bluuebunny/crossref_metadata_2025 huggingface dataset:
Así Stan Lee como William Shakespeare
Authors: Madrid Brito Débora
Published: September 2021

Resumen: En los años noventa se produce un renovación generacional de cineastas que marcará distancias con sus predecesores. Destacan por la mezcla de referencias audiovisuales de todo tipo alejadas de la literatura, que había sido el modelo predominante hasta el momento y entre las que el cómic tiene una presencia relevante. Este artículo estudia los casos paradigmáticos de Álex de la Iglesia, Óscar Aibar y Javier Fesser analizando sus óperas primas en busca de aquellos elementos que evidencian en sus películas la relación con el ámbito de la historieta.

Abstract: A generational renovation is notable in 90’s Spanish cinema. The new filmmakers make use of a mixture of audiovisual references that move away from the literary model, which had been the main reference for the preceding generation. In this context, comic was one of those cultural manifestation that influenced on filmmaker’s storytelling way in this period. This paper proposes an analysis of the paradigmatic cases of Álex de la Iglesia, Óscar Aibar and Javier Fesser, whose first works show many features that evidence their intertextual relation with comic.
La amenaza de la máquina que habita en mí:
Authors: Martín Hernández Tomás
Published: September 2021

Resumen: Un cíborg es un ser humano mejorado mediante implantes, que si bien nació en la tecnociencia ha sido muy utilizado por la ficción. Mientras que en la realidad el cíborg representa la solución a algunos retos, en la ficción es representado como una amenaza. El cómic y el cine, en la mayoría de los casos, han proyectado una visión del cíborg como un ataque contra la normalidad. La ciencia ficción ha empleado al cíborg como un reflejo de nuestra ambigua relación con las máquinas. Pretendemos ser fieles a nuestro origen natural, pero la integración con la tecnología es cada vez más relevante en nuestras vidas.

Abstract: Cyborg is an implant-enhanced human being. Cyborgs originated in techno science, but have been widely used in science fiction. While cyborgs truly represent an advancement, they are mostly depicted in science fiction works as a threat. In most cases, comic books and films have projected an image of the cyborg as an affront to normality. In science fiction, a reflection of the ambiguous relationship between humans and machines is shown. We as humans wish to remain faithful to our natural inception, but integration with technology is ever more relevant in our lives.
De la escena a la viñeta:
Authors: Silvela Calvo Alejandro
Published: September 2021

Resumen: P. Craig Russell ha destacado, entre otras aportaciones, por su labor a la hora de realizar una larga serie de adaptaciones del mundo de la ópera a la viñeta. El estilo de Russell se caracteriza por partir de la idea de adaptar una obra musical a un medio plástico y visual haciendo que no solo se convierta en la simple narración de una ópera musical, sino que crea una obra en sí misma en la que intenta recoger diferentes sensaciones estilísticas, estructurales y estéticas de la obra y generar una representación de las mismas. En este artículo nos valdremos de su adaptación de Salomé, ópera de Richard Strauss de 1905 basada en la obra teatral homónima de Oscar Wilde. Se tratará la idea de musicalización del cómic y la forma en la que Russell plasma diferentes ideas musicales referentes no solo a timbres, leitmotiv u orquestación, sino atendiendo a diferentes parámetros que engloba la obra de Strauss, en torno a la idea de maximalización y decadencia del arte de finales del siglo XIX y principios del siglo XX.

Abstract: P. Craig Russell has stood out, among other contributions, for his work in making a long series of adaptations from the world of opera to comic. Russell's style is characterized by starting from the idea of adapting a musical work to a plastic and visual medium, making it not only become the simple narration of a musical opera, but also creates a work in itself in which he tries to collect different stylistic, structural and aesthetic sensations of the work and generate a representation of them. In this article we will use his adaptation of Salomé, an opera by Richard Strauss from 1905 based on the play of the same name by Oscar Wilde. The idea of musicalization of the comic will be discussed and the way in which Russell expresses different musical ideas referring not only to timbres, leitmotivs or orchestration, but also taking into account different parameters that encompass Strauss's work around the idea of maximalization and decadence of art from the end of the 19th century and the beginning of the 20th century.
Poesía gráfica
Authors: Trabado Cabado José Manuel
Published: September 2021

Reseña de: DEL REY CABERO, E. Y SÁEZ DE ADANA, F. (eds.), Dúplex. Poesía y cómic, Marmotilla, Alas Ediciones, 2019.
Más allá del sueño americano. Jóvenes migrantes retornados a Las Margaritas, Chiapas
Authors: Porraz Gómez Iván Francisco
Published: September 2021

La palabra retorno posee numerosas acepciones referidas al regreso, a desde dónde se partió, a regresar a una situación anterior o a volver atrás. Sin embargo, para algunos jóvenes migrantes retornados que intentan reconstruir sus biografías desde sus vivencias en Estados Unidos, el volver a casa no siempre significa "volver a uno mismo", a "mis costumbres" o "al punto de partida", pues es un hecho que ha marcado su presente. En este libro, Iván Francisco Porraz Gómez analiza la vida cotidiana de los jóvenes migrantes internacionales
La etnografía y la cuestión nacional en Centroamérica. Una aproximación
Authors: Medina Hernández Andrés
Published: September 2021

