English Language Teaching in Multilingual Classrooms: A Study of L2 Teachers’ Strategies to Manage Many Languages

The teaching plus learning practices have become a challenge for ESL teachers and learners significantly at the undergraduate level in Pakistan.  This difficulty occurs to teachers when they have to deal with ESL learners from such diverse backgrounds. In Pakistan, the English languages is majorly taught as second language at college and university levels in public and private sectors. At general level, English language is in practical pedagogy as a compulsory subject from schools to colleges and universities. The English language today is used as the world’s language some also call it as ‘’Universal language’’ because of its wide usage across the world, that contributes into the usage and learning of the language in all the domains and areas of study (Yunus, 2013).  This research study attempted to investigate the strategies ESL teachers use in multilingual English language classrooms at undergraduate level in universities to deal with learners and cope up with such linguistic diversity in classrooms.  The qualitative research paradigm was employed with structured online interviews of the undergraduate teachers of University of Sindh, Mehran University of Engineering and technology, Jamshoro, and Quaid-e-Awam University of Engineering, science and technology, Nawabshah, Sindh, Pakistan respectively. The study proposed that there are diversified learners in multilingual ESL classrooms at undergraduate level in universities having different backgrounds. The teachers use multiple strategies to cater multilingual learners in ESL classrooms and these situations have both positive and negative effects on learners’ performances. Keywords: English language teaching, English as Second language (ESL), learner’s experiences, learner’s difficulties, language learners, teacher’s strategies, pedagogy. DOI: 10.7176/JLLL/64-02 Publication date: January 31st 202

Can computer assisted diagnosis (CAD) be used as a screening tool in the detection of pulmonary nodules when using 64-slice multidetector computed tomography?

Objectives:To evaluate (1) whether or not the addition of computer-assisted diagnosis (CAD) to 64-slice multidetector computed tomography (CT) can be used as a screening tool for detection of pulmonary nodules in routine CT chest examinations and (2) whether or not to advocate the incorporation of CAD as a screening tool into our daily practice. Materials And Methods: A retrospective cross-sectional analysis of 109 consecutive Patients who had all undergone routine contrast-enhanced CT chest examinations for indications other than lung cancer at the Radiology Department of Aga Khan University Hospital, Karachi, between November 2010 and January 2011. All examinations were evaluated in terms of the detection of pulmonary nodules by a consultant radiologist and CAD (ImageChecker CT Algorithm R2 Technology) software. The ability of CAD software to detect pulmonary nodules was evaluated against the reference standard. In addition, a chest radiologist also calculated the number of pulmonary nodules. The sensitivity and specificity of the CAD software were calculated against the reference standard by using a 2 * 2 table. The Mann-Whitney U test was applied to compare the performances of CAD and the radiologist. Results: CAD detected 610 pulmonary nodules while the radiologist detected only 113. The reference standard declared 198 pulmonary nodules to be true nodules. CAD detected 95% of all true nodules (189/198), whereas the radiologist detected only 57% (113/198). In the detection of true pulmonary nodules, CAD had 98% sensitivity compared with the radiologist who had 57% sensitivity, the statistical difference between their performances had a P value Conclusion: Considering the high sensitivity of CAD to detect nearly all true pulmonary nodules, we advocate its application as a screening tool in all CT chest examinations for the early detection of pulmonary nodules and lung carcinoma

Normothermic Perfusion: a game-changer for kidney transplantation?

Respected Madam, Organ transplantation has revolutionized the field of medicine. Kidney transplant, in particular, is of significant importance in Pakistan as there is an estimated prevalence rate of patients with end-stage renal disease (ESRD) of 100 per million population. The annual transplant rate is only about 8 to 10 cases per million.1,2 Due to this shortage in organ transplants, over 15,0000 people lose their lives each year due to end-stage organ failure, among which 15000 are patients with end-stage kidney failure. These numbers can be reduced greatly if the number of kidneys available is increased.3 As the number of organs available for a kidney transplant is limited in Pakistan owing to strict regulations to end transplant tourism, it is crucial to increase the viability of the organs  available to ensure the success and survival of patients suffering from ESRD.4 An exciting finding was revealed by Kidney Research UK, where 100 kidneys could potentially be saved for transplant each year after being retrieved from donors in the UK via normothermic perfusion, This technique  has shown promising results in numerous research.5  As evident from the name, in this technique, oxygen is provided to organs during preservation to allow aerobic metabolism.  In a review conducted by Franka Messner et al, it was concluded that this technology may be used as an ex-vivo organ assessment and treatment platform. During renal NMP, mesenchymal stromal/stem cells, multipotent adult progenitor cells, and microRNA have been used in studies, and preliminary data shows that these therapies do indeed reduce kidney injury and inflammatory response. Furthermore, in comparison to any cold preservation approach, normothermic ex vivo kidney perfusion (NEVKP) revealed a considerable reduction in preservation harm in a study conducted by Laura I Mazilescu et al.6 As the demand for kidney transplants increases in Pakistan, normothermic perfusion can be studied further to provide an efficient technique for the preservation of organs. By ensuring the better viability of the available organs, we can perhaps help to increase the chances of survival of patients suffering from ESRD since we already face a shortage in the number of organs available for transplantation

