Ambulatory Hysteroscopy in Abnormal Uterine Bleeding: A Tertiary Care Hospital Perspective

Background: To avoid delays in outpatient facilities for managing benign gynecological conditions like abnormal uterine bleeding (AUB), there is a need to evaluate the usage of unconventional methods like outpatient hysteroscopy. Objectives: To evaluate the usage of outpatient diagnostic hysteroscopy in women with abnormal uterine bleeding. Methods: An observational study was conducted at the Obstetrics and Gynecology Department of Combined Military Hospital, Kharian. The study included 56 women having AUB with or without a history of failed medical treatment. The study participants underwent outpatient diagnostic hysteroscopy. Diagnostic hysteroscopy was done under the local para-cervical block in the Outpatient department. Procedure indications, outcome and biopsy findings were recorded on predesigned proformas. Results: Median age of the study participants was 44 years. The most common indications for diagnostic hysteroscopy were postmenopausal bleeding (34%) and heavy menstrual bleeding (28%). Hysteroscopy outcomes included endometrial biopsy (34%), discharge with no biopsy (25%), further test and evaluations required (21%), and admission due to failed outpatient procedures (20%). Sixty-two percent of the study participants had normal biopsy findings while other biopsy findings included polyps (20%), fibroids (14%) and endometrial hyperplasia (4%). Nine percent had unsuccessful hysteroscopy due to patient refusal to proceed. Conclusion: Outpatient hysteroscopy can be helpful in the early and rapid diagnosis of women with abnormal uterine bleeding.  

Improving Teaching English Speaking Skills in Lower Secondary Schools of Karachi

English is taught as a second language in the Pakistani context where traditional methods such as Grammar-Translation Method (GTM) are dominant in most of the English language teachers' classroom practices. Generally, teachers are found to be neither equipped nor familiar with the communicative ways of teaching English in general and English speaking skills in particular. Therefore, they face challenges and difficulties in their classroom teaching practices, which limit students' learning and drive the teaching-learning processes towards rote- and examination-oriented learning. Many research studies have been conducted in all aspects and skills of second language learning. I have conducted my study with a similar aim that is, to improve the teaching and learning of English language speaking skills. The study was conducted in a lower secondary community school in Karachi, Pakistan, having a low socio-economic status. The methodology selected for the study was Action Research. This study was conducted to explore how teachers can be facilitated in improving their teaching of English speaking skills to grade six students. This entailed introducing new teaching strategies, such as role play, story-telling, and discussion, along with songs as encouraging activities. The findings of the study can facilitate the present researcher in his context, and therefore, improve his own practice as a teacher educator. Data were collected by using different methods and tools, such as observation, audiorecording of interviews of the participant teacher and classroom lessons, video-recording of the first and last teaching lessons, researcher's and teacher's reflective diaries, and document analysis. The study findings, during the reconnaissance stage, reveal that the existing teaching practices are teacher-centered, GTM- oriented, and replete with use of Urdu language. They also reveal the participating teacher's lack of pedagogical content knowledge and skills in addition to her inadequate English speaking skills. They further show students as passive listeners with minimum class participation, overloaded with tasks requiring heavy writing at the same time. Overall, reading and writing skills were focused with less emphasis given to speaking skill. In contrast, the findings after facilitating the teacher-participant with new teaching strategies demonstrate the following, the strategies improved: her practices of teaching English speaking skills; her awareness concerning pedagogical skills and content knowledge; her understanding of the teacher's role in the class; she also developed various teaching materials and lesson plans, and kept a reflective diary. In addition, the findings revealed some challenges that emerged in the process of facilitating the teacher-participant. For