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Background: The present study was carried out to describe the Histopathological features of various neoplasms in the urinary bladder biopsies and to categorize the neoplastic lesions according to W.H.O (2016)/ISUP classification of urinary bladder tumors. Materials and Methods: A total of 37 cases, 28 urinary bladder biopsies (TURBT) and 9 cystectomy specimens of urinary bladder neoplasia [histologically proved] of patients were studied retrospectively over the period from June 2016- Oct 2018 in Pathology department of Smt. N.H.L. medical college. All cases of urothelial carcinomas were graded histologically according to WHO (2016)/ISUP classification. Results: Maximum numbers of patients are in age group 60-69 years. Males (78.37%) are more frequently affected as compared to female. The most frequent Neoplastic findings in Urinary bladder is Invasive Papillary Urothelial carcinoma (81.06%); Low grade (37.8%) being more common than High grade (35.14%). A large percentage (80%) of high grade invasive urothelial cell carcinomas presented with muscle invasion. Conslusion: Invasion to the muscle propria layer correlates with high grade tumor. In 18.5% cases detrusor muscle was absent, hence the importance of including detrusor muscle in the biopsy specimens needs to be emphasized. We must accept the fact that grading is highly subjective and that in future various molecular and immunohistochemical studies will provide better reproducibility. Keywords: Invasive papillary urothelial carcinoma, Muscle invasion, Urinary bladder neoplasms.

Acinar Cell Cystadenoma (ACA) of pancreas is recently recognized pancreatic lesion by the World Health Organization (WHO) in 2010. It is a very rare benign cystic neoplasm of pancreas that only few cases ( understood. Histologically it is composed of variably sized cystic spaces lined by mature acinar cells, admixed with normal pancreatic parenchyma. Here we present the histopathology of a case of acinar cell cystadenoma with review of literature. Keywords: Acinar cell cystadenoma (ACA), Cystic pancreatic lesions (CPL), Cystic pancreatic neoplasms (CPN), Serous cystic neoplasm (SCN), Mucinous cystic neoplasm (MCN), Acinar cell carcinoma (ACC).

Introduction: Anemia is a common health problem in overall world especially in developing countries. Early and accurate diagnosis is needed to decide correct line of treatment. Material & Methods: The study was conducted in Hematology laboratory of medical college hospital for a period of 12 month during January 2018 to December 2018. Total 1500 anemic patients of 10-70 year of age were included in the study. Interpretation of RBC Histogram and peripheral smear examination was done in each case. Results: Out of total 1500 anemic cases, microcytic anemia is most common cause followed by normocytic, Dimorphic and macrocytic anemia. Female patients are more than male patients and most common involved age group is 31-40 years followed by 21-30 years. Discussion: Interpretation of RBC histograms is useful method for initial diagnosis of anemia and can be used for screening purpose to screen large population.

The objective of this study was to evaluate the performance of a lateral flow antibody test for COVID-19, approved for use in India. Although many point-of-care antibody tests are available globally, they have been subjected to limited clinical validation. This has led to suboptimal outcomes in the field, where antibody tests play a significant role in tracking the immunity of individuals and communities. In this study an antibody test, ImmunoQuick that recognizes antibodies to the Nucleocapsid and Spike proteins of SARS CoV-2 was tested in 100 symptomatic patients with a positive or negative diagnosis of COVID-19, based on RT-PCR results. The overall sensitivity of the test was found to be 86.1% (95% CI: 76.4% to 92.8%) and specificity 100% (95% confidence interval: 73.5% to 100%). The sensitivity reached a peak of 95.7% with samples taken 17 days after the onset of symptoms. Overall, the sensitivity and specificity of the test are sufficient for assessing seroprevalence.

ObjectivesConvalescent plasma (CP) as a passive source of neutralizing antibodies and immunomodulators is a century-old therapeutic option used for the management of viral diseases. We investigated its effectiveness for the treatment of COVID-19.DesignOpen-label, parallel-arm, phase II, multicentre, randomized controlled trial.SettingThirty-nine public and private hospitals across India.ParticipantsHospitalized, moderately ill confirmed COVID-19 patients (PaO2/FiO2: 200-300 or respiratory rate > 24/min and SpO2 ≤ 93% on room air).InterventionParticipants were randomized to either control (best standard of care (BSC)) or intervention (CP + BSC) arm. Two doses of 200 mL CP was transfused 24 hours apart in the intervention arm.Main Outcome MeasureComposite of progression to severe disease (PaO2/FiO2< 100) or all-cause mortality at 28 days post-enrolment.ResultsBetween 22ndApril to 14thJuly 2020, 464 participants were enrolled; 235 and 229 in intervention and control arm, respectively. Composite primary outcome was achieved in 44 (18.7%) participants in the intervention arm and 41 (17.9%) in the control arm [aOR: 1.09; 95% CI: 0.67, 1.77]. Mortality was documented in 34 (13.6%) and 31 (14.6%) participants in intervention and control arm, respectively [aOR) 1.06 95% CI: −0.61 to 1.83].InterpretationCP was not associated with reduction in mortality or progression to severe COVID-19. This trial has high generalizability and approximates real-life setting of CP therapy in settings with limited laboratory capacity. A priori measurement of neutralizing antibody titres in donors and participants may further clarify the role of CP in management of COVID-19.Trial registrationThe trial was registered with Clinical Trial Registry of India (CTRI); CTRI/2020/04/024775.

