Objective: To study knowledge and attitude towards emergency contraception in undergraduate medical students and to evaluate factors affecting it. Method: Pre-validated questionnaire was given to the undergraduate medical students. 1 hr seminar was conducted on emergency contraception for those who did not learn about it. After 7 days, same questionnaire was provided to them. Descriptive statistics and appropriate statistical comparisons were used. Results: Total 316 undergraduate medical students participated in the study.154 students were included in group A (not learnt emergency contraception) whereas 162 students (learnt emergency contraception) in group B. 2 of 154 (1.3%) students of group A showed the adequate knowledge (>75% correct answer) before seminar. After conducting seminar for these students, 20 of 146 (13.7%) students achieved adequate knowledge. Average knowledge of these students was significantly increased after seminar [41±16.88% vs. 59.32±14.46%; P<0.05]. However, it was not achieved up to the level of participants of Group B. Attitude score of group A students significantly improved after attending 1 hour seminar [36.24±10.93 vs. 41.5±10.87; P<0.05]. 36 of 162 (22.2%) students from group B showed adequate knowledge. Average knowledge of group B students was 64.73±12.15% whereas average attitude score was 42.9±9.79. 86.4%, 87% and 89.3% students were not able to describe about emergency contraception, different methods of emergency contraception and advantages of intra-uterine devices over emergency contraception pills, respectively. 82.1% students showed positive interest in learning more about emergency contraception and 70.1% students agreed to recommend use of emergency contraception in future. Students having good knowledge showed more positive attitude towards emergency contraception [r=0.41, P<0.05]. Conclusion: The present study suggests that basic knowledge like indications, correct time limit for administration of emergency contraception, its effectiveness and side effects is proper among undergraduate medical students of our institute. They have difficulties in listing different methods of emergency contraception. They have poor knowledge for special issues arise with emergency contraception during clinical practice and for instructions provided during prescription of emergency contraception. Proper attention should be given to these aspects while teaching them about emergency contraception. Overall attitude of students for emergency contraception is positive and they have shown their positive interest to learn more about emergency contraception.

Golnaz Yadollahikhales is studying medicine at Shiraz University School of Medicine and is going to be graduated by August 2014. He has been granted many awards during his ducation including the best medical student in the country. As his major research interest is elderly disorders, he has conducted research on pathophysiology of memory and Alzheimer’s disease. He has published about 6 papers in ISI journals. His thesis is also about the degenerative deformity of lumbar spine among elderly. He/has also participated in more than 10 international conferences in order to become familiar with the new topics in this field.

Osteoporosis is estimated to affect about 20 million women worldwide. In fact, about one in two women over the age of 50 will break a bone due to osteoporosis. Osteoporosis and its consequences can be regarded as a major source of mortality, morbidity, and medical expenditure around the world. It can affect people mental and social health. This study is aimed at investigating the relationship between the anthropometric and lifestyle factors and osteoporosis in post menopausal women. A sample of 503 postmenopausal women participated in the study. All participants underwent anthropometric measurements to calculate body mass index (BMI), and filled out a two-part questionnaire. The first part was about subjects' demographic data; and the second part contained questions relating to subjects’ lifestyle. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DEXA) at the lumbar spine (L2-L4) and neck region of femur. Then the participants were categorized according to their BMD values of femur or lumbar spine as normal, osteopenic or osteoporotic. Lumbar spine and Femur BMD correlated significantly with age, BMI, and number of pregnancies. Exposure to sunlight showed significant difference among three groups based on lumbar spine site. However, at femur site, diet of fish and poultry, soda consumption and exercise was different among three groups. Aging, low BMI, and numbers of pregnancies were the risk factors associated with osteoporosis in participants. Diet of fish and poultry, restricted amount of soda intake, exercise and exposure to sunlight can prevent osteoporosis.

hesham sait is a 6th year medical student from King Abdulaziz University, Jeddah, Saudi Arabia. he is a member in the scintefic chair of Prof. Abdullah Hussain Basalamah for gynecological cancer. he is a member of the saudi society of internal medicine. he was in 4 published researches. he participated in the 4th and 5th with two researches in the scientific conferences in King Abdulaziz university and the ministry of higher education.

