Identification of Factors Contributing to Primary Female Subfertility by Diagnostic Hystero-Laparoscopy: An Experience of Private Hospital

Background: Management of subfertility is influenced by the diagnosis of its causative factor. Combined diagnostic hystero-laparoscopy has emerged as an effective procedure in identifying causative factors of female subfertility. Objectives: This study aimed to identify contributory factors to primary female subfertility by diagnostic hystero-laparoscopy. Methods: This descriptive study was conducted at the Department of Obstetrics and Gynecology of Hameed Latif hospital, Lahore, Pakistan from December 2021 to May 2022. Data was collected from 344 women with female primary subfertility, undergoing combined diagnostic hystero-laparascopy. All the demographic data along with identified causative factors (tubal blockade, cervical Os stenosis, endometrial polyp, uterine septum, uterine fibroid, endometriosis, peri tubal adhesions and polycystic ovaries) during the procedure were recorded in predesigned study proforma. Data were analyzed through SPSS software 23. Results: Mean age of the patients was 25±5.0 years and the mean duration of subfertility was 3.8+0.55 years. Two hundred and eighty-four (82.56%) patients had abnormal findings, while sixty (17.44%) had normal findings. Out of 284 patients, 94(34%) had one identified factor, while 190 (66%) patients had two or more identified factors for primary subfertility. Polycystic ovaries were seen in 128(37.21%) patients, followed by tubal blockade in 81(23.54%), peri tubal adhesions/hydrosalpinx in 58(16.86%) patients. Conclusions: Diagnostic hystero-laparoscopy is an effective diagnostic procedure for the evaluation of female factor subfertility and may be helpful to gynecologists in devising further management plans.

Enhancing English Language Speaking Skills Through Boosting Motivation, Using Task-Based Instruction Tbi With an Elementary Students Group Studying in a Government School in Ghizer, Gilgit District

In Pakistan, most of the public sector schools have poor teaching/learning practices for English, especially with regard to spoken skills (Rahman, 2003). Enhancing skills in language learning requires both teacher and student motivation and engagement (Azaeem & Dogar, 2011). English language speaking skills are ignored in classroom instruction because it seems that in Pakistani schools, language teachers are not familiar with the new methods of teaching language generally and teaching of speaking skills particularly (Alam & Bashir-ud-Din, 2013). The need to build effective communication skills in learners is increasing as English continues to reign as the global language (Barnes, 2008). Therefore, different educational institutes are applying different methods of teaching speaking skills (Raja, 2013). This study was carried out in the context of Gilgit-Baltistan, Pakistan, to explore how task-based instruction (TBI) can be used to motivate and enhance the English language speaking skills of grade 6 students. It was an action research study located within the paradigm of pragmatism which is concerned with action and change, and knowledge and action (Coldkuhl, 2012). The data were collected in three main phases: reconnaissance phase, intervention phase and after-intervention phase. Data collection tools were: observations, semi-structured interviews, focus group discussions and reflections on classroom teaching cycles. The language teacher of grade 6 and five students participated in this study. This sample was purposively selected. Data analysis of the reconnaissance phase revealed that there are certain issues in the research context dealing with motivation of students to learn English language speaking. One of the important aspects to motivate language learners is student involvement in the tasks (Dornyei, 1998), foreign language anxiety in students and their language confidence (Mahmoodzadeh, 2012), students' willingness to communicate in the target language (Din, 2015) and the students' tendency to use reductive strategies and code-switch from English to local languages (Sert, 2005). On the basis of the reconnaissance phase findings, I planned an intervention and conducted three teaching cycles. During these cycles, I used individual tasks, pair tasks and group tasks which were designed keeping student interest in mind. Findings revealed that the language teachers in my context emphasize on the writing and reading skills of students. They use grammar-translation method to teach language. Teachers focus on the completion of the syllabus. This in turn provides fewer opportunities for learners to practice the target language. The study outcomes suggest that learners' exposure to the target language speaking and language learning