Synthesis of indium oxide microparticles using aerosol assisted chemical vapour deposition

Microparticles of indium oxide (In₂O₃) are deposited on glass substrates at 500 °C using aerosol assisted chemical vapour deposition (AACVD). The structural, morphological and optical properties of the as-deposited particles are reported.

Microparticles of indium oxide (In₂O₃) are deposited on glass substrates at 500 °C using aerosol assisted chemical vapour deposition (AACVD).

Eu2+: A suitable substituent for Pb2+ in CsPbX3 perovskite nanocrystals?

Eu²⁺ is used to replace toxic Pb²⁺ in metal halide perovskite nanocrystals (NCs). The synthesis implies injection of cesium oleate into a solution of europium (ii) bromide at an experimentally determined optimum temperature of 130 °C and a reaction time of 60 s. Structural analysis indicates the formation of spherical CsEuBr₃ nanoparticles with a mean size of 43 ± 7 nm. Using EuI₂ instead of EuBr₂ leads to the formation of 18-nm CsI nanoparticles, while EuCl₂ does not show any reaction with cesium oleate forming 80-nm EuCl₂ nanoparticles. The obtained CsEuBr₃ NCs exhibit bright blue emission at 413 nm (FWHM 30 nm) with a room temperature photoluminescence quantum yield of 39%. The emission originates from the Laporte-allowed 4f⁷-4f⁶5d¹ transition of Eu²⁺ and shows a PL decay time of 263 ns. The long-term stability of the optical properties is observed, making inorganic lead-free CsEuBr₃ NCs promising deep blue emitters for optoelectronics.

Nodular Mucinosis of Male Breast: A Rare Case Report

Multinodular accumulation of stromal mucin in breast known as nodular mucinosis is an extremely rare condition of breast. Alternatively it is known as myxoma or nerve sheath myxoma of breast. This benign lesion is confined to only nipple and areola region presenting as slow growing, soft and non tender lobulated mass. Histopathologically it reveals well circumscribed non-encapsulated myxoid/mucinous lesion with few infiltration of spindle cells within a collaginized stroma. The mucinous substance is stained positively with Alcian blue. Mucinous carcinoma or phylloids tumour are important differential diagnosis of nodular mucinosis of breast. Here we report a case of nodular mucinosis of male breast with clinical, radiological and pathological findings with differential diagnosis and treatment modalities.

Laparoscopic Adrenalectomy: Two Years Experience at Bangabandhu Sheikh Mujib Medical University

Laparoscopic surgery has become an efficient tool for many complex surgical procedures. In last decades, laparoscopic adrenalectomy has become a more viable option for removal of adrenal pathology, with many surgeons preferring it to the conventional open technique. This study was done to evaluate the outcomes of lateral transperitoneal adrenalectomy (LTA) in our department and evaluate the feasibility of lateral transperitoneal adrenalectomy (LTA) in our perspective. This study is case series observational study carried out at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2015 to May 2017. Suspected primary adrenal malignancies were excluded. Seventeen (17) patients (10 male and 7 females with mean age of 35.29 years) underwent 18 adrenalectomy (one bilateral). Seventeen (17) adrenal tumours were resected through laparoscopy and one adrenal tumour is resected through open approach due to conversion. All the patients underwent hormonal evaluation, ultrasonogram and computed tomography of whole abdomen. Ten (10) patients (58.82%) had hormonal active adrenal mass. Seven (7) patients (41.18%) were asymptomatic of which 2 had associated cholelithiasis, 7 patients had generalized weakness, 3 had weight gain with Cushing syndrome (one drug induced) and one had Hirsutism with musculanizing effect. Nine (9) patients had hypertension and 6 patients had diabetes mellitus. Eight (8) right, 8 left and 1 bilateral LTA were performed. The mean age of the patients were 35.29 years, adrenal tumour size ranges from 15-65mm and operation time ranges from 75-120 minutes for unilateral adrenalectomies and 220 minutes for bilateral adrenalectomy. Estimated blood loss ranges from 30 to 130 ml in 16 cases and in one case it was 220 ml in which conversion was done. Mean post operative stay in hospital was 3.94 days. In 16 cases no major or minor complications were observed but in one case due to haemorrhage and infiltration of the tumour to kidney conversion are done in the form of right adrenalectomy with upper partial nephrectomy (Histopathology revealed angiomyolipoma). In pathological examination 9 patients (52.94%) had adrenocortical adenoma, 2 patients (11.76%) had phaeochromocytoma including bilateral one, 2 patients (11.76%) had myolipoma of which one converted to open, 2 patients (11.76%) had adrenocortical hyperplasia, one patient (5.88%) had adrenal cyst and one patient (5.88%) had haemorrhagic cyst. LTA is a safe and efficient minimally invasive treatment options for both secreting and non secreting adrenal masses. The procedure has a learning curve and should be performed by a surgeon experienced in both open and laparoscopic adrenal surgery.

