bluuebunny/crossref_metadata_2025 huggingface dataset:
Un ladrón asalta el vacío del cuadro
Authors: Venet-Gutiérrez Jacqueline , Rubira-García Rainer
Published: September 2021

Resumen: Análisis de la obra gráfica y fílmica del creador español Carlos Vermut. A partir de su trabajo como ilustrador, historietista y director de cine, demostraremos cómo desde el cómic articula su discurso audiovisual tomando como referencia el universo gráfico que consume y/o diseña. Este procedimiento nos permitirá un examen de los elementos fílmicos y los de naturaleza extra cinematográfica, considerando los rasgos temáticos y formales que los emparentan. Su obra se organiza en un complejo entramado referencial. En esta concomitancia perenne entre diversos textos previos, destaca el manga. Así, lo que comienza como un ejercicio intertextual se complejiza hacia un mecanismo citatorio más elaborado construyendo un libre juego de identidades desde un triple foco de reescritura: el manga, el cómic concebido por el propio autor y su cine.

Abstract: Analysis of the graphic and film work of the Spanish creator Carlos Vermut. From his work as an illustrator, cartoonist and film director, we will demonstrate how he articulates his audiovisual discourse from the comic, taking as a reference the graphic universe that he consumes and / or designs. This procedure will allow us to examine the filmic elements and those of an extra cinematographic nature, considering the thematic and formal features that relate them. His work is organized in a complex referential framework. In this perennial concomitance among various previous texts, the manga stands out. Thus, what begins as an intertextual exercise becomes more complex towards a more elaborate citation mechanism, constructing a free game of identities from a triple focus of rewriting: manga, the comic conceived by the author himself and his cinema.
Cellulite ou l’individu rêvé par Claire Bretecher
Authors: Vázquez Lydia , Ibeas-Altamira Juan Manuel
Published: September 2021

Résumé: Cellulite voit le jour de la main de Claire Bretécher dans la revue Pilote en 1969. Avec ce personnage féminin plein d’énergie, la dessinatrice cherche à déconstruire l’image d’une jeune femme absolument parfaite. Le prénom de la protagoniste est déjà toute une déclaration d’intentions : pas de beauté conquérante, pas de finesse séduisante, pas de soumission possible. Dans un cadre moyenâgeux cette « nouvelle femme », en vraie « paladine » du féminisme, transforme notre monde par ses gestes rebelles et insoumis, mais aussi par ses maladresses et ses doutes. Cette bande dessinée est le meilleur cadeau de Bretécher non seulement aux générations soixante-huitardes mais aussi à leurs héritiers.

Resumen: Celulitis nace de la mano de Claire Bretécher en la revista Pilote en 1969. Con este personaje femenino lleno de energía, la dibujante busca deconstruir la imagen de una joven en todo perfecta. El nombre de la protagonista es en sí mismo toda una declaración de intenciones: no hay ninguna belleza avasalladora, ninguna finura seductora, ninguna sumisión parece posible. En un marco medieval esta “mujer nueva”, autentica “paladina” del feminismo, transforma nuestro mundo con sus gestos rebeldes e insumisos, pero también con sus torpezas y sus dudas. Este comic es el mejor regalo de Bretécher no solo a las generaciones de mayo del 68 sino también a sus herederos.
El funcionamiento del cine a través del lenguaje del cómic
Authors: Asión Suñer Ana
Published: September 2021

Reseña de: Ross, E., Filmish. Un viaje grafico por el cine (título original: Filmish. A Graphic Journey through Film), Barcelona, Reservoir Books, 2017.
Aromatherapy: Prophylactic and Therapeutic Approach to Diseases of the Respiratory System
Authors:   MSc. Pharmacist of the Clinical Research Group at Instituto de Ensino e Pesquisa Alberto Ferreira da Costa. ZIP Code: 52.010-075 – Recife, PE – Brazil1. PhD Pharmacist Professor of the Pharmacy Department at the Pernambuco Health College – FPS2
Published: September 2021

Infectious diseases are a significant public health challenge due to the increasing recognition of new infectious agents and the resurgence of infections until recently controlled. These infectious illnesses constitute many hospital admissions, mainly respiratory focus, which requires high-cost therapy. One of the strategies to prevent injuries leading to hospitalization is reducing the body’s inflammatory response. Thus, aromatherapy seems to be a useful adjuvant therapeutic tool due to the essential oils’ synergistic action with proven anti-inflammatory and antimicrobial properties. Hence, this study proposes an integrated review of the literature on aromatherapy as a tool to be used in prophylaxis and therapy in respiratory system disorders. After passing the criteria of exclusion and content analysis, a set of 124 articles narrowed to 44 articles that support the anti-inflammatory properties of the sesquiterpenes, such as the farnesol. This substance treats the respiratory system and is present in Cymbopogon nardus, Cymbopogon flexuosus, and Rosa damascena. Caryophyllene and its derivatives are present in Syzygium aromaticum, Rosmarinus officinalis, and Cannabis sativa. Besides, α-bisabolol and chamazulene present in Matricaria recutita and Achillea millefolium. Other oils have antibiotic properties that act against gram-positive and gram-negative bacterias according to their constitution’s complexity and interaction with these microorganisms. In this context, some species such as Cinnamomum zeylanicum, Citrus hystrix, Cymbopogon Citratus, Eucalyptus globulus, Eucalyptus odorata, Juniperus communis, Lavandula angustifólia, Lavandula intermedia, Melaleuca leucadendra, Mentha piperita, Pinus sylvestris, Syzygium aromaticum, and Thymus vulgaris are in the spotlight. Several studies, both in vitro and in vivo, have demonstrated the potential use of essential oils alone or combined with oils from other species as a strategy for the prevention of respiratory diseases and potentiation of standard therapies. This approach is possible due to the synergistic effects of substances with bioactive potential such as sesquiterpenes, monoterpenes, and phenylpropanoids.
Laparoscopic approach for pancreato-splenic abscess from disseminated melioidosis: Surgical outcome and review of literature
Authors:   Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore 529889.
Published: September 2021

