The English/Urdu-Medium Divide in Pakistan: Consequences for Learner Identity and Future Life Chances

Both Urdu, the national language of Pakistan, and English the official language are widely used for spoken and written communication in different contexts in Pakistan. In education; however, a linguistic divide is evident in the two-stream system of education - mainly referred to as Urdu medium and English medium - according to the dominant language of instruction in an institutional setting. Urdu medium schools are normally the state schools providing free education to the poorer communities while the English medium schools are private fee-paying schools for the economically well-off sections of society. This disparity in the educational system has loaded the labels English medium and Urdu medium with a range of meanings that constitute self and other’s perceptions of identity, in addition to signaling linguistic capital, particularly in terms of proficiency in English. This paper reports findings of a small-scale qualitative study undertaken to understand how students at a higher education public-sector institution in Pakistan experience and construct their own and others’ identities in relation to their previous and current educational and social experiences of language learning and use. Insights gained from this study further our understanding of how linguistic inequalities can be sanctioned by the state’s language policy and related practices.Keywords: English/Urdu as medium of instruction, identity, language policy,linguistic capital, linguistic inequality, Urdu-medium

Long scarf injuries

Long scarf (Dopatta) traditionally worn by females in South-East Asia have been described to make the females prone to sustain specific injuries when they ride pillion on the cycle powered rickshaw or motor bike. Two cases of females have been described

Salvage of infected non-union of the tibia with an Ilizarov ring fixator.

Abstract PURPOSE: To review outcomes of 24 patients who underwent Ilizarov ring fixation for infected nonunion of the tibia. METHODS: Medical records of 21 men and 3 women aged 13 to 74 (mean, 38) years who underwent Ilizarov ring fixation for infectednon-union of the tibia were reviewed. The mean bone defect was 3.3 (range, 2-5) cm. The mean time from injury to presentation was 11.9 (range, 1-36) months. The mean number of previous surgeries was 2 (range, 0-14). A local flap was used in 2 patients and a free flap was used in one patient. Nine of the patients underwent Ilizarov ring fixation without soft tissue and bony resection, as inadequate stability was the reason for non-union. Patients were assessed using the Association for the Study and Application of the Method of Ilizarov criteria. RESULTS: Patients were followed up for a mean of 11 (range, 8-46) months. Functional outcome was excellent in 8 patients, good in 12, fair in 2, and failure in one, whereas bone union outcome was excellent in 6 patients, good in 14, fair in one, and poor in 2. The mean time to union was 8 (range, 3-31) months. The mean external fixation index was 4.2 (range, 1.5-15.7) cm/month. Complications encountered were pin tract infection (n=5), re-fracture (n=2), soft tissue impingement by Ilizarov rings (n=2), recurrence of wound infection (n=1), mal-union (n=1), and mortality (n=1). CONCLUSION: Ilizarov ring fixation is a viable option for infected non-union of the tibia. Adequate assessment of bone union is crucial before removal of fixator to prevent re-fracture

A Low-cost Method to Identify Tubewells for Longitudinal Research on Arsenic in Groundwater

Exposure to high concentrations of arsenic in tubewell groundwater from the shallow aquifers of Bangladesh could result in up to 300,000 arsenic-related cancer cases over the next four decades. Understanding the magnitude and temporal dynamics of this exposure, via longitudinal studies, is imperative for planning effective mitigation and management strategies. Appropriate methods are needed to identify tubewells for longitudinal sampling. A plastic band marked with a unique identification number was developed, and various methods for attaching the band to the tubewell were tested, resulting in the choice of a galvanized-iron split-rivet. Two follow-up surveys at two and 14 months post-banding assessed the durability and longevity under field conditions in the JiVitA Project area in rural, northwestern Bangladesh. After two months, ~96.0% of the original bands on 1,063 tubewells were functional, although the rivets were partially corroded. After 14 months, ~65% of a subsample of the bands were functional. With further improvements to the rivets, these bands offer an inexpensive, durable, enumeration technology for longitudinal studies on groundwater arsenic

Craniocerebral aspergillosis in immunocompetent hosts: Surgical perspective

Craniocerebral aspergillosis is a rare but dangerous variety of central nervous system infections. Surgery is being widely recognized as the cornerstone of management. Due to the rarity of the disease, difficulty and delay in diagnosis and poor outcome, there is very little in the literature regarding the various surgical strategies that may be adopted in these patients. Early aggressive surgery followed by chemotherapy offers the best chances. Surgical planning would depend upon the type and location of the disease process as well as the condition of the patient. Perioperative care holds immense importance and knowledge of possible complications is essential. Aspergillosis of the central nervous system is difficult to diagnose and equally difficult to treat. Surgery remains the cornerstone of management followed by systemic antifungal medications. Results are better in immunocompetent patients as compared to those who are immunocompromised

