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Melas: A Complex And Challenging Diagnosis, Kumail Khandwala, Anwar Ahmad, Taha Sheikh 2018 Aga Khan University

Melas: A Complex And Challenging Diagnosis, Kumail Khandwala, Anwar Ahmad, Taha Sheikh

Department of Radiology

Mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is a rare multisystem disorder and is the most common maternally inherited mitochondrial disease. This condition has a special predilection for the nervous system and muscles. Typical findings on brain imaging include stroke-like areas, calcification of basal ganglia and brain atrophy. This accounts for the disease being, both clinically and radiologically, mistaken for ischemic stroke. The differentiation features from stroke include comparatively young age of the patients, site of the lesions, and relative overlap between the cerebral vasculature territories. In this case report, we discuss a 16-year male with clinical and radiological ...


A Rare Case Of Enhancing Anterior Interhemispheric Racemose Neurocysticercosis With Foci Of Calcification And Direct Parenchymal Extension, Anupama Chandrappa, Rajesh Raman, Suchetha Satish 2018 JSS Medical College Hospital, JSS University, Mysore

A Rare Case Of Enhancing Anterior Interhemispheric Racemose Neurocysticercosis With Foci Of Calcification And Direct Parenchymal Extension, Anupama Chandrappa, Rajesh Raman, Suchetha Satish

Journal of Global Radiology

Neurocysticercosis (NCC) refers to the central nervous system (CNS) infestation of the larvae of pork tapeworm Taenia solium. It is endemic in Central and South America, Asia and Africa. It most commonly presents as intraparenchymal subcentimetric ring enhancing lesions of variable ages (or size and duration) with surrounding vasogenic edema. The lesions calcify with time. Rarely, NCC can occur in extraparenchymal locations, within the subarachnoid space and ventricles. At these locations it is usually seen as a proliferative lobulated cystic mass without a scolex which is termed racemose neurocysticercosis. Racemose cysticerci do not show calcification, scolex, or enhancement.

We report ...


Positioning Of Patients For Pelvic Radiation: Variability Across Treatment, Mashhood Ahmad Bodla, Alexander Lukez, Lauren O'Loughlin, Jennifer Baima, Janaki Moni 2018 University of Massachusetts Medical School

Positioning Of Patients For Pelvic Radiation: Variability Across Treatment, Mashhood Ahmad Bodla, Alexander Lukez, Lauren O'Loughlin, Jennifer Baima, Janaki Moni

Orthopedics and Physical Rehabilitation Publications and Presentations

Objectives: We aimed to determine the variability in position of the pelvis for patients while receiving daily radiation treatments for pelvic malignancies.

Design: Therapeutic radiation targets lymph nodes that lie along the curvature of the sacrum. Any change in pelvic tilt could inadvertently move these targets in or out of the radiation field. This variability has clinical significance both to target cancerous lymph nodes and avoid healthy sacrum.

To better understand this variability, we observed trends in the change in the sacral slope. This measurement was chosen because it is an objective radiographic finding, there is no significant difference between ...


Closed-Loop Stimulation Of Temporal Cortex Rescues Functional Networks And Improves Memory., Youssef Ezzyat, Paul A. Wanda, Deborah F. Levy, Allison Kadel, Ada Aka, Isaac Pedisich, Michael R. Sperling, Ashwini Sharan, Bradley C. Lega, Alexis Burks, Robert E. Gross, Cory S. Inman, Barbara C. Jobst, Mark A. Gorenstein, Kathryn A. Davis, Gregory A. Worrell, Michal T. Kucewicz, Joel M. Stein, Richard Gorniak, Sandhitsu R. Das, Daniel S. Rizzuto, Michael J. Kahana 2018 University of Pennsylvania

Closed-Loop Stimulation Of Temporal Cortex Rescues Functional Networks And Improves Memory., Youssef Ezzyat, Paul A. Wanda, Deborah F. Levy, Allison Kadel, Ada Aka, Isaac Pedisich, Michael R. Sperling, Ashwini Sharan, Bradley C. Lega, Alexis Burks, Robert E. Gross, Cory S. Inman, Barbara C. Jobst, Mark A. Gorenstein, Kathryn A. Davis, Gregory A. Worrell, Michal T. Kucewicz, Joel M. Stein, Richard Gorniak, Sandhitsu R. Das, Daniel S. Rizzuto, Michael J. Kahana

