalayan Acescent
Authors: Dr Sourav Iswarari MBBS, MD (PM&R), Dr Ushnish Mukherjee MBBS, Dr Rachit Gulati MBBS, Dr Jayanta Kumar Rout MBBS, MD (Biochemistry), Dr Tapobrata Guha Ray MBBS, MD (Community Medicine)
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.09
Abstract
Introduction: Two Bengali mountaineering team of expeditionist one from Kolkata, India other from Bangladesh took part in a study to determine the effect of acetazolamide by easily usable parameters in quick high altitude sojourns .The aim was also to see if data collected can be used by layman expeditionist for meaningfully accessing team’s condition thereby making rational choices in such wilderness.
Materials & Methods: Two expeditions were conducted separately in the same region of Trans Himalayan high altitude deserts of Northern most Spiti in Himachal Pradesh, India. Those who had any acute or chronic illness, patients on regular medications, and those who had sojourns at an altitude > 2500 meters during the previous 4 weeks, age < 20 or > 60 years and hemoglobin concentration < 12.0 g/dL were not involved in the study. Sojourns were attempted at month of July/August in two consecutive seasons. In group 1 from Kolkata 13 subjects were put on acetazolamide. The regimen was to take 125 mg acetazolamide twice daily. In group 2 from Bangladesh had 9 subjects who did not opt for medical prophylaxis by choice. During high-altitude exposure, resting measurements of peripheral capillary oxygen saturation (SpO2), heart rate (HR) and Lake Lewis Score (LLS) were taken in the evening of 1st, 2nd, 5th day, 6 Th and 8th day starting from 293 meter and ending in 5200 meter as subjects climbed relentlessly.
Results: Average age in group 1 was 43.08 ± 11.62 years (range: 25 to 65 years) while that of group 2 was 30 ± 4.74 years (range: 23 to 36 years). All were males. RANK tests are done for data which were not normally distributed and analyzed by Man-Whitney U. This showed significant difference of LLS noted between two groups at 3910 m only. The group under acetazolamide prophylaxis showed significant better outcome then ones without it. In independent sample test of parametric data, t-test for equality of means revealed Sp02 (t=4.616 ) and HR (t=-3.486) had highly significant changes .The group who were not given acetazolamide prophylaxis showed comparative increase in HR and decreased Spo2 at that critical altitude which were statistically significant.
Conclusion: Acetazolamide was shown to further the process of acclimatization at a critical time-line and altitude window. The study in the process was able indicate definable relationship between various parameters at different altitudes which were in concurrence with physiological responses.
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