Highly Sensitive C - Reactive Protein In Hypertension, As A Potential Marker Of Cardiovascular Events A Case-control Hospital-based Study

As inflammation had a role in every stage of atherogenesis and hypertension, in turn leading to Cardiovascular Disease. Hs-CRP level estimation can be an important screening method for assessing the risk. Thus, this study to evaluate the effect of essential hypertension on hsCRP levels in Indian adult population. As well as clustering of other cardiovascular risk factors in comparison with a control group in a population. Acase-control study was carried out in of Era's Lucknow Medical College & Hospital, Lucknow, and Uttar Pradesh. All patients coming in out-patient department were screened for inclusion & exclusion criteria. Those selected were subjected to screening of risk factors of cardiovascular diseases & serum hs CRP estimation.Significant CAD risk factors in our cases came out to be: higher weight (p-value: 0.0470), raised BMI (>25) (p-value: 0.005), higher waist circumference (p-value: 0.0010) & smoking (p-value: 0.008). Average hs-CRP values in the hypertensive group (cases) was higher (2.85 ± 2.4 mg/L) than in normotensive group (control) (2.36 ± 2.08 mg/L). No significant difference in values among the controlled & uncontrolled group of previously diagnosed hypertensives was observed but a significant difference was found between newly diagnosed Stage I & Stage II hypertensives.Also, though not significant a rising trend was noted in hs-CRP values with an increase in the risk category. On CAD risk stratification according to hs CRPvalues cases hada significantly higher prevalence of hs-CRP levels than controls. Conclusion: The study did not reveal any significant difference in hs CRPvalues in hypertensives than from the normotensive population. But the significant difference between Stage I & Stage II of hypertension was observed in hs-CRPvalues.

Isolated distal cutaneous thrombosis: An unusual presentation and an interesting etiology.

A middle-aged hypertensive male, with a fatty liver and chronic alcohol intake, relocated to a high altitude of 2100 m above sea level; in the first winter season, he developed bluish skin lesions over the tip of the nose, margins of both ear lobes, both knees, and subungual location. Systemic examination was unremarkable. Skin biopsy showed thrombi in dermal vessels without any evidence of vasculitis; immunofluorescence was negative. Investigations revealed mild elevation in plasma homocysteine levels, weakly positive antinuclear antibodies and elevated antiphospholipid antibodies, methylene tetrahydrofolate reductase C677T heterozygosity, and protein S deficiency. The patient received prednisolone for 2 weeks, aspirin and pentoxyphylline for 3 months, and continues to be on folic acid and vitamin B6. After 3 months, antiphospholipid antibodies and antinuclear antibody levels were normal. Isolated distal cutaneous thrombosis is an uncommon entity and precipitation by extreme cold in a hypertensive male with three thrombophilic states - one transient, one hereditary, and one acquired - is fascinating.

Tuberculous epidural abscess - an unusual presentation.

A 23 year old female presented clinically as a case of transverse myelitis. However, MRI suggested an epidural abscess extending from T7 vertebral level to L 1 vertebral level. Histopathological analysis revealed the abscess to be tuberculous in nature. Patient responded to surgical decompression and anti-tuberculous therapy.