Introduction: TTF-1 is a helpful marker for primary lung adenocarcinoma and is considered as a reliable marker to distinguish between primary and secondary lung carcinoma. However, some studies showed that TTF-1 also can be expressed in extrapulmonary adenocarcinomas. The data on TTF-1 expression in endometrial cancer is limited and conflicting. The aim of this study is to evaluate the immunoexpression of TTF-1 in primary endometrial adenocarcinoma. Material and methods: Tissue microarrays were prepared from archival of endometrial carcinoma obtained from the Department of Pathology at King Abdulaziz University Jeddah, Saudi Arabia. Tissue sections were immunostained using monoclonal antibodies to TTF-1. The immunohistochemical stains were scored semiquantitativly from 0 to 5+. Results: The categories of endometrial adenocarcinoma include 78 grade I endometrioid, 17 grade II endometrioid, 12 grade III endometrioid, 7 serous, 2 clear cell. TTF-1 immunoexpression was detected only in 2 carcinoma (1 serous and one endometrioid type) and in both cases the staining score was 1+. Conclusion: TTF-1 is a reliable marker for lung carcinomas; however, in patient with focal TTF-1 immunoexpression, endometrial carcinomas should be considered when evaluating patients with adenocarcinoma of unknown origin and in patients with a history of endometrial adenocarcinoma. Key Words: Immunoexpression, thyroid transcription factor-1, TTF-1, endometrial carcinoma, metastasis.

Lovina Machado completed her medical studies from St. Johns Academy of Medical Sciences, Bangalore in 1984 and subsequently postgraduation from Kasturba Medical College, Manipal with honors in 1987 followed by MRCOG(UK) in 1999.She was awarded Fellowship of the Royal College of Physicians, Ireland in 2011 and Fellowship of the Royal College of Obstetricians & Gynaecologists, UK in 2012. Dr. Lovina joined the Dept of OBGYN at SQU in 1990 and has been one of the founder members involved in setting up the Department. Her special interests are maternal fetal medicine, high risk pregnancies and ultrasound. She is a popular teacher, actively involved in teaching, co-ordination, examination and curriculum design both for undergraduates and residents. She is the Assistant Program Director and Member of the Scientific Committee for Oman Medical Specialty Board (Ob/Gyn), the Examination and Curriculum sub-committees of OMSB ,Founder member of Oman Society of Obstetrics & Gynaecology and was Executive Committee Member of the Obstetrics & Gynaecology Club of Oman . In addition, she is a member of many Departmental, Hospital and College Committees. She is also involved in training doctors and technicians in basic obstetric & gynaecological ultrasound. She is a keen researcher and has over 30 publications in national and international peer reviewed journals and is also involved in many University funded and non-funded research projects. Dr. Lovina has also been an invited speaker at several national workshops and international conferences and has many international platform and poster presentations to her credit as well.

