Family planning has been a topic of major concern in the research field for years.The correspondence between sociodemographic characteristics and choice of contraceptive method of use specifically among married couples has not been sufficiently studied and thus imperfectly acknowledged in Indonesia.The intention of this study was to establish if an association exists between choices ofcontraceptive methods and socio-demographic factors,evaluate the consequences sociodemographic characteristics have on the use and choice of contraceptive and determine the factors that influence the choices and use of various contraceptive methods among married Muslim women in Indonesia.The data obtained from Demographic and Health Survey(DHS) dataset was applied in this crosssectional study design.A total of 1252 women aged 15-49 years who were currently married at the moment ofsurvey were included in the analysis.Descriptive and bivariate analysis to ascertain difference in choices and use of contraceptive methods by sociodemographic factors conducted.Multinomial logistic regression model was used to assess if an association exists between the response variable "choices of contraceptive methods" and the set of predictor factors,identify the significant determinants and fit a model a for predicting the choice of contraceptive methods.The estimates,adjusted odds ratio together with 95%CI of the determinants linked with choices of contraceptive methods were evaluated by multinomial logistic regression with 5% level of significance.This study revealed low contraceptive prevalence among married Muslim women 55.8%with 44.2%, 20.5% and 35.3% proportion of non-users, long-term and short-term contraceptive method users respectively. Standard of living index,respondent and partner education level,age and number of births were found to be significant determinants of the choice of contraceptive methods among married Muslim women.Poor women were less likely to use any contraceptive method compared to their richer and richest counterparts,there seems to be a larger gap in use and choice of contraceptive methods between the poor and rich women. Concerned stakeholders should target the uneducated,poor ,younger and older women and bring awareness on family planning this will translate to increased use of various contraceptive methods hence reduced unwanted and unintended pregnancies and maternal mortality rates.comprehension of determinants of choices of contraceptive methods could give confirmation for the concerned stakeholders to evolve policies,programs and interventions for married Muslim Indonesian women grounded on the use of the various contraceptive methods.

There are many determinants of the KES-USD exchange rate. This study took a descriptive stance to look at interest rates differential and interest rate differentials and how they affect the exchange rate. For the period from august 2008 to July 2022. Purchasing power parity and international fisher effect are the theories on which the study was based on. STATA was the software that was used to analyze the data. The variables were tested for stationarity, cointergration, autocorrelation, normality, and heteroscedasticity and multi collinearity. Exchange rates and interest differentials were not found to be stationary and as a result the 1st difference was calculated and used for analysis. There was no evidence of autocorrelation and multi-collinearity. Cointergration tests showed that there’s a long run relationship, interest rate differential is significant at 5% while inflation differential is not. According to the STATA output, a significant P value of zero indicated existence of heteroscedasticity problem which was corrected using the robust command before analysis of the data. Inflation differential was found to have a positive but weak correlation with exchange rate with a correlation of 0.0378. Interest differential however has a stronger but negative correlation of -0.2830 with exchange rates. A correlation of 0.10234 is positive but weaker for the correlation between inflation differential and interest differentials. After correction the error term to normality using the robust command, the following output was obtained for the regression analysis. The null hypothesis of the F test is that R²= 0 suggesting that the model has no explanatory variable while the alternative hypothesis is that R² ≠0 suggesting that the model has explanatory power. With a P value of the F test of 0.3683, the model is not significant at the 10%, 5% or 1% significance levels. With an R² value of 0.0088, our model explains only about 0.8% of the exchange rate by the interest rate differential and inflation differential. The p tests for the independent variables are all statistically insignificant. The p test is significant at the 5% significance level with a p value of the t test of 0.015 for the constant. Coefficient of 0.013848 and -0.0498889 for inflation differential and interest rate differential both suggest that exchange rates vary positively with inflation differential and negatively with interest rate differential. The study found that both the purchasing power parity and international fisher effect were violated for the KES-USD exchange rate in Kenya.

