what is the treatment of AMS?

If anybody has AMS sick then they should have to go down, down and down. It is very important and safety way and it is very good madicin for AMS. There is not magic altitude which you should descend. Go down to the place where you were comfortable before. This is usually about 300 meters pr more. Stay where you are and do not ascend if you have moderate AMS. If one is badly struck, we could only need time for him/her to go down by the use of inject able or oral steroid (dexamethasone at the dose of 4 to 8 mg 6 hourly), oxygen, diamox, pressure bag (Gamow bag) and diuretics (drug which makes one pee)Nifedipine, a drug used commonly in hypertension could be used in a setting of HAPE at the dose of 10mg three to four times per day. Diamox should be avoided in people who are allergic to sulfa drugs. The most common side effect is tingling of the hands and feet and the eyes and the lips. Some might experience that the aerated drinks taste flat. People may wake up several times in the night because of the diuretic effect. Gastritis is the commonest side effect with dexamethasone and can be effectively tackled with the use of drugs like ranitidine. Remember, all these only buy time one still needs to go down, go down and go down.

What do we do?

AMS is preventable and treatable. Our body is a machine, it always gives signs when it is malfunctioning. All we need to do is to listen to our body and help, not hinder its process. Avoid the risk factors. By slow ascent, we can digest the altitude, the process is called acclimatization. Here, our body gets sufficient time to adjust to the high altitude. It is prudent to take a rest day every third day with the rate of ascent not more than 400 metes per day after the altitude of 3000 meters. Climb high and sleep low is another of the dictum of altitude medicine. Moderate exertion on rest day is also recommended. People acclimatizing well will have increased diuresis which helps prevent fluid accumulating in the body. The process of acclimatization can be accelerated by the use of a drug called acetazlamide ( diamox) taken at a dose of 250mg twice daily (5mg/kg for kids)

what are the risk factors for AMS?

Rapid ascent is the main risk factor. Dehydration, airway infections, overexertion, sleeping pills, obesity, and alcohol are other risk factors. Previous history of altitude sickness is the vest predictor of whether one would be struck again. Non flexible itineraries. peer pressure, tough and stoic personality are some other risk factors. Excess chill and cold exposure is a known risk factor for HAPE.

Why does AMS happen?

All is because of low atmospheric pressure. Low atmospheric pressure leads to low oxygen tension in the air which we inhale and causes a series of changes in the body which may lead to AMS. There is leakage of fluid from the blood stream into the brain. The arteries of the lungs also constrict causing increase in pressure in them which promotes fluid leakage into the lungs. These occur when our body does not get sufficient time to adapt to the change in pressure. Some people may be unable to adapt at all because of some abnormalities in their bodies, for e.g. absence of one pulmonary artery. the relative preparation their brain and the skull etc.

About HAPE.

It is characterized by increasing breathlessness even at rest, productive cough and bluish discoloration of lips and tongue. The sputum may become blood tinged later on. It usually strikes the second night onwards. The bluish discoloration is a late sign and should not happen in the hands of good friends. One important thing about HAPE is that it can occur in a setting outside of AMS. people can have full blown HAPE without headache and other symptoms of AMS. Thus when confronted with the above signs and symptoms of HAPE, toes should not be ignored or dismissed in the light of absence of headache. HAPE likewise seems to be a completely different pathology. It is invariably fatal unless interfered with.

About HACE

It is characterized by increasing headache and vomiting, staggering gait, altered consciousness and other neurological signs. It is thought to be the progression of AMS. The condition develops more rapidly in the night in someone with AMS, probably because of further decrease in ventilation during the night. This explains the common belief in our people that somebody with a bad headache should not go to sleep. This is true but what is equally important is that they should not remain in the same place either. This fact highlights the importance of keeping a high index of suspicion and making decisions about descent in the day and not waiting for the night or the next morning. The single most important test to detect HACE in somebody with AMS is the tandemgait test where a person walks straight on a line in a hill to toe fashion.If he falls beyond the line, it is strongly suggestive of HACE. The person becomes comatose soon thereafter. It is invariably fatal unless interfered with.

Acute Mountain sickness (AMS)

It is a syndrome complex of (a) headeach (b) nausea (c) dizziness (d) sleeplessness and (e) fatigue. Of these, headache is the cardinal symptom. Nobody is immune to AMS above 2500 meter. It is not related to physical fitness or gender. Early AMS feels exactly like alcohol hangover. It is also heralded by the feeling of deep inner chill or a sense of not being well. Late or advanced AMS denotes increase in severity of the above mentioned symptoms. A typical picture will be a porter arrives at a high altitude carrying a heavy load. Immediately, he goes in a corner of a dark room and rests there covered with a blanket from head to toe. He doesn't want any tea or snacks. He starts to throw up once in a while. \when asked, he says he has the worst headache as if somebody is hammering a nail into his forehead and he feels terrible. He is still huddled in the corner at dinner time. When friends bring him food, he does not even want to look at it. when asked, he says yes, I want to go down. High altitude sickness is classified as (a) mild AMS (b) moderate AMS and (c) severe AMS.
If not interfered with, AMS could progress to two fatal complications. (a) High altitude cerebral edema (HACE), meaning swelling of the brain or water in the brain. (b) high altitude pulmonary edema (HAPE) meaning water in the lungs.

