A Case Report on Hypocalcemic Seizures Secondary to Maternal and Infant Vitamin D Deficiency

Maternal vitamin D insufficiency is not uncommon. Usual causes of maternal deficiency in vitamin D and or calcium are due to cultural modifications in their diets or clothing habits. Infant born to mothers who are on breastfeeding are also at risk of developing vitamin D deficiency, hypocalcemia and seizure. We present a case of an infant with hypocalcemic seizures secondary to vitamin D deficiency.Hypocalcemic seizure may occur in term or preterm neonates due to maternal vitamin D insufficiency. It is not common to present with hypocalcemic seizures at 4 to 5 months age in an otherwise healthy child with uneventful neonatal period

Convergence of MEC and DRL in non-terrestrial wireless networks: key innovations, challenges, and future pathways

The rapid growth in mobile communication technologies has turned mobile edge computing (MEC) into a paradigm-shifting technology that extends cloud-like capabilities and storage resources to the edge of the network. This allows computation-intensive and latency-sensitive applications to be performed at close proximity to the end-users, thereby overcoming the bottleneck issues of resource-constrained devices. However, ensuring efficient operations in MEC-empowered systems requires intelligent task execution and resource allocation across MEC servers. To this end, MEC-empowered non-terrestrial wireless networks (MeNT-WiN) systems are one of the applications in which deep reinforcement learning (DRL) is seen as a powerful method to enhance the MEC abilities in edge servers and network entities. This paper presents a thorough overview of the applications of DRL in MeNT-WiNs. In particular, it underlines the main contribution of DRL in enhancing the performance of MeNT-WiNs, including unmanned aerial vehicles (UAV) and satellite communications networks. This paper investigates how DRL can meet the unique requirements of MeNT-WiNs by enhancing system efficiency, scalability, and decision-making processes across MEC architectures. First, the article reviews the fundamentals of DRL, it later goes on to discuss its integration with MeNT-WiNs and demonstrates its relevance for the optimization of satellite communications and management of UAV swarms, as well as enhancing connectivity in remote areas. The survey also identifies key challenges for DRL-driven MeNT-WiN systems, such as computational complexity and real-time adaptability, while being scalable. Finally, it discusses future research possibilities, emphasizing the importance of new solutions that integrate DRL with MEC in order to fully exploit the potential of MeNT-WiNs

Posterior Impingement in a Pediatric Population

Fracture of the os trigonum is exceptionally rare, and it is even rarer in the pediatric age group. Symptomatically and radiographically, it may be confused with what is known as the os trigonum syndrome (constellation of symptoms produced by fracture of the lateral tubercle of the posterior talar process). The authors report a case of a fracture of the os trigonum, as well as its clinical features and management. </jats:p

A rare case of intradural spinal hydatid cyst in a paediatric patient.

Intradural extramedullary type of spinal hydatid disease is a rare variety of hydatid disease, and is even rarer in paediatric age group. Spinal hydatid disease should be considered in the differential diagnosis of spinal cord compression syndrome in endemic countries and should be evaluated with imaging and serological investigations. Our case was a 9- year-old boy who presented with lower back pain lasting for 8 months and progressive bilateral lower extremities weakness lasting for 2 month. Neurological examination was suggestive of lower motor neuron type of paraperesis. Magnetic resonance images of the lumbar spine showed an intradural cystic lesion displacing and compressing the lower cord and cauda equina. The cystic mass was explored with L1-L4 laminectomy and after durotomy; it was separated from cord and dura mater by hydrodissection. It contained a clear fluid. The pathological diagnosis was hydatid disease

Primary hyperparathyroidism having multiple Brown tumors mimicking malignancy

Primary hyperparathyroidism is a disease characterized by excessive secretion of parathormone. During the course of this disease, bone loss occurs, particularly depending on resorption of the skeletal system. One of the complications of primary hyperparathyroidism is fibrotic, cystic bony changes which is called Brown tumor. Skeletal manifestations in the form of Brown tumors are rare and according to literature occur in less than 2% of patients suffering from any form of hyperparathyroidism. Such rare and multiple benign lesions may simulate a malignant neoplasm and pose a real challenge for the clinician in its differential diagnosis. We present a case of a 23-year-old Indian woman who was evaluated for multiple lytic expansile lesions with a strong suspicion of malignancy and fibrous dysplasia but turned out to be a case of primary hyperparathyroidism

Correlation between serum neuron specific enolase and functional neurological outcome in patients of acute ischemic stroke

Context: The use of biomarkers to predict stroke prognosis is gaining particular attention nowadays. Neuron specific enolase (NSE), which is a dimeric isoenzyme of the glycolytic enzyme enolase and is found mainly in the neurons is one such biomarker. Aims: This study was carried out on patients of acute ischemic stroke with the aims to determine the correlation between NSE levels on the day of admission with infarct volume, stroke severity, and functional neurological outcome on day 30. Materials and Methods: Seventy five patients of acute ischemic stroke admitted in the Department of Medicine were included in the study. Levels of NSE were determined on day 1 using the human NSE ELISA kit (Alpha Diagnostic International Texas 78244, USA). Volume of infarct was measured by computed tomography (CT) scan using the preinstalled software Syngo (version A40A) of Siemen′s medical solutions (Forchheim, Germany). Stroke severity at admission was assessed using Glasgow coma scale (GCS) and functional neurological outcome was assessed using modified Rankin scale (mRS) on day 30. Statistical Analysis Used: Statistical analysis was performed using the SPSS software for windows version 15.0 (SPSS). Results: A positive correlation was found between concentration of NSE on day 1 and infarct volume determined by CT scan (r = 0.955, P < 0.001). A strong negative correlation was found between GCS at presentation and concentration of NSE on day 1 (r = −0.806, P < 0.001). There was a positive correlation between NSE levels at day 1 and functional neurological outcome assessed by mRS at day 30 (r = 0.744, P < 0.001). Conclusions: Serum levels of NSE in first few days of ischemic stroke can serve as a useful marker to predict stroke severity and early functional outcome. However, larger studies with serial estimation of NSE are needed to establish these observations more firmly