Age and symptoms at natural menopause: a cross-sectional survey of rural women in Sindh Pakistan

Age at menopause and symptoms vary among populations and societies. Scarce data is available about menopausal age, symptoms and socio-demographic and reproductive factors from rural women of Sindh, Pakistan. The present study was conducted to find out the self reported age at natural menopause, prevalence of menopausal symptoms, and to identify sociodemographic and reproductive factors that may influence the onset of menopause. A survey was carried out on women aged 40-70. A multistage random sampling technique was used to retrieve 1,355 women with natural menopause from 10 union councils of district Matiari. These women were further categorised into 3 groups, I, II, and III having menopause for 1-5, 6-10, >10 years respectively. Pearson's chi-square test was used to analyse the percentage of symptoms distribution. ANOVA was used to analyse the relationship between demographic, reproductive factors and the age at natural menopause. Age at menopause in our subjects was 46.2 +/- 6.4 years. The prevalence of menopausal symptoms ranges from 26% to 83%. Frequency of somatic, psychological and urogenital symptoms was high in group II. No significant association was found between parity, socioeconomic status and age at natural menopause. The results have shown the early age at menopause. The prevalence of menopausal symptoms is high. Results regarding correlation of age at menopause with socio-demographic and reproductive characteristics were different from literature.

Hypertensive disorders of pregnancy: frequency, maternal and fetal outcomes

To determine the frequency and distribution of different types of hypertensive disorders of pregnancy and to determine the impact of hypertensive disorders of pregnancy [HDP] on maternal and fetal outcomes. A descriptive retrospective study. The study was conducted in the department of Gynaecology and Obstetric of Isra University Hospital Hyderabad from January to December 2007. All the patients who were diagnosed to have hypertensive disorders of pregnancy during study period were categorized as group I. One hundred nineteen women delivered during the same period without hypertensive disorders of pregnancy were included as group II. The data regarding demographic and obstetrical parameters, associated risk factors, fetal and maternal complications were gathered from available data on medical record files. Total number of deliveries during the same period was obtained. Frequency of hypertensive disorders of pregnancy was calculated. Statistical analysis was performed by SPSS V11. Pearson's chi square and student's t test was used for comparison of variables in between two groups. P value < 0.05 was considered significant. The frequency of Hypertensive disorders of pregnancy was 8.9% in our study. The mean maternal age was 28.57 +/- 5.8 years and 26.56 +/- 5.0 years for group I and II respectively. Forty eight [76.2%] of group I patients were Unbooked for antenatal care, 37[58.7%] belonged to poor socioeconomic status and 82[45.1%] were multipara. Statistically significant difference was found for antenatal booking status [P. 0.04] and socioeconomic status [P. 0.01] and parity [P 0.04] in both groups. Twenty three [36.5%] patients from group I had past history of hypertensive disorders of pregnancy, while it was reported only by 8[6.7%] of group II patients. It was observed that women with HDP have strong family history of hypertension [P. <0.001]. Regarding maternal outcome more patients from group I were shifted to ICU as compared to group II. Maternal mortality was significantly high in group I [P <0.001]. The mean gestational age was 35.29 +/- 2.6 weeks and 38.03 +/- 1.3 weeks in group I and II respectively. The mean birth weight of baby was 2.5 +/- 0.73 kilograms and 2.8 +/- 0.41kilograms in group I and II respectively. Statistically significant difference was observed in both groups for mean gestational age [P<0.001] and mean birth weight of baby [P<0.001]. Statistically significant difference was observed for Preterm birth, Still born, Neonatal death and admission of newborn in neonatal intensive care unit [P <0.001], [P <0.001], [P <0.001], [P<0.001] respectively. The Perinatal mortality was 230/1000 births in group I, while it was 40/1000 in group II. Frequency of HDP is high in our set up. It is associated with high maternal and perinatal morbidity and mortality

Tobacco use and its health hazards among male teaching and non-teaching staff of a public sector health sciences university in Pakistan

To determine the frequency of tobacco use and to assess the health hazards of tobacco use in male teaching and non-teaching staff of Liaquat University of Medical and Health Sciences [LUMHS] Jamshoro, Sindh - Pakistan. This descriptive cross sectional survey was conducted from 15[th] July to 14[th] December 2005. One hundred forty nine staff members belonging to teaching and non-teaching cadres were selected for study through systematic random selection by the use of standardized formula, Informed consent was taken and data were gathered on a questionnaire containing variables regarding demography, use of tobacco, form of tobacco and health related problems due to use of tobacco. Female staff members were excluded from the study. All the data were analyzed by software programs SPSS 11.0. One hundred forty-nine staff members were interviewed. Frequency of tobacco use was 55[37%]. Among them, 33 [60%] subjects were cigarette smokers, 06[11%] had habit of chewing paan/chaalia mixed with tobacco, 11[20%] were taking naswar while 03[5.45%] and 02[3.6%] were using gutka and mainpuri respectively. The most frequent reason for use of tobacco was friends/company in 37[67.27%] subjects. Out of fifty-five tobacco users, 36[65.45%] had some health related problem. The most frequent reported complaints were teeth staining in 24[66%] subjects while cough with sputum in 06[16.6%] cases. Other problems were GERD in 03[8.3%] and gum ulcers in 02[5.5%] subjects respectively. This study concludes that high proportion of staff working at LUMHS consumes tobacco. The frequent pattern of tobacco use is cigarette smoking and health related problems are common in the users of tobacco

Frequency, intensity and impact of premenstrual syndrome in medical students

To determine the frequency and severity of Premenstrual Syndrome [PMS] in medical college students, evaluate the impact of the condition on the quality of life and find out the associated risk factors. An observational study. Isra University Hospital, Hyderabad, Sindh, Pakistan, from August to December 2006. Unmarried medical students aged 18-25 years with regular menstrual period for the last 06 months were recruited by convenience sampling. PMS-related data was collected on daily record of severity of problems [DRSP] for two prospective cycles. Health-related quality of life data was collected on medical outcome study Short Form 36 [Sf- 36] after taking informed consent from participants. Descriptive and inferential analysis was done by two-tailed t-test and multivariate logistic regression analysis. Study participants [n=172] had mean age of 21.2 +/- 1.9 years. Eighty-nine [51%] girls met the criteria for PMS recording to ICD - 10, among them, 53 [59.5%] had mild PMS, 26 [29.2%] had moderate and 10 [11.2%] had severe PMS. Ten [5.8%] girls were found to have Premenstrual Dysphoric Disorder [PMDD] according to DSM - IV criteria. The order of frequency of symptoms were anger, irritability, anxiety, tiredness, difficult concentration, mood swings and physical symptoms like breast tenderness and general body discomfort with great impairment in social life / activities and work efficiency/productivity. Dysmenorrhea [p=0.003] and family history of premenstrual syndrome [p <0.001] were significantly associated with premenstrual syndrome on univariate and multivariate analysis. Sf - 36 score on Mental Component Summary [MCS] and Physical Component Summary [PCS] were significantly lower in the affected group. Premenstrual syndrome is a common problem in young girls which adversely affects their educational performance and emotional well-being. Strategies should be adopted for detection and management of PMS in young girls