Reviewer ’s report  
 
Title: Menstrual pattern among adolescent girls of Pokhara Valley: A cross sectional study  
 
Version: 1 Date: 23 Jun 2016 
 
Reviewer: Rafael  Moroni  
 
Reviewer's report:  
 
         The authors present an observational  cross sectional survey intended to investigate the 
menstrual characteristics of school -age girls in a certain demographic (Pokhara Valley - Nepal). 
The survey utilized questionnaire -acquired information.  
         The study report should follow the STROBE  statement for observational cross -sectional 
studies, thus the authors should address the  following points:  
- At the end of the Background section, the authors should explicitly state the objectives of the 
survey (currently, only the motivati on for the study - "…a dearth of documented research..." - 
is mentioned.  
- Setting and design are adequately explained; however eligibility criteria are not thoroughly 
explored. The authors state that students from grades 5 to 10 were selected , that 260 girls 
were included in the survey, and the purposive non probability sampling was used. There 
should be more details regarding  eligibility - were all the females in such grades invited to 
participate? How many girls were there spanning all thes e grades, and if not all of them 
participated, what were the reasons for exclusions?  
- Consider drawing a flowchart depicting each stage of the research - from inclusion of eligible 
subjects, to depiction of excluded subjects with reasons, to number of subjects analyzed in 
the survey.  
- In the discussion section, I feel a more thorough exploration of the proposed association 
between studies variables should be performed. The association between school absenteeism 
and dysmenorrhea,  for example, is quite intriguing, and yet it is almost non -discussed.   
- Study limitations should be acknowledged, as well as potential sources of bias - e.g although 
it is a hard -to-obtain datum, the reliance on memory of the school grade i n which menarche 
occurred could bias the results.  
 Surveys such as these usually lack external validity, but serve to gather information that 
could eventually be locally  useful both to inform and to serve as background information to 
introduce health pol icies.  
 Although the survey is well thought (and follows many other similar surveys already 
performed in other demographics), these details should be addressed before the report is feasible 
for publication. Also, a language workup is necessary, as there a re several instances of typos and 
inadequate language constructions.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
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 adequa tely supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommende d, please specify 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 manuscript:  
 
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, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this  manuscript, either now 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 f or patents relating to 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 interests' 
below.  If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests  
 
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