Interior Sindh Research Articles

The Impact of Maternal Weight With Fetal Outcome; A Cohort Study In An Underdeveloped Region Of Pakistan

Objective: This study has been conducted to observe the association of maternal weight with fetal outcomes among women in an underdeveloped region of interior Sindh. Methods: This was an observational study conducted at CMH Hospital Choor, from 1st November 2021 to 30th April 2022, on 84 pregnant women. All antenatal women as early as 16 weeks presented for antenatal visits, were included. Their BMI (body mass index) was calculated. Their increase in weight during pregnancy was noted. Any pre-existing medical complications (hypertension) antenatal or intrapartum complications (including Anemia, Preterm labour, IUGR, and fetal distress) were noted in the mother. The fetal APGAR score was calculated. The passage of meconium and, the need for NICU admission were noted. Results: There is a positive but insignificant and weak correlation between maternal and birth weight using Pearson correlation analysis. The correlation between the above two variables is 0.069 which is positive but weak. It was found that there was a significant association between low maternal weight and NICU admission of the baby at delivery, p-value < 0.05. There were 33 cases (39%) with low maternal weight of 35-46kg and 51 (61%) cases with normal weight of 47-58 kg. There was only one case of meconium aspiration. Conclusion: Women who had low BMI during the antenatal period were observed to be associated with increased morbidity and poor perinatal outcome of the fetus in terms of poor APGAR score, meconium staining and need for NICU admission. Keywords: BMI, IUGR, preterm labour, meconium staining, APGAR score

Spatial Disparities in Human Development Index across the Districts of Pakistan: An ESDA Analysis

Pakistan is spatially a diverse state in terms of the location of its economic activities, and regional disparities in human development level have been a vital concern in its history. The article aims to analyze the distribution of the development index across 97 districts of Pakistan through exploratory spatial data analysis for periods 2004-05 and 2014-15. For this purpose, an augmented development index is constructed for measuring development levels across districts. The index consists of three sub-indexes of education, health, and household welfare level, with each index further consisting of five indicators. The findings of the study indicate positive global autocorrelation, thus indicating that a district with a high (low) is linked spatially with bordering districts that also have a high (low) Development level. The results also display the HH quadrant in the scatterplot of the development Index, which includes most districts of Punjab and KP, while LL illustrates a cluster of most districts from Interior Sindh and Balochistan for both the 2004-05 and 2014-15 periods. Overall, the findings demonstrate the twofold structure of Pakistan’s economic geography, as explained by most of the previous studies. Since the geography of development matters, it is recommended to reduce inequalities across districts by developing the social and economic institutions and infrastructure in Balochistan and Interior Sindh.

Arabic and Sindhi manuscript collections in Sindh, Pakistan: Resources and perspectives from the Indian Ocean

AbstractThis article presents an introduction to an array of historical sources from Sindh (in modern‐day Pakistan) in the Arabic and Sindhi languages. It highlights the sizeable number of Arabic manuscripts in Sindhi institutions and discusses some of the larger historical forces that shaped their collection in the colonial and pre‐colonial periods. In addition, it reflects on the significance these sources may hold for the field of Indian Ocean history, especially in terms of legal and intellectual history. Finally, this article lists and discusses bibliographical resources and catalogs that researchers can use to navigate major libraries and archival institutions across Karachi, Jamshoro, and interior Sindh.

Triad of minimal antenatal care, pre-eclampsia and dementia in rural women: A deep insight and call for awareness.

