A comparative study of the knowledge and practices related to menstrual hygiene among adolescent girls in urban and rural areas of Sindh, Pakistan: A cross-sectional study.

BACKGROUND: Menstrual hygiene management plays a significant role in the achievement of sustainable development goals, including good health and well-being, quality education, gender equality, women's empowerment, and sanitation. Even though the United Nations emphasizes menstrual hygiene management as a global public health and human rights issue, studies from different parts of the world have shown there is a lack of policies in this area that affects adolescent girls. OBJECTIVE: The study aimed to assess the menstrual-related knowledge and practices of adolescent girls (10-18 years) attending urban and rural public schools of district Khairpur of province Sindh of Pakistan. DESIGN: This research is an analytical cross-sectional study design. METHODS: Adolescent girls (n = 310), 159 girls from urban and 159 girls from rural schools, were enrolled. Data were collected through self-administered questionnaires. Knowledge was considered satisfactory if the participant scored ⩾12/20, and <12/20 was considered unsatisfactory knowledge. Practice scores were considered good for >10 and poor for <10. Statistical Package for the Social Science (SPSS) version 20.0 was used for data analysis. Descriptive statistics such as mean and standard deviation were calculated. The chi-square test was used to assess and compare the differences between practices and knowledge of menstrual hygiene management between urban and rural adolescent school girls. RESULTS: We found significant differences in menstrual hygiene management among adolescent girls between urban and rural areas. Approximately two-thirds of the total school girls thought that school management had inadequate resources and toilet facilities (rural: 76% versus urban: 62%). The major source of knowledge in adolescent rural and urban girls for menstrual-related matters was mothers. More girls from the urban school (81%) were aware of using sanitary pads during menstruation. The majority of the girls from urban areas showed satisfactory knowledge whereas only 38% of rural girls were shown to have satisfactory results. Nearly 71% of urban girls were found to have good practices when compared with rural girls (12%). CONCLUSION: With further importance by the United Nations on female education in less developed regions, where the health of women is usually given less importance, policies are required on the inclusion of reproductive health of female adolescents in the curriculum.

Comparing Simvastatin Monotherapy V/S Simvastatin-Ezetimibe Combination Therapy for the Treatment of Hyperlipidemia: A Meta-Analysis and Review.

Longstanding hyperlipidemia can increase the risk of cardiovascular disease. Statins are currently the mainstay of treatment in hyperlipidemia. Combination therapy of statin with ezetimibe is only indicated for severe hypercholesterolemia and very high-risk atherosclerotic cardiovascular disease (ASCVD) population. There is a paucity of studies comparing statin monotherapy vs combination therapy with ezetimibe. This study aims to perform a meta-analysis of the existing literature and compare the effectiveness of statin monotherapy with statin-ezetimibe combination therapy in the management of hyperlipidemia. A systematic electronic search of the scientific literature was performed in PubMed, EMBASE, and Scopus. Only randomized controlled trials comparing simvastatin monotherapy vs simvastatin-ezetimibe combination therapy between the years 2000 and 2021 and published in English language were included. Fifteen studies were included in the final analysis. The main outcomes that were compared were a reduction in low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Our study showed that combination therapy led to a higher reduction of LDL-C (Mean difference: -20.22(-26.38, -14.07); P<0.0001) compared to monotherapy with a statin alone. There was no significant difference in the reduction of HDL-C values (Mean difference: -0.07(-0.45,0.32); P-0.04) between the two groups. Our study indicates that the combination therapy of simvastatin and ezetimibe is more effective in reduction of LDL-C levels compared to simvastatin monotherapy alone. Currently, guidelines recommend combination therapy only for severe hypercholesterolemia and high-risk ASCVD patients, more studies are needed to study the effectiveness of simvastatin-ezetimibe combination therapy in low-risk ASCVD population.

Pattern of solid paediatric malignant neoplasm at Lumhs, Jamshoro, Pakistan.

BACKGROUND: To evaluate pattern and frequency of solid malignant tumour in paediatric age group in our region. METHODS: A retrospective study of 113 patients, whose surgical biopsies submitted in histopathology section of Pathology department, LUMHS Jamshoro from January 2001 to December 2005. RESULTS: Total of 113 cases, 61 male and 52 female children in age group from 4 months to 15 years were diagnosed as solid malignant tumour with M/F ratio of 1.79:1 and mean age of 6.6 year. Maximum no. of patients was in 0-4 age 50.4%, followed by 32.7% in 4-9 and 16.8% in 10-15 years. The five most common tumours were Retinoblastoma 38.9%, Wilm's tumour 13.2%, Brain tumour (Glial tumours) 10.6%, Hodgkin disease 9.7% and soft tissue sarcomas 9.7%. Retinoblastoma and Wilm's tumour were common in 0-4 year age group, where as rest of tumour were more frequent in 5-9 and 10-15 years age group. Brain tumours and soft tissue sarcomas were common in females, while Hodgkin's disease was more common in males. CONCLUSION: Retinoblastoma was most common solid malignant tumour in early age group. It calls for ophthalmologic screening of all children below 1 year and high risk children until the age of 7 year, in order to detect retinoblastoma as early as possible.