Star anise (Illicium verum): Chemical compounds,antiviral properties,and clinical relevance

Medicinal herbs are one of the imperative sources of drugs all over the world. Star anise (Illicium verum), an evergreen, medium‐sized tree with star‐shaped fruit, is an important herb with wide distribution throughout southwestern parts of the Asian continent. Besides its use as spice in culinary, star anise is one of the vital ingredients of the Chinese medicinal herbs and is widely known for its antiviral effects. It is also the source of the precursor molecule, shikimic acid, which is used in the manufacture of oseltamivir (Tamiflu®), an antiviral medication for influenza A and influenza B. Besides, several other molecules with numerous biological benefits including the antiviral effects have been reported from the same plant. Except the antiviral potential, star anise possesses a number of other potentials such as antioxidant, antimicrobial, antifungal, anthelmintic, insecticidal, secretolytic, antinociceptive, anti‐inflammatory, gastroprotective, sedative properties, expectorant and spasmolytic, and estrogenic effects. This review aimed to integrate the information on the customary attributes of the plant star anise with a specific prominence on its antiviral properties and the phytochemical constituents along with its clinical aptness.     

A randomised comparative study on sublingual versus vaginal administration of misoprostol for termination of pregnancy between 13 to 20 weeks

BACKGROUND: Misoprostol is the drug of choice for medical abortion worldwide but consensus is yet to be reached regarding its preferred route of administration. AIMS: To compare the outcome of sublingual with vaginal administrations of misoprostol for induction of second trimester abortion. METHODS: A randomised comparative trial where 300 women at 13-20 weeks gestation, requiring medical abortion, were randomly assigned to sublingual or vaginal route for misoprostol administration with a dose schedule of 400 microg three-hourly, up to a maximum five doses over 24 h. The same doses were repeated for another 24 h in non-responders. Primary outcome measure was complete abortion rate at 24 and 48 h, and the secondary outcome measures were induction-abortion interval, failure rate, side-effects and patients' preference to the route. RESULTS: No statistically significant differences in the complete abortion rates were observed at 24 h (64.03% vs 61.59%, P = 0.767) and at 48 h (79.14% vs 82.01%, P = 0.651) when sublingual and vaginal groups were compared. Mean induction-abortion intervals in sublingual and vaginal groups were 14.1 and 14.5 h, respectively (P = 0.066). Other outcome measures were also more or less similar in both groups. Differences in the incidence of side-effects were also statistically insignificant when both groups were compared. Sublingual administration of the drug was preferred by most of the women as compared to vaginal administration (P < 0.0001). CONCLUSION: Both sublingual and vaginal administrations of misoprostol are equally effective in inducing medical abortion during second trimester but sublingual route was preferred by the patients.     

Definition of an algorithm for the management of common skin diseases at primary health care level in sub-Saharan Africa

In order to help primary health care (PHC) workers in developing countries in the care of common skin diseases, an algorithm for the management of pyoderma, scabies, superficial mycoses, contact dermatitis and referral of early leprosy cases (based on the identification of diseases through the presence of objective key signs, and on treatments by generic drugs) was elaborated. One thousand patients were seen by trained dermatologists, who established diagnoses and treatments; in addition, there was systematic recording of each key sign, according to the successive algorithm steps. We compared the diagnostics and treatments obtained for several combinations of diagnostic signs, with those of the dermatologists. Sensitivity, specificity, positive predictive value and negative predictive value of defined combinations were high for pyoderma, scabies and superficial mycoses. Values were less exact for dermatitis and leprosy, but were considered sufficient for the level of health care targeted. The apportionment of treatments between the algorithm and the dermatological approaches was considered appropriate in more than 80% of cases; mismanagement was possible in 7% of cases, with few predictable harmful consequences. The algorithm was found satisfactory for the management of the dermatological priorities according to the standards required at the PHC level.     