Pre-eclampsia, a prominent gestational hypertensive disorder, affects around 2-8% of pregnancies and is the dominating cause of late- life maternal morbidities worldwide. Frequent signs of this disorder such as proteinuria, hypertension, and thrombocytopenia, are detected by physicians during the routine antenatal checkups of expectant women. Pre-eclampsia, if left untreated, delineates with complications like central nervous system dysfunction, microangiopathies, thromboembolism, and cerebrovascular accidents in later life of women.[1] Vascular dementia is noticed as one of the late-life complications in women with a history of preeclampsia. Two cohort analyses disclosed a significantly increased risk of vascular dementia in later life of women with a history of preeclampsia. [2,3] Incidence of vascular dementia was noticed as being thrice more common in these women when compared to the non-pre-eclamptic ones. [2] Like all over the world, high percentage of pre-eclampsia cases are also rampant in the rural areas of Pakistan. An analysis from Sukkar, rural Sindh, Pakistan, showed that Preeclampsia and eclampsia cases in a tertiary care hospital accounted for 112 (5.56%) of total 2012 deliveries. Out of these cases, 6.45% were unbooked, depicting the negligence of antenatal care, and 5.8% were found linked to low education levels. [4] The extensive urban-rural gap in the utilization of antenatal care can be determined by the fact that according to reports, 70% of women in the lower quantile of South Asia undergo labor at home in comparison 40% of them deliver without any professional assistance. In Southeast Asia, only 17.7% of lower area women were recorded to use public maternity facilities.[5] A survey from Interior Sindh of Pakistan reported that most rural women have no access to maternity centres within 10km of their living. The authors further stated that the rural residents believed that medical interventions could pose a threat to pregnancy so they preferred untrained midwives over proper maternity centre visits, which could be one of the prime reasons for undiagnosed gestational disorders in these women.[6] Lack of antenatal care utilization could be due to paucity of awareness amongst rural women or the dearth of maternity centres in such underdeveloped areas. Together these factors presented as the key attributes to vascular dementia favouring pre-eclampsia. In rural areas, where barriers to healthcare services and socioeconomic inequality already prevail, this untended rise is a red flag situation. Respective Governments should channel efforts in expanding the accessible maternity setups in these poorly facilitated areas. --Continue

Frequency of different Indications and findings for colonoscopy in a Tertiary Care Hospital

Colonoscopy is one of the most important diagnostic tools to assess the structural abnormalities of the large intestine and distal ileum. To date, there is a paucity of data in Pakistan on indications and findings of colonoscopy. Therefore, our study aimed to evaluate the indications and endoscopic findings of patients who underwent colonoscopy at a tertiary care hospital in interior Sindh, Pakistan. This prospective cross-sectional study of 125 patients who underwent lower gastrointestinal endoscopy was conducted in the Endoscopy Unit of LUMHS Civil Hospital Hyderabad / Jamshoro from April 2020 to September 2020. To be eligible participants had to be 14 years or older, of either gender and giving informed consent. Data regarding demographic characteristics, indications, and endoscopic findings were gathered on a pre-designed proforma. A total of 125 participants were recruited with a mean age of 39 ± 20, out of which 60% were males. Rectal bleeding was the most common indication (70.4%) followed by abdominal pain (9.6%), chronic diarrhea (8%), altered bowel habits (6.4%), constipation (2.4%), post-cancer surveillance (1.6%), weight loss, and anemia (0.8%) each. The most common colonoscopy findings were hemorrhoids (29.6%),and suspected tumor/growth (14.4%), while 22.4% were normal. The most common indication in our study was per rectal bleeding with hemorrhoids as the most common endoscopic finding on colonoscopy.

Crimes and Determinants of Young Criminals: A Study of Interior Sindh, Pakistan

The purpose of the study is to identify the crimes perpetrated by young offenders in the interior districts of Sindh, including Shikarpur, Sukkur, Dadu, and Ghotki, as well as to investigate the underlying causes of criminal behavior. This qualitative study was undertaken by collecting FIRs from four districts using random sampling. The sample consists of 485 FIRs of convicted young male offenders from 2019 to 2020. The study found that youth are involved in various crimes such as murder, rape, larceny, assault, drug/alcohol consumption, and illegal weapon possession. In addition, the study's findings identified the factors that inspire young offenders to commit crimes, including poverty, land conflicts, tribal feuds, provocation, retaliation, sexual passion, and thrill. Consequently, illegal activities, as opposed to more constructive ones, are gaining popularity among the younger generation; therefore, the study suggests establishing a parental care and control program to improve educational and training facilities, increase employment opportunities, decrease the availability of dangerous weapons and drugs and alternative methods of crime prevention should be implemented.

