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BMS‐986184 is a human, second‐generation, anti–interferon‐γ–induced protein 10 (IP‐10) monoclonal antibody. In this study the pharmacokinetics and target engagement (TE) of BMS‐986184 in healthy participants were characterized using population‐based target‐mediated drug disposition (TMDD) modeling and data from a first‐in‐human study (NCT02864264). The results of the first‐in‐human study and the model generated were used to conduct stochastic simulations of a virtual population of healthy participants to predict pharmacokinetic exposures and TE responses for different dosage regimens. A 2‐compartment, 2‐target, TMDD structural model, assuming quasi‐steady‐state and stimulated production on treatment, was developed by simultaneous fitting of the total drug, serum‐free IP‐10, and serum total IP‐10 concentration data, with the second unobservable target contribution to drug elimination described by the Michaelis‐Menten elimination term. Model evaluation confirmed agreement between model predictions and observed data. Simulation of a virtual population of healthy individuals demonstrated that steady state was reached at the eighth dosing interval, and that around 150 mg subcutaneously every other week could be a suitable target dosage regimen for future clinical trials. Integrated modeling strategies such as this can be used to help guide rational clinical trial development of drugs with TMDD, leading to improved dose selection and greater patient benefits.

Baseline eosinophils reside in the gastrointestinal tract; however, in several allergic disorders, excessive eosinophils accumulate in the blood as well in the tissues. Recently, we showed in vitro that interleukin (IL)‐18 matures and transforms IL‐5‐generated eosinophils into the pathogenic eosinophils that are detected in human allergic diseases. To examine the role of local induction of IL‐18 in promoting eosinophil‐associated intestinal disorders, we generated enterocyte IL‐18‐overexpressing mice using the rat intestinal fatty acid‐binding promoter (Fabpi) and analysed tissue IL‐18 overexpression and eosinophilia by performing real‐time polymerase chain reaction, Enzyme‐Linked Immunosorbent Assay and anti‐major basic protein immunostaining. Herein we show that Fabpi‐IL‐18 mice display highly induced IL‐18 mRNA and protein in the jejunum. IL‐18 overexpression in enterocytes promotes marked increases of eosinophils in the blood and jejunum. Our analysis shows IL‐18 overexpression in the jejunum induces a specific population of CD101(+ ) CD274(+) tissue eosinophils. Additionally, we observed comparable tissue eosinophilia in IL‐13‐deficient‐Fabpi‐IL‐18 mice, and reduced numbers of tissue eosinophils in eotaxin‐deficient‐Fabpi‐IL‐18 and IL‐5‐deficient‐Fabpi‐IL‐18 mice compared with Fabpi‐IL‐18 transgenic mice. Notably, jejunum eosinophilia in IL‐5‐deficient‐Fabpi‐IL‐18 mice is significantly induced compared with wild‐type mice, which indicates the direct role of induced IL‐18 in the tissue accumulation of eosinophils and mast cells. Furthermore, we also found that overexpression of IL‐18 in the intestine promotes eosinophil‐associated peanut‐induced allergic responses in mice. Taken together, we provide direct in vivo evidence that induced expression of IL‐18 in the enterocytes promotes eotaxin‐1, IL‐5 and IL‐13 independent intestinal eosinophilia, which signifies the clinical relevance of induced IL‐18 in eosinophil‐associated gastrointestinal disorders (EGIDs) to food allergens.

OBJECTIVE: To describe the seroprevalence and risk for SARS-CoV-2 among healthcare workers (HCWs) by job function and work location following the pandemic’s first wave in New York City (NYC). METHODS: A cross-sectional study conducted between May 18 and June 26, 2020, during which HCWs at a large inner-city teaching hospital in NYC received voluntary antibody testing. The main outcome was presence of SARS-CoV-2 antibodies indicating previous infection. Seroprevalence and adjusted odds ratios (aORs) for seropositivity by type and location of work were calculated using logistic regression analyses. RESULTS: Of 2,749 HCWs tested, 831 tested positive, yielding a crude seroprevalence of 30.2% (95% CI, 29%-32%). Seroprevalence ranged from 11.1% for pharmacy staff to 44.0% for nonclinical HCWs comprised of patient transporters and housekeeping and security staff, with 37.5% for nurses and 20.9% for administrative staff. Compared to administrative staff, aORs (95% CIs) for seropositivity were 2.54 (1.64-3.94) for nurses; 2.51 (1.42-4.43) for nonclinical HCWs; between 1.70 and 1.83 for allied HCWs such as patient care technicians, social workers, registration clerks and therapists; and 0.80 (0.50-1.29) for physicians. Compared to office locations, aORs for the emergency department and inpatient units were 2.27 (1.53-3.37) and 1.48 (1.14-1.92), respectively. CONCLUSION: One-third of hospital-based HCWs were seropositive for SARS-CoV-2 by the end of the first wave in NYC. Seroprevalence differed by job function and work location, with the highest estimated risk for nurses and the emergency department, respectively. These findings support current nationwide policy prioritizing HCWs for receipt of newly authorized COVID-19 vaccines.