La intención de este trabajo es mostrar la importancia de la etnografía y de la historia para un mejor conocimiento de los pueblos indios, en este caso centrándonos en los del istmo centroamericano, y señalando la importancia de distinguir a los pueblos de las dos áreas comprendidas, y definidas por Paul Kirchhoff, Mesoamérica y Circuncaribe, cada una con diferentes características culturales, reflejadas en sus modos de vida, en sus tradiciones históricas y en sus reivindicaciones políticas. Este contraste entre las dos regiones culturales comprendidas se manifestó abiertamente en la lucha de los pueblos de la Costa Atlántica por la autonomía, por un lado, y en la del pueblo maya por su reconocimiento como una fuerza política nacional con sus respectivos derechos referidos a sus especificidades sociales y culturales, por el otro.
Política y democracia en Centroamérica y México. Ensayos reunidos
Authors: Álvarez Garro Laura , Gómez-Abarca Carlos de Jesús , Martínez Espinoza Manuel Ignacio , Méndez-Gómez Delmar Ulises , Nájera de León Emmanuel , Uc Pablo , Solís Cruz Jesús
Published: September 2021

Con frecuencia a la democracia se le carga de expectativas que no puede resolver, más si se trata de democracias formales, electorales, procedimentales, liberales. La potencia de la democracia no puede llegar tan lejos porque se teje en el marco de un sistema de relaciones capitalistas cuya naturaleza es injusta, excluyente, pauperizante, deshumanizadora. Más todavía cuando el Estado ha perdido su naturaleza social para convertirse en una palanca para el desarrollo del mercado capitalista. Ahora la democracia procedimental es funcional al régimen neoliberal, lo legitima en el juego de un proceso electoral en el que los partidos políticos ofrecen a los ciudadanos mejorar sus condiciones de vida, pero cuando llegan al poder no se cumplen las promesas porque ello implicaría afectar los intereses de los grupos de poder económico que aportan recursos financieros a las campañas. Los ensayos reunidos en este volumen muestran una serie de problemas emergentes, y otros más de carácter estructural que la democracia no ha podido solventar tanto para el caso de los países centroamericanos analizados, como para México, en especial para Chiapas, que es la puerta de entrada más grande de Centroamérica hacia el norte.
FISCAL CORRECTION OF REPORTING TAX PAYABLE TAXPAYER BASED ON GENERAL RATE OF CORPORATE INCOME TAX IN 2020 (CASE STUDY AT PT. KARMILA UTAMA SENTOSA)
Authors: Suprianto  , Sarifudin  , Agustiani Eka
Published: September 2021

ABSTRACT

       This study takes the title "Fiscal Correction of Reporting Tax Payable Taxpayer Based on General Rate of Corporate Income Tax in 2020 (Case Study at PT. Kamilia Utama Sentosa ). The aim is to analyze the fiscal correction and income tax payable in fulfilling the tax obligations of corporate taxpayers based on the 2020 Corporate Income Tax General Rate.

       This research was conducted at PT. Kamilia Utama Sentosa in Mataram with the application of the case method, namely the case at PT. Kamilia Utama Sentosa related to corporate taxpayer tax obligations referring to government regulations regarding general corporate income tax rates for 2020.

Fulfillment of Corporate Taxpayer Obligations PT. Kamilia Utama Sentosa for the 2020 fiscal year, namely the Fulfillment of Corporate Taxpayer Obligations related to the calculation, deposit, and reporting of the Annual SPT has been carried out in accordance with applicable regulations, namely the application of the Corporate Income Tax rate of 22%. The results of the fiscal correction show that there is a time difference in the calculation regarding the recognition of expenses according to the tax law. Positive correction according to fiscal, there is a difference of Rp. 13,674,428, - while the Taxable Income in the Profit/Loss report is Rp. 496,659,611, so that the income tax payable by the Taxable Entrepreneur (KPKP) who gets the facility (50 % x 22 % ) x Income Tax Those who get the facility, namely income tax payable amounting to Rp 34,062,397,- After deducting the total tax credit that has been deposited, the underpaid/overpaid income tax (PPh payable – Tax Credit) is Rp 34,062,397 – 61,917,344 = Rp 27,854. 947,- (overpaid income tax).        Overpayment of corporate income tax of PT. Kamilia Utama Sentosa can be requested back or refunded and or calculated in the 2021 tax year or the excess tax is returned to PT. Kamilia Utama Sentosa by submitting an application to the Directorate General of Taxes.
Algorithms for Access Point Selection at Pre-Routing Stage
Authors: Danigno Marcelo Freire , Fogaça Mateus , Monteiro Eder , Ferreira Jorge , Oliveira André , Reis Ricardo , Butzen Paulo
Published: September 2021

Pin accessibility has arisen as a major issue for detailed routing due to the increased number of design rules and higher pin density of modern technology nodes. The existing literature tackles this problem across many stages of the design flow: standard-cell layout, placement optimization and routing. In our present work, we cope with the pin accessibility challenge as a pre-processing step for detailed routing. We devise five techniques to find on-track locations in which the router can access I/O pins of standard cell instances without causing design rule violations (DRVs.) We provide the algorithm complexity analyses for each of our techniques. Some of our methods tackle the complexity of checking the design rules using pessimism (i.e., they are subject to false positives). We also study the cases in which our methods are overly pessimistic and ways to overcome pessimism. Finally, we validate our techniques using the 45 and 32 nanometer designs from the ISPD 2018 contest on initial detailed routing and show that our most robust technique can find DRV-free access points for more than 99\% of the pins of the test cases in less than 5 minutes.
Study of the UTBB BESOI Tunnel-FET working as a Dual-Technology Transistor
Authors: Mori Carlos Augusto Bergfeld , Agopian Paula Ghedini Der , Martino João Antonio
Published: September 2021

