It is the most common cardiovascular disorder, posing a major public health problem of the world and especially to the population in socioeconomic and epidemiological transition. [1] It is one of the major and independent risk factors for non-communicable diseases (NCD) such as cerebrovascular disease, coronary heart disease, and cardiac and renal failure. [2] The recent WHO report states that considering the prevalence of any diseases, hypertension ranks fourth in the world. [3] As it is hidden beneath an

Background: With increase in the footfall to mountainous areas for occupational and recreational purposes, tackling the burden of high-altitude illnesses is a growing public health challenge. High-altitude pulmonary edema (HAPE) is a serious medical condition with peculiar epidemiological characteristics. HAPE is a significant cause of morbidity and mortality among Indian soldiers posted to high-altitude areas. Aims and objectives of the study were to study the common clinical presentation of HAPE among Indian army soldiers and to study the association between induction patterns and acclimatization status with the onset of HAPE.Methods: An observational study was undertaken to study the clinical and epidemiological characteristics of all cases of HAPE from years 2016 to 2019, among Indian army soldiers posted to high-altitude areas in Ladakh. Diagnosis was made by the Lake-Louise consensus criteria. Data was entered in Microsoft Excel and descriptive and inferential statistical tools were applied to test for associations between the variables studied.Results: The overall incidence rate of HAPE was found to be 5.91 per 1,000 soldiers with high frequency among young men. Breathlessness, cough, and headache were the common complaints. 69.45% of cases occurred among men who revisited the mountains after a brief sojourn to the plains. At higher altitudes, incidence rates were higher among acclimatized individuals.Conclusions: HAPE occurs more frequently during the subsequent visits compared to first exposure to high altitude. At extreme altitudes, acclimatization protocols do not confer complete protection against HAPE.

BACKGROUND Elderly people are often neglected in the society particularly with regards to the healthcare service delivery in Indian context. Most of them live with certain forms of morbidities. The consequences of these illnesses in terms of severity affect their willingness to seek help from health care services. Therefore, understanding the morbidities and their health seeking behaviour is a prerequisite for providing essential need-based healthcare services to this marginalised population. A cross sectional study was conducted to understand the pattern of comorbidities and factors of health seeking behaviours of the elderly in a rural area of Thrissur district, Kerala. METHODS A total of 243 elderly participants who were above 60 years was selected from a rural area of Thrissur district to participate the study. SPSS Ver. 16.0 was used to carry out analysis of the data. Descriptive statistics were used to express the pattern of chronic morbidity, and assess the health seeking behaviour and associated factors in the above population. RESULTS Our findings revealed that majority of the study population (82.7 %) was suffering from at least one chronic health problem; among them, 44 % had hypertension, 35.8 % had diabetes mellitus and 23.5 % had musculoskeletal diseases. 60.5 % were not doing any kind of exercise. Health seeking behavior was highest for diabetes and hypertension (100 % and 97.1 %). It was lowest for urinary disorders (72.72 %) followed by visual problems and respiratory problems (82.75 % and 83.3 %). Most common reasons for not seeking health care were that they consider the illness to be insignificant or they believe it to be a part of ageing process (37.5 %). CONCLUSIONS Prevalence of chronic morbidity is high among the elderly. Health seeking behavior is better in Kerala compared to other states. KEYWORDS Chronic Morbidity, Healthcare Seeking Behaviour, Morbidity, Elderly, Kerala