Catha edulis (Vahl.) Forssk. ex Endl. (Celastraceae) is a plant which is predominantly used for its euphoretic and stimulant actions. Other indigenous uses of the plant which have been reported include; treatment of Helminthiasis, toothache, asthma, gonorrhea, heartburn, diarrhoea and fatigue. Information on the antimicrobial efficacy and safety of Catha edulis (Vahl.) Forssk. ex Endl., from Embu County is limited. This study aimed at documenting the Ethnobotanical uses of Catha edulis (Vahl.) Forssk. ex Endl., which is grown in Embu County, antimicrobial properties and toxicity. Ethnobotanical data on Catha edulis (Vahl.) Forssk. ex Endl., was collected from 35 key informants using semi-structured questionnaire between July and November 2020. Antimicrobial efficacy of Catha edulis Acetone extracts (CEAC), Catha edulis Aqueous extracts (CEAQ), and Catha edulis Methanol extracts (CEMET) against Bacillus cereus, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Candida albicans were determined by using micro broth dilution and agar well diffusion techniques. Changes in body weights, Haematological, and Biochemical parameters of female and male Sprague Dawley rats over a 28-day period were used to determine the toxicity of the plant extracts. The Haematological parameters which were evaluated included; White Blood Cells (WBC), Red Blood Cells (RBC), Lymphocytes (LYM), Haemoglobin (HGB), Mean Corpuscular Haemoglobin Concentration (MCHC), Platelets (PLT) and the Mean Corpuscular Volume (MCV). The Biochemical parameters which were evaluated included; Kidney function tests (KFT’s) such as Creatinine (CR), Urea (UR), Total protein (TP), and Albumin (ALB) and Liver function tests (LFT’s) such as Alanine amino transferase (AST), Alkaline phosphatase (ALP), Alanine transferase (ALT), Direct bilirubin (DB) and Total bilirubin (TB). All informants were married males who were over 50 years old in age and had at least a Primary level of education. The majority of the informants, who were mostly from Kithunthuri Sub Location had been practicing Traditional medicine for more than ten years and had received no formal training. The sources, local names, preparation, storage conditions, indications for Human and Veterinary uses, frequency of use, dosage, and side effects of Catha edulis (Vahl.) Forssk. ex Endl., were documented. The Aqueous, Methanol and Acetone plant extracts were ineffective against gram negative E.coli, P. aeruginosa and C. albicans (fungi). Moreover, the extracts had limited efficacy against gram positive B. cereus and S. aureus. The mean weight gains in female and male rats which were given low, intermediate or high doses of CEAQ orally were not significant statistically (p<0.05). Female rats demonstrated significantly greater (p<0.05) mean levels of DB and CR than male rats after receiving a 250 mg/kg dosage of CEAQ. Male rats, on the other hand, had significantly higher (p<0.05) average levels of UR, ALP, AST, ALT, and TP than female rats. There was no substantial difference in the mean levels of TB and Albumin in male and female rats at a dose of 250 mg/kg of CEAQ. The mean level of ALB was significantly greater (p<0.05) in female rats than male rats at a dose of 500 mg/kg of CEAQ. However, the average levels of ALP, AST, and ALT in male rats were significantly greater (p<0.05) than in female rats. There was no difference in the mean levels of UR, CR, TB, DB and TP in male and female rats at a dose of 500 mg/kg of CEAQ. At a dose of 1000 mg/kg of CEAQ, female rats had substantially greater (p<0.05) mean levels of UR, TB, and ALB than male rats. However, the average levels of CR, ALP, AST, and ALT, and TP in male rats were significantly greater (p<0.05) than in female rats. There was no statistically substantial change in the mean levels of DB and TB in male and female rats at a dose of 1000 mg/kg of CEAQ. The mean levels of WBC and LYM were significantly greater (p<0.05) in male rats than female rats at low and intermediate doses of CEAQ. There was no substantial statistically change in the average levels of PLT, HGB, MCHC, RBC, and MCV in male and female rats at low and intermediate doses of CEAQ. The mean levels of WBC, LYM, and MCV were significantly greater (p<0.05) in male rats than female rats at a 1000 mg/kg dose of CEAQ. The average levels of PLT, HGB, MCHC, and RBC were significantly greater (p<0.05) in male rats than female rats at a 1000 mg/kg dose of CEAQ. Histopathological examination of the liver, spleen, kidney, heart, and testes of male and female rats revealed that high, intermediate and low doses of CEAQ resulted in local congestion of the cardiac and hepatic vessels. Moreover, high, intermediate and low doses of CEAQ resulted in localized interstitial connective tissue proliferation, multifocal kidney interstitial haemorrhage and localized tubular epithelium necrosis in the kidney in some female and male rats. However, there were no adverse effects on lungs and testes. The Ethnopharmacological relevance of Catha edulis (Vahl.) Forssk. ex Endl., which was collected from the Mbeere community was documented. The limited antimicrobial efficacy and observed toxicity limit the use of leaves for medicinal purposes from Catha edulis (Vahl.) Forssk. ex Endl.