About helthe information.

Most of tourist are from sea label and Nepal is in high place located. For every one will not be fine so that it is very important health care. this is the basics of high altitude sickness. This is to acquaint you with the possible problems which might come your way during your journey to high altitude environments. This is not to scare you but to assist you in preparing yourself and to prevent the preventable.

Going to high altitude there is some risk because you leave the comforts of your daily livings. Different climatic conditions. Your previous medical history act as a predisposing factor. Some time it is not adjust your body and food too. In high place it is mean different of the oxygen presser. In high place there is low oxygen and in low place is plenty of oxygen for the body so it is very important care of the health in mountain are. It begins avobe 2500 meters. It is big different between here and where you are staying so it must take mediations and oxygen bottle available. It is just for trekking to the mountains area.

Culture heritage of Nepal.

Nepal is one of the riches cultural country in the world. Culturally, Nepal is among the most diversified countries in the world. A visible indicator is the spoken language carrying indigenous knowledge on natural resources and life styles. According to the Summer institute of linguistics, there are 125 languages in Nepal of which one has become extinct.

IUCN Nepal Heritage society have documented 1,254 heritage sites in 72 districts outside the Kathmandu valley. According to the 1975 survey, the kathmandu valley holds 888 heritage sites of global significance. Apart from these, there are numerous temples and monuments in the valley. Recognizing the spectacular natural heritage and refined cultural heritage of Nepal, UNESCO has listed ten spots in Nepal as the world heritage sites. Two natural and eight cultural. The two natural sites are the Sagarmatha National park and the Royal chitwan National park. The seven monumental zones of the kathmandu valley were recognized as the cultural world heritage sites in 1979. there are Pashupatinath,Swoyaghunath, bouthanath, Changu Narayan
temple complexes and the three historical palaces of bhktpur,Lalitpir and kathmandu dities. In fact, the kathmandu valley with towns and settlements spread over the fertile alluvial lands irrigated by the perennial springs and streams and surrounded by the woody hills form the integral parts of the heritage sites. With towns capes and temple skylines, live cultural activity's like festivals and ceremonies are part of every day and night. Intricate arts and agricultural practices.

Nature heritage of Nepal.

Nepal represents 118 ecosystems and 35 forest types. It is biological diversity ranging between Indo-Malayan and palaeparctic fauna and flora includes 3critically endangered, 14 endangered and 42 vulnerable faunalspecies, and 2 endangered and 4 vulnerable flora species according to the 2000 IUCN Red list of threatened species. As per Nepal records, there are over 6,500 vascular plants including 252 endemic plants, 400 species of trees and 700 species of medicinal plants and over 844 birds, 181 mammals, 100 reptiles and 43 amphibians. It is also a fact that Nepal's hydro power outbreak is 84000MW that would be a total hydro power potential.

Government of Nepal has declared two significant areas of the country as Gifts to the Earth in support of the wwF's global cmpaign to save the earth. They are the Kangchenjunga region and the prosoded extension of the Royal Bardia Netional park. Similarly,wwF has indentified four of the Global 200 Eco- regions in Nepal representing major biodiversity regions of the world that need special attention. Sagarmatha Nestional Park. Lumbini, the birthplace of Lord buddha, has been inclided in the world Heritage sites. Lumbiniis a living example of human civilixation that established the philosophy of peace and harmony not only among humankind but also with the mature. It also offers nesting ground for the endangered species like saras crane. Tengboche monastery to protect the surroundings in the Sagarmatha National park as a sacred Gifr for a living planet at the Bhaktapur celebration in November 2000.

World Heritage of Nepal.

The world Heritage list was established under terms of the convention concerning the protection of the world cultural and Neutral Heritage adopted on November16, 1972 at the 17th session of the General conference of UNESCO held in Paris from October 17 to November21, 1972. Government of Nepal accepted the convention on June 20, 1978. There are 175states who are signatory to the convention as of September 28, 2002.Thus, the convention is one of the most universally accepted international legal instruments for the protection of heritage. Nepal is rich in both natural and cultural heritage is economically poor country as per the global standards. Its per capital gross domestic product is US 240 for the year 2000/2001. On top of it its gross notional happiness has also been decreased visible with the increasing number of casualties. It would be a wishful thinking to put a price tag on the sagamatha, or on the 5-story temple.

Medical information

You need medical equipments because of most of tourist or visitor are staying around sea label so Nepal is a mountaineering country so it should have information of the altitude sickness. It is possible to suggest a medical kit that will offer drugs or equipment for a very wide variety of emergencies, expeditions very widely in their requirements and the expertise of their medical personnel. Judgements have to made about the scale of equipment to be carried. It is very important bringing madicin with you. In Nepal it is very high place from the sea label. In high place oxygen goes low every step up to Mountain.

