Tuberculosis verrucosa cutis (TBVC)--foot with miliary tuberculosis.

Tuberculosis Verrucosa Cutis (TBVC) or warty tuberculosis is a variant of cutaneous tuberculosis in patients with good cell mediated immunity (CMI) to Mycobacterium Tuberculosis, while Miliary Tuberculosis is associated with very poor CMI. Two widely different clinical presentations in the same patient are very rare and being reported.

Modulation of blood pressure, lipid profiles and redox status in hypertensive patients taking different edible oils.

BACKGROUND: Free oxygen radicals and insufficiency of antioxidants have been implicated in the pathogenesis of hypertension. We determined the effect of edible oils on blood pressure, lipid profiles and redox status in hypertensive patients given antihypertensive therapy (nifedipine-calcium channel blocker). METHODS: 530 patients medicated with nifedipine were divided into 3 groups (356 patients-sesame oil; 87 patients-sunflower oil; 47 patients-groundnut oil) and the control group (n=40) received only the drug, nifedipine. The respective oils were supplied to the patients and instructed to use as the only edible oil for 60 days, which comes to 35 g of oil/day/person. Blood pressure, lipid profiles [total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglycerides (TG)], lipid peroxidation [thiobarbituric acid reactive substances (TBARS)], enzymatic [superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)] and nonenzymatic [(vitamin C, vitamin E, beta-carotene and reduced glutathione (GSH)] in blood were measured at baseline and after 60 days of oil substitution. RESULTS: Patients with nifedipine alone or with respective oils had significantly lowered blood pressure. TC, LDL-C and TG decreased while HDL-C elevated in sesame and sunflower oil groups. Increases of HDL-C and TG were noted in groundnut oil group. TBARS levels reduced in all the groups whereas the reduction was remarkable in sesame oil group. Activities of SOD elevated in the 3 oil groups whereas GPx and CAT increased only in sesame oil group. Levels of vitamin C, vitamin E, beta-carotene and GSH increased in sesame oil group whereas vitamin E and beta-carotene were elevated only in sunflower and groundnut oil groups. GSH increased in drug control group also. CONCLUSION: Among the 3 oils, sesame oil offers better protection over blood pressure, lipid profiles and lipid peroxidation and increases enzymatic and nonenzymatic antioxidants.

Oxidative stress and antioxidants in patients with cardiogenic shock complicating acute myocardial infarction.

BACKGROUND: Lipid peroxidation and derived oxidized products are being intensively investigated because of their potential to cause injury and because of their pathogenic role in several diseases. The view that an excess of lipid peroxidation products is present and is relevant in the pathogenesis of cardiogenic shock-induced damage has still not received definitive support. METHODS: To evaluate the extent of lipid peroxidation, the status of enzymatic and nonenzymatic antioxidants in patients with cardiogenic shock that complicate acute myocardial infarction (AMI) and to compare with normal subjects. RESULTS: Compared with normal subjects, cardiogenic shock patients had higher malondialdehyde, conjugated dienes and reduced activities of erythrocyte antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and lower concentrations of reduced glutathione (GSH) in erythrocyte and in plasma GSH, vitamin C, vitamin E and in beta-carotene. CONCLUSIONS: Cardiogenic shock is associated with greater than normal lipid peroxidation and with an imbalance in antioxidants' status. These results indicate that low activities of SOD, CAT, GPx and low concentrations of GSH, vitamin C, vitamin E and beta-carotene in the circulation of patients with cardiogenic shock complicating AMI may be due to increased utilization to scavenge lipid peroxides. Decrease in plasma concentrations of GSH, vitamin E and beta-carotene seems to be responsible for the elevation of lipid peroxidation in cardiogenic shock complicating AMI compared with MI.