Oxygen saturation response to exercise VO2 at 2100 m and 4350 m in women mountaineering trainees.

Human work performances decreases at high altitude (HA). This decrement does not appear to be similar for every individual, may be due to variety of factors like elevation, mode of induction, work intensity, physical condition and specificity of the subjects. The purpose of the study was to evaluate the effects of alteration in responses of oxygen saturation (SaO2) and oxygen consumption (VO2) to a standard exercise in women mountaineering trainees under hypobaric hypoxia. Experiments were conducted in 2 groups (10 each) of females and compared the difference in responses of native women of moderate altitude with those of the plains/low altitude. A standard exercise test (Modified Harvard Step-Test for women) was performed on a 30 cm stool with 24 cycles/min for 5 min, initially at 2100 m and then at 4350 m. The exercise VO2 values for plains dwelling women achieved apparently VO2max level at both altitude locations with significant reduction in SaO2 during standard exercise. Exercise VO2 values decreased on exposure to 4350 m with further reduction in SaO2. Whereas with same work intensity, under same situation the exercise VO2 values of the moderate altitude women did not appear to have reached VO2max. They also maintained comparatively higher level of SaO2. It may be concluded that hypoxic exposure along with mountaineering training, the moderate altitude women maintained a higher level of SaO2 during standard exercise at both altitude locations, compared to low altitude women who might have lost a compensatory reserve to defend the hypoxic stress to exercise. Thus, moderate altitude women are proved to be better fit for hypoxic tolerance/HA performance.

Immediate treatment of frostbite using rapid rewarming in tea decoction followed by combined therapy of pentoxifylline, aspirin & vitamin C.

BACKGROUND & OBJECTIVES: Frostbite, the severest form of cold injury is a serious medical problem for our Armed Forces operating in the snow bound areas at high altitude. Effects of treatment by rapid rewarming in tea decoction followed by combined therapy of pentoxifylline, aspirin and vitamin C were evaluated in amelioration of tissue damage due to experimentally induced frostbite in rats. METHODS: Experiments were conducted in 2 groups (25 each) of albino rats (control i.e., untreated and experimental i.e., treated). Frostbite was produced experimentally in all the animals by exposing one of the hind limbs at -12 +/- 1 degree C with wind flow 25-30 lit/min for 30 min in a freezing-machine, with simultaneous recordings of rectal and ambient temperatures. The degree of tissue damage was assessed after 10 days. Following cold exposure, neither external thawing nor any medication was given to the animals of the control group; while the exposed limb of the experimental animals was rewarmed in tea decoction maintained at 37-39 degrees C for 30 min immediately after cold exposure, with simultaneous oral ingestion of warm tea decoction. These animals were also given pentoxifylline (40 mg/kg), aspirin (5 mg/kg) and vitamin C (50 mg/kg) twice daily orally for the next 7 days. RESULTS: In the control group, 68 per cent animals suffered from severe (56%) to very severe (12%) frostbite, while the remaining 32 per cent had moderate frostbite. No animals of this group could escape injury or suffered anything less than moderate frostbite; whereas 52 per cent of experimental animals escaped injury (no frostbite) and 32 and 16 per cent suffered only with primary and moderate degree of injury, respectively. None from this group suffered from severe or very severe frostbite. INTERPRETATION & CONCLUSION: It is evident from the study that this combined therapy resulted in significant improvement in the degree of tissue preservation and proved to be highly beneficial as an immediate treatment of frostbite in rats. The combined pharmacological properties of these drugs might have altered the haemorrheologic status of blood and produced curative beneficial effect in improving tissue survival. Clinical studies are required for confirmation of these beneficial effects in humans, which has already been taken up.

Effect of yogic exercises on physical and mental health of young fellowship course trainees.

