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With the growing use of mixed reality teaching simulations in teacher education there is a need for researchers to examine how preservice teacher (PST) learning can be supported when using these simulations. To address this gap the current study explores how 47 PSTs used an online teaching simulation to facilitate a discussion focused on argumentation with five student avatars in the MursionTM mixed reality simulated classroom environment. We assessed PSTs' performance in the simulation using rubric-level scores assigned by trained raters and then compared the scores to PSTs' survey responses completed after their discussion asking them to self-report their goals for the discussion, how successful they thought they were across five dimensions of facilitating high-quality, argumentation-focused discussions, and their overall perceptions of the mixed reality teaching simulation. Findings suggest that PSTs' understanding of the discussion task's learning goals somewhat predicted their success in facilitating the discussion and that PSTs' self-assessment of their performance was not always consistent with raters' evaluation of the PSTs' performance. In particular, self-assessment was found to be most consistent with raters' evaluations for those PSTs with higher rater-assigned scores and least consistent for those with lower rater-assigned scores. The implications of these findings are as follows: (1) researchers should be cautious in relying on PST self-report of success when engaging in mixed reality teaching simulations, particularly because low performance may be obscured, (2) teacher educators should be aware that reliance on self-report from PSTs likely obscures the need for additional support for exactly those PSTs who need it most, and (3) the field, therefore, should expand efforts to measure PSTs' performance when using mixed reality teaching simulations.

Introduction: The Papanicolaou Society of Cytopathology System for reporting Pancreaticobiliary Cytology (PSCPC) is a reliable method to classify pancreatic fine needle aspiration cytology (FNAC) smears. However, it is not without practical problems which can diminish the diagnostic accuracy of the cytological diagnosis. Aims and Objectives: To determine the diagnostic pitfalls while reporting cytomorphology of pancreatic lesions according to PSCPC on correlating FNAC findings with histopathology. Materials and Methods: Retrospective analysis of pancreatic FNAC smears received in the Department of Pathology of our tertiary care institute over a period of 2 years was done. The cytological diagnoses were classified according to the Papanicolaou Society of Cytopathology system of reporting pancreaticobiliary cytology and correlated with histopathology. The reasons of cyto-histological discordance were analyzed. Results: Out of 50 cases in which both FNAC and biopsy of pancreatic lesions were done, 34 cases were positive/malignant (Category VI), eight cases were suspicious for malignancy (Category V), three cases were neoplastic (Category IV), two cases were atypical (Category III), two cases were negative for malignancy (Category II), and one case was non-diagnostic (Category I). Out of 50 cases, histopathology was non-diagnostic due to inadequate material in six cases. The cytological diagnoses were compared with histopathology in the remaining 44 cases. Categories III, IV V, and VI were considered as positive for neoplastic pathology. The sensitivity of FNAC to predict neoplastic pathology was 97.5%, while the specificity was 25%. The positive predictive value was 92.9%. Two cases reported as atypical (Category III) turned out to be adenocarcinoma on histopathology. One case reported as neuroendocrine tumor and two cases reported as adenocarcinoma on cytology displayed features of chronic pancreatitis on histology. One case reported as neoplastic mucinous cyst (Category IV) turned out to be adenocarcinoma on histology (limited concordance). Conclusion: The cytopathologist needs to be wary of the potential pitfalls to improve the diagnostic accuracy of FNACs.