AN EXPLORATION INTO THE WOODEN FURNITURE INDUSTRY THROUGH THE THEORETICAL LENS OF PORTER’S CLUSTER- A CASE STUDY OF KHAIRPUR MIRS

Furniture industry of Pakistan is considered as one of the high potential yet neglected clusters. This industry is famous for its elaborate wooden carvings on the blocks of Sheeshum and Rosemary. The leading furniture making areas of Pakistan are Chiniot, Gujrat, Peshawar, Lahore and Karachi. However, Pakistan’s share in the international wooden furniture market is insignificant, despite the fact that the country has a history of craftsmanship and innovation in the field of wooden furniture. Especially Sindh region which specializes in wood furniture making have not been explored for its potential in increasing the furniture export. Further, there is a dearth of literature pertaining to their geographical clustering as well as the causes of the underdevelopment of interior Sindh’s wooden furniture industry. In response to this gap, this case study research a) conducts geographical mapping of Khairpur Mirs wooden furniture industry through GIS, and b) constructs a SWOT Matrix in light of Porter’s Cluster Theory on the basis of thematic analysis. The findings highlight that the location of the business units is at Station Road from Khaki Shah pull to Nimm More (approximately 1 km area) with around 150 to 200 furniture houses/ manufacturers. This research identifies the causes of underdevelopment of wooden furniture cluster in Khairpur on the basis of which participant driven solutions are proposed. Finally, this research presents policy recommendations to improve this small scale industry’s potential for socio economic growth.

Bilateral proptosis after snakebite

Snake envenomation is a major public health challenge in the interior Sindh region of Pakistan. Ocular complications ensuing snake envenomation are comparatively scarce. A case report of bilateral proptosis and blindness in a 3-year-old girl presenting 5 days after a snakebite is a rare manifestation. Even antivenom and other medical/surgical management could neither reverse her visual loss nor save her life. This report has enlightened the eminence of problems related to snake envenomation in the interior Sindh, Pakistan, and highlights the need for early referral and that ocular manifestations must be treated as an emergency.

Statistical analysis of waiting time of patients by queuing techniques: case study of large hospital in Pakistan

<p class="JARTEAbstractHeader">The purpose of this empirical research was to analyze the comfortable waiting time (CWT) of patients at the outpatient department (OPD) of Gastrology of ABC hospital of Karachi. It is based on the analysis of CWT of patients who were being served at the OPD of Gastrology of ABC hospital of Karachi. The data was collected by the help of questionnaire. Altogether 250 questionnaires were distributed among the patients, 210 of them were collected back and 10 of them were incompletely filled. Data was analysed in the statistical package for social sciences (SPSS) version 22. Data analysis included frequency distribution of various demographics;stratification tables were made for the comparison of CWT across various demographics. Results indicated that more females (old aged) had greater CWT in the comparison of males. It is found that the mean CWT of patients decreased with decreasing age, increasing OPD visiting time and increasing income. It is also found that he mean CWT for the patients from Afghanistan was greater than the patients from other regions i.e. Baluchistan, interior Sindh and Karachi. The authors highlighted that when patients arrive at the hospital and wait for their service, in this scenario, waiting cost is associated with their waiting time; since it is the matter of cost, thus it should be known to the hospital that if patients are made to wait longer, it can lead to the customer dissatisfaction. In this regard, analysis of comfortable waiting time of patients was extremely needed. Since, Karachi is the biggest city of Pakistan and targeted hospital is one the biggest private hospitals of Karachi and in the analysis of this paper. Only 200 patients were approached for data collection which is the main limitation of the paper. In future, the researchers should also focus on the same OPD for more responses and at the same time, other departments can also be targeted for conclude better and precise results. The authors have tried to focus on the CWT of patients so that the waiting capacity of patients could be highlighted. At the same time, detailed analysis was conducted across demographics so that their influence on CWT could be analysed.</p><p class="JARTEKeywords"> </p>

Suicide by poisoning in Pakistan: review of regional trends, toxicity and management of commonly used agents in the past three decades.

