Policy and Research

The aim of LIP’s Policy and Research Programme is to create a culture of collating an evidence base in Ladakh where the concept of conducting research on the health and social care needs of the population is still non-existent. We at LIP are attempting to spearhead this concept by carrying out: epidemiological research qualitative research and action research.

Furthermore we have been able to ascertain the prevalence of diseases in the population of Ladakh. There is still a long way to go as LIP being a voluntary organisation has its limitations in terms of resources. However, we have been able to carry out several useful researches which have helped to highlight previously unknown diseases such as environmental silicosis (disease caused by inhalation of fine dust containing silica) and stomach cancer. LIP strives to work in partnership with other institutes and organisations from within India and abroad.

Researches:

Research achievements during the last three years.

  1. K.Otsuka; T.Norboo; Y.Otsuka; H.Higuchi.M.Hayajiri; C.Narushima; Y.Sato; T.Tsugoshi; S.murakami; T.Wada; M.Ishine; K.Okumiya; K.Matsubayashi; S.Yano; T.Chogyal; D.Angchuk; K.Ichihara; G.Conelissen; F.Halberg:
    “Chronological health watch of arterial stiffness and Neuro-pulmonary function in elderly community of high altitude(3524 m), compared with Japanese town. Biomedicine and pharmacotherapy 59(2005)S58-S67.
  2. K.Otsuka; T.Norboo; Y.Otsuka; H.Higuchi; M.Hayajiri; C.Narushima;S.Sato; T.Tsugoshi; S.Murakami; T Wada; M.Ishine: K.Okumiya; K.Matsubayashi; S.Yano;T.Chogyal; D.Angchuk; K.Ichihara; G.Corneliss En; F Halberg:
    “Effect of aging on blood pressure in Leh, Ladakh, a high altitude (3524 m) community, by comparison with Japanese town.” Biomedicine and pharmacotherapy 59 (2005) S54-S57.
  3. T. Norboo, S. Rohatgi, D. Diskit, V. Ahuja:
    High prevalence of gastro esophageal reflux disease in high altitude rural areas of Ladakh ‘Indian journal of gastroenterology 2006 vol. 25 (supplement 2) A23’. Abstracts: Indian society of gastroenterology.
  4. Norboo T; Stobdan T; Diskit D; Angchuk N and Kunzang M:
    ‘Chronic mountain sickness in Ladakh.’ Japanese journal of Autonomic nervous system (2007) page 71 – 75
  5. Tsering Norboo; Keith Ball:
    “High Altitude Pulmonary Oedema in the Himalayas: A Preventable condition” The Practitioner, 9th of May 1988, vol. 232: 557-560.
  6. Norboo T:
    “Tourism & health at high Altitude” Indian Mountaineer 1996, 32: 93-95.
  7. Norboo. T.: Angchuk P.T.; Yahya M: Kamat S.R. ; Pooley F.D; Corrin B; Keer I.H; Bruce N ; Ball K.P.
    “Silicosis in a Himalayan village Population: Role of Environmental Dust”. Thorax 1991; 46: 341- 343.
  8. Norboo T.: Yahya M; Bruce NG; Heady JA; & Ball KP:
    “Domestic Pollution & Respiratory illness in a Himalayan Population”, International journal of Epidemiology 1991 Vol. 20 No. 3; 749-757.
  9. Saiyed HN; Sharma Yk; Sadhu HG; Norboo T. et al:
    “Non-occupational Pneumoconiosis at high altitude villages in central Ladakh.” British Journal of Industrial medicine 1991; 48; 825-829.
  10. Khan Q; Heath D; Smith P; Norboo T; et al:
    “The Histopathology of carotid bodies in High Landers of Ladakh. International journal of Biometelogy 1998:32:254-259.
  11. Ball KP; Norboo T; Usha Gupta; Shafi Shuja:
    “Is tetanus rare at High Altitude?” Tropical Doctor 1994; 24; 78-80.
  12. Norboo T; Angchuk ST; P. Tsering ; Phuntsog ST:
    “High Altitude Cerebral Edema in Ladakh”. “Proceeding of 3rd world Congress on mountain Medicine & Physiology at high Altitude” May 20-24, 1998, Mutsumuto Japan, Page 212.
  13. Norboo T; P.Tsering Angchuk PT:
    “High Altitude Pulmonary Edema in Ladakh”. “Proceeding of 3rd world Congress on mountain Medicine & Physiology at high Altitude” May 20-24, 1998, Mutsumuto Japan, Page 210-211.
  14. K. Srinath Reddy; M. Vijay Kumar; T. Norboo:
    “Investigators of Indian Componenets of “Inter study “. Intersalt; An International study of Electrolytes excretion & blood pressure “: Result of 24 hours urinary Sodium & potassium Excretion: Intersalt cooperative Research group BMJ Vol 297, 30th July 1988 p-319-328.
  15. Norboo T; P.Tsering:
    “Preservation of Ladakhi Culture through Women’s organisation.” Voice of Himalaya 1998, page 3-5.
  16. Norboo . T:
    “ A Tribute to SNM Hospital” Ladags Melong, Vol 1, issue 5; August 2002, p-20-22.
  17. S. Wood; T. Harris; M. Lilly; T. Norboo & M. Eldridge:
    “Effect of gender, age and pregnancy on SaO2, Haemoglobin & heart rate of Tibetan and Ladakhi Highlander. FASEB Journal 1999”.
  18. Judith Romero Gallo; Guillermo.I. Parez-Parez; Richard P. Novick, Tsering Norboo; Patrick Kamath; Martin J. Blaser:
    “Responses to Helicobacter pylori whole cell and cagA antigens amongst Ladakhi Patients undergoing Endoscopy.” (2002) Clin. Diagn. Lab. Immunology. 9,1313-1317.
  19. Norboo T:
    “Tobacco gaints exploits innocence of Ladakh” Ladakh Melong Vol 2, Issue 2. 1997; 28-29.
  20. Tsering Dolma; Norboo T. Yahya M; Richard Hopson & Ball K.P:
    “Seasonal Koilonychia in Ladakh.” Contact Dermatitis. 1990; 22;78-80.
  21. Norboo T; Morup T:
    “Culture health and Illness in Ladakh.” Recent research in Ladakh proceeding of VI International colloquium on Ladakh Leh 1193;205-210.
  22. M A Qadir Pasha; A P Khan ; Ratan Kumar; S K grover; R B Ram; Norboo T; K K Srivastava; W Silvamurthy & S K Brahmachari:
    “Angiotensin converting enzyme insertion allele in relation to the high altitude” Adaptation; Ann. Hum genetics (2001) 65,531-536.
  23. Anna Spathis, Kenneth W. Heaton;, Pauline M. Emmett; Norboo T; Linda Hunt:
    “Gall Stones in a community free of obesity but prone to slow intestinal transit” European Journal of Gastro enterology and Hepatology.
  24. Wood Steve; Norboo T; Miles Lilly; Ken Yoneda; Marlowe Edridge:
    “ Cardio-Pulmonary functions in High altitude residents of Ladakh” High Altitude medicine and Biology Vol. 4 No 4; 2003; 445-454.
  25. Norboo T; Tsering P; Morup T; Nilza Angmo:
    “Challenges and opportunities to prevent and control impending disease of the new Millennium.” “Ladakh in the new millennium”. Ladakh ecological group Publication 2001;18-36.
  26. Norboo T; HN Saiyed; Angchuk PT; P Tsering; ST Angchuk; ST Phuntsog etal.
    “Mini Review of High altitude health problems in Ladakh.” Biomedicine and Pharmacotherapy 58(2004) 220-225.