Introduction: Anemia is most prevalent health problem in our country in all age group and present in both men and women. Women of reproductive age group are most vulnerable for anemia. Objectives: This study was to find out the present status and the prevalence of anemia cases in our hospital which is tertiary care health centre. Methodology: This study was undertaken at the medical college hospital. A total of 650 cases of anemia were studied over a period of one year between January 2018 and December 2018. In all cases blood sample were collected in EDTA vaccute and Hb estimation and other findings were obtained from automated hematology analyzer and Peripheral smear examination was also done. Results: Out of total 650 anemic samples were from female patients and were from male patients. Majority of cases of anemia were having blood picture of microcytic hypochromic type. Conclusion: Females having more number of anemic cases and most them are preventable with early diagnosis, proper nutrition and awareness about their cause.

Introduction: Anemia is most prevalent health problem in our country in all age group and present in both men and women. Correct and early diagnosis of anemia is needed in each case to start proper treatment. Objectives: This study was to find out the correlation of findings obtained automated hematology analyzer and by peripheral blood smear examination in diagnosis and morphological classification of anemia. Methodology: This study was done at a tertiary care hospital attached with a medical college for a period of 3 month during January 2019 to March 2019. It was a prospective observational study having sample size of 400 anemic samples. In all cases blood sample were collected in EDTA vaccute and than further processed for hemoglobin estimation and findings of automated hematology analyzer and peripheral smear examination noted and compared. Results: Out of total 400 anemic samples 153 samples were from Males and 247 samples were from females and in 88.75% of cases (355 out of 400) findings of both methods are very well correlated. Conclusion: Both diagnostic methods have their own importance, automated hematology analyzers are useful in mass screening and bulk of work while PBS examination is needed to diagnose RBC abnormalities and correct morphological typing of anemia.

Introduction: Giant cell lesions of bone include true giant cell tumors & numerous benign osteoclasts and pseudo-anaplastic-appearing giant cells containing variants.Many times it is difficult to differentiate between true giant cell tumor and other tumor like conditions. Aims: To study histopathology of various giant cell rich tumor and tumor like conditions of bone. Methods and Material: Retrospective analysis of 50 cases of giant-cell rich lesions of bone diagnosed and treated at Smt. N.H.L. Municipal Medical College Ahmedabad, Gujarat during 1 st January 2002 to 1 st January 2003 included in the study. Patients’ clinical, radiological details, histopathological examination were studied using structured proforma. The cases were classified in different categories according to age groups, types of tumour, benign versus malignant category. Results: The most common giant cell containing benign tumor is giant cell tumor (19 cases) followed by Aneurysmal bone cyst (5), Most of the giant cell containing tumors of bone are found in younger age group and are located in epiphysis The common giant cell containing malignant tumor is osteogenic sarcoma (7 cases) followed by Talangiectatic O.S (01). The majority of cases found in age between 15 - 28 years and most common sites are epiphysis of long bones. Conclusion: The most common giant cell rich benign bone tumor is giant cell tumor and most common giant cell rich malignant bone tumor is osteosarcoma commonly occurs in younger age groups in the epiphysis region long bones DOI:10.21276/APALM.1524

ObjectiveTo investigate the effectiveness of using convalescent plasma to treat moderate coronavirus disease 2019 (covid-19) in adults in India.DesignOpen label, parallel arm, phase II, multicentre, randomised controlled trial.Setting39 public and private hospitals across India.Participants464 adults (≥18 years) admitted to hospital (screened 22 April to 14 July 2020) with confirmed moderate covid-19 (partial pressure of oxygen in arterial blood/fraction of inspired oxygen (PaO2/FiO2) ratio between 200 mm Hg and 300 mm Hg or a respiratory rate of more than 24/min with oxygen saturation 93% or less on room air): 235 were assigned to convalescent plasma with best standard of care (intervention arm) and 229 to best standard of care only (control arm).InterventionsParticipants in the intervention arm received two doses of 200 mL convalescent plasma, transfused 24 hours apart. The presence and levels of neutralising antibodies were not measured a priori; stored samples were assayed at the end of the study.Main outcome measureComposite of progression to severe disease (PaO2/FiO2ResultsProgression to severe disease or all cause mortality at 28 days after enrolment occurred in 44 (19%) participants in the intervention arm and 41 (18%) in the control arm (risk difference 0.008 (95% confidence interval −0.062 to 0.078); risk ratio 1.04, 95% confidence interval 0.71 to 1.54).ConclusionConvalescent plasma was not associated with a reduction in progression to severe covid-19 or all cause mortality. This trial has high generalisability and approximates convalescent plasma use in real life settings with limited laboratory capacity. A priori measurement of neutralising antibody titres in donors and participants might further clarify the role of convalescent plasma in the management of covid-19.Trial registrationClinical Trial Registry of India CTRI/2020/04/024775.

