A US National Institutes of Health study in Kisumu, Kenya, involving 2,784 men aged 18 to 24 showed a 53 per cent reduction of HIV infections in circumcised men compared to uncircumcised men. A parallel study involving 4,996 men aged 15 to 49 in Rakai, Uganda, showed circumcised men were 48 per cent less likely than uncircumcised men to become infected.

Researchers previously had noticed that in places where circumcision is common, HIV was less common.

Results of the first major study on the issue were reported last year in South Africa, with researchers seeing a 60 per cent reduction in HIV risk for circumcised men. Researchers viewed the new trials as strong confirmation.

Public health leaders said the results indicated a potential way to reduce HIV in Africa. "It does have the potential to prevent many tens of thousands, many hundreds of thousands and perhaps millions of infections over coming years," Dr Kevin De Cock, the director of the World Health Organisation's Department of HIV/Aids, told reporters.

As the Christmas party season gets going, the British Pregnancy Advisory Service says: "You don't wait until you have a headache before buying aspirin and it makes no sense to wait until you have unprotected sex before you get emergency contraception."

A spokesman told The Daily Telegraph: "We are trying to make the morning-after pill as normal as Nurofen. Having it at home should be as normal as that."
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The charity's argument is that the emergency contraceptive pill can prevent pregnancy if taken up to 72 hours after sex, but can be up to 50 per cent more effective if taken within 12 hours.

It is rarely available to women in advance, the BPAS said, and many women struggle to get it within 72 hours, especially at weekends or during public holidays.

However, critics said the BPAS was encouraging reckless behaviour and lack of self-control.

Valerie Riches, the founder-president of Family and Youth Concern, said she was astounded. "All this assumes people have no self-control. It simply encourages a more promiscuous attitude to relationships which cannot be good for people in the long-term."

Norman Wells, the director of the Family Education Trust, said: "This is a very irresponsible move. The original medical assessment report of this powerful hormonal drug cautioned against over-treatment because of its unknown long-term effects.

"Adolescents, whose bodies are still developing and undergoing rapid hormonal changes, will be particularly vulnerable as a result of making the morning-after pill available in advance without proper medical advice from a practitioner who knows her personal and family history.

"When the morning-after pill was first approved for use in the UK, assurances were given that it would be used only in exceptional circumstances and would remain a prescription-only drug under the control of doctors.

"If we now start marketing it as a 'just in case' drug and make it as readily available as aspirin, we are embarking on a very dangerous experiment with unknown consequences."

At present, emergency contraceptive pills are available free on prescription from doctors and family planning clinics, and are on sale from pharmacies. But the BPAS said it can be difficult for women to get a doctors' appointment in time and many family planning clinics have restricted opening hours.

Pharmacists are only permitted to sell the pill to women who have already risked pregnancy. The retail cost of emergency contraceptive pills is a deterrent to some, at around £26.

Because BPAS is a charity providing not-for-profit sexual health care, its doctors and nurses can prescribe the pill for only £10.

Ann Furedi, the chief executive of BPAS, said: "Sometimes contraception fails, and sometimes we fail to use it effectively. In the real world, accidents happen.

"Emergency contraceptive pills give us a second chance to avoid a problem pregnancy. It makes sense to keep it in the bathroom cabinet, along with your plasters and paracetamol."

Advance prescribing of the emergency contraceptive pill has the support of the Faculty of Family Planning and Reproductive Health Care of the Royal College of Obstetricians and Gynaecologists, the BPAS said.

Family Planning Association research indicates that the emergency pill would prevent up to 95 per cent of "no-precaution" pregnancies if taken within 24 hours, up to 85 per cent if taken between 25-48 hours, and up to 58 per cent if taken between 49-72 hours.

The World Health Organisation stresses that the pill is for emergency use and not an alternative to regular forms of contraception.

"One of our tasks in the next few months will be to define what information is communicated from one twin to the other and vice versa," Dr. Cochrane said.

