The practice of internal medicine in a conflict zone is a unique challenge. In counter insurgency/ counter terrorism (CI/CT) areas, the hostile environment, austere conditions and limited logistics makes the decision making more difficult. There is enough literature available on the role of surgeon in combat zone both internationally and in Indian armed forces1,2, however there is paucity of literature on the role of internal medicine specialists in combat zone 3, 4. This article is aimed at analyzing the profile of medical morbidity and the role of internal medicine in combat environment.
Material and methods
This study was carried out in a zonal hospital situated at 6000ft above mean sea level and deployed in CI/CT area in northern region …show more content…
It is a known fact that medical illnesses constitute greatest strain on troops even in combat zone5. Although cardiovascular diseases have overtaken infectious diseases during recent wars6, infectious diseases still play a prominent role in our settings as evidenced by increased occurrence of viral hepatitis, malaria and liver abscess. In our search we didn’t find any other study from a hospital deployed in combat zone having such wide variety of illnesses. We deliberately excluded the common respiratory, gastro intestinal and infectious diseases that required less than 05 days of admission. All the patients were males and most of them were below 40 yrs of …show more content…
None of the patients had secondary hypertension and evidence of target organ damage. It is well documented that deployment with multiple combat exposures predisposes to hypertension than deployment to combat area per se7. In this study most of the patients who had STEMI were thrombolysed because of early recognition and evacuation by air from remote areas. In two cases we had prinzmetal angina which may be due to coronary spasm which was relieved promptly by administration of nitrates by the primary care medical professionals. The understanding of basic skills of 2D echocardiography helped us in timely intervention in 02 cases of cardiac tamponade and Left ventricular thrombus. Most of the patients who were referred were for chest pain were assessed by basic history, physical examination augmented by ECG, Cardiac enzymes , 2D echocardiography and tread mill test which were performed before retuning vast majority of patients to units similar to the study carried out by Sullenberger and Gentkesk8. Patients with cardiac disease were transferred to tertiary care centre for further
Material and methods
This study was carried out in a zonal hospital situated at 6000ft above mean sea level and deployed in CI/CT area in northern region …show more content…
It is a known fact that medical illnesses constitute greatest strain on troops even in combat zone5. Although cardiovascular diseases have overtaken infectious diseases during recent wars6, infectious diseases still play a prominent role in our settings as evidenced by increased occurrence of viral hepatitis, malaria and liver abscess. In our search we didn’t find any other study from a hospital deployed in combat zone having such wide variety of illnesses. We deliberately excluded the common respiratory, gastro intestinal and infectious diseases that required less than 05 days of admission. All the patients were males and most of them were below 40 yrs of …show more content…
None of the patients had secondary hypertension and evidence of target organ damage. It is well documented that deployment with multiple combat exposures predisposes to hypertension than deployment to combat area per se7. In this study most of the patients who had STEMI were thrombolysed because of early recognition and evacuation by air from remote areas. In two cases we had prinzmetal angina which may be due to coronary spasm which was relieved promptly by administration of nitrates by the primary care medical professionals. The understanding of basic skills of 2D echocardiography helped us in timely intervention in 02 cases of cardiac tamponade and Left ventricular thrombus. Most of the patients who were referred were for chest pain were assessed by basic history, physical examination augmented by ECG, Cardiac enzymes , 2D echocardiography and tread mill test which were performed before retuning vast majority of patients to units similar to the study carried out by Sullenberger and Gentkesk8. Patients with cardiac disease were transferred to tertiary care centre for further