Familial constrictive pericarditis is extremely rare. We report a case of two brothers both suffering constrictive pericarditis along with having multiple painless joint deformities. Genetic workup confirmed the clinical diagnosis of camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome CACP syndrome and also revealed a rare mutation in the causative gene.

Tuberculosis of spleen is an extremely rare clinical entity. It often poses diagnostic difficulties as microbiological confirmation of diagnosis is not easy. We came across a case of middle aged immunocompetent female from good socioeconomic background who presented with weight loss and pain in left hypochondriac region. Ultrasonography of abdomen revealed multiple hypo echoic lesions in the spleen. Splenectomy was performed and sample was sent for histopathological examination and also microbiological analysis. Gross examination of the specimen showed multiple nodules coalescing to form large yellowish white mass of firm consistency. Histopathological examination showed large areas of caseation surrounded by multiple granulomas of epitheloid cells and Langhan's type of giant cells throughout the splenic pulp. PCR was done by using IS6110 primers. This was consistent with the diagnosis of Mycobacterial infection. Mycobacterium tuberculosis grew on culture from the tissue after 5 weeks. No primary focus of infection was detected in the lungs or any other organ. Diagnosis within just a few hours was made possible because of PCR.

The present study indicates that, despite comparable surgical trauma, the OPCAB significantly reduces tissue injury. The overall pattern of endothelial activation after OPCAB is significantly lower than that after CABG. This may contribute to improved organ function, and improved postoperative recovery.

Background:Clinical relevance of association of cabergoline use for hyperprolactinemia and cardiac valvulopathy remains unclear.Objective:The aim of the study was to determine the prevalence of valvular heart abnormalities in patients taking cabergoline for the treatment of prolactinoma and to explore any associations with the cumulative dose of drug used.Design:A cross-sectional echocardiographic study was performed in patients who were receiving cabergoline therapy for prolactinoma.Results:Hundred (61 females, 39 males) prolactinoma cases (81 macroprolactinoma and 19 microprolactinoma) were included in the study. The mean age at presentation was 33.9 ± 9.0 years (range: 16–58 years). The mean duration of treatment was 53.11 ± 43.15 months (range: 12–155 months). The mean cumulative dose was 308.6 ± 290.2 mg (range: 26–1196 mg; interquartile range: 104–416 mg). Mild mitral regurgitation was present in one patient (cumulative cabergoline dose 104 mg). Mild tricuspid regurgitation was present in another two patients (cumulative cabergoline dose 52 mg and 104 mg). Aortic and pulmonary valve functioning was normal in all the cases. There were no cases of significant valvular regurgitation (moderate to severe, Grade 3–4). None of the patients had morphological abnormalities such as thickening, calcification, and restricted mobility of any of the cardiac valves.Conclusion:Cabergoline appears to be safe in patients with prolactinoma up to the cumulative dose of ~300 mg. The screening for valvulopathy should be restricted to those with higher cumulative cabergoline exposure.

Among clinical responders to surgical pericardiectomy, echocardiographic assessment revealed a significant reduction in vena caval congestion, LA size, ratio of LA to aortic annulus, septal bounce, respiratory variation in mitral and tricuspid E velocities, mitral annular medial e' and the phenomenon of annulus reversus. Also, there was a significant rise in minimum tricuspid and mitral E velocities and the E/e' ratio.