Melioidosis is a severe systemic infection caused by Burkholderia pseudomallei. It commonly affects the lungs, liver and kidneys. Pancreatic and splenic abscess from melioidosis is rare, with few reports in the literature. We present a series of 4 patients with disseminated melioidosis of pancreas and spleen who required surgical intervention. A MEDLINE database review was conducted. Relevant publications were evaluated and demographic data, clinical, radiological findings as well as management options were collected. We found 10 case reports describing this clinical condition. In our series, median age was 57. Median operative time 260 minutes. All four patients failed trial of antibiotic therapy and required surgery. Three underwent distal pancreatosplenectomy and one underwent splenectomy alone. Laparoscopic distal pancreatosplenectomy was successful in two patients. Median length of stay 11.5 days. No post-operative complications and mortality reported. Surgery is indicated in failed medical therapy and laparoscopic approach is safe and feasible.
Isolated metastasis of hepatocellular carcinoma in the right atrium: a case observed in a university hospital in West Africa (Bouake, Ivory Coast)
Authors:   University hospital center of Bouake, Ivory Coast. University Alassane Ouattara, Medecine department
Published: September 2021

Intracardiac metastases from hepatocellular carcinoma (HCC) are rare and have a poor prognosis. We report an observation in a West African university hospital in a 39-year-old black patient admitted with upper gastrointestinal bleeding. Clinical examination noted signs of cirrhosis, namely hepatocellular failure, portal hypertension, melena and signs of right heart failure against a background of deterioration in general condition (WHO-3). The CT scan showed a focal hepatic lesion with arterial enhancement and portal lavage compatible with HCC and a right intracardiac mass taking contrast. Doppler echocardiography confirmed the presence of a large heterogeneous mass occupying almost the entire right atrium. Palliative and symptomatic treatment was instituted in the patient improving his clinical condition. His death occurred two months after his release. The intracardiac localization of HCC, although rare, is not exceptional and of appalling prognosis. It should be sought in the assessment of the extension of HCC, especially in the presence of signs of cardiac involvement.
El arcoíris de la disidencia. Novela gay en México
Authors: Robles Ruiz Alejandra
Published: September 2021

Este libro da cuenta de la incidencia de los imaginarios sociales de una época y espacio particulares —la de finales de la década de los setenta y principios de los ochenta en México— en las identidades de los sujetos homosexuales, que se desprende de un análisis e interpretación de tres de las novelas más significativas de la llamada literatura gay mexicana: El vampiro de la colonia Roma (1979), Utopía gay (1983) y Las púberes canéforas (1983). Partiendo de conceptos y categorías como “representaciones sociales” y habitus, que coadyuvan a la visibilización de dichos imaginarios, es posible que la autora profundice en las identidades de los protagonistas de estas obras; identidades, que como dice Gilberto Giménez: “no son más que el lado subjetivo (o, mejor, intersubjetivo) de la cultura, la cultura interiorizada en forma específica, distintiva y contrastiva por los actores sociales en relación con otros actores”. El resultado es esta investigación, que se ubica en los campos de los estudios y la crítica literarios, al mismo tiempo que se apoya en la perspectiva de género por la naturaleza de los textos que aborda.
Articulación biocultural : Un marco de referencia metodológica para estudios bioculturales
Authors: Céspedes Ochoa Elizabeth
Published: September 2021

En este estudio se afrontan y debaten planteamientos que pueden conducir a la aceptación o el rechazo de presupuestos en torno a las relaciones integradoras entre las ciencias sociales y las investigaciones del medio ambiente en un contexto de colaboración de todas las ciencias, las humanidades, la población y las agencias comprometidas. Este enfoque de los problemas socioambientales, la acción antrópica y la seguridad humana en la búsqueda de sustentabilidad se apoya en una amplia literatura científica relacionada con el tema, con un exquisito vaciado bibliográfico que orienta la evidencia con una estructura teórica estricta, acompañada con figuras, mapas, tablas y anexos. Además, el hilo narrativo permite seguir las reflexiones teóricas y metodológicas y dar un carácter problemático tanto a los presupuestos como a los resultados del estudio.
Un poeta olvidado de Tabasco, José Manuel Puig y Domínguez
Authors: Morales Bermúdez Jesús
Published: September 2021