Interleukin (IL)-15 overexpression in eosinophilic gastrointestinal disorders is reported, but IL-15’s role in promoting eosinophilia gastroenteritis is largely unknown. Therefore, we generated enterocyte-overexpressed IL-15 transgenic mice using Fabpi-promoter. The Fabpi-IL-15 (iIL-15) transgenic mice show induced IL-15 levels in the jejunum with a marked increase in jejunum eosinophils. However, no induction of eosinophilia in the blood or any other gastrointestinal segment was observed. Eosinophilia in the jejunum villus was substantially higher in iIL-15 mice compared to wild type mice. In addition, goblet cell hyperplasia was also observed in the jejunum of iIL-15 mice. Furthermore, a significant correlation between induced IL-15 transcript and the IL-18 transcripts was observed. Therefore, to further understand the role of IL-18 in IL-15 mice associated gastrointestinal disorders; we generated iIL-15/IL-18Rα(−/−) mice. Using these mice, we found that IL-18 has an important role in promoting IL-15-induced eosinophilia. Since intestinal IL-15 overexpression is reported in food intolerance; we examined OVA intolerance in iIL-15 mice. The OVA-sensitized and challenged iIL-15 mice experienced weight loss, diarrhea, and eosinophilia in the jejunum. Taken together, our findings demonstrate that intestinal IL-15 overexpression induces IL-18-dependent eosinophilia and immunoglobulin in the intestine that promotes food allergic responses.

In this article, a printed triangular-shaped monopole antenna is proposed for emerging ultrawideband application. The pro- posed antenna uses a triangular radiating patch which is directly fed by a 50-X microstrip feed line. To improve the impedance bandwidth, a round-corner ground plane has been used. To further improve the impedance bandwidth for the entire band, a microstrip transition (near the antenna front end) has been introduced between the microstrip feed line and the triangular radiator that provides a wide impedance band- width from 1.8 to 15.0 GHz for jS11 j� 210 dB. The proposed antenna has been realized using the FR-4 printed circuit board substrate and occupies a small size of about 24 3 30 3 1.6 mm 3 compared to conven- tional antenna structures. The proposed antenna has nearly omni- directional radiation pattern and moderate gain throughout the operat- ing frequency region. V C 2014 Wiley Periodicals, Inc. Microwave Opt

Acrylamide (C3H5NO), a hydrogen-bonded amide, is an important compound from the point of view of basic and material research. It can be used as a model system for studying hydrogen bonding interactions in amides under pressure. As it is a monomer of polyacrylamide, an important polymer, high pressure investigation of polymerization in this material is also of interest. Our in-situ high pressure Raman spectroscopic investigations of acrylamide carried out up to 17 GPa under quasi-hydrostatic conditions indicate possible structural variations through the reconstruction of the N-H---O hydrogen bonds at pressures above 2.6 GPa. Emergence of several new spectral features at higher pressures indicate onset of polymerization. The characteristic polymer band becomes discernible at ~17 GPa. The increase in the relative intensity of the polymer peaks with respect to the monomer peaks on release to ambient conditions suggests that higher fraction of polymer is obtained on decompression. Copyright © 2013 John Wiley & Sons, Ltd.

Mycobacterium tuberculosis infection is one of many opportunistic infections in renal transplant recipients, arising either from reactivation of latent infection or de novo infection, occasionally donor derived. M. tuberculosis hepatitis has never been reported in patients who have received alemtuzumab as part of their renal transplant management. We describe 2 patients who underwent deceased-donor renal transplantation following alemtuzumab induction therapy and presented with a febrile syndrome, subsequently diagnosed as tuberculous hepatitis, one with disseminated disease. Both responded well to treatment without significant side effects, resulting in excellent graft function. The importance of chemoprophylaxis should be emphasized to minimize the risk of developing active tuberculosis in patients with latent tuberculosis infection undergoing solid organ transplantation.

