An Unusual Presentation of Recurrent Childhood Kimura Disease: Ileocecal Involvement.

Kimura disease commonly presents as an isolated swelling over the head and neck region. Intestinal involvement by Kimura disease in children is uncommonly reported. We report a 10-year-old boy who had presented with an ileocaecal mass with peripheral blood eosinophilia and elevated immunoglobulin E levels. The histopathologic examination from the ileocaecal mass was suggestive of Kimura disease. He had 2 recurrences once in the left axillary region and once in the bilateral cervical region. Ileocaecal involvement in Kimura disease is an uncommon presentation in childhood. Careful evaluation of complete blood count is critical in making diagnosis and avoiding unnecessary invasive procedures.

A Randomized Comparison between Video Demonstration and Verbal Instruction in Improving Rota Haler Technique in Children with Persistent Asthma: A Pilot Study.

INTRODUCTION: Inhalation therapy is the cornerstone in management of asthma. Failure to use the device properly is one of the factors incriminated in poor control of asthma. AIM: To compare the technique of rota haler use in children with persistent asthma immediately after receiving either verbal instruction or a video based demonstration and again at one month following intervention. MATERIALS AND METHODS: A total of 28 children, older than six years attending the childhood asthma clinic of our hospital, who were prescribed rota halers for the first time and who were technique naïve were enrolled into the study, after obtaining informed consent from the parents after meeting inclusion and exclusion criteria. They were then randomly assigned to either verbal instructions (group of 14) or video demonstration group (group of 14), for teaching them the rota haler technique. Their technique was then assessed using a modified version of the inhaler device assessment tool immediately after education and one month after the intervention. The proportions of children with good technique in both groups at both time points were compared. RESULTS: There was no significant difference in the baseline variables like age, gender, location, socio-economic status and disease duration between both groups. The proportion of children achieving good technique was significantly more in the video group than the oral instruction group at immediate assessment and also at one month post intervention with an odds of 8 and 23.40 respectively (p=0.0262 and 0.0075 respectively). CONCLUSION: Video demonstration is effective in improving the technique of rota haler use at immediate assessment and at one month post intervention. Further studies are needed to validate this study and to assess factors that predict successful device use.