Profile of non traumatic surgical disorders found in the pilgrims/trekkers travelling to Shri Amarnath Ji cave.

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. METHODS 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. RESULTS 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.