Cystic dystrophy in heterotopic pancreas is a rare, poorly understood benign disease of gastric and duodenal wall, which was described for the first time by the French authors in 1970, who reported the presence of focal pancreatic disease localized in an area comprising the C-loop of duodenum & the head of pancreas. We report a case of 33 years old male patient with complaint of recurrent abdominal pain with the probable diagnosis of groove pancreatitis on the clinoradiological findings. Whipple surgery was done. Diagnosis of cystic dystrophy in heterotopic pancreas in duodenal wall with chronic pancreatitis was given histopathologically.

Background: Both macroscopic and microscopic appearance helps in identification of the colon lesion which supports in the treatment of the patient in a better way. The authors were aimed at the prevalence of various colon lesions site wise distribution of various neoplastic and non-neoplastic lesions of the patients and to compare the distribution according to their age, sex and site.Methods: A retrospective study was designed to study of various intestinal biopsies sent for histopathological examination at Department of Pathology, N.H.L. Municipal Medical College and V.S. Hospital, Ahmedabad, from January 2015 to December 2016 for period of 2 years. The study was based on the histomorphological evaluation of colon lesions received during the study period.Results: A male preponderance was seen in the incidence of tumors irrespective of tumor type and site of tumor and M:F ratio was 1.64:1. In the large intestine, adenocarcinomas were the commonest malignant tumor. 46 cases (62.61%) were reported. The highest occurrence of appendicitis is in the 2nd and 3rd decade.Conclusions: The study revealed that various types of lesions in large intestine along with the age group and gender affected more. Male patients were majorly affected. Morphological identification helped to diagnose the type of lesion for early diagnosis. This study focuses the role of histopathological identification in early diagnosis of the disease so that the survival rates in such cases will be increased.

Today's teachers face a formidable challenge—how to facilitate the acquisition of basic skills, demanding content knowledge, and personal problem-solving capabilities for all students in increasingly diverse and competitive learning environments. Among the six national educational goals for the year 2000 (U.S. Department of Education, 1991), we seek to achieve (a) a high school graduation rate of at least 90%; (b) the demonstration of students' competency in challenging subject matter, including English, mathematics, science, history, and geography, and their readiness for responsible citizenship and productive employment; (c) the highest global standing for U.S. students in science and mathematics achievement; and (d) literacy and essential skills for every adult American. As educators concentrate on these goals and the accompanying educational reform directed toward their achievement, there is a fervent search for new ideas, along with an unprecedented tolerance for mold-breaking initiatives undertaken in both the public and the private sector (e.g., curriculum reform, site-based management, movement toward inclusion or unified special education/general education programs for students with and without disabilities, for-profit schools, national outcome measures). Across these diverse initiatives, commitment to the development of increased competency in academics, problem solving, personal development, and social responsibility represents a unifying theme. Ellis's article focuses on one critical challenge—the integration of "traditional teacher-directed approaches to content instruction with instructional approaches designed for teaching information processing and problem solving designed . . . [to] maximize students' acquisition of new knowledge and their ability to use effective and efficient information processes and problem-solving skills." Termed Integrative Strategy Instruction (ISI), the "potential" model is especially relevant for general education and special education teachers employed in systems seeking to increase the amount of time students with specific learning disabilities (and other disabilities) spend in the general education program. For those who have followed the development and use of instruction designed to promote strategic learning, Ellis's ISI model is a natural and appealing extension of previous efforts. It incorporates findings from foundation research, including work conducted by the University of Kansas Institute for Research in Learning Disabilities (KU-IRLD) research team, of which Ellis has been an active collaborator for many years. Drawing on a rich foundation of strategy or cognitive instruction research and information-processing theory, Ellis presents a well-articulated model with accompanying illustrative examples depicting how teachers can help adolescents, including those with learning disabilities, acquire an enriched content knowledge base necessary for independent and successful functioning and become "good" or "strategic" information processors and problem solvers. As with previously described models (e.g., Deshler & Lenz, 1989), this approach is based on the premise that efficient and effective learning is enhanced through the creation of strategic learning environments that foster the development of strategic behavior and are sensitive to learner attributes. In such environments, students develop learning strategies or tools that can be used to facilitate the analysis of task demands, determine how to best approach a problem, guide task completion, and monitor the effectiveness of their problem-solving process along the way. Distilling the presentation, the ISI model involves teacher-mediated instruction to facilitate strategic acquisition of declarative, procedural, and conditional knowledge and presentation of information-processing strategies within four "interacting" subthemes (i.e., use of prior knowledge and experiences, various cognitive strategies, metacognition, and selfmotivation techniques). Ellis views the model as being particularly useful for teaching content area subjects to stu

