BACKGROUND:Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), poses significant diagnostic challenges, particularly in South-East Asia, where its prevalence has risen sharply. Although endoscopic biopsies and histopathological evaluations are central to IBD management, inconsistencies in sampling, processing and reporting hinder accurate and reliable diagnosis. METHODS:To address these gaps, the Indian Association of Pathologists and Microbiologists (IAPM), the Indian Society of Gastroenterology (ISG) and the Colitis and Crohn's Foundation, India, (CCFI) collaborated to formulate comprehensive guidelines. Using a structured Delphi process and expert consensus, recommendations were developed to standardize biopsy protocols, histological evaluation and reporting of mucosal biopsies and tackling critical diagnostic challenges. RESULTS:The recommendations cover biopsy sampling, optimal processing, orientation, interpretation methods, histopathological algorithms, recommendations on histological scoring, follow-up biopsies and differentiation of IBD from its mimickers based on existing literature and expert's experience. Reporting formats were suggested to ensure uniformity in practice. CONCLUSION:These evidence-based, practical recommendations aim to enhance diagnostic precision, unify practices and improve patient outcomes in IBD care, providing pathologists in resource-diverse settings with a standardized approach to gastrointestinal mucosal biopsy evaluation.
Background and objectives:Ertapenem is well suited for outpatient parenteral antimicrobial therapy (OPAT) due to its once-daily dosing and favourable safety profile; however, increasing enzyme-mediated resistance limits its clinical utility. Ertapenem/zidebactam (WCK 6777) is a novel β-lactam/β-lactam enhancer combination in which zidebactam exhibits high-affinity binding to penicillin-binding protein 2 (PBP2), augmenting ertapenem activity and overcoming β-lactamase-mediated resistance. We evaluated the in vitro activity of ertapenem/zidebactam against carbapenem-resistant Escherichia coli and Klebsiella pneumoniae clinical isolates from India. Methods:MICs of ertapenem/zidebactam and comparator agents (carbapenems, imipenem/relebactam, ceftazidime/avibactam and aztreonam/avibactam) were determined by broth microdilution method. Carbapenemase genes and PBP3 insertions were identified using PCR. Results:Ertapenem/zidebactam demonstrated potent activity against E. coli, inhibiting 99.5% of isolates at the PK/PD breakpoint of ≤8 mg/L (MIC90, 0.5 mg/L), including NDM producers with PBP3 insertions. Against K. pneumoniae, susceptibility reached 93.6% among NDM producers and 88.5% among dual carbapenemase producers at the same breakpoint. Comparator agents showed variable activity, with limited efficacy against metallo-β-lactamase producers. Conclusions:The enhanced activity of ertapenem/zidebactam is attributed to zidebactam's dual mechanism, β-lactamase inhibition and high-affinity PBP2 binding, enabling effective coverage despite complex resistance mechanisms. Its once-daily dosing supports its potential as an OPAT-enabling therapeutic option and warrant further clinical development.
How to cite this article: Agrawal U. Bacteriophages: A Long-forgotten Past, or Hope for the Future? Indian J Crit Care Med 2026;30(3):185-188.
We report a rare case of synchronous presentation of cutaneous CD30 (cluster of differentiation 30)-positive anaplastic large T-cell lymphoma and glomangioma involving the labial mucosa of the upper lip, highlighting its diagnostic challenges and clinical significance. A 61-yearold woman presented with a mildly tender mucosal lump measuring approximately 7× 4× 2 mm on the inner aspect of the upper lip, without ulceration, discoloration, or other distinctive clinical features. An excisional biopsy was performed under local anesthesia. Histopathological examination revealed a high-grade lymphoproliferative lesion composed of pleomorphic large, atypical cells, consistent with anaplastic large cell lymphoma. Notably, the lymphomatous lesion was located over a well-circumscribed glomangioma characterized by dilated vascular channels. This case underscores the importance of maintaining a high index of suspicion and performing thorough histopathological and immunohistochemical evaluation of all excised lesions, even when clinical features suggest a benign process. The rarity of this synchronous presentation underscores the need for heightened diagnostic vigilance and contributes valuable insight to the existing literature on unusual tumor associations in the oral and maxillofacial region.