Objective: A rare case of a giant borderline mucinous cystadenoma presenting as acute abdomen on the 7th postpartum day following an uncomplicated pregnancy and normal vaginal delivery is presented. Introduction: The incidence of adnexal masses in pregnancy is 0.5-2 per 1000 pregnancies. More than 90% of these are benign. About 28% of adnexal masses diagnosed during pregnancy are serous or mucinous cystadenomas and torsion is the commonest complication followed by rupture of the cyst. Mucinous cystadenomas are benign epithelial ovarian tumors, tend to be unilateral and multilocular with a smooth surface and contain mucinous fluid & tend to occur in the third to fifth decades of life. 75% of all mucinous tumors are benign, 10% borderline and 15% invasive carcinomas. They may attain a large size during pregnancy and may also tend to be hormonally responsive with stromal luteinization, maternal virilisation and intrauterine growth restriction. It is presented a 26 year old Para 3, unbooked for antenatal care at our hospital, who presented to the emergency room 7 days following a spontaneous normal vaginal delivery with acute generalized abdominal pain. Examination revealed a huge soft, mass with a smooth surface arising from the pelvis extending to the xiphisternum. The uterus was not separately palpable. She had been following up at health centres during pregnancy, scans did not report any abnormality, pregnancy and delivery was uneventful. The neonate was healthy and of normal weight. Lab. Investigations: Normal CBC, electrolytes, LFT, RFT. CA-125-37, beta HCG 137 iu/l, other tumor markers were normal. At laparotomy, peritoneal fluid sent for cytology. A massive left sided ovarian tumor about 38x30 cms in diameter was found weighing 4ooo gms, mostly cystic, some areas hemorrhagic. Capsule was intact. Entire cyst removed intact. Left salpingo-ovariotomy performed rt. ovarian biopsy. Peritoneal and omental biopsy was taken. Other intra-abdominal organs were normal. Appendectomy done as frozen section was reported as left ovarian benign mucinous cystadenoma. Multiple saline washes given though no spillage occurred. Histopathology however revealed a left ovarian borderline mucinous cystadenoma with no evidence of microinvasion. Post-op recovery was uneventful. CA-125 and scans were normal on six month follow up. Discussion: Most adnexal masses are discovered incidentally during pregnancy on routine scans. The most common are cystic teratomas (36%) and cystadenomas (15%). Giant cysts of 20 cms or more are found in less than 1% of all ovarian cysts complicating pregnancy. Fortunately, most of these are benign. Giant mucinous cystadenomas complicating pregnancy are extremely rare. Histologically, they are lined by tall columnar non-ciliated epithelial cells with apical mucin & basal nuclei, goblet cells (intestinal type) as in our case. The other type is the mullerian, which is typically associated with endometriotic cysts. There are about 10 case reports in literature of mucinous cystadenomas complicating pregnancy that have been surgically removed during pregnancy or during cesarean sections, to our knowledge, this is the fifth reported case of a giant mucinous cystadenoma not interfering with pregnancy or vaginal delivery & presenting for the first time with acute abdominal pain on the 7th postpartum day and only the second reported case of a giant borderline mucinous cystadenoma in pregnancy.

Cervical cancer is the second most common cancer among women worldwide, with 80% cases in developing countries. In Pakistan it is not considered to be a huge problem. This study was carried out to ascertain the incidence of abnormal Pap smears among Pakistani women, to objectively justify the need for a cervical cancer screening program in Pakistan. 525 patient case notes attending gynaecology out patients over 18 month’s period were reviewed. Spatula and cytobrush samples were taken for all post menopausal women and in those where squamo-columnar junction was not visible. All patients with HSIL & ASC-H underwent colposcopy & biopsy. Endometrial sampling was performed if indicated Results: Negative for intraepithelial lesions, 56 % Inflammatory in 25.33 % Atrophic in 4 % Inadequate 1.33% Cytological abnormalities were present in -13.34 % The incidence of cytological abnormalities among Pakistani women is significant. The progression of HSIL to invasive disease is well documented. This study highlights the urgent need for a national cervical pre-cancer screening program in Pakistan. Conclusion: The incidence of cytological abnormalities among Pakistani women is significant. The women included in the study were asymptomatic and had no past history. This study highlights the desperate need for a cervical pre-cancer screening program in Pakistan.

`Materials & methods: Face to face interviews were conducted using a standard questionnaire (n=400). Information was gathered about risk factors, personal risk perception, lifestyle effects, early diagnosis & breast cancer. Results: The age range was 25-65 years with a fairly uniform distribution of socioeconomic status and educational level. Knowledge regarding risk factors for breast cancer was very poor. 35% women were aware of their risk of breast cancer and majority admitted having a great fear of it. Most women thought early diagnosis was not possible and would not change the outcome. Lifestyle factors were not considered to be important by majority of respondents. 83% believed diet and physical activity had no effect on the risk profile. Tight bra, deodorant usage and large breast size were seen as significant risk factors by 70% respondents. Only 35% women were aware of the protective effect of breast feeding. Correct knowledge about mammogram was sparse and a significant proportion actually believed it could cause. Likewise only a small minority was aware of BSE and only 4% of those who were aware actually practiced it. Conclusion: Breast cancer is the commonest female cancer in Pakistan and a rising incidence has been reported. The importance of lifestyle factors in causation of breast cancer cannot be overstated and a recent study reaffirms that factors such as maintaining a healthy weight, breastfeeding, exercising regularly can reduce the risk for breast cancer.This study highlights that the level of knowledge about breast cancer, associated risk factors and screening is very low, irrespective of socio-economic and educational status. A national women awareness program is urgently needed. There is also a clear need for intervention to reduce the huge gap between knowledge and practice. Another important observation made in this study was that breast cancer screening and prevention was never discussed or offered to 96% women by their doctors .This shows the clear need of capacity building of doctors and Para medical staff along with significance of information dissemination up to level of beneficiaries.