In this work, we further investigate the operation of the BESOI (Back-Enhanced Silicon-On Insulator) Dual-Technology FET, analyzing not only its behavior as a p-type Tunnel-FET when a negative back bias is applied to the struc-ture, but also as an nMOS when a positive back bias is ap-plied. The working principle is based on the generation of a channel of either holes or electrons by the back gate electric field, which can then be depleted through the front gate bias. TCAD device simulation was used for the proof of concept.
FinFET Inverter Designs: Behavior and Challenges of Process Variability
Authors: De Moraes Leonardo Barlette , Zimpeck Alexandra Lackmann , Minhardt Cristina , Reis Ricardo Augusto da Luz
Published: September 2021

Abstract— Technology scaling alongside the increasing process variability impact in modern technology nodes are themain reasons to control deviations over metrics in IC nanome-ter designs. Schmitt Triggers are traditionally used for noise immunity enhancement, and have been recently applied to mitigate radiation effects and process variability impact. The main contribution of this work is to trace the relationship between transistor sizing, supply voltage, and process variability to get a low energy consumption circuit while still keeping low levels of deviations due to the impact of process-induced variability. It is shown that a cost-benefit analysis can highlight sets of sizing and supply voltage where it can provide a 37.51% decrease in energy consumption while only increasing its sensibility by 7.42%. Furthermore, it is presented that the dependence of supply voltage and sensibility to process variability is not directly related, with slight decreases in the supply volt-ages bringing better results. Overall, the traditional CMOS inverter is still the fastest and most energy-efficient circuit, although, when comparing noise immunity characteristics, the 6-Transistor Schmitt Trigger presents higher noise margins, slopes, gains, and hysteresis ratios. The improvements,although, may increase propagation times, energy consumption, and area.
Exploring the CORDIC Algorithm and Clock-Gating for Power-Efficient Fast Fourier Transform Hardware Architectures
Authors: Sapper André , Paim Guilherme , Da Costa Eduardo Antônio César , Bampi Sergio
Published: September 2021

This work explores hardware-oriented optimizations for the CORDIC (COordinate Rotation Digital Computer) algorithm investigating the power-efficiency improvements employing N-point Fast Fourier Transform (FFT) hardware architectures. We introduced three hardware-oriented optimizations for the CORDIC: (a) improving the signal extension, (b) removing the angle accumulation and (c) eliminating the redundancies in the iterations, both unnecessary when processing the FFT processing. Fully sequential FFT architectures of 32, 64, 128, and 256 points were synthesized employing ST 65 nm standard cell libraries. The results show up to 38% of power savings on average when using our best CORDIC optimization proposal to the FFT architecture comparing to the explicit multiply-based butterfly version. Moreover, when combining our best CORDIC optimization with the clock-gating technique, the power savings rises to 78.5% on average for N-point FFT.
Virtualization of Programmable Forwarding Planes with P4VBox
Authors: Rodrigues Pablo , Saquetti Mateus , Bueno Guilherme , Cordeiro Weverton , Azambuja Jose
Published: September 2021

Networking virtualization has shown to enable faster service provioning and server as a main driver of innovation, from Software-Defined Networking (SDN) to Network Function Virtualization (NFV) and Local Area Networks (VLAN). Recent investigations began assessing the feasibility of virtualization in Programmable Data Planes (PDP). Despite the progress achieved, much work remains to assess their effectiveness for programmable virtual switches. In a prior work, we introduced P4VBox, an architecture for virtualization of programmable switches written using the P4 language. P4VBox provides the execution of multiple P4 based switch instances running in parallel, with the ability of hot-swapping through full and partial reconfiguration. In this work, we build upon P4VBox to provide novel insights, substantiated by experimental evaluation on a real-world testbed, on the evaluation of the real power of switch virtualization in a NetFPGASUME board, deploying three use cases. We measured resource utilization and performance to observe the behavior of P4VBox when handling large flows. Our results demonstrate that P4VBox incurs a small overhead compared with the canonical NetFPGA reference design. Yet, it increases orders of magnitude considering the existing works.
Effect of Substrate Bias and Temperature Variation in the Capacitive Coupling of SOI UTBB MOSFETs
Authors: Da Silva Everton Matheus , Doria Renan Trevisoli , Doria Rodrigo Trevisoli
Published: September 2021

In this work, the electrical features related to the capacitive coupling and temperature influence of the Ultra-Thin Body and Buried Oxide SOI MOSFET (UTBB) transistors are explored through numerical simulations. The impact of the substrate bias is observed for a set of values ranging from -3 V to 2 V for a temperature range between 100 K and 400 K. Also, structures with different types of ground plane (GP-P and GPN) and without GPhave been evaluated. This approach analyzes the capacitive coupling through the body factor and shows that the negative biasing for all GP types significantly improves the structure coupling and that the device with P-type ground plane has the lowest value of body factor for all the evaluated conditions. The dependence of the body factor on the temperature has shown to be negligible for longer devices. However, for devices shorter than 50 nm, the position of the maximum electrons concentration inside the silicon layer may affect the capacitive coupling.
The Impact of Spacer Oxide Material on the Underlapped SOI-nFinFET Working as Charged Based Radiation Sensor
Authors: Fonseca William da Silva , Agopian Paula Ghedini Der
Published: September 2021

