INTRODUCTION Globally the population is ageing rapidly. According to WHO it is projected that the number of persons aged 60 or over is expected to more than triple by 2100. Mental health and emotional well-being are as important in older age as at any other time of life. As estimated by WHO, unipolar depression occurs in 7% of the general elderly population. 1 Multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time. As well as the typical life stressors common to all people, many older adults lose their ability to live independently because of limited mobility, chronic pain, frailty or other mental or physical problems, and require some form of long-term care. In fact, depression is a common cause of disability in older adults. Among its consequences are reduced life satisfaction and quality, social deprivation, loneliness, cognitive decline, ADL limitations, suicide and increased non-suicide mortality. Mental health has an impact on physical health and vice versa. All of these factors can result in isolation, loss of independence, loneliness and psychological distress in older people. Depression is both under diagnosed and undertreated in primary care settings. Symptoms of depression in older adults are often overlooked and untreated because they coincide with other late life problems.

In recent years substance use has increased greatly throughout the world. Adolescence is the critical period when the first initiation of substance use takes place. Interventions at the adolescent age are effective to bring about lifestyle modifications. A community-based, cross-sectional study was carried out among 260 randomly selected adolescents in an urban slum area, with the objective of studying the prevalence and determinants of substance use among adolescents. The adolescent age group was selected as defined by the World Health Organization (WHO) (10 - 19 years). The overall prevalence of substance use was 32.7%. About 31% initiated substance use at 13 - 15 years of age, and the reason was peer pressure in 52.9%. Education of the study subject, education of parents, and substance use by parents and by peers were significantly associated with substance use. Children and parents should be educated to prevent substance use. There was a need to change the social environment.

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INTRODUCTION Food which is defined as an early article manufactured, sold or represented for the use as food or drink for human consumption or any item that enters into or is used in composition, preparation or preservation of any food or drink , is an important basic necessity , it's procurement, preparation and consumption are vital for sustenance of life. 1 Food handler is defined as a person in food trade or someone professionally associated with it, such as an inspector, who in his routine work comes into direct contact with food in the course of production, processing, packaging or distribution. 1

Background: Due to advancement in the medical science, the life expectancy is showing an increase in every census. Hence there is also growing demand to have good quality of life among the elderly. The objective of the study was to assess and compare the health status of elderly in urban areas of Shapur and rural areas of Gummadidala.Methods: A Community based cross sectional study was carried out in rural areas located at Gummadidala, Nallavelli, Anantharam and in urban areas located at Shapur, Kalavathinagar, Subashnagar among geriatric aged people above 60 years. Study was conducted over a period of eight months from August 2017 to March 2018.Results: Overall almost all diseases were more common in rural elders compared to the urban elders except gynecological diseases. Among these hypertension, ear diseases, skin diseases, musculoskeletal disorders, psychological disorders, cancer and neurological diseases were significantly more common in rural elders than urban elders (p<0.05). Only gynecological diseases were significantly more common in urban women and this may be due to more percentage of hysterectomies among rural females.Conclusions: Elderly people in the rural areas are more prone to suffer from diseases as compared to their urban counterparts.

Sir, Worldwide, breast cancer is the most frequent cancer in women and represents the second leading cause of cancer death among women. Presently, 75,000 new cases occur in India each year. [1] A record-based study of 557 breast cancer patients was conducted at a tertiary care hospital. Patients who had mastectomy outside were excluded.Majority of the patients (47.6%) presented in the fourth and fifth decades of their life. The incidence of breast carcinoma in males was found to be 1.6%. Isolated lump in the breast was the chief presenting complaint in majority of the patients (59.4%).Maximum number reported to the health facility after 1 year of onset of symptoms. This may be due to rural background, low literacy rates and ignorance among patients. 61.1% women with breast carcinoma were post menopausal. Fine needle aspiration cytology (FNAC) including FNAC + excision (38.9%) and excision biopsy (45.6%) were the principal diagnostic modalities used compared to mammography (1.6%) and other methods like use of core needle biopsy and vacuum assisted biopsy with mammographic or ultrasonographic guidance. Surgery was performed in 343 (61.6%) of the cases and MRM remained the gold standard for maximum of the breast carcinoma. Maximum cases were ductal invasive carcinoma, i.e. 272 (79.3%), compared to only nine (2.6%) cases of ductal carcinoma in situ. This can be attributed to late reporting. Whereas in western countries due to early reporting and detection, ductal carcinoma in situ accounts for more than 20% of breast cancer cases. [2] The important epidemiological risk factors for the development of breast cancer are age, family history, parity, age at menarche and menopause, prior history of breast biopsy, diet, socioeconomic status, and history of exposure to radiation and use of oral contraceptive pills. [3] These risk factors were not recorded in the present hospital records, except a few of these like age, age at menopause, family history and parity. We found that no patient had a positive family history of breast cancer. Similar finding was reported by Sandhu et al. [4] This may be due to the fact that appropriate history taking aspect had been either neglected or the patients were not aware about the breast carcinoma. Information on parity was available in only 32 out of 548 women (5.8%). Sandhu et al., [4] in their study, also found that out of the records of 304 patients studied, the information on parity was available in only 108 records. Other risk factors were not recorded in the present records studied. These records form an important basis of epidemiological information and should have comprehensive format and adequate recording when the patient is seen for the first time. A medical social worker should be appointed to take care of these records and history taking of patients.

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