Histiocytic necrotising lymphadenitis (kikuchi's disease) [a 5 year histomorphological study].

Background: Kikuchi’s disease is a rare, benign, self-limiting disease, mainly involving the lymph nodes of young people. The disease has unknown etiology. Clinical symptoms and basic investigations in a patient often leads to a misdiagnosis, due to similar findings in other lesions like, lymphomas and chronic granulomatous inflammations of lymph nodes like tuberculosis. Lymph node biopsy shows characteristic diagnostic features. Methods: We studied all lymph node biopsies received in department of pathology & from other private laboratories in Rural and Urban areas, in & around Bareilly region of North India, in 5 years (2006-2010). Relevant clinical data was collected. Findings were correlated with previous studies. A total number of 1015 cases were examined. Results: A total of 15 cases showed histopathological features of Kikuchi’s disease. Most number of cases was seen in females, in the age group of 20-25 years. Patients presented with fever and lymphadenopathy, with a clinical provisional diagnosis of tuberculosis in maximum number of cases.Conclusion: Necrotising lymphadenitis has a striking predilection for cervical lymph nodes of females and is usually accompanied by fever. Most commonly, this disease is mistaken for tuberculosis or Lupus Lymphadenitis. Detailed clinical examination and characteristic histopathological findings help in diagnosing these lesions.

Teaching public health: seminar or lecture?

Introduction: Several pedagogical methods can be used to impart medical education but the challenge is to make students appreciate critical thinking and apply their knowledge. Objectives: We developed a strategy to train students in public health due to the managerial constraints and academic interest. The academic purpose was to avoid passive learning, increase student involvement, encourage interaction and make learning more engaging and effective.  Methods: Instead of delivering lectures, we encouraged the students to prepare seminars on topics of public health importance based on the guidelines provided by the lecturers and present them to their peers. The lecturers were present only to guide and supervise the students. Using a questionnaire, students’ perception on the lecture and seminar mode of teaching was evaluated.  Results: Lecture: Organizational content and the learning outcomes were better (p=0.00). Study material easily available (p=0.003), useful (p=0.01), better content (p=0.00) and quality (p=0.00). The students claim that there was more teacher guidance (p=0.00), care for student learning (p=0.00) and the interest and understanding in the subject taught increased (p=0.00). Flow of the subject matter was also better (p=0.00).Seminar: More students assumed that their knowledge was adequate prior to the seminars (p=0.00). They found the seminars to be difficult. Motivation to read about the topic was increased. Improved the students presentation skills (p=0.001), communication skills (p=0.00) and provoked interest in the topics taught (p=0.04). Played a bigger role in student interaction, problem solving and teamwork. More students agreed that there was more student involvement and that seminar provoked their interest. Conclusion: From the findings of this study we found that a combination of both the methodologies is ideal as both have strengths as well as weaknesses

Teaching public health: seminar or lecture.

Introduction: Several pedagogical methods can be used to impart medical education but the challenge is to make students appreciate critical thinking and apply their knowledge. Objectives: We developed a strategy to train students in public health due to the managerial constraints and academic interest. The academic purpose was to avoid passive learning, increase student involvement, encourage interaction and make learning more engaging and effective. Methods: Instead of delivering lectures, we encouraged the students to prepare seminars on topics of public health importance based on the guidelines provided by the lecturers and present them to their peers. The lecturers were present only to guide and supervise the students. Using a questionnaire, students’ perception on the lecture and seminar mode of teaching was evaluated. Results: Lecture: Organizational content and the learning outcomes were better (p=0.00). Study material easily available (p=0.003), useful (p=0.01), better content (p=0.00) and quality (p=0.00). The students claim that there was more teacher guidance (p=0.00), care for student learning (p=0.00) and the interest and understanding in the subject taught increased (p=0.00). Flow of the subject matter was also better (p=0.00). Seminar: More students assumed that their knowledge was adequate prior to the seminars (p=0.00). They found the seminars to be difficult. Motivation to read about the topic was increased. Improved the students presentation skills (p=0.001), communication skills (p=0.00) and provoked interest in the topics taught (p=0.04). Played a bigger role in student interaction, problem solving and teamwork. More students agreed that there was more student involvement and that seminar provoked their interest. Conclusion: From the findings of this study we found that a combination of both the methodologies is ideal as both have strengths as well as weaknesses.

Unmet Needs for Contraception in Married Women in a Tribal Area of India

Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception. Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS. Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception. Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.

pattern of sensitisation to inhalant allergens in Omani patients with asthma, allergic rhinitis and rhinoconjunctivitis

Identification of relevant allergens that are prevalent in each environment which may have diagnostic and therapeutic implications in allergic diseases. This study aimed to identify the pattern of sensitisation to inhalant allergens in Omani patients with asthma, allergic rhinitis and rhinoconjunctivitis. The study was carried out during three consecutive years [2004-2006] at the allergy skin test laboratory of Sultan Qaboos University Hospital, Oman. Records of patients who had undergone an allergy skin prick test with a referring diagnosis of asthma, allergic rhinitis or rhinoconjunctivitis were reviewed. Two panels were used during the 3 years period. The frequencies of positive skin tests were analysed. Results: 689 patients were tested, 384 for the first panel and 305 for the second panel. In the first panel, the commonest positive allergens were: house dust mites [37.8%], hay dust [35.4%], feathers [33.3%], sheep wool [26.6%], mixed threshing dust [25.8%], cat fur [24.2%], cockroach [22.7%], straw dust [22.7%], horse hair [17.4%], maize [16.?%], grasses [11.5%], cotton flock [10.7%], trees [10.4%], cow hair [7.8%], Alternaria alternata [3.6%], Aspergillus Niger [3.4%], and Aspergillus fumigatus [?.3%]. In the second panel, the commonest positive allergens were also house dust mites: Dermatophagoides pteronyssinus [50.8%], Dermatophagoides farinae [47.9%]; Mesquite [Prosopis glandulosa] [35.7%], Russian thistle [Salsola kali] [34.4%], cockroach [32.1%], Bermuda grass [Cynodon dactylon] [19.7%], grass mix-five standard [18.0%], wheat cultivate [14.1%], cats [13.8%], Penicillium notatum [4.3%], Alternaria tenius [3.9%], Aspergillus Niger [3.3%], feather mix [3.0%], dog [2.6%], horse hair and dander [2.6%], and Aspergillus fumigatus [1.6%]. The pattern of sensitisation to environmental allergens in Oman seems to be similar to other reports from the Arabian Peninsula. Methods to identify and characterise environment specific allergens like a pollen survey may help in the management of patients with allergic asthma, allergic rhinitis and rhinoconjunctivitis

learning organization and health care education

The 'Learning Organisation' is a concept first described by Peter Senge as an organisation where people continuously learn and enhance their capabilities to create. It consists of five main disciplines: team learning, shared vision, mental models, personal mastery and systems thinking. These disciplines are dynamic and interact with each other. System thinking is the cornerstone of a true learning organisation and is described as the discipline used to implement the disciplines. In a learning organisation, health care education aims to educate its members with up to date knowledge to produce competent and safe personnel, who can promote quality in health care services. In addition, there are some educational concepts and theoretical models, which are of relevance to the learning organisation, and can provide a framework for managerial decisions. The stages required to achieve the principles of a learning organisation will be described in detail. Moreover, in a proper culture which supports the learning organisation, members continuously learn to improve the environment and never remain passive recipients