3582–3589. 5. Feng FY, Kim HM, Lyden TH, et al. Intensity-modulated chemoradiotherapy aiming to reduce dysphagia in patients with oropharyngeal cancer: clinical and functional results. J Clin Oncol 2010;28:2732–2738. 6. Chronowski G, Garden A, Morrison W, et al. Unilateral radiotherapy for the treatment of tonsillar cancer. Int J Radiat Oncol Biol Phys 2011 Oct 2. [Epub ahead of print] 7. Bourhis J, Le Maitre A, Baujat B, Audry H, Pignon JP. Individual patients' data meta-analyses in head and neck cancer. Curr Opin Oncol 2007;19:188–194. 8. Bourhis J, Overgaard J, Audry H, et al. Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet 2006;368: 843–854. 9. Eisbruch A, Harris J, Garden AS, et al. Multi-institutional trial of accelerated hypofractionated intensity-modulated radiation therapy for early-stage oropharyngeal cancer (RTOG 00-22). Int J Radiation Oncol Biol Physics 2009;76:1333–1338. 10. Kies MS, Holsinger FC, Lee JJ, et al. Induction chemotherapy and cetuximab for locally advanced squamous cell carcinoma of the head and neck: results from a phase II prospective trial. J Clin Oncol 2010;28:8–14.

As part of the Stage III Pig-a multilaboratory validation trial, we examined the induction of CD59-negative reticulocytes and total red blood cells (RETCD59− and RBCCD59−, respectively) in male Sprague Dawley® rats treated with 4-nitroquinoline-1-oxide (4NQO), for 28 consecutive days by oral gavage, at doses of 1.25, 2.50, 3.75, 5.00, and 7.50 mg kg−1 day−1 (the high dose group was sacrificed on Day 15 due to excessive morbidity/mortality). Animals also were evaluated for: micronucleated reticulocytes (mnRET) by flow cytometry; DNA damage in peripheral blood, liver, and stomach using the Comet assay; and chromosome aberrations (CAb) in peripheral blood lymphocytes (PBL). All endpoints were analyzed at two or more timepoints where possible. Mortality, body and organ weights, food consumption, and clinical pathology also were evaluated, and demonstrated that the maximum tolerated dose was achieved at 5.00 mg kg−1 day−1. The largest increases observed for the genetic toxicology endpoints (fold-increase compared to control, where significant; all at 5.00 mg kg−1 day−1 on Day 29) were: RETCD59− (21X), RBCCD59− (9.0X), and mnRET (2.0X). In contrast, no significant increases were observed for the CAb or Comet response, in any tissue analyzed, at any timepoint. Because 4NQO is a well known mutagen, clastogen, and carcinogen, the lack of response for these latter endpoints was unexpected. These results emphasize the extreme care that must betaken in dose and endpoint selection when incorporating genotoxicity endpoints into routine toxicity studies as has been recommended or is under consideration by various regulatory and industrial bodies. Environ. Mol. Mutagen., 2011. © 2011 Wiley-Liss, Inc.

Recent spectroscopic investigations of various amino acids report intriguing high-pressure and low-temperature behavior of NH3+ groups and their influence on various hydrogen bonds in the system. In particular, the variation of the intensity of NH3+ torsional mode at different temperatures and pressures has received much attention. We report here the first in situ Raman investigations of fully deuterated α-glycine up to ∼20 GPa. The discontinuous changes in COO− and ND3+ modes across ∼3 GPa indicate subtle structural rearrangements in fully deuterated α-glycine. The decrease in the intensity of ND3+ torsional mode is found to be similar to that of undeuterated α-glycine. The pressure-induced stiffening of ND and CD2 stretching modes are discussed in the context of changes in the hydrogen-bonding interactions. Copyright © 2011 John Wiley & Sons, Ltd.