The conjoined twins are growing like weeds -- each weighing exactly 6.6 pounds -- and have already developed distinct personalities.

Krista cries more than Tatiana and demands more attention from her mother and nurses at the health centre, where the tiny pair have lived since they were delivered by cesarean section seven weeks ago.

The conjoined girls have distinct brains as well; each has her own frontal lobe, lower brain stem and cerebellum.

But with this new "bridge" discovery, they are more intertwined than originally thought.

For example, blood that originates in one girl's brain, travels through the other's, and vice versa.

The new findings cast doubt on whether the twins, who are anatomic mirrors of one another, can ever be successfully separated.

Dr. Cochrane used the analogy of a traffic maze to describe the web of connected brain tissue shared by the girls.

"It [the connecting tissue] is sort of the No. 1 highway that brings information to the surface of the brain, then delivers it down through the more basic functions and through the spinal cord," Dr. Cochrane said.

"So it's likely that there's important wiring, so to speak, in that bridge," he added.

The neurosurgeon said doctors still don't know what kind of brain signals travel along this corridor. Right now, the infants, who were born two months prematurely on Oct. 25, are at the same developmental stage as a newborn.

"One of our tasks in the next few months will be to define what information is communicated from one twin to the other and vice versa," Dr. Cochrane said. "I'm not sure I know how to interpret it, as yet," he said, adding there is no medical precedent for this kind of brain fusion.

The twins are scheduled to be flown home to Vernon, B.C., today with their mother, Felicia Simms, and a team of medical professionals.

The daily cost of caring for the twins over the seven weeks has been $1,000 a baby. The tab, billed to British Columbia's Medical Services Plan, is a basic one and doesn't include the cost of diagnostic tests.

The girls have thrived in their first weeks of life, and tests show their hearing and vision are normal. Both infants are being bottle-fed their mother's breast milk.

Despite their relatively good health, Ms. Simms, 21, faces a monumental task in caring for her girls, the doctors said. Feeding, bathing and even carrying the infants is a job for two, said Brian Lupton, clinical director of the health centre's neonatology unit.

A specially designed car seat was donated to the family.

During Ms. Simms' pregnancy, there was some public speculation about how the young woman would cope with the stress and work involved in raising conjoined twins.

Ms. Simms has two other young children, ages 2 and 3, with her partner, Brendan Hogan. Ms. Simms's mother and sister have pledged to help care for the twins.

"Felicia is doing very well," Dr. Lupton said. "She is an experienced mother and it shows," he said, noting that Ms. Simms spends nights in her daughters' hospital room.

Dr. Cochrane said he was surprised at the emotional impact the girls' birth has had on him.

"I've come to know a family who is absolutely committed and absolutely strong. They are dedicated to these children. . . . That, from my perspective, has been the principal learning experience.

"I find the definition of anatomy and function all very interesting . . ., but I think the more important thing is the rejoicing of this family."

As for the future, Dr. Cochrane said it's still too early to say if separation is medically possible, especially with the discovery of the brain bridge.

"It would raise the question of knowingly creating an injury to the twins as a result of separating. . . . We're trying to understand the traffic in that particular nerve bundle."

The girls are to return to Vancouver for more tests in the spring.

The twins defied the odds simply by being born. Even though they were delivered early to avoid late-term complications, the two still had only a one-in-four chance of surviving for 24 hours.

The study also found that suicidality rates in Canada differ little from those in the U.S., despite the fact that universal health coverage north of the border gives Canadians better access to health care.

Experts say the study indicates a need for school programs to better educate students about depression and suicide, which is the second leading cause of death among teens in Canada.

The new mechanical heart, which is powered by batteries located in pouches on Mr. Langevin's body, provides a continuous flow of blood so the patient has no pulse.

"Mr. Langevin happens to be the only individual currently living in Canada without a pulse and without a measurable blood pressure," Dr. Cecere said Wednesday.

