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Article ; Online: Knowledge, Attitude and Practices Regarding Extreme Environments and Cold Adaptation at Extreme Altitudes on the Himalayan Ranges

Inam Danish Khan

International Journal of Travel Medicine and Global Health, Vol 8, Iss 1, Pp 18-

2020 Volume 21

Abstract: Introduction: Extreme-altitudes (5500 m/18045 ft and higher) pose environmental, psychophysiological, infrastructural, logistic, and ergonomic challenges that question explorer’s adaptability and mission-efficiency due to isolation, monotony, ... ...

Abstract	Introduction: Extreme-altitudes (5500 m/18045 ft and higher) pose environmental, psychophysiological, infrastructural, logistic, and ergonomic challenges that question explorer’s adaptability and mission-efficiency due to isolation, monotony, intimidating environment and terse health conditions. The assessment of an explorer’s comprehensive adaptability in extreme-altitudes is of paramount importance in ensuring mission-preparedness. Knowledge, attitude, and practices (KAP) of explorers staying on extreme-altitudes was assessed through personal interview technique. Methods: 125 healthy, acclimatized, mountain-trained explorers staying above 4570 m/15 000 ft in winter-season for at least 30 days on extreme-altitudes were assessed by a single cross-sectional study through personal interviews on KAP related to extreme-altitude and cold-adaptation. Results: Mean duration of stay on extreme-altitude was 55.7 days. All explorers knew about difficulties and health-problems at extreme-altitude. All explorers felt that mountain-training and acclimatization were beneficial. 92% felt that mission tenure of 90 days on the extreme-altitude was adequate. 92.8% felt they were adequately trained for the extreme-altitude; however, only 52% felt confident about health-training. 66.4% did preventive rewarming of extremities. 66.4% regularly smoked/chewed tobacco. 57.6% had sleep problems and 64% had altered appetite. 26.4% felt difficulties related to living conditions, infrastructure, and logistics. Conclusion: Explorers at extreme-altitude exhibited adequate knowledge and performed activities with progressive attitude and healthy practices. Explorers endured altered psychophysiology at extreme-altitude and regarded the utility of training and acclimatization programs. Knowledge-practice gap existed towards tobacco consumption. There was a felt need for the improvement of living conditions, infrastructure, logistics, and health-related training.
Keywords	health knowledge ; attitudes ; practice ; psychophysiology ; Medicine ; R
Subject code	380
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	International Travel Medicine Center of Iran
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: A Rare Case of Cytomegalovirus Colitis with Subsequent Non-tubercular Mycobacteria Immune Reconstitution Inflammatory Syndrome.

Hashmi, Syed Asif / Arora, Sumit / Danish Khan, Inam / Varghese, Jeenu / Pandey, Rahul

Middle East journal of digestive diseases

2023 Volume 15, Issue 1, Page(s) 63–65

Abstract: Cytomegalovirus (CMV) colitis occurs commonly in immunocompromised patients with high mortality. CMV infection has also been reported in immunocompetent individuals and it has a varied clinical presentation. When HIV-infected patients are started on ... ...

Abstract	Cytomegalovirus (CMV) colitis occurs commonly in immunocompromised patients with high mortality. CMV infection has also been reported in immunocompetent individuals and it has a varied clinical presentation. When HIV-infected patients are started on antiretroviral therapy (ART) there is a reconstitution of the immune system which results in the paradoxical worsening of existing conditions or development of new disease conditions known as immune reconstitution inflammatory syndrome (IRIS). In the setting of IRIS one of the most common infections to occur is non-tubercular mycobacteria (NTM). The infection generally develops when the CD4 count is < 50 cells/µL. Here we present a rare case of CMV colitis followed by NTM infection in the setting of IRIS, its management, and treatment outcomes.
Language	English
Publishing date	2023-01-30
Publishing country	Iran
Document type	Case Reports
ZDB-ID	2623796-9
ISSN	2008-5249 ; 2008-5230
ISSN (online)	2008-5249
ISSN	2008-5230
DOI	10.34172/mejdd.2023.323
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evaluation of thyroid lesions by the bethesda system for reporting thyroid cytopathology

Syed Asif Hashmi / Monika Aggrawal / Rahul Pandey / Deepika Gulati / Inam Danish Khan

Journal of Marine Medical Society, Vol 25, Iss 1, Pp 73-

2023 Volume 77

Abstract: Introduction: Thyroid swellings are one of the most commonly encountered lesions with most of the thyroid swellings being benign. The cancerous lesions of the thyroid also present as nodules or masses and pose a diagnostic challenge. The thyroid cytology ...