Electrosurgery Dissection versus Sharp Dissection: Effect on Early Postoperative Wound Complications in Modified Radical Mastectomy

Modified radical mastectomy (MRM) is still the most commonly performed operation for breast cancer, despite the trends toward breast-conserving treatment. Since 1970s, electrosurgery (also known as electrocautery, diathermy) has been a widespread surgical tool to raise flaps and excise the breast specimen in order to perform a bloodless mastectomy. Use of diathermy has been well blamed for wound complications. To prevent undue delay in the adjuvant treatment, it is important to minimize the surgical complications. This quasi experimental study was conducted in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh to evaluate the effects of electrosurgery and sharp dissection on early postoperative wound complications in MRM. 46 patients were included in the study (23 in each group). Data analysis done in SPSS version 23.0 and 'p' value <0.05 considered significant at 95% confidence interval. In Electrosurgery Dissection (ED) group mean duration of drainage was 7.8±1.2 days and in Sharp Dissection (SD) group 6.4±1.0 days (p value 0.000). Mean total drainage in ED group found 1082±287ml and in SD group 693±194ml (p value 0.000). Seroma formation found 7(30.4%) in ED group and 3(13.0%) in SD group (p value 0.004). Wound dehiscence found 5(21.7%) in ED group and 2(8.7%) in SD group (p value 0.013). Flap necrosis rate was 4(17.4%) and 1(4.4%) in ED and SD group respectively (p=0.003). Demographic and clinical variables were similar or differences were not statistically significant in two groups. No difference found in operating time and wound infection rate in two groups. The result of the study showed that, electrocautery dissection caused early postoperative wound complications more than the sharp dissection.

Cytologically Indeterminate Follicular Thyroid Nodule on Fine Needle Aspiration Cytology is an Indication for Total Thyroidectomy

The magnitude of case management of indeterminate thyroid nodule is very difficult and controversial. In addition there is recent evidence that the incidence of follicular lesion may be increasing that will prove to be follicular cancer. This prospective observational study was done in the department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from February 2016 to January 2017 to investigates the rate of malignancy and inability of demographical, clinical and sonographic data to predict malignancy in indeterminate nodules and the unreliability of intraoperative frozen section biopsy with the scope of determining the need for total thyroidectomy in these patients. The study population consisted of 40 cases presenting indeterminate nodules (Thy3): females (80%) and males (20%) with a mean age of 35.73±11.11 years. All patients underwent total thyroidectomy. Malignancy was diagnosed in 27 out of 40 patients (67.5%). The mean nodule size was 3.67±1.69mm in malignant lesions, 40.7% of the malignant nodules were more than 3cm in size, 51.9% of malignant cases were irregular border and 29.6% of malignant lesions were hard in consistency; these data are statistically significant (<0.05) and correlated with malignancy. The rate of malignancy in cytologically indeterminate lesions was high in the present study sample compared to other reported studies. Thus, considering the fact that demographical, clinical and sonographic features were found to be inaccurate predictors of malignancy, it is our opinion that total thyroidectomy should always be recommend in such patients.

Abstract P6-18-32: Profiling the early haematological dynamics and treatment modifications with palbociclib when used as first line treatment for ER-positive, HER2-negative metastatic breast cancer

