33 results on '"Basnyat, Buddha"'
Search Results
2. The treatment of enteric fever
- Author
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Basnyat, Buddha, primary
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- 2007
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3. Medical problems of porters and trekkers in the Nepal Himalaya
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Basnyat, Buddha, primary and Litch, James A., additional
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- 1997
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4. Prakash Adhikari: April 13, 1965 to October 23, 2020.
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Zafren K, Basnyat B, Baniya S, Bashyal G, Brugger H, Dawadi S, Freer L, Johnson E, and Systermans B
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- History, 20th Century, History, 21st Century, Nepal, Rescue Work history, Wilderness Medicine history
- Published
- 2021
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5. Erythema annulare centrifugum in a patient with chronic myeloid leukaemia on ponatinib.
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Maharjan K, Adhikari S, Amatya A, Kayastha G, and Basnyat B
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- Erythema chemically induced, Humans, Imidazoles adverse effects, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Pyridazines adverse effects
- Abstract
Competing Interests: No conflict of interests declared
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- 2020
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6. Pediatric High Altitude Cerebral Edema in the Nepal Himalayas.
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Church BJ, Basnyat B, Mattingly B, and Zafren K
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- Altitude Sickness etiology, Brain Edema etiology, Child, Female, Humans, Male, Nepal, Treatment Outcome, Altitude Sickness drug therapy, Brain Edema drug therapy, Mountaineering
- Abstract
High altitude cerebral edema (HACE) is a rare complication of ascent to altitudes of over 2500 m (8200 ft). We are not aware of a previously published case report of HACE in a patient under the age of 18 y. We report on 2 cases of suspected HACE in 2 patients, aged 12 and 16 y, who presented to the Manang Himalayan Rescue Association clinic at 3500 m. The 16-y-old patient presented with severe headache, vomiting, and ataxia after rapid ascent to 3800 m. The 12-y-old patient presented with severe headache, vomiting, visual disturbances, and ataxia at 4500 m, which began to resolve with descent to the clinic at 3500 m. Our cases suggest that HACE can occur in children and adolescents. Because there are no specific guidelines for treatment of acute mountain sickness or HACE in patients under the age of 18 y, we recommend treatment as for adults: oxygen, immediate descent, and dexamethasone. Simulated descent in a portable hyperbaric chamber can be used if oxygen is not available and if actual descent is not possible., (Copyright © 2019 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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7. In Reply to Dr Bennett.
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McIntosh SE, Hemphill M, McDevitt MC, Gurung TY, Ghale M, Knott JR, Thapa GB, Basnyat B, Dow J, Weber DC, and Grissom CK
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- Altitude, Humans, Acetazolamide, Altitude Sickness
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- 2019
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8. Reduced Acetazolamide Dosing in Countering Altitude Illness: A Comparison of 62.5 vs 125 mg (the RADICAL Trial).
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McIntosh SE, Hemphill M, McDevitt MC, Gurung TY, Ghale M, Knott JR, Thapa GB, Basnyat B, Dow J, Weber DC, and K Grissom C
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- Adult, Carbonic Anhydrase Inhibitors administration & dosage, Carbonic Anhydrase Inhibitors therapeutic use, Double-Blind Method, Female, Humans, Male, Middle Aged, Pulmonary Edema prevention & control, Acetazolamide administration & dosage, Acetazolamide therapeutic use, Altitude Sickness drug therapy, Mountaineering
- Abstract
Introduction: North American guidelines propose 125 mg acetazolamide twice daily as the recommended prophylactic dose to prevent acute mountain sickness (AMS). To our knowledge, a dose lower than 125 mg twice daily has not been studied., Methods: We conducted a prospective, double-blind, randomized, noninferiority trial of trekkers to Everest Base Camp in Nepal. Participants received the reduced dose of 62.5 mg twice daily or the standard dose of 125 mg twice daily. Primary outcome was incidence of AMS, and secondary outcomes were severity of AMS and side effects in each group., Results: Seventy-three participants had sufficient data to be included in the analysis. Overall incidence of AMS was 21 of 38 (55.3%) in reduced-dose and 21 of 35 (60.0%) in standard-dose recipients. The daily incidence rate of AMS was 6.7% (95% CI 2.5-10.9) for each individual in the reduced-dose group and 8.9% (95% CI 4.5-13.3) in the standard-dose group. Overall severity of participants' Lake Louise Score was 1.014 in the reduced-dose group and 0.966 in the standard-dose group (95% CI 0.885-1.144). Side effects were similar between the groups., Conclusions: The reduced dose of acetazolamide at 62.5 mg twice daily was noninferior to the currently recommended dose of 125 mg twice daily for the prevention of AMS. Low incidence of AMS in the study population may have limited the ability to differentiate the treatment effects. Further research with more participants with greater rates of AMS would further elucidate this reduced dosage for preventing altitude illness., (Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
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- 2019
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9. Nail the Diagnosis.