In this work, the influence of the underlap region on the electrical behavior of a SOI-nFinFET transistor has been studied with the purpose of radiation sensing. The analysis was performed by evaluating the impact of variations in the underlap region on the on-state current and by studying its sensitivity. The impact of the underlap region on the drain current and, consequently, on the devices’ sensitivity was explained by the analysis of series resistance, the fringing field and electron density. Considering the main impact of radiation in these devices, the study of sensitivity was also performed taking into consideration the variation of oxide trapped charges density. When applying the transistor to a harsh environment, the Underlapped FinFET showed to be a quite respectable radiation sensor, since the results performed with very good sensitivities when using long and narrow spacer oxide with low permittivity oxide. With thicker spacer oxide in the underlap region, the charge concentration makes the spreading field high enough to overcome the series resistance effect, which results in a less sensible device. Once presented the on-state current variation of the Underlapped FinFET, the study turns radiation-sensing purpose applicable using the excellent characteristics of this device, which is shown in detail throughout this work.
A Survey on Microtransformers
Authors: Nascimento Fellype , Telles Antonio Carlos da Costa , Joanni Ednan , Teixeira Ricardo Cotrin
Published: September 2021

The miniaturization of magnetic devices is a subject of enduring interest, since inductors and transformers of very small dimensions are constantly being required for integration into microchips and electrical circuit boards. The main objective of this survey is to supply a compilation of the published research on microtransformers, and to work as a support material, helping in the choice of the most appropriate technology and device configuration for a particular application. The text describes the historical development of microtransformers, the structures in which these devices might be assembled, the various proposed geometries, the fabrication processes, and the type of core used. A brief discussion of equivalent circuit modeling is presented. The current state of the technology in relation to commercial devices is then examined, pointing out some unsolved problems that warrant further studies.
Programmable Data Planes meets In-Network Computing: A Review of the State of the Art and Prospective Directions
Authors: Reinehr Gobatto Leonardo , Rodrigues Pablo , Tirone Mateus Saquetti Pereira de Carvalho , Cordeiro Weverton Luis da Costa , Azambuja José Rodrigo Furlanetto
Published: September 2021

Improving network traffic in networks is one of the concerns between networking researchers and network operators since the architecture of modern networks still faces challenges to process large data traffic without the cost of consuming a significant amount of resources not related to computing specifically. On the other hand, network programmability has enabled the development of new applications and network services, from software-defined networking to domain-specific languages created to program network devices and specify their behavior. The development of programmable hardware and hardware accelerators like FPGAs, GPUs, and CPUs help this new paradigm go one step further. Use the artifact of programmability of these devices to solve problems, such as improve the processing of data traffic is the key of in-network computing. It offers the opportunity to execute programs typically running on end-hosts within programmable network devices already incorporated on the network, thus being capable of provides a reduction on the in-network processing load and requires no extra cost, since operations can be concluded using a fewer amount of devices of the network and no extra device are needed. In this paper, we survey in-network computing, as well as we suggest classifying related works to in-network computing according to the hardware accelerator used. Also, we discuss challenges and research directions.
The Effect of Skimming Method to Improve Students’ Ability in Reading Comprehension on Narrative Text.
Authors: Dhillon Bobby Pramjit Singh , Herman Herman , Syafryadin Syafryadin
Published: September 2021

This research deals with the effect of using skimming method in teaching reading comprehension  smk negeri 2 pematangsiantar on narrative text. The problem of this research are “what is the students’ ability in reading  without using skimming method at Grade XI students’ of SMK N.2 Pematangsiantar. What is the students’ ability in reading by using skimming method at Grade XI students’ of SMK N.2”. The purpose of this research are to find out the students’ ability in reading without using skimming method at grade XI students in SMK N 2 Pematangsiantar on reading narrative  text, to find out the the students ability in reading by using skimming method to the skill of grade XI students in SMK N 2 Pematangsiantar on reading narrative text. To answer the problem the researchers uses theories: Micklukey and Jefferies (2007), Grellet (2000), Milter (2001), Jhon and Dara (2005), David Nunan (1991), Douglas Newton (2000), Douglas Brown (2003), Rae Pica (2000), Roger Brown (1973), Ronald Carter (1998), Scoot Thornburry (2002), Wilga Rivers (1987), Diane Larsen (1990), Judi Willis (2008), Jack and Theodore (1986). The research design is a quantitative research. As an experimental research, it aims to know the effect of the technique that given and apply whether it influences to the object or no. In this research in collecting the data the researcher has to do three steps, they are pre-test, treatment, post-test. The researchers find out that the effect of using skimming method can increase the students’ skill in reading of narrative text. It can be proven from the test of students’ score in posttest of experimental class which the treatment the researchers did the treatment by using skimming method. By using skimming method, the students can increase their ability in reading of narrative text.
An English Proficiency Study on Students of Developing Islamic Higher Education
Authors: Rofik Abdur , Christina Christina , Hidayah Atinia
Published: September 2021

