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Introduction The trend of prescribing VD preparations for nonspecific body aches and self-medication has increased significantly. The importance of vitamin D toxicity (VDT) has been underestimated and under recognized. This study was done to determine the frequency toxicity (>150 ng/ml) in subjects for 25-hydroxyvitamin D (25OHD) and evaluate the vitamin D (VD) supplements used by these subjects. Methodology This descriptive cross-sectional study was conducted at the Section of Chemical Pathology, Aga Khan University Hospital Karachi from April 2020 to March 2021. Subjects with 25OHD toxicity were contacted and information related to history of calcium and VD supplementation were collected. The statistical analysis was performed using the Microsoft Excel 2016. Results Over a year period 105398 subjects were tested for serum 25OHD, of which 0.34% (n = 364) subjects had 25OHD level of >150 ng/ml. After satisfying exclusion criteria 186 subjects (78 were <18 years of age and 108 were adults) were included in final analysis. All of these were using VD supplements and the main indications were delayed growth/short height (43.7%, n = 34) and aches or pains in (54.6%, n = 59) in pediatric and adult subjects respectively. Most of the subjects were taking supplements orally (74.1%, n = 138). Commonly prescribed preparation in adults and pediatric was 200,000 IU (70.4%, n = 76) and 400 IU (35.9%, n = 28) respectively. Most subjects took supplements for 1–3 months (68.3%, n = 127). Stated total supplementation ranged from 20,000 IU to 3600,000 IU in pediatric subjects and 200,000 IU to 96,00,000 IU in adults. Conclusions Supplementation is a leading cause of potential toxic levels of 25OHD. The condition can be prevented by careful use of VD supplements and consistent monitoring.

In this article, we propose a class of generalized exponential type estimators to estimate the finite population mean by using two auxiliary variables under non-response in simple random sampling. The proposed estimator under non-response in different situations has been studied and gives minimum mean square error as compared to all other considered estimators. Usual exponential ratio type estimator, exponential product type estimator and many more estimators are also identified from the proposed estimator. We use three real data sets to obtain the efficiencies of estimators.

In this paper, we propose an exponential cum ratio-product type class of estimators for population median under simple random sampling scheme using the supplementary variable. Expressions for bias and mean square error (MS E) are obtained up to first order of approximation. The proposed class of estimators is more efficient as compared to all considered estimators under certain conditions. Four real data sets and simulation studies are carried out to observe the performances of the estimators. Both numerical and simulation studies show that the proposed class of estimators performs better as compared to all considered estimators.

Objective: To assess impact of stringent Internal Quality Control (IQC) checks on performance of proficiency testing Material and methods: This was a Prospective study conducted between September 2020 and April 2021 at Chemical pathology lab of Fauji Foundation Hospital Rawalpindi. External quality control data (EQC) from the month of September was evaluated. As part of corrective action plan IQC checks were enforced, internal quality control (IQC) data of the month of September 2020 and April 2022 were assessed. Performance characteristics of routine chemistry analytes coefficient of variance (CV), standard deviations (SD)and Bias were calculated and compared using paired –T- test. Results:  Proficiency testing report (NEQAPP) of cycle 10 round 1 showed 11% External Quality Control (EQC) failure among 18 biochemical parameters. Serum Creatinine and Total Protein failed acceptability criteria with Z-score of greater than 2. As part of corrective action IQC checks were done, which led to improvement in CV (SD) of these parameters. The next EQC lab report for routine chemistry analytes met the acceptability criteria with z-scores of all anaytes being less than 2. Conclusion: Precise & accurate IQC results lead to better performance in EQC results

Introduction Reference intervals (RIs) of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are age, assay and population specific. Currently, the age and assay-specific RIs for TSH are not available for children under two years of age. This study aimed to establish reference intervals for serum concentrations of TSH and FT4 in healthy children aged 1–24 months as per CLSI C28-A3 guidelines. Methods This prospective cross-sectional study was conducted in children from 1 to 24 months visiting the clinical laboratory for serum vitamin D testing but without any recent illness, hospitalization, medication and history of maternal thyroid diseases from August 2018 to March 2019 were invited to participate in the study. Serum TSH and FT4 were measured on ADVIA Centaur (Siemens Diagnostics, US), using chemiluminescence immunoassay. Kolmogorov–Smirnov test assessed normality of the data and RIs based on central 95% of the population were established using the non-parametric approach. Results After excluding one subject with confirmed congenital hypothyroidism, a total of 131 children were included in the study. The median (IQR) age of the study subjects was 12 months (11), and majority 78 (59.5%) were boys. The RIs were established using non-parametric approach as the data was not normally distributed. Reference interval for TSH was 0.73–4.94 μIU/mL and for FT4 was 0.81–1.51 ng/dl. Conclusion We established assay-specific RIs for serum TSH and FT4 in children aged 1–24 months in our population. The RIs were slightly lower from RIs developed on other platforms in different population.