Reviewer ’s report  
 
Title: Knowledge and practice of adolescent females abou t menstruation and menstruation 
hygiene visiting a public healthcare institute of Quetta, Pakistan  
 
Version: 1 Date: 01 Jul 2019  
 
Reviewer: Kelly Alexander  
 
Reviewer's report:  
 
"Demographic characteristics revealed that mean age of the respondents was 15.45±1.92 years"  
 -- I think that you can just round to full years, as it isn't relevant to have the decimals.  
 
"Mothers' stayed main source of information,"  
-- I am unclear what this means  
 
The sentences from the abstract are repeated 2 -3 times throughout the paper. I thin k it is best 
practice to not copy and paste.  
 
"An important issue which is often neglected is that even though the epoch of teenage years is a 
hale and hearty fraction of life."  
-- This sentence is awkward and doesn't really make sense  
 
"Many young girls are often poorly knowledgeable, less experienced and not XXXX comfortable 
when it comes to reproductive and sex related information and services."  
-- I would take out "much"  
 
The tables should all have n=xxx instead of just frequency or N. The tables need to be arranged 
better. Also there should not be judgement on bathing or other knowledge without references, as 
washing with water or not bathing daily during menstruation is not necessarily incorrect. What is 
incorrect is the idea that things need to be do ne differently during menstruation -- but that these 
branch from social taboos that were taught to them, not necessarily the girls lack of education. I 
agree with the conclusion that girls need more knowledge about menstruation from health 
centres, schools  or other places -- however from this discussion this doesn't really make sense: 
"Whereas, 77.7% participants of the current study had had no prior classes about menstruation at 
school etc.,  probably due to lack of confidence and shyness about discussion, of adolescent 
health, with the teachers." How is not having classes due to shyness?  
 
"Surprisingly, a high number of respondents didn't consume medicines but rested to ease the 
discomfort and used napkins as an adsorbent material, which is quite different from the findings 
of Khan  et al., who reported an under usage of napkins due to lack of affordability and comfort 
availed from using homemade pads in Pakistan [24]."  
 
--Run on sentence  
Also not sure what "rag made" is. And homemade (pad?) is one word.  
The survey questionnaire should be included  
 
Overall the discussion needs to be revised, as it currently is awkward and does not flow well. It 
does not tie together well the current results, other studies, and remaining questions (or 
limitations).  
 
"This prob able difference might be a result of difference in community outlook and 
socioeconomic rank."  
-- this sentence seems out of place and "this probable difference" doesn't make sense.  
 
 
 
Are the methods appropriate and well des cribed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Needs some language corrections before being published  
 
 
 
 
 
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may  in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either n ow or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating t o the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing int erests' 
below. If your reply is yes to any, please give details below.  
 
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