Department of Neurology Faculty Papers

Memory failures are frustrating and often the result of ineffective encoding. One approach to improving memory outcomes is through direct modulation of brain activity with electrical stimulation. Previous efforts, however, have reported inconsistent effects when using open-loop stimulation and often target the hippocampus and medial temporal lobes. Here we use a closed-loop system to monitor and decode neural activity from direct brain recordings in humans. We apply targeted stimulation to lateral temporal cortex and report that this stimulation rescues periods of poor memory encoding. This system also improves later recall, revealing that the lateral temporal cortex is a reliable target ...


Electrical Stimulation Modulates High Γ Activity And Human Memory Performance., Michal T. Kucewicz, Brent M. Berry, Vaclav Kremen, Laura R. Miller, Fatemeh Khadjevand, Youssef Ezzyat, Joel M. Stein, Paul Wanda, Michael R. Sperling, Richard Gorniak, MD, Kathryn A. Davis, Barbara C. Jobst, Robert E. Gross, Bradley Lega, S Matt Stead, Daniel S. Rizzuto, Michael J. Kahana, Gregory A, Worrell 2018 Mayo Clinic

Electrical Stimulation Modulates High Γ Activity And Human Memory Performance., Michal T. Kucewicz, Brent M. Berry, Vaclav Kremen, Laura R. Miller, Fatemeh Khadjevand, Youssef Ezzyat, Joel M. Stein, Paul Wanda, Michael R. Sperling, Richard Gorniak, Md, Kathryn A. Davis, Barbara C. Jobst, Robert E. Gross, Bradley Lega, S Matt Stead, Daniel S. Rizzuto, Michael J. Kahana, Gregory A, Worrell

Department of Neurology Faculty Papers

Direct electrical stimulation of the brain has emerged as a powerful treatment for multiple neurological diseases, and as a potential technique to enhance human cognition. Despite its application in a range of brain disorders, it remains unclear how stimulation of discrete brain areas affects memory performance and the underlying electrophysiological activities. Here, we investigated the effect of direct electrical stimulation in four brain regions known to support declarative memory: hippocampus (HP), parahippocampal region (PH) neocortex, prefrontal cortex (PF), and lateral temporal cortex (TC). Intracranial EEG recordings with stimulation were collected from 22 patients during performance of verbal memory tasks. We ...


Deep Gaze Velocity Analysis During Mammographic Reading For Biometric Identification Of Radiologists, Hong-Jun Yoon, Folami Alamudun, Kathy Hudson, Garnetta Morin-Ducote, Georgia Tourassi 2018 Biomedical Sciences, Engineering, and Computing Group Health Data Sciences Institute, Oak Ridge National Laboratory

Deep Gaze Velocity Analysis During Mammographic Reading For Biometric Identification Of Radiologists, Hong-Jun Yoon, Folami Alamudun, Kathy Hudson, Garnetta Morin-Ducote, Georgia Tourassi

Journal of Human Performance in Extreme Environments

Several studies have confirmed that the gaze velocity of the human eye can be utilized as a behavioral biometric or personalized biomarker. In this study, we leverage the local feature representation capacity of convolutional neural networks (CNNs) for eye gaze velocity analysis as the basis for biometric identification of radiologists performing breast cancer screening. Using gaze data collected from 10 radiologists reading 100 mammograms of various diagnoses, we compared the performance of a CNN-based classification algorithm with two deep learning classifiers, deep neural network and deep belief network, and a previously presented hidden Markov model classifier. The study showed that ...


Mammographic Breast Density And Breast Cancer Molecular Subtypes: The Kenyan-African Aspect, Asim Jamal, Maeve Mullooly, Shahin Sayed, Rose Ndumia, Innocent Abayo, James Orwa, Ronald Wasike, Zahir Moloo, Gretchen L. Gierach 2018 Aga Khan University

Mammographic Breast Density And Breast Cancer Molecular Subtypes: The Kenyan-African Aspect, Asim Jamal, Maeve Mullooly, Shahin Sayed, Rose Ndumia, Innocent Abayo, James Orwa, Ronald Wasike, Zahir Moloo, Gretchen L. Gierach

Internal Medicine, East Africa

Introduction: Data examiningmammographic breast density (MBD) among patients in Sub-Saharan Africa are sparse.We evaluated how MBD relates to breast cancer characteristics in Kenyan women undergoing diagnostic mammography.