This is a case study that aims at analyzing students' English proficiency as reflected in students' TOEFL-Like scores at Universitas Sains Alqur'an Central Java in Wonosobo, Indonesia particularly years 2017, 2018, and 2019. The study focuses on students' achievement of English proficiency embedded in TOEFL-Like scores which consist of three sections, namely Listening, Structure and Written Expression, and comprehension of Reading. Considering the huge number of the data (2811 participants), to do the research, the data are conducted statistically using the SPSS application. In detail, the data were analyzed using descriptive statistics to find mean (to know students proficiency achievement), minimum, maximum and standard deviation values (to know the variance of students' English proficiency levels). Categorization of the proficiency levels is referred to Common European Framework of Reference for Languages (CEFR) standard. The study revealed that structure and written expression is the most difficult test faced then consecutively reading and listening. Then, the lowest and the highest scores were 217 and 567 with a standard deviation 31, 4. Furthermore, the mean of the total TOEFL-Like score achieved was 369, 09. Therefore, the students were mostly categorized as basic users (A2). The study suggests that an appropriate module can be considered to help the students to reach better proficiency, especially in a matter of structure and written expression section.
Motivating English Language Learners and Teachers in Indonesia
Authors: Khasbani Imam , Hidayat Didin Nuruddin
Published: September 2021

Motivation has been long believed to be an essential contributor to students’ success in learning English. Many studies (e.g., Gbollie & Keamu, 2017; Wang, 2008; Zhang & Xiao, 2006) have been dedicated to investigating the relationship between motivation and success in learning English. While these studies have contributed to shedding light on the importance of motivation on students’ achievement in learning English, insufficient research has been conducted to address the concept of motivation itself, how the concept has evolved since the first time it was developed, and to what extent motivation affects both teachers and students’ performances at school. Owing to this fact, the present article seeks to discuss the notion and conceptualization of motivation by following several steps. First, the present paper took on arguments from prominent figures on the field of motivation to explore the essence of motivation and why it is essential for English as second or foreign language (ESL/EFL) learning. The conversation then built on the current theoretical framework of types and factors influencing student and teacher motivation. Following that, a plethora of discussions on the possible ways to increase student and teacher enthusiasm and motivation inside EFL classrooms were elaborated.
Students’ Perception on Learning Language at the Graduate Program of English Education Amids the COVID 19 Pandemic
Authors: Yunita Wisma , Maisarah Ira
Published: September 2021

This research aims to determine students' perceptions on the implementation of the learning process during the Covid 19 pandemic at the graduate program of English Education of the University of Bengkulu. This research is a descriptive research involving students in academic year of 2019/2020 from two classes consisting of 34 students. The data was taken using a questionnaire in the form of Google form consisting of 40 questions with 5 answer options: strongly agree, agree, neutral, disagree, and strongly disagree and semi-structured written interview given through the Google Classroom application. The data obtained were analyzed quantitatively and qualitatively. The results of this research indicate that students have a positive perception of the implementation of the learning process during the Covid19 pandemic the the graduate program of English Education of university of Bengkulu with the averageobtained  score of 1211.25 which is in the good category. Moreover, the data obtained from the written interview showed that most students gave positive responses to online learning conducted at the graduate program of English education of the University of Bengkulu. These findings are expected to be taken into consideration to improve and prepare for the better future online and offline learning process at the University of Bengkulu, especially at the Graduate Program of English Education of the University of Bengkulu.
HYSTEROSALPINGOGRAPHY
Authors: NAILA USMA
Published: September 2021

Objective: To assess the diagnostic accuracy of Hysterosalpingographyin determining tubal patency in cases of sub fertility. Design: Prospective analytical study. Setting: Department ofGynaecology and obstetric Combined Military Hospital Multan in collaboration with Radiology department. Population:One hundred sub fertile women in their reproductive age having sub-fertility greater than 36 months or less than it, ifmaternal age was greater than thirty years or there was history of pelvic pain or abnormal pelvic findings. Period: May2003 – April 2004. Material & Methods: One hundred patients underwent Hysterosalpingography in follicular phasefollowed by laparoscopic chromopertubation in secretory phase in next cycle. Results: Hysterosalpingography andlaparoscopy were successfully performed in 100% of cases. Full concordant findings from two procedures wereobtained in 80% of cases for tubal blockade. Evaluation of clinical efficacy of Hysterosalpingography regarding tubalpatency showed a sensitivity of 91%, specificity 74.2% with positive predictive value 64.5% and negative predictivevalue 94%. On the other hand a low sensitivity of Hysterosalpingography was obtained regarding peri-tubal adhesions.Both the procedures were free of major complications. Incidence of minor complication was 17% for laparoscopy and18% for Hysterosalpingography. Conclusion: Because of high sensitivity, Positive Predictive Value and reasonablygood concordance rate of Hysterosalpingography with laparoscopy, it should remain an integral part of female subfertilitywork-up. Although it cannot replace laparoscopy but it can be used as first line screening investigation of tubalpatency irrespective of duration of sub-fertility.
VAGINOPLASTY
Authors: GANATRA MOHAMMAD ASHRAF , SHEIKH TAHIR , FAYYAZ GHULAM QADIR
Published: September 2021