Suicide is one of the leading mental health crises and takes one life every 40 seconds. Four out of every five suicides occur in low- and middle-income countries. Despite religion being a protective factor against suicide, the estimated number of suicides is rapidly increasing in Pakistan. Our review focuses on the trends of suicide and means of self-poisoning in the past three decades, and the management of commonly used poisons. We searched two electronic databases (PubMed and PakMediNet) for published English-language studies describing agents used for suicide in different regions of Pakistan. A total of 46 out of 85 papers (N = 54 747 cases) met our inclusion criteria. Suicidal behaviour was more common among individuals younger than 30 years. Females comprised 60% of those who attempted suicide in our study sample, although the ratio of completed suicides favoured males. There were regional trends in the choice of agent for overdose. Organophosphate poisoning was reported across the nation, with a predominance of cases from the agricultural belt of South Punjab and interior Sindh. Aluminium phosphide ('wheat pills') was a preferred agent in North Punjab, whereas paraphenylenediamine ('kala pathar') was implicated in deaths by suicide from South Punjab. Urban areas had other means for suicide, including household chemicals, benzodiazepines, kerosene oil and rat poison. Urgent steps are needed, including psychoeducational campaigns on mental health and suicide, staff training, medical resources for prompt treatment of self-poisoning and updated governmental policy to regulate pesticide sales.

Knowledge, Attitude and Practice of Cardiac Patients Regarding Reversible Risk Factors

The major aim of this study was to assess the knowledge, attitude and practice of numerous risk factors of cardio vascular disease among the local population of Sukkur district. Embracing of western culture and quick conversion of rural areas into urbanization leads to enhance the cardio vascular burden on the population of modern world. Developing countries has not enough medical facilities to overcome the burden of Cardio vascular Disease (CVD) and it is co-related with education and awareness about the cardiac disease.
 Descriptive Crossectional study was carried out at National Institute of Cardio Vascular Disease (NICVD) Sukkur for the period of 06 months from July 2020 to December 2020. Total 186 patients were included in the study and the selection criteria for study subjects was depends on the different factors such as patients, who had admitted in the hospital for more than 03 days with positive Troponin T and disturbed ECG reports. A well designed questionnaire was used for the collection of demographic and clinical data from the patients regarding research.
 From the obtained data 123 were male patients and area of residency of mostly patients was rural areas. 39 patients complain about chest pain, 74 about shoulder pain, 44 had severe headache and 29 were presented with cardiac arrest. 109 patients were diagnosed with hypertension, 34 had Diabetes Mellitus, 26 had gastric issues. Trop T test was positive among 91 patients, 109 had disturbed ECG. 64 patients were aware about various risk factors of CVD.
 In our research it was concluded that people of interior Sindh were unaware of modifiable risk factor for cardiovascular disease when presented with heart problem, most of the population even couldn’t identify the obesity, physical exercise, heavy diets and smoking as major reversible risk factors for CVD. Mass counseling and seminar should be conducted from time to time in order to overcome the raising issues of cardio vascular disease and its risk factors.

Child Marriages: International Laws and Islamic Laws Perspective

A Child marriage is a serious issue in Pakistani society particularly in rural areas and interior Sindh province. The reasons and forms of child marriages are very harmful and against the fundamental rights of children granted by various international and domestic laws. The practice causes severe effects not only to children but also to society as a whole. This article discusses the legislative efforts made by the United Nations and the international community to restrain child marriages around the globe. The issue of child marriages is discussed under the ambit of human rights and women’s rights and highlighted in various conventions and treaties. State parties are bound to make their domestic laws according to the essence of such conventions and treaties. Similarly, Islamic law holds an important position in domestic laws of Pakistan. Therefore, the issue is analysed in light of Islamic law as well as international law. This research identifies and analyze the available international, Islamic and domestic legal instruments that are relevant to help in restrain of child marriage. The methodology employed in this research is qualitative method of legal case study, where by researchers analyzed secondary sources including articles, books, reports, online web sites and court cases. After the analysis of the available data and legal instruments, this research finds that i) child marriage in Pakistani society are practiced arbitrarily, ii) very young spouses are not having opportunity to pursue their post marriage education, iii) the community, especially female, are not aware of the existence of legal assistance in the legal system to protect them from such early marriage; iv) available laws in Pakistan are inadequate in restraining of the practice, v) equality promoted in the Constitution of Pakistan is not strictly followed by authorities, vi) although, international conventions condemn the practice but there is no proper international law sanction to prohibit child marriage vii) Islamic law permits a guardian of a child to marry off his ward before she attains puberty but the marriage can only be consummated after she attained puberty.
 
