A clinical psychiatric study o f twelve patients seeking sex change surgery is presented. The demographic data, clinical characteristics and the results of psychological testing are described. Unlike as in the Western countries, males and females were equally distributed in the study sample. The diagnosis of true trans­sexualism could be made in six cases. The alternative diagnoses were schizophrenia and sexual deviation. The aetiology of trans­sexuality, its diagnostic criteria, the differential diagnosis and the associated medico-legal and ethical problems are pointed out

Surgical manifestations of filariasis as seen in 150 cases over a period of three years in the department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha are reviewed. The genital manifestations are more common than the elephantiasis in this endemic zone.

Electrocardiographic studies have been carried out in 50 patients with acute cerebrovascular accidents. These cases included 31 cases from non-haemorrhagic group and 19 cases from haemor­rhagic group. `T' or T-U wave abnormalities were seen in 63.1% of cases in haemorrhagic group and in 35.4% of cases from non-hae­morrhagic group. Abnormal prolongation of QTc interval (105% of normal i.e. 0.45 Secs.) was observed in 73.6% cases from haemorrhagic group and in 35.4% of cases from non-haemorrhagic group. On comparing these two groups it was found that QTc was signi­ficantly more prolonged in patiens of haemorrhagic group than non­-haemorrhagic group. The CSF pressure was found to be signi­ficantly more in patients with ECG abnormalities. However, there teas no correlation between serum electrolyte levels and ECG abnormalities. After 2 weeks, the ECG abnormalities disappeared, except in two cases from haemorrhagic group. There was no signi­ficant difference in the incidence of mortality between patient having ECG abnormalities and the patients without ECG abnormalities. In the light of these findings the probable mechanism of production of ECG changes in acute cerebrovascular accidents is discussed.

Ethacridine Lactate (0.1%) has been tried in dogs to show it's safety by clinical and histopathological examination of vas at dif­ferent time intervals. Also in vitro titration was carried out with normal human semen and serially diluted ethacridine lactate. With this preliminary study, 0.1% Ethacridine lactate was found to be safe and effective for flushing the distal vas at the time of vasectomy for producing immediate azoospermia. It was also found to cause instant immobilization and lysis of the spermatozoa.

Irrigation of the vas with 0.1% ethacridine during vasectomy flushes the sperms and causes lysis from the distal genital tract, without any serious complication or side effect. In the light of this experience, it is suggested that this method can be used in all vasec­tomy operations carried out for primary sterilisation so as to pro­duce immediate sterility.

Eleven hundred and five cases of vaginal hysterectomy are analysed and their complications discussed. More than 90% of the patients were between the ages of 31 to 60 years. The common indications for hysterectomy were prolapse (51%) and dysfunctional uterine bleeding (34.9%). In four cases abdominal approach was necessary to complete the operation. The overall incidence of major complications was 4% and the corrected mortality rate was 0.18%. The complications of vaginal hysterec­tomy by other authors are discussed.

One hundred cases of acute leukaemia were studied, by Romanowsky stains and by cytochemical stains such as Sudan Black B, Periodic Acid Schiff, Alkaline phosphatase and Peroxidase stains. Cases difficult to diagnose by Romanowsky stained smears were easily classified by these supplementary stains. Their importance as supplements to the routine Romanowsky staining in the diagnosis of leukaemia is emphasized and the division of acute lymphoblastic leukaemia based on these patterns is suggested.

Surgically removed nasal polyps have been studied histologi­cally and histochemically. Out of the 70 specimens studied, 55 polyps (77.2%) were of edematous type with allergy and infection as the etiological factors while 15 (22.8%) constituted rest of the types which are not likely to be allergic in nature. The stand­ard line of treatment of nasal polyps is combined anti-allergic and anti-inflammatory, but for the polyps which are not allergic in nature, we propose that mere surgical resection without anti­allergic therapy would suffice for the complete cure.

A cystic swelling over the right frontal bone above the medial half of the eyebrow in a 37 year old male was found to be caused by Rhinosporidium seeberi. The patient did not have any past or concurrent lesion which could be presumed to be due to Rhino­sporidiosis. The lesion was subcutaneous with overlying healthy skin and had caused erosion of underlying bone.

This is a report of an unusual case showing a mitral valve prolapse in the presence of a biventricular endomyocardial fibrosis (EMF). The EMF was strongly suspected on left ventricular angiography and later proved at autopsy. The prolapse of the mitral valve was detected at echocardiography. To the best of our knowledge this is the first report of a case of EMF associated with mitral valve prolapse.

A case of the unilateral streaked ovary syndrome is presented with documentation by cytologic, chromosomal, laparoscopic and hormonal studies. This, the Slotnick-Goldfarb's syndrome, is characterized by oligomenorrhoea progressing into secondary amenorrhoea in a normal phenotypic female with a streaked ovary in one adnexa and an hypoplastic ovary in the other. This case presented with secondary amenorrhoea and primary sterility. She was tall with an increased carrying angle and had hypo plastic breasts and underdeveloped external and internal genitalia. Inves­tigations revealed a normal female karyotype, a mid-zonal matura­tion index, low normal urinary ketosteroids and elevated urinary gonadotrophins. Laparoscopy clinched the diagnosis. The aetiology, prognosis and treatment are briefly discussed. Stress is laid on the fact that whilst investigating a case of sterility and amenorrhoea, this new syndrome must be kept in mind.