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Background: The expeditious changes of the world today present massive challenges and demand rapid modifications in our education system. Focusing on concept-based learning and core understanding of topics for practical application is the cornerstone for a better outcome. Didactic Lectures (DL) are the most widely used method; however, in the current changing face of our education system, newer techniques like Self-directed Learning (SDL), SDL with Focussed Discussion (SDL-FD) and Problem- based Learning (PBL), which encourage active participation by the learner are being increasingly employed for better understanding of the subject. Aim and Objectives: To examine the effect of transition from traditional to newer methods on student performance. Material and Methods: We conducted a retrospective study involving 409 students, over two years, to evaluate the scores attained in examinations among topics delivered by different modalities namely DL, SDL, PBL and SDL-FD. Results: The scores achieved were higher among topics delivered by DL when compared with SDL and PBL approach which were statistically significant. The score of DL when compared with SDL-FD was higher, however did not have statistical significance. Conclusion: DL may help the learner immensely in a scenario of an examination-oriented evaluation. However, it may limit the learners' ability to question and ponder over the subject matter, mindlessly clinging to facts dissipated in class room. We recommend that a unified approach along with activities of self-learning and discussions, may tremendously improve the outcome. [ABSTRACT FROM AUTHOR]

Human parvovirus B19 is a known etiological agent for aplastic crisis in patients with chronic hemolysis and immunodeficiencies. The aplastic state caused in healthy children and adults is usually transient as compared to the more severe form seen in at risk population. Here we present a case of adult immunocompetent male with megaloblastic anemia complicated by aplastic crisis induced by parvovirus B19. A 23 year old male on treatment for megaloblastic anemia, presented with breathlessness, weakness and mild hepatomegaly. Laboratory investigations revealed an Hb-5.7g/dl, reticulocyte count-0.13% and absolute reticulocyte count of 0.00 × 106/µL. His serum vitamin B levels were 974 pg/ml. Bone marrow studies were 12 done to evaluate the cause. Aspiration smears showed erythroid suppression with large proerythroblasts having vacuolated cytoplasm and eosinophilic intranuclear inclusions (Lantern cells). Biopsy showed proerythroblasts with nucleomegaly, pale chromatin and eosinophilic intranuclear inclusions, morphologically suggestive of parvovirus infection. Parvovirus B19DNA was isolated by TaqMan PCR. Patient was managed by red blood cell transfusion to which he responded well. Aplastic crisis due to parvovirus B19 has been reported in patients with sickle cells anemia, thalassemia, haematological malignancies, transplant recipients and acquired immunodeficiency states. Development of erythroblastopenia due to parvovirus in background of nutritional anemia is unusual. A bone marrow examination in such a scenario helps to exclude causes like myelodysplastic syndrome, lymphoproliferative disorder and provides clues for diagnosis of parvovirus infection which is a treatable etiology. [ABSTRACT FROM AUTHOR]

Malignant pilomatricoma is an extremely rare tumour arising from the hair follicle. About 80 known cases are reported in literature till date. Presented herewith are two cases of malignant pilomatricoma, occurring in young female patients, each with a different clinical presentation and outcome. It is important to be aware of this entity as malignant pilomatricoma, though, initially locally aggressive, can recur if incompletely excised and also can metastasize to lungs, bones and lymph nodes.