Is early age at menarche associated with multimorbidity? Findings from the Azar Cohort study.

AIMS: This study aimed to assess the association of age at menarche (AAM) with multimorbidity and chronic diseases. METHODS: We used data regarding the reproductive history of 8,294 female participants of the Azar Cohort Study. A questionnaire assessed the participants' demographic information, reproductive history, personal behaviors, smoking status, socioeconomic status, activity status, and wealth score index. RESULTS: Among 8,286 women included in the analysis, the AAM was < 12 years (early) in 648 (7.8%), 12-14 years (normal) in 4,911 (59.3%), and > 14 years (late) in 2,727 (32.9%) individuals. Early menarche was associated with a high risk of diabetes, obesity, and high WHR. On the other hand, late menarche was associated with higher rates of hypertension, stroke, and diabetes but a lower risk of MM, rheumatoid disease, obesity, abdominal obesity, and WHtR. CONCLUSION: Changes in AAM have significant health implications. Factors predisposing individuals to early menarche and its consequences should be considered in chronic disease prevention strategies for adolescents and young adults.

Conservative Management of Asymptomatic Pneumoperitoneum; Report of Two Cases.

Peptic ulcer disease is a common gastrointestinal disorder, the prevalence of which has reduced in recent years due to effective new treatments. Peptic ulcer perforation is an emergent life-threatening condition that causes pneumoperitoneum and septic shock. It often requires surgical procedures. We describe two cases of peptic ulcer perforation with only mild discomfort on the epigastric region since several months before. The patients were treated with a high dose proton pump inhibitor and conservative treatment without surgical procedures. Weekly follow up of the cases showed that the clinical condition of patients remained stable without any new signs and symptoms. This report shows that noninvasive treatment alone can be effective in some cases with mild symptoms.