1
|
Singh J, Rajesh NG, Dubashi B, Maroju NK, Ganesan P, Matta KK, Charles I, Kayal S. Pattern of expression of CDX2 in colorectal cancer and its role in prognosis. J Cancer Res Ther 2022; 18:S420-S427. [PMID: 36510997 DOI: 10.4103/jcrt.jcrt_1723_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background CDX2, a nuclear protein, is essential for the proliferation and development of intestinal epithelial cells and is frequently down-regulated during tumorigenesis. We have evaluated the pattern of CDX2 expression in all stages of colorectal cancer (CRC) and its association with prognosis. Methods We performed CDX2 staining by immunohistochemistry (IHC) on the available biopsy blocks of patients of CRC registered in our institute from January 2014 to January 2018. CDX2 scoring was done using the semi-quantitative method. Results A total of 286 patients were registered during the study period, of which only 110 biopsy blocks were available for staining. Of 110 patients, 77 (70%) had colon cancer and 33 (30%) had rectal cancer. The median age was 54.2 years, with 62 (56.4%) being male and 48 (43.6%) female with a male to female ratio of 1.3:1. In the study cohort, 33 (30%) patients had stage II disease, 30 (27.3%) had stage III, and 47 (42.7%) had stage IV. Seventy-three (66.4%) were positive for CDX2 and 37 (33.4%) were negative. Loss of CDX2 expression was significantly associated with advanced stage, rectal site, poor grade of differentiation, and presence of lymphovascular invasion. With a median follow-up of 16 months, progression-free survival (PFS) at 2 years was 30% for CDX2-negative patients compared to 67% for CDX2-positive patients (P = 0.009), whereas the overall survival (OS) at 2 years was 46% for CDX2-negative versus 77% for CDX2-positive patients (P = 0.01). Conclusion Loss of CDX2 expression is associated with advanced stage, higher tumor grade, presence of LVSI, worse PFS, and OS and thereby functions as a poor prognostic factor in CRC.
Collapse
Affiliation(s)
- Jagdeep Singh
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Biswajit Dubashi
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Nanda Kishore Maroju
- Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Prasanth Ganesan
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Kiran Kumar Matta
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - I Charles
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Smita Kayal
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| |
Collapse
|
2
|
Jayanth KS, Madan S, Gurushankari B, Sureshkumar S, Anandhi A, Rajesh NG, Kate V. The Diagnostic Dilemma of Ruptured Liver Metastasis in a Patient with Lung Cancer. Sultan Qaboos Univ Med J 2022; 22:421-425. [PMID: 36072072 PMCID: PMC9423753 DOI: 10.18295/squmj.6.2021.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 11/28/2022] Open
Abstract
Spontaneous rupture of a metastatic liver tumour is rarely documented in the literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary. We report a case of ruptured liver metastasis from an adenocarcinoma of the lung mimicking ruptured liver abscess, challenging the clinical diagnosis. A 42-year-female patient presented to a tertiary care institute in 2020 with complaints of abdominal pain, breathlessness and fever. On examination, the patient was tachypnoeic with a right hypochondriac mass. A contrast-enhanced computed tomography of abdomen and thorax revealed an ill-defined heterogeneously enhancing lesion in the liver with a communicating subcapsular collection and hypo-enhancing lesions in the left lobe and heterogeneously enhancing lesion in the left lung. Adenocarcinoma of the lung with hepatic metastasis was confirmed with a core needle biopsy. The patient was managed conservatively with intravenous antibiotics, intercostal drainage tube and gefitinib. However, despite best efforts, the patient succumbed to the disease.
Collapse
Affiliation(s)
- K S Jayanth
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shivakumar Madan
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balakrishnan Gurushankari
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sathasivam Sureshkumar
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Amaranathan Anandhi
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vikram Kate
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
3
|
Harsha BS, Manikandan R, Sreerag KS, Dorairajan LN, Rajesh NG, Kar R. Eosinophilic Leukemoid Reaction with Eosinophilic Tumor Tissue Infiltration as an Extermely Poor Prognostic Factor in Urinary Bladder Cancer- a Known Entity Revisited. Pathol Oncol Res 2020; 26:2817-2819. [PMID: 32227297 DOI: 10.1007/s12253-020-00807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 03/17/2020] [Indexed: 11/27/2022]
Abstract
Eosinophilia can be a manifestation of a variety of causes such as infections, allergic reactions and autoimmune processes. Also, it is described in various solid malignancies in the presence of tumour eosinophilic infiltration. We report a patient of high-grade urinary bladder cancer with eosinophilic leukemoid reaction and tumour histopathology demonstrated diffuse infiltration of eosinophils. Though the entity is described to carry a good prognosis in literature, our experience is totally different as the patient deteriorated rapidly in a matter of days, was deemed inoperable in view of worsening performance status and was referred for palliative management.