A study was undertaken to observe any beneficial effect of yogic practices during training period on the young trainees. 54 trainees of 20-25 years age group were divided randomly in two groups i.e. yoga and control group. Yoga group (23 males and 5 females) was administered yogic practices for the first five months of the course while control group (21 males and 5 females) did not perform yogic exercises during this period. From the 6th to 10th month of training both the groups performed the yogic practices. Physiological parameters like heart rate, blood pressure, oral temperature, skin temperature in resting condition, responses to maximal and submaximal exercise, body flexibility were recorded. Psychological parameters like personality, learning, arithmetic and psychomotor ability, mental well being were also recorded. Various parameters were taken before and during the 5th and 10th month of training period. Initially there was relatively higher sympathetic activity in both the groups due to the new work/training environment but gradually it subsided. Later on at the 5th and 10th month, yoga group had relatively lower sympathetic activity than the control group. There was improvement in performance at submaximal level of exercise and in anaerobic threshold in the yoga group. Shoulder, hip, trunk and neck flexibility improved in the yoga group. There was improvement in various psychological parameters like reduction in anxiety and depression and a better mental function after yogic practices.

Effects of mountaineering training at high altitude (4,350 m) on physical work performance of women.

BACKGROUND: Little is known about work performance of women in hypobaric hypoxia. Moreover, whether native women of moderate altitude (2,000-2,100 m) differ from their lowland counterparts in their ability to adjust to hypobaric hypoxia is also not known. Hence, physiological alterations on work performance due to mountaineering training with altitude adaptation was evaluated in two groups of women and compared to the differences in the responses of the native women of moderate altitudes (Highlanders-HL) with those of the plains (Lowlanders-LL). METHODS: Pre-training tests were conducted at 2,100 m, then during sojourn to 4,350 m and re-tested again after return to 2,100 m. Physical work performance was assessed following standard step-test-exercise on a 30 cm stool with 24 cycles x min(-1) for 5 min. Heart rate, BP, ventilation, oxygen consumption and oxygen saturation were monitored at rest and during exercise followed by 5 min recovery in all three situations. RESULTS: During initial assessment, HL showed higher cardiovascular efficiency with faster recovery of exercise heart rate. Both groups showed significant improvement in physical performance due to mountaineering training at high altitude (HA). The difference in performance between two groups narrowed down at 4,350 m and further reduced during re-test with maintenance of initial superiority of the HL. CONCLUSIONS: a) Native women of moderate altitude (HL) are more fit compared with their plains counterparts (LL); b) All women achieved marked improvement in cardiovascular and respiratory efficiency as well as the step-test score due to intense mountaineering training at HA, and the rate of improvement in physical performance was higher in LL; c) Further, induction by trekking under progressive hypoxia coupled with rigorous mountaineering activity at HA merits in understanding better acclimatization and improved physical performance.

Effect of vitamin C and E in modulating peripheral vascular response to local cold stimulus in man at high altitude.

At high altitude (HA), cold stress is aggravated by hypoxia, perhaps due to the increased formation of free radicals which trigger oxidative stress. This may be one of the contributing factors for adverse effects including disturbances in microcirculation and capillary permeability resulting in decreased peripheral blood flow. This leads to altered cold-induced-vasodilatation (CIVD) response on exposure to HA. The present study was conducted on 40 male volunteers (4 groups of 10 each) to evaluate the utility of supplementation of vitamin C (500 mg/d)and vitamin E (400 mg/d) singly, as well as in combination, in modulating peripheral vascular response by assessing CIVD response under local cold stimulus both at Delhi (200 m) and at HA (3,700 m). On exposure to 3,700 m, decreased CIVD response was observed in all the groups. The responses were better in vitamin supplemented groups, in general, as compared to the placebo group. The best CIVD response was seen in the vitamin C (singly)-treated group. Administration of vitamin C and E together did not result in any additional benefit. Facilitation of CIVD response due to supplementation of vitamin C may be attributed to its (a) antioxidant effect, and (b) major physiological functions of increased metabolism and thermogenic properties, facilitation of collagen synthesis, restoration of intercellular substances and better maintenance of the rheological status of the blood. Hence, vitamin C is effective for improving peripheral blood flow and thereby reduces the incidence of cold injuries during acclimatization or outdoor duties at HA.