Ofrezco, en las páginas a continuación, un conjunto de poemas hasta ahora dispersos de un poeta decimonónico de Tabasco. Me mueve a hacerlo cierto interés por reconocer la región del sur de México, de Centroamérica también, así sea de manera fragmentada, desde el campo de la literatura. Es claro, la poesía, como la música, la narrativa y las artes, son prácticas que nos hacen ser al tiempo que dicen cómo somos, ya fuere de manera ideal, conceptual, imaginaria.
CONSTRUCTED WETLANDS A COMPREHENSIVE REVIEW
Authors: Hadidi Luna Al
Published: September 2021

Constructed wetlands are wastewater treatment systems composed of one or more treatment cells in a building designed and constructed to provide wastewater treatment. Constructed wetlands are classified into two types: free water surface (FWS) wetlands (also known as surface flow wetlands) closely resemble natural wetlands in appearance because they contain aquatic plants that are rooted in a soil layer on the bottom of the wetland and water flows through the leaves and stems of plants. Subsurface flow wetlands (SSF) or known as a vegetated submerged bed (VSB) systems do not resemble natural wetlands because they have no standing water. They contain a bed of media (such as crushed rock, small stones, gravel, sand, or soil) that has been planted with aquatic plants. When properly designed and operated, wastewater stays beneath the surface of the media, flows in contact with the roots and rhizomes of the plants, and is not visible or available to wildlife. Constructed wetlands are an appropriate technology for areas where inexpensive land is generally available and skilled labor is less available. In this paper, a comprehensive review covered types, characteristics, design variation and considerations, limitations, and the advantages and disadvantages of constructed wetlands.
Tecnologia, corpo e educação física: entre a formação e a prática docente
Authors: Corrêa Evandro Antonio , Lima Deivide Telles de
Published: September 2021

ResumoEste ensaio visa refletir as relações entre a formação em Educação Física, o corpo em movimento e as tecnologias na educação escolar. Compreendemos que a Educação Física precisa compreender esse corpo e suas diferentes nuances face as tecnologias, as quais podem contribuir como ferramentas auxiliadoras no processo de emancipação dos seres humanos no sentido de se tornarem mais reflexivos, críticos e criativos. Com os avanços das tecnologias observamos mudanças rápidas na sociedade, e o mesmo com o corpo. Torna-se necessário o debate sobre as inter-relações que ocorrem na sociedade entre a tecnologia, corpo e educação como um processo histórico e contínuo de transformações que envolvem questões culturais, econômicas, políticas, sociais que tem (re)configurado a atuação do professor de Educação Física com “novos” saberes e competências no âmbito escolar.Palavras-chave: Educação Física. Corpo. Tecnologia. Educação.
Technology, body and physical education: between training and teaching practiceAbstractThis essay aims to reflect the relationship between training in Physical Education, the body in movement and technologies in school education. We understand that Physical Education needs to understand this body and its different nuances in the face of technologies, which can contribute as auxiliary tools in the emancipation process of human beings in order to become more reflective, critical and creative. With advances in technologies, we observe rapid changes in society, and the same with the body. It is necessary to debate the interrelationships that occur in society between technology, body and education as a historical and continuous process of transformations involving cultural, economic, political, social issues that have (re)configured the role of the Physical Education teacher with “new” knowledge and skills in the school environment.Keywords: Physical Education. Body. Technology. Education.
Tecnología, cuerpo y educación física: entre la formación y la práctica docenteResumenEste ensayo tiene como objetivo reflejar las relaciones entre la formación en Educación Física, el móvil y las tecnologías en la educación escolar. Entendemos que la Educación Física necesita comprender este cuerpo y sus diferentes matices de cara a las tecnologías, que pueden contribuir como herramientas auxiliares en el proceso de emancipación del ser humano para volverse más reflexivo, crítico y creativo. Con los avances de la tecnología observamos cambios rápidos en la sociedad, y lo mismo ocurre con el cuerpo. Es necesario debatir las interrelaciones que se dan en la sociedad entre tecnología, cuerpo y educación como un proceso histórico y continuo de transformaciones que involucran cuestiones culturales, económicas, políticas, sociales que han (re) configurado el rol del docente de Educación Física con “nuevos” saberes, competencias en el entorno escolar.Palabras clave: Educación Física. Cuerpo. Tecnología. Educación.
Phase and Amplitude Control Integrated Circuit in 0.18 μm SiGe BiCMOS for Sub-6 GHz Phased Array Applications
Authors: Filippov Ivan
Published: September 2021

This paper presents simulation results of the C-band transmit/receive (Tx/Rx) phased-arrays integrated circuit (IC) for sub-6 GHz communication links. It is based on 0.18 μm SiGe BiCMOS technology. Phase and amplitude control IC consists of one Tx/Rx channel. Digitally controlled phase shifter allows adjusting relative phase of the output microwave signal in the range from 0 to 360 degrees with 5.625 degree step (6-bit resolution). Digitally controlled active attenuator provides the transfer ratio adjusting in the range from 0 to –31 dB with 1 dB step (5 bit resolution). Amplitude and phase correction system based on integrated temperature sensor, auxiliary 4-bit phase shifter, 4-bit attenuator and digital control unit is implemented. Correction in –60—85 °C temperature range with 5-bit resolu-tion is provided. The root mean square (rms) phase adjustment error does not exceed 1.6 degree. The rms attenuation error does not exceed 0.37 dB. The noise figure in Rx mode is below 6.5 dB. The output power in Tx mode is above 6 dBm at P1dB. The power consumption is 375 mW and 525 mW in Rx and Tx modes respectively.
A Multi-Agent-Based Network-on-Chip Simulator
Authors: Lima Gustavo , Adamatti Diana , Brião Eduardo , Meinhardt Cristina , Mendizabal Odorico Machado
Published: September 2021