Introduction: Small, undifferentiated cells with high nuclearto-cytoplasmic ratios predominate in Small Round Blue Cell Tumours (SRBCT) and are characterised by their monotony. The classification of small round-cell tumours is further facilitated by Immunohistochemistry (IHC). Determine the line of differentiation using IHC, which also acts as a proxy for underlying molecular genetic changes. To identify the presence of a particular protein marker that can help with accurate cancer categorisation and diagnosis, histology uses IHC. In light of this, SRBCT are a subgroup of highly aggressive malignant neoplasms that are primarily comprised of monotonous, small, undifferentiated cells with high nuclear-to-cytoplasmic ratios. Aim: The study is aimed to analyse the role of IHC in the SRBCT to differentiate and accurately diagnose the tumour cells using molecular markers. Materials and Methods: This ambispective was conducted from August 1st, 2010 to 31 st July 2015, a total of five years. All specimens of SRBCT less than 18 years of age were analysed grossly and microscopically. The study covered patients who were in the paediatric age range. The study did not include the small, spherical, blue-cell tumours of the bone marrow. The SRBCT were distinguished and categorised using immunohistochemical staining. CD99, CD20, CD15, CD30, CD3, desmin, CD45/LCA (the Lymphocyte Common Antigen), chromogranin, Myogenin, Synaptophysin (SYP), Cytokeratin (CK), and Epithelial Membrane Antigen (EMA) were among the immunomarkers used in this investigation. Results: Total 54 cases of SRBCT were analysed. This included 12 cases of Non Hodgkin’s Lymphoma (NHL), 10 cases of Ewing/Primitive Neuroectodermal Tumours (PNETs), 12 cases of Hodgkin’s Lymphoma (HL), nine cases of rhabdomyosarcoma, four cases of neuroblastoma, two cases each of Langerhans Cell Histiocytosis (LCH) and synovial sarcoma, and one case each of olfactory neuroblastoma, sarcoma and ganglioneuroblastoma. Conclusion: This study shows that utilising IHC in challenging circumstances is incredibly helpful and crucial where clinicalhistomorphological findings are not sufficient for arriving at the final diagnosis. The majority of SRBCT developed in younger age groups, with lymphoma being the most prevalent type.

The population of the elderly in the world will double from 2015 to 2050, reaching nearly 2.1 billion. The ageing population suffers from physical, mental health, and psychological well-being. There such customized policy that caters to helping the ageing population. The current examination studies ageing women, their health, and their quality of life () in India. The study tried to capture the two major and vast diversified areas. Respondents were randomly selected from four south and north Indian states. The present investigation covered 64 cities in these four states and collected 1,100 samples. The data analysis revealed that QoL has a significant difference with different demographic factors as well as health status, Literacy level, marital status, socioeconomic status, and health status of elderly women. Most of them suffer from diabetes, hypertension, and digestive system issues, so they need regular medical care and attention. Further data analysis unearthed that most ageing women belong to middle and lower socio-economic backgrounds. The government should focus more on their financial assistance and food security and arrange proper counselling therapy for their mental health to improve their QoL. The study contributes to the constructive and reflective handling of the health and well-being of the ageing female population. Policymakers must look into the health issues of the elderly population and make customised policies and actions that can assist the elderly population.

Sugarcane, an important sugar producing crop provides raw materials for sugar industries hence, creates employment for the human population. In India, sugarcane planting has large sowing window starting from autumn (October-November) to spring season (February- March/April). To determine the optimum planting time of sugarcane cultivars, a field experiment was conducted during 2017-18 at two diverse locations (Faridkot and Gurdaspur) of Punjab, in split plot design having three planting dates (February 25th, March 25th and April 25th) in main plots and four sugarcane cultivars (CoPb 91, CoJ 88, Co 0118 and Co 0238) in sub-plots with 3 replications. Results described that the sugarcane crop planted on February 25 produced more tillers that resulted in maximum millable canes (i.e., 113.8 '000 / ha at Faridkot and 107.3 '000 / ha at Gurdaspur, respectively). At both sites, maximum cane yield of 128.4 and 136.3 t / ha was recorded under the February 25 planted crop, which was 15.5 and 18.4 % more than March 25 and 31.2 and 36.9% higher than the April 25 planted crop, respectively. At both locations, the higher cane yield (128.4 and 136.3 t / ha) under February 25 planted crop might be attributed to improved yield parameters such as more millable canes (113.8 and 107.3'000/ha), higher single cane weight (1.2 and 1.4kg) and better quality attributes viz., extraction (55.9 and 56.1%), brix (18.5 and 18.6%), sucrose (16.5 and 16.8%), purity (89.3 and 90.5%) and commercial cane sugar (11.5 and 11.8%). Stable sugarcane yield of Co 0238 was obtained in agro climatic zone II, while CoJ 88 was very uniform in agro climatic zone IV, so these varieties can be selected for cultivation in respective agro climatic zones of Punjab. Therefore, variety CoJ 88 is suitable for Faridkot and Co 0238 for Gurdaspur. In contrast, Co 0118 showed very inconsistent performance at both regions.

