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Sixty patients with symptomatic duodenal ulcer were randomized to receive either omeprazole (20 mg each morning) or famotidine (40 mg at night time) for 2-4 weeks in a double-blind parallel group clinical trial. Healing rates were higher with omeprazole in comparison with famotidine after 2 weeks (77% vs. 40%, P0.001) and 4 weeks (93% vs. 80%, P = 0.2) of treatment. Assessment of daily diary cards completed by all patients revealed that omeprazole rapidly relieved ulcer-related day pain and nocturnal pain in comparison to famotidine. Treatment with omeprazole for 2 weeks was also associated with lower cumulative antacid intake (P0.05) and reduced absenteeism from work. Helicobacter pylori infection was present in all patients and remained unaffected by treatment with either of the drugs. None of the drugs produced any significant adverse effects. During 6 months follow-up of all the patients after ulcer healing (without maintenance therapy), ulcer relapse was seen in 40% of omeprazole- and 37% of famotidine-treated patients (P0.1). The duration of ulcer-free period following initial healing of ulcer was also similar in both the groups (median time: 22 weeks for omeprazole, 21 weeks for famotidine). We conclude that omeprazole is superior to famotidine in rapidly healing duodenal ulcers and achieving more rapid pain relief, but does not influence subsequent ulcer relapse.

We studied the risk of post-transfusion hepatitis (PTH) in recipients of blood collected from voluntary donors screened for HBsAg. Two hundred and fifty patients without any previous history of liver disease or transfusion were followed up for 12 months subsequent to cardiac surgery. Thirty-five of them had closed-heart surgery without receiving transfusion and served as controls. The remaining 215 patients received single-point transfusions (mean 4 +/- 2.4 units). None of the controls and 15 (6.9%) blood recipients developed PTH. Three (20%) patients had hepatitis-B-virus-induced hepatitis while the remainder (80%) had non A, non B (NANB) hepatitis. The number of units of blood transfused and surrogate markers for development of PTH (donor alanine aminotransferase, anti-HBc and anti-HBs antibody) were not associated with the occurrence of PTH (p greater than 0.05). Nine (60%) of the 15 patients developing PTH were asymptomatic. All the patients recovered from the PTH, except one who died of fulminant hepatitis. At the end of 1 year of follow-up, none of the patients had evidence of chronic hepatitis. Only three (25%) of the patients with NANB-PTH developed anti-hepatitis C virus (HCV) antibody during the follow-up. We conclude that the incidence of PTH in India is similar to other parts of the world and NANB virus was the major cause of the PTH. The absence of chronicity and lack of seroconversion to anti-HCV antibody in the majority of the patients after 1 year of follow-up may suggest the possibility of a NANB virus other than HCV as the major cause of PTH in India.

Primary laryngeal amyloidosis is a rare clinical entity. A clinicopathological study done in 14 cases and the observations are reported herewith. Relevant literature on the subject has been reviewed.

Melanomas are mostly pigmented tumour, having very often malignant course and poor prognosis, developed in the functioning melanoblast cells rarely occur in nasopharynx, paranasal sinuses, and oral cavity, appear to have some genetic predisposition and multiple primary lesions, lymphatic and vascular metastasis to regional gland and distant regions. These tumours in Head and Neck appear as bulky black or brown lobular masses with occasional cauliflower like ulcers having recurrent epistaxis or blood stained discharge from nose or oropharynx. The diagnosis is usually delayed because of indefinite symptoms. The best chances of cure are possible with a combination of radical surgery. Electrodissection and Irradiation. Block dissection may sometimes be postponed for future unless there is suspicion of existing nodal metastasis. In surgically hopeless cases Radiotherapy and chemotherapy offer the best hope for some palleation, separately or in combination.

Existing leterature on the subject has been discussed. The clinical features of the case have been described. The reappearance of tumour after successful operation on opposite side has been brought to light as a new feature of the case. The massive mass of tumour and extensions have been discussed. Attempts have been made to explain the cause of reappearance of the tumour. An elaborate technique of operation alongwith difficulty experienced in anaesthesia have been explained.

Carcinoma of middle ear and mastoid is a notoriously lethal disease because of its rarity and therefore difficult diagnosis, its rapid extensions to vital intracranial structures and yet remaining asymptomatic, its arduous surgery and inadequate irradiation in dense petro-mastold bone. The reported attempts for the extirpation of this tumour by combined intra and extra cranial approach involves high mortality. In our country the majority of the patients come for treatment when the tumour has already advanced and extended and with the general condition of the patients not suitable for such major eradicative surgery, we have to remain contented with conservative type of surgery and irradiation. In G. M. and Associated Hospitals, Lucknow, during last 7 years,. 17 cases were observed and Dr. S. C. MS. D.L 0. lecturer Dr. M. L. Bhatia MS. D. L.O Professor & Head of Department of Otolaryngology, Lucknow Medical College, Luckhow, Read at twentieth annual conference of the 'association of Otolaryngologists of India, 9-11 May 1968 held at Calcutta. Received for publication on 11-5-68. treated for carcinoma of mastoid and middle ear with conservative excision followed by radiotherapy. The result in terms of palliation have been quite satisfactory and are considered worth reporting.

1. A case of chondroma of larynx arising from epiglottis is reported which was treated by conservative enucleation and preservation of functioning larynx. 2. Problems and management of supraglottic stenosis are presented. 3. Literature is reviewed.

Massive traumatic anorectal and perianal hemorrhage postoperatively is rare. Six cases of massive bleeding, four postoperative and two traumatic, have been discussed. None of these patients had a systemic bleeding disorder. The bleeding may be external, internal, or both. It is treated by immediate restoration of blood volume and by stopping the bleeding by ligature or by packing with hypochlorite-soaked gauze (Eusol) and local cooling.

SUMMARY Methaqualone, a non-barbiturate hypnotic, was used as the sole anaesthetic for short surgical procedures in 27 patients. In a further 13 it was, in addition, injected intermittently during nitrous oxide anaesthesia for longer operations. Rapid loss of consciousness followed intravenous injection of adequate doses. Transient generalized muscle spasm followed theonset of sleep, after which there was muscle relaxation. Recovery was uneventful and after a single dose consciousness began to return in 10–15 minutes.

Osteoclastoma involves the long bones of the extremities and some of the flat bones such as the sacrum, mandible patella and vertebrae. Eggston and Wolff (1947) mentioned the possibility of its origin from bones of the upper jaw, ethmoid and sphenoid sinuses. Amongst the skull bones, Rosenwasser (1969) described a case of giant cell tumour of the middle ear, yet such a tumour arising from the nasopharynx and sphenoid seems to be extremely rare.

317 cases of pulmonary tuberculosis were put on the following different reqimens of anti-tuberculous drugs.