Hematological, Biochemical and Etiological factors of Chronic Liver Disease in a tertiary care Hospital of Lahore

Chronic Liver Disease (CLD) progresses from hepatocyte inflammation to fibrosis, regeneration, cirrhosis and in some cases to Hepatocellular Carcinoma (HCC). In general, the main etiologies of Liver Cirrhosis (LC) are viral infections (hepatitis C and B viruses), chronic alcohol abuse and Non-Alcoholic Fatty Liver Disease (NAFLD), including Non-Alcoholic SteatoHepatitis (NASH). Major complications of CLD are ascites, upper gastrointestinal bleeding, jaundice (acute or chronic) and hepatic encephalopathy. Objectives: This study assesses the etiological factors and complications of CLDin a tertiary care hospital of Lahore, Pakistan. Study Design: Cross-sectional. Methods: Study was carried out in indoor and Accident & Emergency Departments of Mayo Hospital Lahore. 100 clinically diagnosed CLD cases were chosen through “Convenient Sampling” technique during 3 months. Observations: Most common complications of CLD were upper GI variceal Bleeding (48%) & hepatic encephalopathy (34%) and acute or chronic hepatitis (AVH) (33%). Other less common complications observed were hepatorenal syndrome (10%), Spontaneous bacterial peritonitis (15%), Ascites (5%) and HCC (10%). Conclusions: Hepatitis C was found as main etiological factor of CLD. Bleeding andhepatic encephalopathy are the common complications. Awareness programmes regarding CLD and its complications are mandatory in our society to improve human health.

Use of Inquiry in Science Classroom Teaching in Pakistani Middle Schools

Science is not a basket of facts and principles. It is an ever-growing, ever-expanding and ever-changing body of knowledge. It provides useful methods of exploring the unknown secrets of nature. Because of its distinctive spirit and nature, science demands the learner to be skeptical and challenge it. For several reasons, in the Pakistani middle school science classroom, the teaching-learning standard is not satisfactory. In the middle schools, the expository method is pre-dominantly used by science teachers. This traditional teaching method emphasizes the practice of transmission of information just to meet the needs of the examination system. It ignores the fact that knowledge often emerges from problems and scientific thinking. Therefore, there is a genuine need that current methods and strategies for science teaching should be reversed or modified and more innovative teaching approaches should be introduced in the middle school science classrooms. In relation to teaching for conceptual understanding of primary, middle and secondary school science content, research literature has come up with a wide variety of teaching techniques, methods and approaches, such as problem solving, discovery, investigation, and inquiry. For this study, one of the innovative teaching methods Inquiry Approach' was selected. The Inquiry Approach is a powerful means of seeking deeper understanding in the scientific concepts and it emphasizes process-oriented classroom activity and provides ample opportunities to the children for realizing the process objective of science teaching and learning. The study focused on the possibilities and limitations associated with the use of the Inquiry Approach in Pakistani middle school science classrooms. The study employed a qualitative mode of research and was carried out in one of the private middle schools located in Karachi with two science teachers of different academic background and experience. Interviews and observations were relied on as major data sources. As a result of the qualitative analysis of the data, the study has come up with some findings related to possibilities and limitations associated with the use of the Inquiry Approach. One of the significant possibilities was the positive response to teaching through an Inquiry Approach. The second possibility worth mentioning possibility was the ability to develop knowledge and skills about using Inquiry Approach in the science classroom.