Integrated systems have incorporated a variety of functionalities within the same chip, requiring on-chip communication mainly based on the Network-on-Chip (NoC) design paradigm. Complex systems may impose strict requirements concerning performance, power and reliability. Thus, the choice of proper routing algorithms to the on-chip communication for NoCs merits special attention. To assist designers to adjust communication parameters, implement routing algorithms, and check system correctness, simulators become powerful and cost-effective solutions. This article explores Multi-Agent System to develop a high level abstraction NoC simulation environment. The simulator allows designers to evaluate routing algorithms, test alternative configurations and message formats. The simulation provides important measurementssuch as rate of utilization of routers, network contention and delay in sending messages. As a case study, the XY and WF routing algorithms were modeled and analyzed. Results highlight the pros and cons of each algorithm, and outline the simulator overall performance.
Evolutionary Algorithms in Approximate Computing: A Survey
Authors: Sekanina Lukas
Published: September 2021

In recent years, many design automation methods have been developed to routinely create approximate implementations of circuits and programs that show excellent trade-offs between the quality of output and required resources. This paper deals with evolutionary approximation as one of the popular approximation methods. The paper provides the first survey of evolutionary algorithm (EA)-based approaches applied in the context of approximate computing. The survey reveals that EAs are primarily applied as multi-objective optimizers. We propose to divide these approaches into two main classes: (i) parameter optimization in which the EA optimizes a vector of system parameters, and (ii) synthesis and optimization in which EA is responsible for determining the architecture and parameters of the resulting system. The evolutionary approximation has been applied at all levels of design abstraction and in many different applications. The neural architecture search enabling the automated hardware-aware design of approximate deep neural networks was identified as a newly emerging topic in this area.
A Survey on Domain-Specific Memory Architectures
Authors: Soldavini Stephanie , Pilato Christian
Published: September 2021

The never-ending demand for high performance and energy efficiency is pushing designers towards an increasing level of heterogeneity and specialization in modern computing systems. In such systems, creating efficient memory architectures is one of the major opportunities for optimizing modern workloads (e.g., computer vision, machine learning, graph analytics, etc.) that are extremely data-driven. However, designers demand proper design methods to tackle the increasing design complexity and address several new challenges, like the security and privacy of the data to be elaborated.This paper overviews the current trend for the design of domain-specific memory architectures. Domain-specific architectures are tailored for the given application domain, with the introduction of hardware accelerators and custom memory modules while maintaining a certain level of flexibility. We describe the major components, the common challenges, and the state-of-the-art design methodologies for building domain-specific memory architectures. We also discuss the most relevant research projects, providing a classification based on our main topics.
Developing Supplementary Teaching Speaking I Materials for Students of English Education Program of State Institute for Islamic Studies (IAIN) Bengkulu, Indonesia
Authors: Efrizal Dedi
Published: September 2021

Most of third semester students of English Education program of State Institute for Islamic Studies (IAIN) Bengkulu, Indonesia, encountered many problems in speaking activity. The main problem was there were not appropriate teaching English speaking materials yet that give big portion and opportunity for the students to speak actively and freely based on their contextual or daily experiences and background in order to support teaching and learning process of English speaking I. the objective of this research is developing a set of supplementary teaching English speaking materials for the students based Contextual Teaching and Learning. This research used Research and Development design with the procedures: conducting need assessment, developing supplementary materials, conducting expert validation, revising the materials, trying out the materials, and revising the materials. The researcher collected the data by using questionnaires, interview, analyzing the syllabus, and field note. The product of this research is four units of supplementary teaching English speaking I materials for third semester students of English Education program of State Institute for Islamic Studies Bengkulu, Indonesia.
A New Language Policy for Indonesia
Authors: Saputra Eko , Saputra Andri
Published: September 2021

Indonesia is the house of multicultural ethnic groups with more than 700 individual vernacular languages. This diversity puts Indonesia into both strategic and a vulnerable condition. It is strategic because the culture-rich Indonesia can commodify the diversity for the benefits of the people, however, it is also vulnerable as it can pose serious threats to the existence of the nation. For several decades, Indonesia has given attention to the language policy. Yet, the implementation still needs appropriate modification for the improvement. Objective of the paper: This paper is written on the purpose of giving a new form of language policy to be implemented in Indonesia. Theoretical Framework: A scheme of language policy is proposed for educational setting in Indonesia. Justification: Some arguments are also provided to provide a strong justification for the necessity of implementation of the policy. Conclusion: 1. It is imperative to have a language policy that can promote unity and prevent any potential separatism, provide a sense of belonging to the nations and ethnic culture in terms of nationalism, and open access to knowledge enhancement and the global world. 2. It is also important to have qualified and committing teachers to the implementation of language policy. If both points are present, the benefits of language policy can obviously be obtained.
Teachers and Students’ Perception toward Character Education in English Textbooks
Authors: Permana Dio Resta , Inderawati Rita , Vianty Machdalena
Published: September 2021