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Adhikari S, Sigdel KR, Paudyal B, and Basnyat B
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- Albendazole therapeutic use, Anemia, Iron-Deficiency drug therapy, Anthelmintics therapeutic use, Diagnosis, Differential, Feces parasitology, Female, Hookworm Infections drug therapy, Humans, Middle Aged, Nepal, Anemia, Iron-Deficiency blood, Anemia, Iron-Deficiency complications, Hookworm Infections complications, Hookworm Infections diagnosis, Nails, Malformed etiology
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- 2018
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10. Wilderness Mass Casualty Incident (MCI): Rescue Chain After Avalanche at Everest Base Camp (EBC) In 2015.
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Zafren K, Brants A, Tabner K, Nyberg A, Pun M, Basnyat B, and Brodmann Maeder M
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- Disaster Planning, Earthquakes, Humans, Interinstitutional Relations, Interprofessional Relations, Nepal, Rescue Work, Triage, Wilderness, Avalanches, Emergency Medical Services methods, Emergency Medical Services organization & administration, Mass Casualty Incidents, Wilderness Medicine methods, Wilderness Medicine organization & administration
- Abstract
The Nepal Earthquake of 2015 killed over 8000 people and injured over 20,000 in Nepal. Moments after the earthquake, an avalanche of falling ice came down from above Everest Base Camp (EBC). The air blast created by the avalanche flattened the middle part of EBC, killing 15 people and injuring at least 70. The casualties were initially triaged and treated at EBC and then evacuated by air to Kathmandu for definitive care. There were intermediate stops at the villages of Pheriche and Lukla during which the casualties were offloaded, retriaged, treated, and loaded again for further transport. Most of the authors of this article helped to provide primary disaster relief at EBC, Pheriche, or Lukla immediately after the earthquake. We describe the process by which an ad hoc rescue chain evacuated the casualties. We discuss challenges, both medical and nonmedical, what went well, and lessons learned. We make recommendations for disaster planning in the Khumbu (Everest) region, an isolated high altitude roadless area of Nepal., (Copyright © 2018 Wilderness Medical Society. All rights reserved.)
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- 2018
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11. Mismanagement of Severe Altitude Illness in a Tertiary Hospital in Nepal: A Cautionary Tale.
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Baniya S and Basnyat B
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- Adult, Altitude, Altitude Sickness complications, Altitude Sickness etiology, Altitude Sickness therapy, Brain Edema diagnosis, Brain Edema diagnostic imaging, Brain Edema etiology, Humans, Male, Nepal, Pulmonary Edema diagnosis, Pulmonary Edema diagnostic imaging, Pulmonary Edema etiology, Brain Edema therapy, Pulmonary Edema therapy
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- 2018
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12. Common Bite-Bizarre Rash.
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Thapa SS and Basnyat B
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- Administration, Oral, Administration, Topical, Animals, Cellulitis diagnosis, Diagnosis, Differential, Exanthema drug therapy, Exanthema etiology, Exanthema immunology, Histamine Antagonists administration & dosage, Humans, Hypersensitivity drug therapy, Hypersensitivity etiology, Hypersensitivity immunology, Male, Nepal, Steroids administration & dosage, United States, Young Adult, Culicidae, Exanthema diagnosis, Hypersensitivity diagnosis, Insect Bites and Stings complications
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- 2018
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13. In Reply to Drs Lipman and Hackett.
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Kanaan NC, Peterson AL, Pun M, Thapa GB, Tiwari A, Basyal B, Holck PS, Starling J, Freeman TF, Gehner JR, Keyes L, Levin DR, O'Leary CJ, Stuart KE, Velgersdyk JL, Zafren K, and Basnyat B
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- 2017
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14. Impact of a Newly Constructed Motor Vehicle Road on Altitude Illness in the Nepal Himalayas.