Oxygen is very important. Bottled oxygen is available and it is good to get more oxygen for body. In high place goes less and less oxygen for the body and then our hemoglobin of the blood get sick. It goes very difficult to circulation of the blood for all body. In that time will get sick. Here are some all drugs are labelled and listed.
paracetamol Tablets 500bg, take 2 every 4 hours. Codeine phosphate Tablets 30mg, pain/diarrhoea take 2 every 4 hours. Diclofenac 50mg tablets pain take one 3 times daily. Dimorphic 10mg tablets( cd) severe pain pain one every six hours. Dianmorphine 5mg injection (cd) very severe pain one ever six hours. Acetazolamide 250mg tablets take one tablet twice daily. Nifedipine 10mg tablets, take two tablets three times daily. Dexamethasone 2mg tablets, take two tablets four times daily.Dexamethasone 8mg injection (2ml vials) take one 4mg injection 4 times daily.For severe altitude sickness. Dexamethasone2mg tablets and Nifedipine 10mg tablets, take two of each three times daily and come down. Anoxycillin 500mg capsules, antibiotic take one capsule 3 times daily. ciprofloxacin 500mg tablets, antibiotic take one twice a day. Oxtetracylind250mg tablets, antibiotic take one four times daily. Cefotaxime 2g injection antibiotic give one2g inj 3times daily. Metronidazole tablets 400mg, antibiotic take one tablet 3 times daily. tinidazole 500mg tablets, amoebic dysentery take 4 tablets then one twice daily. Quinine 600mg tab;ets Malaria take one 8 hourly.Mebendazole 100mg tablets worms take one twice daily for 3 days. Rabis vaccine read instructions, dog bites give one injection in arm.
If these kind of medicin does not help and then it need rescue.

paragliding in Nepal.

Some excitement into your life with a fantastic activity holiday time. Activity holidays are the perfect way to pump some adventure into your life. Simply give you chance to just switch off from your day to day life and do something different other different holidays are multi activity holidays in which you choose various activities of your choice to do. It must be very enjoyable. For example you could do paragliding in Nepal.You can have more fun because here are many exciting activities waiting for you to experience. In life every adventures can do and you can have enjoy your life. Here are some place for the paragliding in Nepal but on of the popular place is in Sarnkot. It is above 2100 meter high from the see Laval and here is very excellent views you can have in your life.

Rafting adventure

Rafting adventure is one of the popular sport in the river. A lot of Travers having fun in the life. Some excitement into your life with a fantastic activity holiday. Activity holidays are the perfect way to pump some adrenaline into your life. Simply give you chance to just switch off from your day to day life and do something different other different holidays are multi activity holidays in which you choose various activities of your choice to do. For example you could be doing from rafting in Nepal. You can have more fun because here are many exciting activities waiting for you to experience.

other adventure in Himalaya

Other adventure in Himalaya can do in other part of world. In Nepal here are some mountains over 8000 meters. Mt.Everest,Mt.Kanchanjuga, Mt. Makalu, Mt.Lotse, Mt.Dhawalagiri, Mt. Mansalu, Mt.Annapurna Mt.Lotser.Those are in Nepal and some 8000 meter mountains are out of Nepal. Mt. k2 is in pakistan, Mt. choyu is china.

Camp no 4

Camp numer 4 is last camp. From last camp to summit it is one day

Cravas into Ice fall

Khumbu Ice fall there are craves and it is very deep. Around this kind of place should be verycarefull.

Way to camp 1

Bas camp and camp1 is Khumbu Ice fall. In this way is very danger place. There are so many craves and it is place which is danger of the Avalanche. A lot of high porters die in this area.

Everest expedition in Bascamp

Everest Bas camp is very busy place in spring expedition time. In expediting season all the time a lot of claiming members us to come for expedition from different countries. In bas camp it Begins of adventure expedition.
All the claiming gear, equipment and food bring to bas camp. Every climber they fix the plan from bas cam. Every climber supply theirs food and claiming gears from bas camp to high camp or camp1, camp2, camp3, camp4.

Mountain Expeditions

Mountain is north part of Nepal. There are so many mountains and they are dividing three classes. They are 5000-6000m.,6000-7000m.,and above 8000m. The pictures is from expedition. Everest expedition from south col.

Expedition

Expedition means relation with Mountains. Expedition is basically the symbols of adventure sport. It need modern equipment and technique. In high altitude, decrease oxygen pressure, high radiation values,low temperatures and low humidity of the air.
Expedition means an act of expedition on any peak of the mountain range of world. There are some mountains which are over 8000m in the world. Expedition season is spring season is one of the best time. In that time it is very enough strong Ice to fix the mountain gear. In this time is not very cold and not very warm. This season comes after winter season. In winter season will be very snow all over the Mountains and over the ground too. In winter everywhere the ground will frozen and there is much snowfall especially in the months of January and February.
In October time also possible to make small trekking peak expedition. It should be for short peered. It is not for long peered. In this time only bellow 6000m. mountains. In this time less expedition on mountains.