Identification of hydrochemical fingerprints, quality and formation dynamics of groundwater in western high Himalayas.

Identifying hydrochemical fingerprints of groundwater is a challenge in areas with complex geological settings. This study takes the Gilgit-Baltistan, a complex geological area in west high Himalayas, Pakistan, as the study area to get insights into the hydrochemcial genesis and quality of groundwater in complex geological mountainous regions. A total of 53 samples were collected across the area to determine the hydrochemical characteristics and formation of groundwater. Results revealed groundwater there is characterized by slightly alkaline and soft fresh feature. Groundwater is dominated by the hydrochemical facies of HCO3·SO4-Ca·Mg type. The factor method yields three components (PCs) of principal component analysis, which together explain 75.71% of the total variances. The positive correlation of EC, TDS, Ca2+, SO42-, K+ in PC1, and NO3-, Cl- in PC2 indicate that a combination of natural and anthropogenic activities influences groundwater hydrochemistry. Water-rock interaction is the main mechanism governing the natural hydrochemistry of groundwater. The negative correlation of Cl-, SO42-, Ca2+, and Na+ with NDVI attributes to inorganic salt uptake by plant roots. Groundwater chemical composition is also affected by the type of land use. Groundwater is characterized as excellent and good water quality based on the entropy-weighted water quality index assessment, and is suitable for drinking purposes except for very few samples, while aqueous fluoride would pose potential health threats to water consumers in western high Himalayas, and infants are most at risk compared to other populations. This study will help to deepen the hydrochemial formation mechanism and exploitation suitability of groundwater resources in the mountainous areas that undergone the combined actions of nature and human activities, and provide insights into the characteristics of water environmental quality in western Himalayas area.

Comparative Analysis of Outcomes in Acute Organophosphate Poisoning With and Without N-acetyl Cysteine Intervention.

INTRODUCTION: Organophosphorus poisoning (OPP) stands as a significant health concern in numerous regions, especially in developing nations. Despite the rising complexities and case fatalities associated with exposure, the treatment approach has remained unchanged for many years. Based on clinical insights, certain pharmacologic agents have demonstrated utility in enhancing outcomes and reducing complications arising from this type of exposure. OBJECTIVES: The objective of this study is to compare the outcome of N-acetyl cysteine in the treatment of acute organophosphate poisoning cases. In terms of a) its impact on the requirement of atropine, b) Length of hospital stay, and mortality. METHODS: The study was conducted in the intensive care unit (ICU) of the General Hospital Lahore. Thirty patients with a history and clinical presentation indicative of acute organophosphorus poisoning were randomly divided into two groups in a 1:1 ratio. The treatment group received parenteral administration of atropine, pralidoxime, and N-acetylcysteine (NAC) as an adjuvant, and the control group received standard treatment for acute organophosphate (OP) toxicity. RESULT: Throughout the study duration, 30 patients suffering acute organophosphate (OP) toxicity (14 men, 16 women) were examined, with an age mean of (25.83±11.59) years. In the interventional group, only four patients required ICU admission, but in the control group, eight patients were admitted to ICU. The correlation result between the dose of atropine and length of hospital stays was not statistically significant between both study groups (<0.005). Plasma Cholinesterase (PChE) level (KU L-1) and total dose of Pralidoxime (g) were statistically significant in the length of hospital stay. The data was not normally distributed, so the non-parametric tests were applied. The Wilcoxon ranked test showed significant improvement in both the controlled and interventional groups because the p-value was (<0.005). Intergroup comparison analyzed by using the Mann-Whitney U test showed a significant reduction in the severity and other associated symptoms in the interventional group because the p-value was (0.001). CONCLUSION: The outcome demonstrated that the NAC group had a decreased demand for atropine rather than Pralidoxime. In the NAC group, the length of hospital stay and mortality was decreased. The administration of NAC to the present study procedure for acute organophosphate (OP) poisoning is suggested.