This study aimed at investigating how far teachers and students really understand the existence of character education in the curriculum, especially through the teaching and learning process in the classroom by using English textbooks as a medium. There were six teachers and six students who participated in this research. A semi-structured interview with a one-on-one interview was conducted in order to see the perspective of teachers and students about character education in their textbooks.  The study revealed that both teachers’ and students’ agreed that character education is essential in creating good individuals with noble characters to tackle moral degradation. Their understanding of character education in the textbooks they were using now was satisfactory. It can be seen through both teachers and students were aware of dealing with character values in the textbooks that embedded in the teaching and learning materials which can be presented both in form of implicit and explicit but they did not know about 18 character values proposed by the government yet.
English Language Teaching Strategy for ASD (Autism Spectrum Disorder) Students
Authors: Lasintia Mifta , Prihantoro Prihantoro , Edy Sarwo , Ariani Desti
Published: September 2021

This study aimed at investigating the realization of English language teaching strategies for Autism Spectrum Disorder (ASD) students, especially in terms of the implementation of teaching strategies. This study took place at SMPLB of Curup, Bengkulu, Indonesia. There was only one English teacher who taught ASD students, and the teacher was involved as the subject of this study. The data were garnered form interviews and document analysis. The data were further analyzed using an interactive model extending to data collection, data condensation, data display, and drawing conclusions. The results showed that the teacher used three strategies in teaching children with autism, namely developing oral language comprehension, echolalia, and communication skills enhancement through the PECS method. In addition, the teacher also modified the form of the strategy according to the needs of students with autism.
MALARIA
Authors: REHMAN ABDUL
Published: September 2021

Objective: To study the trend of malaria in this area from 2001 to2004. Material and Methods: It is a longitudinal study. The record of outdoor patients of Tehsil Hospital Liaqatpur andtheir PCD (Passive Case Detection) slides data from Malaria Control Programme Laboratory at Tehsil HeadquarterHospital Liaqatpur from 2001 to 2004 were collected and analyzed. Results: The annual parasite incidence (per 1000)from 2001 to 2004 was 9.8, 5.766, 1.97 and 0.99 respectively. The annual falciparum incidence from 2001 to 2004 was1.48, 1.27, 0.10 and 0.05 respectively. The slide positivity rate (%) from 2001 to 2004 was 17.11, 9.35, 5.76 and 5.74respectively while slide falciparum rate (%) from 2001 to 2004 was 2.59, 2.06, 0.297 and 0.307 respectively. Malariacases were noted throughout the year. Conclusion: There is gradual decrease in malaria from 2001 to 2004.
PERFORATED DUODENAL ULCER
Authors: KHAN MUHAMMAD SHOAIB , Malik Zaka Ullah , AWAN AFZAL SAEED , Mian Muhammad Aamir , VASEEM MUHAMMAD
Published: September 2021

Objective: Perforated duodenal ulcer is a common surgical emergency.Controversy exists regarding simple closure of perforation or definitive surgery in emergency setting. The objective ofthe study is to see the result of simple closure of perforated duodenal ulcer followed by eradication of H. Pylori in youngsoldiers. Design: Descriptive and analytical. Place and duration of study: This study was carried out at CMHKharian/CMH Rawalpindi between Jan 1998 to June 2002. Subject and method: Fifty three young soldiers presentingwith perforated duodenal ulcer were included in the study. They were treated with simple closure of perforation followedby eradication of H. Pylori. These patients were followed up in OPD for two years. Depending upon their symptoms theywere placed in different Visick grades. Result: Six patients (11.3%) were lost in followup and excluded from the study.Out of remaining forty seven patients thirty nine patients (82.5%) remained asymptomatic and did not require furthertreatment. Four patients (8.5%) required symptomatic treatment. Three patients (6.3%) required another course ofomeprazole. One of them (2.1%) required vagotomy and gastrojejunostomy for gastric outlet obstruction. Conclusion:It was concluded that simple closure of perforation with H. Pylori eradication is a simple and safe procedure to treat thisemergency.
WILSON DISEASE
Authors: AYESHA HINA , CHOUDHRY AAMIR ALI , BUTT MUHAMMED ASGHAR
Published: September 2021

Objectives: 1). To study the genotypic differences, if any, betweenPakistani children suffering from Wilson’s disease from those in the west and to correlate phenotype with genotype. 2).To find out the most frequent mutations present in our patients and screen out asymptomatic siblings of the index cases.Setting: Department of Pediatrics, Allied Hospital, Punjab Medical College, Faisalabad. Duration: May 1997 to June2005. Materials and methods: 41 patients ranging from 5-18 years were diagnosed based on clinical and laboratorydata. 13 patients and 6 asymptomatic siblings along with their parents were subjected to mutation analysis. at Universityof Vienna, Austria. Results: None of the patients had His1069Gln, the commonest European mutation. R969Q andI1102T detected in our patients have previously been described. Four novel mutations were found. Asymptomaticsiblings screened were either heterozygote or normal. R969Q appears to be associated with sub-acute liver diseasewith hepatosplenomegaly. I1102T was seen in children with chronic liver disease and L1071W, C1079Y and E583R-fs(insA) with early onset of neurological disease. Conclusion: Our Patients are phenotypicaly as well as genotypicalydifferent. Different genotype could be responsible for the phenotype. Further studies are needed with a larger samplesize so that molecular genetic tests be devised for early diagnosis and family screening.
CONGENITAL RUBELLA SYNDROME
Authors: HUSSAIN MISS NAGEEN
Published: September 2021