Introduction: Motivation is the driving force beyond all human activities. Without motivation, human species are not capable of implementing any planned activity. The more one's motivation is in line with her interests and skill sets, the higher chance the individual has to achieve success in her professional and educational endeavors. This study was performed to determine midwifery students' motivation and related factors about their field Method: This descriptive cross-sectional study was conducted on all midwifery students who are studying at Islamic Azad University of Rasht in the first semester of academic year 2011-2012. The information was gathered through questionnaire which has two parts, personal information and the questions about motivation for choosing field of study. The data was analyzed by SPSS 16 software using descriptive and analytical statistics. Result: The mean score of students' motivation for choosing field of study was 49/85±6/14 which obtained score was higher than the acceptable score. There were not significant relationship between score of motivation and research variables (job and education of parents, marital status, and university entry quotas, living place, diploma score, economic situation and students' age). Conclusion: The research shows that the students of Midwifery are highly motivated and enjoy great enthusiasm for the study of this academic discipline. Therefore, it is imperative for the authorities to seize this opportunity and make an all-out effort to improve the educational standards of the promising students in order to maximize their productivity.

Background: Birth weight is an important biological determinant of newborn survival in adverse conditions. That shows fetal exposition to risk factors such as maternal unfavorable demographic conditions and diseases. This study aimed to determine prevalence and predictors of low birth weight. Methods: This was a cross-sectional study on 560 pregnant women attending health care centers of Rasht, Iran from March 2010 to March 2011. Data collections were based on their health record information in health centers. Finally, relationship between infant birth weight with maternal demographic characteristics and pregnancy outcomes were analyzed statistically by software spss and t-test, ANOVA, and correlation tests. Results: The mean infant birth weight obtained 3266.14 grams that the prevalence of low birth weight was 4.1%. According to the analysis, the factors associated with low birth weight were: mother pre-pregnancy Body mass index, hypertension, pre-eclampsia, preterm rupture of membrane, preterm labor and neonatal sex. The significant risk factors for infant birth weight were: birth interval, mother's weight gain during pregnancy, gestational age, preterm labor and hypertension. Conclusions: Maternal biosocial, medical and obstetric factors have strong association with low birth weight. To overcome this problem, special attention is required to strengthen the mother and child health care services in the community.

Tamer Farouk Borg is an Assistant professor of obstetrics and gynecology in the faculty of medicine Ain Shams University in Cairo since 2011.He has finished his medical college in 1996 with honor grading and has received his master degree on 2001 and his MD in obstetrics and gynecology from Ain Shams University on 2004.over the last 10 years he has served as a consultant of OB.Gyn. Both inside Egypt and outside in the Kingdom of Saudi Arabia with one of his major speciality being prenatal assessment of high risk pregnancy. He has many international and national publications and has participated in many scientific conferences inside and outside Egypt.

Objectives: To prove the usefulness of grey scale sonography, color pulsed Doppler and microscopic hematuria in the prenatal diagnosis of abnormal placental adherence in pregnancies complicated by placenta previa at the third trimester of gestation. Materials and methods: Thirty women with known placenta previa at the third trimester were consented for transabdominal sonography, color and pulsed Doppler, and urine testing for microscopic hematuria. Confirmation of abnormal adherence of the placenta was made on histological examination in patients who required Cesarean hysterectomy and by clinical assessment during Cesarean section. Results: A total of 30 women with placenta previa were included and prenatal diagnosis of placenta accreta was made in five women. The diagnosis was made using grey ¬scale ultrasonography in all cases, with one false positive case. Morphological criteria of placenta accreta by color Doppler ultrasound had 100% sensitivity, 100% specificty, 100% positive predictive value and 100% negative predictive value for making the prenatal diagnosis. Sixteen of the 30 women had microscopic haematuria, including the five women who had placenta accreta, therefore giving sensitivity 100%, specificity 56%, PPV 31%, and NPV 100% Conclusion: Although the numbers are small, the results of this study suggest that abnormal placental adherence can be diagnosed antenataly by ultrasound and color Doppler with a great accuracy. Microscopic haematuria is only a good negative test. This prenatal diagnosis improves forward planning of delivery of such women.