Methods: This crosssectional study included women with pathologically confirmed breast cancers (𝑛 = 123). Pretreatment mammograms of the unaffectedbreast were assessed to estimate absolute dense area (cm2), nondense area (cm2), and percent density (PD). Relationships between density measurements and clinical characteristics were evaluated using analysis of covariance.

Results: Median PD and dense area were 24.9% and 85.3 cm2. Higher PD and dense area were observed in younger women (𝑃 < 0.01). Higher dense and nondense areas were observed in obese women (𝑃-trend < 0.01). Estrogen receptor (ER) positive patients (73%) had higher PD and dense area than ER-negative patients (𝑃 ≤ 0.02). Triple negative breast cancer (TNBC) patients (17%) had lower PD and dense area (𝑃 ≤ 0.01) compared with non-TNBCs. No associations were observed between MBD and tumor size and grade.

Conclusions: Our ...


Pilot Study To Assess Visualization And Therapy Of Inflammatory Mechanisms After Vessel Reopening In A Mouse Stroke Model, Ebba Beller, Laura Reuter, Anne Kluge, Christine Preibisch, Ute Lindauer, Alexei A. Bogdanov Jr., Friederike Lammer, Claire Delbridge, Kaspar Matiasek, Benedikt J. Schwaiger, Tobias Boeckh-Behrens, Claus Zimmer, Alexandra S. Gersing 2018 Klinikum rechts der Isar der Technischen Universität München

Pilot Study To Assess Visualization And Therapy Of Inflammatory Mechanisms After Vessel Reopening In A Mouse Stroke Model, Ebba Beller, Laura Reuter, Anne Kluge, Christine Preibisch, Ute Lindauer, Alexei A. Bogdanov Jr., Friederike Lammer, Claire Delbridge, Kaspar Matiasek, Benedikt J. Schwaiger, Tobias Boeckh-Behrens, Claus Zimmer, Alexandra S. Gersing

Radiology Publications and Presentations

After reperfusion therapy in stroke patients secondary inflammatory processes may increase cerebral damage. In this pilot study, effects of anti-inflammatory therapy were assessed in a middle cerebral artery occlusion (MCAO) mouse model after reperfusion. 1 hour after MCAO, the artery was reopened and tacrolimus or NaCl were administered intra-arterially. Perfusion-weighted (PWI) and diffusion-weighted images (DWI) were obtained by MRI during MCAO. DWI, T2- and T1-weighted images with and without Bis-5HT-DTPA administration were obtained 24 hours after MCAO. Neutrophils, Myeloperoxidase-positive-(MPO+)-cells and microglia, including M1 and M2 phenotypes, were assessed immunohistochemically. Treatment with tacrolimus led to significantly smaller apparent diffusion ...


Dual Radiosensitization And Anti-Stat3 Anti-Proliferative Strategy Based On Delivery Of Gold Nanoparticle - Oligonucleotide Nanoconstructs To Head And Neck Cancer Cells, Surong Zhang, Suresh Gupta, Thomas J. Fitzgerald, Alexei A. Bogdanov Jr. 2018 University of Massachusetts Medical School

Dual Radiosensitization And Anti-Stat3 Anti-Proliferative Strategy Based On Delivery Of Gold Nanoparticle - Oligonucleotide Nanoconstructs To Head And Neck Cancer Cells, Surong Zhang, Suresh Gupta, Thomas J. Fitzgerald, Alexei A. Bogdanov Jr.

Radiology Publications and Presentations

Constitutively activated signal transducer and activator of transcription 3 (STAT3) factor is an important therapeutic target in head and neck cancer (HNC). Despite early promising results, a reliable systemic delivery system for STAT3- targeted oligonucleotide (ODN) drugs is still needed for future clinical translation of anti-STAT3 therapies. We engineered and tested a novel ODN duplex/gold nanoparticle (AuNP)-based system carrying a therapeutic STAT3 decoy (STAT3d) payload. This strategy is two-pronged because of the additive STAT3 antagonism and radiosensitizing properties of AuNP. The specificity to head and neck cancer cell surface was imparted by using a nucleolin aptamer (NUAP) that ...