Introduction Fine-needle aspiration cytology (FNAC) is an easy, quick, and specialized technique to distinguish neoplastic from non-neoplastic adrenal lesions, yet limited to tertiary care centers. It helps in analyzing symptomatic, as well as incidental adrenal lesions with high sensitivity and specificity. Aim This study was conducted to determine the cytological spectrum of adrenal lesions in a tertiary care center. Material and Methods This was a retrospective study which included a total of 19 cases of adrenal FNAC received from June 2017 till June 2019 in a north Indian tertiary care university hospital. All the lesions were broadly classified into non-neoplastic and neoplastic categories. The non-neoplastic lesions were divided into infective causes and cystic lesions. Neoplastic lesions were further grouped into benign and malignant lesions. Immunohistochemical findings were retrieved from the hospital records wherever accessible. Results A total of 19 cases were aspirated, of which 16 cases (84.20%) yielded satisfactory material. Six cases (31.57%) showed non-neoplastic pathology of which one was a cystic lesion, three were infective (two histoplasmosis and one tuberculosis), and two showed only benign adrenal cortical cells in a setting of known extra-adrenal primary malignancy. The neoplastic group comprised of 10 cases (52.63%) of which 4 cases showed metastatic carcinomatous deposits from a known extra-adrenal primary malignancy and 6 cases showed primary adrenal neoplasm (one case of myelolipoma, one case of pheochromocytoma, and four cases of adrenal neoplasm) which were then subjected to biopsy and immunohistochemistry. A final diagnosis of pheochromocytoma was made in three cases, adrenocortical carcinoma in one case, and one case was inconclusive because of nonrepresentative biopsy. Conclusion Image-guided fine-needle aspiration cytology of adrenal lesions helps to determine the exact nature of the infection, avoids unnecessary surgery, and helps in targeted management. However, histopathological evaluation with immunohistochemistry remains the diagnostic modality of choice with regard to neoplastic lesions.

Administering myelosuppressive chemotherapy to patients with aggressive malignant hematologic disorders typically poses serious infectious complications, which can be exacerbated by the presence of active COVID-19 infection. We report on a case of a successfully treated fit elderly woman with refractory acute myeloid leukemia (AML) who also had mild COVID-19 infection and detectable viral load at the time she was found to have recurrent disease. Prior to initiation of reinduction treatment with cytarabine/idarubicin, this 2-dose COVID-19-vaccinated patient received antiviral therapy with remdesivir with resolution of upper respiratory symptoms. This was followed by sotrovimab on the third day of chemotherapy. Throughout her hospital course, she remained hemodynamically stable with one episode of neutropenic fever without other identified infections. Symptomatic reactivation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 was not observed. After achieving biopsy-confirmed morphologic remission of AML and with neutrophil recovery, the patient gradually cleared the virus, eventually testing negative on polymerase chain reaction test of the nasopharynx. This case underlines the importance of considering initiation of timely chemotherapy, although myelosuppressive, in appropriate patients with aggressive hematologic malignancies and concomitant SARS-CoV-2. It demonstrates management of active COVID-19 infection in this group of patients and the dynamics of SARS-CoV-2 viral load during leukemia treatment.

Indian children experienced large-scale disruption in educational, psychological, and social welfare access when schools abruptly closed due to COVID-19. In addition to education, the Indian public school system provides services such as meals and benefits related to improving gender parity and indirectly preventing child labor, child marriages, and abuse. Therefore, sustained school closures led to an unfolding disaster in terms of learning loss and multiple unknown effects on children’s social and psychological wellbeing. This descriptive study attempts to understand these consequences by asking Indian parents about the emotional, psychological, and academic impacts on their children. Results suggest an adverse impact on children’s education and wellbeing. Families reported higher levels of psychological distress, anxiety, and aggression among children. However, the manifestations and ramifications seem to be different—while families from low-income segments struggled to get access to digital devices, others in upper-income segments had to confront excessive device time use. The results suggest that there is a need for a concerted, sustained, multipronged, differential response from the government and civil society to ensure that families can handle these challenges accordingly.