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Reisman J, Deonarain D, and Basnyat B
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- Acute Disease epidemiology, Altitude Sickness etiology, Brain Edema etiology, Incidence, Motor Vehicles, Mountaineering, Nepal epidemiology, Pulmonary Edema etiology, Retrospective Studies, Altitude Sickness epidemiology, Brain Edema epidemiology, Pulmonary Edema epidemiology, Travel statistics & numerical data
- Abstract
Objective: This study investigated the impact that motor vehicle travel along a newly constructed road has on altitude illness (including acute mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema). The new road from Besisahar (760 m) to Manang (3540 m) in Nepal was completed in December 2014., Methods: We enrolled all patients diagnosed with altitude illness at the Himalayan Rescue Association Manang clinic in fall 2016. Phi coefficients were calculated to test for an association between Nepali ethnicity and rapid ascent by motor vehicle. A retrospective review looked at all patients with altitude illness from fall (September-November) 2010 to spring (February-May) 2016., Results: In fall 2016, more than half (54%) of patients with altitude illness traveled to Manang by motor vehicle, and one-third (33%) reached Manang from low altitude (Besisahar) in less than 48 hours. Nepali nationality had a significant association with motor vehicle travel (phi +0.69, P < .0001) as well as with rapid ascent to Manang (phi +0.72, P < .0001). Compared to previous seasons, fall 2016 saw the most patients diagnosed with altitude illness. The proportion of people with altitude illness who traveled by vehicle and reached Manang in less than 48 hours was significantly greater than the proportion prior to completion of the road (P < .0001 for both)., Conclusions: Rapid ascent by the newly constructed road from Besisahar to Manang appears to be related to a significant increase in the number of patients with all forms of altitude illness, especially among Nepalis. The authors believe that educational interventions emphasizing prevention are urgently needed., (Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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15. Prophylactic Acetaminophen or Ibuprofen Results in Equivalent Acute Mountain Sickness Incidence at High Altitude: A Prospective Randomized Trial.
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Kanaan NC, Peterson AL, Pun M, Holck PS, Starling J, Basyal B, Freeman TF, Gehner JR, Keyes L, Levin DR, O'Leary CJ, Stuart KE, Thapa GB, Tiwari A, Velgersdyk JL, Zafren K, and Basnyat B
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- Adolescent, Adult, Aged, Altitude Sickness drug therapy, Double-Blind Method, Female, Humans, Male, Middle Aged, Mountaineering, Nepal, Prospective Studies, Surveys and Questionnaires, Treatment Outcome, Acetaminophen therapeutic use, Altitude Sickness prevention & control, Ibuprofen therapeutic use
- Abstract
Objective: Recent trials have demonstrated the usefulness of ibuprofen in the prevention of acute mountain sickness (AMS), yet the proposed anti-inflammatory mechanism remains unconfirmed. Acetaminophen and ibuprofen were tested for AMS prevention. We hypothesized that a greater clinical effect would be seen from ibuprofen due to its anti-inflammatory effects compared with acetaminophen's mechanism of possible symptom reduction by predominantly mediating nociception in the brain., Methods: A double-blind, randomized trial was conducted testing acetaminophen vs ibuprofen for the prevention of AMS. A total of 332 non-Nepali participants were recruited at Pheriche (4371 m) and Dingboche (4410 m) on the Everest Base Camp trek. The participants were randomized to either acetaminophen 1000 mg or ibuprofen 600 mg 3 times a day until they reached Lobuche (4940 m), where they were reassessed. The primary outcome was AMS incidence measured by the Lake Louise Questionnaire score., Results: Data from 225 participants who met inclusion criteria were analyzed. Twenty-five participants (22.1%) in the acetaminophen group and 18 (16.1%) in the ibuprofen group developed AMS (P = .235). The combined AMS incidence was 19.1% (43 participants), 14 percentage points lower than the expected AMS incidence of untreated trekkers in prior studies at this location, suggesting that both interventions reduced the incidence of AMS., Conclusions: We found little evidence of any difference between acetaminophen and ibuprofen groups in AMS incidence. This suggests that AMS prevention may be multifactorial, affected by anti-inflammatory inhibition of the arachidonic-acid pathway as well as other analgesic mechanisms that mediate nociception. Additional study is needed., (Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
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- 2017
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16. A Pain in the Neck. Clay shoveler's fracture due to cervical spine trauma.
