Vascular oxidative stress is an important factor in hypertension-associated vascular damage and is mediated by nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activation. The C242T polymorphism at the p22PHOX gene affects binding of p22PHOX to heme, leading to variants of NADPH oxidase that produce different levels of reactive oxygen species (ROS). Specific variations in ROS are associated with an altered risk of developing cardiovascular disease. In the present study, 140 permanent Kashmiri-resident individuals were recruited (75 with essential systemic hypertension and 65 normotensive controls). Endothelial function was assessed non-invasively using high-resolution ultrasonography of the brachial artery. Endothelium-dependent vasoreactivity was expressed in terms of flow-mediated dilation. The TT genotype was identified in 2% of hypertensive and 7% of normotensive individuals. Frequency of the T-allele was not observed as significantly different between hypertensive and normotensive individuals (P=0.24; OR=0.4; 95% CI, 0.07-2.2). Blood pressure or the prevalence of hypertension did not vary between C242T p22PHOX genotypes or in the presence or absence of the T-allele.

Background: Even in developed countries suboptimal anticoagulation and low adherence to guidelines is frequently observed in Atrial fibrillation (AF) patients. There is no data from our regional population and very scarce Indian data about the utilization patterns and adherence to guidelines for stroke prevention in AF. Aims and Objectives: To characterize clinical profile and assess adherence to guidelines in stroke prevention in AF in north Indian population. Material and Methods: It was a single centre observational study. All patients presenting to outpatient department or admitted in cardiology wards from May 2014 to April 2016 with AF were included. Detailed history, examination and relevant investigations were carried out .CHADS 2 score was used for risk stratifying and prescribing oral anticoagulants in nonvalvular AF. The effectiveness of oral anticoagulant was assessed by INR. Result: Total of 446 patients were included. Mean age of our patients was 60.83±16.86 years. 48% were males and 52% were females. Rheumatic heart disease was most common (37.2%) ethology followed by hypertensive cardiovascular disease (18.2%). Mean CHADS 2 score was 2.63±1.5 in non valvular AF. Out of 446 patients, 409(92%) patients were found to have indication for prescription of OAC as per guidelines, out of which only 290 (71%) patients actually received OAC. OAC prescription was significantly higher in valvular vs. non valvular AF ( p=0.0001).The rates of OAC prescription in our patients in age group, ≤65, 66-75, >75 years were 84.4%, 65% and 60.2% respectively Out of 290 patients who were eligible for OAC ,only 102(25%) patients were optimally anti-coagulated. Conclusion: Discordance between guidelines and practice was found regarding prescription of OACs and maintenance of optimal anticoagulation for stroke prevention in our population. Optimal anticoagulation needs to be emphasized on both patients as well as physicians to prevent strokes and achieve better outcomes.

Subaortic left ventricular outflow tract pseudoaneurysms are rare lesions that are associated with aortic valve diseases, infective endocarditis, trauma or surgery. We present dynamic multidetector computerized tomography and cine magnetic resonance imaging features of a case of subaortic aneurysm arising from interaortic-mitral valvular region in a child with past history of infective endocarditis.

Isolated congenital valvular stenosis of either aortic or pulmonary valve is commonly seen yet the presence of both these lesions in the same patient is rare. This combination presents unusual diagnostic as well as management problems. Apart from a few case reports, there is little in the literature on the combined stenosis of both semilunar valves. We present here a case report of a three and half year old boy diagnosed as a combined congenital severe valvular aortic stenosis with valvular pulmonary stenosis. The patient underwent successful balloon dilatation of both these valves in the same sitting.

Objective To examine the usefulness of a test for prostate specific antigen (PSA) to predict survival in hormonally treated patients with metastatic prostate cancer. Patients and methods The study comprised 49 patients (mean age 72 years, sd 6) who underwent orchidectomy for metastatic prostate cancer. PSA was measured before orchidectomy and after 6 months, and the absolute, differential and proportional decreases calculated. A Cox proportional hazards regression model, which controlled for patient age, tumour (Gleason) grade and the number of skeletal metastases, was then used to evaluate these estimates of PSA as predictors of survival. Results The 6‐month proportional decrease in PSA from the pre‐operative level was the most accurate predictor of patient survival (P=0.006) after hormonal therapy for metastatic prostate cancer. Conclusion This information may help to direct appropriate patients to new and experimental therapies for metastatic disease.