Objective: Realizing that programs to control tobacco addiction will be more effective awareness is created in the formative years of life, the present study was undertaken to evaluate effectiveness of school based tobacco awareness initiatives in rural Maharashtra.

Methods: It was a longitudinal study design in which a power point presentation regarding hazards of tobacco was shown to the school children in the age group 13-15yr. Retention of knowledge was assessed using a structured questionnaire immediately and one month after the presentation.

Results: In all 112 students in the age group of 12-14 years participated in the study. Teachers were the main source of information regarding health effects of tobacco projects Awareness about hazards of smokeless tobacco products increased after the program. 90 % of the students shared their knowledge after the program with family members, friends and neighbours.

Conclusions: The finding that 90% of the students shared their knowledge with family and friends underlines the importance of such initiatives to educate the community at large.

Key words: Awareness, educational intervention, schoolchildren, Tobacco hazards

The use of nanoscale materials to develop entirely new class of therapeutics continue to receive increasing interest. Many of these developments are still at the early stages, but some have already been translated into viable clinical products. Here, we provide an overview of recent developments in nanomedicine and highlight several areas of opportunity where current and emerging nanotechnologies can address numerous medical and health-related issues.

Key words: Biomedical, diagnostics, drug delivery, nanotechnology, therapy

Oral submucosal fibrosis (OSMF) is an Areca nut induced, proliferating oral disease found in Southeast Asian regions including India, affecting millions. The limited collective wisdom prevailing in the understanding of OSMF is ineffective in the management of the disease. A tentative disease grading strategy, the iterations of which are periodically published, is used by dentists, oral surgeons, and clinicians, in general, to determine the severity of OSMF. The lack of recognition of a single authoritative staging system compounded by the unavailability of an unbiased measurement tool presents a diagnostic problem. The review presents a case for implementing higher standards of clinical research and the need to correlate various disease parameters with the appropriate disease stage for effective therapeutic approach. Given the irreversible nature of the fibrotic process in advanced stages, the complications of OSMF are discussed in addition to patient compliance issues. A perspective on the potential of future OSMF initiatives is also presented.

Key words: OSMF, collagen metabolic disorder, fibrous bands, areca, gutka, pan-masala, arecoline, tobacco

Bilateral partial shoulder replacement (PSR) is a rare rather uncommon entity. It is used when glenoid socket is intact and does not need to be replaced. In these operations, humeral component is implanted and humoral head is replaced. Only ball of shoulder joint replaced. There is no need of plastic socket. The advantage is that it has smaller incision than total shoulder replacement. In this case, a 45-year-old female who fainted by poor nutrition and was lifted up with relatives by shoulder causing bilateral fracture of humoral head was selected. She needed bilateral urgent PSR. By and large, expertise is required in shoulder joint replacement. We planned anesthesia with interscalene brachial block with clonidine as additive on one side and general anesthesia for other side. Other side was supplemented with continuous catheter technique for post-operative pain relief and good physiotherapy.

Key words: Partial shoulder replacement, interscalene brachial plexus block, general anesthesia

Phyllodes tumor of the breast is an uncommonly encountered disease. They are rare fibroepithelial tumors that constitute <1% of all known breast neoplasms. These tumors were first characterized by Johannes Muller in 1838, and he coined the term cystosarcoma phyllodes to describe them, based on the “leaf-like” projections into cystic spaces and sarcomatous stroma. However, this is a misleading term as 70% of these tumors are benign in nature and only rarely demonstrate cystic features. These tumors may appear as benign fibroadenoma-like lesions, locally recurrent aggressive tumors, or widely metastatic malignant forms. When these advanced tumors ulcerate, they reduce the quality of life dramatically because of associated pain, infection, malodor, profuse discharge, and bleeding. The standard of care for the treatment of phyllodes tumor entails complete surgical excision with a margin of >1 cm. They most commonly metastasize through hematogenous spread; thus, there is no role for axillary lymph node dissection for the staging of these tumors. Local recurrent rates have been shown to decrease with the administration of adjuvant radiation therapy for borderline or malignant tumors following wide local excision. The tumor presenting as a fungating breast mass or “ruptured“ breast is an even more rare presentation of an unusual disease. We report a case with an atypical presentation of a 60-year-old female with a huge exophytic fungating mass of the left breast infected with maggots. Cytology was suggestive of malignancy, so left mastectomy was performed. The final pathology report was consistent with phyllodes tumor. Our aim is to highlight the features of this rare breast cancer and the challenges in obtaining a definitive diagnosis.

Key words: Malignancy, phyllodes tumor, rupture breast, simple mastectomy