Neuroimaging evaluation for first attack of unprovoked nonfebrile seizure in pediatrics: when to order?

Objective: To assess the value of neuroimaging studies in evaluating pediatric patients presenting with a first attack of nonfebrile seizure

Method: We reviewed the medical records of pediatric patients aged 28 days to 12 years who were admitted between 1 January and 31 December 2013 with a first attack of unprovoked, afebrile seizure. These patients had undergone neuroimaging studies. The exclusion criterion was patients with known predisposing conditions for seizure. The computed tomography [CT] scan and magnetic resonance imaging [MRI] results were either normal or abnormal, and the abnormal ones were further classified into clinically insignificant or significant. Descriptive analysis was performed to summarize the data

Result: Fifty children were identified with a mean age of 5.2 +/- 3.8 years. Of the 50 subjects, 29 [58.0%] were males and 21 [42.0%] were females. Sixteen patients [32.0%] had abnormal neuroimaging studies [CT scan, MRI or both]; however, only 1 was considered to have a clinically significant abnormality, later diagnosed as Moyamoya disease

Conclusion: In this study, the neuroimaging studies were found not to be useful in evaluating pediatric patients presenting with a first attack of unprovoked, nonfebrile seizures

Knowledge and self-reported practice of universal precautions among Kuwait university medical students in their clinical years

This cross-sectional study aimed to assess the knowledge and practice of universal precautions among Faculty of Medicine, Kuwait University, medical students in their clinical years. A self-administered questionnaire including 9 knowledge and 9 practice questions of universal precautions was used. A score was calculated for both knowledge and practice. These scores were dichotomized into less than median score [poor] and more than median score [good]. 244 students were invited to participate. Of the 244 students, 220 [90.2%] accepted to participate. Of the 9 knowledge questions about universal precautions, 7 were answered correctly by more than 60% [range 64.8-90.4] of the students. All questions regarding the practice of universal precautions were answered correctly by over 60% [range 61.8-96.4] of the students. The prevalence of poor knowledge was 38.2% [84/220] and poor practice was 27.7% [61/220]. Grade point average was significantly [p = 0.008] associated with the knowledge status of the respondents; however, it was not significantly associated [p = 0.397] with practice of universal precautions. Furthermore, neither the knowledge status nor any of the sociodemographic variables were significantly associated with the practice of universal precautions. A substantial number of students of the Faculty of Medicine, Kuwait University, in their clinical years appeared to have poor level of both knowledge and practice of universal precautions. Efforts are needed to optimize the level of knowledge and practice among students to minimize the risk of preventable infections