Vitamin D deficiency is becoming more common around the world, owing to reduced sunshine exposure and an imbalanced diet. However, severe hypocalcemia as a result of vitamin D insufficiency is a rare occurrence, and it rarely leads to seizures in children. We present such a case in a 6-month-old infant who presented with status epilepticus secondary to hypocalcemia due to vitamin D deficiency, which was first misdiagnosed as epilepsy. Thereby, we want to emphasize that hypocalcemia secondary to vitamin D deficiency can lead to convulsion and the importance of vitamin D supplementation.

Vitamin D deficiency is becoming more common around the world, owing to reduced sunshine exposure and an imbalanced diet. However, severe hypocalcemia as a result of vitamin D insufficiency is a rare occurrence, and it seldom leads to seizures in children. We present such a case in a 6-month-old infant who presented status epilepticus secondary to hypocalcemia due to vitamin D deficiency, which was first misdiagnosed as epilepsy. Thereby we want to emphasize that hypocalcemia secondary to vitamin D deficiency can lead to convulsion and the importance of vitamin D supplementation.

Đặt vấn đề: Nhiễm trùng thần kinh trung ương (NTTKTW) là bệnh lý thường gặp, để lại nhiều hậu quả về sức khỏe cũng như tâm lý nặng nề cho từng gia đình cũng như toàn xã hội. Bệnh có tỉ lệ tử vong cao, đặc biệt là trẻ em. Biểu hiện lâm sàng nhiễm trùng thần kinh trung ương ở trẻ em rất đa dạng và thay đổi theo lứa tuổi. Việc phát hiện triệu chứng nghi ngờ để chẩn đoán sớm có ý nghĩa quan trọng, góp phần cải thiện tiên lượng bệnh qua việc quyết định điều trị sớm. Đối tượng: 61 trường hợp bệnh nhi được chẩn đoán và điều trị NTTKTW tại Trung tâm Nhi khoa Bệnh viện Trung ương Huế. Phương pháp nghiên cứu: Mô tả cắt ngang. Kết quả: NTTKTW hay gặp nhất ở nhóm trẻ > 5 tuổi (chiếm 52,5%); Các triệu chứng cơ năng thường gặp là ăn, bú kém (62,8% VMN, 98,9% viêm não), đau đầu (34,9% VMN, 61,1% viêm não), nôn (48,8% VMN, 38,9% viêm não); Các dấu hiêu thực thể thường gặp là sốt (79,1% VMN, 73,3% viêm não), rối loạn tri giác (79% VMN, 22,7% viêm não), hội chứng tăng áp lực nội sọ (65,1% VMN, 72,2% viêm não), hội chứng kích thích màng não (36,6% VMN, 22,2% viêm não), co giật (14% VMN, 44,4% viêm não, p < 0,05). Có mối tương quan nghịch giữa sự biến đổi tri giác ban đầu của bệnh nhi (đánh giá bằng thang điểm glasgow) với tần số tim (r = -0,412), tần số thở (r = -0,33), thời gian nằm viện (r = -0,612) và số lượng tế bào trong dịch não tủy (VMNM r = -0,575); VMN tăng lympho r = -0,686, VN r = -0,804). Kết luận: Biểu hiện lâm sàng của các nhóm bệnh lý nhiễm trùng thần kinh khá đa dạng, biến đổi tri giác ban đầu bệnh nhi là yếu tố tiên lượng bệnh. Từ khóa: Lâm sàng, cận lâm sàng, nhiễm trùng thần kinh trung ương trẻ em. ABSTRACT CLINICAL AND SUBCLINICAL CHARACTERISTICS OF CENTRAL NERVOUS SYSTEM INFECTION IN CHILDREN Background: Central nervous system infection (CNS) is a common disease, leading to many serious health and psychological consequences for each family’s patient as well as the whole society. The disease has a high mortality rate, especially in children. Clinical manifestations of CNS infections in children are variable, depending on age.Detecting suspicious symptoms for early diagnosis is important, contributing to improving prognosis through early treatment decisions. Subjects: 61 cases of patients diagnosed and treated at Pediatrics Center in Hue Central Hospital. Methods: Prospective observational study. Results:It showed that CNS infections are most common in children > 5 years old (52.5%); Commonsymptoms were poor feeding (62.8% meningitis, 98.9% encephalitis), headache (34.9% meningitis, 61.1% encephalitis), vomiting (48.8% meningitis, 38.9% encephalitis); Commonsigns are fever (79.1% meningitis, 73.3% encephalitis), altered mental status (79% meningitis, 22.7% encephalitis), increased intracranial pressure syndrome (65.1% meningitis,72.2% encephalitis), convulsions (14% meningitis, 44.4% encephalitis, p < 0.05). There is an inverse correlation between the change in the patient’s initial consciousness (assessed by the glasgow scale) with heart rate (r = -0.412), respiratory rate (r = -0.33), duration of hospitalization(r = -0.612) and the number of cells in the cerebrospinal fluid. Conclusions: Clinical manifestations of CNS infection are variable, the initial change in the patient’s consciousness is a predictor of the disease. Key words: Clinical, subclinical, Central Nervous System Infections.

These years, the debate surrounding the role of the first language (L1) in the second/foreign language (L2) classrooms in general and in English ones has been a controversial issue. On one hand, people support the idea that the influence of mother tongue should be excluded from second language acquisition. Meanwhile, the component of English-only method emphasizes the significance from the use of L1 in English classes. This paper aims to investigate the positive influences of the use of Vietnamese in English learning process. From this point, two main things will be demonstrated. Firstly, using Vietnamese has a facilitating role to play in the classroom and can actually boost students’ learning. And secondly, there are good reasons for teachers and students to use Vietnamese to fully suit the context of specific lessons. To conduct this study, both quantitative and qualitative approaches were used. First of all, an online survey was conducted to collect realistic information from the students’ perspective. On the other hand, there were some in-depth interviews for teachers and tutors to express their experience as well as their own ideas about this issue. Finally, two separate classes were formally observed when they took a sample lesson which was taught in different methods. At the end of the course, a small test was provided to students to examine how much they understood their lesson. All the statistics and information received was analyzed, then mentioned in the paper.