Magnetically Focused Proton Irradiation Of Small Volume Radiosurgery Targets Using A Triplet Of Quadrupole Magnets, Patrick McGee, Grant McAuley, Andrew Wroe, James M. Slater, Jerry D. Slater 2017 Loma Linda University

Magnetically Focused Proton Irradiation Of Small Volume Radiosurgery Targets Using A Triplet Of Quadrupole Magnets, Patrick Mcgee, Grant Mcauley, Andrew Wroe, James M. Slater, Jerry D. Slater

Loma Linda University Student Journal

Proton therapy is an advantageous choice for the irradiation of tumors in proximity of critical structures due to rapid dose fall off and high dose deposition at target compared to dose at the surface of the patient (ie, peak-to-entrance dose ratio (P/E)). However, with target fields below 1.0 cm, as often encountered in proton radiosurgery, multiple Coulomb scattering (MCS) broadens proton beams leading to diminished P/E advantages and reduced dose delivery efficiency (DDE). Magnetic focusing tends to counteract MCS and is a promising method to reduce these undesirable effects. The purpose of this research is to investigate ...


Diffusion Tensor Imaging Findings In Pediatric Patients With Mild Traumatic Brain Injury, Tshea Dowers, B L. Bartnik, Barbara Holshouser, Stephen Ashwal, Samuel Barnes 2017 Loma Linda University Medical Center

Diffusion Tensor Imaging Findings In Pediatric Patients With Mild Traumatic Brain Injury, Tshea Dowers, B L. Bartnik, Barbara Holshouser, Stephen Ashwal, Samuel Barnes

Loma Linda University Student Journal

Approximately 14% of school age children with sports-related concussions (SRC) remain symptomatic 3 months after injury. Previous studies have used diffusion tensor imaging (DTI) to detect white matter tract changes in regions of interest in symptomatic patients; however data in the pediatric population remains limited. This study was undertaken to determine whether DTI metrics can provide valuable information in pediatric mTBI patients with persistent symptoms.


Pretargeting Of Internalizing Trastuzumab And Cetuximab With A 18f-Tetrazine Tracer In Xenograft Models, Outi Keinänen, Kimberly Fung, Jacob Pourat, Vilma Jallinoja, Delphine Vivier, NagaVara Kishore Pillarsetty, Anu J. Airaksinen, Jason S. Lewis, Brian M. Zeglis, Mirkka Sarparanta 2017 University of Helsinki

Pretargeting Of Internalizing Trastuzumab And Cetuximab With A 18f-Tetrazine Tracer In Xenograft Models, Outi Keinänen, Kimberly Fung, Jacob Pourat, Vilma Jallinoja, Delphine Vivier, Nagavara Kishore Pillarsetty, Anu J. Airaksinen, Jason S. Lewis, Brian M. Zeglis, Mirkka Sarparanta

Publications and Research

Background: Pretargeting-based approaches are being investigated for radioimmunoimaging and therapy applications to reduce the effective radiation burden to the patient. To date, only a few studies have used short-lived radioisotopes for pretargeting of antibodies, and such examples with internalizing antibodies are even rarer. Herein, we have investigated pretargeting methodology using inverse electron-demand Diels-Alder (IEDDA) for tracing two clinically relevant, internalizing monoclonal antibodies, cetuximab and trastuzumab.

Results: Bioorthogonal reaction between tetrazine and trans-cyclooctene (TCO) was used for tracing cetuximab and trastuzumab in vivo with a fluorine-18 (t½ = 109.8 min) labelled tracer. TCO-cetuximab or TCO-trastuzumab was administered 24, 48, or 72 ...


Impact Of Trust On Global Health And Global Radiology Initiatives, Nathalie Duchesne, Margaret Graham 2017 CHU de Québec

Impact Of Trust On Global Health And Global Radiology Initiatives, Nathalie Duchesne, Margaret Graham

Journal of Global Radiology

This editorial discusses how the best way to improve implementation and sustainability of humanitarian missions, including those of global imaging, is to employ the currency of the new economy: trust.


