Review: Anaerobic Biotechnology for Industrial Wastewater Treatment

There has been the microbiological formation of methane since ages in many diverse habitats such as paddies, marshes, hot springs, benthic deposits, deep ocean trenches, pigs, trees, cattle, termites, iguanas and human beings. Anaerobic digestion has been proved as the most appropriate technique for the treatment of high strength organic effluents. This technique is more reliable and advanced as compared to the conventional water treatment procedures. It uses very less amount of chemicals and treats the wastes in a facile and effective manner and has been considered as an attractive option for effluents treatment. The anaerobic technology causes the decrease of high level of waste materials and different reactors were developed for this particular purpose. It generates best level of fuels used as biogas. The biogas produced in anaerobic digestion burns cleanly and the biogas plants make more energy than they consume to operate, whereas the energy produced by aerobic digestion is very much lower than that produced by anaerobic digestion

Free Cash Flow Impact on Firm’s Profitability: An Empirical Indication of Firms listed in KSE, Pakistan

This study determines the significance of free cash flows on the profitability of firms listed at the Karachi Stock Exchange. Descriptive statistics was used to analyze the impact of free cash flow on the profitability of firms listed at the KSE. The population consisted of 580 companies listed in KSE as on March 7th, 2015. Data were obtained from audited annual reports and financial statements of firms sourced from KSE for a period of five years (2010 –2014). Regression model was used to analyze the quantitative data.  Research indicates that free cash flow is significantly and positively correlated with profitability of firms on the basis of obtained data. This is evidence that free cash flow is a crucial prerequisite for a firm’s profitability. The study concludes that free cash flows enhance the firm performance but excess free cash flows create the agency problem due to this the conflict of interest increased between owner and management and because of such conflict firm performance decrease

Free Cash Flow Impact on Firm’s Profitability: An Empirical Indication of Firms listed in KSE, Pakistan

This study determines the significance of free cash flows on the profitability of firms listed at the Karachi Stock Exchange. Descriptive statistics was used to analyze the impact of free cash flow on the profitability of firms listed at the KSE. The population consisted of 580 companies listed in KSE as on March 7th, 2015. Data were obtained from audited annual reports and financial statements of firms sourced from KSE for a period of five years (2010 –2014). Regression model was used to analyze the quantitative data.  Research indicates that free cash flow is significantly and positively correlated with profitability of firms on the basis of obtained data. This is evidence that free cash flow is a crucial prerequisite for a firm’s profitability. The study concludes that free cash flows enhance the firm performance but excess free cash flows create the agency problem due to this the conflict of interest increased between owner and management and because of such conflict firm performance decrease

Daily Living Tasks Affected by Sensory and Motor Problems in Children with Autism Aged 5-12 Years

Background:Children with Autism Spectrum Disorder faces sensory and motor problems (Vestibular, proprioceptive, Tactile, Auditory and visual processing). Due to these problems, individuals faces difficulties in performing their daily task properly. Objective(s):The objective of this study was to determine how daily living (DL) tasks affected in children with  autism Spectrum disorder having sensory and motor problems aged 5-12 years. Methodology:The study conducted in Rehab care school for special children and Hamza Montessori School for special children. Data was collected by using purposing sampling technique in the duration of 4 months. Cross sectional study design was used. 60 patients from both genders were included. Sample selection criteria included the children with autism spectrum disorder with age range of 05-12 years. Sensory profile questionnaire based on Ayers sensory integration theory and Standardized Barthel index scale were used and the data was analyzed by SPSS to determine how daily living task are affected by sensory and motor problems. Results:The results showed that Tactile and auditory processing disorders were highly affecting the performance of the children. About 70% of these individuals were having problems in performing their daily living tasks. Conclusion(s):It was concluded that most of the children with autism spectrum disorder have sensory and motor problems. The performance in activities of daily living is affected by sensory and motor problems especially the tactile and auditory processing. Tactile processing shows that children have difficulty in performing activities like dressing, eating and toileting. Keywords: ASD, DL, Sensory and motor problems DOI: 10.7176/JHMN/92-02 Publication date:August 31st 202

