Aging is increasingly regarded as an independent risk factor for development of cardiovascular diseases such as atherosclerosis and hypertension and their complications (e.g. MI and Stroke). It is well known that vascular disease evolve over decades with progressive accumulation of cellular and extracellular materials and many inflammatory processes. Metabolic syndrome, obesity and diabetes are conventionally recognized as risk factors for development of coronary vascular disease (CVD). These conditions are known to accelerate ageing process in general and vascular ageing in particular. Adverse events during intrauterine life may programme organ growth and favour disease later in life, popularly known as, ‘Barker's Hypothesis’. The notion of fetal programming implies that during critical periods of prenatal growth, changes in the hormonal and nutritional milieu of the conceptus may alter the full expression of the fetal genome, leading to permanent effects on a range of physiological.

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Background & objectives: Coronary artery disease (CAD), a leading cause of mortality and morbidity worldwide has multifactorial origin. Epicardial adipose tissue (EAT) has complex mechanical and thermogenic functions and paracrine actions via various cytokines released by it, which can have both pro- and anti-inflammatory actions on myocardium and adjacent coronaries. The alteration of EAT gene expression in CAD is speculated, but poorly understood. This study was undertaken to find out the difference in gene expression of epicardial fat in CAD and non-CAD patients. Methods: Twenty seven patients undergoing coronary artery bypass graft (CABG) and 16 controls (non-CAD patients undergoing valvular heart surgeries) were included in the study and their EAT samples were obtained. Gene expressions of uncoupling protein-1, monocyte chemoattractant protein-1 (MCP-1), adiponectin, adenosine A1 receptor (ADORA-1), vascular cell adhesion molecule-1 ( VCAM-1 ) and tumour necrosis factor-alpha ( TNF-α ) were studied by real-time reverse transcription-polymerase chain reaction. Glucose, insulin, lipid profile, high-sensitivity C-reactive protein, homocysteine, vitamin D, TNF-α and leptin levels were estimated in fasting blood samples and analyzed. Results: Leptin levels were significantly higher in CABG group as compared to controls ( P <0.05), whereas other metabolic parameters were not significantly different between the two groups. MCP-1 , VCAM-1 and TNF-α were upregulated in the CABG group as compared to controls. Further, multivariate analysis showed significantly reduced adjusted odds ratio for MCP-1 [0.27; 95% confidence interval: 0.08-0.91] in the CABG group as compared to controls ( P <0.05). Interpretation & conclusions: Our findings showed an alteration in EAT gene expression in CAD patients with significant upregulation of MCP-1 . Further studies with a large sample need to be done to confirm these findings.

Mild hirsutism and alopecia in postmenopausal women can be a normal physiological response. Sex cord stromal tumors of ovary account for approximately 5-8% of all ovarian tumors. When hirsutism is accompanied by signs of virilization such as severe balding, deepening of voice or clitoromegaly, an underlying androgen-secreting tumor, that may be malignant must be ruled out. We report a rare case of 46 year old female with premature menopause and symptom of hair loss. She had high testosterone levels and left ovary mass. As Cushing syndromes and late onset congenital adrenal hyperplasia were ruled out, an ovarian source of androgen was suspected. She underwent hysterectomy with bilateral salpingo-oophorectomy. A diagnosis of left ovarian sex-cord stromal tumor favoring Sertoli-Leydig cell tumor was confirmed.We report this case for its rare nature and atypical presentation.

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