Physiological and psychological effects of ageing in man.

A cross-sectional study involving men in various age groups was carried out to evaluate some of the physiological and psychological correlates responsible for functional alteration with advancement of age. Each group consisted of 20 soldiers. Their resting physiological variables, lung function parameters, psychophysiological tests, and different mental functions were studied in thermoneutral laboratory. The results revealed the age related decline in various physiological and psychological functions.

Efficacy of pentoxifylline with aspirin in the treatment of frostbite in rats.

The efficacy of pentoxifylline--a haemorrheologic agent along with aspirin--an analgesic agent was evaluated in the amelioration of the tissue damage due to experimentally induced frostbite in 5 groups (20 each) of rats with body weights ranging between 175 and 200 g. Frostbite was produced experimentally in the hind limbs by exposing the animals to -15 +/- 1 degrees C for 1 h using the harness technique, with simultaneous recording of rectal and environmental temperatures. The degree of tissue damage was assessed on the basis of tissue necrosis after 15 days. Administration of pentoxifylline (40 mg/kg bw) 30 min before and 30 min after the cold exposure followed by two doses of the same daily for the next 5 days along with aspirin (5 mg/kg bw) twice daily for the same duration only after cold exposure, resulted in significant improvement in the degree of tissue preservation. The findings of this preliminary study have brought to light the potential usefulness of these drugs in the treatment of frostbite. The combined pharmacological properties of these two drugs might have altered the haemorrheologic status of blood and produced the curative beneficial effect in improving tissue survival following experimentally induced frostbite in rats.

Physiological, biochemical and histological changes due to physostigmine in monkeys.

Physostigmine (Phy), a short-acting reversible anticholinesterase agent is considered to be a potent prophylactic antidote for the highly toxic organophosphorous (OP) compounds. The toxic effects, if any, of the probable prophylactic doses of Phy have been evaluated by studying its physiological, biochemical and histological effects in monkeys. Phy only at 100 micrograms/kg resulted in certain cholinergic signs such as salivation, lacrymation and muscular faciculations; physiological changes such as mild tachycardia, tachypnea, higher amplitude in electrical activity of the brain, clinico-chemical effects like fall in PO2, PCO2 and alkalosis and histologically an inflammatory reaction in the lungs. On the other hand, the lower dose, i.e. 50 micrograms/kg appeared to be devoid of cholinergic signs and symptoms. However, we observed a significant inhibition of both plasma and erythrocyte ChE and increase in the rectal temperature in both the Phy treated groups. From this study, Phy at a dose of 50 micrograms/kg could be inferred as a safe, sign free intramuscular dose and may probably be used in pretreatment regimen against nerve agents.

Acclimatization at high altitude in gradual and acute induction.

The study assessed physiological responses to induction to high altitude first to 3,500 m and then to 4,200 m and compared the time course of altitude acclimatization in two groups of male volunteers. The acutely inducted group was transported by aircraft (AI) to 3,500 m in 1 h, whereas the gradually inducted group was transported by road (RI) in 4 days. Baseline recordings of basal cardiovascular, respiratory, and blood gas variables were monitored at sea level as well as at 3,500 m on days 1, 3, 5, and 7. Blood gases were measured on day 10 also. After 15 days at 3,500 m, the subjects were inducted to 4,200 m by road, and measurements were repeated on days 1, 3, and 5, except blood gas variables, which were done on day 10 only. Acute mountain sickness symptoms were recorded throughout. The responses of RI were stable by day 3 of induction at 3,500 m, whereas it took 5 days for AI. Four days in transit for RI appear equivalent to 2 days at 3,500 m for AI. Acclimatization schedules of 3 and 5 days, respectively, for RI and AI are essential to avoid malacclimatization and/or high-altitude illness. Both groups took 3 days at 4,200 m to attain stability for achieving acclimatization.