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Koirala P, Wolpin S, Phuyal P, Basnyat B, and Zafren K
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- Adult, Humans, Male, Pain, Treatment Outcome, Accidents, Occupational, Cervical Cord injuries, Running, Spinal Fractures diagnosis, Spinal Fractures therapy
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- 2015
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17. An itchy situation.
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Phuyal P, Koirala P, Basnyat B, and Zafren K
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- Adult, Back Injuries chemically induced, Back Injuries pathology, Back Injuries therapy, Dermatitis, Contact etiology, Dermatitis, Contact pathology, Dermatitis, Contact therapy, Humans, Male, Nepal, Pruritus chemically induced, Pruritus pathology, Pruritus therapy, Young Adult, Back Injuries diagnosis, Dermatitis, Contact diagnosis, Kerosene toxicity, Pruritus diagnosis
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- 2015
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18. From Matterhorn to Mt Everest: empowering rescuers and improving medical care in Nepal.
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Maeder MM, Basnyat B, and Harris NS
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- Aircraft, Altitude, Hospitals, Humans, Mountaineering statistics & numerical data, Nepal, Wilderness Medicine, Emergency Medical Services organization & administration, Emergency Medicine education, Rescue Work methods
- Abstract
This article describes a private initiative in which professional Swiss rescuers, based at the foot of the Matterhorn, trained Nepalese colleagues in advanced high altitude helicopter rescue and medical care techniques. What started as a limited program focused on mountain safety has rapidly developed into a comprehensive project to improve rescue and medical care in the Mt Everest area for both foreign travelers and the local Nepalese people., (Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
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- 2014
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19. In reply to "ibuprofen for prevention of acute mountain sickness-is bigger really better?".
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Gertsch JH, Holck PS, Basnyat B, and Corbett BM
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- Female, Humans, Male, Altitude Sickness prevention & control, Anti-Inflammatory Agents, Non-Steroidal pharmacology, Ibuprofen pharmacology
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- 2013
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20. Altitude Sickness in Climbers and Efficacy of NSAIDs Trial (ASCENT): randomized, controlled trial of ibuprofen versus placebo for prevention of altitude illness.
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Gertsch JH, Corbett B, Holck PS, Mulcahy A, Watts M, Stillwagon NT, Casto AM, Abramson CH, Vaughan CP, Macguire C, Farzan NN, Vo BN, Norvelle RJ, May K, Holly JE, Irons H, Stutz AM, Chapagain P, Yadav S, Pun M, Farrar J, and Basnyat B
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- Adult, Altitude Sickness epidemiology, Double-Blind Method, Female, Humans, Incidence, Lost to Follow-Up, Male, Mountaineering, Patient Compliance, Severity of Illness Index, Surveys and Questionnaires, Altitude Sickness prevention & control, Anti-Inflammatory Agents, Non-Steroidal pharmacology, Ibuprofen pharmacology
- Abstract
Objective: To study the effectiveness of ibuprofen versus placebo in preventing acute mountain sickness (AMS) and high altitude headache (HAH)., Methods: Double-blind, randomized, placebo-controlled trial., Results: Two hundred ninety-four healthy Western trekkers were recruited on the Everest approach at 4280 m or 4358 m and randomly assigned to receive either 600 mg of ibuprofen or placebo 3 times daily before and during ascent to 4928 m. One hundred eighty-three of 294 participants completed the trial. Of the participants who did not complete the trial, 62 were lost to follow-up and another 49 broke trial protocol. In an intent-to-treat analysis (232 participants), ibuprofen was found to be more effective than placebo in reducing the incidence of AMS (24.4% vs 40.4%; P = .01) and the incidence of HAH (42.3% vs 60.5%; P < .01). Ibuprofen was also superior to placebo in reducing the severity of HAH (4.9% vs 14.7%; P = .01). The end point of oxygen saturation was also higher in the ibuprofen group (80.8 % vs 82.4%; P = .035). For the 183 participants who completed the trial and conformed to the protocol, the incidence of AMS between placebo and treatment groups was not significant (32.9% vs 22.7%; P = .129 for AMS incidence, 9.6% vs 8.2%; P = .74 for AMS severity, 54.8% vs 42.7%; P = .11 for HAH incidence, and 8.2% vs 3.6%; P = .18 for HAH severity)., Conclusions: Ibuprofen was found to be effective in preventing AMS in the intent-to-treat analysis group but not in those who completed the trial. This loss of significance in the subjects who completed the trial may be explained by persons in the placebo group having a higher burden of illness and associated decreased compliance with the protocol. An important limitation of this study may be the possibility that ibuprofen can mask headache, which is a compulsory criterion for the diagnosis of AMS., (Copyright © 2012 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
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- 2012
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21. Performance-enhancing drugs-commentaries.
