Mir I S, Mir M, Ahmed M
Government Gousia Hospital, Jammu & Kashmir, India.
Indian J Med Res. 2008 Dec;128(6):740-3.
BACKGROUND & OBJECTIVES: The "Shri Amarnath Ji Yatra" is an annual congregation in which the devotees trek a difficult route of around 40 km to reach to a cave at a height of approximately 14,000 feet at Pahalgam in the State of Jammu & Kashmir, India. These trekkers are subjected to stress and strain of the long mountainous route and difficult security scenario as a result of which they are prone to develop some surgical disorders. We ascertained the profile of non-traumatic surgical conditions met in these people at the various medical aid centres and the base hospital Pahalgam so that a policy could be framed to prevent these conditions.
This study was conducted at the Government Base Hospital Pahalgam, Kashmir, between June and August 2006. The patients with non traumatic surgical conditions attending the hospital were included in this study. Necessary investigations were done and patients requiring surgical intervention were operated upon.
Of the 1,54,000 devotees who undertook the "yatra", in 2006 the personnel of the Directorate of Health Services, Kashmir, extended medical aid to 40,082 pilgrims. Of these 40,082 pilgrims, 172 were admitted on the surgical side for various non traumatic surgical disorders. The commonest cause for admission was exacerbation of acid peptic diseases. Nine emergency surgical procedures were conducted at the base hospital and the commonest cause for intervention was perforation of a duodenal ulcer. There was no mortality and the patients responded well to conservative ulcer procedures.
INTERPRETATION & CONCLUSION: The stress of high altitude trekking and assembly of a large gathering of people during the annual "Amarnath Ji yatra" can pose a number of health related problems especially in the old and infirm people as was observed in the study. Pilgrims who intend taking up the yatra in future should seek medical advice prior to their departure. If a person is diagnosed to have peptic ulcer disease he or she should be put on anti-ulcer therapy to prevent potential complications.
“阿玛纳特圣地之旅”是一项年度集会活动，信徒们需徒步艰难跋涉约40公里，前往印度查谟和克什米尔邦帕哈尔甘海拔约14000英尺处的一个洞穴。这些徒步者要承受漫长山路带来的压力和紧张，以及艰难的安全状况，因此容易患上一些外科疾病。我们确定了在各个医疗救助中心和帕哈尔甘基地医院遇到的这些人的非创伤性外科疾病情况，以便制定预防这些疾病的政策。
本研究于2006年6月至8月在克什米尔帕哈尔甘政府基地医院进行。本研究纳入了到该医院就诊的患有非创伤性外科疾病的患者。进行了必要的检查，并对需要手术干预的患者实施了手术。
在2006年进行“圣地之旅”的15.4万名信徒中，克什米尔卫生服务局的工作人员为40082名朝圣者提供了医疗救助。在这40082名朝圣者中，172人因各种非创伤性外科疾病入住外科病房。入院的最常见原因是消化性疾病加重。基地医院进行了9例急诊外科手术，干预的最常见原因是十二指肠溃疡穿孔。无死亡病例，患者对保守性溃疡治疗反应良好。
正如研究中所观察到的，年度“阿玛纳特圣地之旅”期间高海拔徒步旅行的压力以及大量人群的聚集可能会引发许多与健康相关的问题，尤其是在老年人和体弱者中。未来打算参加圣地之旅的朝圣者在出发前应寻求医疗建议。如果一个人被诊断患有消化性溃疡疾病，他或她应该接受抗溃疡治疗以预防潜在并发症。
