Chronic myeloid leukemia presenting with absence of basophils and marked dyspoiesis.

A 61-year old woman presented to us with fever, weakness and ecchymotic patches for one year. She had leucocytosis, anemia and thrombocytopenia. Peripheral blood smear showed 62% neutrophils, 32% myelocytes and metamyelocytes, 2% promyelocytes, 1% blasts, 2% monocytes, 1% lymphocytes but no basophils and marked dyspoiesis. Bone marrow picture was essentially the same. A diagnosis of atypical chronic myeloid leukemia was suggested. The correct diagnosis of chronic myeloid leukemia-accelerated phase was, however, made on cytogenetic analysis which showed Philadelphia chromosome (Ph) and isochromosome 17q [i(17q)]. This case describes a rare and diagnostically difficult presentation of CML arising out of a combination of prominent dyspoiesis and near absence of peripheral blood basophils.

The use of focus groups in social and behavioural research: some methodological issues.

The use of focus groups as a qualitative method for rapid assessment is discussed. A focus-group session is an in-depth discussion in which a small number of people (usually 8-12) from the target population discuss topics that are of importance for a particular study or project. Generally the participants are chosen purposively, and it is recommended that they should be homogeneous with respect to characteristics which might otherwise impede the free flow of discussion. Focus groups can be used for idea generation, in conjunction with a quantitative method, or as a primary data-collection method. However, if focus groups are used as a primary data-collection method, their results must be treated with caution. The main advantage of using focus-group discussions during rapid assessment is that they provide in-depth information without requiring full-scale anthropological investigations. The informal group setting is believed to make people feel at ease, encouraging them to express their views freely. However, there are a number of limitations to focus-group discussions. The samples are small and purposively selected, and therefore do not allow generalization to larger populations. In addition, as with other qualitative methods, the chances of introducing bias and subjectivity into the interpretation of the data are high. There are a number of methodological issues which still need to be addressed in order to further develop the method. Little is known about how many discussion sessions are needed to be reasonably sure that most aspects related to the subject of inquiry have been explored.(ABSTRACT TRUNCATED AT 250 WORDS)