Knowledge, Attitude and Practices towards Menstrual Hygiene among Government and Private School Girls KAP towards menstrual hygiene in school girls

Menstruation is a normal physiological process unique to females. Pre-menarche is characterized by physiological, cognitive, and psychological transitions which may be initiated from the midst of their second decade. The onset of puberty/ menstruation in girls tends to change their role in society. Overall inadequate awareness levels accompanied by socio-cultural taboos and prevailing myths and misconceptions about menarche and menstruation have played havoc on human society. Objective: To diagnose and compare the prevailing level ofknowledge, attitude, and practices of adolescent girls studying in government and private schoolstowards menstrual hygiene and management. Methods: This Analytical and cross-sectional study was conducted at Government Jouhar Girls High School and Shiblee Grammar School System, Gulberg Branch (private) Faisalabad. A self-administered survey-based questionnaire was developed. Prior formal written approval from school authorities was followed by the pre-planned scheduled visits, explaining the purpose of the study, assuring confidentiality of acquired information, and self-administration of survey-based questionnaires. Results: The results indicated that the mean age at menarches of the girls was 13.69±0.95 years. A relatively more percentage of government (59.6%) school respondents followed by private school respondents (57.1%) had satisfactory knowledge about their age of first menarche (p = 0.806). Motivated by the socio-cultural taboos and /or fear or shame a majority of government (59.6%) and private school respondents (57.1%) had satisfactory knowledge about their age of first menarche (p = 0.806). A strong prevalence of Urinary Tract Infection (UTI) was found in private school girls 87(49.2%) and 21(11.9%), followed by respective percentages of 78(43.8%), 16(9.0%) amongst the government school respondents who recorded their responses as agreed and strongly agreed about the development of reproductive tract infection in the post-menstruation period. As far as the adoption of hygienic practices is concerned a relatively high percentage of government school 28(15.7%) followed by private school 14(7.9%) girls strongly disagreed about changing their absorbent material on daily basis. The development of skin abrasions like rashes, itching, and urinary tract infection was found in a relatively high proportion amongst the government school girls 30(16.9%) followed by private school respondents 18(10.2%) in the post-menstruation period. A most common and alarming unhygienic practice prevalent amongst the government and private school girls was the reuse of absorbent cloth,   who responded as agreed and strongly agreed in respective terms as 43(24.2%),   22(12.4%), and 69(39%) and 28(15.8%).  Conclusions: The study concluded that the persistent myths, misconceptions, socio-cultural taboos, and unhygienic practices i.e. Use of old clothes as absorbent, reuse of absorbent material, and delaying tendency of changing absorbent,   amongst the adolescent school girls of government and private institutes which may pose direct adverse health and life quality concerns for the female Pakistani community. The current situation calls for active participatory contributions from education communities to initiate various communication and awareness campaigns regarding pre-menarche knowledge and menstruation management which may aid to strengthen and transform their role as a significant representative of society. 

To Study the Effect of Salts and Complexes of Lead and Arsenic Metals on the Status of Thiols in Blood Components, Pharmacological and Toxicological Perspectives

