Congenital Heart Disease: Causes and Risk Factors Congenital Heart Disease: Causes and Risk Factors

Congenital Heart Defect (CHD) is a multifactorial disorder based on both genetic and environmental factors involved in development. The basic problem lies in the structure of heart leading to CHD that occurs in walls, valves, arteries and veins of heart. During cell cycle, the gene that controls this process may mutate, causing disturbance in any portion of heart leading to disturbed blood flow, blood flow in wrong direction or complete blockage. Defect may range from simple with no manifestations to complex with severe symptoms. Simple defects need no treatment while some babies with complex birth defects during birth require special care, vaccination, medication or otherwise treated with surgery. The incidence of CHD has declined from 80 to 20% due to progress in heart surgery techniques, medical treatment and interventional cardiology. Various genetic and non-genetic increase the susceptibility for CHD. The diagnosis and treatment of CHD has greatly improved in recent years. Almost all the children with CHD survive to adulthood and spend healthy and active lives after being treated.

The Impact of Grade Retention on the Self-Esteem and Academic Performance of the Students

This mixed method study examines the impact of grade retention on the academic performance and self-esteem of the students. For the quantitative part, the students of grade four in public schools of Rawalpindi city were taken as the study sample. Initially, this sample was divided into two main groups, i.e. identified poor performers and the normal group of students. After annual examinations, the former group was further divided in two subgroups on the basis of results, i.e. Repeaters Sample and Identified Poor but Promoted Sample. A multiphase panel study was designed to collect quantitative data. The data related to academic performance was collected by locally developed tests of the five subjects taught in grade four of the public schools of the Punjab. The self-esteem of the students was measured through Urdu translation of Beck Youth Inventory for Self-Concept of Children (BSCI-Y). A series of analysis were performed with quantitative data to analyze the variations in academic performance and self-esteem of all the three groups. A group of experienced school teachers teaching at primary level in public schools of Rawalpindi city were selected as the key informants of qualitative aspect of the study. Semi-structured, open-ended interviews were conducted with participant teachers. The first part of the interview was nested in the study, while the second part was triangulated with quantitative findings in order to verify and strengthen the results. The two sets of data were collected concurrently, whereas the triangulation of both types was carried out after the completion of the analysis stage. The findings of the study suggested that there was significant positive impact of grade retention on the academic performance of the repeaters, whereas the impact on self-esteem was found considerably negative. However, the academic performance of the repeaters was not significantly greater than those of the identified poor but promoted group and normal group.