Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception. Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS. Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception. Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.

Majority of doctors show no interest in research although research is now a requirement and is being done in every field of medicine. The objective of this survey was to describe the involvement in research activities among doctors in Penang and Seberang Jaya hospitals in Penang. A self-administered questionnaire was used. A total of 302 doctors participated in the survey. The differences in age (p=<0.001), years since graduation (p=0.001), occupation (p=<0.001), post graduate qualification (p=0.001) and career focus (p=0.005) were statistically significant for the involvement in research activities. Respondents who had additional training in statistics (OR 2.86 95% CI 1.76; 4.67), who read journals regularly (OR 3.79 95% CI 2.29; 6.27), who were confident in interpreting medical literature (OR 3.08 95% CI 1.84;5.17), interested in a career in research (OR 7.35 95% CI 4.26;12.68) and who had knowledge in the use of statistical packages (OR 11.10 95% CI 6.29;19.60) were more likely to be involved in research. By hierarchy, having knowledge in statistical packages (aOR 11.57 95% CI 5.49; 24.42), interested in a career in research (aOR 8.54 95% CI 3.99; 18.28) and having a post graduate qualification (aOR 1.48 95% CI 1.01;2.16) were significant associated factors. It is imperative that doctors be given ample opportunity to attend research methodology training programmes to increase their participation in research activities.

Osteoradionecrosis, a rare complication of radiation therapy, is a slow progression disease which affects the surrounding structures of spinal components. It essentially weakens the soft tissue and bony configuration and can cause nerve impingement or cord compression. We describe a patient who underwent radiotherapy for thyroid cancer and presented with cervical kyphosis with anterolisthesis of C3/C4 and C4/C5 some 32 years later. We explore the role of anterior and posterior fusion, as well as hyperbaric oxygen therapy in promoting healing.
Osteoradionecrosis

We hereby report a rare case of a woman who presented with symptoms of urogenital prolapse and menorrhagia. She was erroneously diagnosed to have cervical mass and underwent examination under anesthesia and was found to have only a vaginal leiomyoma. The fibroid was enucleated successfully through a vaginal incision. We discuss the rare case.

No abstract available.

Background: The World Health Organization recommends the practice of exclusive breastfeeding of infants for the first 6 months after birth. The objective of present study was to estimate the prevalence and the factors influencing exclusive breastfeeding. The perceptions of mothers about breastfeeding in an urban slum area of Western India were also enquired. Methods: This cross sectional study was conducted over six months amongst 200 mothers of children in the age group of 6 – 12 months attending the growth and development clinic in one of the urban health centres. Data was collected using a pre-tested, structured questionnaire on breastfeeding practices. Factors related to exclusive breastfeeding were analysed using bivariate and multivariate analysis. Results: Prevalence of exclusive breastfeeding reported by the participants was 61.5%. Having a male child, maternal age < 30 years, level of education of mother, parity, receiving infant feeding advice, initiation of breastfeeding within one hour of birth and administration of colostrum to the baby were associated with exclusive breastfeeding (p<0.001). Multivariate logistic regression analysis revealed that male sex (adjusted odd ratios: 20.03), primiparity (0.19), home delivery (0.32), receiving infant feeding advice (5.90), initiation of breastfeeding within one hour of birth (0.26) and giving colostrum to the baby (2.56) were independently associated with exclusive breastfeeding. Prelacteal feeds were given by almost 35% of mothers. Conclusion: Prevalence of exclusive breastfeeding was higher than the national figures. However, practices like discarding the colostrum, giving prelacteal feeds, early/late weaning and use of formula feeds are still widely prevalent and need to be addressed.

Medullary carcinoma is a rare breast carcinoma with a syncytial growth pattern and high-grade cytology. It can be difficult to diagnose and may be missed on conventional imaging as the findings may overlap with benign lesions i.e. fibroadenomas. The authors report a case of a 25-year-old female who presented with multifocal breast lumps diagnosed with medullary carcinoma and fibroadenomas. Imaging and pathological correlation with contrast-enhanced MRI are presented in the diagnosis of these lesions.

Gestational breast cancer (GBC) or pregnancyassociated breast cancer was defined as breast cancer diagnosed during pregnancy and within 1 year of delivery. Breast cancer is the second commonest cancer after cervical seen in pregnancy and lactation. Nevertheless, the incidence is low and accounts for approximately 1 in 3000 of pregnancies. A delay in diagnosis is common and 70% to 89% of patients with operable primary lesions already have positive axillary lymph nodes. Breast cancer identified during pregnancy can be extremely distressing for the mother despite it has similar course of disease and prognosis seen in nonpregnant women of the same age and stage of disease. Diagnostic and treatment options should be carefully decided to prevent further harm to the mother or any potential risk to the developing fetus.

Objective: To isolate compounds from K. pinnata and elucidate their structures and to explore preliminary antioxidant, antimicrobial, cytotoxic and thombolytic activities of extractives of the plant. Methods: The methanol extract of whole plant of K. pinnata has been subjected to different chromatographic separation and purification processes to isolate the secondary metabolites. The structures of the isolated compounds have been elucidated by extensive NMR studies. The free radical scavenging activity of the crude extract and its different Kupchan fractions were determined on stable radical DPPH. In vitro antimicrobial activity was determined by the disk diffusion method. Cytotoxicity screening has been performed against Artemia salina. Total phenolics content, membrane stabilizing activity and thombolytic activities were assessed by following established protocol. Results: The isolated compounds were identified as glut-5(6)-en-3-one, taraxerone, 3β-friedelanol, β-amyrin-3-acetate, 3,5,7,3',5'-pentahydroxyflavone and β-sitosterol. The chloroform soluble fraction showed potent antioxidant activity of (IC50=80.0 μg/mL) and significant cytotoxicity, while the crude extract demonstrated noticeable total polyphenol content (149.24 mg of GAE/gm of extractive), moderate membrane stabilizing activity and inhibition of clot lysis of blood. Conclusions: The obtained results rationalize the folkloric use of the plant and can be further investigated to isolate the active compounds responsible for the biological activities.