Labrad : Vol 43, Issue 3 - December 2017, Aga Khan University Hospital, Karachi 2017 Aga Khan University

Labrad : Vol 43, Issue 3 - December 2017, Aga Khan University Hospital, Karachi

LABRAD

  • Levey Jennings Chart and Guide to use Westgard Rules
  • Quality Assurance in Frozen Section Studies
  • Performance Improvement Monitors in Histology
  • Quality Assurance in Immunohistochemistry: The Way We Do It
  • Quality Assurance in Laboratory Biosafety
  • Quality Control of Culture Media Used in Clinical Microbiology
  • Quality Assurance (QA) in Qualitative Tests in the Clinical Laboratory
  • Radiology Pathology Correlation
  • Quality Requirements for Reporting Sickle Haemoglobin
  • Meeting Report of International Federation of Clinical Chemistry (IFCC) Conferences- 2017


Silent Sentence Completion Shows Superiority Localizing Wernicke's Area And Activation Patterns Of Distinct Language Paradigms Correlate With Genomics: Prospective Study., Kamel El Salek, Islam S. Hassan, Aikaterini Kotrotsou, Srishti Abrol, Scott H. Faro, Feroze B. Mohamed, Pascal O. Zinn, Wei Wei, Nan Li, Ashok J. Kumar, Jeffrey S. Weinberg, Jeffrey S. Wefel, Shelli R. Kesler, Ho-Ling Anthony Liu, Ping Hou, R. Jason Stafford, Sujit Prabhu, Raymond Sawaya, Rivka R. Colen 2017 University of Texas MD Anderson Cancer Center

Silent Sentence Completion Shows Superiority Localizing Wernicke's Area And Activation Patterns Of Distinct Language Paradigms Correlate With Genomics: Prospective Study., Kamel El Salek, Islam S. Hassan, Aikaterini Kotrotsou, Srishti Abrol, Scott H. Faro, Feroze B. Mohamed, Pascal O. Zinn, Wei Wei, Nan Li, Ashok J. Kumar, Jeffrey S. Weinberg, Jeffrey S. Wefel, Shelli R. Kesler, Ho-Ling Anthony Liu, Ping Hou, R. Jason Stafford, Sujit Prabhu, Raymond Sawaya, Rivka R. Colen

Department of Radiology Faculty Papers

Preoperative mapping of language areas using fMRI greatly depends on the paradigms used, as different tasks harness distinct capabilities to activate speech processing areas. In this study, we compared the ability of 3 covert speech paradigms: Silent Sentence Completion (SSC), category naming (CAT) and verbal fluency (FAS), in localizing the Wernicke's area and studied the association between genomic markers and functional activation. Fifteen right-handed healthy volunteers and 35 mixed-handed patients were included. We focused on the anatomical areas of posterosuperior, middle temporal and angular gyri corresponding to Wernicke's area. Activity was deemed significant in a region of interest ...


Influence Of Longitudinal Position On The Evolution Of Steady-State Signal In Cardiac Cine Balanced Steady-State Free Precession Imaging, Tyler J. Spear, Tori A. Stromp, Steve W. Leung, Moriel H. Vandsburger 2017 University of Kentucky

Influence Of Longitudinal Position On The Evolution Of Steady-State Signal In Cardiac Cine Balanced Steady-State Free Precession Imaging, Tyler J. Spear, Tori A. Stromp, Steve W. Leung, Moriel H. Vandsburger

Saha Cardiovascular Research Center Faculty Publications

Background: Emerging quantitative cardiac magnetic resonance imaging (CMRI) techniques use cine balanced steady-state free precession (bSSFP) to measure myocardial signal intensity and probe underlying physiological parameters. This correlation assumes that steady-state is maintained uniformly throughout the heart in space and time.

Purpose: To determine the effects of longitudinal cardiac motion and initial slice position on signal deviation in cine bSSFP imaging by comparing two-dimensional (2D) and three-dimensional (3D) acquisitions.

Material and Methods: Nine healthy volunteers completed cardiac MRI on a 1.5-T scanner. Short axis images were taken at six slice locations using both 2D and 3D cine bSSFP. 3D ...