Advantages of Smart Phone Hearing Aids Over Traditional Hearing Aids

Hearing is the process by which the ear transforms sound vibrations in the external environment into nerve impulses that are conveyed to the brain, where they are interpreted as sounds. A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. A hearing aid can help people hear more in both quiet and noisy situations. Objective: To find out the Advantages of smart phone hearing aids over traditional hearing aids. Keywords: Audiologist, Hearing Aids, Satisfaction with Amplification in Daily Life. DOI: 10.7176/JHMN/85-08 Publication date: January 31st 202

Sonographic Evaluation of Endometrial Thickness in Postmenopausal Women- A Systemic Review

Postmenopausal bleeding (PMB) is highly suspicious of being a sign for the presence of endometrial cancer (EC) and around 5–12% of PMB results from EC. Endometrial cancer is the most common gynecologic malignancy in developed countries. A thin endometrium (≤4 mm) has a very high negative predictive value (99%). A thickened endometrium has been regarded as an indication for an invasive evaluation. Endometrial sampling is recommended, with a cutoff value of 4 mm or 5 mm, for symptomatic postmenopausal women. However, different guidelines use different cut-off values of endometrial thickness, varying from 3 mm-5 mm, for excluding endometrial malignancy. The widespread use of sonography has also allowed the incidental finding of endometrial thickening in asymptomatic postmenopausal women. There are few data on the workup of these women, and the best cut-off value for the endometrial thickness that should warrant endometrial sampling is not known. However, it has been suggested that the 4‐ or 5‐mm limits generally used for excluding malignancy in symptomatic postmenopausal women are not transferable to asymptomatic patients. The objective of this study was to sonographic evaluation of endometrial thickness in postmenopausal women. About 9 studies were selected for this systemic review. We extracted the following information: Study design, Age of patient mean and range, Duration of menopause mean and range, Body mass index mean and range, and Endometrial thickness mean and range. From the above analysis we concluded that, the endometrial thickness with a recommended change in the cut-off to 3mm in routine ultrasound practice should be done in high risk women to detect malignancy earlier in postmenopausal women and ultrasound is proved to be a useful tool for the disgnostic purpose. Keywords: Postmenopausal bleeding, Endometrial  thickness, Endometrial Carcinoma. DOI: 10.7176/JHMN/82-04 Publication date: November 30th 202

Cognitive Impairments in Children with Down Syndrome

This study is designed to determine the cognitive impairments in individuals with Down syndrome. This study was conducted in September to November 2014. Sample of 30 patients was taken by using purposive sampling technique within three months. Observational and Cross-sectional study design was used. This was a hospital-based study in which patients with Down’s syndrome between the age range of 5-18 and both genders were included. A structured questionnaire was developed that was based on Piaget’s theory of cognitive development to assess the cognitive abilities by assessing tasks related to developmental ages. Out of those 30 patients 15(50٪) were male and 15(50٪) were females. Most of the patients were found in age range of 5-10 years according to frequency 16 (53.3٪) followed by 10 (33.3٪) patients in 10-15 years and 4 (13.3٪) in 15-20 years. The preoperational stage of cognitive development showed that the girls were more impaired. Pretend-play (boys (50%), girls(46.7%)),Centration(boys(40.%), girls(33.3%) and irreversibility boys (50%) girls(40.%) are the aspects in which boys were tending to show better than boys. In concrete operational stage and in formal operational stage both genders were tending to show equal impairments in their cognitive aspects. In the children with Down syndrome it is observed that there is high frequency of cognitive impairment and girls are more cognitively impaired than boys. While the tasks which require more accuracy and intelligence such as reasoning, meta-cognition, inductive and deductive reasoning are rarely present in both genders. Keywords: Down syndrome, pre-operational, concrete-operational and formal-operational. DOI: 10.7176/JHMN/71-12 Publication date: February 29th 202

Sonographic Evaluation of Chronic Kidney Disease Correlating with Serum Creatinine Level