Collapse
Affiliation(s)
- Bokka Sri Harsha
- Department of Urology and Renal Transplantation, JIPMER, Puducherry, India.
| | - R Manikandan
- Department of Urology and Renal Transplantation, JIPMER, Puducherry, India
| | - K S Sreerag
- Department of Urology and Renal Transplantation, JIPMER, Puducherry, India
| | - L N Dorairajan
- Department of Urology and Renal Transplantation, JIPMER, Puducherry, India
| | - N G Rajesh
- Department of Pathology, JIPMER, Puducherry, India
| | - Rakhi Kar
- Department of Pathology, JIPMER, Puducherry, India
| |
Collapse
|
4
|
Satish H, Parameswaran S, Srinivas BH, Rajesh NG, Jayasurya R, Padhi R, Priyamvada PS. Early Eosinophilic Antibody-mediated Rejection in a Renal Allograft Recipient. Indian J Nephrol 2018; 28:389-392. [PMID: 30271003 PMCID: PMC6146726 DOI: 10.4103/ijn.ijn_102_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Although the predominant component of acute allograft rejection is the T-cells, the milieu is not devoid of other inflammatory cells including plasma cells, eosinophils, and histiocytes. Apart from the CD8 T cell and CD4 T cell-FasL cytotoxicity, experimental models had proven a pivotal role of Th-2 cells in acute rejection, and these have been associated with marked tissue eosinophilia. Herein, we present a unique case of severe eosinophilic acute antibody-mediated rejection in a 22 years old deceased donor renal allograft recipient, within 4 days of transplantation without peripheral eosinophilia. The pathology was successfully dealt with the prevailing modalities of therapy, including steroids, plasmapheresis, intravenous immunoglobulin, and bortezomib. Concurrently, we have briefly reviewed the literature about the role of eosinophils in graft rejection and its prognostication.
Collapse
Affiliation(s)
- H Satish
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sreejith Parameswaran
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - B H Srinivas
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R Jayasurya
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rajesh Padhi
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P S Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
5
|
Ezhilnilavan S, Priyamvada PS, Haridasan S, Rajesh NG, Parameswaran S. Acute gastric dilatation in a patient with lupus nephritis: An uncommon presentation of lupus mesenteric vasculitis. Saudi J Kidney Dis Transpl 2018; 29:429-434. [PMID: 29657215 DOI: 10.4103/1319-2442.229279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abdominal symptoms are common in patients with lupus nephritis and are often attributed to drugs or uremia per se. Lupus mesenteric vasculitis (LMV) or lupus enteritis is a rare entity reported in patients with active systemic lupus erythematosus. It usually occurs in patients with a long-standing history of lupus with high disease activity. Usually, small bowel is predominantly affected. The stomach and rectum are spared in view of significant collateral circulation. Here, we describe an 18-year-old boy who presented with nephrotic syndrome without any extrarenal features of lupus. On subsequent evaluation, he was found to have active lupus nephritis. He developed acute gastric dilatation secondary to extensive LMV. Imaging showed an extensive involvement of gastrointestinal tract from the stomach to the sigmoid colon, sparing the rectum. To the best of our knowledge, this is the first report of LMV presenting as acute gastric dilatation.