Objectives: To assess the efficacy of amniotic membrane as a true coveringin vaginoplasty. Design: A prospective hospital based study. Setting: Department of Plastic Surgery Dow MedicalCollege & Civil Hospital Karachi and Punjab Medical College & Allied Hospital Faisalabad. Period: From 1997 to 2002.Subjects & Material: All patients selected for vaginoplasty surgery were explained every detail about the procedure.Amniotic membrane was obtained from caesarean section placentas, washed with solution of normal saline, crystallinepenicillin and sodium hypochlorite. A pocket was created between rectum and urinary bladder. Amniotic membranewas wrapped on vaseline bandage and inserted into neo vagina. First dressing was changed on 5th day andsubsequent dressings with amnion were done on 7th, 9th and 11th days. Results: Amnion was used in five patients.There was shrinkage of vaginal cavity in all these patients. Conclusion: Amniotic membrane should be avoided inreconstruction of vagina.
INCIDENCE OF ANGIOTENSIN CONVERTING ENZYME INHIBITOR INDUCED COUGH
Authors: AMIR MUHAMMAD , TAHIR MUHAMMAD , KHAN BADSHAH
Published: September 2021

Objective: The objective of our study was to assess the incidence of ACEinhibitor induced cough in our population. Study Design: Mainly prospective, multicenter, open labeled study of 500patients. Setting: Department of Medicine of Combined Military Hospital (CMH) Lahore and PNS SHIFA (NavalHospital) Karachi. Period February 2000 to February 2001. Material and Method: 500 Patients using eight differenttypes of ACE inhibitors were selected and an especially designed Performa was completed. In this study preferencewas given to patients to whom ACE inhibitors were prescribed for the first time. Patients with concomitant respiratorydiseases like chronic bronchitis, chronic obstructive airway disease and pulmonary tuberculosis were excluded. Patientswere followed up on fortnightly basis for six to eight months. On each visit besides recording their blood pressure theywere specifically inquired about occurrence of any cough. They were also requested to complete the coughquestionnaire. Results: A dry cough incidence with different ACE inhibitors was 12.8%, ranging from 6.8% withCaptopril to 17.3% with Enalapril. The dry cough was mild in the majority of our patients and they were willing tocontinue their ACE inhibitor, because their blood pressure was well controlled with it. Only a small percentage 3.6%discontinued ACE inhibitor due to severe bothersome, irritating cough. They switched over to other group ofantihypertensives mostly Angiotensin II antagonists. Incidence of cough was slightly more in females (14.3%) ascompared to males (12.0%). Conclusion: Although ACE inhibitors have a low incidence of adverse effects, a dry coughwas class effect occurring with all ACE inhibitors.
NEONATAL SEPSIS
Authors: WASEEM RIZWAN , KHAN MUHAMMAD , IZHAR TAHIRA S. , Qureshi Abdul Waheed
Published: September 2021

Objective: To find out the bacterial pathogens in neonatal sepsis and todetermine antimicrobial sensitivity patterns of these pathogens. Place and Duration: At the Neonatal Unit of GhurkiTrust Teaching Hospital Lahore, from February 2003 to December 2004. Design: It was an analytical comparativestudy, done in prospective fashion. Subjects and Methods: A total of 100 culture proven neonates of sepsis wereincluded. Clinical data including neonatal and maternal history, physical examination and laboratory data includingblood counts and cultures were recorded. The cases that have already been given antibiotics were excluded. Standarddisc-diffusion method was used to assess the sensitivity pattern for the antibiotics (ampicillin, gentamicin, cefotaxime,ceftazidime, amikacin and imipenem). Results: Out of total of 100 cases, 64 belonged to Early onset Sepsis (EOS)and 36 belonged to Late onset Sepsis (LOS). Gram negative organisms were isolated from more than 80% of thecases. E. Coli was the commonest isolate (n=34), followed by Klebsiella (n=30) and Pseudomonas (n=13), involvingboth early and late onset groups. No isolate of group B streptococci (GBS) was found. Out of 34 isolates ofE.Coli,14.70%(n=5),17.6%(n=6),41.17%(n=14),61.76%(n=21),79.4%(n=27) and 97.05%(n=33) were sensitive toampicillin, gentamicin, cefotaxime, amikacin, ceftazidime and imipenem respectively. Klebsiella and Pseudomonas alsoshowed a low sensitivity to ampicillin, gentamicin, and cefotaxime, while good sensitivity to amikacin, ceftazidime andimipenem. The mortality was significantly high (P<0.05) in low birth weight infants. Conclusion: Improvement inantenatal and natal services is mandatory to reduce incidence of neonatal sepsis and related mortality. Most of theorganisms are resistant to commonly used drugs. Surveillance is required on regular basis.
ACUTE MYOCARDIAL INFARCTION
Authors: MALIK ISHTIAQ AHMED , RAJA M KHALID , MAHMOOD KHALID
Published: September 2021

Acute myocardial infarction is still one of the major killers of mankind. Minute’Acute myocardial infarction is still one of the major killers of mankind. Minute’means muscles i.e earlier the management is started in the form of thrombolytic therapy, better is the prognosis. Forthis purpose researchers all over the world are striving hard to find the tests, which can be used in making the earlydiagnosis. Rapid Troponin-T test is a new addition to the better of tests. Design: A prospective study. Setting: InArmed Forces Institute of Cardiology. Period: From Jan 2004 to Jan 2005. To study the comparative efficacy of rapidtrop-T test verses conventional biochemical markers like creatine kinase MB (CK-MB) and Lactic Dehydrogenase(LDH). Material & Methods: Fifty patients of both sexes and all age groups fulfilling WHO criteria of new onset acutemyocardial infarction were included in the study. Rapid Trop-T test, CK-MB and LDH were performed on every patientat 0,2,4,6,12 and 24 hrs on day one, and daily from 2 to 7 days. Rapid Trop-T assay had almost same sensitivity &specificity as CK-MB in early hours after infarction and LDH in the next few days after infarction, this test has few clearadvantages of being easy to perform, requiring no special equipment and expertise, and can be a useful tests atperipheral hospitals lacking good laboratory setup.
LITTRE’S HERNIA
Authors: SHAHID NAEEM , IBRAHIM KHALID
Published: September 2021