Cloud computing technology is rapidly growing globally and many businesses are starting to adopt cloud computing to leverage the computing power and cost of operation. Therefore, cloud-based storage services are gaining popularity among organizations and people since they provide simplicity in storing and transferring data across several geographical locations at a low cost. However, with the difficulties in retrieving artifacts of evidential and economic value from cloud providers, cloud storage has become a target for cybercriminals for exploitation. As a result, artifacts from the client's computer might offer valuable evidence on which to build a case. This study looked into the artifacts left by Evernote, a widely known cloud storage service, on Windows 10. The study used dead and live forensics to identify Evernote artifacts on Windows 10 for several situations such as Evernote install, file upload, file delete, and uninstall. Investigating these leftovers provides digital forensics investigators with a comprehensive grasp of the traces that are likely to persist and their evidential and business value. The Evernote installer files, link files, browser, registry, prefetch files, and network traffic were identified as possible sources of information throughout the investigation. The traces discovered in the research can help in a criminal probe involving Evernote because they offer valuable information in trying to recreate the crime scene, and establish a chronology of occurrences, as well as knowledge of how to avoid such incidents in the future.

Background-The most commonly diagnosed endocrine disorder in adolescents, children and young adults is T1DM. The prevalence of T1DM in Kenya is rising with an estimated 1,694 children and adolescents having T1DM (IDF Diabetes Atlas 2019). Seasonal variation is an environmental factor that triggers type 1 diabetes onset in genetically predisposed children. Studies done show an increased type 1 diabetes diagnosis in cold seasons for particular age groups compared to warm seasons. Objectives-The study aimed to determine the seasonal variation of T1DM diagnosis in children, adolescents and young adults in diabetes clinic in KNH between 2009 to 2021 and its correlation with the various age categories and geographical patterns. Methodology-This was a retrospective cohort study carried out at diabetic clinic at Kenyatta National Hospital among children, adolescents and young adults who at the point of diagnosis with T1DM were aged between 0 - <25 years between 2009 to 2021.Demographic data (age, sex), age at diagnosis with T1DM, month and season of diagnosis and patient’s geographical origin were recorded in a data collection form. The outcomes of interest were the seasonal variation in the diagnosis of T1DM based on sex, age and age categorization, geographical origin, month and season of diagnosis of T1DM.Data was analyzed based on age, sex and month, season of diagnosis and geographical origin. Age categorization of 5 year intervals at 0-4 years, 5-9 years, 10-14 years, 15-19 years and 20-24 years were used and seasonal and geographical origin were compared. Categorical variables were summarized into proportions and continuous variables into medians where applicable. Statistical analytical methods using available software R Studio was used to inference any association and strength or significance of the associations thereof in seasonality of diagnosis of T1DM. Statistical tests were interpreted at 5% level of significance (p value less or equal to 0.05) and findings presented in form of tables, graphs and charts. Results-A total of 1,250 patient charts were identified by health records using ICD 10 code for T1DM diagnosis. Out of these 379 were consecutively sampled and included in the study and analyzed. The median age was 9 years with an interquartile range of 3-12 years. There were 201(53%) males and 178(47%) females. The data was grouped into six age categories ages: 10-14 years were the majority at 35.1% (n=133) followed by those aged 0-4 years at 29% (n=110). Participants aged 20-24 years were the least at 4.5% (n = 17).Four Kenyan seasons were used as per Kenya Meteorological Department namely MAM or “long rains” season, OND or “short rains” season , JJA &S or “cool dry” season and JF or hot and dry xiiseason. Among the four seasons, JJA&S had the highest diagnosed cases at 37.5% followed by MAM at 27.4%. JF season had the least diagnoses at 16.4%.In the 12 months of the year, March had the highest percentage of cases at 12.1% followed by August and September at 11.3% each. The month of November had the least diagnoses at 3.2%.To determine seasonality of the data decomposition of additive time series to was done using two approaches. The first was a time series plot of the monthly decomposed data for each year from 2009 to 2021 and the second involved time series plot of the four Kenyan seasons decomposed data for each year from 2009 to 2021.In both, repeating patterns of highs (peaks) and lows (troughs) was observed in the seasonal panel related to the months and seasons of the year, which suggested seasonality in the data. A significant statistical association between gender and season of diagnosis was established (p<0.01) with more females in the MAM season. There was also an association between the various age categorization at diagnosis and seasonality (p=0.04).It was also established that there was a significant association between the place of residence (urban vs rural) and season of diagnosis (p=0.004). Conclusion-In this study we observed seasonality of T1DM in children, adolescents and young adults attending KNH diabetic clinic. This is the first study exploring seasonality of T1DM in Kenya. The study alludes to the role of environmental factors in triggering T1DM diagnosis. The study also provides a basis for evaluation of the time varying environmental variables such as rainfall precipitation, temperature, seasonal viral and bacterial infections and specific geographical points of locations in regards to onset of T1DM diagnosis.