Introduction: The incidence of opportunistic fungal infections has increased considerably in recent years. The clinical manifestations of these infections are non specific, and laboratory methods generally cannot diagnose infection at an initial phase.So,it is necessary to understand these infections for the treatment of immunocompromised patients adequately. Aim: To study the prevalence of common opportunistic fungal infections in immunocompromised patients in northern India. Materials and Methods: A prospective cross-sectional observational prevalence study was conducted in the Department of Microbiology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India, from March 2020 to August 2021, on 185 immunocompromised patients. Follow-up was done for a period of six month. Weekly blood samples were drawn and presence of any fungal colonisation was identified with methods such as growth in sabouraud dextrose agar and Indian ink staining. Statistical tests used were prevalence and positive prevalence rate to estimate the most common opportunistic infection in immunocompromised individuals. Results: Out of 185 patients, oropharyngeal candidasis was found to be most common (143, 77.3%) in which opportunistic fungal infections caused by Candida spp. were found in 67 (46.8%) patients representing the most common causing agents followed by Pneumocystis jiroveci (12.5%) and Cryptococcus meningitis (38.2%). Conclusion: Oropharyngeal candidiasis was found to be most common opportunistic fungal infection. This study would help to extend the awareness to clinicians to come up with the right diagnosis and earlier treatment of those infections with the right management of the patients especially in resource limited regions in India.

Background: Unilateral pleural effusion is a challenge for a physician as the differential diagnosis is varied; sparse epidemiological data are available from India on this subject. Methods: We prospectively studied consecutive adult patients (aged >18 years) presenting with unilateral pleural effusion who underwent thoracocentesis with or without radiological guidance for diagnostic workup. Results: Over a period of 1 year, 116 patients admitted with unilateral pleural effusion were included, majority (63.8%) were in the age group of 20–60 years. Most common presenting symptoms were shortness of breath (56%), fever (53.4%), cough (52.5%), chest pain (35.3%), anorexia (34.5%) and weight loss (18.9%). Ninety-nine patients (85.3%) had exudative and 17 patients (14.6%) had transudative pleural effusion. Amongst exudative, tuberculosis (TB) pleural effusion was the most common cause (45.7%) followed by para-pneumonic (12.9%), malignant (10.3%), among others. TB (44.8%) and malignancy (10.3%) were common aetiologies among the lymphocyte-predominant effusions, whereas para-pneumonic effusion (11.2%) and empyema (4.3%) were common aetiologies amongst the neutrophil-predominant effusions. Pleural fluid lymphocyte-to-neutrophil ratio >0.75 increased the sensitivity and specificity to diagnose TB pleural effusion. Conclusions: Patients with TB pleural effusion were comparatively younger as compared to patients with malignant and para-pneumonic pleural effusion. Most pleural effusions resolved with treatment of underlying cause.

Background: Leukemic infiltration of the optic nerve is a neuro-oncologic emergency and also a sign of extramedullary central nervous system relapse. It presents a clinical dilemma in the early stages due to multiple differentials. Patients with leukemia receive radiation and chemotherapy are thus, susceptible to inflammatory, toxic, and infectious causes of optic neuropathy, besides infiltration with tumor cells. Clinical Description: A 15-year-old boy treated for acute lymphoblastic leukemia (ALL) and in remission for 7 months, presented with the unilateral decreased vision for 7 days. A structured evaluation was done, comprising visual acuity, color vision, field of vision, fundus, ophthalmoscopy, ultrasound b-scan, and magnetic resonance imaging of the orbit. The final diagnosis was leukemic infiltration of the optic nerve. Cerebrospinal fluid (CSF) analysis confirmed the presence of atypical lymphocytes. Management: The patient was diagnosed with extramedullary relapse of ALL. Since there are no standard guidelines, a literature review was performed, and the treating team decided to start the patient on stand-alone chemotherapy. Symptomatic resolution became apparent within 10 days. On follow-up, the optic nerve lesion resolved with residual gliosis in the surrounding retina. The CSF has become clear, and the patient is now considered to be in remission. Conclusion: It is important to use a structured clinical approach coupled with investigations to recognize the ocular involvement of ALL (especially in younger patients). There is a need for a regular routine ophthalmological examination in patients in remission for early detection of a relapse. There is a strong felt need for pediatric hemato-oncologists to plan research in this area to generate data so that recommendations for the management of extramedullary relapses are formulated.

Radiological investigations are essential for the diagnosis and classification of fungal rhinosinusitis; however, radiological findings might occasionally be misleading. Computed tomography (CT) scan and magnetic resonance imaging (MRI) complement each other, facilitating clinicians to arrive at a diagnosis. Hence, even with the best radiological modalities, correlation between clinical and microbiological findings is crucial for the accurate diagnosis of fungal rhinosinusitis. In addition, the role of traditional methods such as KOH microscopy and culture should be accurately evaluated. To this end, we aimed to diagnose rhinosinusitis with a fungal etiology based on radiological findings and subsequently correlate these findings with those of microbiological techniques, namely culture and KOH microscopy. A total of 57 clinically suspected fungal rhinosinusitis cases were included in the study. Radiological investigations were performed using either CT or MRI. Tissues samples were processed and analyzed using KOH microscopy and culture. The results of the study suggest that using a single method for the diagnosis of fungal rhinosinusitis is inadequate. Rather, the diagnosis should be based on radiological as well as microbiological findings, especially for cases that are clinically ambiguous.