The role of free radicals in cold injuries.

Cold injury is a tissue trauma produced by exposure to freezing temperatures and even brief exposure to a severely cold and windy environment. Rewarming of frozen tissue is associated with blood reperfusion and the simultaneous generation of free oxygen radicals. In this review is discussed the current understanding of the mechanism of action of free oxygen radicals as related to cold injury during rewarming. Decreased energy stores during ischaemia lead to the accumulation of adenine nucleotides and liberation of free fatty acids due to the breakdown of lipid membranes. On rewarming, free fatty acids are metabolized via cyclo-oxygenase and adenine nucleotides are metabolized via the xanthine oxidase pathway. These may be the source of free oxygen radicals. Leukocytes may also play a major role in the pathogenesis of cold injury. Oxygen radical scavengers, such as superoxide dismutase and catalase, may help to reduce the cold induced injury but their action is limited due to the inability readily to cross the plasma membrane. Lipid soluble antioxidants are likely to be more effective scavengers because of their presence in membranes where peroxidative reactions can be arrested.

Responses of Arctic and tropical men to a standard cold test and peripheral vascular responses to local cold stress in the Arctic.

Thermoregulatory, metabolic and peripheral vascular responses to cold were studied in two groups (six each) of healthy men during exposure to the natural cold environment of the Arctic. Group A comprised of two arctic natives and four temporary residents who had migrated from the temperature zone of Russia. Group B consisted of six soldiers from a tropical region (India). Group B was airlifted to the arctic (70 degrees N, 38 degrees E). Both groups stayed in a field camp. The experiments were conducted during the 7th week of the stay. The volunteers were subjected to a standard cold test at 10 degrees C for 2 h wearing only shorts. Their heart rate, blood pressure, ventilation, oxygen consumption, oral temperature, mean skin and extremity temperatures were recorded initially and at 30 min intervals during standard cold test. The cold-induced vasodilatation response in both groups was also studied separately. The tropical natives (Group B) were flown back to Delhi and retested after 6 weeks. The physiological responses to general cold exposure as well as peripheral vascular response to local arctic cold stress were similar in both groups. The observation suggested that cold acclimatization in tropical men is similar to that of the people of Russian origin from a temperature zone.

Acute oral toxicity of insect repellent N,N-diethylphenylacetamide in mice, rats and rabbits and protective effect of sodium pentobarbital.

Median lethal dose (LD50) of undiluted liquid insect repellent N,N-diethylphenylacetamide (DEPA) in male mice, rats and rabbits was 900, 825 and 635 mg/kg respectively when administered by gavage. Signs of DEPA intoxication point to stimulation of central nervous system (CNS). Acetazolamide (10 mg/kg), sodium bicarbonate (40 mg/kg), and atropine (5 mg/kg) when injected (ip) 5 min after a lethal oral dose of DEPA (1700 mg/kg) did not prevent mortality, while sodium pentobarbital (SPB; 20 mg/kg) when injected 5 min after or 15 min before DEPA provided greater protection to the animals. SPB pretreatment elevated the LD50 of DEPA to 1780 and 1535 mg/kg in mice and rats respectively and 85% rats survived when SPB was injected 5 min after acute oral exposure to DEPA (1000 mg/kg). Carboxylesterase (CaE) inhibition is not a factor in the protection mechanism of SPB. DEPA (1000 mg/kg) when given orally elevated blood PCO2 and reduced pH, O2 content and per cent O2 saturation, while administration of SPB after the same dose of DEPA reduced the degree of acidosis and raised PCO2, and increased the O2 content and per cent O2 saturation to near normal status. The CNS depressant action of SPB may be a crucial factor in protection of rats from DEPA poisoning.

Experimental studies on the treatment of frostbite in rats.