Mr. Langevin admitted to reporters that, before the operation, he felt his time was up after he suffered his second heart attack in July.

He had the other in 2002.

"I was finished. I had no time left. I probably had only a few months left to live," Mr. Langevin said.

He admitted he was afraid and hesitant about having the implant.

"My wife pushed me a lot to have the operation and I don't regret it."

Mr. Langevin, who comes from Coteau-du-Lac, southwest of Montreal, added it was "better than staying out for the count."

Dr. Nadia Giannetti, director of the MUHC's heart transplant program, said Mr. Langevin was deemed an unsuitable candidate for a heart transplant because of other medical conditions.

"Previously, we would have had little to offer and his heart would have continued to deteriorate," she said.

Dr. Giannetti said the entire procedure cost $100,000, with the tab being picked up by the hospital foundation.

The "Heartmate II" is currently part of a clinical trial at several hospitals in Canada and the United States.

Only one other Canadian hospital-the Toronto General Hospital- was invited to take part in the study.

The device has yet to be approved for use in either country.

Doctors says Dr. Langevin is well enough to be released from hospital in the coming days.

But some gynaecologists argue that there is no reason why women should continue to suffer the pain, discomfort and emotional disturbance associated with menstruation. They say it is easily eliminated and no different from treating the menopause with hormone replacement therapy or impotence with Viagra.

Lybrel is not yet licensed but its maker, the American company Wyeth, has applied to regulators on both sides of the Atlantic. It is expected to be launched in the US and UK next year.

David Archer, professor of obstetrics and gynaecology at Eastern Virginia Medical School, who led the study published in the journal Contraception, said: "There is a rising tide of awareness and discussion on this issue [of ending periods]. But it will always be predicated on what women want and what they are prepared to tolerate. What we have done is taken an oral contraceptive and tweaked it to give women another choice."

He said that when the contraceptive pill was introduced in the 1960s, it could have been designed to eliminate the fertility cycle. But no simple pregnancy test was available and scientists believed women would want the reassurance of a monthly period as proof they were not pregnant.

In 1977, the first trial of "extended use" oral contraceptives was conducted, in which women took the pill for months at a time. "The results showed the consumers liked it but the doctors didn't," Professor Archer said.

In 2000, two fertility experts from the Population Council of Mexico - Sarah Thomas and Charlotte Ellertson - delivered an impassioned plea in The Lancet for modern drugs to end menstruation.

They wrote: "At a minimum, it is a nuisance that requires planning, expensive sanitary supplies and paracetamol to avoid messy discomfort for about one week each month.

"In many cases, however, it has a far greater impact. Hormonal fluctuations accompanying the menstrual cycle have medical consequences that are largely ignored, women are expected to function as normal and minimal attention is paid to physical and mental discomfort."

The monthly period had been "mythologised and socialised" into being the unquestioned natural state for woman, they said.

Professor Archer said his study showed 58 per cent of women were free of periods after using the pill for a year. But the downside was some had irregular bleeding, which was unexplained. "This product is not for everyone. But for women wanting to suppress periods it is a good choice," he said.

A spokeswoman for the UK's Family Planning Association said it welcomed the extra choice for women. "Some do not like the inconvenience of periods but others use them as a way of checking they are not pregnant," she said.

An oral history

1930s Scientists found that steroid hormones, such as androgens, oestrogens and progesterone inhibited ovulation

1950s Experiments in the US using hormones to prevent pregnancy started in humans

1960 Enovid, the first contraceptive pill, approved by the US Food and Drug Administration

1967 Contraception including the pill was legalised in France

1999 The Pill is approved for use in Japan after safety concerns over its long-term use were finally dispelled

2003 Seasonale, the first three-month version of the pill, launched in the US, bringing less frequent periods

2007 Expected launch of Lybrel, first continuous dose oral contraceptive designed to end periods.