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Most Respected Viewers ! its all about the Types/ Risk / Factors / Symptoms / Screening Treatment & Prevention What Is Down Syndrome? Down syndrome (sometimes spelled “Down’s syndrome”) is a genetic abnormality. It is the most common single cause of birth defects in the United States This syndrome occurs because of an extra copy of chromosome 21. Your chromosomes contain your genetic material, & any problems with your chromosomes can cause serious physical and mental health problems Down syndrome causes lifelong developmental delays that can range from moderate to severe. It cannot be cured, but there are options. Down syndrome can be managed with educational interventions, specialized parenting techniques, and community engagement. These all can encourage a person with Down syndrome to develop life skills and social bonds, so that they can live a long (many Down syndrome patients live past the age of 50) and fulfilling life. Causes What Causes Down Syndrome? Down syndrome is e genetic disorder. TO understand how it happens, we first need to understand some basic genetics. In all cases of reproduction, both parents pass their genes on to their children. These genes are carried on chromosomes. When the baby’s cells develop, each cell is supposed to receive 23 pairs of chromosomes. Half of the chromosomes are from the mother and half from the father. In children with Down syndrome, one of the chromosomes does not separate properly. The baby ends up with three copies of chromosome 21 instead of two. This extra chromosome causes problems as the brain and physical features develop. Types Types of Down Syndrome There are three types of Down syndrome: Trisomy 21 Trisomy 21 means there is an extra copy of chromosome 21 in every cell. This is the most common form of Down syndrome. Mosaicism Mosaicism means there is an extra chromosome in some but not all of a child’s cells. Individuals with mosaic Down syndrome tend to have fewer symptoms. Translocation In this condition, children have only an extra part of chromosome 21. There are 46 total chromosomes. However, one of them has an extra piece of chromosome 21 attached. Risk Factors Will My Child Be at Risk for Down Syndrome? Certain parents have a greater risk of giving birth to a child with Down syndrome: women age 35 and older males 50 and older people with a family history of Down’s syndrome people who carry the genetic translocation Symptoms What Are the Symptoms of Down Syndrome? During pregnancy, there are no signs that a child will have Down syndrome. At birth, babies with Down syndrome usually have certain characteristic signs, including: flat facial features small head and ears short neck bulging tongue eyes that slant upward oddly shaped ears poor muscle tone A Down syndrome infant can be born a normal size. However development is twice as slow as for an unaffected child. There is usually some degree of mental retardation, but it is often mild to moderate. Mental and social development delays may mean that the child will have: impulsive behavior poor judgment short attention span slow learning capabilities Medical complications often accompany Down syndrome. These are caused by the extra chromosome. These may include: congenital heart defects hearing loss poor vision cataracts (clouded eyes) hip problems, such as dislocations leukemia chronic constipation sleep apnea (interrupted breathing during sleep) dementia (thought and memory problems) hypothyroidism (low thyroid function) obesity late tooth growth, causing problems with chewing Today, despite the medical and developmental delays, a child born with Down syndrome can live past the age of 50 (Mayo Clinic). Screening Screening for Down Syndrome During Pregnancy Screening is offered as a routine part of prenatal care in the United States. However, it is not required. First Trimester An ultrasound evaluation and blood tests can look for Down syndrome in your fetus. These tests are done between the 10th and 14th week of pregnancy. An ultrasound looks at the back of the baby’s neck, called the nuchal translucency. If there are problems with the baby’s development, more fluid collects in this area. Blood tests looks at the level of pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (HCG). High levels of these proteins suggest a developmental problem. These tests have a higher false-positive rate than tests done at later pregnancy stages. If results are not normal, your doctor may follow up with an amniocentesis. In this test, an amniotic fluid sample is used to confirm the results. Second Trimester An ultrasound and quadruple marker screen (QMS) test can help identify Down syndrome and other neural tube defects. This test is done between 15 and 20 weeks. These tests measures four pregnancy-related factors: human chorionic gonadotropin (HCG) unconjugated estriol alpha-fetoprotein (AFP) inhibin-A If any of these tests are not normal, you will be considered at high risk for birth defects. Additional Prenatal Tests Your doctor may order additional tests to detect Down syndrome in your baby: amniocentesis: Your doctor takes a sample of amniotic fluid to examine the