Understanding the factors contributing to the persistence and retention of students in science, technology, engineering, and mathematics (STEM) is among the main issues of concern within STEM post-secondary education. The literature suggests that teacher self-disclosure and emotional and behavioral engagement play a significant positive role in the learning process across disciplines. Such factors may lead to improved academic achievements and retention in STEM disciplines. A variety of studies examined the relationship between teacher self-disclosure and emotional and behavioral engagement within the field of humanities, but less within the fields of STEM. This study used structural equation modeling (SEM) to examine the relationship between teacher self-disclosure and emotional and behavioral engagement of 208 undergraduate students enrolled in a two-year Freshman Research Immersion program. The results showed significant relationships between different aspects of teacher self-disclosure and classroom engagement. Additionally, STEM students view that high amounts of teacher self-disclosure can be related to negative aspects of classroom engagement such as emotional engagement anxiety. The study’s significance lies in practical recommendations associated with the strategic use of instances of teacher self-disclosure while teaching STEM classes and ways to support STEM undergraduate students’ levels of classroom engagement.

As the world experienced the COVID-19 outbreak, education was one of the multiple systems that were hit hard. We explored the consequences of the reconfiguration of schooling based on the experiences of the educational stakeholders caught up in the sudden transition to virtual schooling during COVID-19. Using Bronfenbrenner’s (1976) Ecological Systems framework, we underscored the complexity of the individual’s socio-cultural world and the myriad influences that impact the individual’s growth to examine how agents involved in the educational system have dealt with this unanticipated crisis academically, personally, socially, and emotionally. People can endorse contradictory positions on the same policy. Recognizing that multiplicity of voices might bring a different perspective, we captured various voices—an administrator leading the teachers’ professional development, a public-school elementary teacher, and a parent with two kids. Using unstructured interviews, we unpacked the narratives and counter-narratives of the participants to unpack “what worked” and “what did not work” during virtual learning and teaching environment. The voices centered in this article offer a rich source of insight into challenges faced by those who are at the forefront of the educational crisis—teachers and parents. The results showed how various communities cooperated to deal with such unprecedented times while maintaining the responsibility of educating children. The key trends that emerged from our qualitative investigation were: 1) development of collaboration among teachers as they transitioned into virtual teaching, 2) flexibility of the school leaders to assist the teachers in this new instructional modality, and 3) parents’ acknowledgment of the teachers’ efforts to assist their children.

Examining the nature of teachers’ emotions and how they are managed and regulated in the act of teaching is crucial to assess the quality of teachers’ instruction. Despite the essential role emotions play in teachers’ lives and instruction, research on teachers’ emotions has not paid much attention on teachers’ emotions in the context of daily teaching. This paper explored elementary teachers’ emotions while preparing for teaching and during teaching mathematics, reasons that underlie these emotions, and the relationship between their emotions and the quality of their mathematics instruction. Participants were seven elementary teachers working in the U.S. who participated in Holistic Individualized Coaching (HIC) professional development that consisted of five cycles of coaching over an year. For each coaching cycle, pre-coaching conversation and post-coaching conversation data were collected regarding emotions teachers felt in anticipation of teaching and during teaching retrospectively. In order to compare teachers’ emotions with instructional quality, coaching sessions were video recorded and analyzed to determine the quality of instruction. Findings of this study showed that teachers reported six categories of emotions (positive, negative, neutral, blended-positive, blended-negative, and mixed), described emotions often in non-typical ways (e.g., “not nervous”, “anxious but in a positive way”), and experienced mixed emotions (co-occcurence of positive and negative emotions) as the most dominant emotion. Teachers also had more positive emotions anticipating teaching than actually teaching the lesson. The reason teachers felt mixed emotions reflected the complex and context-specific nature of teaching, a phenonemenon not currently described in the teacher emotion literature. There were no clear relationships between emotional experiences and instructional quality. This study allowed participants to freely describe their authentic, complex, overlapping, and ambiguous emotions in the context of active teaching, which contributes opening up the possibilities of diversifying teacher emotion research and shows the significance and usefulness of understanding teachers’ emotions related to active instruction.