Inorganic cations play decisive roles in many cellular and physiological processes and are essential components of plant nutrition. Therefore, the uptake of cations and their redistribution must be precisely controlled. Vacuolar antiporters are important elements in mediating the intracellular sequestration of these cations. These antiporters are energized by the proton gradient across the vacuolar membrane and allow the rapid transport of cations into the vacuole. CAXs (for CAtion eXchanger) are members of a multigene family and appear to predominately reside on vacuoles. Defining CAX regulation and substrate specificity have been aided by utilising yeast as an experimental tool. Studies in plants suggest CAXs regulate apoplastic Ca(2+) levels in order to optimise cell wall expansion, photosynthesis, transpiration and plant productivity. CAX studies provide the basis for making designer transporters that have been used to develop nutrient enhanced crops and plants for remediating toxic soils.

Aliment Pharmacol Ther 2011; 33: 1194–1201 Summary Background Eosinophilic oesophagitis clinically presents with recurrent episodes of dysphagia and food impaction. Recently, we observed patients with noncardiac chest pain and eosinophilic oesophagitis. Aims To estimate the prevalence of abnormal eosinophilic infiltration in noncardiac chest pain patients and examine diagnostic utility of demographic, clinical and endoscopic variables to predict eosinophilic oesophagitis. Methods Retrospective study of 171 consecutive patients referred for EGD evaluation of noncardiac chest pain. Endoscopic signs consistent with eosinophilic oesophagitis were recorded. The histological findings were grouped as normal: 0–5 eosinophils/high power field (e/hpf), indeterminate: 6–20 e/hpf, and eosinophilic oesophagitis: ≥21 e/hpf. Abnormal eosinophilic infiltration was defined as ≥6 e/hpf. Results Abnormal eosinophilic infiltrate was noted in 24 patients (14%). Thirteen (8%) had indeterminate counts, while 11 (6%) had eosinophilic oesophagitis. Compared with normal, those with abnormal oesophageal eosinophilic infiltration were more likely to be male (71% vs. 34%, P = 0.001), have allergies (29% vs. 12%, P = 0.050), have current GER symptoms (42% vs. 18%, P = 0.013), rings (54% vs. 22%, P = 0.002), furrows (21% vs. 1%, P

In search for a better anticonvulsant drug and the importance of semicarbazones and 2,5-disubstituted 1,3,4-oxadiazoles as anticonvulsant pharmacophore, a series of novel substituted semicarbazones were designed, synthesized, and evaluated for their anticonvulsant activity. The chemical structures of the synthesized molecules were confirmed by elemental and spectral (IR, (1) H NMR, (13) C NMR and MS) analysis. The anticonvulsant activities of the compounds were investigated using maximal electroshock seizure and subcutaneous pentylenetetrazole (scPTZ) models. Efforts were also made to establish structure-activity relationships among synthesized compounds. The results of the present study validated that the pharmacophore model with four binding sites is essential for anticonvulsant activity.

The biochemical properties and regulation of several plant CAX (CAtion eXchanger)-type vacuolar Ca2+/H+ exchangers have been extensively analysed in yeast expression assays. In the present study, we compare and contrast the phenotypes of yeast cells expressing the CAX1 cDNA and open reading frame (ORF). We report that the CAX1 ORF, but not the cDNA containing the 3′-untranslated region (UTR), was able to confer Ca2+ tolerance when expressed in a Ca2+-sensitive yeast mutant. Additionally, only yeasts expressing the N-terminal truncated CAX1 ORF were able to grow on high Mn2+ media, suggesting that removal of the 3′-UTR altered activity. However, removal of the 3′-UTR from another CAX did not alter the yeast phenotypes. Expression studies demonstrated that expressing the CAX1 ORF in yeast elevates CAX1 RNA and protein levels. Our results suggest that the 3′-UTR modulates expression of CAX1 in yeast.

