Factor X deficiency: a rare cause of puberty menorrhagia.

Factor X deficiency is an extremely rare coagulation defect inherited as an autosomal recessive disorder with variable bleeding manifestations. The authors report case of a 16 y-old girl born from a consanguineous marriage who presented with excessive bleeding at the start of menarche. Investigations revealed severe anemia, prolongation of both prothrombin time and activated partial thromboplastin time and moderate deficiency of factor X (1 %). She was given multiple transfusions including packed cells and fresh frozen plasma and was advised to remain under regular follow up.

Placental laterality as a predictor for development of preeclampsia.

OBJECTIVE: To find whether placental laterality as determined by ultrasound can be used as predictor for the development of preeclampsia. METHODS: This prospective study was conducted in the Department of Obstetrics and Gynecology, Govt. Medical College, Jammu from 2006 to 2007. 150 pregnant women attending antenatal clinic both OPD and IPD at 18-24 weeks of gestation without any high risk factor were subjected to ultrasound examination, and placental location was determined. These cases were followed for the development of signs and symptoms of preeclampsia. RESULT: Out of the total 150 women, 84 (56 %) had laterally located placenta and of them, 56 (66.6 %) developed preeclampsia, while the remaining 66 (44 %) had centrally located placenta and of them, 24 (36.3 %) developed preeclampsia. So, the overall risk of developing preeclampsia with laterally located placenta was 5.09 (odds ratio) and 95 % confidence interval (2.40-10.88). The difference was found to be statistically significant, p value (0.00002) by χ(2) test. CONCLUSION: From the above study, we concluded that females with laterally located placenta determined by USG at 18-24 weeks of gestation have five times greater risk of developing preeclampsia.

Hemothorax following snakebite.

We report a 12 year old girl with snakebite, who developed hemothorax 5 days after admission. One liter of blood was aspirated. The bite was presumed to be that of saw scaled viper (Echis carinatus) that resulted in DIC and direct endothelial injury leading to bleed. Selective bleed into the pleural cavity is a rarity.