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To evaluate neurological changes developing during paediatric Acute Lymphoblastic Leukaemia (ALL) therapy clinically and through electrophysiological Study of Somatosensory Evoked Potentials (SSEPs) changes in different phases of therapy. Thirty five-ALL patients with age range from 3-14 years were included compared to 30 healthy controls. History, neurological examination, complete blood counts, cytological examination of bone marrow aspirate and cerebrospinal fluid with Measurement of Serum Methotrexate (MTX) were done. The SSEPs were performed and patients subjected to another SSEP with measurement of serum MTX level before and 10 days after intra-thecal injection (IMTX). Clinical neurological findings in patients after induction were depressed deep tendon reflexes (43.3%), hypotonia (28.6%), lost pain sensation (28.6%), muscle weakness (17.1%) and movement disorders (17.1%). Percentage of delayed SSEPs after induction were at levels of brachial plexus (28.6%), spinal cord (68.6%), cortical conduction (31.4%), ERB-N13 Inter Peak Latency (IPL) (74.3%) and N13-N20 IPL (17.1%) in the studied patients. Significant prolonged latency of N13 (p = 0.005), N20 (p = 0.04) and IPL of ERB-N 13 (p = 0.005), N13-N20 (p = 0.01), Inter-Side Difference (ISD) of N13 (p = 0.01), ERB-N13 (p = 0.02) and N13-N20 (p = 0.03) after induction compared to values at diagnosis. Significant positive correlation were found between serum MTX after IMTX with N13-N20 IPL (p = 0.01), N20 ISD (p = 0.03) with significant prolongation in N20 latency, N13-N20 IPL and ISD of N20 compared to values before injection. ALL patients have prolonged latency of SSEPs at cervical cord and cortical levels which increased after IMTX due to axonal injury throughout the cord. SSEPs could be an early diagnostic tool for subclinical neuropathy.

Background: Diabetic Nephropathy is one of the serious and life perilous complications of diabetes mellitus. Prolong duration of diabetes, no proper care and management, poor glycemic control in diabetic nephropathy can lead to End Stage Renal Disease (ESRD). Objective: To assess the relation of serum uric acid & micro albuminuria in the patients of diabetes mellitus for early detection of diabetic nephropathy. Methodology: This cross-sectional study was conducted in the Department of Medicine, LUMHS Jamshoro, with a total of 80 diabetic patients as case study subjects and 80 non-diabetic healthy participants as controls. Random glucose was measured using the gluco oxidase technique, and serum uric acid was measured using the uricase enzyme method in a calorimeter. Immunoterbidimetory kit technique was used to calculate microalbuminuria. Results: The mean value of random blood sugar (RBS) in the control group was 135 ± 10.11  mg/dl, but RBS in the case study group was 224 ± 13.52 mg/dl, indicating that RBS in the case study group was extremely significant (P < 0.001). The mean serum uric acid level in the control group was 4.7 ± 0.6 mg/dl, while it was 6.6 ± 1.4 mg/dl in the case study group, which is highly significant (P <0.001) with correlation (r= 0.34). Albumin in urine in the control group was 10 .2 ± 1.78 mg/gm, while it was 54± 10.34mg/gm in the case study group, which is a significant (P< 0.05) increase in the case study group with correlation (r= 0.28).  In diabetics, serum uric acid and microalbuminuria show a positive connection. Conclusion: This study concluded that there is strong positive relation of serum uric acid and micro albuminuria in diabetic patients for the early detection of diabetic nephropathy.