Background: The incidence of coronary artery disease (CAD) has risen considerably in developing world due to industrialization, urbanisation and lifestyle changes, especially among Indians and South Asians. The onset of CAD has been seen to occur at an early age and the severity of the disease and mortality associated with CAD has also increased. The pathology of atherosclerosis needs to be re-evaluated to develop targeted therapy which can contain the disease process at the earliest stage. Aims and Objectives: Most of the morphological studies on atherosclerosis have been done on autopsy cases. In this study, we have analysed the morphological spectrum of atherosclerotic lesions in live patients. Materials and Methods: We retrospectively analysed the histopathology slides of 85 cases whose endarterectomy plaques were received in the Department of Pathology over a period of three and half years (January 2014 to June 2017) and classified the lesions according to Modified American Heart Association classification of atherosclerosis. Results: The average age of patients was 60 years and male to female ratio of 4.3:1. Left anterior descending artery was the commonest vessel involved (52.4%). Majority of the cases had fibrocalcific plaques,followed by fibrous cap atheroma and calcified nodules. Conclusion: Coronary artery plaques were found even in patients less than 40 years old. Aggressive lipid defense therapy needs to be the cornerstone of management of CAD.

Entamoeba histolytica has been rarely reported as superadded infection over carcinomatous growth on rectal brushings. We present a case of 68-year-old male who presented with abdominal pain and bleeding per rectum who was found to have an ulceroproliferative growth on sigmoidoscopy. Rectal brushings revealed coexistence of E. histolytica with malignant cells of adenocarcinoma. No organism was detected on biopsy of the tumor, which also showed adenocarcinoma, because of possible surface colonization of the tumor by Entamoeba. This case highlights the role of rectal brushings in detecting superadded infection in a case where both brushings and biopsy were performed. It is always important to report infection superadded on malignancies for optimum management of the patients.

Preparing future mathematics teacher educators (MTEs) with knowledge that are needed to effectively support pre-service teachers (PSTs) is very important. However, little attention was paid to MTEs’ knowledge development, which is multifaceted and complex. This study investigates successes, challenges, and tensions that four international graduate MTEs and one mathematics teacher educator (TE) experienced in developing their identity as math teacher educators. In total, 20 h of interactive interviews were analyzed by using qualitative methods. Emerging themes include how MTEs establish a sense of credibility and how they feel they are navigating multiple identities. Among the graduate MTEs, credibility was described as having the following: (a) knowledge of and experience teaching in the US education system; (b) experience in teaching using a problem-solving approach; (c) the ability to enact theory in practice. While navigating multiple identities, graduate MTEs recognize their ethnic identities are central and influence their perceptions of self as MTEs, and how they think they are perceived by others. The results highlight the importance of understanding MTEs tensions and challenges and provide “in-the-moment” support along the journey of becoming teacher educators.

The article discusses the idea of the self in Samuel Beckett’s late short prose writings. The nature of the self, presented in disintegrated and essenceless form in Beckett’s works, responds powerfully to the category of world literature through their crossing of cultural boundaries. Beckett read the German philosopher Arthur Schopenhauer and Schopenhauer in turn, was influenced by the Eastern philosophies of Buddhism and the Vedas. The essential characteristic of the presentation of the self in Beckett’s writings, when filtered through Schopenhauer’s understanding of the Eastern philosophy, leads to what Beckett called ‘an intellectual justification of unhappiness’ and the understanding of the ‘veil of Maya.’ Keywords: Buddhism; Veil of Maya; Arthur Schopenhauer; Emptiness; Self; Phenomena

Background: Quality assurance in the hematology laboratory is a must to ensure laboratory users of reliable test results with high degree of precision and accuracy. Even after so many advances in hematology laboratory practice, pre-analytical errors remain a challenge for practicing pathologists. This study was undertaken with an objective to evaluate the types and frequency of preanalytical errors in hematology laboratory of our center. Methods: All the samples received in the Hematology Laboratory of Dayanand Medical College and Hospital, Ludhiana, India over a period of one year (July 2013-July 2014) were included in the study and preanalytical variables like clotted samples, quantity not sufficient, wrong sample, without label, wrong label were studied. Results: Of 471,006 samples received in the laboratory, preanalytical errors, as per the above mentioned categories was found in 1802 samples. The most common error was clotted samples (1332 samples, 0.28% of the total samples) followed by quantity not sufficient (328 sample, 0.06%), wrong sample (96 samples, 0.02%), without label (24 samples, 0.005%) and wrong label (22 samples, 0.005%) Conclusion: Preanalytical errors are frequent in laboratories and can be corrected by regular analysis of the variables involved. Rectification can be done by regular education of the staff.