Future Areas for Research

Since the concept of carrying out research is still not widely practised within the statutory healthcare system in Ladakh as indeed the more pressing need is to treat patients which in itself is a challenge particularly considering the geographical location , climate, infrastructure and resources.

Moreover we feel that it is important to understand the health needs of this particular population which can help to make the best use if available resources by targeting identified health needs.

Future areas of research:

  • Neuro-cardio-vascular epidemiology in Ladakh and follow up action. A public health measure designed to detect (by screening) and reduce the risk factors for cardio-vascular and neurovascular and degenerative disease and offer the most appropriate long range approach for prevention of most of the life style related disease of 21st Century.
  • Chronic Mountain Sickness in Ladakh: To study a cohort of nomadic male population born and living at an altitude of 4450 m from the point of view of adaptation/maladaptation to long residence at high altitude. The study has local/national and international applied aspect of studying in depth human adaptation to chronic Hypoxia with rich prospect of application of the knowledge to sea level where hypoxia is at root of many common cardiovascular, neurodegenerative and many other diseases.
  • Nutritional status of children of Ladakh with special emphasis on prevalence of dental fluorosis (A plot project for a bigger study plan)
  • Cognitive impairment and functional impairment in urban and rural elderly high altitude resident of Ladakh. Scope of the project are (i) Developing an adequate screening instrument for rapid identification of potentially demented individuals in a largely, illiterate, culturally distinct high altitude population. (ii) Dementia/Alzheimers disease is becoming a major public health problem with increasingly ageing population. Therefore a timely screening and interventions for these diseases will be a worthwhile public health measure.