Collapse
Affiliation(s)
- S Ezhilnilavan
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P S Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Haridasan
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Parameswaran
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
6
|
Rampelli SK, Rajesh NG, Srinivas BH, Harichandra Kumar KT, Swaminathan RP, Priyamvada PS. Clinical spectrum and outcomes of crescentic glomerulonephritis: A single center experience. Indian J Nephrol 2016; 26:252-6. [PMID: 27512296 PMCID: PMC4964684 DOI: 10.4103/0971-4065.158574] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is limited data on the etiology, clinical and histopathological spectrum and outcomes of crescentic glomerulonephritis (CrGN) in adult Indian population. This prospective study was done to evaluate the etiology, clinicohistological patterns and predictors of outcome of CrGN in South Indian population. All the patients received standard protocol based immunosuppression in addition to supportive care. Immune-complex glomerulonephritis (ICGN) was the most common etiology (n = 31; 77.5%) followed by pauci-immune glomerulonephritis (PauciGN; n = 8; 20%) and anti-glomerular basement membrane disease (n = 1; 2.5%). The most common etiology of ICGN was IgA nephropathy (n = 11; 27.5%) followed by lupus nephritis (n = 7; 17.5%) and post-infectious glomerulonephritis (PIGN) (n = 7; 17.5%). The patients with PauciGN were significantly older compared to those with ICGN (44.5 ± 15 years vs. 31.8 ± 11 years; P = 0.01). The patients with PauciGN presented with significantly higher serum creatinine (9.7 ± 4.4 vs. 6.6 ± 3.3 mg/dl; P = 0.03). The histopathologic parameters of ICGN and PauciGN were comparable except for a higher proportion of sclerosed glomeruli in ICGN. At the end of 3 months follow-up, only two patients went into complete remission (5.4%). Majority of the patients had end-stage renal failure (48.6%) and were dialysis dependent and seven patients (18.9%) expired. There was no signifi difference in the renal survival (10.9 ± 1.9 vs. 9.6 ± 3.3 months) or patient survival (17.5 ± 2.1 vs. 17.3 ± 4.3 months). The parameters associated with adverse outcomes at 3 months were hypertension (odds ratio [OR]: 0.58; confidence interval [CI]: 0.36–0.94), need for renal replacement therapy (OR: 0.19; CI: 0.04–0.9), serum creatinine at admission (P = 0.019), estimated glomerular filtration rate (P = 0.022) and percentage of fibrocellular crescents (P = 0.022).
Collapse
Affiliation(s)
- S K Rampelli
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - B H Srinivas
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K T Harichandra Kumar
- Department of Biometrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R P Swaminathan
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P S Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
7
|
Priyamvada PS, Shankar V, Srinivas BH, Rajesh NG, Parameswaran S. Acute Interstitial Nephritis Following Snake Envenomation: A Single-Center Experience. Wilderness Environ Med 2016; 27:302-6. [PMID: 26970860 DOI: 10.1016/j.wem.2015.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 12/05/2015] [Accepted: 12/07/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To identify the clinical and histopathological characteristics of patients who develop acute interstitial nephritis (AIN) following snake envenomation. METHODS A retrospective analysis of patients diagnosed with snake envenomation-induced AIN from October 2013 to November 2014. RESULTS After snake envenomation, 88 patients developed acute kidney injury (AKI). Biopsies were performed on 7 patients due to nonrecovery of kidney function. Among these, 5 patients had AIN. Thus, AIN accounted for 5.7% of snakebite-related acute kidney injury. All patients had severe envenomation at presentation and had prolonged renal failure. Kidney biopsy found a mixed infiltrate composed of predominantly lymphocytes, with variable proportions of other cells including eosinophils neutrophils and plasma cells. The response rate to corticosteroids was 80%. CONCLUSIONS AIN after snake bite is not uncommon. AIN needs to be considered in patients with persistent renal failure after snake envenomation. Identifying this complication is of utmost importance because of the potentially reversible nature.