Histoplasma capsulatum is no longer confined to certain geographic areas and should always be considered in the differential diagnosis of lymphadenopathy and organomegaly in HIV-positive patients. We present an unusual case of a 20-year-old immunocompromised male of African origin presenting with fever, jaundice, hepatosplenomegaly, and retroperitoneal and cervical lymphadenopathy. Fine needle aspiration (FNA) smears from the cervical lymph node revealed numerous yeast forms of histoplasma in macrophages. The patient succumbed to the fulminant infection. Postmortem liver biopsy also revealed infiltration by histoplasma, confirming the diagnosis of disseminated histoplasmosis. This case highlights the variable nature of the clinical presentation of disseminated histoplasmosis which can mimic tuberculosis, leishmaniasis, or lymphoma. FNA cytology is a rapid, cost-effective, and reliable diagnostic tool for early detection and prompt management of histoplasmosis.

Pigmented Villonodular Synovitis (PVNS) is a unique benign proliferative process of unknown aetiology involving the synovial lined joints diffusely or focally. The entity remains a diagnostic challenge. This condition is attributed to an increased synovial proliferation causing villous or nodular changes of synovial lined joints leading to PVNS, Pigmented Villonodular Bursitis (PVNB) when arising from bursae or Pigmented Villonodular Tenosynovitis (PVNTS) originating from the tendon sheath. We present a case of a young female with nodular masses on right thumb with cytomorphological features on FNAC suggestive of PVNS which was finally confirmed by histopathology.

Preservice teachers (PSTs) need to be able to use ambitious teaching practices to help support their students' productive engagement in scientific practices such as analyzing and interpreting data or using evidence-based reasoning to support their claims. Approximations of practice are one way in which teacher educators can support their PSTs to develop their skills in enacting ambitious teaching practices. In this study, we report on the use of a suite of three online, simulated approximations of practice where secondary PSTs practiced facilitating discussions focused on engaging students in argumentation. Using information from both PSTs' and teacher educators' perspectives, we examined their main takeaways from each simulation experience, how learning from one simulation was used to prepare for the next simulation, PSTs' perception of the simulations' authenticity, and their views about whether they would recommend using this online suite of simulations in future teacher preparation courses. Findings suggested that teacher educators and PSTs alike noted a variety of main takeaways, including understanding the importance of planning and asking good questions. Furthermore, they recommended the suite for use in future teacher education courses. Implications of the work for productively integrating online simulations into teacher education settings are discussed.

Multiple myeloma is a disorder of plasma cells which can involve kidneys in the form of cast nephropathy. Neoplastic plasma cells produce either complete immunoglobulins or fragments of immunoglobulins leading to a monoclonal spike in the serum and/or Bence Jones proteinuria. Very few patients present as non-secretory myeloma when no immunoglobulins (M spike) are produced or only light chains are secreted which can only be detected in urine. Acute renal failure due to cast nephropathy can rarely be the first presentation of multiple myeloma. We here in report a case in which primary diagnosis of multiple myeloma was made on renal biopsy due to its characteristic histomorphology. The diagnosis was later on supported by presence of neoplastic plasma cells in the aspirate and biopsy of bone marrow.

Eosinophilic angiocentric fibrosis is a rare pathology of the sinonasal tract and the upper respiratory system characterised by fibrosis with poorly understood pathogenesis. A 47-year-old male presented with a swelling over the dorsum of the nose. The possibility of fungal granuloma was being suggested on Magnetic Resonance Imaging (MRI). Histopathology showed thick collagen bundles whorling around vessels giving an onion skin appearance with focal area of vasculitis. An inflammatory reaction rich in eosinophils along with a fibrotic stroma was seen which was highly characteristic of eosinophilic angiocentric fibrosis. Clinically & microscopically it mimics Granuloma faciale, Wegener’s Granulomatosis, Churg-Strauss Syndrome, Kimura’s disease and few other granulomatous conditions thus making diagnosis difficult. A probable allergic origin is being suggested because of the typical eosinophil-rich inflammatory reaction. Finally the diagnosis of Eosinophilic Angiocentric Fibrosis was given. It is a diagnosis of exclusion having characteristic histomorphological findings thus biopsy is always required to distinguish it from other lesions whose treatment differs.

