High altitude headache - an etiological based study

To determine the various causes of headache in patients evacuated from high altitude. Descriptive study An observational hospital based study carried out on 50 soldiers evacuated from Northern Areas to Military Hospital Rawalpindi between Sep 2009 to Mar 2010 for evaluation of headache as their major complaint. Necessary investigations including neuroimaging were carried out in coordination with Department of Neurology, Military Hospital and an appropriate diagnosis was made in each case. The data was analyzed accordingly. A total of 50 patients were analyzed .They were all males and the mean age was 25 years. 52% patients had Acute Mountain Sickness, 12% hypertension, 10% High altitude cerebral edema, 8% Tension type headaches, 6% Dural venous sinus thrombosis, 6% migraine, 2% encephalitis, 2% were of Subarachnoid hemorrhage and 2% patients Hydrocephalus. Acute mountain sickness and high altitude cerebral edema accounts for a significant number of patients with high altitude headache

Sudden cardiac death - Morphological changes in myocardium and coronaries

To determine the changes in coronary arteries in patients of sudden cardiac death. Materials and Observational descriptive study was carried out at Armed Forces Institute of Pathology, Rawalpindi, in year 2000 on autopsy of 58 cases with sudden cardiac death. Coronary arteries of 56 out of 58 cases revealed varying degree of atherosclerosis. 38 [65%] cases showed severe atherosclerosis. The percentage of cases below 40 years was 67% which is higher than the previous series on this subject. Left coronary artery remains the commonest artery showing significant atherosclerosis [84%] and left anterior descending coronary artery is the most frequent artery to be occluded by a thrombus. Coronary atherosclerosis was the major cause of sudden cardiac death. Decreasing age in incidence for sudden cardiac death is a worrisome cause and should be addressed with public health awareness

Morphological changes in coronary arteries in cases of sudden cardiac death at high altitude

To determine the changes in coronary arteries in patients dying at high altitude. Observational descriptive study was carried out at Armed Forces Institute of Pathology and Army Medical College Pathology Laboratory, Rawalpindi form 2002 to 2004 on autopsy of 58 cases dying at high altitude. In 53 out of 58 cases, death was attributed to coronary atherosclerosis. The majority of cases were less than 40 years as also observed in people dying below high altitude. However triple vessel coronary atherosclerosis was seen in 67% cases and left anterior descending coronary artery was involved in almost 100% cases. Coronary atherosclerosis remains the major cause of death at high altitude in acclimatized individuals. Accelerated coronary atherosclerosis with triple vessel involvement in patients without prior history of ischemic heart disease points to specific indicators. Dietary modifications with high carbohydrate diet are recommended at high altitudes