Six percent of 300 secondary syphilitics had skeletal manifestations within 12 weeks of infection. About one third had bone complaint, half of joints and rest of both. Typical bone pain was present in about one fourth of the cases. Of 18,8 had tenderness of bones, 10 of joints and 2 had hydrarthrosis. One had acute osteoperiostitis left ulna, left radius and right tibia. Thirteen had rash and 10 lymphadenopathy. Response to penicillin therapy was excellent.

The present study includes 88 cases with skeletal manifestations of late Syphilis. Incidence seems to be lower than what was reported before. In 19 mode of infection could not be determined. 66% were between 11 and 30 years and 48% were labourers. Three fourth of the acquired group and one third of congenital group had positive anamnesis. Definite history of trauma was present in only 4. Eight (26%) of the acquired group had incomplete treatment. Average duration of infection was 15.5 and 14.5 years in acquired and congenital groups respectively. Duration of complaints was less than one year in about 45% of cases. Pain (23%) and swelling (24%) were the two most common complaints. 60% of congenitals and 26% of acquired group showed collateral evidences. Nose was involved in 41%, hard palate in 24%, left tibia in 20% and right tibia in 17%. Involvement of long bones of the extremities were fairly common. Of the joints, involvement of knees, ankles or both were only observed. About 92% had gummatous osteoperiostitis. Blood VDRL was negative in 9%. CSF in 8 out of 25 examined was abnormal. Most of the cases X-rayed showed radiological findings in favour of syphilis. Treatment was complete in about 82% and satisfactory result was obtained in about 55% cases.

A case of lupus vulgaris of the thigh and vulva with pseudo- elephantiasis of vulva in a Hindu girl is reported.

A preliminary comparative study of staphylococci carrier rates in clinical and non-clinical medical students was made. Nasal carriage was found to be predominant in the non-clinical group and the perineal carriage in the clinical group. It is suggested that the inhaled particles of antibiotic-laden dust in the hospital, perhaps may be causing suppression of nasal staphylococcal flora in the clinical students.

A study of serum protein patterns in 131 cases of furunculosis, fofliculitis, impetigo contagiosa and ecthytna has been undertaken. No pattern characteristic of any one type of pyoderma was found. The course of the disease showed profound influence on serum protein changes. In case of acute pyoderma there was slight fall in total proteins, a marked fall in serum albumin level and a marked increase in alpha-I alpha-II and betaglobulin levels. Gamma globulins in acute primary pyoderma did not show significant change except in impetigo contagiosa where they were elevated. Resistant and recurrent pyodermas showed a significant fall in albumin level of the serum. Levels of alpha-I and alpha-II and beta globulins were raised. Gamma globulin levels of the serum in resistant and recurrent cases showed a significant decrease. Changes in serum protein fractions were most marked in resistant cases, less so in recurrent and least in acute cases. Surface area of the lesions bears a significant correlation with serum albumin and gamma globulins. Increase in surface area has a direct correlation with decrease in serum albumin in the cases of grade II and III of primary pyodermas. A significant correlation was also found between decrease in gamma globulin levels of serum with increase in surface area of lesions of grade 11 and III in resistant and recurrent cases of primary pyodermas.

Diffuse scleroderma is now recognised to be a widespread disturbance of connective tissue, which in addition to characteristic involvement of skin (scleroderma) is marked by change in the synovium and a number of internal organs, particularly the heart, lung, gastrointestinal tract and kidney. The report is devoted to a description of the clinical course of this disease and is based on a study of 100 patients who have been observed by the author over the past 9 years. It seems that nearly all patients with scleroderma if followed for a long enough period of time will develop evidence of visceral sclerosis. In general the outlook is poor in those cases marked by rapid progression of dermal disease, severe malabsorption or cardiac failure, and is seemingly uniformly fatal, at this time, in those patients who develop renal involvement. In many cases, however disability incident to systemic involvement may be only moderate in degree and not necessarily threatening to life.

A case report of granuloma inguinale in perianal region in a Punjabi is presented. Its mode of transmission is discussed.