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Cushing TA, McIntosh SE, Keyes LE, Rodway GW, Schoene RB, Basnyat B, and Freer L
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- Acetazolamide therapeutic use, Altitude Sickness therapy, Dexamethasone therapeutic use, Humans, Nifedipine therapeutic use, Oxygen administration & dosage, Oxygen Inhalation Therapy ethics, Oxygen Inhalation Therapy methods, Altitude Sickness prevention & control, Mountaineering ethics, Performance-Enhancing Substances administration & dosage, Wilderness Medicine ethics
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- 2012
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22. Spironolactone does not prevent acute mountain sickness: a prospective, double-blind, randomized, placebo-controlled trial by SPACE Trial Group (spironolactone and acetazolamide trial in the prevention of acute mountain sickness group).
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Basnyat B, Holck PS, Pun M, Halverson S, Szawarski P, Gertsch J, Steif M, Powell S, Khanal S, Joshi A, Shankar R, Karambay J, Alexander HD, Stone A, Morrissey C, Thompson BH, and Farrar J
- Subjects
- Acetazolamide administration & dosage, Adult, Altitude Sickness epidemiology, Double-Blind Method, Female, Headache epidemiology, Headache prevention & control, Humans, Male, Mountaineering, Nepal epidemiology, Oxygen blood, Prospective Studies, Treatment Outcome, Altitude Sickness prevention & control, Spironolactone administration & dosage
- Abstract
Objectives: Over the last 20 years a number of small trials have reported that spironolactone effectively prevents acute mountain sickness (AMS), but to date there have been no large randomized trials investigating the efficacy of spironolactone in prevention of AMS. Hence, a prospective, double-blind, randomized, placebo-controlled trial was conducted to evaluate the efficacy of spironolactone in the prevention of AMS., Methods: Participants were sampled from a diverse population of western trekkers recruited at 4300 m on the Mount Everest base camp approach (Nepal side) en route to the study endpoint at 5000 m. Three hundred and eleven healthy trekkers were enrolled, and 251 completed the trial from October to November 2007. Participants were randomly assigned to receive at least 3 doses of spironolactone 50 mg BID, acetazolamide 250 mg BID, or visually matched placebo. A Lake Louise AMS Score of 3 or more, together with the presence of headache and 1 other symptom, was used to evaluate the incidence and severity of AMS. Secondary outcome measures were blood oxygen content and the incidence and severity of high altitude headache (HAH)., Results: Acetazolamide was more effective than spironolactone in preventing AMS (OR = 0.28, 95% CI 0.12-0.60, p < 0.01). Spironolactone was not significantly different from placebo in the prevention of AMS. AMS incidence for placebo was 20.3%, acetazolamide 10.5%, and spironolactone 29.4%. Oxygen saturation was also significantly increased in the acetazolamide group (83% ± 0.04) vs spironolactone group (80% ± 0.05, p < 0.01)., Conclusions: Spironolactone (50 mg BID) was ineffective in comparison to acetazolamide (250 mg BID) in the prevention of AMS in partially acclimatized western trekkers ascending to 5000 m in the Nepali Himalaya., (Copyright © 2011 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
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23. Brain blood flow in Andean and Himalayan high-altitude populations: evidence of different traits for the same environmental constraint.