Rise of tuberculosis globally after a decline

Dear Madam, Tuberculosis is an infectious disease caused by Mycobacterium Tuberculosis that primarily affects the lungs and spreads via respiratory droplets from person-to-person contact. Tuberculosis has remained endemic in Pakistan for many decades despite the preventative measures taken. With an overwhelming population of 179.6 million, Pakistan ranks fifth amongst the countries with the highest TB burden. 63% of TB cases come from Pakistan in the eastern Mediterranean region. Furthermore, according to the National Tuberculosis Control Program (NTP), 413,450 TB cases (of all types) occur in Pakistan each year, with an incidence of 231 per 100,000 people. According to the NTP, the prevalence of tuberculosis is 630,000 cases (364/100,000 people), with mortality rates in the 60,000 (34/100,000 people) range. [1] The enormity of the population, coupled with a lack of trained medical personnel and the shortage of medical facilities provided, especially in rural areas, makes it extremely difficult to detect and treat the patients. Pakistan already has a fragile healthcare system, and with the addition of the covid 19 pandemic, tuberculosis seems to be on the rise more than ever. Because of the acute and rising burden of the pandemic, the priorities were shifted. Interruptions in regular outpatient services caused by government-mandated lockdowns, general fear of visiting hospitals, and redirection of TB-specific facilities all attributed to the deterioration of case management of TB detection, allowing countless cases to go undiagnosed. [2] The World health organization’s 2022 Global TB report showed that 10.6 million people were diagnosed with tuberculosis in 2021, a staggering increase of %t from the previous year. Approximately 1.6 million people lost their lives to this disease. From 2021 to 2022, the burden of drug-resistant TB increased of 3%, coupled with 450 000 additional cases of rifampicin-resistant tuberculosis (RR-TB) in 2021. [3] As the burden of the pandemic and other infectious diseases, such as poliomyelitis, are still under scrutiny, we need to put more efficient measures to come up with new systems to prevent and lessen the burden of TB, especially when there is a marked global rise in cases

The Effects of Tillage and Straw Incorporation on Soil Organic Carbon Status, Rice Crop Productivity, and Sustainability in the Rice-Wheat Cropping System of Eastern China

Soil management practices are used to enhance soil organic carbon, fertility, and crop productivity around the world. However, accurate information about the appropriate amount of straw incorporation is not available, because it is generally believed that at least 30% of the soil surface should be covered by straw, which is not implemented in all field environments. Therefore, a two-year (2016–2017) field experiment was conducted to investigate the impact of different percentages of straw incorporation and tillage methods, i.e., reduced tillage (RT) and conventional tillage (CT), on crop yield, soil organic carbon (SOC), total nitrogen (TN), and soil carbon storage (SCS) in rice–wheat cropping systems, under eight treatments. The experimental results showed that the greatest reduction in soil dry bulk density ( ρ b ) was found under CT with 100% straw coverage (9.79%), whereas the least reduction occurred under CT with no straw (1.31%). The mean TN concentration, soil organic matter (SOM), and soil carbon storage (SCS) were significantly higher by 0.98 g/kg, 17.07%, and 14.20%, respectively, under reduced tillage with 60% straw incorporation (RTsi60) compared with all other treatments. Our findings demonstrate that the incorporated wheat residues resulted in the highest rice production (7.95–8.63 t/ha) under RTsi60. We recommend the adoption of reduced tillage with 60% straw incorporation to increase rice yield, improve soil structure, and enhance TN, SOM, and SCS in paddy soil under rice-wheat rotation fields for agricultural sustainability

Line × Tester Analysis for Earliness Yield and Yield Contributing Traits in Gossypium hirsutum L.

