Spasticity and flexor spasms can be most incapacitating in SCI victims. Muscle relaxants, physiotherapy and elimination of triggering factors must be tried before opting for peripheral surgery or alcohol block. The choice of alcohol block or peripheral surgery depends in whether damage to the spinal cord is complete or incomplete. Results of both the procedures are satisfactory in rightly chosen patients. Alcohol block is a simple, safe and effective method of treating spasticity in the patients of complete paraplegia. The effect is immediate and almost permanent. However, alcohol block is contra-indicated in the patients of incomplete paraplegia where peripheral surgery is a better choice.

The records of the Diabetes Hospital, Tripoli, Libya for the years 1961-1983 were examined and the available particulars relating to 24,962 diabetic patients (12,486 males + 12,476 females) registered during this period were obtained. The highest number of male and female diabetic patients were in the age group 40-50 years and the highest number of obese diabetic patients also belong to this age group. There was a gradual increase in the number of diabetic patients visiting the Diabetes Hospital with the highest number in 1983. The increase has been both in the type I and type II patients. In 1983, 15% of the diabetic patients belong to type I diabetes. Family history of diabetes appears to be an important factor in the onset and manifestation of type II diabetes. Patients with diabetes in the family have a lower mean body mass index and fasting blood glucose level as compared with those of patients without known case of diabetes in the family. This may be due to greater alertness, early diagnosis of the disease and steps taken to control blood glucose levels and body weight in the case of patients with family history of diabetes.

The lesser known manifestations of myxoedema encompass a wide spectrum of neurologic, psychiatric, endocrinologic and autoimmune pathology that mask obvious clinical diagnosis. Interesting head and neck presentations are discussed. The relationships with the Pendred and Down syndromes raise hereditary and genetic considerations.