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Jansen GF and Basnyat B
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- Blood Flow Velocity physiology, Bolivia, Brain Chemistry physiology, Deuterium Oxide, Hematocrit, Humans, Middle Cerebral Artery physiology, Nepal, Nitric Oxide metabolism, Oxygen blood, Oxygen Consumption physiology, Peru, Population, Ultrasonography, Doppler, Transcranial, Altitude, Cerebrovascular Circulation genetics, Cerebrovascular Circulation physiology, Environment
- Abstract
Humans have populated the Tibetan plateau much longer than the Andean Altiplano. It is thought that the difference in length of occupation of these altitudes has led to different responses to the stress of hypoxia. As such, Andean populations have higher hematocrit levels than Himalayans. In contrast, Himalayans have increased circulation to certain organ systems to meet tissue oxygen demand. In this study, we hypothesize that cerebral blood flow (CBF) is higher in Himalayans than in Andeans. Using a MEDLINE and EMBASE search, we included 10 studies that investigated CBF in Andeans and Himalayans between 3,658 and 4,330 m altitude. The CBF values were corrected for differences in hematocrit and arterial oxygen saturation. The data of these studies show a mean hematocrit of 50% in Himalayans and 54.1% in Andeans. Arterial oxygen saturation was 86.9% in Andeans and 88.4% in Himalayans. The CBF in Himalayans was slightly elevated compared with sea-level subjects, and was 24% higher compared with Andeans. After correction for hematorit and arterial oxygen saturation, CBF was ∼20% higher in Himalayans compared with Andeans. Altered brain metabolism in Andeans, and/or increased nitric oxide availability in Himalayans may have a role to explain this difference in brain blood flow.
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- 2011
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24. Complications of steroid use on Mt. Everest.
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Subedi BH, Pokharel J, Goodman TL, Amatya S, Freer L, Banskota N, Johnson E, and Basnyat B
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- Acute Disease, Adult, Altitude, Altitude Sickness complications, Altitude Sickness diagnosis, Confusion chemically induced, Confusion complications, Confusion diagnosis, Drug-Related Side Effects and Adverse Reactions complications, Drug-Related Side Effects and Adverse Reactions diagnosis, Exanthema chemically induced, Exanthema complications, Exanthema diagnosis, Gastrointestinal Hemorrhage chemically induced, Gastrointestinal Hemorrhage complications, Gastrointestinal Hemorrhage diagnosis, Humans, Male, Muscle Weakness chemically induced, Muscle Weakness complications, Nepal, Panic Disorder complications, Steroids therapeutic use, Altitude Sickness drug therapy, Mountaineering, Steroids adverse effects
- Abstract
Steroids are used for the prevention and treatment of high-altitude illnesses. However, these agents can cause significant side effects. We report a case of altered mental status, gastrointestinal bleeding, skin rash, and avascular necrosis in a climber taking prophylactic dexamethasone prior to an attempt to climb Mt Everest. High-altitude cerebral edema (HACE), steroid toxicity, and acute adrenal crisis can have similar clinical presentations. Differentiating between these life-threatening conditions at high altitude is essential for successful treatment., (Copyright © 2010 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
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25. Prospective, double-blind, randomized, placebo-controlled comparison of acetazolamide versus ibuprofen for prophylaxis against high altitude headache: the Headache Evaluation at Altitude Trial (HEAT).
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Gertsch JH, Lipman GS, Holck PS, Merritt A, Mulcahy A, Fisher RS, Basnyat B, Allison E, Hanzelka K, Hazan A, Meyers Z, Odegaard J, Pook B, Thompson M, Slomovic B, Wahlberg H, Wilshaw V, Weiss EA, and Zafren K
- Subjects
- Adolescent, Adult, Aged, Double-Blind Method, Female, Headache epidemiology, Humans, Logistic Models, Male, Middle Aged, Mountaineering, Pain Measurement, Placebos, Young Adult, Acetazolamide administration & dosage, Altitude Sickness complications, Altitude Sickness prevention & control, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Headache etiology, Headache prevention & control, Ibuprofen administration & dosage
- Abstract
Objective: High altitude headache (HAH) is the most common neurological complaint at altitude and the defining component of acute mountain sickness (AMS). However, there is a paucity of literature concerning its prevention. Toward this end, we initiated a prospective, double-blind, randomized, placebo-controlled trial in the Nepal Himalaya designed to compare the effectiveness of ibuprofen and acetazolamide for the prevention of HAH., Methods: Three hundred forty-three healthy western trekkers were recruited at altitudes of 4280 m and 4358 m and assigned to receive ibuprofen 600 mg, acetazolamide 85 mg, or placebo 3 times daily before continued ascent to 4928 m. Outcome measures included headache incidence and severity, AMS incidence and severity on the Lake Louise AMS Questionnaire (LLQ), and visual analog scale (VAS)., Results: Two hundred sixty-five of 343 subjects completed the trial. HAH incidence was similar when treated with acetazolamide (27.1%) or ibuprofen (27.5%; P = .95), and both agents were significantly more effective than placebo (45.3%; P = .01). AMS incidence was similar when treated with acetazolamide (18.8%) or ibuprofen (13.7%; P = .34), and both agents were significantly more effective than placebo (28.6%; P = .03). In fully compliant participants, moderate or severe headache incidence was similar when treated with acetazolamide (3.8%) or ibuprofen (4.7%; P = .79), and both agents were significantly more effective than placebo (13.5%; P = .03)., Conclusions: Ibuprofen and acetazolamide were similarly effective in preventing HAH. Ibuprofen was similar to acetazolamide in preventing symptoms of AMS, an interesting finding that implies a potentially new approach to prevention of cerebral forms of acute altitude illness., (Copyright 2010 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
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26. Frostbite in a Sherpa.
