This paper aims to offer a critical reading of the contemporary English author lan McEwans fifth novel entitled Black Dogs (1992). I postulate that literary critics have frequently read his fiction for what it is not. As such, McEwans thought-provoking engagement with cultural questions has more often than not gone unexamined owing to a critical blueprint that, reducing his oeuvre to the topoi of violence, or to a gallery of obnoxious characters branded as psychopaths, typecasts him as a writer of disturbing, salacious fiction. Arguing that McEwan writes to dissect and criticise contemporary culture, I offer a reading of his novel as a literary intervention into a cultural debate. I argue that of crucial importance in McEwans novel is the question of the narrative structure through which the different segments of Black Dogs are recounted. Drawing on the narratological concepts and terminology introduced in the works of Gerard Genette and Shlomith Rimmon-Kenan, I examine the complexities of the narrative discourses of McEwans novel and its interlinking thematic analogies. Based on this reading, I conclude that McEwans intervention in the ongoing cultural debates of today makes of him a severe critic of our time.

Sound is one of the forms of mechanical energy and the two main characteristics of sound are intensity or power and frequency or wavelength of sound.their performance against the incoming sound wave, industrial silencers can be divided into two general groups of resonating and absorption silencers, the main difference between these silencers is the release of sound energy from the channeling system, which is one of the common examples of the use of resonating type silencers, their use in It is the INTERNAL combustion engines that distinguish absorption silencers from the resonator type based on the fact that the main and visible part of the act of muting the sound is achieved by changing sound energy to heat energy.The goal of this article is to design a muffler based on the breaking of sound frequencies resulting from the movement of fluid in the exhaust output of vehicles, which leads to a reduction of at least 50 db of sound and gives the operator enough peace and concentration. In this article, after examining three types of mufflers, absorbent mufflers that use the properties of porous absorbent material to absorb passing sound and are the simplest form of mufflers, have been selected, analyzed and reviewed and are suitable for the OM457 engine of Idem Industrial Company. It designed for maximum inlet exhaust temperature is 520 and for the maximum kW power is 315 with the maximum discharge relative pressure of 185 mbar for homogenization with the standard atmosphere.

Purpose: To report a patient with MEWDS.Patient and findings: A 65-year-old man presented with sudden decrease of vision in his right eye. On ophthalmoscopy of the involved eye, numerous small discrete white lesions were detected superficially and deep in the retina around the disc and macula. On visual field examination, enlargement of the blind spot was detected. Fluorescein angiography was unremarkable. On electroretinography, the a-wave was decreased minimally. The patient was followed and after 2 months, significant improvement of visual acuity and visual field was observed.Conclusion: MEWDS is a rare intraocular inflammatory disease of unknown etiology and in contrast to our patient, more frequent in females. The natural course is generally benign with spontaneous disappearance of the lesions and improvement of vision in 6 to 8 weeks.

Purpose: To compare the anatomical and functional results of deep vitrectomy with and without ILM peeling for full thickness macular hole.Materials & Methods: 37 eyes of 37 patients with full thickness macular hole (FTMH), confirmed by clinical examination and optical coherence tomography (OCT), enrolled in this clinical trial. Based on the stage of FTMH (stage 2, 3, 4) as described by Gass and the techniques of surgery (with or without ILM peeling) the patients were randomized into two different groups. All patients underwent preoperative Act and at least one OCT image was obtained during the postoperative follow up.After obtaining informed consent, deep vitrectomy and 20% SF6 injection was performed. The patients were unaware of their allocation status. Patients data & surgical outcome were collected and statistically analyzed. Anatomical success was defined as hole closure at postoperative OCT and functional success was referred to any improvement in visual acuity. Macular hole index (MHI) was defined as a ratio of the greatest height to the base diameter of the hole on cross-sectional OCT images.Results: 37 eyes of 37 patients (15 men & 22 women) were enrolled. The mean age of the patients was 56.4±21.94 years and FTMH were traumatic in 13 cases (35%) and Idiopathic in 24 (65%) cases. Twenty cases underwent deep vitrectomy with ILM peeling (ILM group) and the remaining cases underwent vitrectomy without ILM peeling (no ILM group).The mean preoperative 10gMAR visual acuity was 1.38±1 in the ILM group and 1.22±0.13 in the no ILM group, these improved to 0.95±1 and 0.77±0.31 postoperatively in the ILM and no ILM group, respectively (P=0.871). The overall anatomical success rate was 64%. The hole was closed in 70% of ILM peeling and 47% in the no ILM group (Chi-square test, P=0.15). In anatomically successful cases the mean of postoperative VA was significantly improved (P=0.001).In traumatic subgroup, ILM peeling seems did not affect the anatomical (P=0.2) and visual Success rates (P=0.5). There was no significant differences in hole closure rates between the traumatic and idiopathic FTMH (P=0.968). Visual acuity significantly improved after operation In MHI ³ 0.5 group compared with the MHk 0.5 group. The stage of the hole did not affect the anatomical success rate (P=0.52) or visual acuity improvement (P=0.741). Macular hole index ³ 0.5 had a prognostic value for postoperative visual acuity improvement. The hole duration was not related to anatomical success rate but there is an inverse relation between duration of the symptoms and improvement in VA.Conclusion: Deep vitrectomy and SF6 injection was a safe & effective surgical technique for full thickness macular hole and peeling of the ILM seems did not affect the anatomical or functional success rates. The hole duration, stage and origin of the hole (traumatic or idiopathic) does not related to the anatomical success or visual acuity improvement. MHI  ³ 0.5 seems to be a prognostic factor for postoperative visual improvement but not for closure rate.

Background: Prognostic models have clinical appeal to aid therapeutic decision making. Two main practical challenges in development of such models are assessment of validity of models and imputation of missing data. In this study, importance of imputation of missing data and application of bootstrap technique in development, simplification, and assessment of INTERNAL validity of a prognostic model is highlighted.Methods: Overall, 310 breast cancer patients were recruited. Missing data were imputed 10 times. Then to deal with sensitivity of the model due to small changes in the data (INTERNAL validity), 100 bootstrap samples were drawn from each of 10 imputed data sets leading to 1000 samples. A Cox regression model was fitted to each of 1000 samples. Only variables retained in more than 50% of samples were used in development of final model.Results: Four variables retained significant in more than 50% (i.e.500 samples) of bootstrap samples; tumour size (91%), tumour grade (64%), history of benign breast disease (77%), and age at diagnosis (59%). Tumour size was the strongest predictor with inclusion frequency exceeding 90%. Number of deliveries was correlated with age at diagnosis (r=0.35, P<0.001). These two variables together retained significant in more than 90% of samples.Conclusion: We addressed two important methodological issues using a cohort of breast cancer patients. The algorithm combines MULTIPLE imputation of missing data and bootstrapping and has the potential to be applied in all kind of regression modelling exercises so as to address INTERNAL validity of models.