Aust Dent J 2018 Apr 21. Epub 2018 Apr 21.

Conservative Dentistry and Endodontics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India.

Intraoral frostbite as such, is an unusual occurrence. Careful literature review revealed rare cases of intraoral frostbite, attributed to intentional inhalational abuse of fluorinated hydrocarbons, dry ice, liquid nitrogen etc,. Hypothermal injuries of the gastric mucosa caused by ingestion of liquid nitrogen have been reported but none of these patients suffered from any direct injury affecting the oral mucosa. Read More

High Alt Med Biol 2018 Apr 2. Epub 2018 Apr 2.

4 Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute , Ljubljana, Slovenia .

Gorjanc, Jurij, Shawnda A. Morrison, Rok Blagus, and Igor B. Mekjavic. Read More

Zhongguo Zhong Yao Za Zhi 2018 Jan;43(2):410-414

China Association of Traditional Chinese Medicine Pharmacology Specialized Committee, Henan University of Chinese Medicine, Zhengzhou 450046, China.

Frostbite is a common disease in winter, and systemic or local injury caused by low temperature invasion. Frostbite sites are commonly face, ears, nose, hands, feet and other peripheral blood circulation parts. The main symptoms are pale skin, cold, pain and numbness, skin itching in high temperature, and severe cases may suffer from skin erosions and ulcers. Read More

Case Rep Dermatol 2018 Jan-Apr;10(1):17-23. Epub 2018 Feb 1.

bDepartment of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan.

The association between ultraviolet radiation exposure and skin cancer is well established. Limited studies have reported an association between frostbite and the development of non-melanoma skin cancer but evidence for a proven link is insufficient and possible carcinogenic mechanisms have not been fully explored. In this report, 3 cases of non-melanoma skin cancer (1 case of basal cell carcinoma and 2 cases of squamous cell carcinoma of the skin) which developed at a site of previous frostbite caused by exposure to extremely cold temperatures in Astana, the capital city of Kazakhstan, are described. Read More

Hautarzt 2018 Mar 2. Epub 2018 Mar 2.

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

Physical and chemical emergencies are often caused by household or work accidents. Regardless of the medical field and outside specialized clinics, the physician may be confronted with the situation for first or secondary care. The identification of the causing agent and a rapid assessment of the extent and severity of the tissue damage are essential to initiate early transfer to a specialized burn clinic. Read More

J Foot Ankle Surg 2018 Mar - Apr;57(2):382-387

Director and Assistant Professor, Podiatric Medicine and Surgery Residency, University of Pittsburgh Medical Center Mercy, Department of Orthopedic Surgery, University Pittsburgh School of Medicine, Pittsburgh, PA.

Acute compartment syndrome of the foot and ankle is a relatively rare clinical finding. Lower extremity compartment syndrome is customarily due to vascular or orthopedic traumatic limb-threatening pathologic issues. Clinical correlation and measurement of intracompartmental pressure are paramount to efficient diagnosis and treatment. Read More

Rev Infirm 2018 Feb;67(238):40-43

Service médical d'urgence, Brigade de Sapeurs-Pompiers de Paris, 3 rue Darmesteter, 75013 Paris, France. Electronic address:

Frostbites are cold-freezing injuries of the extremities due to the exposure to temperatures below 0°C. The risk, in the absence of treatment, is the amputation of frostbitten areas which become gangrenous. Victims of frostbite must be treated and evacuated urgently. Read More

Behav Brain Sci 2017 Jan;40:e279

Department of Psychology,Stanford University,Stanford,CA

Machines that learn and think like people must be able to learn from others. Social learning speeds up the learning process and - in combination with language - is a gateway to abstract and unobservable information. Social learning also facilitates the accumulation of knowledge across generations, helping people and artificial intelligences learn things that no individual could learn in a lifetime. Read More

Nursing 2018 Feb;48(2):26-33

Linda Laskowski-Jones is editor-in-chief of Nursing2018 and Vice President of Emergency and Trauma Services at Christiana Care Health System in Newark, Del. She and Lawrence J. Jones are directors of the Appalachian Center for Wilderness Medicine in Morganton, N.C., and members of the Blue Mountain Ski Patrol in Palmerton, Pa.