number of chromosomes the baby has. The test is usually done at 15 weeks. It carries a one in 200 miscarriage risk. chorionic villus sampling (CVS): Your doctor will take cells from your placenta to analyze fetal chromosomes. This test is done during the ninth and 14th week of pregnancy. It carries a miscarriage risk of one in 100. percutaneous umbilical blood sampling (PUBS): Your doctor will take blood from the umbilical cord and examine it for chromosomal defects. It is done after the 18th week of pregnancy. It carries an even higher rate of miscarriage, so it is performed only if all other tests are uncertain. Some women choose not to undergo these tests, because of the risk of miscarriage. They would rather risk having a child with Down syndrome than losing the pregnancy. Tests at Birth At birth, your doctor will: perform a physical examination of your baby order a blood test called a karyotype to confirm Down syndrome Treatment Treating Down Syndrome There is no cure for Down syndrome. However, parents can provide early intervention and opportunities to help their child with Down syndrome succeed. Early intervention programs promote a child’s learning. They offer the best chance for success. In these programs, special education teachers and therapists will help your child learn: sensory skills social skills self-help motor skills language and cognitive abilities Children with Down syndrome often meet age-related milestones. However, this may take up to two times longer than for other children. A team of physicians and specialists can help provide medical care and manage the medical complications. Because obesity can be particularly dangerous to the health of children with Down syndrome, it is important to encourage physical activity and avoid high-calorie foods. However, before beginning exercise or sports, the child’s hip, neck, and spine should be examined. It is important to teach children with Down syndrome about being independent and staying safe. Parents should establish a support network in the family and community. Learn as much as possible about your child’s condition. This can help you understand what it means as your child grows and develops. Many people with Down syndrome lead successful lives in their community. They often go to school, hold jobs, and become independent. Prevention Preventing Down Syndrome There is no way to prevent Down syndrome. You may want to speak with a genetic counselor: before having a child, to see if you are at risk if you already have a child with Down syndrome and are considering getting pregnant again Regards from' Oxfordcadets Team J Block Firdos Market Gulberg iii Lahore skype id oxfordcadets g mail oxfordcadets at g mail dot com whatsapp +92 333 4/6/3/3/9/9/0 Get Updates on + 92 342 37 2 5 129

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ASIM & ASIM LAW FIRM PROFILE • Senior Partner: Ch. Muhammad Asim Gujjar Advocate High Court • Number of partners worldwide: 15 • Number of other lawyers worldwide: 5 • Languages: English, Urdu, Arabic, Punjabi, ________________________________________ FIRM OVERVIEW: ASIM & ASIM LAW ASSOCIATES was founded in 2012 and is the largest firm in Pakistan. Having established ourselves as one of the largest and most respected law firms in Pakistan, we embarked on a strategic focus in our offerings specializing in Strategic Advice and Structuring as well as Litigation & Dispute Resolution It is one of the world’s foremost offshore law firms which combines an old world approach to client service with a new world approach to business and technology. It is professional and pragmatic, analytical and creative, rigorous and open to new ideas. ASIM & ASIM LAW ASSOCIATES are trusted advisers to clients both locally and overseas who seek legal guidance in a fast-moving, multi-jurisdictional world. Though rooted in Pakistan, the firm has an international clientele in key jurisdictions around the world, with many assignments involving cross-border advice. The extent of the firm’s expertise, combined with its worldwide network including major London, continental and UK law firm links, gives ASIM & ASIM LAW ASSOCIATES the reach to satisfy all of its clients’ needs. OUR VISION ASIM & ASIM LAW ASSOCIATES vision is to continue providing legal services to international standards in a commercial and responsive manner. Today, our market leading presence and experience makes us the first choice among the leading national and international corporates and financial institutions looking for Pakistani legal advice. Indeed our standards of professionalism have been commented on by leading international legal publications. We are proud to have attained this position and remain determined to maintain it. We remain committed to developing areas of legal services in Pakistan that have not reached the same standards as transactional practices. OUR VALUES AND MISSION STATEMENT ASIM & ASIM LAW ASSOCIATES mission statement reflects what we consider our raisson d’être and is based on the five core values, which are : Integrity, Diligence, Responsiveness, Care and Citizenship. We firmly believe that success in achieving our mission is only possible if we live by our core