Collapse
Affiliation(s)
- P S Priyamvada
- Departments of Nephrology (Drs Priyamvada, Shankar, and Parameswaran) and Pathology (Drs Srinivas and Rajesh), Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | - Vijay Shankar
- Departments of Nephrology (Drs Priyamvada, Shankar, and Parameswaran) and Pathology (Drs Srinivas and Rajesh), Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - B H Srinivas
- Departments of Nephrology (Drs Priyamvada, Shankar, and Parameswaran) and Pathology (Drs Srinivas and Rajesh), Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - N G Rajesh
- Departments of Nephrology (Drs Priyamvada, Shankar, and Parameswaran) and Pathology (Drs Srinivas and Rajesh), Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sreejith Parameswaran
- Departments of Nephrology (Drs Priyamvada, Shankar, and Parameswaran) and Pathology (Drs Srinivas and Rajesh), Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
8
|
Kumaravel S, Bharath K, Rajesh NG, Singh R, Kar R. Delay and misdiagnosis of basidiobolomycosis in tropical South India: case series and review of the literature. Paediatr Int Child Health 2016; 36:52-7. [PMID: 26825223 DOI: 10.1080/20469047.2015.1109220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Basidiobolomycosis caused by Basidiobolus ranarum is a rare infection of the subcutaneous tissues in immune-competent patients which occurs predominantly in children and young adults. Primary physicians often misdiagnose the condition owing to its slow, painless, relentless growth, absence of response to antibiotics and anti-inflammatory drugs and unfamiliarity with this lesion. All cases of subcutaneous basidiobolomycosis in children aged between 1 and 12 years presenting at a tertiary hospital in Pondicherry over a period of 4 years (2007-2011) were analysed. Eight cases were seen and confirmed by histopathology and microbiology. Referral diagnoses varied widely from chronic abscess to tuberculosis to malignancy, including testicular tumour. Lesion sites include the gluteal region, thigh and scrotum (extremely rare). Four weeks of oral itraconazole in seven children and fluconazole (5 mg/kg) in one cured them completely. During follow-up for over 1 year, no recurrence or new lesions were noted. Basidiobolomycosis is a rare, often misdiagnosed infection in children which responds well to triazole antifungals such as itraconazole and fluconazole.
Collapse
|
9
|
Affiliation(s)
- M M Patil
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605 006, India
| | - S Kamalanathan
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605 006, India
| | - J Sahoo
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605 006, India
| | - N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.
| |
Collapse
|
10
|
Suneeva SC, Prasanth R, Rajesh NG, Viswanathan P. Transformation of Brevibacillus, a soil microbe to an uropathogen with hemagglutination trait. World J Microbiol Biotechnol 2014; 30:1837-44. [PMID: 24464621 DOI: 10.1007/s11274-014-1605-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/15/2014] [Indexed: 02/05/2023]
Abstract
An urinary tract infection (UTI) with Brevibacillus agri, an aerobic soil bacteria is discussed. The preliminary urine analysis tested negative for UTI, while the patient was diagnosed with focal pyelonephritis. The urine sample was analyzed for the presence of possible micro-organisms. The isolated micro-organism was phenotypically characterized and compared with a standard B. agri strain and an established uropathogen Eschericia coli, CFT073. Each experimental mouse was trans-urethrally infected using 2.5 × 10(8) c.f.u. for the generation of an UTI model. The kidney tissues were stored in buffered 10 % formaldehyde solution for histopathological analysis. The destruction of the glomerular and tubular morphology with prominent hemagglutination in the tubular region in the mouse kidneys were confirmed by light microscopic examination of the H&E stained sections. Hence, the identity of pathogen was confirmed using the 16S rRNA gene sequencing. The phylogenetic tree constructed using the 16S rRNA sequence obtained from the isolated microbial strain showed 99 % similarity with the strain, B. agri AB112716. Finally this study concludes based on the phenotypic characteristics, production of lipopolysaccharide, the ability to aggregate in the presence of ammonium sulphate, agglutinate erythrocytes in the presence of mannose, and the potential to resist the interactions of serum, the possibility that the soil microbe could have undergone genotypic modification to cause UTI. However, further detailed and in-depth genetic analysis are required to point out exactly how the soil bacterium has adapted itself to cause infection in a human subject.