Psychol Med 2017 Dec 5:1-8. Epub 2017 Dec 5.

Department of Psychiatry,Psychotherapy and Psychosomatics,University Hospital of Psychiatry II,Medical University Innsbruck,Innsbruck,Austria.

Background: Psychotic episodes during exposure to very high or extreme altitude have been frequently reported in mountain literature, but not systematically analysed and acknowledged as a distinct clinical entity.

Methods: Episodes reported above 3500 m altitude with possible psychosis were collected from the lay literature and provide the basis for this observational study. Dimensional criteria of the Diagnostic and Statistical Manual of Mental Disorders were used for psychosis, and the Lake Louise Scoring criteria for acute mountain sickness and high-altitude cerebral oedema (HACE). Read More

J Food Sci Technol 2017 Dec 24;54(13):4277-4283. Epub 2017 Oct 24.

Department of Nuclear Engineering, Faculty of New Sciences and Technologies, University of Isfahan, Esfahān, Iran.

In this study, the effect of gamma irradiation on the shelf life and properties of cucumber was investigated. These properties include weight reduction, fruit density, juice, tissue firmness, total soluble solids (TSS), total titratable acidity, chlorophyll and vitamin C, pH, marketability, flavor, frostbite and fungal effects. For this purpose, cucumbers were irradiated with dose of 2, 2. Read More

Pflugers Arch 2017 Nov 21. Epub 2017 Nov 21.

Section of Vascular Biology and Inflammation, School of Cardiovascular Medicine and Research, BHF Cardiovascular Centre of Research Excellence, King's College London, Room 3.74, FWB, 150 Stamford Street, London, SE1 9NH, UK.

Cold exposure is directly related to skin conditions, such as frostbite. This is due to the cold exposure inducing a vasoconstriction to reduce cutaneous blood flow and protect against heat loss. However, a long-term constriction will cause ischaemia and potentially irreversible damage. Read More

Indian J Nucl Med 2017 Oct-Dec;32(4):367-368

Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA.

A 39-year-old male presented to the emergency department (ED) with frostbite to the fingers of both hands. In the ED, he received warm baths, acetylsalicylic acid, clopidogrel, and heparin. A three-phase bone scintigraphy with technetium-99m-methylene diphosphonate revealed absent radiotracer uptake in distal phalanges of both hands. Read More

MSMR 2017 Oct;24(10):12-21

From July 2016 through June 2017, a total of 387 members of the active (n=328) and reserve (n=59) components had at least one medical encounter with a primary diagnosis of cold injury. Among active component service members, the total number of cold injuries in the 2016-2017 cold season was the lowest since 1999 and the overall incidence rate was lower than in any of the previous four cold seasons. Frostbite was the most common type of cold injury. Read More

Emerg Med J 2017 Nov;34(11):763-764

Belgian Red Cross-Flanders, Mechelen, Belgium.

A short cut review was carried out to establish whether routine use of emollients on the face reduced the incidence of frostbite in cold environments. 126 papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. Read More

J Therm Biol 2017 Oct 21;69:334-340. Epub 2017 Sep 21.

Foolad Institute of Technology, Fooladshahr, Isfahan 84916 63763, Iran.

Frostbite is considered the severest form of cold injury and can lead to necrosis and loss of peripheral appendages. Therefore, prediction of endurance time of limb's tissue in cold condition is not only necessary but also crucial to estimate cold injury intensity and to choose appropriate clothing. According to the previous work which applied a 3-D thermal model for human finger to analyze cold stress, in this study, an expression is presented for endurance time in cold conditions to prevent cold injury. Read More

Emerg Med J 2017 Oct;34(10):689-690

Oregon Health & Science University, Portland, Oregon, USA and Manchester Royal Infirmary, Manchester, UK.