 Received: 31 October 2020 / Accepted: 6 January 2021 / Published: 10 May 2021

RETROSPECTIVE EVALUATION OF BURDEN OF LUNG CANCER IN DIFFERENT ETHNIC GROUPS AND GENDERS AT KARACHI, PAKISTAN

Lung cancer is a third leading cancer in Pakistan with high mortality rate. To determine incidences in the population of Karachi, Pakistan, a retrospective study in different ethnic group was conducted from January 2011 to December 2015 to determine incidences of lung cancer in last five years registered in oncology wards of major hospitals of Karachi. Registered patients of lung cancer with confirmed diagnosis cytologically and/or histologically was included in the study. Secondary data from retrospective patient’s charts and files have been gathered. Most of the cases were from city of Karachi, Interior Sindh and Balochistan provinces. Minimum sample size of study was 147, however, evaluation was done on 169 patients. In addition to type of cancer, ethnicity, gender and age were also recorded. SPSS 20 software was employed for analysis including mean age, standard deviation, standard error and co-efficient of variation. Number of cases and incidences of lung cancer in different ethnic groups were found to be; Sindhi male 51 (38%), Sindhi female 12 (34%), Urdu speaking male 32(24%), Urdu speaking female 09 (26%), Balochi male 10 (07%), Balochi female 04 (11%), Pukhtoon male 09 (07%), Pukhtoon female 03 (09%), Punjabi male 25 (19%), Punjabi female 05 (14%), Siraikis male 03 (02%) minorities and other males 04 (03%), minorities and other females 02 (06%). Highest incidences are observed in Sindhi and Urdu speaking population of Sindh province, especially in male. Active, passive smoking, air-pollution and occupational exposure could be reason of high number of incidences in major ethnic groups of Karachi, therefore screening parameters are of paramount importance to reduce the burden of disease.

Awareness regarding weaning and its associated factors among mothers in rural Sindh

Objective: To determine the awareness regarding weaning and its associated factors among mothers in Kashmore, rural Sindh.
 Methods: A cross-sectional study was conducted among infant’s mothers regarding awareness for weaning at Kashmore, a rural community in interior Sindh, from March 2108 to November 2018. The inclusion criteria were age of mothers 30 years or above and child’s age more than two years whereas mothers refusing to give verbal informed consent were excluded from the study. A total of 200 mothers were included in the study and were interviewed by using a questionnaire designed specifically for the study. Data were analyzed using statistical package for social sciences version 20 while Mann Whitney U test and Kruskal Wallis H test were used for inferential analysis. The study duration spanned over 9 months.
 Results: The mean age of the mothers was 27.1 ± 6.3 years and the average number of children for every household was 2.4 ± 1.3. When participants were asked about what weaning foods should be given to assess their awareness, 176 (88.0%) mothers said bread or roti, 153 (76.5%) said yogurt, 144 (72%) said boiled rice, 133 (66.5%) said vegetables, 130 (55.0%) said suji or kheer, 95 (47.5%) said egg yolk while only 71 (35.5%) said fruits. The study results further showed that among the socio-demographic characteristics compared the mean awareness scores of the mothers were significantly different across categories of mothers’ education (p<0.001), fathers’ education (p<0.001), monthly household income (p<0.001) and type of family (p=0.025).
 Conclusion: Based on study results it can be concluded that certain socio-demographic factors influence the awareness of the mothers regarding the weaning of their children. Therefore any effort aimed at improving their awareness should take into account the factors identified in this study.