Rubella is a major public health problem which is usually a mild rashillness in children and adults. However, its seriousness and public health importance stems from the ability of Rubellavirus to cross the placental barrier and infect fetal tissue, which may result in congenital rubella syndrome. Themechanism by which Rubella virus causes fetal damage is not well understood. Congenital rubella syndrome is anunder-recognized public health problem in Pakistan and can be reduced by vaccinating all seronegative women
WEIGHT OF CALCANEUM AND TALUS FOR DETERMINATION OF SEX
Authors: AHMAD RIAZ , AHMAD IMRAN , KAUKAB NABILA
Published: September 2021

Introduction: Talus & Calcaneum are involved in the transmissionof body weight to the ground, considerable variation in the morphological features and weight of these bones havebeen reported by various authors. Objectives: To determine the importance of bone weight as a discriminative factorin identification of sex. Material and Method: 198 calcanei and 150 tali from Anatomy department of Quaid-e-AzamMedical College Bahawalpur were selected for the study. Mean weight of male & female bones on right & left side weredetermined. To increase the efficacy of the results they were statistically reevaluated by applying ±3SD anddetermining a calculated range. From this range, D.P. or demarcating points were established. Results: Bones of theright side were found to be heavier than those of the left side; also the mean weights of the male bones were greaterthan those of the female bones. On applying D.P.s it was possible to identify sex with greater accuracy than with othermetrical criteria. Conclusion: These findings suggest that weight of tarsal bones is a useful metrical feature for sexdetermination.
POLYTRAUMA
Authors: QURESHI MUHAMMAD AZHAR
Published: September 2021

Objective: To study the epidemiology of trauma and prognostic significanceof various trauma score systems. Design: A multi-center descriptive study Place and duration of study: The studywas conducted from July 1995 to March 2005 comprising almost 10 years in services hospitals of Lahore, Malir, Sialkot,and Mianwali. Patients and Methods: 271 patients of various age groups were studied. Cases were grouped as burns,head injuries and multisystem injuries and were managed according to Advance Trauma Life Support (ALTS) andparameters of various trauma scores recorded and compared with outcome. Results: Probability of survival ascalculated by TRISS methodology has better prognostic significance than various trauma score systems alone. Thestudy revealed low specificity in all types of injuries showing late deaths and unexpected complications. Revised TraumaScore and TRISS methodology were more accurate in multiple injuries than in burn and head injuries. Conclusion:Revised Trauma Score (RTS) is useful tool as triage and prognostic indicator for multiple injuries but not in cases ofburns and head injuries. We need to develop our own norms and coefficients for TRISS methodology and unexpectedoutcome should be minimized by sound clinical judgment. Moreover, we need radical improvement in burn care andneuro-surgical facilities in our country
MORBIDITY DATA ON HYPERTENSION
Authors: KHAN HAMZULLAH , HAFIZULLAH MOHAMMAD
Published: September 2021

Objectives: To find out morbidity data on hypertension, in a hospital basedstudy in Peshawar. Study Design: Prospective observational study. Duration: From march 2004 to July 2005. Setting:Cardiology Department of Lady Reading Hospital and Medical Department of Khyber Teaching Hospital Peshawar.Patients and Methods: A total of 718 patients with established diagnosis of associated complications of hypertensionwere included. Relevant information were recorded from the patients with the help of a pre-designed questionnaireprepared in accordance with the objectives of study. Results: A total of 718 patients were selected. Age ranged frompatients was from 25 to 92 years with mean age of 58.5 years were included. Out of 718 sampling 433 were femalesand 285 were males. Three hundred and eighty three patients had more than ten years duration of the disease. Thedistribution of associated complications of hypertension was: coronary artery disease (61.42%), left ventricularhypertrophy/left ventricular failure (19.63%), stroke (11%), retinopathies (3.62%), end stage renal disease (1.39%), andmultiple complications (2.50%). Conclusion: Hypertension is a major modified risk factor for coronary artery disease,stroke, eye abnormalities and end stage renal disease, which require proper counseling and management of patients.
TISSUE EXPANSION
Authors: AWWAL RAYHANA , KHUNDKAR SHAFQUAT HUSSAIN , JOARDER RUHUL HASSAN
Published: September 2021

Objective: To study the use of tissue expansion for reconstruction in various sitesof the body. Design :Retrospective study. Data source: Hospital records of plastic surgery dept of Dhaka Medicalcollege Hospital. Setting: Dhaka Medical College Hospital. Period:Jan2001-Dec2004. Materials and Methods:12patients with various amount of tissue loss undergone tissue expansion to cover the defect. Results: In this studysuccessful reconstruction was possible in 10 out of 12 cases. In 2 case expander had to be taken out .It was possibleto use expander in almost all sites of the body. Complication occurred in 7patients ,of which major complicationoccurred in 3 cases.
SURGERY FOR LOWER LID SENILE ECTROPION
Authors: QAMAR RAO MOHAMMAD RASHAD , Jones Carole A , AHAD MUHAMMAD A , Araian Tariq Mahmood , CHUA CHUNG N
Published: September 2021

