Rising summer temperatures pose significant challenges to healthcare systems, particularly in low-resource settings. This article examines the impact of heatwaves on government sector tertiary care emergency centers in Karachi, Pakistan and addresses the alarming increases in heatstroke cases and associated mortality during extreme heat events. The study signifies the urgent need for adaptive measures to enhance emergency preparedness, public awareness, and heat mitigation strategies. Addressing heat-related illnesses requires collaborative efforts from healthcare providers, policymakers, and community leaders. Effective interventions can mitigate the impact of rising temperatures on vulnerable populations and reduce heat-associated mortality.

Euglycemic diabetic ketoacidosis (euDKA) is an uncommon but potentially life‐threatening complication that may arise in patients treated with incretin‐based therapies or Sodium–Glucose Cotransporter‐2 (SGLT2) inhibitors. We report a 41‐year‐old female with Type 1 Diabetes Mellitus (T1DM) who developed severe euDKA after initiating tirzepatide for weight loss while on empagliflozin and basal–bolus insulin therapy. She presented with severe vomiting and profound metabolic acidosis (pH 6.96, bicarbonate 1.5 mmol/L) despite only modest hyperglycemia (glucose 190–200 mg/dL). The severity of acidosis necessitated intubation and intravenous bicarbonate therapy. Laboratory findings revealed elevated amylase (688 U/L), suggesting possible tirzepatide‐associated pancreatic stress. No infection or other precipitating factor was identified. The patient recovered after intensive insulin and fluid replacement. This case highlights the risk of severe euDKA with the administration of tirzepatide in T1DM, particularly in combination with an SGLT2 inhibitor. Clinicians should keep a high index of suspicion for ketoacidosis in such patients despite normal or mildly elevated glucose levels and inform them of early detection of symptoms and sick day management.

Background: This report presents a unique case of subacute BCS in a patient with systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and multiple inherited thrombophilic disorders No previous history and lack of inciting events meant extensive investigation had to be done to figure out the underlying pathology. The amalgam of thrombophilias presenting initially as Sub-Acute Budd Chiari syndrome is very rare to find in the literature and highlights the importance of early screening and diagnosis to prevent complications of Thrombosis. Case Presentation: The patient presented with a 3 months history of progressive abdominal distension, hematemesis, and altered consciousness. The diagnosis made was Sub-Acute Budd Chiari Syndrome. The patient was managed with anticoagulation, diuretics, and symptomatic treatment. After stabilization the patient was discharged for follow-up after 2 weeks. Conclusion and Key Take-Away Lessons: This case highlights the diagnostic challenges of BCS, particularly in patients with hereditary hypercoagulability. Early recognition and management are critical in preventing severe complications of thrombosis. Moreover, it underscores the impact of limited healthcare access in rural settings, emphasizing the need for improved screening, awareness, and targeted interventions for thrombophilic disorders with a set diagnostic criteria for sub-acute presentation.

In light of growing cases of aortic stenosis and aortic regurgitation secondary to degenerative calcific aortic valve disease from increasing population aging, the burden of valvular heart disease is only increasing. Third-world countries still need to catch up to modern practices and continue to perform surgical aortic valve replacement in high risk patients. Current guidelines backed by significant research recommend Trans Catheter Aortic Valve Replacement (TAVR) in high-risk patients. However, resource constrained countries struggle to keep up with the cost and training requirements. This mini-review sheds light on the barriers to TAVR in third-world countries and provides future recommendations to optimize its integration into standard care.