What women go through Pediatric care and support: While pediatric palliative care mirrors adult palliative care in many ways issues related to the delivery of HIV palliative care for pediatric clients are different. The clinical course of HIV is more rapid in children, and mortality for infected babies is as high as 40 percent in the first year of life. Maternal antibodies make serologic diagnosis of HIV difficult in the first 18 months. Unless virology diagnostic tools are diagnosis are available, this means that interventions such as cotrimoxazole prophylaxis and safe infant feeding must be initiated before diagnosis is confirmed. Children are dependent on adults for their care. These adults need to be identified, recruited, and educated as to how to care for a child. Family-centered care need to be supported, and caregivers encouraged to seek care and treatment interventions for a child. Certain symptoms are more common in children, including skin disorders, sore mouth, and convulsions. Some, such as pain, are more difficult to children. Nutrition and growth are critical indicators of well-being, and of response to care and treatment. Failure to thrive is a key indicator of clinical deterioration. Safe infant feeding is a critical issue both for prevention and for care

Background: In the world, more than half the numbers of pregnant women are anemic. The burden of disease is heavy yet poorly estimated. Knowledge of the current situation in our environment is necessary. This knowledge will enhance early detection and timely management of anemia in pregnancy. The prevalence of anemia in Kenya has been variously studied with no reliable statistics by region though estimates exist. In Nairobi specifically, there are no documented studies on prevalence. However, pregnant women attending antenatal clinic are routinely put on iron supplementation in their second through to third trimester of pregnancy but the burden of disease remains high as determined by anemia related fetal and maternal mortality and morbidity. This study will seek to determine the prevalence of anemia in Nairobi as well as its associated etiological factors. The results of this study as well as its recommendations will help put in place policies to effectively investigate and manage anemia in pregnancy and therefore reduce the burden of disease. Objective: The objective was to determine the prevalence of anemia among pregnant women attending antenatal care at Mbagathi Hospital, a Level Four Government Hospital in Nairobi County. Pregnant women were enrolled in the study at their first antenatal visit and questionnaires were administered to obtain demographic information. All the women who had a hemoglobin level of less than 11g/dl had further laboratory investigations to evaluate etiologic type and severity of anemia. Results: Out of 381 women enrolled in the study, one hundred and thirty eight (36.2%) were found to be anemic. Anemia was more prevalent in the second (46.0%) and third (52.6%) trimesters. Seventy one women (51.4%) had mild anemia, sixty six women (47.8%) had moderate anemia while only one had severe anemia. One hundred women (72.5%) had microcytic anemia while thirty eight (27.5%) had normocytic anemia. There was no case of macrocytic anemia. Associations between presence of malaria and helminthic infestations were not found to be statistically significant. Twenty women (5.3%) had their first visit in their first trimester while one hundred and fifty nine (42.7%) had their first visit in their second trimester and one hundred and ninety three (43.8%) in their third trimester. Other sociodemographic characteristics had no statistically significant relationships with anemia in pregnancy. Conclusion: Microcytic anemia most likely due to iron deficiency was the most prevalent type. Routine iron supplementation should be encouraged early in pregnancy and educating women on early initiation of antenatal clinic attendance would reduce the problem of anemia in pregnancy. Early diagnosis, treatment and prophylaxis for anemia in pregnancy should be undertaken to reduce the burden of disease.