Objectives: To compare the results of lateral tarsal strip procedure with fullthickness pentagonal lid resection in the correction of involutional ectropion. Material and Method: A retrospectivestudy of 102 patients who underwent surgery for senile ectropion of lower lid. All the patients underwent either lateraltarsal strip operation or full thickness pentagonal resection. On the basis of signs and site of ectropion, the patientswere divided into three main groups; 1) Medial ectropion, 2) General ectropion and 3) ectropion with chronic lid marginchanges. Success was defined as relief of symptoms and good lid position. Results: 69% of patients had lateral tarsalstrip and 31% of patients had full thickness pentagon resection. Overall success was achieved in 90% patients whounderwent lateral strip operation and in 91% patients with full thickness pentagonal lid resection. In patients with medialectropion the success rate was 87% in lateral tarsal strip procedure compared to 96% with full thickness lid resection.In general ectropion group, the success rate was 92.5% with lateral tarsal strip and 80% with full thickness lid resection.In patients with secondary lid margin changes the success rate was 74% in lateral tarsal strip procedure compared to87% with full thickness pentagon resection. Conclusion: Both lateral tarsal strip and pentagon resection are effectivein the treatment of senile lower lid ectropion,
RISK FACTORS OF DIASTOLIC HEART FAILURE
Authors: ALI LIAQAT , AZHAR MUHAMMAD , ABID ABDUL REHMAN
Published: September 2021

Background and objective: Isolated diastolicdysfunction /heart failure is the cause of congestive heart failure in 50% of patients with normal systolic function. Severalfactors have been shown to be predisposing conditions associated with the development of diastolic dysfunction anddiastolic heart failure. This study was designed to study the common and important factors leading to diastolicdysfunction of the heart. Study design: This was a descriptive analytic study. Place & Duration: This study wasconducted at Cardiology Department of Mayo Hospital Lahore from January 1998 to September 1998. Material andmethods: One hundred patients of diastolic heart failure who fulfilled our inclusion criteria were studied when theypresented to echo room for echocardiography. Detailed Echocardiography examination of all patients included in thisstudy was done to measure Doppler parameters of diastolic dysfunction like deceleration time, isovolumic relaxationtime, S & D wave measurements on pulmonary vein. Detailed history was taken and physical examination wasperformed to evaluate the risk factor associated with diastolic dysfunction in each patient. Results Mean age of thestudy population was 511 18 years. Majority of patients 50(50%) had age range from 36 to 55 years. There were62(62%) male and 38(38%) female patients. Majority of patients 34(34%) had NYHA class I symptoms and 30(30%)patients were in NYHA class II. Ejection fraction was normal in 54(54%) of patients while it was less than 40% in 24%of patients. Majority of patients, 28(28%) had Ischemic heart disease while 24(24%) patients had hypertension and14(14%) had diabetes mellitus. Hypertension and Ischemic heart disease were present in 14(14%) patients.Conclusion Approximately 40% - 50% of patients with or without overt clinical features of heart failure have isolateddiastolic dysfunction / DHF with normal systolic function. Coronary artery disease, arterial hypertension and diabetesmellitus are the major factors associated with diastolic dysfunction and DHF. Obesity and aging also contributeindependently to the development of diastolic dysfunction in a reasonable number of patients.
VESICO-VAGINAL FISTULA REPAIR
Authors: RASOOL MUMTAZ , MUMTAZ FARIHA , TABASSUM SHAFQAT ALI
Published: September 2021

Objectives: To evaluate outcome of surgical repair of VVF with transabdominal and transvaginalapproaches. Design of study: Prospective study. Setting: Depart of Urology Bahawal Victoria Hospital Bahawalpur.Period: Jan 1999 to Dec 2004. Materials & Methods: All consecutive patients with VVF irrespective of age andaetiology were included in this study. Patients with very large VVF and involvement of bladder neck were excluded.These patients were analysed for results of surgical repair by trans-abdominal and transvaginal approaches. ResultsThis study included 26 patients with age range between 20-48 years (mean age of 34 years). Etiology of VVF wasobserved to be transabdominal hysterectomy in 15 patients, transvaginal hysterectomy in one patient. While obstructedprolonged labour caused VVF in 10 patients. Transabdominal repair was done in 18 patients while 08 patients haveundergone transvaginal repair after investigations and evaluation. We achieved 94.45% success with transabdominalrepair of VVF while 100% success with transvaginal repair. Conclusions:The etiology of this disease is preventable.It is best to wait for at least 03 months after occurrence of VVF, so that inflammatory changes due to previous surgery/birth trauma may have settled completely before attempting at repair. Best resultrs are achieved at first attempt ofrepair. Both approaches of surgical repair of VVF have good results.
ELECTRO CONVULSIVE THERAPY
Authors: KHAN FARRUKH HAYAT , KHAN KHALID HAYAT
Published: September 2021