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Subedi BH, Pokharel J, Thapa R, Banskota N, and Basnyat B
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- Frostbite pathology, Humans, Male, Nepal epidemiology, Treatment Outcome, Young Adult, Frostbite epidemiology, Frostbite therapy, Mountaineering injuries
- Abstract
Frostbite is frequently seen in high altitude climbers. Many Sherpas, members of an ethnic community living high in the Himalayas in Nepal, help the climbers as a guide or an assistant. They often seem to undertake few precautionary measures thus suffer more from frostbite. A young Sherpa, who had reached the top of Mt Kanchenjunga in March 2009, suffered from deep frostbite in his fingers. Fortunately, he recovered well with generous treatment. Though there is no evidence whether Sherpas are more or less prone to frostbite, simple techniques for adequate prevention of hypoxia, hypothermia and dehydration will benefit any climber to the high altitudes., (Copyright (c) 2010 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
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27. Clinical images: a pneumonic confusion.
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Zafren K, Basnyat B, and Basnyat G
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- Bed Rest, Humans, Male, Middle Aged, Radiography, Thoracic, Altitude, Altitude Sickness diagnosis, Pulmonary Edema diagnosis
- Published
- 2009
- Full Text
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28. Adaptation to high altitude in Sherpas: association with the insertion/deletion polymorphism in the Angiotensin-converting enzyme gene.
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Droma Y, Hanaoka M, Basnyat B, Arjyal A, Neupane P, Pandit A, Sharma D, Ito M, Miwa N, Katsuyama Y, Ota M, and Kubo K
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- Adult, Asian People, Female, Gene Deletion, Gene Frequency, Genotype, Humans, Male, Mutagenesis, Insertional, Nepal, Peptidyl-Dipeptidase A metabolism, Polymerase Chain Reaction methods, Acclimatization genetics, Altitude, Altitude Sickness genetics, Peptidyl-Dipeptidase A genetics, Polymorphism, Genetic
- Abstract
Objective: Sherpas are well-known for their physical strength at high altitudes. They adapt to high altitude so well that little acute or chronic mountain sickness has been documented in them. The possible genetic basis for this adaptation is, however, unclear. The objective of this study was to elucidate the genetic background underlying this characteristic among Sherpas with respect to the angiotension-converting enzyme (ACE) gene., Methods: We enrolled 105 Sherpa volunteers in Namche Bazaar (3440 meters) and 111 non-Sherpa Nepalese volunteers in Kathmandu Valley (1330 meters) in Nepal. Information about high-altitude exposure and physiological phenotypes was obtained via fieldwork investigation. The genotype of the insertion/deletion (I/D) polymorphism in the ACE gene was identified by polymerase chain reaction. Serum ACE activity was also measured., Results: The distribution of the I dominant genotype (II & ID) and the I allelic frequency were significantly more prevalent in Sherpas (II & ID: 94.3%, I allele: 73.3%) than in non-Sherpas (II & ID: 85.6%, P = .035; I allele: 64.0%, P = .036). Moreover, despite residing at high altitude, the circulating ACE levels of Sherpas were statistically similar to those of non-Sherpas at low altitudes (Sherpas: 14.5 +/- 0.4 IU/L/37 degrees C; non-Sherpas: 14.7 +/- 0.4 IU/L/37 degrees C; P = .755)., Conclusions: These findings suggest that the overrepresented I allele of the ACE gene in Sherpas might be one of the fundamental genetic factors responsible for maintaining physiological low-altitude ACE activity at high altitude, which may have an advantageous physiological role in adapting to a high-altitude environment.
