The mechanism of hypotensive action of R-1230, a new disub­stituted piperazine derivative was studied in anaesthetised normo­tensive cats. Rapid intravenous injection of R-1230 produced an immediate transient fall in blood pressure attributable to a direct peripheral vasodilator action as concluded from cat's hindquarters' perfusion experiment. The prolonged secondary hypotensive re­sponse appeared to be of complex nature. Inhibition of centrally mediated pressor reflexes on intracerebroventricular administra­tion, accompanied by peripheral adrenergic blockade, points to the dual mechanism of drug induced hypotension. Results in decere­brate and spinal preparations indicated the lower brainstem region lo be the principal site of central hypotensive action.

Trimethoprim and Nitrofurantoin are both effective against urinary tract infections. Trimethoprim till now has been used in combination with sulphamethoxazole. We have investigated the combination of Trimethoprim and Nitrofurantoin on 182 pathogenic cultures isolated from 165 cases of urinary tract infection which had a significant colony count of >10 ⁵ orgs/ml. 65% of the strains exhibited synergy to the combination. Clinical results of this combi­nation are very promising and are reported in another communica­tion.

A combination of long acting oestrogen-ethinyl estradiol-3­cyclopentyl ether 2 mg (Quinestrol) and a progestin-norethindrone acetate-3-cyclopentylenol ether 2.5 mg (Quingestanol acetate) was clinically investigated as a "Pill-a-month" contraceptive in 94 Indian women for 529 months of use. Totally 6 pregnancies occurred due to the method failure, the Pearl index being 13.6 per 100 women years (the 95 per cent confidence region per 100 women years has the lower limit of 4.5 and the upper limit of 30). The drug related drop-out was 68% at the end of 2 years' trial (95 per cent conf. dente region for per cent observed rate has the lower limit of 64 and the upper limit of 72 per cent). The high pregnancy rate has been validated by the multicentric Indian data.

Four cases of acute renal failure following copper sulphate poisoning have been described. All of them had intravascular hae­molysis with varying degree of methaemoglobinaemia, -needing specific therapy for the same. They also were icteric due to acute hepatic damage and two of them died from irreversible hepatic damage despite dialysis which were given to them with a view to remove copper and uremic metabolites.

The nineteenth authenticated report of human sarcocpstis is made and all available literature reviewed on the subject.

A case of congenital contractural arachnodactyly is reported for its rarity. It is a recent entity reported first from the United States in 1971. The contractures improve with time but the scoliosis may progress and usually require surgical correction.

A case of dancing feet and dancing eye is presented for its peculiar features of ataxia, nystagmoid movements of the eye and asynchronous random jerks of the muscles, extreme irritability but total lack of mental clouding. Most of the laboratory investigations are normal except that the electrophoretic analysis of CSF protein shows a distinct pre­-albumin band and increase in gamma globulin. There is uniformly favourable response to corticosteroids.

Abnormal electrocardiographic findings in a case of Chlorpro­mazine poisoning are presented. The manifestations and mecha­nisms of cardiac effects of phenothiazines have been discussed. Patients on prolonged phenothiazine therapy should have a regular cardiological follow up to avoid catastrophe. A pretreatment electro­cardiogram will help to detect the high risk patients.

A case of hemoglobin-E disease with rheumatic mitral stenosis is presented. Reported world incidence is mentioned. Association of heart disease with hemolytic anemia is discussed.