Assessment of factors responsible for early menopause in Interior Sindh, Pakistan

Objective: To evaluate the factors leading to the early onset of menopause (<40 years) in the women in the interior of Sindh.
 Materials and Methods: A cross-sectional study was conducted on 218 individuals among them 109 were postmenopausal women (with premature menopause) and 109 were normal menstruating females during the period of six months from November 2014 to April 2015, data was obtained from Interior Sindh, Larkana, Hyderabad, and Benazirabad. Factors considered were age, number of children, history of the obstetric process (ovarian and uterine), diseases, and premature menopause history in first-cousin marriages. The questionnaire data and blood samples were collected for hormonal assays such as LH, prolactin, and FSH. The hormone levels were analyzed by ELISA method, SPSS version 17 was used for data analysis.
 Results: Out of 109 subjects the percentage of early menopause due to: anorexia nervosa was 17%, brain tumor 7%, ovarian cancer 6%, hormonal disorders 23%, hysterectomy 15%, oophorectomy 5%, Pituitary gland dysfunction 4%, Sheehan Syndrome 24%, Polycystic Ovarian Syndrome (PCOS) 8%.
 Conclusion: Early menopause was found related to pathological and psychological factors including brain tumor, ovarian cancer, family history, Anorexia nervosa, and certain surgical interventions.

Pluralities of History: Carrying Folklore Across Languages and Cultures

If history is a distilled collection of stories that was handpicked by colonisers, victors, and those in power, then folklore is a pool of abundant and overlapping remembered pasts from the common person. My research considers the possibility of folklore being a truer, more relevant version of history by analyzing written and oral stories from the province of Sindh. Research took place in two simultaneous phases: 1) Interviews in Karachi with people in the cultural sector, such as a literary scholar, author, musician, dancer, and archeologist to investigate the relationship between folklore and artistic and cultural practices; 2) Field visits to archaeological sites, shrines, and historic monuments that involve talking to locals about the presence of folk stories in their communities. Methods of carrying on folklore are interdisciplinary and overlapping. They include singing verses that detail stories at shrines, incorporating stories into new music, interpreting stories through dance and theatrical performance, and preserving archaeological sites. Folk stories are allowed to be multiple, overlapping, and contradicting, as the reality that they present is of a plural, collective memory. They belong in literature as much as they belong in anthropology, music, performance, and other disciplines. These pluralities are present in the interviews and field research, which will be shared and discussed, showing how the version told by an expert in the field of literature was just as valid as the story shared by a villager in interior Sindh.

Ultrasonographic estimation of Thyroid gland volume in healthy subjects of interior Sindh (Province of Pakistan).

Ultrasonography is the most common & easy method to estimate the thyroid gland volume. There is wide variation in the volume of the thyroid gland in normal individuals of different ages, sex, races & geography location. Objectives: To estimate the ultrasonographic thyroid gland volume & its reference range in healthy volunteers of interior Sindh, province of Pakistan. Study Design: Cross Sectional Prospective study. Setting: Conducted in Department of Radiology of PUMHS Nawabshah. Period: From 15 August 2017 to 15 February 2018. Material & Methods: Total 102 healthy subjects were included. The subjects having history of any thyroid disease or surgery, systematic disease, iodine deficiency or taking any drug were excluded. Every subject’s thyroid ultrasound was performed by experienced radiologist & thyroid gland volume of each lobe was calculated. Results: The mean total thyroid gland volume of all study subjects was 9.14+2.97 cm3. The mean volume of right lobe is significantly larger than that of left lobe (5.27+3.82 vs 3.82+1.41, p< 0.005). The mean thyroid volume of the male subjects was larger than in the females (11.67+3.06 vs 8.50+2.87 cm3), the difference between both sexes was statistically significant (p< 0.005) (Table-I). There was no statistically correlation was found between thyroid gland volume with body mass index ((p< 0.005). Conclusion: We tried to contribute to establish the reference values for our local population and further large studies are required to establish national wide reference values of thyroid gland volume.

