HIV-inhibitory diterpenoid from Anisomeles indica

The 1H- and 13C-NMR spectral data of ovatodiolide (1), a diterpenoid from Anisomeles indica, and its anti-HIV activity are reported.

Low molecular weight heparins: current use and indications

Thromboembolic complications are associated with significant morbidity and mortality in postoperative patients. For many years, unfractionated heparin has been used successfully in primary and secondary prophylaxis of these complications. In recent times, however, the usefulness of LMWHs has caught the attention of clinicians because of improved bioavailability, predictable anticoagulation, ease of administration, and the lack of need for monitoring anticoagulation. In clinical situations, LMWHs have been tested and proved to be safe and equipotent or supe rior when compared with unfractionated heparin or warfarin (Table 5). It is clear from clinical trials that LMWHs are superior in primary prophylaxis of DVT in orthopaedic surgical procedures, treatment of unstable angina, and in patients with multiple traumas. LMWHs were also tested and found to be an acceptable alternative to unfractionated heparin in both the primary prophylaxis of DVT in high risk general surgical procedures and in the treatment of patients with DVT and pulmonary embolism. However, the role of LMWHs in ischemic heart diseases, valvular heart diseases, postcoronary angioplasty, and vascular surgery remains to be proved. The major impact of LMWHs would be in allowing clinicians to treat PE and DVT in an outpatient setting, which would directly impact medical economics. LMWHs are associated with similar complications as unfractionated heparin is, but the complications occur less frequently. Currently, the main limitation in using LMWHs in place of unfractionated heparin or warfarin is its cost. However, taking into account the cost incurred by hospitalization and longterm monitoring of anticoagulation in patients treated with unfractionated heparin, certain trials have proved the cost of LMWHs to be the same or less than the cost of unfractionated heparin overall. We envision that LMWHs will be widely used in the future and will bring welcomed change in the treatment of thromboembolic diseases.

Dystrophic calcification in the neck--a case report

One 55 years aged male person was admitted with progressive painless neck swelling with multiple discharging sinuses. His X-ray of the neck showed a dense radio-opaque shadow & serum calcium level was 2 mmol/l. On neck exploration, an irregular calculus was revealed; hooking around the left carotid sheath. Histopathology confirmed the clinical diagnosis of tuberculosis. Anti-TB chemotherapy for six months cured him.

Anterior cervical osteophytes: a rare cause of dysphagia

Anterior cervical osteophyte is a rare cause of dysphagia usually occurring in the elderly. We report two cases in which the anterior cervical osteophytes impinged upon the esophagus, and we describe their surgical management. Initial investigation of a case of dysphagia should be directed to the common causes; however, in the elderly and in those with disorders of the cervical spine an anterior cervical osteophyte may be the cause of dysphagia.

Muscle fibrillation following thiopentone and pancuronium bromide. An association with metachromatic leucodystrophy

A case is reported of muscle 'gibrillation' following the administration of thiopentone and pancuronium to a patient suffering from metachromic leucodystrophy and possible mechanisms are discussed.