A short cut review was carried out to establish whether an infusion of iloprost can be used to treat frostbite to reduce the risk of needing an amputation. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. Read More

Eur J Med Genet 2017 Dec 13;60(12):690-694. Epub 2017 Sep 13.

Department of Pediatric Rheumatology, Cukurova University Faculty of Medicine, Adana, Turkey. Electronic address:

Three prime repair exonuclease 1 degrades single and double stranded DNA with 3'-5' nuclease activity and its mutations are related to type 1 IFN mediated autoinflammation due to accumulated intracellular nucleic acids. To date, several cases of systemic lupus erythematosus, Aicardi-Goutieres syndrome, familial chilblain lupus, retinal vasculopathy-cerebral leukodystrophy have been reported with TREX1 mutations. Chilblain lupus is a skin disease characterized by blue-reddish coloring, swelling or ulcers on acral regions of body such as fingertips, heels, nose and auricles. Read More

Mil Med 2017 Sep;182(9):e1764-e1768

Tactical Research Unit, Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD 4226.

The Arctic Ram Exercise was conducted in February 2016, near Resolute Bay on Cornwallis Island in Nunavut, Canada, to demonstrate the ability of the Canadian Armed Forces (CAF) to rapidly deploy to the arctic as an immediate response team. This report describes medical problems experienced by the 187 CAF and 28 U.S. Read More

J Burn Care Res 2017 Aug 31. Epub 2017 Aug 31.

From the *Lewis Katz School of Medicine at Temple University, Philadelphia, PA; †Albert Einstein Healthcare Network, Philadelphia, PA; ‡Temple Burn Center, Philadelphia, PA.

Reports of iatrogenic cold thermal injuries are rare in the literature. Conductive cooling devices, typically employed for their neuroprotective effects, use conductive hydrogel pads to achieve rapid and precise temperature control approaching the level of water immersion. Despite a number of built-in safeguards, prolonged or improper use of these devices can lead to significant thermal injury. Read More

Curr Rheumatol Rep 2017 Aug 26;19(10):61. Epub 2017 Aug 26.

Unit for Rheumatology and Clinical Immunology, Medical Center Baden-Baden, Beethovenstr.2, 76530, Baden-Baden, Germany.

Purpose Of Review: Familial chilblain lupus belongs to the group of type I interferonopathies and is characterized by typical skin manifestations and acral ischaemia. This review aims to give an overview of clinical signs and the pathophysiological mechanisms.

Recent Findings: There are several mutations that can lead to this autosomal dominant disease. Read More

Undersea Hyperb Med 2017 Jul-Aug;44(4):365-369

Maasstad Hospital, Department of Burn and Trauma Surgery, Rotterdam, The Netherlands.

Frostbite is an injury caused by the freezing of tissue, causing varied levels of tissue damage and necrosis. Case reports have shown a positive effect of hyperbaric oxygen (HBO₂) in such injuries, in acute cases as well as delayed (up to 21 days) presentation with complications. In this case report we present the course of hyperbaric treatment of two patients (a brother and sister, age 58 and 62) who sustained frostbite injuries to both feet 28 days earlier while hiking in the Himalayas. Read More

Burns 2017 Nov 1;43(7):1455-1463. Epub 2017 Aug 1.

Helsinki Burn Centre, Department of Plastic Surgery, Töölö Hospital, Helsinki University Hospital, University of Helsinki, Finland.

Background: Severe frostbite can result in devastating injuries leading to significant morbidity and loss of function from distal extremity amputation. The modern day management approach to frostbite injuries is evolving from a historically very conservative approach to the increasingly reported use of early interventional angiography and fibrinolysis with tPA. The aim of this study was to evaluate the results of our frostbite treatment protocol introduced 3 years ago. Read More

Burns 2017 Nov 1;43(7):1449-1454. Epub 2017 Aug 1.

