Wireless Body Area Networks (WBANs) are emerging in the livestock industry for remote monitoring of cattle using wireless body sensors (WBS). The random mobility of animals acting as nodes causes the network's topology to change rapidly, originating from scalability and reliability issues. Stable transmission of acquired data to the base station requires an intelligent clustering mechanism that reduces the energy consumption and fulfills the network's constraints. Several clustering techniques are available as a solution, but these techniques yield numerous cluster heads, resulting in more energy utilization. Higher energy utilization lessens the effective life of WBSs and increases monitoring costs. This paper presents a metaheuristic approach for selecting optimal clusters in WBANs to realize an energy-efficient routing protocol for livestock health and behavior monitoring. The proposed approach employs Ant Lion Optimizer (ALO) to select the optimal clusters for different pasturage sizes using sensors of different transmission ranges considering user's preferences about cluster density. The proposed technique with ALO is compared with other recent techniques such as Ant Colony Optimization, Grasshopper Optimization, and Moth Flame Optimization. The comparison results show the proposed technique's effectiveness in realizing energyefficient protocols of WBANs for remote monitoring applications.

Objective: To compare efficacy and safety of corticosteroids and combined therapy with corticosteroids and vigabatrin in infantile spasm. Study Design: Randomized Controlled Trial. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health Multan, Pakistan. Period: November 2020 to November 2022. Material & Methods: A total of 320 children of either gender aged 1-24 month with clinical diagnosis of infantile spasm were included. Infants were randomized into either receiving prednisolone (Group-A) or vigabatrin plus prednisolone (Group-B). Demographical information along with treatment outcomes and adverse effects were noted. Final outcomes were labeled at day-180. Results: In a total of 320 children, 170 (53.1%) were male. Overall, the mean age was 1.3±0.5 years while 166 (51.9%) children were aged between 1 to 2 years. A total of 166 (51.9%) children responded to allocated treatment. The response rate was significantly better in Group-B (n=118, 73.8%) versus Group-A (n=48, 30.0%), p<0.0001. Significantly more children in Group-A missed follow-ups in comparison to those in Group-B (11.8% vs. 1.9%, p=0.0006). Mortality was statistically similar in both study groups (2.5% vs. 1.9%, p=0.7023). The most treatment related adverse effect was noted to be increased appetite and/or weight, gastrointestinal symptoms and sleep disturbance in 253 (79.1%), 121 (37.8%) and 117 (36.6%) respectively. Increased appetite and/or weight gain was significantly more in Group-A (p<0.0001). Conclusion: The findings of this study are in support of using combination therapy of prednisolone and vigabatrin instead of monotherapy for patients with infantile spasm as reflected by higher number of responders to therapy.