Objective: The most frequent type of nutrient shortage is Vitamin D deficiency, which affects about of half of the world’s population. Vitamin D deficiency responsible for numerous acute and chronic conditions not only in malnourished children but also in well-nourished children. Our objective was to determine vitamin D levels among malnourished and well-nourished school going children at district Tharparkar Pakistan. Design: Cross-sectional study Setting: This study was conducted in Mithi, District Tharparkar among school age-children (between 10-18 years). Vitamin D was estimated by Cobas e411 analyzer Roche (made in Japan). Results were descripted as mean ± SD. Students t test was used to find out the significant of results. A 0.05 or lower p -value was judged as meaningful. Results: 300 children were divided in malnourished and well-nourished groups. Vitamin D deficiency affected 74% of school age children. Boys accounted for 30% of the group, while girls made up 44%. We noticed that 4 girls had severe vitamin D deficiency. Conclusion: Vitamin D deficiency is more prevalent in school going children. Even well-nourished girls are more vitamin D deficit than boys. Children are seen as important members of society and are regarded as the country's future architects. As a result, investing in children's health is the most important factor in improving Pakistan's economic, political, and social conditions, because malnutrition has a significant impact on mental and physical inadequacy. Keywords: Vitamin D, Malnutirion, school going children

Major depressive disorder is a serious and disabling disease in world; it is a most common chronic and recurrent disorder with fourth cause of loss in disability in the worldwide. Objectives: To evaluate the efficacy and adverse effects of Paroxetine in major depressive disorder patients. Study Design: Open Labeled study. Setting: Department of Psychiatry, Chandka Medical College Hospital Larkano. Period: Three months (August to October 2019). Material & Methods: Total 40 patients of either sex were enrolled from OPD of Psychiatric department with age of 18 to 65 years. Follow-up visits were carried out fortnightly after making evaluation on symptoms at base line visit (day 0) continued till 90 days, and then results were compiled. The SPSS-16 version was used for the analysis of data. Results: Paroxetine is highly significant (p=0.001) to decrease the symptoms of depression during treatment of 90 days. Conclusion: In this study, Paroxetine is more effective drug to decrease the symptoms like, weight loss, sexual disturbance, insomnia and with less adverse effects in patients of major depressive disorder.

Introduction: Nutrition is a fundamental need of human. World hunger reached a historic high level with more than one billion people living with chronic hunger. Objective: The main objective of the proposed study was to identify the challenges of food and nutrition security. Methods: The study team conducted interviews in the respective UCs with the support of the field team and once the data was collected and analyzed. Results: The present finding indicated that the majority of the households were cleaning the water container/bottle and storage tank on a daily basis, twice in a week, and weekly while the majority washed their hands after defecation, similarly, after child cleaning, before preparing food, and before feeding. The significant 32% household that they gave children food/fluids within one month followed breastfeeding strictly. About 81% breast-feeding practice is strictly followed at the household level. 23% gave one meal to a child between the age group of 6-23 months, 22% two meals, 27% three meals, and 28% four meals. Data suggest that about 11% children faced issues during feeding practices, while a big number of 89% children did not face any feeding issues. About 95% PLWs who did not practice fasting habits and food restrictions. End line study, about 2 to 3% pregnant and lactating women eat additional food. Conclusion: There is a need to spread the message through media at the district and province levels and a need to engage multistakeholders, so the efforts are synergized to have a sustainable and long-term impact.

Aim: To compare the effect of various PPIs (Omeprazole Esomeprazole & Pantoprazole) with and without Inulin on renal functions and serum electrolytes in the rabbit model. Study Design: An experimental study was conducted by the Department of Pharmacology and Therapeutics, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh. Place and Duration: This study was completed in a duration of 6 months from 1st February 2021 to 31st July 2021. Methodology: Male and female rabbits weighting 1 to 3 Kilograms apparently healthy with no known illness were selected for the sample. In total 56 rabbits matching study eligibility criteria were included in the study and randomly divided into seven study groups each comprising of eight rabbits. Three groups were provided with three different PPIs i.e. Omeprazole, Esomeprazole and Pantoprazole while other three groups were provided with three different PPIs as well as inulin. However, the control group was only provided with placebo. Blood samples were collected at day 0 and at the end of 6th week. Serum electrolytes were analyzed for serum Magnesium, Calcium, Urea and Creatinine by using Cobas C-311 analyzer. Data was analyzed using SPSS version 19. Results: The study found no statistically significant differences in pre and post-intervention weight of rabbit in any of the experimental groups. The serum urea and creatinine levels showed considerable rise following intake of PPI, indicating a somewhat diminished efficiency of the kidneys to get rid of the body from excess urea and creatinine. However, the rise in urea and creatinine was statistically significant for Group A and Group C with rise in creatinine level following use of Omeprazole and Pantoprazole respectively (p-value <0.05).Electrolyte deficiencies were observed among all experimental groups. Groups that were treated with PPIs and inulin both showed much improved results as compared to rabbits which were treated with PPIs only. Practical Implications: Administration of PPIs along with inulin among human subjects to reduce the adverse effects; specially among critically ill patients or patients with compromised renal function human subject evidence needs to be established by conducting similar trials. This can be breakthrough in treatment protocols for gastritis and patients with renal disease who are also need to take PPIs for any medical indication. Conclusion: Proton Pump Inhibitors significantly change the normal electrolyte composition by increasing concentration of Serum Urea & Creatinine. However simultaneous inulin administration prevent most imbalances and possibly serves to reduce the adverse events associated with use of PPIs significantly. Keywords: Proton Pump Inhibitors, Inulin, Electrolytes,