Collapse
Affiliation(s)
- S C Suneeva
- Renal Research Lab, School of Bio Sciences and Technology, VIT University, Vellore, 632 014, Tamil Nadu, India
| | | | | | | |
Collapse
|
11
|
Rao S, Siddaraju N, Mishra P, Muthalagan E, Toi PC, Rajesh NG. Significance of lupus erythematosus (LE) cell detection in pericardial fluid in an era of sophisticated techniques. Cytopathology 2014; 26:200-2. [DOI: 10.1111/cyt.12152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Rao
- Department of Pathology; Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER); Pondicherry India
| | - N. Siddaraju
- Department of Pathology; Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER); Pondicherry India
| | - P. Mishra
- Department of Pathology; Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER); Pondicherry India
| | - E. Muthalagan
- Department of Pathology; Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER); Pondicherry India
| | - P. C. Toi
- Department of Pathology; Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER); Pondicherry India
| | - N. G. Rajesh
- Department of Pathology; Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER); Pondicherry India
| |
Collapse
|
12
|
Rajesh NG, Siddaraju N, Muthalagan E, Jain D, Kumari R, Balasubramanian P. Report of a case emphasizing the clinical utility of fine needle aspiration cytology in the diagnosis of histoid leprosy. Cytopathology 2014; 26:132-3. [PMID: 24734966 DOI: 10.1111/cyt.12144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | | | | | | | | | | |
Collapse
|
13
|
Hanifah M, Balachandran G, Rajesh NG. Subcutaneous mucor zygomycosis with potential life-threatening visceral complication. Indian J Med Microbiol 2013; 31:182-4. [PMID: 23867678 DOI: 10.4103/0255-0857.115226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A mass in right supraclavicular fossa in a diabetic patient mimicking tuberculosis (TB) adenitis that ultimately proved to be subcutaneous zygomycosis. A high degree of clinical suspicion is needed for diagnosis especially when these lesions occur at typical sites for the more common indolent infections like TB. This case is being presented not only because of its rarity, but to emphasize the role of early diagnosis and appropriate treatment to prevent serious complications due to proximity to major structures. Fluconazole was used despite not being the ideal drug, solely due to cost constraints. Our patient responded well. However, we do emphasize that response to fluconazole is the exception rather than the rule.
Collapse
Affiliation(s)
-
- Department of Surgery, Indira Gandhi Medical College and Research Institute, Pondicherry, India
| | | | | | | |
Collapse
|
14
|
Ranugha PSS, Mohanan S, Chandrashekar L, Basu D, Thappa DM, Rajesh NG. Epidermolysis bullosa pruriginosa showing good response to low-dose thalidomide - a report of two cases. Dermatol Ther 2013; 27:60-3. [DOI: 10.1111/dth.12047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- P. S. S. Ranugha
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - S. Mohanan
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - L. Chandrashekar
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - D. Basu
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - D. M. Thappa
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - N. G. Rajesh
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| |
Collapse
|
15
|
Shiju TM, Rajkumar R, Rajesh NG, Viswanathan P. Aqueous extract of Allium sativum L bulbs offer nephroprotection by attenuating vascular endothelial growth factor and extracellular signal-regulated kinase-1 expression in diabetic rats. Indian J Exp Biol 2013; 51:139-48. [PMID: 23923607 DOI: pmid/23923607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
To investigate the nephroprotective effect of garlic and elucidate the mechanism by which it prevents the progression of diabetic nephropathy in diabetic rats, diabetes was induced by a single ip injection of streptozotocin (45 mg/kg body weight). Garlic extract (500 mg/kg body weight) and aminoguanidine (1 g/L) were supplemented in the treatment groups. Histopathological examination using H&E, PAS staining and the immunohistochemical analysis of vascular endothelial growth factor (VEGF) and extracellular signal-regulated kinase-1 (ERK-1) expression were performed on kidney sections at the end of 12 weeks. Significant change in both, the urine and serum biochemistry confirmed kidney damage in diabetic animals which was further confirmed by the histological changes such as mesangial expansion, glomerular basement membrane thickening, glycosuria and proteinuria. However, the diabetic animals treated with garlic extract showed a significant change in urine and serum biochemical parameters such as albumin, urea nitrogen and creatinine compared to that of diabetic rats. Further, the garlic supplemented diabetic rats showed a significant decrease in the expression of VEGF and ERK-1 compared to diabetic rats, attenuating mesangial expansion and glomerulosclerosis. Thus, garlic extract rendered nephroprotection in diabetic rats.
