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.  

Areas of Professional Development of Public Sector Teachers at Primary Level in District Peshawar, Khyber Pakhtunkhaw: A Critical Analysis.

The study was designed to investigate the Areas for Professional Development of public sector Teachers at Primary school level in District Peshawar, Khyber Pakhtunkhwa. The Purpose of this study was to evaluate the teachers’ performance in those Areas and National Professional Standards which are directly related to the class room practices and its main focus was to identify the areas where professional development of the teachers is needed. The main objectives of thestudy were; To critically evaluate the teaching Performance of public sector teachers at boys’ primary school level at Urban and Rural areas in district Peshawar; To evaluate the teachers teaching in light of National Professional Standards; To appraise the teachers’ teaching in light of the prescribed Areas of Instruction for 2006 curriculum; To compare the performance of the selected eight circles of District Peshawar; To identify the areas where professional development of the teachers is needed. For data collection an observational rubric with a four point coded rating scale was developed. Data was collected from 360 teachers of 120 schools of the total population 3465. The collected data was analyzed with the help of software SPSS version 16. The analysis of various levels indicated that maximum numbers of teachers were at level-4 (unsatisfactory) i.e more than 60% of the total teachers observed. The study recommended that Education department chalk out a wide-ranging plan for the training on all standards. Implementable training policy was recommended to frame all types of training programs. As a collaborative approach a four tier model, for continuing professional development, was recommended. Along with such other recommendations, a Teacher Performance Management Wing (TPMW) was also recommended to be established to appraise and supervise the instructional process.