Browsing by Author "Kodiatte, TA"

Now showing 1 - 3 of 3
  • No Thumbnail Available
    Item
    Anti-phosphohistone H3 (PHH3) as a proliferation marker to assess mitotic activity and to grade neuroendocrine neoplasms of hepatopancreaticobiliary (HPB) system
    (Wolters Kluwer - Medknow, 2025-03) Santhanam, AP; Joel, A; Paul, A; Zachariah, UG; Rebekah, GJ; Kodiatte, TA
    Background: The world health organization (WHO) classification of neuroendocrine neoplasms (NENs, i.e. neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs)) of the gastrointestinal system involves grading of these tumors by mitotic count (i.e. H and E mitotic index or Haematoxylin and Eosin mitotic index [HE?MI] and Mindbomb E3 ubiquitin protein ligase 1 labelling index (MIB1?LI) into Grade 1 (G1), Grade 2 (G2), or Grade 3 (G3). However, the assessment of HE?MI and MIB1?LI is hindered by several factors that contribute to discordance between these two grading methods. Clinical data demonstrate the dependency of prognosis on grade. Objectives: The objective of this study was to compare the grading of NENs of the hepatopancreatobiliary (HPB) system using Anti-phosphohistone H3 mitotic index (i.e.PHH3?MI), HE?MI and MIB1?LI. Materials and Methods: In a cohort of 140 NENs selected from January 2011 to August 2019, the concordance and correlation between HE?MI, MIB1?LI and PHH3?MI grading methods were analysed using Cohen’s weighted kappa (?) statistics and Spearman’s correlation (?), respectively. Receiver operating characteristic (ROC) curve and cut?off analyses were done to determine optimal PHH3?MI cut?off values to grade NENs. Results: The rates of discordance between HE?MI vs. MIB1?LI, PHH3?MI vs. MIB1?LI and PHH3?MI vs. HE?MI were 52% (? =0.416), 29% (? =0.64) and 41% (? =0.508), respectively. There was a significant correlation between the grading methods. PHH3?MI had good overall sensitivity and specificity at cut?offs 2 and 17 in distinguishing between G1 vs. G2, and G2 vs. G3 tumors, respectively. Conclusion: PHH3 immunolabeling allowed for quick and easy identification of mitotic figures (MF). It had the highest concordance with MIB1?LI. At cut?off values of 2 and 17, there was good overall sensitivity and specificity. The interobserver agreement was excellent.
  • Thumbnail Image
    Item
    Cutaneous botryomycosis of the foot: A case report and review of literature
    (Indian Association of Medical Microbiologists, 2018-09) John, K; Gunasekaran, K; Kodiatte, TA; Iyyadurai, R
    Botryomycosis is a chronic bacterial infection that manifests clinically as tumours or plaques that are often ulcerated and have discharging sinuses draining small white-coloured granules. Therefore, they closely mimic mycetoma or other fungal infections. It is most commonly caused by Staphylococcus aureus. It can present as cutaneous or visceral disease. The cutaneous form can invade deep tissue leading to extensive destruction and disfigurement. A 31-year-old female presented with progressive swelling of her right foot over a period of 8 years. She had a disfigured right foot with multiple sinuses discharging pus. X-ray and magnetic resonance imaging of the foot showed invasion and destruction of the deep layers of the foot including the bone. Deep biopsy from the foot showed an abscess cavity with Gram-positive cocci within and bacterial culture grew S. aureus establishing the diagnosis of botryomycosis. Botryomycosis is a rare presentation of a common pathogen and needs to be considered while evaluating a chronic invasive subcutaneous infection.
  • Thumbnail Image
    Item
    What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors
    (Indian Council of Medical Research, 2019-04) Goel, A; Ramakrishna, B; Zachariah, U; Sajith, K G; Burad, DK; Kodiatte, TA; Keshava, SN; Balasubramanian, K A; Elias, E; Eapen, C E
    In India, an unexplained enteropathy is present in a majority of non-cirrhotic intrahepatic portal hypertension (NCIPH) patients. Small intestinal bacterial contamination and tropical enteropathy could trigger inflammatory stimuli and activate the endothelium in the portal venous system. Groundwater contaminated with arsenic is an environmental factor of epidemic proportions in large areas of India which has similar consequences. Von Willebrand factor (a sticky protein) expressed by activated endothelium may promote formation of platelet microthrombi and occlusion of intrahepatic portal vein branches leading to NCIPH. Environmental factors linked to suboptimal hygiene and sanitation, which enter through the gastrointestinal (GI) tract, predispose to platelet plugging onto activated endothelium in portal microcirculation. Thus, NCIPH, an example of poverty linked thrombophilia, is a disease mainly affecting the lower socio-economic strata of Indian population. Public health measures to improve sanitation, provide clean drinking water and eliminate arsenic contamination of drinking water are urgently needed. Till such time as these environmental factors are addressed, NCIPH is likely to remain 'an Indian disease'.