Estimates by the World Health Organization indicates that 80 % of the global population use herbal medicines for prophylaxis and curative purposes. In rural Kenya, Traditional Medicine is the primary source of healthcare, and most often the only source of healthcare service. This is due to its ease of accessibility, affordability and trust by millions of people. The cost factor of most phytomedicines makes them all the more agreeable at a time of spiralling healthcare expenses and nearly widespread austerity. Even though conventional medicine exists concomitantly with Traditional Medicine, phytomedicines have often been popular for cultural and historical reasons. Herbal medicinal products have turned out to be commercially widely available, particularly in industrialised nations. The rationale for the use of Ocimum americanum L. (Lamiaceae) in antimicrobial phytotherapy is largely based on the long-term experience of traditional medicine practitioners. This study aimed to investigate the antimicrobial activity and cytotoxicity of crude extracts and their fractions in a microbial and brine shrimp model. Several solvents were selected, their crude extracts and fractions evaluated for their antimicrobial activity, cytotoxicity and phytochemical composition. These included: aqueous, acetone, 70 % hydroethanolic, chloroform and ethyl acetate. Standard bacterial strains of Bacillus cereus (ATCC 11778), Staphylococcus aureus (ATCC 25925), Escherichia coli (ATCC 25922), Klebsiella pneumoniae (ATCC 700603) and one fungal strain, Candida albicans were used to assess the Minimum Inhibitory Concentration and Minimum Bactericidal Concentration of the Ocimum americanum L. sample extracts and their fractions via standard antimicrobial procedures at the microbiology laboratory, Department of Public Health, Pharmacology and Toxicology University of Nairobi. The data was evaluated for susceptibility of bacterial species and considered significant at 95 % confidence interval. Cytotoxicity of the crude samples and fractions were analysed using brine shrimp lethality test with ten-fold dilutions of 1000 µg/mL, 100 µg/mL and l0 µg/mL. Median Lethal Concentration at p < 0.05 confidence intervals was determined using Probit analysis. Established xiiphytochemical screening tests were performed to show the presence or absence of secondary metabolites. Cardiac glycosides, flavonoids, tannins, phenolics and reducing sugars were present in all sample extracts and fractions while polyuronides were absent. Two crude extracts and their fractions exhibited activity against the tested microorganisms. The hydroethanolic extract and its fractions were most active against the tested microbes. There was no significance difference (p > 0.05) in antibacterial activity between the acetonic and hydroethanolic extracts and their fractions. Gram-positive bacteria were more susceptible to the extracts/fractions than Gram-negative microbes. Bacillus cereus was most susceptible while Escherichia coli exhibited the highest resistance. All the sample extracts had statistically significant (p < 0.05) cytotoxicity at LC50 < 1000 µg/mL. Amongst all the samples the fractions of aqueous alcohol crude samples were more prospective thus good candidate for further research. Chloroform fraction of hydroethanolic sample extract was highly toxic with LC50 value of 0.59 µg/mL. The ethyl acetate sample fractions of aqueous alcohol crude sample have demonstrated promising antimicrobic effects against the Gram-positive microorganism Bacillus cereus. The fractions of hydroethanolic crude samples have potential bioactive molecules which are accountable for antimicrobial and cytotoxicity properties respectively. Results from the present research will provide a groundwork for finding an innovative natural phytomedicine. However extensive study is needed to quantify, isolate and characterise the phytocompounds.