values and reflect these in all our interactions with our clients, our people and the community at large. RESPONSIBILITY TO OUR CLIENTS • Maintaining excellent and high quality legal services to our clients. • Delivering the highest standards of integrity, efficiency and responsiveness in all our work. • Providing accurate, timely and effective legal advice to clients. • Attending hearing at court. • Presenting evidence in court to support client in legal proceeding. • Advising clients in their legal rights and obligations. • Getting to know clients developing and maintaining relationships with them. • Looking for evidence that will back up a client case. • Preparing arguments to be submitted in court. • Preparing question to ask witnesses. RESPONSIBILITY TO OUR PEOPLE • We shall endeavour to provide opportunities, on-going training and guidance to all our people to help them reach their potential. • We shall endeavour to make the workplace a friendly environment. RESPONSIBILITY TO OUR COMMUNITY • We shall strive to be an outstanding corporate citizen. • We shall strive to lead the growth of the legal community and the community legal awareness. MAIN AREAS OF PRACTICE: Corporate & Commercial: The firm provides a full range of legal services for clients ranging from small businesses to major multinationals. It advises corporate clients working in or through Pakistan on a wide variety of cross-border transactions and financing structures. Other matters handled include international corporate restructures, joint ventures, M&A and corporate franchising, tax and e-commerce. Litigation: The department handles most aspects of litigation, with a niche focus on international commercial and trust litigation. The firm’s litigators practice as both barristers and solicitors, and provide a full range of litigation services at all levels for both local and international clients. International Finance & Banking: The firm has particular experience in banking and financial markets. The firm’s lawyers also advise in banking regulation and licensing work, including the establishment of offshore operations and regulatory advice, as well as the implementation of various legal and tax structures including repackaging and securitization. It is the only firm in Pakistan to combine specialist expertise in derivatives regulation with a substantial banking, tax and securitization practice. Telecommunications: The firm has advised on the privatization of the government of Pakistan telephone services and advises one of the main carriers. The firm advises on all aspects of telecommunications including broadcasting and wireless telegraphy, and was instructed by the International Telecommunications Union to report on the state of telecommunications legislation in various territories in the Pakistan region. Private Client: The firm has specialist lawyers who regularly advise on all aspects of private client matters including asset protection, trusts, domiciliation and taxation. Drafting: The firm advised the government on the transposition of EU directives into Pakistan law. Principally, this work has concerned legislation relating to financial services and telecommunications. Contacts have also been established with a number of other governments requiring assistance in this area. Trust & Company Administration: Through an associated company the firm provides administration services for both companies and trusts. Among the users of these services are international clients who the firm advises on the use of Pakistan trusts and offshore companies. Maritime: The firm has strong links with major English shipping firms and has been involved in a number of significant international admiralty cases. The firm also handles ship registration and finance. Property: The firm acts for most of the major local and international developers and builders. The firm advises in matters concerned with secured lending, mortgages and charges for most banks and building societies in Pakistan. Clients: The firm’s international clients predominantly come from the US, the UK, and continental Europe (in particular Luxembourg, the Netherlands, Spain and Portugal). They include global corporations, private equity groups, international banks and insurance companies. AREAS OF PRACTICE • Constitutional Law • Administrative Law • Banking & Finance, including Islamic Banking • Corporate Law & Governance • Securitization Law • Securities Market Transactions • Commercial Transactions • Sale of Goods • Election Law • NAB Law • FIA • Criminal Law • Cyber Crimes • Family Laws • International Trade Law • Taxation • Energy (Oil, Gas & Electricity) • Public Procurement Law • Mergers and Acquisitions • Anti-Trust and Competition • Privatization • Employment, Labour & Service • Commercial Arbitration (Domestic & International) • Construction Arbitration • Legislative Drafting • Media and Telecommunications • Foreign Investment BRANCHES • Turner Road, Near Lahore High Court Lahore • Cell No. 00923416186958 • 351-A/1, Johar Town, Lahore • Cell No. 00923416186958 • Foot Ball Ground Block, F-8 Markaz, Islamabad • Cell No. 00923416186958 • District Courts of Sargodah, Punjab • Cell No. 00923416186958