Meckel’s diverticulumis the commonest congenital anomaly of thegastrointestinal tract, occurring in approximately 2% ofthe population. Most of the Meckel’s diverticula areentirely asymptomatic, which are incidentally discoveredduring autopsy, exploratory laparotomy, or bariumstudies. The clinical presentation of a Meckel’sdiverticulum can be gastrointestinal bleeding, intestinalobstruction or diverticulitis. Intestinal obstruction mayoccur as a result of a volvulus, intussusception, or, veryrarely, Littres hernia (incarceration of the Meckel’sdiverticulum in an inguinal hernia).
ANASTOMOTIC LEAK AFTER SMALL GUT SURGERY
Authors: LODHI FAISAL BILAL , SHAFIQ M , FAROOQ TARIQ , Hussain Riaz
Published: September 2021

Background: Anastomotic leak after gastrointestinal surgery is animportant postoperative event that leads to significant morbidity and mortality. Postoperative leak rates are frequentlyused as an indicator of the quality of surgical care provided. Objective:(1).To define factors associated with leakageof small gut anastomosis. (2) To find technique of small gut anastomosis associated with lowest risk of anastomoticdehiscence. Study Design: Retrospective, Descriptive Duration: 02 Years (May 2003 to May 2005) Material andMethods: This study was conducted at Surgical Unit-II, Allied Hospital, Punjab Medical College, Faisalabad from Dec2003 to May 2005. A total number of 36 cases were included in this study comprising of both adult male and femalepatients developing anastomotic dehiscence following resection and end to end anastomosis of small gut. Results:Peritonitis was the risk factor identified in 69% of the patients. Hypovolemic shock both preoperatively and in theimmediate postoperative period was noted in 56% cases while 83% of the patients with anastomotic dehiscence hadhaemoglobin concentration less than 10g%. High concentration of blood urea was noted in 42% of the cases. It turnedto normal as soon as the hypovolemia was corrected in these cases. Small gut anastomosis done in emergency setting(75% cases) was associated with increased risk of anastomotic dehiscence as compared to the dehiscence noted in09 cases (25%) operated on elective list. Three different techniques were used for small gut anastomosis. The rate ofanastomotic leakage ranged from 19-45%. Conclusion: Peritonitis, hypovolaemia and low hemoglobin alone or incombination are associated with increased risk of small gut anastomotic leakage especially after emergency surgery.Single layered extramucosal interrupted anastomosis was associated with less risk of dehiscence than the full thicknessand continuous extramucosal anastomosis.
POLYCYSTIC OVARIAN DISEASE
Authors: RAO SHAHID IRSHAD , KOKAB HINA , SADIQ RASHIDA
Published: September 2021

Introduction: Poly Cystic Ovarian Disease (PCOD) is probably one of the most commonendocrinological disorders amongst the women during their reproductive years. Using USG criteria only 20-33% ofapparently healthy women in childbearing period, have been found to have PCOD in population study. Whereasprevalence of 4-10% in women of reproductive age is commonly reported when the diagnosis is based on clinical,biochemical and US scan features. Objective:-Diagnosis and management of polycystic ovarian disease. Setting SeyalMedical Centre, Multan. Duration From January 2002 to December 2003. Material and Methods: Sample size: 200patients. Results: Most of he patients were in the age group of 21-30 years. The youngest patient was of 17 years andeldest was of 42 years. Majority of the women were nulliparous or of low parity comprising 92% of cases. Thecommonest symptom was menstrual disorder in 168 Patients (84%). Ultrasound is very helpful for diagnosis of POD.About 80% of patients were diagnosed as PCOD on ultrasound. There is increased level of LH in 72% patients, 8%have raised prolactin levels. All patients were first treated with clomiphene citrate while surgical treatment is done inonly 30% of cases. GnRH analogue and purified FSH were not used because they are quite expensive. Conclusion:PCOD is found to be one of the commonest problem in reproductive years of life. Clomiphene citrate is first linetreatment in PCOD for infertility. Laparoscopic drilling has very good results especially in clomiphene resistant cases.
SPONTANEOUS BACTERIAL PERITONITIS
Authors: IMRAN MUHAMMAD , Rashid Haroon-ur- , HASHMI SHOAIB NAIYAR , Hussain Assawar , ALTAF ASHFAQ
Published: September 2021

