Evaluating effectiveness of patient counseling, teach back versus standard method

Background: The aim of the study was to assess memory retention of new prescription education by comparing Teach back method and standard counseling method. And also to evaluate association of age, sex, drug use in past and education in memory retention.Methods: A prospective experimental study was carried out for a period of six months. Eligible subjects visiting pulmonary medicine outpatient department were screened and grouped into standard groups and teach back group. Patients in the standard group are taught eight counseling points about the drugs by one way dialogue method and asked at the end if there are any questions. while patients in the teach back method builds on the standard method by asking three open ended questions to recall what was taught and correcting any misunderstandings by two way dialogue method.Results: The demographic information (age, sex, education, current prescription use) are collected from both groups. The post counseling score is assessed by evaluator using a scoring sheet. Scores were analyzed using Mann Whitney U test Teach back group shows statistically significant (p value = 0.0001) increase in score compared to standard group. The mean value of teach back scoring is 6.28 while that of standard is 4.44.Conclusions: All the demographic parameters (Age, sex, drug use in past three months and education) do not show any significant association with scoring and memory retention (p value >0.05 for chi square test). The group that received teach-back method of counseling showed a significant improvement in patient knowledge and memory retention.

Papilloma of lip associated with human papilloma viruses‑32 infection in a child.

Squamous papilloma is the most common benign oral epithelial lesion, and it is well known to be associated with human papilloma virus 6 and 11. Here, we report a case of squamous papilloma associated with human papilloma viruses (HPV)‑32 in a 4‑year‑old boy who presented with a verrucous lesion on the lower lip. HPV‑32 is often associated with a rare benign condition focal epithelial hyperplasia (FEH). A limited number of lesions and the absence of characteristic histology ruled out FEH in our patient. To the best of our knowledge, the association of oral squamous papilloma with HPV‑32 is hitherto unreported.

Microlithiasis of the epididymis: a case report and review of literature.

Microlithiasis of the epididymis, which is not associated with epididymal inflammation, is a rare entity that has been infrequently published in the literature. We report, one such case that was incidentally detected in association with prostatic adenocarcinoma.

Adrenal schwannoma: a case report and review of literature.

Nerve sheath tumors occurring in the adrenal gland are uncommon. Although schwannomas originating in retroperitoneal and juxta-adrenal locations have been reported, those occurring in adrenal gland are rare. Till date no such case has been documented in the Indian literature.

Differentiated adamantinoma: a case report and review of literature.

Adamantinoma of the long bones are uncommon, slow growing tumors with a predilection for the tibia. A special rare variant known as the osteofibrous dysplasia-like adamantinoma or differentiated adamantinoma is thought to be a precursor of the classic adamantinoma. We report a case in a 24 year old female who presented with pain and lytic lesion of the left tibia. Microscopy showed a tumor composed predominantly of osteofibrous dysplasia-like areas with focal cytokeratin positive epithelial islands. This case is highlighted because of its rarity, its association with good prognosis and possible misdiagnosis as osteofibrous dysplasia.

A thyroid nodule with adipose metaplasia in a nodular goitre: a case report.

Fat containing lesions of the thyroid gland are a rarity with very few cases reported in the literature. We report a case ofa thyroid nodule with adipose metaplasia in a nodular goiter in a 67-year-old female.

Mucinous metaplasia of the prepuce--a case report and review of literature--a case report.

Benign mucinous metaplasia of the prepuce is a rare and under recognized entity which can easily be mistaken for extramammary Paget's disease. It is characterized by the presence of benign mucin containing cells in the squamous epithelium. To the best of our knowledge only 6 such cases have been documented in the literature. We would like to report the first case in our country.

Age related changes in Fas (CD95) and Fas ligand gene expression and cytokine profiles in healthy Indians.

Ageing in human and animal models show changes in many aspects of protective immunity, particularly lymphopoenia and progressive decline in immune functions leading to increased frequency of infection and neoplasia. However, the exact mechanism of these defects is still unclear. In this study, elderly subjects showed a decline in CD3+ and CD4+ T-cell subsets as well as serum IL-2 levels. Serum IL-6 was significantly raised while expression of its signaling receptor gp130 was significantly impaired in elderly as compared to the younger ones. Additionally, all the elderly individuals showed constitutive expression of Fas and FasL mRNA; however, none of the younger individuals expressed mRNA transcripts constitutively although induced expression was seen in both the groups. Similarly, frequency of Fas and FasL expressing CD4+ and CD8+ T-cell subsets were significantly (p < 0.001) higher in elderly subjects as compared to the younger ones. Elderly individuals also showed a significantly (p < 0.001) higher frequency of activation induced cell death (AICD). Since interaction of Fas with its cognate ligand (FasL) activates death inducing caspases leading to apoptosis, and gp130 induces anti-apoptotic signal through STAT-3 pathway, these results suggest that the decline in protective immune functions in aged individuals may be related to Fas and FasL mediated apoptosis of peripheral T-cell subsets.

Rosette formation in non Hodgkin's lymphoma in the bone marrow--a case report.

This is a case report of rosette formation in non-Hodgkin's lymphoma in the bone marrow. A 66 year old female on treatment for metastatic papillary carcinoma thyroid and non-Hodgkin's lymphoma of the nodular small cleaved cell type was found to have bone marrow infiltration by a low grade B cell lymphoma. Bone marrow aspirate, imprint and trephine biopsy showed rosettes of the abnormal lymphoid cells. The associations of papillary carcinoma thyroid, hyperglobulinemia and retroperitoneal fibrosis in this case which explain the histogenesis of rosette formation are discussed.