Prior research suggests the interdependent nature of prospective teachers (PTs) beliefs about mathematics and beliefs about teaching and learning mathematics. Further, PTs' beliefs are said to be shaped by their prior experiences as mathematics learners. Using structural equation modeling, we assessed the relation between early childhood and elementary prospective teachers' (N = 213) prior school experiences with their Beliefs about Mathematics and Pedagogical Beliefs about teaching and learning mathematics as measured by the Integrating Mathematics and Pedagogy (IMAP) survey. The results suggest a significant direct relation between PTs' Beliefs about Mathematics and Pedagogical Beliefs. One main recommendation is that within the teacher preparation programs the classes should "speak" to each other as opposed to content being taught in one department and methods course in another department. In addition, results highlighted a non-significant indirect relation between PTs' Beliefs about Mathematics and Pedagogical Beliefs when mediated through their prior experiences. This signifies that regardless of prior experiences, PTs' Beliefs about Mathematics influence their Pedagogical Beliefs. This calls for teacher training programs to design learning experiences in a way that assists in shaping PTs beliefs irrespective of their experiences as elementary mathematics learners.

Introduction: The Papanicolaou Society of Cytopathology System for reporting Pancreaticobiliary Cytology (PSCPC) is a reliable method to classify pancreatic fine needle aspiration cytology (FNAC) smears. However, it is not without practical problems which can diminish the diagnostic accuracy of the cytological diagnosis. Aims and Objectives: To determine the diagnostic pitfalls while reporting cytomorphology of pancreatic lesions according to PSCPC on correlating FNAC findings with histopathology. Materials and Methods: Retrospective analysis of pancreatic FNAC smears received in the Department of Pathology of our tertiary care institute over a period of 2 years was done. The cytological diagnoses were classified according to the Papanicolaou Society of Cytopathology system of reporting pancreaticobiliary cytology and correlated with histopathology. The reasons of cyto-histological discordance were analyzed. Results: Out of 50 cases in which both FNAC and biopsy of pancreatic lesions were done, 34 cases were positive/malignant (Category VI), eight cases were suspicious for malignancy (Category V), three cases were neoplastic (Category IV), two cases were atypical (Category III), two cases were negative for malignancy (Category II), and one case was non-diagnostic (Category I). Out of 50 cases, histopathology was non-diagnostic due to inadequate material in six cases. The cytological diagnoses were compared with histopathology in the remaining 44 cases. Categories III, IV V, and VI were considered as positive for neoplastic pathology. The sensitivity of FNAC to predict neoplastic pathology was 97.5%, while the specificity was 25%. The positive predictive value was 92.9%. Two cases reported as atypical (Category III) turned out to be adenocarcinoma on histopathology. One case reported as neuroendocrine tumor and two cases reported as adenocarcinoma on cytology displayed features of chronic pancreatitis on histology. One case reported as neoplastic mucinous cyst (Category IV) turned out to be adenocarcinoma on histology (limited concordance). Conclusion: The cytopathologist needs to be wary of the potential pitfalls to improve the diagnostic accuracy of FNACs. [ABSTRACT FROM AUTHOR]

Indian children experienced large-scale disruption in educational, psychological, and social welfare access when schools abruptly closed due to COVID-19. In addition to education, the Indian public school system provides services such as meals and benefits related to improving gender parity and indirectly preventing child labor, child marriages, and abuse. Therefore, sustained school closures led to an unfolding disaster in terms of learning loss and multiple unknown effects on children's social and psychological wellbeing. This descriptive study attempts to understand these consequences by asking Indian parents about the emotional, psychological, and academic impacts on their children. Results suggest an adverse impact on children's education and wellbeing. Families reported higher levels of psychological distress, anxiety, and aggression among children. However, the manifestations and ramifications seem to be different—while families from low-income segments struggled to get access to digital devices, others in upper-income segments had to confront excessive device time use. The results suggest that there is a need for a concerted, sustained, multipronged, differential response from the government and civil society to ensure that families can handle these challenges accordingly. [ABSTRACT FROM AUTHOR]