e19526 Background: Imatinib remains the standard of care for CML-CP in many countries because of its affordability and safety with long term use. Given that upfront Nilotinib has higher rates of major molecular response and early deep responses predict long term responses, we hypothesized that upfront Nilotinib as induction followed by Imatinib maintenance may help to capitalize on the efficacy of Nilotinib without sacrificing the safety and efficacy of Imatinib. Methods: CML CP patients were divided into 3 groups at the time of diagnosis. Group 1 received Imatinib 400mg OD upfront, Group 2 and 3 received Nilotinib 300 mg BD for 1st 3 and 6 months respectively then switched over to Imatinib 400 OD. Quantitative real time PCR for BCR-ABL (RQ PCR for BCR-ABL) was done at 3, 6,12, 18, 24, 30, and 36 months to assess response. 3 early molecular responses were defined for analysis. EMR 1 was defined as Bcr-abl RQPCR < 10% at 3 months, EMR 2 as < 1% at 6 months and EMR 3 as < 0.1% at 6 months. Results: Patients on Nilotinib induction had deeper responses than patients on Imatinib at 3 and 6 months. However, subsequent molecular responses were similar in all 3 groups. The rates of Early Molecular responses were significantly better in the Nilotinib group compared to the Imatinib group. Significantly lesser patients in Group 1 had EMR 1 compared to Groups 2 and 3 [80.49% vs 100% vs 95.56%, p value 0.001]. Results were similar for EMR 2 and 3 [EMR 2: 34.15% vs 42.11% vs 60%, p value 0.017, EMR 3: 25.71% vs 25.53% vs 44.44%, p value Group 1 vs Group 3: 0.030]. TKI failure/progression rates were significantly better amongst patients who achieved EMR vs those who did not achieve EMR for EMR 2 and 3 but not EMR 1. For EMR 2, 42.68% who did not achieve EMR eventually had TKI failure compared to 18.03% of those who achieved EMR (p value 0.002). Similarly, 32.95% who failed to achieve EMR 3 progressed vs 11.9% of those who achieved EMR 3 (p value 0.011). 3 patients in group 1 and 1 patient in group 2 developed T315I mutation while none did in Group 3. Conclusions: The early advantage achieved with Nilotinib Induction was not sustained after switching to Imatinib maintenance. Nevertheless, target responses were still achieved and similar failure rates were present in all 3 groups. Patients who attained an EMR < 1 % at 3 months or < 0.1% at 6 months tend to have higher EFS and lower rates of TKI failure/progression irrespective of the treatment arm.

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BACKGROUNDRHD is the leading cause of morbidity and mortality in the underdeveloped world. The burden of RHD has been estimated variably depending on the method and tool of examination. Recent echocardiography-based studies, generally accepted as the best tools to detect RHD, had shown 10-fold increased prevalence of RHD compared to clinical examination albeit fear for overestimation of the disease. While studies using more stringent criteria of WHF 2012 are limited and no such study has been conducted in this part of the country, we felt it necessary to conduct such a study in this hilly state of India. MATERIALS AND METHODSThis is a community based cross sectional study in which each and every selected child aged 5-15 years from randomly selected schools of Manipur were examined physically and by 2D colour Doppler Echocardiography. The anthropometric parameters, clinical details and echocardiography findings were all recorded. Echocardiography loops were recorded for review by another cardiologist later. Analysis was done by using T test, descriptive statistics and with 95% confidence interval. All the analysis was done using STATA 13.0 (Stata Corp, USA).

BACKGROUND CHD is the leading cause of morbidity and mortality in the developed world, while reports from India looking into the burden of the disease have been variable depending on the age group of subjects studied and the methodology involved. We were interested to find the prevalence and pattern of the disease in this north eastern Indian state of Manipur, which has a unique geographical and racial composition. MATERIALS AND METHODS This is a community based, prospective, cross sectional study where each and every child aged 5-15 years from randomly selected schools of Manipur were examined by 2D colour Doppler Echocardiography and physically as well, where the examiners were blinded, and the findings were noted independent of each other. The anthropometric parameters, clinical details and echocardiography findings were all recorded. RESULTS Of the 3600 children examined, 47 cases of CHD were detected, giving echocardiographic prevalence of 13 per 1000 where BAV (44%) was found as the commonest lesion followed by VSD (17%) and ASD (14%). Clinically detectable lesion was found in 21 subjects (VSD-8, ASD-7, PS-3, PDA-1, AVSD-1, BAV-1 with AR). Of the clinically detectable CHD, VSD was the commonest followed by ASD. In the subclinical CHD category, 20 cases of BAV, 4 cases of mild MVP without MR, 1 case of apical LV discompacta, 1 case of IASA were detected. CONCLUSION The echocardiography prevalence of congenital heart disease in school going children of Manipur is 13/1000. This highest ever reported prevalence of CHD in children is most probably related to the use of the highly sensitive investigative tool of Echocardiography in each subject of our study resulting in detection of clinically silent lesions.

BACKGROUND The purpose of this study was to analyse the spectrum of bone marrow aspiration and biopsy results and their clinicohaematological profile. MATERIALS AND METHODS This retrospective descriptive study was conducted from 1 st September 2017 to 31 st August 2018. All bone marrows examined during his period were included. Demographic profile including age, sex, clinical history etc. were analysed from the records available in the bone marrow register which is maintained in Pathology department, Jawaharlal Nehru Institute of Medical Sciences, Imphal. A total of 94 bone marrows were included. Appropriate statistical analysis was applied. RESULTS Check marrows (25.88%) was the most common reason for bone marrow examinations. Acute leukaemias (18.82%) were the most haematological disorder encountered followed by nutritional dual deficiency anaemia (5.88%). CONCLUSION The results of this study will assist in future planning for installation of special tests such as flow cytometry and molecular laboratory. Finally bone marrow aspiration (BMA) and bone marrow biopsy (BMB) are two separate but complimentary techniques which are required for diagnosis of various haematological disorders.