Department of Burns, Third Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Institute of Burn Research, Baotou, Inner Mongolia, China. Electronic address:

Background: The aim of this study is to analyze the data of amputees in the burn center of the Inner Mongolia region and to provide instructive suggestions for a preventative reduction of the amputation rate.

Methods: Between 2004 and 2016, all patient medical profiles were reviewed to extract data of patients with major amputation. Demographic data, mechanism of injury, location and level of amputation were recorded. Read More

Cardiovasc Intervent Radiol 2017 Dec 12;40(12):1824-1831. Epub 2017 Jul 12.

Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.

Purpose: To report outcomes of intra-arterial thrombolysis versus non-thrombolytic management of severe frostbite with respect to digital amputation rates and hospital length of stay (LOS).

Materials And Methods: Seventeen patients with severe frostbite were identified from 2000 to 2017. Eight (47%) patients with mean age of 40 years underwent intra-arterial thrombolysis and served as the treatment group. Read More

Indian J Nucl Med 2017 Jul-Sep;32(3):203-207

Department of Nuclear Medicine, Army Hospital Research and Referral, New Delhi, India.

Frostbite or cold burn is the medical condition in which localized damage is caused to exposed skin and subcutaneous tissue due to freezing. Frostbite most likely involves body parts farthest from the heart and those with large exposed areas. At or below 0 °C (32 °F), blood vessels close to the skin start to constrict, and blood is shunted away from the extremities via the physiological feedback action of glomus bodies. Read More

Sud Med Ekspert 2017;60(3):42-49

Bureau of Forensic Medical Expertisem Moscow Health Department, Moscow, Russia, 107023; Federal state budgetary institution 'Russian Federal Centre of Forensic Medical Expertise', Ministry of Health of the Russia, Moscow, Russia, 125284.

The authors present the data of the literature publications and theoretical considerations concerning the causes and conditions behind the formation of the chilling injury. It is demonstrated that the chilling injury develops as a consequence of a disturbance in the relationship between the hypothermic protection of the organism and the cooling potential of its environment. The thermal balance of the human organism depends not only on the natural mechanisms of physical and chemical thermoregulation but also on the character of artificial thermoregulation including the man-made means of cold protection. Read More

World J Gastroenterol 2017 Jun;23(22):4080-4089

Qiao-Huan Yan, Department of Geriatrics, the First Hospital of Handan, Handan 056001, Hebei Province, China.

Aim: To observe the effect of targeted therapy with 64-slice spiral computed tomography (CT) combined with cryoablation for liver cancer.

Methods: A total of 124 patients (142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group ( = 56, 65 tumors) and 64-slice group ( = 8, 77 tumors). Read More

BMJ Case Rep 2017 Jun 19;2017. Epub 2017 Jun 19.

Ilulissat Hospital, Ilulissat, Greenland.

Frostbite may cause lesions. The severity ranges from superficial wounds to severe cases with loss of limbs and tissue. Hence, proper treatment is of utmost importance. Read More

J Burn Care Res 2017 May 26. Epub 2017 May 26.

From the Department of Surgery, Hennepin County Medical Center, Minneapolis, MN.

Cold exposure that leads to frostbite puts patients at high risk for extremity amputations. Recent treatment advances, such as thrombolytic administration, have decreased amputation rates. However, little is known about patient outcomes with early mobilization of affected limbs. Read More

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017 Jun;60(6):605-617

Abteilung Allergologie, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Deutschland.

Background: Multiple environmental exposures may derange the regulatory and repair mechanisms of the skin and lead to dermatological disease.

Objectives: Provide an overview of non-allergic skin diseases associated with environmental factors.

Materials And Methods: Review of current scientific evidence for associations of non-allergic skin diseases with environmental exposures: irritation, chemicals, infection, UV-radiation, temperature. Read More

Adv Wound Care (New Rochelle) 2017 May;6(5):143-152

Angie Purvis, LLC, Evergreen, Colorado.