Heavy and transition metals have been widely known for their toxicities for centuries. Arsenic and Lead are highly valued in terms of toxicity to living systems due to their high affinity for sulfhydryl (-SH) containing residues. The chemical interactions of Arsenic and Lead with thiols (–SH rich molecules) results in numerous ill-health effects. As a part of this PhD thesis, the chemical status of GSH was determined in the presence of inorganic and organic complexes of lead and arsenic employing simple spectrophotometric analysis and 1H NMR methods. The behavior of Ellman’s reagent towards the metal-thiol chemistry was initially investigated to begin with the study of the changed status of thiols resulting from metal-thiol coordination. Chapter 2 describes the use of NMR methods to study the species in solutions. 1H NMR allowed us to identify additional components of the reaction mixture, their relative abundance and consequently the involvement of these additional Ellman’s based species in the spectrophotometric errors associated with the use of Ellman’s reagent. Using 1H NMR methods we are able to show that Ellman’s reagent can exchange with thiolates previously coordinated with lead and arsenic. In the context of this 1H NMR study, some limitations were found to be associated with the use of Ellman’s reagent in our study. Ellman’s reagent was found able to react with the thiols being previously attached with arsenic and lead, leading to an over estimation of the thiols in the solution systems. 4,4′-dithiodipyridine (DTDP) was adapted instead of Ellman’s reagent for the spectrophotometric determination of the mixtures involving metal-thiols complexes in aqueous solution and biological mixtures after establishing limitations associated with the use Ellman’s reagent in this capacity of the study. Chapter 3 describes the 1H NMR carried out to study the conditions and ratios of the complexed thiolates (complexes of both arsenic and lead with some important low molecular weight thiols (Glutathione, N. acetyl cysteine and D-Penicillamine). 1H NMR study presented in this chapter provides detailed information about the changes in the chemical status of GSH that might be the basis of this chemical change observed spectrophotometrically in the form of depletion. 1H NMR methods confirmed metal-thiol adducts (i.e., As-SG3 and Pb-SG2) to be the mechanism behind the GSH depletion in the presence of these metal compounds. After establishing the limitation associated with the use of Ellman’s reagent, 4,4′- dithiodipyridine was used for the spectrophotometric determination of the unbound thiols in the presence of complexed thiolates in aqueous solutions. In the course study presented in XII chapter 4, we have spectrophotometrically investigated the reactions of arsenic and lead with sulfhydryl containing thiols i.e., Glutathione, N-Acetyl cysteine and D-Penicillamine in aqueous solutions. In this chapter, the effects of arsenic (Sodium arsenite and Methylarsonous acid) and lead (Lead acetate and Lead acetyl acetonate) on low molecular weight thiols (Glutathione, N. acetyl cysteine and D-Penicillamine) have been spectrophotometerically quantitated in aqueous solutions. Employing influential variables (i.e., different metal concentrations, incubation times and pH ranges) to the study in aqueous solutions, prominent and regular decrease in the thiol levels were caused by each of the inorganic and organic compounds of arsenic and lead in spectrophotometric analysis. Chapter 5 describes the spectrophotometric estimation of important and most abundant low molecular weight thiol (Glutathione) in the whole blood and blood components (cytosolic Fraction and plasma) of human volunteer. In order to improve our understanding of the coordination chemistry of arsenic and lead in whole blood, cytosolic fraction and Plasma, a systematic study of the changes in glutathione (GSH) levels in these biological samples of healthy human volunteers, has been carried out. The effects of the inorganic and organic compounds of arsenic and lead on glutathione status in these biological samples have been spectrophotometerically evaluated by 4,4′-dithiodipyridine. Chapter 6 describes the spectrophotometric estimation of Glutathione in WBCs (Lymphocytes and Monocytes) isolated from human blood, while the study carried out in chapter 7 describes the estimation of Glutathione in liver isolated from rabbits. Chapter 8 describes the exchange of arsenic (AsIII) and lead (PbII) between Proteins (Albumin) and low molecular weight thiols (Glutathione, N. acetyl cysteine and D- Penicillamine). In addition to thiol disulfide exchange reactions, the exchange of arsenic and lead between Proteins (Albumin) and low molecular weight thiols (Glutathione, N. acetyl cysteine and D-Penicillamine) has also been investigated by Column chromatographic methods using Ellman’s reagent. The exchange behaviour of arsenic and lead between proteins and low molecular weight thiols have been analyzed spectrophotometrically by making use of Ellman’s reagent. Column chromatographic methods have been used to collect complexed proteins. The sulfhydryls present on the pure and complexed proteins have been estimated spectrophotometerically. The study regarding the thiol disulfide exchange reactions resulted that the low molecular weight thiolates (Reduced glutathione and N-acetylcysteine) take off As(III) and Pb(II) species which are attached to proteins. XIII Results from multiple studies presented in this PhD thesis are consistent to conclude and anticipate that lead and arsenic species are dynamic in nature as in the case of using Ellman’s reagent, thiolates could be removed from the coordination sphere of the arsenic and lead in As(SR)3 and Pb(SR)2 respectively and in the case involving albumin, the slow exchange of lead and arsenic species bound to cys-34 is the basis for a mechanism by which toxic species can become widely distributed around the body.