- Published
- 2008
- Full Text
- View/download PDF
29. Changes in metabolic and hematologic laboratory values with ascent to altitude and the development of acute mountain sickness in Nepalese pilgrims.
- Author
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Shah MB, Braude D, Crandall CS, Kwack H, Rabinowitz L, Cumbo TA, Basnyat B, and Bhasyal G
- Subjects
- Acute Disease, Adolescent, Adult, Altitude Sickness epidemiology, Altitude Sickness metabolism, Blood Chemical Analysis, Blood Gas Analysis, Cohort Studies, Cross-Sectional Studies, Female, Humans, Incidence, Male, Middle Aged, Nepal epidemiology, Oximetry, Prospective Studies, Respiration, Altitude Sickness blood, Altitude Sickness etiology, Blood Volume physiology, Travel
- Abstract
Objective: During August of each year, thousands of Nepalese religious pilgrims ascend from 2050 m to 4500 m in 1 to 3 days. Our objectives were to evaluate the incidence of acute mountain sickness (AMS) among this large group of native people, to explore changes in serum electrolytes as subjects ascend to high altitude, and to attempt to determine whether decreased effective circulating volume is associated with the development of AMS., Methods: This was a prospective study with 2 parts. In the first part, demographic, physiologic, and laboratory data were collected from a cohort of 34 pilgrims at both moderate (2050 m) and high altitude (4500 m). Changes that occurred with ascent were compared in subjects who did and did not develop AMS. The second part was a cross sectional study of a different group of 57 pilgrims at the high-altitude site to further determine variables associated with AMS., Results: In the cohort of 34 subjects, Lake Louise score, heart rate, respiratory rate, blood urea nitrogen (BUN), BUN:creatinine ratio, and pH increased at high altitude, whereas oxygen saturation, bicarbonate, creatinine, and PCO2 decreased. Sixteen of these 34 subjects (42%) were diagnosed with AMS; these patients had a statistically significantly lower hematocrit, oxygen saturation, and self-reported water consumption than those without AMS. Of the 57 subjects enrolled in the cross sectional study, 31 (54%) were diagnosed with AMS. These pilgrims had higher heart rates and BUNs than did their non-AMS counterparts., Conclusions: Fifty-two percent of the subjects developed AMS. With ascent to altitude, subjects showed some evidence of decreased effective circulating volume, though there were no clinically significant changes. The data did not show whether decreased circulating volume is a significant risk factor in the development of AMS at high altitude.
- Published
- 2006
- Full Text
- View/download PDF
30. "Preliminary report of the beneficial effect of chloromycetin in the treatment of typhoid fever"--a commentary.
- Author
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Basnyat B
- Subjects
- Anti-Bacterial Agents therapeutic use, Baltimore, Chloramphenicol therapeutic use, Controlled Clinical Trials as Topic history, History, 20th Century, Humans, International Cooperation history, Malaysia, Typhoid Fever drug therapy, Anti-Bacterial Agents history, Chloramphenicol history, Typhoid Fever history
- Published
- 2004
- Full Text
- View/download PDF
31. Clinical images. A mystery.
- Author
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Basnyat B, Tingay D, and Basnyat G
- Subjects
- Adult, Brain Edema pathology, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Male, Altitude, Brain Edema diagnosis, Mountaineering
- Published
- 2004
- Full Text
- View/download PDF
32. It's OK, it's TB.
- Author
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Basnyat B
- Subjects
- Adult, Anecdotes as Topic, Antitubercular Agents therapeutic use, History, 19th Century, History, 20th Century, Humans, Male, Nepal, Tuberculosis, Pulmonary drug therapy, Tuberculosis, Pulmonary history
- Published
- 2002
- Full Text
- View/download PDF
33. Pleural tuberculosis in a Nepali trekker.
- Author
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Basnyat B
- Subjects
- Adult, Diagnosis, Differential, Humans, Male, Nepal, Tuberculosis, Pleural pathology, Altitude Sickness diagnosis, Mountaineering, Pulmonary Edema diagnosis, Tuberculosis, Pleural diagnosis
- Published
- 2002
- Full Text
- View/download PDF
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