Background: The photocopying occupation contributes to various health issues in workers. Elevated levels of oxidative stress have been found to be associated with respiratory problems in occupational workers. The intention of the current research is to evaluate the association between the pulmonary function parameters, a biomarker of oxidative stress, and the photocopying occupation in Lahore, Pakistan. Material and Methods: The study was performed on a group of photocopying operators (N = 100) and a control group (N = 100). A structured questionnaire was developed to gather the demographic attributes. Lung function testing was done with the spirometer. The blood lipid peroxides level, as thiobarbituric acid reactive substances (TBARS), was assessed spectrophotometrically. Results: A statistically significant reduction was found in the pulmonary function parameters as compared to the control group. In the study group, the prevalence of respiratory symptoms, including cough (31%), sneezing (18%), wheezing (9%) and breathing issues (19%), was high as compared to the control group. A significantly higher plasma TBARS concentration was observed in the photocopying workers. A negative correlation prevailed between FVC (−0.081), FVC% predicted (−0.038) and FEV1 (−0.043), and the duration of exposure. Conclusions: The study showed that the occupational exposure could have a significant effect on the normal pulmonary function and the oxidative potential of well-being. The profound emissions in the vicinity of photocopying centers may be responsible for the variations in the pulmonary function parameters and oxidative stress.

Hyper-immunoglobulin E (IgE) is a disorder of immune system characterized by assemblage of symptoms including recurrent skin and pulmonary infections, skeletal anomalies and elevated serum IgE (>2000 IU/ml).  More recently, apart from the typical features, neurological manifestations have also been described including central nervous system infections, facial nerve palsy and demyelinating disorders. Here we describe three patients with hyper IgE syndrome having diverse neurological manifestation varying from CNS infection to basal ganglia stroke and progressive leukoencephalopathy.

Background and Objective: Duchenne Muscular Dystrophy is caused by mutations in dystrophin gene that include deletion, duplication and small mutations. Introduction to newer drug therapies in DMD is based on the type of mutation. The objective of this study was to assess distribution and percentage of different mutations among DMD patients. Methods: This retrospective cross-sectional study was conducted in Pediatric Neurology department of UCHS & Children Hospital Lahore. All the  cases of Duchenne Muscular Dystrophy confirmed through genetic analysis from January 2022 to June 2022 through MLPA method were enrolled in the study. Data was recorded on detailed history and physical examination of the subjects and all lab investigations along with genetic study was reviewed to collect the data on given Performa. All the collected data was saved for final analysis. Results: Total 60 patients were enrolled in the study. The most common mutation was deletion, detected in 32 (56%) cases, duplication was detected in 10 (17.5%) cases and genetic study of 15 (26.5 ) patients was turned out to be normal. The most common deletion was found to be at 45-52 (43%) exons. Conclusion:  The most common mutation among genetically confirmed cases of DMD was found to be deletion at 45-52 exons. This mutational evaluation is the first step toward trial of new medicines while treating DMD, as mechanism of action of new drugs is based on the type of mutation.

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Objective: To determine the variations in clinical presentation, neuroimaging and electroencephalography patterns of subacute sclerosing panencephalitis. Study Design: Cross-sectional study. Place and Duration of Study: Children’s Hospital & Institute of Child Health, Lahore, Pakistan, from Jul to Dec 2020. Methodology: We recruited children presented with clinical features suggestive of subacute sclerosing panencephalitis, along with positive anti-measles antibodies on cerebrospinal fluid. Association between variables was determined to formulate an early diagnosis of subacute sclerosing panencephalitis. Results: Out of 47 children, 29 were males with a mean age of 6.54 ± 2.9 years. Only 23% were fully immunized against measles, 36.2% were unvaccinated and 40.4% received partial immunization. The mean age of measles infection was 1.49 ± 1.2 years; the mean interval between measles and onset of SSPE was 4.13 ± 3 years. Atypical clinical presentation was seen in 38.3% with intractable epilepsy (8.5%), focal deficit (8.5%) and extrapyramidal symptoms (8.5%) being commonest followed by coma (6.4%), visual loss (4.3%) and psychosis (2.1%). Neuroimaging was suggestive of cortical hyperintensities in 46.8% and was normal in 46.8%. Electroencephalography showed burst suppression in 55.3% and atypical findings in 19.1%. Younger age (1-1.5 years) of measles and unimmunized status were associated with early onset of SSPE with a p-value of 0.001 and 0.05 respectively. Non-immunized status was associated with atypical presentation of SSPE (p-value <0.05). Conclusion: The younger age of measles infection and failure to receive complete immunization led to early onset of Subacute sclerosing panencephalitis with an atypical presentation.