Demographic and Clinical Profile of Women Attending Genetic Clinic for Prenatal Invasive Testing at a Tertiary Referral Center, India

Background The Prenatal Invasive Tests (PIT) are used during pregnancy for the detection of genetic anomalies. Studies addressing the profile of women who come to seek prenatal invasive testing are scarce. Objective To assess the socio-demographic characteristics and clinical profile of women who are referred for prenatal invasive testing in a tertiary referral center in India. Method A descriptive, cross-sectional study was undertaken in 60 women who came to the genetic clinic at a tertiary referral center, New Delhi, India following counseling regarding prenatal invasive testing. Data was collected using a self-developed and validated semi-structured questionnaire, administered after the counseling for the test by the counselor. Data were analyzed using mean, percentage, standard deviation and range. Result The majority of the women were from urban residences and all of them were literate. Nearly half of the women were in the age group 21-30 years. Mean gestational age was 19.24 ± 2.63 weeks and most were pregnant for the second time. The main reasons for referral were advanced maternal age and abnormal obstetric ultrasonography. The participant's understanding of the test was still incomplete despite the counseling and there was a need for additional counseling/information. One-third of them preferred additional counseling whereas, the remaining twothirds preferred booklets and pamphlets. Conclusion The profiles of pregnant women referred to genetic clinic provide better insight about their background for the health personnel and this study emphasizes rechecking the understanding regarding invasive tests following counseling; which eventually helps for appropriate decision making regarding the tests.

Computerized Axial Tomography Findings in Children with Afebrile Seizures: A Hospital Based Study at Eastern Nepal

BACKGROUND

Computerized Tomography can be performed in resource limited areas where Magnetic Resonance Imaging is less practical. This study was conducted to find out the proportion of cases with abnormal CT scan and findings of CT scan in children with afebrile seizures in a resource limited area.

METHODS

This prospective study was conducted from 1st July 2009 to 31st March 2014 in a university hospital of Nepal. Patients (1 month to 20 years of age) presenting with history of afebrile seizure were included. Neuroimaging was prescribed; children were treated and followed-up as per standard guideline. Data were analyzed using SPSS 16.0.

RESULTS

There were 447 children with afebrile seizures included in the study. Male to female ratio was 1.6:1. Median age at presentation was 84 (interquartile range 36-144) months. CT scan was done in 321 (71.8%) cases. CT was abnormal in 143 cases, accounting for 32.0% out of total cases and 44.5% out of investigated cases. Among investigated cases, common CT findings were atrophy (13.4%), neurocysticercosis (12.1%), structural abnormalities (4.4%), stroke (3.7%), post-encephalitis changes (3.1%), nonspecific calcification (1.6%), tuberculoma (1.2%), tumor (0.9%), neurocutaneous syndromes (0.9%), hydrocephalus (0.9%) and other findings (2.2%).

CONCLUSIONS

In a resource limited area CT scan is a valuable alternative tool in evaluating a child with afebrile seizure. Majority of these children have remote symptomatic seizures and the underlying brain pathologies can be well detected by CT scan.