Objective: To evaluate the prevalence, diagnostic criteria and microbialspectrum of spontaneous bacterial peritonitis (SBP) and its variants in cirrhotic patients with ascites. Design: A hospitalbased prospective study carried out in cirrhotic patients with ascites. Place and duration of Study: The study wasconducted in the Department of Medicine Military Hospital Rawalpindi during October 2000 to March 2002. Subjectand Methods: One hundred and eighty consecutive patients of cirrhotic liver between the ages of 20-65 yearspresenting with ascites reporting to outdoor patient department of Military Hospital Rawalpindi were included in thestudy. The diagnosis of cirrhosis was made on history, clinical examination and the ultrasonographic findings. Thesepatients were subjected to ascites fluid tap and the patients were divided into SBP and non-SBP groups in the light ofresults of ascitic fluid routine examination and culture. The SBP group was further categorized into culture positive SBP,culture negative neutrocytic ascites (CNNA) and bacterascites (BA) on the basis of culture results and total leukocytecount, absolute polymorphonuclear leukocyte count per cubic mm of ascitic fluid. Results: The study included 144males and 36 females having cirrhosis with ascites. The mean age of these patients was 52.32±7.87 years. On thebasis of routine examination and culture of tapped ascitic fluid from these cases 57 of 180(31.66%) patients werediagnosed to have SBP or its variants. In addition to classic SBP in 18(31.58%) patients, its variants namely culturenegative neutrocytic ascites and bacterascites were detected in 37(64.92%) and two (3.5%) cases respectively. E. coliwas the most frequently cultured organism. It was isolated in 12 cases of SBP (60%). In 4 cases (20%) Klebsiella wascultured whereas Proteus mirabilus and Streptococcus were reported in two cases (10%) each. Conclusion: This studyindicates that spontaneous bacterial peritonitis is common and potentially fatal complication in cirrhotic patients withascites. E. coli is the most frequent offending organism.
CU-375 (MULTILOAD)
Authors: SIDDIQA AISHA , MASOOM KAUSAR
Published: September 2021

Objectives: To study the complications associated with the use of multi-load CU375 and reasonsfor discontinuing its use. Design: Descriptive Study. Place and duration of study: From 10th January 2002 to 10thJanuary 2004. Private Clinic: Saleem Medical Complex Quetta. Patients & Methods: The study populationincluded 100 women aged 22 – 35 years requiring contraception in the form of multi-load CU 375. Patients and insome cases their husbands were counseled and selected according to a pre-set proforma. Results: Out of 100patients the mean age of the acceptors was 30 years and mean parity was 4. Insertion of the device was very easy,main complications were disturbed menstrual cycle, heavy menstrual bleeding experienced by 40%, inter-menstrualspotting by 8% and continuous vaginal bleeding by 3%, 2% of the patients had gestational ammenorrhea of 8 &12weeks. Vaginal discharge was complained of by 10%. There were two expulsions and 7 removals, reasons forremoval were metrorrhagia, menorrhagia, pain and spotting in most cases. There were no cases of perforation orectopic pregnancy. Conclusion: It was concluded that multi-load CU 375 is an effective contraceptive device withmenstrual irregularities and pelvic inflammatory disease being the main complications and principle causes forremoval of IUCD.
FULL TERM SECONDARY ABDOMINAL PREGNANCY
Authors: FARHAT RAHILA , ROOHI DR. MAHNAAZ
Published: September 2021

In properly evaluated patients full term abdominal pregnancy can be managed, although advancedabdominal pregnancy is a complex condition demanding challenging management. This care report describes caseof a young lady 35 years age who was diagnosed as a case of secondary abdominal pregnancy and was managedsuccessfully.
PULSE OXIMETRY
Authors: CHOHEDRI ABDUL-HAMEED , DAHGHANI MOHSEN
Published: September 2021

Background/Aim: Pulse oximetry has emerged as a clinical tool inanesthesia and is becoming popular in developing countries. Unfortunately, its use is usually not accompanied byappropriate staff training. The aim of this study was to evaluate the knowledge about pulse oximetry among the 7th yearmedical student Interns (MS) and nursing staff (NS) of Intensive Care Unit (ICU), Coronary Care Unit (CCU) andRecovery Room (RR) of four medical-school affiliated hospitals in Shiraz, Iran. Study Period: Feb 2001- Feb 2002Materials and Methods: A 14-item questionnaire (4 demographic and 10 knowledge), multiple-choice and open ended,was developed to assess knowledge of pulse oximetry. Among 150 7th year medical students and 200 nursing staff,40 from each group was randomly selected and invited to complete the questionnaire. Results: A 100% response ratewas achieved. All of the participants used pulse oximetry regularly in their daily work. The mean test scores for MS andNS were 60.5 ± 21 and 49 ± 17%, respectively (p < 0.05). None of the participants had adequate training in the useof pulse oximetry. Conclusion: Our study revealed that medical students and staff nurses were untrained in pulseoximetry, lacked knowledge of basic principles, and made serious errors in interpretation of readings. Therefore, werecommend that medical schools and nurse training programs place emphasis on teaching the principles andapplications of pulse oximetry and the oxyhemoglobin dissociation curve.
PHYLLOIDES TUMOUR
Authors: WADOOD AHSAN UL , Mirza Jamil Ahmed , BARI ABDUL , Masud Khawaja Usman , QASIM KHAWAJA FAROOQ
Published: September 2021

Phylloides tumour is a raretumour of breast. Its incidence being less than 1% ofmalignant breast tumours1. The term of phylloides wascoined by Johanes Muller2 due to leaf like cleft spaceson sectional surface. The age incidence is similar as ofbreast carcinoma, the median age is 45 years, althoughit can present at any age. It is a peculiar tumour that hascharacteristic pathological features. Grossly the size oftumour varies. Typical phylloides tumours are roundrelatively well circumscribed and firm, many are largeand may acquire huge dimensions2. Its sectional surfaceis solid with cleft like spaces imparting leaf likemacroscopic appearance3. Microscopically the twofeatures of phylloides tumour are stromal hypercellularityand presence of benign glandular component4.Seven cases of phylloides tumour are discussed withtheir pathological features and clinical significance ishighlighted.