Chapter I  PAKISTAN: Hindukush, Karakoram, Himalaya Mountains

 

Dr. Muhammad Ilyas

International Medical Research Center, PHF, Hayatabad, Peshawar

Prof. Farakh A. Khan 

King Edward Medical College, Lahore

Other Regions Kaghan, Murree, Gabral, Kalam, HKH

B.  Highlanders’ Health

1. General introduction

2. History of Mountain Medicine in Kyrgyzstan

3. Short term adaptation to high altitude

4. Cardiovascular system at high altitude

5. Pulmonary Circulation at high altitude

    5.1 Pulmonary Circulation during acute induction to high altitude

    5.2 Effects of intermittent high altitude hypoxia on pulmonary circulation

    5.3 High altitude pulmonary hypertension and high altitude cor pulmonale

6. Common medical condition at high altitude

    6.1 Coronary heart disease

    6.2 Cardiac rhythms disturbances

    6.3 Chronic obstructive pulmonary disease

    6.4 Essential hypertension

    6.5 High altitude and congenital heart diseases 

7. Immune system at high altitude

8. Use of high altitude adaptation for training, treatment and prophylaxis of certain diseases

1. Introduction

2.  Geographical and bio-climatic peculiarities of Kyrgyzstan’s mountain regions 

3. Evaluation of labourer’s “weight” and bio-energetic costs of human activity in high altitude

4. Work capacity and fatigue in the conditions of bio-energetic discomfort of mountains

5. Changes of pro- antioxidative  systems of human organism during mountain adaptation

6. Methods and means for optimizing a human functional state and metabolism Pharmacology of mountain

    sickness and disadaptational disorders

7. Conclusion

 

Prof. Tian-Yi Wu 

High Altitude Medical Research Center, Xining, Qinghai, China

1. Does chronic mountain sickness really exists in the Himalayas?

    Introduction

    Nepal, India-Ladakh, Kashmir

    Qinghai-Tibetan plateau, China

    Han Chinese migrated and CMS

    True Monge’s disease ” in Tibetans

    Epidemiology

    Excessive polycythemia of high altitude in young soldiers

    Pathophysiological studies

    Ventilation and HVR Pulmonary hemodynamics

    Sleep studies Erythropoietin (EPO) 

    2,3-diphosphoglyceric acid (2.3-DPG)

Tianyi Wu,

John T. Reeves

3. A general adaptive pattern-lower hemoglobin concentration in the Himalayan natives

    1. Tibetans

    2. Sherpas

    3. Nepalies

    4. Ladakhis

    5. Other nationalities

4. High altitude heart disease: a hypoxic pulmonary hypertension syndrome

Introduction

   1. Definition and Nomenclature

   2. Incidence and importance

   3. Population differences

   4. Clinical features

   5. Hemodynamic studies

   6. Diagnosis

   7. Pathology

   8. The nature of HAHD

   9. Treatment and prevention

Tianyi WU et al

5. Acute respiratory distress syndrome/multiple organ dysfunction (ARDS/MODS) at high altitude

    1. Introduction

    2. Evaluation of diagnostic criteria of ARDS/MODS

    3. Animal model and path physiology

    4. HAPE and ARDS

Shifan Zhang,

Tianyi Wu

 

Prof. Gustavo F. Gonzales Prof. Roger Guerra- García

  Instituto de Investigaciones de la Altura (High Altitude Research Institute) and Department of 

    Biological and Physiological Sciences, Universidad Peruana Cayetano Heredia. Lima, Peru

1. Peruvian Contribution To The Study On Human Reproduction At High Altitude

   1.1 Settlement Of The Andes

   1.2 Effect Of Altitude On First Human Beings At The Andes

   1.3 Human Reproduction At High Altitude In Peru: Historical Background

   1.4 Fertility

   1.5 Mortality

2. Altitude, Birth Weight And Neonatal Mortality

3. Pulse Oxygen Saturation At High Altitudes In Peru

    3.1 Newborns

    3.2 Post Menopausal Women

4. Altitude, Migration And Health

5. Morbidity And Mortality Patterns At High Altitude In Peru

    5.1 Morbidity At High Altitude

          5.1.1 Newborn And Infants

          5.1.2 Symptoms Of Disease In Infants, Young, Adults And Olders At High Altitude And At

                  Sea Level.