Topical oxygen devices are Food and Drug Administration (FDA) cleared for the following indications for use of various etiologies: skin ulcerations due to diabetes, venous stasis, postsurgical infections and gangrenous lesions, decubitus ulcers; amputations/infected stumps; skin grafts; burns; and frostbite. The goal of this study was to understand the impact of topical oxygen therapy (TOT) on patient outcomes, including amputation and healing rates. This retrospective chart review included records collected between January 1, 2007, and July 18, 2016, from male and female patients ranging in age from 4 years to 105 years. Read More

Int Arch Occup Environ Health 2017 10 11;90(7):645-652. Epub 2017 May 11.

Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, 901 87, Umeå, Sweden.

Purpose: To investigate whether exposure to cold could influence the thermal perception thresholds in a working population.

Methods: This cross-sectional study was comprised of 251 males and females and was carried out at two mines in the northern part of Norway and Sweden. The testing included a baseline questionnaire, a clinical examination and measurements of thermal perception thresholds, on both hands, the index (Digit 2) and little (Digit 5) fingers, for heat and cold. Read More

Wilderness Environ Med 2017 Jun 5;28(2S):S82-S89. Epub 2017 May 5.

Department of Surgery, Center for Translational Injury Research, University of Texas Health Science Center, Houston, Texas (Holcomb).

For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients. Read More

Neural Regen Res 2017 Mar;12(3):440-446

Institute of Neurobiology, College of Life Science, Henan University, Kaifeng, Henan Province, China.

Cold exposure is an external stress factor that causes skin frostbite as well as a variety of diseases. Estrogen might participate in neuroprotection after cold exposure, but its precise mechanism remains unclear. In this study, mice were exposed to 10°C for 7 days and 0-4°C for 30 days to induce a model of chronic cold exposure. Read More

Int J Circumpolar Health 2017 ;76(1):1273677

e Department of Radiology , University Hospital North Norway, Tromsø , Norway.

Frostbite sequelae are a relevant occupational injury outcome for soldiers in arctic environments. A Caucasian male soldier suffered frostbite to both hands during a military winter exercise. He developed sensory-motor disturbances and cold hypersensitivity. Read More

Emerg Med Clin North Am 2017 May;35(2):281-299

Department of Vascular Surgery, University Hospital Coventry and Warwickshire NHS Trust, Warwick Medical School and Coventry University, Coventry, UK.

Deep frostbite is a thermal injury associated with significant morbidity. Historically, this has been associated with military personnel; however, increasingly it is becoming an injury that afflicts the civilian population. The use of intravenous iloprost or intra-arterial thrombolytics has led to promising tissue salvage. Read More

Int Arch Occup Environ Health 2017 10 11;90(7):587-595. Epub 2017 Apr 11.

Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.

Purpose: To describe the self-reported ambient cold exposure in northern Sweden and to relate the level of cumulative cold exposure to the occurrence of sensory and vascular hand symptoms. We hypothesize that cold exposure is positively related to reporting such symptoms.

Methods: A questionnaire about cold exposure and related symptoms was sent out to 35,144 subjects aged 18-70 years and living in northern Sweden. Read More

Z Rheumatol 2017 May;76(4):322-327

ACURA-Rheumazentrum Baden-Baden, Rotenbachtalstr. 5, 76530, Baden-Baden, Deutschland.

Familial chilblain lupus belongs to the group of type 1 interferonopathies and is particularly characterized by typical skin manifestations and ischemia of the acra. There are various mutations that can lead to this autosomal dominant disease. A mutation in the TREX-1 gene has been most frequently found; however, families with mutations in the SAMHD1 gene and recently in the gene which codes for the stimulator of interferon genes (STING) protein were also described. Read More

J Wound Care 2017 Apr;26(4):188-190

Specialty Registrar in Plastic Surgery, Department of Plastic Surgery, St John's Hospital, Edinburgh, Scotland, UK.

