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Acute gastrointestinal bleeding (GIB) is a frequently encountered medical emergency and it can be lifethreatening depending on the etiology and the clinical condition of the patient. The most common causes of GIB are peptic ulcer disease, aspirin-induced gastritis, variceal hemorrhage, esophagitis, neoplasms like gastric cancer. Acquired hemophilia causing acute gastrointestinal bleed is extremely rare and only a few cases are reported worldwide. Acquired hemophilia A (AHA) is a rare disorder caused by the production of autoantibodies that inactivates clotting factor VIII. We present a case of upper gastrointestinal bleed due to AHA which was undiagnosed for two years. A 74-year-old patient with a history of myasthenia gravis, presented with anemia, and GIB. She underwent multiple endoscopies without a clear bleeding source. Coagulation studies showed isolated activated partial thromboplastin time prolongation which was not corrected by mixing study. Factor VIII activity was low and Bethesda titer showed elevated inhibitor levels. Factor Eight Bypassing Agent, recombinant factor VIIa, and steroids were given to control bleeding. Her clinical condition worsened, and she passed away. Elderly patients presenting with an undiagnosed source of GIBs, inconclusive endoscopic studies should be evaluated for acquired coagulopathies, especially in those with a history of autoimmune diseases and malignancies. Prompt diagnosis and treatment are warranted as it carries a high mortality.

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Polypodium vulgare Linn. commonly called as Bisfaij is a medicinal plant which is used in various ailments. It is one of the most archaic and essential plant, belonging to the family Polypodiaceae. It contains organic substances such as resin, tannins, steroids, flavonoids, alkaloids, glycosides, protein, reducing sugar and inorganic substances like calcium, magnesium, potassium, sulphur, iron and chloride. It is used in Unani system of medicine for the treatment of sorethroat, stomach-aches, leprosy, melancholia, spleenomegaly, haemorrhoids, rheumatic swelling of the joints etc. Besides this, it has other pharmacological activities too such as antiepileptic, neuro-psychopharmacological, antipyretic, antibiotic, antiviral etc. This review paper discuses the medicinal values of Polypodium vulgare Linn. in Unani medicine as well as its modern pharmacology and gives a new impetus to utilize Bisfaij in various disorders. Keywords: Bisfaij, Polypodium vulgare Linn, Phytopharmacology, Unani Medicine.