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Aspergillus endocarditis is a rare entity in an immunocompetent host with native valves. Late or misdiagnosis leads to increased morbidity and mortality. In this report authors present a case of native valve Aspergillus endocarditis, in 30-year-old male immunocompetent patient with no co-morbidities. The patient also had a parietal glioma. He underwent four surgeries including valve replacement during the course of illness. Patient improved with appropriate antifungal therapy and surgeries. He was on suppressive antifungals and continued to do well. Aspergillus endocarditis is to be considered in culture negative endocarditis. The optimal management includes adequate surgical debridement in conjunction with prolonged antifungal therapy.

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract (GIT). They can arise anywhere along the gastrointestinal tract. GIST of the small bowel is less common. Clinically, most of the GIST present as GI bleed and rarely with intestinal obstruction. We report here a case of ileal GIST presented with subacute intestinal obstruction.

Aim:To ascertain the level of compliance of present documentation of PRN medication with national and local standards of good practice.Objective:To inform changes to current practice where room for improvement is identified.Methodlogy:Data collection form was designed based upon the standards found in the local prescribing policyAudit was carried out on all inpatients on Chafron and Marlborough House3 month time period August to October 2006The medication records of 19 patients were viewedAll PRN medication was included in the audit.Results against standards:Not more than 1 medicine from any BNF therapeutic category should be prescribed as a PRN at any one time: 2 patients did not meet this standard100% Compliance to standardsThe following 7 standards achieved 100% compliance:Legible prescriptionWritten in black inkDose recordedMethod recordedSignature recordedStart date recordedTime given recorded, where applicable.ReccomendationsIncreased prescribing practice training for medical staff (doctors). This is covered by pharmacist staff at induction.Re-audit in 6 months.