Abstract	Introduction: Thyroid swellings are one of the most commonly encountered lesions with most of the thyroid swellings being benign. The cancerous lesions of the thyroid also present as nodules or masses and pose a diagnostic challenge. The thyroid cytology reporting system has been inconsistent with the use of various terminologies. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was introduced in 2007 to bring about uniformity in reporting of thyroid lesions. Aim: This study aimed to compare conventional reporting with TBSRTC. Materials and Methods: A retrospective study was done in which 6 years of data were retrieved. Cytology slides were reviewed and categorized as per the TBSRTC and compared with other studies. Results: There were numerous categories in the conventional thyroid fine-needle aspiration cytology reporting system which has been reduced to six categories in TBSRTC. TBSRTC has also streamlined the reporting removing the confusion among cytologists and clinicians. Conclusion: TBSRTC is consistent and reproducible and should be used as a standard method of reporting.
Keywords	conventional reporting ; the bethesda system for reporting thyroid cytopathology ; thyroid fine-needle aspiration cytology ; Naval Science ; V ; Medicine ; R
Subject code	333
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: On-site Management of Frostbite in the Himalayas

Inam Danish Khan

International Journal of Travel Medicine and Global Health, Vol 5, Iss 1, Pp 28-

2017 Volume 32

Abstract: Introduction: Frostbite is a common debilitating condition seen in travelers and residents at high altitudes. Emergent on-site management is warranted in the absence of institutionalized care and compromised evacuation facilities. This prospective, ... ...

Abstract	Introduction: Frostbite is a common debilitating condition seen in travelers and residents at high altitudes. Emergent on-site management is warranted in the absence of institutionalized care and compromised evacuation facilities. This prospective, observational study assessed the outcome of on-site emergent management in low-resource, high altitude healthcare setups in the field, applicable in situations of delayed evacuation. Methods: This is a prospective cohort study. All frostbite patients presenting at 4 Himalayan regions were included. Patients were diagnosed, assessed clinically, and evaluated for causation. On-site emergent management was given in situations of delayed evacuation, and responses were monitored. Further prevention was advised for all patients. Results: Frostbite presented in 172 healthy, acclimatized patients having knowledge of frostbite. A total of 158 (91.86%) males and 14 (8.14%) females with a mean age of 27.8 ± 7 years sustained frostbite at altitudes between 9000-24000 feet with a mean of 14575 ± 3848 feet. First-, second-, and third-degree frostbite comprised 62.2%, 34.3%, and 3.49% of cases, respectively. Fingertips were most frequently affected, followed by toe tips. Of the frostbite cases treated on-site, 57.94% were first-degree and 34.29% were second-degree. Conclusion: Frostbite can occur in people who are cold-experienced and knowledgeable. Therapeutic and preventive rewarming can be attempted in limited-resource setups outside the hospital. Frostbite up to second-degree can be treated under high altitude field conditions; however, this is advisable only in situations of delayed evacuation.
Keywords	Frostbite ; On-site management ; Rewarming ; Cold acclimatization ; Himalayas ; Medicine ; R
Language	English
Publishing date	2017-02-01T00:00:00Z
Publisher	International Travel Medicine Center of Iran
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Chronic Mountain Sickness (Cms) Misdiagnosed As High Altitude Cerebral Edema (Hace) At Extreme Altitude (6400 M/21000 Ft)

Inam Danish Khan

International Journal of Travel Medicine and Global Health, Vol 4, Iss 4, Pp 132-

2016 Volume 134

Abstract: Introduction: Chronic mountain sickness (CMS) represents a syndrome of secondary polycythemia along with thrombocytopenia, altered hemorheology, pulmonary and systemic hypertension, and congestive heart failure, occurring due to hypobaric hypoxia-anoxia- ... ...