Summary In competitive racing, horses rapidly accelerate to their top speed and probably perform supramaximal work. Therefore, the primary objective of this study was to examine changes in pulmonary vascular pressures of Thoroughbreds with rapid acceleration to supramaximal exercise which could not be sustained for more than 90 s. Right atrial and pulmonary vascular pressures were studied at rest and during supramaximal exercise in 10 healthy, sound, exercise trained Thoroughbred horses. Exercise was performed on separate days without (control) and with frusemide administration 250 mg i.v., 4 h before exercise. The protocol consisted of a warm-up at treadmill speeds of 2 to 6 m/s (trot) for 60 s each followed by 8 m/s (canter) for 60 s. Thereafter, the treadmill was raised to 10% uphill incline and speed accelerated from 8 to 15 m/s in 8 s. None of the horses could sustain exercise at 15 m/s + 10% incline for more than 90 s. Mean right atrial, pulmonary arterial, pulmonary artery wedge and pulmonary capillary pressures increased sharply as horses accelerated rapidly attaining their zenith as speed reached 15 m/s. Peak values of various pressures were maintained only for the first 45 s of exercise at 15 m/s +10% uphill incline. Thereafter, a declining trend emerged and all pressures decreased significantly as exercise duration increased. Although frusemide significantly lowered the magnitude of pulmonary vascular pressures both at rest and during exercise, it did not affect the rapid escalation in pulmonary vascular pressures upon rapid acceleration of horses or their unsteadiness in the latter 45 s of supramaximal exercise. It is suggested that rapid rate of rise of pulmonary capillary blood pressure during a sudden burst of supramaximal exercise may be a crucial factor in precipitating stress failure of pulmonary capillaries and onset of exercise induced pulmonary haemorrhage.

Summary The present study was carried out to examine whether pentoxifylline administration to horses premedicated with frusemide would attenuate the exercise-induced pulmonary arterial, capillary and venous hypertension to a greater extent than frusemide alone, thereby affecting the occurrence of exercise-induced pulmonary haemorrhage (EIPH). Using established techniques, we determined right heart and pulmonary vascular pressures in 6 healthy, sound Thoroughbred horses at rest and during exercise performed at maximal heart rate at a workload of 14 m/s on 3.5% uphill grade in the control (no medications), frusemide (250 mg i.v., 4 h pre-exercise)-control, and the frusemide (250 mg i.v., 4 h pre-exercise) + pentoxifylline (8.5 mg/kg bwt i.v., 15 min pre-exercise) treatments. Sequence of the 3 treatments was randomised forevery horse and 7 days were allowed between them. In the control study, galloping at 14 m/s on 3.5% uphill grade elicited significant right atrial as well as pulmonary arterial, capillary and venous hypertension and all horses experienced EIPH as detected by the presence of fresh blood in the trachea on endoscopic examination. Frusemide administration was not attended by changes in heart rate at rest or during exercise. Although in the frusemide-control experiments, a significant reduction in mean pulmonary arterial, capillary and wedge pressures was observed both at rest and during galloping at 14 m/s on 3.5% uphill grade, all horses still experienced EIPH. Pentoxifylline administration to standing horses premedicated with frusemide caused nervousness, muscular fasciculations, sweating and tachycardia. Although these symptoms had largely abated within 15 min, there were no significant changes in the right atrial or pulmonary vascular pressures. Exercise in the frusemide + pentoxifylline experiments also caused significant right atrial as well as pulmonary arterial, capillary and venous hypertension, but these data were not found to be significantly different from the frusemide-control experiments. All horses in the frusemide + pentoxifylline experiments also experienced EIPH. In conclusion, our data indicate that pentoxifylline (8.5 mg/kg bwt i.v., 15 min pre-exercise) is ineffective in modifying the pulmonary haemodynamic effects of frusemide in exercising horses. It should be noted, however, that we did not examine whether erythrocyte plasticity was altered by the administration of pentoxifylline. Since the intravascular force exerted onto the blood-gas barrier of exercising horses premedicated with frusemide remained unaffected by pentoxifylline administration, it is concluded that concomitant pentoxifylline administration is unlikely to offer additional benefit to horses experiencing EIPH.

The present study was carried out to ascertain whether beta2-adrenergic receptor stimulation with clenbuterol would attenuate the pulmonary arterial, capillary and venous hypertension in horses performing high-intensity exercise and, in turn, modify the occurrence of exercise-induced pulmonary haemorrhage (EIPH). Experiments were carried out on 6 healthy, sound, exercise-trained Thoroughbred horses. All horses were studied in the control (no medications) and the clenbuterol (0.8 pg/kg bwt, i.v.) treatments. The sequence of these treatments was randomised for every horse, and 7 days were allowed between them. Using catheter-tip-transducers whose in-vivo signals were referenced at the point of the left shoulder, right heart/pulmonary vascular pressures were determined at rest, sub-maximal exercise and during galloping at 14.2 m/s on a 3.5% uphill grade--a workload that elicited maximal heart rate and induced EIPH in all horses. In the control experiments, incremental exercise resulted in progressive significant increments in right atrial as well as pulmonary arterial, capillary and venous (wedge) pressures and all horses experienced EIPH. Clenbuterol administration to standing horses caused tachycardia, but significant changes in mean right atrial or pulmonary vascular pressures were not observed. During exercise performed after clenbuterol administration, heart rate as well as right atrial and pulmonary arterial, capillary and wedge pressures also increased progressively with increasing work intensity. However, these values were not found to be statistically significantly different from corresponding data in the control study and the incidence of EIPH remained unaffected. Since clenbuterol administration also does not affect the transpulmonary pressure during exercise, it is unlikely that the transmural force exerted onto the blood-gas barrier of exercising horses is altered following i.v. clenbuterol administration at the recommended dosage.

