Publications by authors named "Loganathan Kavitha"

3 Publications

  • Page 1 of 1

Intra-observer and inter-observer variability in two grading systems for oral epithelial dysplasia: A multi-centre study in India.

J Oral Pathol Med 2020 Oct 9;49(9):948-955. Epub 2020 Jul 9.

Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK.

Background: The presence and grading of oral epithelial dysplasia (OED) are considered the gold standard for predicting the malignant risk of oral potentially malignant disorders. However, inter-observer and intra-observer agreement in the context of reporting on OED grading has been reputedly considered unreliable.

Methods: We undertook a multi-centre study of six Indian oral pathologists to assess variations in reporting OED using the World Health Organization (WHO; 2005) system and also the recently introduced binary system. The observer variability was assessed with the use of kappa statistics.

Results: The weighted kappa intra-observer agreement scores improved (κ  = 0.5012) on grouping by two grades as no and mild dysplasia versus moderate and severe dysplasia compared to binary grading system (κ = 0.1563) and WHO grading system (κ  = 0.4297). Poor to fair inter-observer agreement scores were seen between the principal investigator (PI) and the other five observers using the WHO grading system (κ = 0.051-0.231; κ  = 0.145 to 0.361; 35% to 46%) and binary grading system (κ = 0.049 to 0.326; 50 to 65%).

Conclusions: There is considerable room for improvement in the assessment of OED using either system to help in standardised reporting. The professional pathology organisations in India should take steps to provide external quality assessment in reporting OED among oral and general pathologists who are engaged in routine reporting of head and neck specimens.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
October 2020

Oral epithelial dysplasia: Classifications and clinical relevance in risk assessment of oral potentially malignant disorders.

J Oral Maxillofac Pathol 2019 Jan-Apr;23(1):19-27

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India.

After more than a decade, the World Health Organization (WHO) published the revised grading system for oral epithelial dysplasia in 2017. The revised classification has changes reflecting our evolution of understanding of the dysplastic process. Although the WHO 2017 three-tier grading system is the gold standard for histological diagnosis of oral potentially malignant disorders, it has certain limitations. Suggestions to overcome these limitations include the use of clinical determinants and molecular markers to supplement the grading system. It has also been suggested that a two-tier system may be more reproducible and clinically translatable for better management. These advances in the understanding of epithelial dysplasia are very important globally and for us in the Indian subcontinent, given the prevalence of habits (tobacco/areca nut) and burden of oral cancer in this part of the world. The following review traces the evolution of the grading system of dysplasia, its relevance and clinical utility.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
May 2019

Association among interleukin-6 gene polymorphisms, type 2 diabetes mellitus, and chronic periodontitis: a pilot study.

J Investig Clin Dent 2017 Aug 21;8(3). Epub 2016 Jul 21.

Department of Oral Pathology and Microbiology, Meenakshi Ammal Dental College and Hospital, Chennai, India.

Aim: The purpose of this pilot study was to determine the association between single nucleotide polymorphisms (-174 G>C) in the interleukin-6 (IL-6) gene with chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM) in south Indian population.

Methods: Genomic DNA was obtained from the white blood cells of 30 patients with T2DM, 30 patients with CP, 30 patients with T2DM with CP, and 30 controls. DNA was amplified using polymerase chain reaction with specific primers flanking the locus -174 of the IL-6 gene and further genotyped using the restriction fragment length polymorphism method. The genotype distribution and allele frequencies between the study groups were determined using χ -test. The relative risk was estimated with a 95% confidence interval.

Results: The CP group (26.7%) displayed a greater percentage of GC genotype (P = 0.026) when compared to the control group (3.3%). A statistically-significant difference in the allele frequencies was found between the control and CP group with the C-allele frequency being greater (0.13) in the CP group than normal controls (0.02).

Conclusion: The GC genotype was found to be the risk genotype and the C allele was found to be the risk allele for the development of CP.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
August 2017