Abstract	Introduction: Chronic mountain sickness (CMS) represents a syndrome of secondary polycythemia along with thrombocytopenia, altered hemorheology, pulmonary and systemic hypertension, and congestive heart failure, occurring due to hypobaric hypoxia-anoxia-induced erythropoiesis reported in both native mountain residents and new climbers after prolonged stays at high and extreme altitudes. Case Presentation: A healthy non-smoker non-drinker reported occipital headache, breathlessness, and insomnia after an uneventful stay of 70 days at 6400 m/21000 ft. His hemoglobin was 21 gm/dL. The patient was diagnosed as having a case of CMS with a Qinghai CMS score >6. Therapeutic phlebotomy was performed; 350 mL was drained on two occasions, reducing his hemoglobin to 14.6 gm/dL. Conclusion: The altered presentation, difficult diagnosis, evacuation, and long-term management highlighted in this case occurring at 6400 m/21 000 ft in the Karakoram Himalayas represents the insidious nature of altitude sickness in acclimatized subjects.
Keywords	Chronic mountain sickness ; Excessive erythrocytosis ; Stress polycythemia ; Gaisböck syndrome ; Cerebral edema ; Extreme altitude ; Triple hypoxia syndrome ; Medicine ; R
Subject code	610
Language	English
Publishing date	2016-11-01T00:00:00Z
Publisher	International Travel Medicine Center of Iran
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Reply.

Khan, Inam Danish

Medical journal, Armed Forces India

2012 Volume 69, Issue 2, Page(s) 202

Language	English
Publishing date	2012-10-23
Publishing country	India
Document type	Journal Article
ZDB-ID	196342-9
ISSN	0377-1237
ISSN	0377-1237
DOI	10.1016/j.mjafi.2013.03.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Interactions of urbanisation, climate variability, and infectious disease dynamics: insights from the Coimbatore district of Tamil Nadu.

Suresh, Sudha / Meraj, Gowhar / Kumar, Pankaj / Singh, Deepak / Khan, Inam Danish / Gupta, Ankita / Yadav, Tarun Kumar / Kouser, Asma / Avtar, Ram

Environmental monitoring and assessment

2023 Volume 195, Issue 10, Page(s) 1226

Abstract: Climate change and shifts in land use/land cover (LULC) are critical factors affecting the environmental, societal, and health landscapes, notably influencing the spread of infectious diseases. This study delves into the intricate relationships between ... ...

Abstract	Climate change and shifts in land use/land cover (LULC) are critical factors affecting the environmental, societal, and health landscapes, notably influencing the spread of infectious diseases. This study delves into the intricate relationships between climate change, LULC alterations, and the prevalence of vector-borne and waterborne diseases in Coimbatore district, Tamil Nadu, India, between 1985 and 2015. The research utilised Landsat-4, Landsat-5, and Landsat-8 data to generate LULC maps, applying the maximum likelihood algorithm to highlight significant transitions over the years. This study revealed that built-up areas have increased by 67%, primarily at the expense of agricultural land, which was reduced by 51%. Temperature and rainfall data were obtained from APHRODITE Water Resources, and with a statistical analysis of the time series data revealed an annual average temperature increase of 1.8 °C and a minor but statistically significant rainfall increase during the study period. Disease data was obtained from multiple national health programmes, revealing an increasing trend in dengue and diarrhoeal diseases over the study period. In particular, dengue cases surged, correlating strongly with the increase in built-up areas and temperature. This research is instrumental for policy decisions in public health, urban planning, and climate change mitigation. Amidst limited research on the interconnections among infectious diseases, climate change, and LULC changes in India, our study serves as a significant precursor for future management strategies in Coimbatore and analogous regions.
MeSH term(s)	Humans ; Urbanization ; India/epidemiology ; Environmental Monitoring ; Communicable Diseases/epidemiology ; Dengue
Language	English
Publishing date	2023-09-19
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	782621-7
ISSN	1573-2959 ; 0167-6369
ISSN (online)	1573-2959
ISSN	0167-6369
DOI	10.1007/s10661-023-11856-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Cholemic nephrosis (bile cast nephropathy) with severe liver dysfunction.

Mukherjee, Tanushri / Khan, Inam Danish / Guha, Rena / Ganguly, Tanmay

Medical journal, Armed Forces India

2018 Volume 75, Issue 2, Page(s) 216–218

Language	English
Publishing date	2018-10-11
Publishing country	India
Document type	Case Reports
ZDB-ID	196342-9
ISSN	0377-1237
ISSN	0377-1237
DOI	10.1016/j.mjafi.2018.03.012
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Article: Extreme altitude pulmonary oedema (EAPO) in acclimatized soldiers.