Collapse
Affiliation(s)
- T M Shiju
- Renal Research Lab, Biomedical Research Center, School of Bio Sciences and Technology, VIT University, Vellore 632 014, India
| | | | | | | |
Collapse
|
16
|
Shiju TM, Rajesh NG, Viswanathan P. Renoprotective effect of aged garlic extract in streptozotocin-induced diabetic rats. Indian J Pharmacol 2013; 45:18-23. [PMID: 23543654 PMCID: PMC3608288 DOI: 10.4103/0253-7613.106429] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 09/28/2012] [Accepted: 10/29/2012] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Aged garlic extract (AGE) has been proven to exhibit antioxidant, hypolipidemic, hypoglycemic and antidiabetic properties. However, its effect on diabetic nephropathy was unexplored. Therefore, the present study was designed to investigate the renoprotective effect of AGE in streptozotocin-induced diabetic rats. MATERIALS AND METHODS Albino Wistar rats were induced with diabetes by a single intraperitoneal injection of 45 mg/kg b.w. of streptozotocin. Commercially available AGE was supplemented orally at a dose of 500 mg/kg body weight/day. Aminoguanidine, which has been proven to be an anti-glycation agent was used as positive control and was supplemented at a dose of 1 g/L in drinking water. The serum and urinary biochemical parameters were analyzed in all the groups and at the end of 12 weeks follow up, the renal histological examination were performed using H & E and PAS staining. RESULTS The diabetic rats showed a significant change in the urine (P < 0.001) and serum (P < 0.01) constituents such as albumin, creatinine, urea nitrogen and glycated hemoglobin. In addition, the serum lipid profile of the diabetic rats were altered significantly (P < 0.05) compared to that of the control rats. However, the diabetic rats supplemented with aged garlic extract restored all these biochemical changes. The efficacy of the extract was substantiated by the histopathological changes in the kidney. CONCLUSION From our results, we conclude that aged garlic extract has the ability to ameliorate kidney damage in diabetic rats and the renoprotective effect of AGE may be attributed to its anti-glycation and hypolipidemic activities.
Collapse
Affiliation(s)
- T. M. Shiju
- Renal Research Lab, Biomedical Research Center, School of Bio Sciences and Technology, VIT University, Vellore - 632 014, India
| | - N. G. Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry-605 006, India
| | - Pragasam Viswanathan
- Renal Research Lab, Biomedical Research Center, School of Bio Sciences and Technology, VIT University, Vellore - 632 014, India
- Correspondence to: Dr. Pragasam Viswanathan, E-mail:
| |
Collapse
|
17
|
Krishnamurthy S, Rajesh NG, Ramesh A, Zenker M. Infantile nephrotic syndrome with microcephaly and global developmental delay: the Galloway Mowat Syndrome. Indian J Pediatr 2012; 79:1087-90. [PMID: 22144119 DOI: 10.1007/s12098-011-0616-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 11/15/2011] [Indexed: 11/28/2022]
Abstract
The authors present the first case of Galloway Mowat Syndrome (GMS), a rare disorder comprising of nephrotic syndrome in association with microcephaly, from India. An 11-mo-old girl with microcephaly, developmental delay and nystagmus presented with nephrotic syndrome. The perinatal and neonatal periods had been uneventful. The renal biopsy revealed mesangial proliferation with IgM deposition, while MRI of the brain showed hypomyelination. Molecular diagnosis by polymerase chain reaction (PCR) did not reveal any pathogenic sequences in the exons and the flanking intronic regions of the NPHS2 gene and LAMB2 gene. The infant responded to prednisolone. GMS must be suspected whenever microcephaly and global developmental delay occurs in association with nephrotic syndrome, as this is important for prognostication and genetic counseling. The genetics of GMS remains an enigma and further research is required to delineate the pathogenesis of this disorder.
Collapse
Affiliation(s)
- Sriram Krishnamurthy
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India.
| | | | | | | |
Collapse
|
18
|
Vinod KV, Chandramohan R, Dutta TK, Rajesh NG, Basu D. Type 2 lepra reaction as a cause of pyrexia of unknown origin. J Assoc Physicians India 2012; 60:70-72. [PMID: 23029751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Leprosy, a commonly encountered disease, can rarely present as a reactional state de novo with fever as the main presenting feature. Here we describe an uncommon presentation of leprosy [with type 2 lepra reaction] as pyrexia of unknown origin with prominent rheumatologic manifestations [acute polyarthritis], renal involvement and generalized lymphadenopathy with rare presentation of type 2 lepra reaction without the classic skin lesions of erythema nodosum leprosum, occurring in a treatment naive patient without prior history of leprosy.
Collapse
Affiliation(s)
- K V Vinod
- Dept. of General Medicine, JIPMER, Dhanvantarinagar, Puducherry-605006
| | | | | | | | | |
Collapse
|
19
|
|
20
|
Prayaga A, Sundaram C, Rajesh NG. Salivary duct carcinoma: Correlation of morphologic features by fine needle aspiration cytology and histopathology. INDIAN J PATHOL MICR 2011; 54:37-41. [DOI: 10.4103/0377-4929.77321] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|