Role of uterine artery velocimetry using color-flow Doppler and electromyography of uterus in prediction of preterm labor

AIM: To evaluate the role of Doppler waveforms of uterine vessels and electromyography (EMG) of the uterus in predicting preterm labor. METHODS: One hundred ante-natal women at >or=24 weeks of gestation who fulfilled the selection criteria were included in the study. A single Doppler recording for bilateral uterine vessels was taken at >or=26 weeks gestation using the transvaginal route. Transabdominal EMG of the uterus was recorded serially at 4-week intervals from 24 weeks until delivery or until 37 weeks were completed. RESULTS: Women with a sensation of heaviness in the lower abdomen during pregnancy had a significant association with preterm delivery. Of the three Doppler indices, the systolic/diastolic ratio and the resistivity index of uterine vessels were found to have a sensitivity as high as 83-95% for the prediction of preterm labor. The electrical activity of uterine musculature, as recorded using EMG, showed that there was a statistically significant difference between the electrical activity recorded for the two groups at 31 weeks and later, while the duration of burst activity was significantly longer in the preterm group at 26 weeks and later. CONCLUSIONS: Patients with a dull aching sensation in the lower abdomen should not be neglected. Doppler of the uterine vessels and EMG of the uterus could prove to be a good predictor of preterm labor.     

A longitudinal study of crevicular fluid in periodontal disease in beagles

A longitudinal study on the composition of crevicular fluid (CF) and serum was carried out in seven beagle dogs during a period from health to 16 weeks of gingivitis and then 8–10 weeks of ligature induced periodontitis (LIPD). The fluids were collected at weekly intervals and the pH and the concentrations of Ca, Mg, Na, and K and the protein profile were determined. Also at weekly intervals, the plaque index, gingival index, calculus index, and pocket depth and attachment loss were recorded for the teeth from which crevicular fluid was collected. Radiographs were taken on the 0 day and after the dogs were sacrificed. Histopathological studies were carried out following sacrifice of the dogs, and the distances between the cemento-enamel junction and the coronal end of the junctional epithelium and the cemento-enamel junction and the crest of the alveolar bone were measured. A two-way ANOVA analysis of the two fluids (CF and serum) and of the two diseases (gingivitis and periodontitis) showed significant differences between the two fluids and between the two diseases. Further statistical analysis showed that in serum none of the constituents studied differed significantly between gingivitis and LIPD, but a significant rise in the concentrations of Ca, Mg, and K was observed in CF during LIPD. The pH of CF was significantly lower during LIPD, but no significant change was observed in the concentration of Na ion. An apparent relationship was observed only between the concentration of K ion in CF and the attachment loss during LIPD. The serum protein profile remained unchanged throughout the period of this study. During gingivitis the CF protein profile was identical to that of serum, but during LIPD a new protein peak appeared. This material had a molecular weight of < 200,000 daltons. Histopathological and radiographic analysis showed bone loss in all but one dog during LIPD. Histopathological study also showed no significant difference in the distance between CEJ and the coronal end of the junctional epithelium between the ligated and the non-ligated sides. This study showed that in beagle dogs the CF differed significantly from that of serum. Also, LIPD caused significant changes in both ionic concentrations and protein profile of crevicular fluid.     

Effect of garlic oil in experimental cholesterol atherosclerosis

Addition of cholesterol in the diet of male albino rabbits produced hypercholesterolaemia, increased tissue cholesterol, and atheromatous changes in the aorta. Supplementation of garlic oil along with cholesterol significantly inhibited the hypercholesterolaemia, decreased tissue cholesterol and minimised the atheromatous changes in the aorta. These results show that the active constituent(s) in garlic responsible for its anti-atherogenic action is present in the oily fraction of garlic.     

Bilateral ovarian hydatid disease--an unusual case

Hydatid disease is caused by parasitic tapeworm Echinococcus. The larval stage of this parasite can thrive in many parts of the body, most frequently in the liver. Primary ovarian location is very rare. In our case the patient had bilateral ovarian cysts which on histopathological study was found to be hydatid cysts. Moreover one of the cysts was multilocular which is also unusual.