A Survey Of Structural Design Of Diagnostic X-Ray Imaging Facilities And Compliance To Shielding Design Goals In A Limited Resource Setting, Flavious B. Nkubli, Christian C. Nzotta, Nwobi I. Nwobi, Silas A. Moi, Thomas Adejoh, Geofery Luntsi, Joseph Dlama, Laushognu S. Shem 2017 University of Maiduguri

A Survey Of Structural Design Of Diagnostic X-Ray Imaging Facilities And Compliance To Shielding Design Goals In A Limited Resource Setting, Flavious B. Nkubli, Christian C. Nzotta, Nwobi I. Nwobi, Silas A. Moi, Thomas Adejoh, Geofery Luntsi, Joseph Dlama, Laushognu S. Shem

Journal of Global Radiology

Purpose: To survey structural designs of x-ray rooms and compliance to shielding design goals of three x-ray imaging facilities.

Methods and Materials: The survey was conducted in three radiodiagnostic centers in South East Nigeria, labeled X, Y and Z for anonymity. A stretchable non-elastic meter rule was used to measure x-ray room dimensions. A Vernier caliper was used to measure lead thickness while a calibrated digital survey meter Radalert 100x was used for radiation survey of controlled and uncontrolled areas. Simple statistical tools such as mean and standard deviation were used for analysis with the aid of Microsoft Excel version ...


Assessing The Reliability Of Ultrasound Imaging To Examine Peripheral Nerve Excursion: A Systematic Literature Review, Ben Kasehagen, Richard Ellis, Rodney Pope, Nicholas Russell, Wayne Hing 2017 Bond University

Assessing The Reliability Of Ultrasound Imaging To Examine Peripheral Nerve Excursion: A Systematic Literature Review, Ben Kasehagen, Richard Ellis, Rodney Pope, Nicholas Russell, Wayne Hing

Faculty of Health Sciences & Medicine Publications

Ultrasound imaging (USI) is gaining popularity as a tool for assessing nerve excursion and is becoming an important tool for the assessment and management of entrapment neuropathies. This systematic review aimed to identify current methods and report on the reliability of using USI to examine nerve excursion and identify the level of evidence supporting the reliability of this technique. A systematic search of five electronic databases identified studies assessing the reliability of using USI to examine nerve excursion. Two independent reviewers critically appraised and assessed the methodological quality of the identified articles. Eighteen studies met the eligibility criteria. The majority ...


Anatomic Humeral Head Replacement With A Press-Fit Prosthesis: An In Vivo Radiographic Study, Bryan Vopat, Jeremy Truntzer, Daniel Aaron, Jack Anavian, Joel Schwartz, Andrew Green 2017 University of Kansas

Anatomic Humeral Head Replacement With A Press-Fit Prosthesis: An In Vivo Radiographic Study, Bryan Vopat, Jeremy Truntzer, Daniel Aaron, Jack Anavian, Joel Schwartz, Andrew Green

Open Access Articles

Successful total shoulder arthroplasty is, in part, dependent on anatomic reconstruction of the glenohumeral joint. The purpose of this study was to evaluate the post-operative anatomy of total shoulder arthroplasty with an anatomic implant design in patients with primary glenohumeral osteoarthritis and compare it to published normative anatomic measurements. Fifty-one patients (56 shoulders) with primary glenohumeral osteoarthritis were treated with a press-fit humeral component as part of a total shoulder arthroplasty (Aequalis, Tornier, Edina, Minnesota). Analysis of postoperative true anterior posterior radiographs was performed with use of a custom software algorithm. The mean humeral inclination (head-shaft angle), mean humeral implant ...


Bilateral Intracranial Calcifications With Bilateral Facial Cutaneous Naevus: Sturge Weber Syndrome, Muhammad Arif Saeed, Kiran Hilal, Prem Chand 2017 Aga Khan University

Bilateral Intracranial Calcifications With Bilateral Facial Cutaneous Naevus: Sturge Weber Syndrome, Muhammad Arif Saeed, Kiran Hilal, Prem Chand

Department of Radiology

Abstract

Sturge Weber syndrome also known as mother spot disease belongs to a group of disorders called phakomatoses (neurocutaneous syndromes involving the central nervous and cutaneous systems). It is a congenital disorder of the vasculature of the meninges, brain, faceand eyes. Clinically, it usually presents with seizures and other neurological complications, including mental retardation, contralateral hemiparesis and glaucoma. Its incidence is estimated at one case in 20 000-50 000 persons with equal frequency in boys and girls. We present a case of 18-months-old boy was brought by parents with history of seizures since birth resulting in fall 1 day back ...


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