Background: Palbociclib plus endocrine therapy (ET) significantly increases progression free survival compared to ET alone. Within PALOMA2 neutropenia was the most common AE and reason for dose reductions. No real data exists regarding dose reductions (DRs), dose interruptions (DIs), toxicities and benefits of palbociclib. Objective: To describe the early haematological dynamics, DRs/DIs with 1st line palbociclib in the context of a routine UK clinical practice. Methods: A prospective record was maintained of all patients with ER-positive, HER2-negative metastatic BC registered on the Pfizer patient programme at the Clatterbridge Cancer Centre NHS Foundation Trust. The clinical records of all patients commenced on treatment between April and December 2017 were reviewed, and clinico-pathological information, haematological data & toxicity data recorded. Data lock was 31st March 2018. Results: 48 patients received at least one cycle of treatment. The median age was 58, 29% (14/48) premenopausal & 71% (34/48) postmenopausal. 43% (21/48) had bone only disease with 42% (20/48) having visceral disease. The median number of cycles delivered 8 (range 2-11). DRs: 18/48 (38%) patients had a total of 21 DRs; 14/18 (78%) had 1 DR to 100mg; 1/18 (5%) 1 DR to 75mg; & 3/18 (17%) 2 DRs to 75mg. Reasons for DRs: 13 neutropenia, 2 leukopenia, 1 thrombocytopenia, 2 fatigue, 1 poor appetite, 1 sore mouth & 1 non-specially unwell. DIs: occurred in 24/48 patients (50%). Details of DRs/DIs by cycle will be presented. 85% (41 of 48) patients remain on treatment with 59% (24/41) on 125mg; 34% (14/41) on 100mg & 7% (3/41) on 75mg. FBC were available for 41/48 (85%) cases & dynamics considered over the first 6 cycles using FBC at the time of planned treatment delivery. Hb Baseline all patients (AP):129 (121 – 138), patients; patients with no dose reductions (NDR) 127 (123 – 139) & patient dose reduction (DR): 130 (118 – 136). Hb changes to cycles 2, 4 and 6 AP: 122 (115 – 131), 121 (116 – 127) and 125 (116 – 134); NDR:122 (110 - 135), 125 (117 - 127) and 131 (116 – 135); DR: 115 (112 - 120), 120 (115 - 124) and 122 (115 – 129). WCC Baseline AP: 6.8 (5.6 – 7.7); NDR: 7.2 (6.3 – 7.7); DR: 6.7 (5.2 – 7.7). WCC changes to cycles 2, 4 and 6 AP: 3.7 (2.9 – 4.4), 3.7 (3.1 – 4.4) and 3.3 (3 – 3.9); NDR: 3.5 (2.9 – 4.1), 3.6 (3.2 – 4.3) and 3.6 (3.1 – 4.1); DR: 2.1 (1.7 – 2.5), 4.3 (3 – 4.6) and 3.3 (2.8 – 3.5). ANC Baseline AP: 4.0 (3.2 – 5.1); NDR: 4.4 (3.4 – 5.0); DR: 3.6 (2.9 – 5.2). ANC changes to cycles 2, 4 and 6 AP: 1.5 (1.2 – 2.1), 1.7 (1.3 – 2.0) and 1.4 (1.2 – 1.9) NDR: 1.5 (1.1 – 2.1), 1.7 (1.4 – 2.0) and 1.3 (1.2 – 2.0); DR: 0.8 (0.6 – 0.8), 1.7 (1.2 – 2.3) and 1.4 (1.3 – 1.6). Plts Baseline AP: 298 (226 – 339), NDR: 252 (211 – 336); DR: 299 (253 – 339). Plt changes to cycles 2, 4 and 6 AP: 252 (198 – 310), 221 (186 – 259) and 200 (169 – 243). NDR: 249 (185 – 334), 229 (171 – 267) and 205 (177 – 263);DR: 208 (199 – 210), 216 (199 – 243) and 194 (162 -210). Conclusion: These initial real world data are consistent with the PALOMA2 data. Baseline WCC & ANC show no significant difference between NDR and DR cases. Updated data will be presented as well as outcome data for first time.

Citation Format: Bhojwani A, Flint H, Hall B, Wong H, Innes H, Cliff J, Ahmed E, Malik Z, O'Hagan J, Tolan S, Hall A, Hyatt K, Errington D, Alam F, Robson P, Thorp N, O'Reilly S, Law A, Cicconi S, Jackson R, Palmieri C. Profiling the early haematological dynamics and treatment modifications with palbociclib when used as first line treatment for ER-positive, HER2-negative metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-32.

Abstract P6-17-27: Real world experience of the medical and surgical management of HER2 positive early breast cancer treated with neoadjuvant trastuzumab and pertuzumab via the NHS England cancer drug fund

Background: Studies of neoadjuvant (NA) dual HER2 blockade with trastuzumab (T) and pertuzumab (P) in combination with chemotherapy (CT) for early breast cancer (BC) have reported pathological complete response (pCR) rates of 39 to 62%. These studies also report manageable toxicity with diarrhoea reported in up to 73% of cases. To date no real-world studies have explored the efficacy and toxicity of this treatment. The objective of this study was to describe the medical and surgical management of women treated with neoadjuvant T-P in combination with CT (NAT-P-CT). As well as to determine the efficacy toxicity of NAT-P-CT in the context of a routine UK NHS clinical practice.

