Water is a valuable compound for plants, animals, and humans. Various contaminating agents pollute it, with arsenic being one of them. Measurements of arsenic in potable water in Upper Sindh were conducted during this study. The samples were prepared by microwave-assisted digestion and analyzed by an atomic absorption spectrophotometer. A total of 240 potable water samples were collected from 8 Talukas of Upper Sindh. DMS coordinates were also recorded with the help of the Global Positioning System (GPS). The highest arsenic content of 50µg/L was observed in Garhi Khairo Taluka. The average arsenic content in water samples of all of the Talukas, except Miro Khan, was found higher than the WHO permissible limit. The 69.2% of samples were found to be contaminated by arsenic. Therefore, the water of the studied area is concluded to be in poor condition for cooking and drinking.

Background: The objective of this study conducted in a neonatal intensive care unit of a tertiary care hospital Larkana was to check the prevalence of respiratory distress in neonates and their morbidity and mortality associated with respiratory distress. Methods: A retrospective analysis of neonates with the respiratory distress syndrome during the period of one year was evaluated. The prevalence, risk factors related with respiratory distress syndrome were compared on the basis of neonatal and maternal factors. Results: The Majority of respiratory distress in our study, were due to Transient Tachypnea of newborn (TTN) 29.8%, RDS 22.1%, birth asphyxia 17%, and Meconium Aspiration Syndrome (MAS) 15.7%.  Overall outcome of Neonatal Respiratory Distress was cure rate in 65.4%, Neonatal mortality rate 26.84% with highest mortality due to RDS and Sepsis and the morbidity rate is 7.7%. Conclusion: The TTN was the most common cause of respiratory distress in neonates. Mortality rate was 26.84% and was highest among the neonates with respiratory distress syndrome.

Background: Diabetes ketoacidosis (DKA) is a common acute complication seen in patients with diabetes mellitus (DM) type 1. It is avoidable by following a good management plan. The risk factors that have been previously identified for DKA are female gender, age, illiteracy, low socio-economic status, infection, poor metabolism, psychological issues, and poor compliance with the treatment. Objective: The present study aims at the determination of age, gender, socio-economic status, DKA at the time of initial diagnosis of DM type 1, parental education regarding the disease, psychological issues, infection, metabolic control, and poor compliance with insulin treatment as the predictive factors of DKA occurrence. Study design: A retrospective cohort study Place and Duration: This study was conducted at GMMC Teaching Hospital Sukkur from November 2021 to November 2022 Methodology: The present study was conducted by using the medical records of patients with DM type 1. The mean age of the patients was 18.2±5.31 with a range of 0-21 years. The data were assessed for the predictive factors of DKA. The dependent variable in the study was DKA occurrence. The independent variables were, compliance with the treatment with insulin, DM type 1, age, infection, psychological issues, metabolic control, parental education, socio-economic status, and diagnosis of DM type 1 on a DKA attack. Logistic regression analysis was done the determination the factors that seemed to increase the incidence of DKA. Results: A total of 42 patients with DM type 1 were included in the study. The incidence of DKA was 27 (64.29%) and 4 (9.52%) of these patients died. Multivariate analysis showed that infection and diagnosis of DM type 1 at the time of DKA were the most significant predictive factors for DKA. Conclusion: Diagnosis of DM type 1 at the time of DKA and infection are the most important factors for increasing the incidence of DKA. Keywords: Diabetic ketoacidosis, type 1 diabetes mellitus, infection, predictive factors

The current study was carried out for quantitative and risk assessment of cadmium (Cd) and arsenic (As) from Talukas Ghora Bari and Mirpur Sakro. The concentration of Cd was determined using Atomic Absorption Spectroscopy instrument. The As concentration was measured with the help of the Arsenic Kit Method. For analysis of Cd, samples were prepared by the Microwave digestion method, whereas for As analysis, water samples were analyzed directly. The range of Cd content was observed from the studied areas as 1 – 10 μg/L and 1.2 – 11.2 μg/L, respectively. The groundwater water of Talukas Ghorabari and Mirpur Sakro showed the mean Cd content of 5 μg/L and 6.1 μg/L, respectively. The Cd contamination of 56% and 80% was found in Ghorabari and Mirpur Sakro, respectively. The range of As content of 0.00 – 50 μg/L and 10 – 80 μg/L was determined from Ghorabari and Mirpur Sakro, respectively. Hazard Quotient for Cd > 1 was found in 40% of both children and infants in the groundwater of the study area, which may cause non-carcinogenic risk. About 48% of water samples declared HQ values > 1 for adults in the water of Ghorabari. Since 84% of samples showed the HQ values > 1 for children and infants. The HQ values of As for Adults of the Mirpur Sakro were observed in 63.3% samples, whereas for children and infants, HQ values were found in 100% samples. It is therefore strongly recommended that groundwater must be treated before consumption by the people of the area under study.

Objective: To determine factors that facilitate and are barriers to self-monitoring of blood glucose in type 2 diabetic patients visiting family medicine clinics at a tertiary care teaching hospital Karachi Pakistan. Methods: Approximately 255 patients were consecutively recruited from the clinics during April 2018 to May 2019 at Family Medicine outpatient clinics at the Aga Khan University Hospital. Data on socio-demographic status, facilitators and barriers to SMBG were extracted through a questionnaire, after obtaining an informed written consent. Data was entered and analyzed in SPSS version 19. Results: Among study participants 47.5% were above 50 years and 51.4% were males. About 30.2% of the participants were practicing SMBG at least once a month and 26% were practicing it daily. Fear of complications was the biggest facilitator (80.1%) and being expensive (51.4%) was barrier for SMBG. Over half of the SMBG practicing participants (59.7%) were diagnosed with diabetes for more than 05 years (p: 0.63). Conclusion: Assessment of blood glucose is a critical component of diabetes treatment and management. It can motivate patients to become active participants in their own care. Health care providers should communicate and educate the patients about the advantages of SMBG.