This case study describes frostbite, a previously unreported complication following cryolipolysis, which resulted in substantial necrosis of the flank. Medical attention was not sought until one week after treatment. On examination, two distinct areas of significant frostbite in the left flank with surrounding erythema were revealed. Read More

Hand Clin 2017 05;33(2):257-267

The University of Chicago Medicine, 5841 South Maryland Avenue, MC 6035, Chicago, IL 60637, USA. Electronic address:

New treatments of frostbite have led to unprecedented salvage of extremities including fingers and toes. Success is predicated on prompt institution of time-sensitive protocols initiated soon after rewarming, particularly the use of thombolytics. Unfortunately, in the urban setting, most patients are not candidates for these treatment modalities. Read More

J Therm Biol 2017 Apr 6;65:153-160. Epub 2017 Mar 6.

Foolad Institute of Technology, Fooladshahr, Isfahan 84916-63763, Iran.

The existing computational models of frostbite injury are limited to one and two dimensional schemes. In this study, a coupled thermo-fluid model is applied to simulate a finger exposed to cold weather. The spatial variability of finger-tip temperature is compared to experimental ones to validate the model. Read More

Metab Brain Dis 2017 Jun 23;32(3):679-683. Epub 2017 Mar 23.

Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt.

Aicardi-Goutières syndrome (AGS) is one of the expanding group of inherited congenital infection like syndromes. Here, we describe the detailed clinical and imaging findings of two sibs with AGS. Each shows scattered periventricular intracranial calcifications, severe global delay, seizures, microcephaly and spasticity. Read More

J Burn Care Res 2017 Mar 15. Epub 2017 Mar 15.

From the Hennepin County Medical Center, Minneapolis, Minnesota.

Frostbite injury causes direct damage to tissues following exposure to temperatures below their freezing point causing tissue death potentially leading to serious amputations. After rewarming, a variety of treatment options have been employed to avoid amputation. This case report details the use of indocyanine green fluorescence microangiography to monitor the clinical progression of perfusion following hyperbaric oxygen therapy (HBOT) for severe frostbite injury. Read More

Clin Sports Med 2017 Apr;36(2):315-335

Department of Otorhinolaryngology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA. Electronic address:

In cases of head trauma, the ear should be evaluated in all of its components. A good understanding of otologic and skull base anatomy enables a thorough trauma assessment of this complex anatomic region. Auricular laceration, abrasion, avulsion, hematoma, frostbite, otitis externa, exostosis, tympanic membrane perforation, ossicular discontinuity, perilymphatic fistula, labyrinthine concussion, temporal bone fracture, facial nerve paresis, and sensorineural hearing loss are a few of the more common otologic injuries seen in active patients. Read More

J Burn Care Res 2017 Sep/Oct;38(5):e877-e881

From the Department of Pharmacy, Loyola University Medical Center, Maywood, Illinois.

Frostbite can lead to severe consequences including loss of digits and limbs. One of the mechanisms of frostbite includes vascular thrombosis. The use of tissue plasminogen activator (tPA) in frostbite has been shown to be effective in case reports and small prospective studies. Read More

J Hand Surg Am 2017 Mar;42(3):175-181.e1

Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH.

Purpose: Limited literature supports using ethyl chloride topical spray as an anesthetic for hand injections whereas documented risks include frostbite, skin irritation, and inhalation toxicity. We hypothesize that ethyl chloride spray imparts no benefit to patients' perception of pain or anxiety for routine hand injections.

Methods: We first surveyed all members of the American Society for Surgery of the Hand to discern the prevalence of ethyl chloride use during routine injections. Read More

Indian J Dermatol 2017 Jan-Feb;62(1):59-65

Department of Dermatology, Military Hospital, Ahmedabad, Gujarat, India.

Approximately, 140 million people worldwide live permanently at high altitudes (HAs) and approximately another 40 million people travel to HA area (HAA) every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV) light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Read More