Methods: Patients with HER2+ BC treated neoadjuvantly with T-P accessed via the NHS England Cancer Drug Fund (CDF) at the Clatterbridge Cancer Centre NHS Foundation Trust between October 2016 and January 2018 were retrospectively identified. Clinico-pathological information, treatment data, nurse led toxicity review and echocardiographic were reviewed. Data lock was 19th June 2018.

Results: 78 female patients were identified with a median age of 50 years (IQR: 44.4-60.2). At diagnosis: median tumour size 30mm (23.0-47.5mm), 62% (48/78) were LN positive & 56% (44/78) ER+. CT regimens: 81% (63/78) FEC-DHP of these 30% (19/63) switched to weekly paclitaxel (wP). or nab-paclitaxel; 5% (4/78); AC/EC-DHP; 9% (8/78) TCHP with 13% (1/8) switched to wP. At time of analysis, 88% (69/78) had undergone definitive surgery. Surgical details: Breast: 52% (36/69) mastectomy & 48% (33/69) WLE, Axillary management: 51% (35/69) axillary dissection (Ax Dx) & 49% (34/69) sentinel node biopsy (4 performed prior to NA treatment). 91% (32/35) of those undergoing Ax Dx were LN+ at presentation, of these 59% (19/32) had no evidence of axillary involvement at surgery. pCR rate (ypT0/is, N0) was 46% (32/69) [pCR by HR: ER+ 43% (21/49) & ER- 55% (11/20]. pCR for 20 patients switched to wP was 60% (12/20). 7% (5/69) achieved pCR in the breast alone (in these LN status ITCx1, micrometsx3 & macrometsx1). Of the 54% (37/69) with residual breast tumour median size was 13mm (1-22mm). Toxicity Data: Ejection fraction (EF) did not decline beyond 10% of baseline in any patients. Diarrhoea (any grade) occurred in 74% of cases, and CTCAE grade 3-4 toxicity occurring in &gt;2% of patients: diarrhoea, fatigue, and infection. Updated analysis regarding pCR rate and toxicity, as well as initial outcome data will be presented.

Conclusion: These results (1) confirm the efficacy of NA T-P in a real world population; (2) support the use of NA wP; (3) indicate significant proportion of patients axilla are downstaged & (4) reveal diarrhoea rates in keeping with the literature. Currently, NHS England rules do not allow wP to be used routinely in NA setting with T-P this should be reviewed in light of these data and those of the BERENICE study. Measures to identify patients who can avoid axillary dissection as well as to mitigate diarrhoea should be considered.

Citation Format: Hall B, Bhojwani A, Innes H, Ahmed E, Cliff J, Malik Z, O'Hagan J, Tolan S, Hall A, Hayat K, Errington D, Alam F, Thorp N, Flint H, Law A, Wong H, O'Reilly S, Jackson R, Cicconi S, Palmieri C. Real world experience of the medical and surgical management of HER2 positive early breast cancer treated with neoadjuvant trastuzumab and pertuzumab via the NHS England cancer drug fund [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-27.

Offering HCV treatment to prisoners is an important opportunity: key principles based on policy and practice assessment in Europe

Background

Prisoners have a high prevalence of hepatitis C virus (HCV) infection but may find it difficult to access healthcare services. This may be related to risk behaviour including history of injecting drugs and marginalisation related to problem drug use/ opioid use disorder (OUD). Direct-acting antiviral products with superior efficacy and safety compared to interferon-based regimens offer HCV cure. Many citizens in Europe have been treated, although few received therapy in prisons.

Methods

Analysis of prisoner HCV treatment need and policy determinants of clinical practice was completed for 5 EU countries. Evidence was collected from national statistical sources and peer-reviewed publications to describe prison populations and HCV prevalence, to map national prison/ HCV health policy or guidance. A consensus of important principles for prisoner HCV care was developed.