The present study was carried out at Agriculture Research Institute (ARI) Tando Jam during 2016. The experimental material consisted of six lines viz., CRIS-134, Sindh-1, Sadori, Malmal, IR-901 and three testers; Bt-3701, Bt-121 and CIM-534.The crosses were made in line × tester mating design. F1 hybrids along with parents were sown in Randomized Complete Block Design with four replications in 2016. Seven yield and early maturing traits was recorded like, days to 1st flowering, days to 75% boll opening, plant height(cm), sympodial branches plant-1, bolls plant-1, seed cotton yield-1(g) and lint (%) for estimating of combining ability. The analysis of variance showed that genotypes, crosses, parents, parent vs crosses, lines, testers and line × tester were significant which demonstrated that genetic difference were present in genotypes for various yield and early maturing parameters. Among the lines, Sindh-1, CRIS-134 and testers, Bt-121 and Bt-3701 were best combiners and F1 hybrids like CRIS-134 × Bt-3701, Malmal × Bt-3701, CRIS-134 × Bt-121 were best combiners for all characters

Line × Tester Analysis for Earliness Yield and Yield Contributing Traits in Gossypium hirsutum L.

The present study was carried out at Agriculture Research Institute (ARI) Tando Jam during 2016. The experimental material consisted of six lines viz., CRIS-134, Sindh-1, Sadori, Malmal, IR-901 and three testers; Bt-3701, Bt-121 and CIM-534.The crosses were made in line × tester mating design. F1 hybrids along with parents were sown in Randomized Complete Block Design with four replications in 2016. Seven yield and early maturing traits was recorded like, days to 1st flowering, days to 75% boll opening, plant height(cm), sympodial branches plant-1, bolls plant-1, seed cotton yield-1(g) and lint (%) for estimating of combining ability. The analysis of variance showed that genotypes, crosses, parents, parent vs crosses, lines, testers and line × tester were significant which demonstrated that genetic difference were present in genotypes for various yield and early maturing parameters. Among the lines, Sindh-1, CRIS-134 and testers, Bt-121 and Bt-3701 were best combiners and F1 hybrids like CRIS-134 × Bt-3701, Malmal × Bt-3701, CRIS-134 × Bt-121 were best combiners for all characters

Jejunoduodenogastric intussusception secondary to percutaneous gastrostomy tube in an adult patient.

Intussusception is the most common abdominal emergency in early childhood, but it is rare entity in adults. Jejenoduodenogastric intussusception is an exceedingly rare retrograde small-bowel intussusception. Percutaneous endoscopic gastrostomy (PEG) has become the preferred procedure for establishing enteral feeding in most clinical situations. Despite the fact that it is relatively safe, a number of complications can occur following PEG placement, jejenoduodenogastric intussusception is one of them, but it is a very rare entity. Here, we report a case of jejenoduodenogastric intussusception secondary to placement of a PEG tube in an adult Patient. To our knowledge, this is the third case of isolated duodenogastric intussusception being reported

Accuracy of 64-slice multidetector computed tomography scan in detection of the point of transition of small bowel obstruction.

Purpose:To determine the accuracy of 64-slice multidetector computed tomography scans in detecting the point of transition of small bowel obstruction by using surgical findings as the gold standard. Materials and Methods: Cross-sectional study of 59 Patients with SBO who underwent 64-slice MDCT scans of the abdomen followed by surgery from 1 June 2008 to 31 January 2010 at a tertiary care center. Point of transition between distended and collapsed small bowel loops were precisely determined on 64-slice MDCT and subsequently correlated with surgical findings. Data analysis was done on SPSS version 16. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of MDCT in detection of the point of transition were calculated. Results:Out of 59 Patients, 64-slice MDCT was able to detect the point of transition of SBO in 90% (53/59) of Patients, while in 10% (6/59) of these Patients the point of transition was not found on MDCT. Overall for detection of the point of transition of small bowel obstruction 64-slice MDCT has 93% sensitivity, 67% specificity, 98% positive predictive value, 33% negative predictive value and 92% accuracy, respectively. Conclusion: Sixty-four-slice MDCT is highly accurate in diagnosing the point of transition of small bowel obstruction with an accuracy of 92%. It can be used as a localizing tool before surgery for small bowel obstruction