This study examines faculty and student perceptions regarding university students with learning disabilities, sensitivity to such students' special needs, accommodations, and the perceived impact of a learning disability. Results reveal a general sensitivity to the special needs of students with learning disabilities; however, group differences suggest several areas warranting further attention.

Background: Carcinoma of the breast is the most common malignancy in adult women and the second leading cause of cancer death in women. There is an uncertainty over natural history and factors leading to emergence of cancer of breast in women as well as in men. Aims & Objective: To study the various morphological types of malignant lesions and their age distribution, from Mastectomy and Post lumpectomy Mastectomy received from in and around Ahmadabad district, at Department of Pathology, Smt NHL MMC and Sheth VS Hospital, Ahmedabad. Material and Methods: Out of the specimens of breast which presented as mastectomy and post lumpectomy mastectomy specimens of breast to the Department of Pathology, Smt NHL MMC and Sheth VS Hospital, Ahmedabad for histopathological examination, 100 cases were taken up for this study. Detailed clinical data were noted as per the proforma with emphasis on history, gross examination and microscopic examination. Results: Majority of cases were carcinoma (87%). Majority of women (63%) were of age 41-60. Painless lump (77%) was found as most common symptoms, while nipple retraction was found in 3% cases and Peaude orange skin was found in 1% cases. Majority of patients had lump in the left breast (53%) followed by right breast (47%). 40% of patients presented with lump in the upper outer quadrant and 11% in lower outer quadrant. Out of the total 88 carcinomas of breast encountered, 85.2%, were Infiltrating Duct Carcinoma [IDC (NOS)], 1.1% were Ductal Carcinoma in Situ (DCIS), 1.1% each of mucinous carcinoma, invasive papillary carcinoma and acinic cell carcinoma, 2.2% were metaplastic carcinoma and 6.8% were invasive lobular carcinoma. Most of tumour was T3 (53.48%) followed by T2 (29.06%). In the case of pathological staging The majority of patients were present in stage IIIA (25.58%), stage IIB (24.41%) and stage IIIC (22.09%), followed by Stage IIA (18.60%). Vascular invasion was 21.3% in the case of IDC, 66.6% in the case of ILC and 25% in the case of stromal carcinoma. Conclusion: This study highlights the importance of histopathological examination in breast lumps not only in establishing the final diagnosis, but also in predicting the prognosis by typing, staging and grading malignant neoplasm of breast.

hen the beginning teacher encounters the realities of teaching, the appropriateness of his pre service preparation is subjected to a critical test: appli cation. Whether the teacher is successful appears to de pend on: (1) the accuracy to which the required skills have been identified by the course instructors and (2) the extent to which the preservice teacher masters the required skills. One set of competencies which we have identified as essential and seek to develop are those procedures which permit the teacher to systematically plan and effect behavior change. We are convinced that many, if not all, of the inap propriate or undesirable behaviors which are exhibited by the teacher and learner in the schools result from two major sources : ( 1 ) insufficient opportunities to learn adaptive behaviors and (2) conflicting inappropriate be haviors which have been learned. We are equally as cer tain that the major thrust should not be directed solely toward a behavior change on the part of the elementary and secondary school student but toward the preservice teacher who is a primary influencer in terms of what experiences will be arranged for the learner. Assuming that modeling (observing and imitating another's behavior) is a source of learning, the pre service teacher has experienced approximately fifteen years of observation which probably will influence his own teaching behavior. In addition, because of the realities of the student teaching experience, there is a tendency to imitate the cooperating teacher who serves as the model. In order to decrease the propensity of the student teachers to randomly imitate teaching behaviors previously observed, we have developed a program to purposefully shape the systematic acquisition of tech niques of proven effectiveness. Generally, preprofessional training includes extensive experiences of observation where the appropriateness of the exposure to models is uncontrolled. It therefore seems imperative that opportunities be provided so that those teaching behaviors presented during the teacher prepara w tin sequence will be the best possible model. In addition, we think that application of these principles should be supervised with sufficient opportunity for evaluation and redirection so that the preservice teacher can experience success.