Results

Data from published sources describing prisoner HCV prevalence is limited. Prisoner population requiring HCV treatment is not known; estimated numbers based on analysis of evidence: England and Wales, 9000, France, 8000, Spain, 6000, Italy, 6000, Germany, 6000. Treatment access: national law defines right to equivalent care in all countries implying access to HCV therapy in prison similar to community; useful prisoner HCV guidance facilitating treatment decisions present in: 4 of 5 national/ regional HCV policy documents, 4 of 5 national prison healthcare policies. Four of five had practical prison HCV clinical guidelines. Despite existence of policy, implementation of guidance, and so HCV treatment, is suboptimal in many locations.

Conclusions

Prison is an important location to detect, address and treat HCV infection in people who may be underserved for healthcare and find it difficult to navigate community treatment pathways. This is often related to problems with OUD and resulting social inequity. HCV management in prisons must be improved. Policy and clinical practice guidance must be set to promote treatment, and practical steps to make treatment easy should be followed including education to promote engagement, set-up of optimal screening and work up processes with modern tools to reduce time needed/ achieve efficiency; programs to make it easier to get specialists’ input include remote working and nurse-led services.

A molecular precursor route to quaternary chalcogenide CFTS (Cu2FeSnS4) powders as potential solar absorber materials

In the present work we report on the synthesis of a tetragonal phase of stannite Cu₂FeSnS₄ powder from Sn(ii) and Sn(iv) using a solvent free melt method using a mixture of Cu, Fe, Sn(ii)/Sn(iv) O-ethylxanthates.

MIXED GERM CELL TERATOMATOUS TUMOUR OF TESTIS IN ADULTS: DIAGNOSTIC CHALLENGES FOR A HISTOPATHOLOGIST (case report)

Background. Testicular tumours account for approximately 1-2 % of the total cancer cases in the male population globally and show higher incidence in the younger male age group of up to 15 years. The majority (~98 %) of testicular tumours are observed to be of the germ-cell origin which can either be of seminomatous type or non-seminomatous type. The non-seminomatous germ cell neoplasm may be pure or of mixed subtype. Objective was to emphasize the rare case of mixed germ cell teratomatous tumour of testis in adult man.Methods.  A mixed germ cell teratomatous tumour of testis comprising of yolk sac tumour and embryonal carcinoma in an adult Indian male is reported in the research.Results. A 45 year-old Indian male presented with enlargement of right testis which was found to be an encapsulated right testicular tumour on exploratory surgery which was followed by radical orchiectomy. Serum AFP and β-hCG levels were elevated to 380 ng/ml and 590 mg/ml respectively. Histopathology revealed a mixed germ cell teratomatous tumour of testis comprising of yolk sac tumour and embryonal carcinoma.Conclusions. In adults teratomas occur usually as a component of mixed germ cell tumours. However in the present case teratomatous embryoid yolk sac germ cell tumour of testis was observed in an Indian adult male. The prognosis of embryoid germ cell tumours of testis is generally poor. The possibility of this condition should always be considered in all cases that present with a testicular lump.

Modelling invasive group A streptococcal disease using bioluminescence

BACKGROUND

The development of vaccines and evaluation of novel treatment strategies for invasive group A streptococcal (iGAS) disease requires suitable models of human infection that can be monitored longitudinally and are preferably non-invasive. Bio-photonic imaging provides an opportunity to reduce use of animals in infection modelling and refine the information that can be obtained, however the range of bioluminescent GAS strains available is limited. In this study we set out to develop bioluminescent iGAS strains for use in in vivo pneumonia and soft tissue disease models.

RESULTS

Using clinical emm1, emm3, and emm89 GAS strains that were transformed with constructs carrying the luxABCDE operon, growth and bioluminescence of transformed strains were characterised in vitro and in vivo. Emm3 and emm89 strains expressed detectable bioluminescence when transformed with a replicating plasmid and light production correlated with viable bacterial counts in vitro, however plasmid instability precluded use in the absence of antimicrobial pressure. Emm89 GAS transformed with an integrating construct demonstrated stable bioluminescence that was maintained in the absence of antibiotics. Bioluminescence of the emm89 strain correlated with viable bacterial counts both in vitro and immediately following infection in vivo. Although bioluminescence conferred a detectable fitness burden to the emm89 strain during soft tissue infection in vivo, it did not prevent dissemination to distant tissues.

CONCLUSION

Development of stably bioluminescent GAS for use in vitro and in vivo models of infection should facilitate development of novel therapeutics and vaccines while also increasing our understanding of infection progression and transmission routes.

