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Objective: To compare the sensitivity and specificity of saline infusion sonohysterography with hysterosalpingography as a diagnostic tool in the assessment of infertile women.., Methods: The comparative cross-sectional study was carried out at a private infertility clinic in Karachi, and comprised women who registered for assessment of infertility from June 2011 to May 2013. Uterine and tubal pathology was assessed as a possible cause of infertility by using saline infusion sonohysterography as an index test and hystero-salpingography as the standard reference. The diagnostic accuracy of the two tests was compared. Sub-fertile patients were followed up for 2 weeks after the tests for any possible adverse effects of the procedures. Data was analysed using SPSS 19., Results: Of the 256 subjects, 184 (72%) presented with primary and 72 (28%) with secondary infertility. Overall mean age of the sample was 28}8 years. The mean BMI was 29.8}4.1 in primary infertile compared to 28.2}.5 in women with secondary sub-fertility. The sensitivity of saline infusion sonohysterography for detecting patency of the tubes was 100% and the specificity was 91% whereas positive predictive value was 69.8% and negative predictive value was 100% (Kappa: 0.61). For large uterine polyps, sensitivity and specificity was 100% and for small polyps sono-hystero-salpingography showed 14% false positive results (Kappa: 0.21)., Conclusions: Saline infusion sono-hysterography was found to be a more reliable method of diagnosing tubal or uterine pathologies compared to hystero-salpingography for cases of infertility.

Objective: To identify Byssinosis in cotton spinning mill workers, probable associations of disease with factors such as different work areas, safety gadget usage and overtime and to ascertain proportions of byssinosis to accidental injuries., Methods: This study was conducted in a spinning mill of Karachi in June 2006. Mill workers who had worked for a period of minimum 5 years were selected. A sample size of 83 conveniently selected workers participated in the research study. Data collection was done via questionnaire, and pulmonary function tests., Results: The mean age of the sample was 30 +/- 6.9 years. Of all the workers 72% used safety gadgets (masks) while working and 50% availed overtime. Smokers amounted to 31% of the total subjects. Around 35% workers complained of having respiratory ailments of which 19% (16 workers) closely matched byssinotic symptoms. Pulmonary Function Tests (PFTs) confirmed 13 of 16 workers to be byssinotics, with the remaining being labeled as Probables. The overall proportion of Byssinotics in the mill was 19.28% (95% C.I. 11-27) and that of accidental injuries was 22.9%. The association of byssinosis with respect to work areas was significantly high in Ring area (O.R. = 2.04) followed by carding (O.R. = 1.3). The association of byssinosis was also high in workers who did not use safety gadgets, e.g. dust masks (O.R = 4.89) and in people who worked overtime (O.R. = 1.82). Associations with respect to duration of employment and smoking could not yield significant results., Conclusion: Results indicate a very high probability of association of disease to non-usage of safety gadgets and overtime working. Studies comprising of a greater sample size would show precisely the overall prevalence of the disease.

Objective: To assess the process of problem-based learning (PBL) as perceived by the medical students and their opinions regarding the process., Methods: A cross-sectional study was conducted at Karachi Medical and Dental College. One hundred and four medical students of fourth year MBBS (52 each of batch 2004 and 2005) were selected for their responses and feedback on problem-based learning in small groups. Data was collected through a closed-ended questionnaire., Results: Seventy nine percent (82 out of 104) of medical students liked the PBL sessions. Overall 85% of students were motivated towards self learning while liking for PBL was 82%. Activation of prior knowledge was observed by 83% students., Conclusion: Students supported problem-based learning (PBL) as an effective method of learning. Majority of students were motivated towards self- learning. They were convinced that PBL helped them in building up communication skills, interpersonal relationship and problem solving capacity.