Factors causing variation in age at menarche

Background: Menarche is an important phase of female reproductive life, which with passage of time is getting earlier worldwide. Early menarche has several psychosocial and behavioral effects on a girl's teenage life, besides it increases the risk of breast cancer, therefore it is important to determine the underlying causes of this change

Objective: To assess the extent of and factors responsible for variation in age at menarche in females of Sindh

Study design: Cross-sectional, questionnaire based

Methodology: The study was conducted by department of physiology on 600 sexually healthy females, belongs to interior Sindh, Hyderabad and Karachi. Informed written consent was obtained, data about menarcheal age and relevant factor was collected using questionnaires containing close-ended questions. Volunteers were divided into three groups, each of 200, based upon their birth year, Group 1 included ladies who were born in 1970s or before, Group 2 consists those who born in 1980s while volunteer from Group 3 were the youngest generation born during 1990's and onwards

Results: Mean age at menarche for Group 1 was 13.6 yrs [Std. Dev +/- 1.3], Group 2, 13.3 yrs [Std. Dev +/- 1.0] and for Group 3 it was 12.3 yrs [Std. Dev +/- 1.1]. Pearson Correlation between age at menarche and menarcheal age of sister for all three groups was significant [P = 0.01]. Twenty-three percent volunteers in Group 1, 37% in Group 2 [P = 0.01] and 48% in Group 3 [P = 0.02] had awareness about menstruation at their time of menarche

Conclusion: Menarcheal age, over time is decreasing, among girls of Sindh, Pakistan. This may be due to pre-menarcheal awareness and hereditary influence

Attitude, behavioural improvement and preferences; in medical students as they move up to the next higher class

Present study endeavoured to assess medical student's ethical behaviour, preferences and improvements one year later. Cross-sectional, questionnaire-based. Liaquat University of Medical and Health Sciences Jamshoro. Sindh. Pakistan. October 2013 - Jan 2014. First year [FY] and second year [SY] MBBS students [n = 122 each year] of both genders, were randomly selected and a questionnaire administered. Fifty six percent male and 40% female students of FY marked proxy attendance; 72% males and 65% female would mark proxy attendance if given a chance. Percentages increased in SY. Significant co-relation existed between gender and proxy attendance [p = 0.01]; self-financed or hostlers showed no association with marking proxy attendance. Sense of responsibility in females and courteous behavior in both genders improved in SY. Teacher's behaviour affected student's conduct; and improvement in understanding English was noted in both genders in both years, however, the small% of students finding English as a barrier were prone to mark proxy attendance [p = 0.05]. Males preferred physiology whereas female preferred anatomy in both years. In FY, subject of choice was anatomy, substituted for Physiology in SY. Majority students preferred chalk and black board vs. multimedia based teaching. Cheating behaviour and sense of responsibility, but civilised behaviour, did not improve after one year education