210Po concentration in selected diatoms and dinoflagellates in the northern Arabian Gulf

Marine phytoplankton is a primary producer in the ocean that forms the base of the marine food web and supports the pelagic food chain. The two dominant groups of phytoplankton observed in northern Gulf waters are diatoms and dinoflagellates. The diatoms outnumber dinoflagellates in the Gulf waters. This study presents baseline information on the concentration of ²¹⁰Po among selected phytoplankton in the northern Gulf. The concentration among diatoms varies between 6.99 and 11.4 Bq kg^-1 wwt, whereas a higher concentration range of 8.51-15.41 Bq kg^-1 wwt was observed among dinoflagellates. The diatoms analyzed includes Thalassiosira spp. - 10.2-11.4 Bq kg^-1 wwt; Chaetoceros spp. - 6.99-7.14 Bq kg^-1 wwt; Rhizosolenia spp. - 9.12-9.95 Bq kg^-1 wwt. The analyzed dinoflagellate genera include Gymnodinium spp. - 8.51-8.78 Bq kg^-1 wwt; Noctiluca spp. - 15.2-15.4 Bq kg^-1 wwt; and Karenia spp. - 14.1-14.9 Bq kg^-1 wwt. The ²¹⁰Po concentration in seawater shows a seasonal variation, with a higher concentration range of 0.70 and 0.58 mBq L^-1 during summer and autumn, whereas a lower range in concentration of 0.38 and 0.30 mBq L^-1 occurring during winter and spring. The resultant computed concentration factors vary between 2 ∗ 10⁴-5 ∗ 10⁴ demonstrating a significant ²¹⁰Po enrichment in the base of the pelagic food chain.

A 15-year single centre retrospective study of antiphospholipid syndrome patients from Northern Malaysia

BACKGROUND

Antiphospholipid syndrome (APS) is an autoimmune disorder characterised by thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPLs) based on the Sydney criteria. We aimed to explore the clinico-laboratory features and treatment strategies of APS patients retrospectively.

METHODOLOGY

The medical records of APS patients registered under Hospital Universiti Sains Malaysia (Kelantan state) between 2000 and 2015 were reviewed.

RESULTS

A total of 17 APS subjects (age 40.7 ± 12.8 years) including 11 primary (64.7%) and six secondary APS (35.3%) patients were identified. The follow-up period was 9.5 ± 6.7 years with male:female ratio of 1.0:4.7. Pregnancy morbidity was the most common clinical manifestation (11/14; 78.6%) followed by recurrent venous thrombosis (10/17; 58.8%). For other clinical features, menorrhagia was the most frequently observed manifestation (4/14; 28.6%) followed by aPLs-associated thrombocytopenia (4/17; 23.5%) and ovarian cyst (3/14; 21.4%). LA and aCL were positive in 94.1% (16/17) and 81.8% (9/11) of the patients, respectively. APTT value (76.7 ± 17.0 sec) was significantly high (p < 0.05). Low intensity warfarin alone was successful to maintain target INR (2.0 - 3.0) and prevent recurrence of thrombosis.

CONCLUSION

The tendency of pregnancy morbidity in this cohort of Malaysian Kelantanese APS patients was high compared to other previously reported APS cohorts. Low intensity warfarin was successful in preventing recurrence of thrombosis, however, APS women receiving long-term anticoagulants should be monitored for possible occurrence of menorrhagia and ovarian cysts.

Peptic Ulcer Disease in Bangladesh: A Multi-centre Study

The incidence of peptic ulcer has steadily declined through out the world. This decreasing trend is also noticeable in this subcontinent. The point prevalence of peptic ulcer (PUD) in Bangladesh was around 15% in eighties. The aim of this study was to see the present prevalence of peptic ulcer at endoscopy and to identify changing trends in the occurrence of peptic ulcer in Bangladesh. This retrospective analysis of the endoscopic records of multiple tertiary referral centres of Dhaka city were done from January 2012 to July 2013. A total of 5608 subjects were the study samples. We included those patients having peptic ulcer in the form of duodenal ulcer, benign gastric ulcer including pre-pyloric ulcer and gastric outlet obstruction due to peptic ulcer. Duodenal ulcer and benign gastric ulcer were found in 415(7.4%) and 184(3.28%) patients respectively and gastric outlet obstruction due to peptic ulcer was found in 23(0.40%) patients.