This article is in continuation with the previous publication. The article reviews various psychopharmacological factors which determine the ultimate success of therapy, even when the drug administered does not have any specific efficacy in conditions under treatment. The importance of usually ignored variables of the psychophysiological state of an individual undergoing therapy, and its relevance to placebo genesis is discussed.

The biochemical assessment of coronary heart diseases (CHD) is done by studying serum lipids. This is usually done to under­stand the pathogenesis o f atherosclerosis which is the cause o f CHD. Indoor patients suffering from CHD were studied for their serum cholesterol, phospholipids, total fatty acids and polyunsaturated fatty acids (PUFA). Cholesterol/phospholipid and triene/tetraene ratios were calculated. It was observed that there was no significant difference in any of the parameters studied on the basis of dietary habit or body size. It was further observed on the basis of triene/tetraene ratio that the patients were ingesting adequate amounts of linoleate, there were high levels of cholesterol, phospholipids and c/p ratio in all the groups. This paradox may be due to disturbed PUFA metabolism and particularly of linoleate so that there is no influence o f linoleate on cholesterol and phospholipid synthesis.

Fungal endocarditis developed in 15 cases out of 205 in whom cardiac valves were replaced during the years 1969-75. Bacterial and fungal infections co-existed in 3 cases. Pure bacterial endo­carditis was seen only in one case during this period. Fungal endo­carditis was not observed following any other type of open or closed heart surgery. Clinicopathologic features of these cases are briefly described. Paucity of clinical signs and symptoms make early diagnosis difficult. The diagnosis of fungal infection was essentially histological. It was corroborated by culture in 3 cases. In 6 cases candida was responsible while in others either Aspergillus or Penicillium was responsible. In 11 out of 15 cases, endocarditis supervened in the early post-operative period stressing the need for vigilance.

Detailed pharmacological investigations of p-N-(3, 4-methylene dioxy phenyl) benzoic acid revealed marked hypotensive action which was dose dependent and most marked in cats; it was absent in rats. Atropine could block this hypotensive action, thus suggest­ing cholinomimetic mechanism. Further studies indicated that the hypotension produced was central and possibly medullary in origin.

Cholinomimetic activity of p, N- (3, 4-methylene dioxy phenyl) benzoic acid was revealed while studying its hypotensive activity in cats. Further evaluation of this activity showed that this com­pound had both muscarinic and nicotinic components. The cholino­mimetic activity was not similar to anticholinesterase like activity. Species variation was present; in rats it failed to show any activity and no activity was exhibited in vitro suggesting some metabolic transformation.

Clonidine was administered as an antihypertensive agent to 20 diabetic patients stabilized on oral hypoglycemic agents. The study lasted for three months. Sixteen patients completed the study. No patient complained of hypoglycemic symptoms. All patients show­ed a good control of blood pressure. Only two patients showed a rise in post lunch blood sugar level on one occasion each during treatment. There was no significant change in the blood sugar levels in the remaining patients. In conclusion, clonidine does not appear to significantly alter the diabetic control by oral hypo­glycemic drugs.

A case of hydrophobia following sero-vaccine prophylaxis is reported. The probable reason was delayed and insufficient treat­ment of extensive severe facial wounds involving conjunctiva and/ or a failure on the part of sero-vaccine treatment.

A case of rupture of retroperitoneal portion of duodenum following blunt trauma is reported and the relevant literature is reviewed.

Diffuse myomatosis of uterus in a post-menopausal woman developing as a result of ovarian thecoma is reported. A brief review of the literature is Presented.