Metolazone [2-methyl-3-(0-tolyl)-6-sulpharnyl-7-chloro-1, 2, 3, 4­tetra hydro-4-quinazolinone] is recently introduced as a new orally acting diuretic. It is structurally related to sulfonamides and benzo­thiazidines. 41 male patients suffering from generalised edema due to various causes including 7 cases of congestive cardiac failure, 6 cases of malnutrition and 28 cases of hepatic cirrhosis were treated with metolazone given orally in a dose varying from 5 to 60 mg per day. The optimum effective dose was found to be 5 mg per day. 36 cases responded well with a loss of body weight ranging from 2.5 kg. to 12 kg. There was a significant increase in the urine volume and the urinary sodium, potassium and chloride excretion. Saluretic response was marked. Urinary sodium increased from 8-20 mEq/ day to 100 to 120 mEq in 24 hours. No serious side effects were observed during this study. Hypokalemia and hyponatremia occurred on increase of the dose. Occasionally leg cramps and abdominal distress were observed. Metolazone was found to be an effective orally active diuretic in a dose of 5 to 10 ^, mg/day.

Thirty six patients with severe hypertension were treated with intravenous clonidine. In 67% of cases maximum response was obtained within 11 hours of administration of the drug. Aver­age reduction in mean arterial pressure was 29%. Paradoxical rise in blood pressure was observed in some patients, immediately after clonidine administration. This could be prevented with prior administration of phentolamine intravenously. Clonidine (I.V.) sup­plied by two drug firms gave identical results.

Out of 866 bacterial isolates grown in significant colony counts from 3 consecutive mid-stream urine samples or from a single sample of urine obtained by suprapubic bladder puncture, 305 isolates (35.22%) were found to be sensitive to Cephradine. It was noted that Gram positive organisms (63.44%) manifested highest sensitivity to this antibiotic. Next in order was E. coli with a sensitivity of 60.54%. The clinical trial revealed a good response in 59.37% and 81.81; of patients with oral and injectable group re­spectively. The maximum response was seen in E. coli infections (89.47%) and Gram positive organisms coming next with 80% re­sponse. No major untoward reactions were noted in patients with or without azotaemia and the antibiotic could be used safely even in presence of renal failure.

Some of the known antimuscarinic agents were studied for their effect on the acetylcholine induced contraction of the super­fused skeletal muscle of frog, All drugs exhibited varying degrees of curarimimetic effect. During recovery from the drug effect, the tissue exhibited an increased sensitivity to the action o f acetyl­choline; in some instances it was immediate, but it was only at very small concentrations.

Urinary 17-ketosteroids (17-KS) have been estimated and correlated with different stages of breast cancer in this study. We observed marked increase in urinary 17-KS in advanced stages of the disease. Further, we noticed a positive correlation between urinary 17-KS levels and the progress of the disease. Thus, estima­tion of urinary 17-KS may prove to be of some prognostic value and may help the clinicians concerned in the clinical evaluation of the stage and the progress of the disease.

Eighty four patients of chronic advanced pulmonary tuber­culosis were subjected to determine the acceptability of ethionamide at different dosage schedules and frequencies of intake of the drug over a period of 10 months. Mild to severe side-effects were observed in 56.6 per cent, 70 per cent and 100 per cent patients of groups A, B and C respectively receiving ethionamide in a dose of 500 mg, 750 mg and 1 gm per day. Gastro-intestinal disturbances were most frequently encountered. Toxic symptoms appeared earlier with higher doses of ethionamide. Patients taking the drug in a single dose had had higher incidence of toxicity than those who were prescribed in two divided doses. Pyrazinamide appeared to enhance ethionamide unacceptability. Age, chronicity of illness and extent of disease did not exhibit any influence on ethionamide acceptability.

One hundred and fourteen patients with chronic advanced pulmonary tuberculosis were studied for 6 months to assess the acceptability of prothionamide at different dosage schedules and frequencies of intake of the drug. Gastrointestinal disturbances were most frequently encountered in patients of all the groups. Mild to severe toxic symptoms were recorded in 34.3 per cent, 44.7 per cent and 80 per cent patients receiving the drug in a daily dose of 500 mg, 750 mg and 1 gm respectively in groups A, B and C. At a dose of 500 mg per day, the incidence of toxicity was identical in the two sexes but beyond this dose it was slightly higher in females than in males. Age, chronicity o f illness and extent o f diseases did not have any influence on prothionamide acceptability. Toxic symptoms developed earlier in patients receiving higher doses of the drug. Prothionamide in a dose of 500 mg per day was very well tolerated by 65.7 per cent of patients and a considerable number of them tolerated a dose of 750 mg per day.

226 volunteer donors and 320 cases of syphilis (with positive VDRL test) were screened for hepatitis B antigen (HBs Ag, Australia antigen). The incidence of hepatitis B antigen in these groups was 0.88% and nil respectively. The present data, though small in size do not indicate any positive correlation between HBsAg and syphilis-as claimed by other workers.

Glycolytic intermediates like ATP, DPG and GSH have been studied in a family with. hereditary elliptocytosis and thalassemia. Results indicate a fall in ATP with a concomitant rise in DPG in the Patient. Findings are discussed in relation to other data.

A case of bronchogenie carcinoma developing in a patient with pulmonary tuberculosis is described and literature reviewed.

A 37 year old man presented with multiple pathological frac­tures, mental symptoms and features o f renal insufficiency without renal stones and nephrocalcinosis. This was found to be a case of primary hyperparathyroidism due to chief cell hyperplasia. Three parathyroids were removed leaving behind the right superior gland. The patient had temporary symptomatic improvement with the healing of the fractures of metacarpals. There was no union of fractures of necks of femora. The symptoms reappeared and the patient died of renal failure more than a year after operation. Severe renal impairment is therefore the most important single complication in advanced osseous lesions. Even if parathyroidectomy is done in such advanced cases probably no permanent clinical improvement may be expected. Better results in these cases might be observed by early diagnosis of the disease and adequate surgery. It is hence suggested that in a case of parathyroid hyperplasia one should aim at excision o f 31- parathyroid glands, i.e., near total parathyroidectomy, to avoid recurrence of disease.

A rare case of diffuse intravascular clotting (DIC) complicat­ing Gram negative bacterial endocarditis following aortic valve replacement is reported. The clinical and pathological findings are presented. The blood coagulation studies are described in detail and which indicated extensive in vivo clotting. Histological exam­ination of the kidneys however, failed to reveal the presence of fibrin. The literature on the subject of DIC following septicemia is reviewed. The value of the use of heparin in such patients is discussed.