Background:: Upper gastrointestinal bleeding (UGIB) is a common cause for hospitalizations and remains an important cause of morbidity and mortality. This study reports on our experience with UGIB in a tertiary center. Material and Methods:: All patients with UGIB (hematemesis, coffee ground vomitus, melena, with significant drop of hemoglobin >2gm/dL or needing blood transfusion) admitted between July 2017 and November 2018 were included. Results:: There were 151 patients (male 62.3%) with mean age 62.1 ± 15.2 years included in the study. Majority had comorbid conditions and one in five were using medications associated with UGIB. Over 88.1% required transfusions and 88.7% had early endoscopy (<24 hours) from time of admissions/referrals. Most common etiology was ulcers and 45% required endoscopic interventions. The median Rockall score was 4.6 ± 2.1. Rebleeding occurred in 9.9% and mortality in 20.9% (inpatient [12.6%] and post-discharge [7.3%]). Female patients had less H. pylori infection (p=0.001), but higher post-discharge mortality (p=0.030) and older group (>60 years) had lower H. pylori infection (p=0.002) and higher Rockall score (p=0.016). Higher Rockall score (>2) was associated with higher rates of rebleeding (p=0.027) and mortality (p=0.035). The Rockall score positively correlated with length of hospitalization. There was no correlation between treatment modalityand rebleeding rate, and there was no correlation between time of endoscopy and treatment modality with morality. Conclusion: Among our patients with UGIB, rebleeding rate and mortality rates remains high. High post-discharge mortality rates are due to significant comorbid conditions. Higher Rockall score was associated with higher rates of rebleeding and mortality and correlated with length of hospitalization.

Introduction: Irritable bowel syndrome (IBS) is common in the West (up to 25%), particularly among female. IBS is less common in the East. There is currently no data available in our local setting. This paper reports the findings of a questionnaire study assessing the prevalence of IBS among nurses and nursing students in the Brunei Darussalam. Materials and Methods: Nurses and students nurses at- tached to RIPAS Hospitals were invited to participate in this self filled questionnaire study. Diagnosis of IBS was based on the ROME II criteria defined as at least 12 weeks, which need not be consecutive, in the preceding 12 months of abdominal discomfort or pain that has two out of the following three fea- tures; relieved by defeacation and/or, onset associated with change in bowel frequency and/or onset associated with change in stool form (appearance). Results: 290 completed questionnaires out of 339 distributed were returned giving a response rate of 84%. The mean age was 26.3 ± 8.7 years with a gender ratio of 235 (81%) female: 55 (19%) male. The prevalence of IBS was 10.7% (n=31). Female had higher prevalence but this was not significant (11.9% vs. 5.5%, p=0.183). There were no differ- ences in the age, body mass index (kg/m2 ), smoking status and supplement use of subjects with and without IBS. Of the psychosomatic symptoms enquired (backache, feeling of depressed, fatigue, head- ache, insomnia and shortness of breath), presence of IBS was significantly associated with backache (p=0.007), depression (p=0.021) and shortness of breath (p=0.003). Conclusions The prevalence of IBS is comparable to what have been reported. Despite the higher prevalence among female subjects, there was no significant difference. IBS was significantly associated with psychosomatic symptoms of depression.