Objective: To compare the efficacy of ECT with those of pharmacologicaltreatment modalities, and to bring to light the continuing usefulness of ECT despite the availability of a number of newerand better medicines. Design: A prospective comparative study. Setting: Department of psychiatry, Combined MilitaryHospital Pano Aqil Cantt Period From Jan 2003 to March 2004. Subjects and Methods: Patients suffering from MajorDepression, Mania, Puerperal Psychosis, and Schizophrenia, were included in the study. Two groups were made. I.e.patients treated with medicines only (group I), and patients treated with ECT alone as first line therapy(Group II). Eachgroup comprised 50 patients. Patients belong to two groups were matched closely regarding their age, sex durationor illness, clinical picture and previous treatment etc. Response to treatment was judged with the help of HDRS in caseof depressed patients and clinically only in rest of the patients. Results of the treatment were recorded and comparisonmade for two groups. SPSS was utilized to obtain statistical significance. Results: ECT proved to be a superiortreatment in the achievement of quick remission, especially in those depressed patients with acute onset, psychomotorretardation, psychotic features, and severe disabling anxiety associated with primary illness. Very excited manicpatients quickly responded to ECT and calmed down. Catatonic Schizophrenics showed dramatic response, and sodid patients with puerperal Psychosis, in achieving early remission. Conclusion: In-spite of misinformation by media,and misconceptions in the minds of lay people, as well as, those related to medical profession, ECT remains a veryeffective and safe treatment even today. It should be used without hesitation wherever indicated. Limitations of presentstudy need improvement in future studies, in order to achieve more scientifically oriented results.
HOARSENESS OF VOICE
Authors: SAEED MUHAMMAD , MIAN FAROOQ AHMED
Published: September 2021

Objectives: To evaluate the etiology of hoarseness of voice. Design: Prospective Setting:Department of ENT Allied Hospital Faisalabad. Period: From Jan 2001 to Dec 2004. Material and Methods: Themajority of patients were admitted through ENT out patient department. The data was collected on the basis of historyphysical examination, investigations, management and follow up. Results: Total 200 patients suffering from hoarsenessof voice l50 males (75%) and 50 females (25%) between 10 to 70 years of age. The highest incidence was seen duringfourth and fifth decade of life (65%). The majority of patients were belonging to poor class (75%). The most commonetiological factor was infection (30%). Conclusion: Hoarseness is the commonest symptom of laryngeal disorders andit should not be ignored if it persists for more than three weeks and does not respond to conventional treatment, thiswill prevent delay in diagnosis and proper management.
EFFECTS OF VERAPAMIL ON CENTRAL & PERIPHERAL AIRWAY FUNCTION OF GUINEA PIGS
Authors: HASAN SYED SAUD , Turabi Aftab , SHAH SHAHEEN SHARAF , Salat Muhammad Yousuf , WAGAN MAHBOOB
Published: September 2021

Introduction: Calcium ions play an important patho-physiological role inallergic reactions. It is therefore likely, Ca++ antagonist, Verapamil may modify the allergic broncho-pulmunaryresponses. Isolated preparations were used to examine the direct action of the Verapamil on bronchial and pulmonarysmooth muscles. Material and Methods: The bronchial spirals and the lung parenchymal strips were prepared thatenabled the investigation of the action of agents on peripheral and central airways in the same species and comparethe responses. To observe the effects on ovalbumin sensitized guinea pigs bronchial and lung parenchymal tissue after10 minutes exposure of verapamil in different concentration and to evaluate the antagonistic / inhibitory effect onantigen induced contractile responses. Results: The data showed that inhibition of antigen induced response withverapamil was better in central airways than to peripheral airways smooth muscle. Conclusion: Concluded from thisstudy that verapamil can influence both central and peripheral airway function by modulating antigen induced bronchoconstriction;however, it leaves query regarding the importance of this activity in clinical set up.
CUTANEOUS BACTERIAL INFECTIONS
Authors: RASHID AJMAL , NAEEM MOHAMMAD A.
Published: September 2021

Objective: To find out causative pathogens and their frequency in study group in common cutaneousbacterial infection and determine antibacterial susceptibility pattern. Design: Samples were collected either by swabsfrom skin lesions or where required aspiration of tissue fluid followed by examination in the laboratory for identificationof organisms through culture on appropriate media and antimicrobial susceptibility testing. Setting: Department ofDermatology Military Hospital Rawalpindi. Subjects: Hundred patients irrespective of age and sex who had notreceived antibiotic in last 72 hours, with a clinical diagnosis of any common cutaneous bacterial infection were selectedirrespective of any coexisting cutaneous or systemic disease. Results: The data was compiled and statistical analysiswas done by using SPSS version 10. Isolated colonies of Staphylococcus aureus were found in 52% of the cases whileStreptococcus pyogenes was found as a pure growth in 18% of the cases. Mixed cultures of both these organisms werefound in 30% of the cases. Staphylococcus aureus resistance to Penicillin (97.5%), Erythromycin (37.8%),Cotrimoxazole (31.7%), Cephradine (30.4%) and Tetracycline (34.1%). Resistance against Cloxacillin (3.6%) andGentamicin (2.4%) was much less. Among 82 isolated Staphylococcus aureus three isolated (3.6%) were found to beMRSA (Methicillin Resistant Staphylococcus Aureus). Streptococcus pyogenes although found completely sensitiveto penicillins, showed resistance to Tetracycline (39.5%), Cotrimoxazole (31.2%) Erythromycin (27%) and Gentamicin(10.5%) Vancomycin sensitivity was shown by 100% of isolates. Conclusion: The comparison of this study withprevious studies indicates that problem of bacterial resistance amongst common cutaneous pathogens is increasing.The situation calls for creating awareness regarding dangers of indiscriminate use of antibiotics.