The study sought to establish the effect of lending practices on credit risk of commercialbanks in Kenya. Descriptive survey design was adopted targeting 40 commercial banks inKenya and census were used, but only 35 commercial banks had the reliable data for analysis. The study covered the period 2017-2021 and both primaryand secondary data was collected. The analysis was done through Statistical Package for Social Sciences version 24 supported by means and standard deviations, correlation and regression analysis and presented through tables. The study established that lending practices and the control variables could explain 60.9% of credit risk and they also significantly affect credit risk (F {df=4,30} =12.065; p=0.000). It was further established that lending practices positively contributes to the improvement of credit risk of the commercial banks (β=0.021; p= 0.000). It was further determined that bank size contributes to the credit risk of the banks (β=0.016, p=0.000). On the operational efficiency, it was determined that it contributes to the credit risk of the banks (β=0.008; p= 0.047). Finally, on the bank liquidity, it was also determined that it significantly contribute to the credit risk of the banks (β=0.034; p=0.000). The study concludes that lending practices mainly KYC play an instrumental role when it comes to credit risk of commercial banks. The study recommends that the credit managers working incommercial banks in Kenya should come up with clear lending policies and practices. In order to mitigate the risk occasioned by non-performing loans, comprehensive customer appraisal systems and techniques should be embraced by commercial banks in Kenya. The policy makers working at the Kenya Bankers Association should develop sound industry practice in regard to lending practices for members. Policy makers working in commercial banks in Kenya ought to relevant industry practice to guide the operations as far as lending practices and credit risk are concerned.

The double burden of both non-communicable and communicable conditions is becoming a reality in developing counties. Changes in lifestyle patterns and longer survival rates in HIV positive patients have led to an increased risk of developing non-communicable diseases like hypertension and other cardiovascular conditions. Hypertension contributes to a greater extend of the heart disease, which may be led to increased rate of sickness and death in HIV positive patients. High blood pressure in Kenya has been on the increase based on data from studies. Available data shows an increase in the prevalence of hypertension in people living with HIV in Kenya, but the research was done in tier three and four health facilities. It is not known if the prevalence and distribution of determinants is similar to that in the tier 2 facilities. Tier two health facilities like Mathare North health centre do not routinely screen HIV positive patients for hypertension. The objective of this study was to assess the prevalence and determinants of hypertension among HIV positive patients at Mathare North health centre, Nairobi. A cross-sectional, mixed method study was conducted in Mathare North Health Centre located in Nairobi – Kenya, Ruaraka Sub County, Mathare North ward. A random sample of 148 participants was drawn from the study population. A questionnaire (modified from the WHO STEPs tool) was used to collect quantitative data from the participants and the registers available at the clinic while focus group discussions and key informant interviews were used for qualitative data. Data was collected on social, economic, demographic, behavioural, physiological and biomedical factors. Measurements of height, weight, blood pressure and blood glucose were taken for all respondents. Descriptive, univariable and multivariable analysis was done using Stata software, version 11 to show which determinants were statistically significant. The qualitative data from the focus group discussions and Key informant interviews was transcribed then analysed using NVivo, 2020. Ethical approval was sought from the KNH-UoN ERC and Nairobi Metropolitan Services (NMS) –Health department before proceeding with the research. Only the patients who gave written approval by signing the consent forms were included in the study. Of the 148 participants included in the analysis, 17.5% were classified as hypertensive. Male respondents represented 51.4%. The participants’ ages ranged between 25 and 73 years with a median age of 40 and an IQR of 15 years. In terms of physiological and behavioural factors, 4.7% and 1.3% of the participants reported current alcohol and harmful alcohol consumption respectively. Majority of the participants (57.4%) reported insufficient physical activity while all had insufficient daily intake of fruits and vegetables. From the multivariable analysis after controlling for other factors, current use of alcohol (aOR 6.78; 95% CI 1.13-40.50) and current regimen – EFV based (aOR 7.48; 95% CI 1.02-55.05) were associated with hypertension in HIV positive patients on ART. Stress and unhealthy diet were reported as the most significant factors associated with hypertension from the qualitative data collected through the focus group discussions and key informant interviews. Therefore, Nairobi Metropolitan services health department, the facility health management team and the implementing partners needs to put in place proper structures for patient health education on predisposing factors (with a focus on modifiable risk factors), blood pressure screening for all patients, proper diagnostic systems and support groups for the hypertensive patients at the clinic to help mitigate stress.

