Objectives: Convalescent 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. Design: Open-label, parallel-arm, phase II, multicentre, randomized controlled trial. Setting: Thirty-nine public and private hospitals across India. Participants: Hospitalized, moderately ill confirmed COVID-19 patients (PaO2/FiO2: 200-300 or respiratory rate > 24/min and SpO2 ≤ 93% on room air). Intervention: Participants 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 Measure: Composite of progression to severe disease (PaO2/FiO2<100) or all-cause mortality at 28 days post-enrolment. Results: Between 22 nd April to 14 th July 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]. Interpretation: CP 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.

Background: Voluntary blood donation forms the basis of procurement of safe blood from a healthy donor. Donor selection is necessary in addition to the screenings of blood bags for infectious diseases. Deferrals lead to loss of precious blood/components available for transfusion. For preventing this, we should be having knowledge of causes of deferral and their frequency. to determine the incidence of deferrals. The aim of our study is to know the incidence of donors who were deferred from donating blood and to determine the causes of permanent and temporary deferral.Result: A total of 21,433 donors were screened. Out of which, 1134 donors were deferred. The total donor deferral rate was 5.29%; the percentages of deferral being 1.62%for females and 3.67% for males. The deferral was maximum between 18-40 years of age.The temporary deferral was more common than permanent deferral; the reasons in males being anemia, low blood pressure and underweight. The reasons documented in females being anemia, menstrual history within one week, followed by underweight. The most common reason in both males and females, for permanent deferral was hypertension.Conclusion: Donor deferral rate of 5.29% was found in this study. Females coming forward for blood donation were significantly low. The major causes of deferral were anemia and hypertension.

Background: Bone tumors are one of the intimidate challenge to the orthopedic surgeon. This call out for even more concern in resource poor settings, in economically developing nations. We analysed bone tumours and tumour like lesions, their demographic features like age and sex distributions, anatomical sites of occurrence and their relative frequencies,clinico-pathological characteristics and histo-morphological features as seen in a tertiary care hospital of India.Methods: This is a retrospective study of 10 years in our department, of 216 cases of bone tumors, including primary bone tumors, metastatic lesions and tumor like lesions.Results: A total of 216 patients were studied aged 1 to 80 years. 114 (52.78%) patients were males and 102(47.22%) were females. Commonest bone tumor observed in our study was metastatic tumors 40/216 cases (18.52%).Commonest benign tumor in our study was osteochondroma 30/103 cases (29.13%) followed by giant cell tumor 27/103 cases (26.21 %). Commonest Primary malignant bone tumor in our study was Ewing's tumor 11/48 cases (22.92%), followed by osteogenic sarcoma and myeloma 9 cases (18.75%) each. Fibrous dysplasia was seen to be commonly located at jaw bone and skull region 6/13 cases (46.15%) whereas aneurysmal bone cyst was located commonly at vertebra 6/10 cases (60%). Out of 40 cases of metastatic bone tumors, 15 cases (37.5%) showed metastasis from lung carcinoma, of which, non-small cell carcinoma made up of 80 % of the cases. Conclusion:Metastatic lesion is commonest bone tumor in our study. Commonest benign tumor was osteochondroma and giant cell tumor. Ewing's tumor is commonest primary bone tumor and fibrous dysplasia in tumor like lesions of the bone.

Therapy related myeloid neoplasm is directly related to previous cytotoxic chemotherapy or radiation therapy. We present a 47-year-old lady who developed therapy related myelodysplastic syndrome (MDS) 2.5 years after she received four cycles of chemotherapy and local radiation therapy for carcinoma breast. She presented with bicytopenia with trilineage dyspoiesis in the peripheral blood, bone marrow aspirate and biopsy. Fluorescent in-situ hybridization studies did not reveal any of the common abnormalities associated with MDS. A diagnosis of therapy related MDS was rendered. Different studies have shown that patients treated with alkylating agents and ionizing radiation present as MDS with a latent period of 3-10 years. Our patient developed MDS within 2.5 years of starting chemotherapy and radiotherapy and did not reveal any of the conventional cytogenetic abnormalities. It highlights the importance of simple tests like a complete blood count and peripheral blood smear examination in follow-up of the patients treated with chemotherapy.

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