The effect of treatment by high dose of vitamin C, rapid rewarming by 37 degrees C water alone and with vitamin C, rapid rewarming by 37 degrees C decoction of Indian black tea alone and with vitamin C for experimentally produced frostbite was evaluated in 6 groups (25 each) of rats. Frostbite was produced experimentally in the hind limbs by exposing the animals at -15 degrees C for 1h using the harness technique. The degree of injury was assessed and classified on the basis of tissue necrosis at the end of 15 days. Administration of high dose of vitamin C for prolonged period and rapid rewarming at 37 degrees C water bath immediately after cold exposure apparently reduced the tissue damage. High dose of vitamin C therapy preceded by rapid rewarming in plain water showed additional benefit. Rapid rewarming in decoction of Indian tea resulted in identical beneficial effect. The degree of tissue preservation was highest with rapid rewarming in tea decoction followed by high dose of vitamin C.

Peripheral vascular response to local cold stress of tropical men during sojourn in the Arctic cold region.

Peripheral vascular response to local cold stress was studied on 4 groups of volunteers by eliciting cold-induced vasodilatation (CIVD) response during immersion of right hand in cold water (4 degrees C) for 30 min, to examine whether tropical men can get acclimatized to local cold compared to temperate zone people, during Arctic cold exposure. Group A and B (10 each) were drawn from tropical region of India, while Group C and D (6 each) from temperate zone of Russia and natives of Arctic, respectively. Initial study was conducted on control Group A at Delhi. Group B was airlifted to the Arctic (70 degrees N, 38 degrees E), where measurements were done on them during the seventh week of acclimatization, then they were flown back to Delhi and retested. For comparison, study was done at the Arctic on six migrants (Group C) from temperate zone of Russia and 6 natives (Group D) of the Arctic. There was a significant improvement of CIVD response and peripheral blood flow of tropical men due to acclimatization to Arctic environment, which was similar to that of the migrants but lower than the natives. Thus local cold acclimatization is possible even in tropical men as in those of the temperate zone people.

Chemoreceptor sensitivity in adaptation to high altitude.

Studies were carried out in a group of 20 young male subjects to investigate the changes in chemoreceptor sensitivity during acclimatization to altitude. Their hypoxic sensitivity and carbon dioxide sensitivity were studied at Delhi, during acclimatization at 3500 m, and on return to sea level. Similar studies were also done in a group of 10 acclimatized lowlanders who stayed at 3500-4000 m for 12-14 months, and also on 10 high-altitude natives. The results showed no significant alteration in the hypoxic sensitivity of the lowlanders; but CO2 sensitivity was markedly elevated at altitude, both in sojourners and acclimatized lowlanders. The high-altitude natives showed less sensitivity to hypoxia, whereas the CO2 sensitivity was normal.

Chemoreceptor sensitivity and maladaptation to high altitude in man.

Studies were carried out to find out the role of chemoreceptor sensitivity in the causation of maladaptation syndromes on acute exposure to altitude. The experiments were done in two phases. In phase I, the responses in chemoreceptor sensitivity were studied in altitude acclimatized subjects and compared with those who suffered from either High Altitude Pulmonary Oedema (HAPO) or Acute Mountain Sickness (AMS). In Phase II, a similar comparison was done in two groups of subjects, one representing normal sojourners at 3,500 m and the other being subjects who had just recovered from HAPO. The first phase was done at Delhi; and the second at an altitude of 3,500 m. Parameters of assessment were hypoxic sensitivity, carbon dioxide sensitivity, ventilation (VE), respiratory frequency (Rf), forced vital capacity (FVC), forced expiratory volume at the first second (FEV1), heart rate (HR), blood pressure (BP), and oral temperature (Tor). The results showed significantly lower sensitivity to both hypoxia and carbon dioxide in maladapted subjects, as compared to those who were acclimatized in both the categories suggesting thereby that reduced chemoreceptor sensitivity might be an initiating factor in the causation of maladaptation syndromes at altitude.