THE PARADOXES: POLITICS OF INEQUITY-POLICIES FOR HIGHER EDUCATION IN PAKISTAN

This reflective paper aims to explore in what ways equity-based empowering educational policies can reduce disparities of marginalized people’ access to opportunities for quality higher education in Pakistan; and how the ‘topocracy’ in Pakistan clutches education policies for their own interest. Using the critical reflective lens, the authors engage with reflections on secondary data on education policies (1947-2009) and policy analysis papers to make meaning. Making meaning is a critical reflective engagement and an approach to data analysis that enables the researchers to draw meanings of complex socio-political and educational phenomena. It enables researchers to present the key findings on ground practices based on current higher education policies of Pakistan. The findings show that policies developed on equality basis could not help the marginalized segments in Pakistan with regard to access to quality higher education. It appears that the inequity-policies and practices created a huge gap between haves and have-nots fostering disparities, sense of isolation and deprivation among the marginalized people who have no access to quality higher education such as Gilgit-Baltistan, Chitral, Baluchistan, South Punjab, interior Sindh and other border areas of Pakistan. This study recommends policymakers to reflect on what ways bringing reforms to the existing policies to introduce opportunities for equity -friendly-polices for the marginalized areas to reduce their sense of deprivation. Keywords: Inequity-Policies, Support Provisions, Higher Education, Marginalized Areas Quality-life- basics, Topocracy

Attitudes Towards English at English Language Centers in Dadu District of Sindh Pakistan

The study aimed at gaining an insight into the attitudes of students towards English. It is tried in the paper to explore the mentality of the students and the people around them, towards English language through different questions related to English language and their point of view regarding those questions. The study further explores the current position of English in the context of interior Sindh through the views of the participants pursuing language courses. The study also explores the reasons behind the expansion and popularity of English language and language centers. The motives of the students to go to learn English also explored in the study along with the role of the elite class and the state in the spread of English and the agenda of past colonial powers. The study used five questions to analyze the attitudes of the learners. The results suggested that the state and the past colonial powers have succeeded in keeping our minds colonized Keywords: EFL, ESL, ATTITUDES, ENGLISH LANGUAGE CENTERES DOI : 10.7176/JLLL/58-04 Publication date :July 31 st 2019

Poor Learning In Operation Theatres Causing Brain Drain

This article was migrated. The article was not marked as recommended. Introduction: In interior Sindh, most of the hospitals including teaching hospitals of Hyderabad, Larkana, Sukkur and Nawabshah lack specialists so the attitude of available specialists as supervisors is important for learning in operation theatre like need good mentorship, observation and hands-on skills. Limited research has been conducted in Pakistan while none of the study has been done considering specifically the hospitals of interior Sindh. Objective: To identify the perception of residents towards learning environment in surgical theatre of a medical school teaching hospital of interior Sindh. Method : A cross-sectional study was conducted at Peoples Medical College, Nawabshah, from May 2018 to October 2018. STEEM questionnaire of 40 statements was used and was validated after pilot study. The participants' responses were calculated using a five-point Likert scale. Randomized sampling technique was used. The reliability was assessed using Cronbach's alpha for the whole questionnaire. Mann-Whitney and the one-way analysis of variance (ANOVA) tests were used as nonparametric methods for comparative statistics for assessing gender differences. We also conducted the factor analysis by using a varimax rotation. Kaiser-Mayer-Olkin (KMO) and Bartlett's tests were applied. Results :Of the 88 participants, 71.6% (n=63) were females and 28.4% (n=25) were males. Majority of participants 43% belong to gynaecology department. The reliability of the scale was 0.822, calculated using Cronbach alpha. The mean overall STEEM score was 108.81 whereas, mean score of males was 115.44 and females was 106.17 which shows there the difference between scores based on gender. Male perceived the educational environment more positive than females in each subscale. Conclusion : Under current circumstances and condition of interior Sindh postgraduate trainees are deprived from good mentorship, observation and hands on skills due to lack and non-serious attitude of consultants/supervisors. The current study concluded that overall learning environment of operating theatre was perceived to be inadequate for learning.