Iron salts have been doped into emeraldine base (EB) successfully using a chemical route. Both FeCl3 and FeSO4 were doped separately into EB in acetonitrile with metal ion and tetramer in the ratio of 4 : 1. The doped samples were characterized by UV-vis absorption, Mossbauer and fourier transform infrared (FTIR) spectroscopy. UV-vis spectra showed a suppression of the characteristic band of EB at 660 nm with an extended absorption towards the infrared regions for both the doped samples. FeSO4 showed electronic absorption behavior similar to the features of acid doped EB. Mossbauer spectroscopy confirmed the presence of single oxidation and high spin states of Fe(III) and Fe(II) in the respective doped polymers. No signature of Fe2+ was observed in the Fe3+ doped EB from the Mossbauer spectrum. FTIR spectroscopy showed a shift towards the lower wave number for the iron salts doped EB as compared to the pristine polymer. An increase in the intensity of the band at 1140 cm−1 is observed, which corresponds to the electronic like absorption confirming the doping of EB. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009

A series of novel N(1)-[5-(4-substituted phenyl)-1,3,4-thiadiazol-2-yl]-N(4)-(4-substituted benzaldehyde)-semicarbazone 1-12, N(1)-[5-(4-substituted phenyl)-1,3,4-thiadiazol-2-yl]-N(4)-[1-(4-substituted phenyl)ethanone]-semicarbazone 13-16, and N(1)-[5-(4-substituted phenyl)-1,3,4-thiadiazol-2-yl]-N(4)-[1-(4-substituted phenyl) (phenyl) methanone]-semicarbazone 17-20 were synthesized for their anticonvulsant activity. The chemical structures of the compounds were proved by elemental and spectral (IR, (1)H-NMR,( 13)C-NMR, and MS) analysis. The anticonvulsant potential of the compounds was investigated using maximal electroshock seizure (MES) and subcutaneous pentylenetrtrazole (scPTZ) models. Compound 19 was found to possess significant anticonvulsant activity in both the models employed for anticonvulsant evaluation. Compounds 8, 13, 15, and 16 also demonstrated a marked anticonvulsant property. The results of the present study validated that the pharmacophore model with four binding sites is essential for anticonvulsant activity. The efforts were also made to establish structure-activity relationships among the synthesized compounds.

Background: Chronic venous disorders are conditions of increasing prevalence in the developing world, and venous ulceration is the terminal sequel. Currently there are only limited data on all aspects of this from Southeast Asia. The aim of the present study was to assess differences in the demography and outcome between varicose vein surgery (VVS) and the relatively new endovenous laser therapy (EVT) in patients from Penang, Malaysia. Methods: A retrospective study was performed. Patients who presented to the outpatient clinic of the surgical department with saphenofemoral junction and/or saphenopopliteal junction incompetence associated with reflux of the great saphenous vein or small saphenous vein, respectively, underwent either surgery (1999–2004) or laser therapy (2004–2006). A single surgeon at a single institution performed all procedures. Results: A total of 350 limbs were treated from 292 patients. Demographics, symptoms, outcomes and complications that arose in both groups were compared. There were significant improvements in pains, swelling, cramps and heaviness postoperatively (P < 0.001) in both groups. Deep venous thrombosis was present as a complication in the VVS group at 3.0%, but was absent altogether in the EVT group. Conclusions: Although both are highly effective procedures, laser therapy has become popular as an elective procedure with its minimally invasive nature, cosmesis, rapid recovery and other advantages. Surgery remains an important and very cost-effective procedure, especially in a developing society such as Penang.