Breast cancer is the most commonly diagnosed cancer among women in both developed and developing countries. Studies have shown several risk factors including viral agents especially high risk HPV which can be diagnosed by studying p16 INK4A expression on formalin fixed, paraffin wax embedded tissue blocks. p16Immunohistochemistry is considered the best candidate for initial diagnosis of high risk HPV related lesions because of its availability, easy interpretation and its high sensitivity and specificity. This study examined p16 INK4A expression in series of invasive breast carcinoma at Kenyatta National Hospital in order to determine its utility in identifying high risk HPV related invasive breast carcinomas. Objectives The primary objective was to establish the p16 INK4A expression as a marker of high risk HPV infection in women invasive breast carcinomas at Kenyatta National Hospital. Design: Our study was retrospective laboratory based. ixSetting: The study was conducted at University of Nairobi, anatomic pathology laboratory at Kenyatta National Hospital. Study population: Ninety-six (96) formalin fixed, paraffin wax embedded tissue blocks from breast biopsies reported as invasive breast carcinomas in women who attended KNH from January 2013 to February 2016. Results: Our study demonstrated that 25 years old patient was the youngest while the oldest patient was 96 years old. The mean age was 46 years. The most affected age group was 41-50 age group (37.5%) followed by 31-40 age group (27%). The predominant histological type was invasive ductal carcinoma NOS (82.2%). Invasive breast carcinoma grade II were predominant (47.3 %) and majority of the patients presented with stage III invasive breast carcinomas (65.6 %). Positivity was considered when there is nuclear and cytoplasmic staining or expression for p16INK4A. Positivity was noted in 11.4% of our cases and majority of the positive cases were noted among grade III breast carcinoma cases. There was no statistically significant association between invasive breast carcinoma stage or grade to p16INK4A expression. Conclusion: High risk HPV infection has been identified in a series of high grade and advanced stageinvasive breast carcinomas in Kenyatta National Hospital. Women aged from 40-50 years are the most affected by invasive breast carcinoma. Mastectomy was most common specimen. P16INK4A expression is not associated with breast tumor stage or grade

Background Breast density is a well-known and proven independent risk factor for breast cancer and can significantly affect the sensitivity of screening mammograms. Mammographic breast density is thus great importance in the evaluation of a mammogram because increased breast density is known to increase the risk of individual breast cancer (1) Analysis of breast density is done through the ACR- Birads lexicon 2013, which categorizes breast density into four categories A-D A- Almost entirely fatty, B- scattered areas of fibroglandular density, C- heterogeneously dense, which may obscure small masses and Dextremely dense, which lowers the sensitivity of mammography. Due to the subjective nature of the visual assessment during categorization, differences may arise when assessing the breast density between two observers. It is important to assess the degree of agreement or variability as this affects the reproducibility of the report. Aim The study aimed to evaluate and record the degree of inter and intra observer variability when assessing the mammographic breast density using the Breast Imaging Reporting and Data System (BIRADS), as defined by American College of Radiology. Methodology Cross-sectional study was carried out at Kenyatta National Hospital, mammography department of Radiology over a period of one year. Four radiologists were required to review mammograms that were of diagnostic value and classify the breast density based on the ACR classification 5th edition. After an interval of one month, they were asked to review the same mammograms again. Mammographic density category for each mammogram by each radiologist was recorded. Statistical Analysis The intra-observer variability was calculated for each radiologist and reported as weighted kappa values and 95% confidence intervals. Fleiss-Cohen Kappa coefficients and their corresponding 95% confidence intervals were used to calculate the inter-observer variability. The levels of agreement were assigned a kappa value between 0.0-1.0 where 0.0 was considered as no agreement and 1.0 was considered perfect agreement. Results ixThere was moderate overall inter-observer variability both at baseline and after the onemonth review with kappa values being 0.49(95% CI 0.43,0.59) and 0.43 ( 95% CI 0.38,0.61)) respectively when using the ACR BI-RADS 2013 lexicon to assess breast density. The intraobserver variability was substantial with kappa values ranging from 0.61(95% CI 0.48- 0.72) to 0.77 (95% CI 0.67-0.87). Conclusion There was a moderate level of inter- and intra- observer variability demonstrated when assessing mammographic breast density but a substantial level of individual intra-observer variability.