Sedigheh Pakseresht graduated in Ph.D. at Maulana Azad Medical college was currently assistant professor in Obstetric Department at faculty of Shahed Beheshti of Nursing and Midwifery in Rasht in Guilan University of Medical Sciences.She was also editor in chief for some journals

Background and aim: Menopause is the critical part of life of women, that one can affected on quality of life with some psychological and physical problems by decreasing of health. This is one of field in reproductive health. May be in the quantitative researches, we couldn’t find attitude of interviewer, so we decided use of focus group discussion as a qualitative research. The aim of this study was to determine consultation needs about menopause among women. Materials and Methods: This qualitative study, performed in Al-Zaharah’s Hospital in Rasht in 1391. 62 women (>40 years) Participated in 7 groups, who’s were selected by using purposive Sampling in focus group discussion. Women’s data were collected by semi questions structured. Interviews were records after getting concept, then health needs request was compiled subsequently transcript from audio-taped interviews. Results: On the basis of results, most of women told the age of menopause is upper 45 years and bake pain, lower abdominal pine and hat flash were as disturbing symptoms, while they did not know about suitable nutrition and protective ways for osteoporosis. But Most of them answered walking is the best in during this time. Conclusion: There was a big gap for health needs about menopause among women in during this time.so for given knowledge to menopause women, needs improve national and local educational services and programs for these valuable groups.

The ovarian hyperstimulation syndrome (OHSS) is a serious and potentially life-threatening physiologic complication, classically encountered in patients who undergo controlled ovarian hyperstimulation (COH) cycles. OHSS is a rare iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy. It is characterized by enlargement of the ovaries, fluid retention, and weight gain. Ovarian hyperstimulation syndrome is self-limiting and will undergo gradual resolution with time. The pathophysiology of OHSS is characterized by increased capillary permeability, leading to leakage of fluid from the vascular compartment, with third-space fluid accumulation and intravascular dehydration. Young age, an explosive response to gonadotropin stimulation evident with rapid increase of serum E2 levels, development of multiple follicles ( 20) during stimulation and the presence of polycystic ovary syndrome have been described as risk factors for the development of the syndrome in IVF patients. There is evidence that several other factors such as vascular endothelial growth factor may play a modulatory role on ovarian physiology and in the pathogenesis of ovarian hyperstimulation syndrome. The aim of this study was to measure the Vascular Endothelial Growth Factor (VEGF) which is a homodimeric 34 - 42 kDa, heparin binding glycoprotein with potent angiogenic, mitogenic and vascular permeability-enhancing activities specific for endothelial cells. The serum was extracted from 3 ml blood from 38 patients, control group is healthy patients (n=8) visiting Dr. Sameer Abbas IVF clinic, H-OHSS group is patients with Polycystic ovarian syndrome (PCOS) visiting in vitro fertilization (IVF) clinic and have a positive history of OHSS (n=10) and PCOS group is patients with PCOS visiting IVF clinic and have no history of OHSS (n=20). The level of VEGF was measured by using Enzyme-linked immunosorbent assay (ELISA) technique. The observed differences in the VEGF between the different groups were statistically significant (P<0.05). It was found that VEGF level in H-OHSS and PCOs groups were statistically higher when they were matched control group. The VEGF levels were markedly the highest among H-OHSS group compared to the control group. The levels were almost seven times higher among H-OHSS patients (718.186 ± 421.241pg/ml) compared to normal control (86.149 ± 73.825pg/ml). The observed differences in the VEGF between the different groups were statistically significant (P<0.05). The VEGF levels were higher among the PCOs group compared to the control group. The levels were almost three times higher among PCOs patients (350.806 ± 252.478pg/ml) compared to normal control (86.149 ± 73.825pg/ml). The observed differences in the VEGF between the different groups were statistically significant (P<0.05). The levels of VEGF were almost two times higher among H-OHSS group (718.186 ± 421.241pg/ml) compared to PCOs group (350.806 ± 252.478pg/ml). The observed differences in the VEGF between the different groups were not statistically significant (P=0.0577). The correlations between VEGF, anthropometric measurement, metabolic and hormones variables were performed in the three groups. In H-OHSS group, only a negative correlation was significant between the testosterone level and the weight of patients. In PCOS group, the level of VEGF was correlated significantly and negatively with estradiol (E2) level. A negative significant correlation was found between the level of E2 and the age, and between E2 and the weight of patients. Also the testosterone level was correlated significantly and positively with the level of FSH. Conclusion: serum VEGF concentrations may predict OHSS occurrence.