A successful model of road traffic injury surveillance in a developing country: Process and lessons learnt

Background: Road Traffic Injuries (RTIs) are one of the leading causes of death and disability worldwide with 90% of global mortality concentrated in the low and middle income countries. RTI surveillance is recommended to define the burden, identify high risk groups, plan intervention and monitor their impact. Despite its stated importance in the literature, very few examples of sustained surveillance systems are reported from low income countries. This paper shares the experience of setting up an urban RTI surveillance program in the emergency departments of five major hospitals in Karachi, Pakistan.Method: We describe the process of establishing a surveillance system including assembling a multi-institution research group, developing a data collection methodology, carrying out data collection and analysis and dissemination of information to the relevant stakeholders. In the absence of a road safety agency, the surveillance system required developing individual partnerships with industry, police, city government, media and many other stakeholders. Impact of the surveillance is demonstrated by some initiatives in the local trauma system and improvements in road design to effect hazard reduction.Conclusion: We demonstrated that a functional RTI surveillance program can be established, and effectively managed in a developing country, despite lack of infrastructure and limitation of resources. Data utilization in the absence of well defined road safety infrastructure within the government is a challenge. More effective actions are hampered by the limited capacity in the transport and health sectors to do in-depth analysis through road safety audits and trauma registries

Morphological and Morphometrical Study of Umbilical Cord of Newborn Babies

out during January to December 1998 at Bangabandhu Sheikh Mujib Medical University, Dhaka to expand the knowledge of gross anatomy of the umbilical cord of Bangladesh. The length of the cords were irrespective of sex ranged from 28 to 93 cm with a mean (±SD) of 55.6 (±10.78). The length of the umbilical cords of males were significantly longer than female (P\u3c0.001). The diameter of the cords irrespective of sex were varied from 1 to 1.9 cm with a mean (±SD) of 1.45±0.31 cm. The mean circumference length percentage ratio index of umbilical cord was 8.31. Thirty-three (66%) cords were inserted eccentrically, all being paracentral in position. The rest were inserted centrally. False knots were more frequent (47; 94%). Only one (2%) showed a true knot in addition of false knot. In 2(4%) cases cord had not any true or false knot. It is concluded that the gross morphological and morphometrical features of the umbilical cord in Bangladesh appear to be similar to those described in western literature

Bioelectrical Impedance among Rural Bangladeshi Women during Pregnancy and in the Postpartum Period

Properties of bioelectrical impedance analysis (BIA) reflect body-composition and may serve as stand-alone indicators of maternal health. Despite these potential roles, BIA properties during pregnancy and lactation in rural South Asian women have not been described previously, although pregnancy and infant health outcomes are often compromised. This paper reports the BIA properties among a large sample of pregnant and postpartum women of rural Bangladesh, aged 12-46 years, participating in a substudy of a community-based, placebo-controlled trial of vitamin A or beta-carotene supplementation. Anthropometry and single frequency (50 kHz) BIA were assessed in 1,435 women during the first trimester (≤12 weeks gestation), in 1,237 women during the third trimester (32-36 weeks gestation), and in 1,141 women at 12-18 weeks postpartum. Resistance and reactance were recorded, and impedance and phase angle were calculated. Data were examined cross-sectionally to maximize sample-size at each timepoint, and the factors relating to BIA properties were explored. Women were typically young, primiparous and lacking formal education (22.2±6.3 years old, 42.2% primiparous, and 39.7% unschooled among the first trimester participants). Weight (kg), resistance (Ω), and reactance (Ω) were 42.1±5.7, 688±77, and 73±12 in the first trimester; 47.7±5.9, 646±77, and 64±12 in the third trimester; and 42.7±5.6, 699±79, and 72±12 postpartum respectively. Resistance declined with age and increased with body mass index. Resistance was higher than that observed in other, non-Asian pregnant populations, likely reflecting considerably smaller body-volume among Bangladeshi women. Resistance and reactance decreased in advanced stage of pregnancy as the rate of gain in weight increased, returning to the first trimester values by the three months postpartum. Normative distributions of BIA properties are presented for rural Bangladeshi women across a reproductive cycle that may be related to pregnancy outcomes and ultimately be used for assessing body-composition in this population