Estrogen deficiency is a major risk factor for osteoporosis in postmenopausal women. Although hormone replacement therapy (HRT) has been rampantly used to recompense for the bone loss, but the procedure is coupled with severe adverse effects. Hence, there is a boost in the production of newer synthetic products to ward off the effects of menopause-related osteoporosis. As of today, there are several prescription products available for the treatment of postmenopause osteoporosis; most of these are estrogenic agents and combination products. Nevertheless, in view of the lack of effect and/or toxicity of these products, majority of the postmenopausal women are now fascinated by highly publicized natural products. This is an offshoot of the generalized consensus that these products are more effective and free from any adverse effects. Recently, certain plant-derived natural products, mostly phytoestrogens (isoflavones, lignans, coumestanes, stilbenes, flavonoids) and many more novel estrogen-like compounds in plants have been immensely used to prevent menopause-related depletion in bone mineral density (BMD). Although, a number of papers are published on menopause-related general symptoms, sexual dysfunction, cardiovascular diseases, Alzheimer's disease, diabetes, colon, and breast cancers, there is paucity of literature on the accompanying osteoporosis and its treatment. In view of the controversies on synthetic hormones and drugs and drift of a major population of patients toward natural drugs, it was found worthwhile to investigate if these drugs are suitable to be used in the treatment of postmenopausal osteoporosis. Preparation of this paper is an attempt to review the (a) epidemiology of postmenopausal osteoporosis, (b) treatment modalities of postmenopausal osteoporosis by hormones and synthetic drugs and the associated drawbacks and adverse effects, and (c) prevention and treatment of postmenopausal osteoporosis by phytoestrogens, their drawbacks and toxicity. It is apparent that both the categories of treatment are useful and both have adverse effects, but the plant products are nonscientific and hence are not advised to be used till more studies are undertaken to ensure that the benefits clearly outweigh the risk, in addition to recognition by Food and Drug Administration.

Objective: To determine the association of risk factors of Gestational Diabetes Mellitus (GDM) to outcome of Glucose Challenge Test (GCT). Place and Duration of Study: From February 2000 to October 2000 at the antenatal clinic of Unit-II at Services Hospital. Subject and Methods: One thousand pregnant women attending antenatal clinic at 24-28 weeks of gestation at Services Hospital were included. Glucose challenge test was performed after a history with special reference to diabetic risk factors. Results: Risk factors were identified in 198 (19.8%); while there were no risk factors in 802 (80.2%) women. An oral glucose tolerance test (OGTT) was carried out in all glucose challenge test positive patients. Out of 198 women with risk factors, 50 women were glucose challenge test positive while 148 were screen negative. Out of 802 women without risk factors 54 were GCT positive while 748 were screen negative. The positive predictive value was 48% and the negative predictive value was 83% Out of ten gestational diabetic women, six (3%) belonged to the risk factor group While four (0.5%) were in the no risk factor group. Conclusion: pregnant women with positive risk factors for diabetes mellitus were found to have a six times greater chance of developing gestational diabetes as compared to those with no risk factors.

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cells/hpf) in patients with U.urealyticum, though this may be attributed to coexisting NG. Agents isolated from endocervix were Ureaplasma parvum 26(40.6%), N.gonorrhoeae, 17 (26.6%), Mycoplasma hominis 11(17.2%), HSV2, 9(14.1%), Ureaplasma urealyticum 5(7.8%), T.vaginalis 4(6.3%), HSV1 and C.trachomatis, 1 each(1.6%) and Mycoplasma genitalium (0%). Bacterial vaginosis was diagnosed in 14(21.9%) patients. Multiple, two, three, four and five agents were isolated in 10, 6, 6 and 1patients respectively. Isolation of M.hominis and U. parvum was significantly associated with bacterial vaginosis (p value 0.04 & 0.003 respectively). Non-usage of condoms predisposed to cervicitis. Conclusion Few C.trachomatis isolates, absence of M.genitalium and increasing prevalence of HSV, highlights the changing etiological pattern of cervicitis. Though U.parvum and M. hominis are usually commensals their high isolation, association with bacterial vaginosis and propensity to cause diseases in preterm infants and extragenital infections puts forth the need for further studies and regular monitoring of agents implicated in cervicitis.