          5.1.3 Prevalence Of Diseases In Adult Natives At High Altitudes In Peru

          5.1.4 Pathology In Pregnant Women At High Altitude

          5.1.5 Other Pathologies Observed At High Altitude

                   1. Pneumoconiosis

                   2. Chemodectomas

                   3. Intestinal Volvulus

                   4. Excessive Erythrocytosis

                   5. Prevalence Of Acromegaly

                   6. Higher Prevalence Of Haemorrhage At High Altitude

     5.2 Mortality

           1. Stillbirth, Neonatal, And Infant Mortality

           2. Net Mortality Rate

           3. Maternal Mortality

6. Endocrine Function And Adaptation To High Altitude In Men

    6.1 Chronic Hypoxemia

    6.2 Testosterone And Ventilation

    6.3 Testosterone And Hypoxia Due To Obstructive Pulmonary Disease

    6.4 Testosterone And Environmental Hypoxia: The Case Of The Native At High Altitude

    6.5 Bioavailability of Testosterone At High Altitude

    6.6 Testosterone And Adaptation To High Altitude In Women  

 

Dr. Tatiana V. Serebrovskaya

Principal Researcher, Doctor of Biology, Academician of the Int. Acad. Sci.
4, Bogomoletz Institute of Physiology, 4 Bogomoletz St., Kiev 01024, Ukraine

1. Short introduction
2. Historical sketch of the MM development in the former Soviet Union
3. Academician Sirotinin - the founder of Ukrainian Hypoxic School
4. High Altitude Lab at Mt. Elbrus: main directions of research.
5. Intermittent hypoxia and pre-acclimatization
6. Mechanisms of the Intermittent Hypoxia beneficial effects on an organism.

 

Prof. P. Beloshitsky 

Head of Elbrus Medical and Biological Station NAS Ukraine

1. Elbrus Medical and Biological Station (EMBS) - the place of the work for Ukrainian scientists.
2. Medical and biological investigations at Elbrus: beginning and prospects.

    2.1 Start of research work under the Prof. Beloshitsky mountain medicine problems
    2.2 Some directions of ecological physiology, its place and importance in the system of   

          biological and medical sciences
    2.3 Prospects of investigations according to contemporary medical and ecological programs

         of Elbrus Center

3. Factors of mountain altitudes and some peculiarities of adaptation mechanisms

    3.1 Peculiarities of high mountain factors influence on organism
    3.2 Peculiarities of adaptation mechanisms to mountain altitude conditions in sousliks

4. Some fundamental problems that were investigated at Elbrus region during the last 75 years.

    4.1 "Elbrus" classification of hypoxic states
    4.2 Comparative and evolutionary aspect of adaptation to hypoxia
    4.3 Investigations of adaptation mechanisms to hypoxia

5. The most  important applied problems under investigation at EMBS.

    5.1 Medical treatment using adaptation to hypoxic environment
    5.2 Age physiology problems for hypoxic states
    5.3 Development of methods for sportsmen athletic results improvement in mountain

         conditions
    5.4 Investigations for cosmos and aviation physiology in high mountains

6. Using of some mathematical methods for the simulation of hypoxic states.

    6.1 Mathematical methods for the simulation of reliability of organisms functioning under the

          extreme conditions of high mountains
    6.2 Mathematical model for hypoxic states development at healthy people and ones with

         ischemic heart disease

7. Summary

Authors

Prof. Roger Guerra- García High Altitude Research Institute and Dept. of Biological and Physiological Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru

Prof. Gustavo F. Gonzales High Altitude Research Institute and Dept. of Biological and Physiological Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru

Dr. Gustavo Zubieta-Castillo High Altitude Pathology Institute(IPPA), Lapaz, Bolivia

	Prof. Tian-Yi Wu High Altitude Medical Research Center, Xining, Qinghai, China		Prof. Ri Li Ge High Altitude Medical Research Center, Xining, Qinghai, China
	Shifan Zhang High Altitude Medical Research Center, Xining, Qinghai, China		Dr. T. Reeves High Altitude Medical Research Center, Xining, Qinghai, China
	Dr. S.N. Carang Hospital of Madu Country   Golou  Tibetan Autonomous  Prefecture  Qinghai, China		Dr. X.S. Cheng Chinese Academy of Medical Sciences, Beijing, China.
	Dr. Z. X. Gele Hospital of Yushu Tibetan Autonomous Perfecture China		Dr. Y.H Liu Cardiovascular Institute Fu Wai Hospital Beijing, China
	Dr. S.X. Pei Workers’ Hospital, Lhasa, Tibet Autonomous Region, China

	Dr. Muzaffar Khan Khattak Pakistan Heart Foundation Hayatabad, Peshawar		Dr. Sardar ul Mulk Department of Health NWFP, Peshawar
	Abdul Latif Malik Pakistan Heart Foundation Hayatabad, Peshawar		Dr. A.H. Dani Quaid Azam University Islamabad
	Dr. Muhammad Ilyas Muhammadi Hospital / IMRC Tatara Avenue, Hayatabad Peshawar		Shabnam Ilyas, Saadia Ilyas Hajira Ilyas, Kausar Ilyas, Saad Ilyas Pakistan Heart Foundation Peshawar
	Dr. Muhammad Said Department of Geography University of Peshawar Peshawar		Dr. M. Tahir Shah National Center of Excellence in Geology University of Peshawar Peshawar
	Col. Iqbal Shaheen Frontier Homeopathic College Hayatabad, Peshawar		Dr. M. Aslamkhan 26, E3, Gulberg III Lahore
	Dr. Akbar Afridi Dept. Community Medicine Khyber Medical College, Peshawar		Dr. M. Azhar Ahmad AFIC Rawalpindi
	Dr. Isa Khan Department of Urology Lady Reading Hospital, Peshawar