Background: Chronic kidney disease is defined as abnormality of urinary system, there is persistent abnormality of structure and upward renal excretory function that is sign of irreversible damage to function of nephron. It is a public health problem world widely and it is 12th most common cause of mortality and morbidity, respectively. Objective: To evaluate chronic kidney disease (CKD) sonographically in addition correlating echogenicity with the level of serum creatinine. Study Design: An analytical Cross sectional prospective study. Settings: Life Care Hospital, Radiology department Lahore. Period: 20th December 2020 till 10th April 2021. Material & Methods: In our study all those patients with age above 18, patients suffering from chronic kidney disease, patient on hemodialysis, diabetic and hypertensive were included. While patient below 18 age, patients on peritoneal dialysis were excluded in which 71 patients were enrolled in the research. All the patient’s data had been composed from indoor of hospital, outdoor of hospital, and emergency department of Life Care Hospital, Lahore. After informed consent, data was composed through ultrasound machine Toshiba Xario Prime. Results: The findings revealed that there were 71 Chronic Renal Failure patients, 45 of whom were male and 26 of whom were female, with ages ranging from 20 to 73. Since the P value is > 0.05 of the relevance indicators, there is no important relationship between the two variables. Conclusion: The ideal sonographic parameter that can be used to correlate the level of serum creatinine with kidney parameter within ultrasound is kidney cortical echogenicity. As kidney cortical echogenicity does not reverses as the disease progress even after the treatment, so it is the most accurate parameter that can be used. Keywords: Chronic kidney disease, Echogenicity grade, Serum creatinine, Ultrasound, estimated Glomerular Filtration rate. DOI: 10.7176/JHMN/90-05 Publication date:June 30th 202

Evaluation of Ischemic and Hemorrhagic Stroke on Computed Tomography

The stroke is the 3rd leading cause of death in Pakistan, wherein back in 2009, stroke used to be the 4th leading cause of death in Pakistan, a 19.2% increase is alarming (IHME, 2019). Ischemic stroke occurs 75-80 percent of the time, while hemorrhagic stroke occurs 8-20 percent of the time. The objective of our study is to evaluate the frequency and ratio of ischemic and hemorrhagic stroke on computed tomography. A Descriptive study was performed using non-probability convenient sampling technique. The study was conducted in Lahore General Hospital, Lahore, Pakistan. The data was collected from November 15, 2020 to February 15, 2021. Informed consent was taken from all the participants. In our study patients with provisional diagnose of clot or thrombosis, History of Ischemic Stroke, History of Hemorrhagic Stroke, patients who came with clinical manifestation of stroke, traumatic or Road Traffic Accidents (RTA) patients, patients with cerebral Transient Ischemic Stroke. Arterial Puncture in Last 7 days, patients with Active bleeding, peroneal nerve injuryand patients who have been injected Botulinum Toxic Injection in last 3 months were included in our study. Patients who had a previous history of Parkinson disease, patients not having any apparent cause or chronic or acute symptoms of stroke, no history of internal bleeding, patients with chronic cerebral disease and patients with other neurological defects were excluded.A total of 85 patients with Stroke were included in our study. Most of the patients were 40 to 65 years of age. The average age of the patients was 59.5 ± 11.1 years. Out of 85 there were 38.8% (P=33) positive with H/O Infarction females (P=11) and males (P=22 ) 55 (62.5%) were males and 33 (37.5%) were females with 1.62: 1 male to female ratio as shown in Fig 5.2. Ischemic stroke was observed in 33 (36.2%) patients and 40 (47.3%) were suffered hemorrhagic stroke and 12 (14.4%) patients were affected with TIA.The conclusion to this study is that to assess early stroke with extreme clarity, computed tomography is the safest modality for evaluating stroke patients and allows radiologists to more accurately assess these patients on CT in terms of prognosis, frequency, morbidity, and legitimacy. Keywords: Stroke, Hemorrhagic Stroke, Ischemic Stroke, Cerebral Infarction, Computed Tomography DOI: 10.7176/JHMN/90-06 Publication date:June 30th 202