Khan, Inam Danish

Medical journal, Armed Forces India

2012 Volume 68, Issue 4, Page(s) 339–345

Abstract: Background: High Altitude Pulmonary Oedema (HAPO) is the most common challenging emergency at Siachen Glacier. This study was aimed at studying various aspects of Extreme Altitude Pulmonary Oedema (>5500 m/18,000 ft) while correlating it with ... ...

Abstract	Background: High Altitude Pulmonary Oedema (HAPO) is the most common challenging emergency at Siachen Glacier. This study was aimed at studying various aspects of Extreme Altitude Pulmonary Oedema (>5500 m/18,000 ft) while correlating it with acclimatization and post acclimatization duration of stay in retrospect and response to HAPO Bag nursing prospectively. Methods: All clinical cases of HAPO on Siachen were included. Cases were diagnosed using Lake Louis criteria, standard treatment given and response monitored. Data was retrospectively correlated for acclimatization and post acclimatization duration of stay on glacier and prospectively for response to HAPO Bag nursing. Results: Extreme Altitude Pulmonary Oedema presented in fully acclimatized, temporarily resident, mountain trained soldiers and also among native highlanders. HAPO Bag ensued dramatic improvement in the absence of oxygen. Extreme altitude presentation of HAPO with such findings has not been reported in literature earlier. Conclusion: HAPO cannot be prevented at extreme altitudes beyond 5500 m (18,000 ft) by scheduled pre-induction acclimatization, mountain training or prolonged stay at such altitudes. The dictum 'Every day is a new day beyond 18,000 ft' needs to be emphasized and due care needs to be taken in ventures at extreme altitudes. HAPO Bag is an indispensable device to save precious lives and prolong survival at such altitudes due to paucity of available oxygen. Easy availability and universal know how should be ensured.
Language	English
Publishing date	2012-09-28
Publishing country	India
Document type	Journal Article
ZDB-ID	196342-9
ISSN	0377-1237
ISSN	0377-1237
DOI	10.1016/j.mjafi.2012.04.018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Feto-maternal Outcome in Patients with Gestational Diabetes Mellitus in Western India

Shazia Khan / Himadri Bal / Inam Danish Khan / Debashish Paul

Iranian Journal of Diabetes and Obesity, Vol 10, Iss 3, Pp 115-

A Two Years Follow up Study

2018 Volume 120

Abstract: Objective: Untreated gestational diabetes mellitus (GDM) may lead to increased risk of macrosomia, congenital anomalies, unexplained stillbirth, hypoglycemia and jaundice in newborns. This prospective study was conducted to evaluate feto-maternal outcome ...

Abstract	Objective: Untreated gestational diabetes mellitus (GDM) may lead to increased risk of macrosomia, congenital anomalies, unexplained stillbirth, hypoglycemia and jaundice in newborns. This prospective study was conducted to evaluate feto-maternal outcome in women with GDM. Materials and Methods: Two hundred pregnant women underwent 75grams glucose challenge test according to Diabetes in Pregnancy Study of India (DIPSI) criteria. All 26 GDM patients were managed by medical nutrition therapy (MNT), metformin and insulin. Monitoring was done through six-point and seven-point plasma glucose profile, anomaly scan between 18-20 weeks, every three weeks fetal sonography after 28 weeks, fetal echocardiography at 25 weeks, weekly non-stress test and amniotic fluid index after 32 weeks. Descriptive statistics and chi square were used to analyze data. Results: Mean (±SD) age of studied patients was 24.26 (± 3.75) years. Two (7.6%) patients with GDM developed vaginal candidiasis. Six (23.7%) patients underwent caesarean and two (7.6%) underwent vacuum-assisted delivery. One (3.8%) underwent spontaneous abortion. Neonatal outcome was affected by hyperbilirubinemia (12%) in three and shoulder dystocia in one (3.8%) neonate. Conclusion: Timely screening of all pregnant women for glucose intolerance, achieving euglycemia in them and ensuring adequate nutrition can reduce adverse feto-maternal outcomes and promote healthy families. The successful maternal, perinatal and neonatal outcome rests on both the obstetrician’s intrepidity and patients’ awareness of her condition, its implications, management and long term prospects.
Keywords	Gestational diabetes mellitus ; Pregnancy complication ; Glucose tolerance tests ; Medicine ; R
Subject code	610
Language	English
Publishing date	2018-09-01T00:00:00Z
Publisher	Shahid Sadoughi University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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