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To study the pneumatization pattern of mastoid bone in cases of squamousal type of chronic otits media and analyze pneumatization pattern of opposite normal ear in cases of unilateral chronic otitis media (COM). A total of 94 patients (104 ears) between the age group of 7-84 years attending the E.N.T outpatients, inpatients and casualty of Acharya Vinoba Bhave Rural Hospital, Sawangi (Maghe), Wardha, after applying inclusion and exclusion criteria were found suitable and hence selected for the present study and were subjected to bilateral X-ray mastoid (Schuller's view). HRCT temporal bone done in selected 55 patients. On analyzing patients radiologically (X-ray mastoid), it was found that out 104 ears, mastoid was pneumatized in 2 (1.92 %) diploic in 20 (19.23 %) and sclerotic in 82 (78.85 %) ears. Contralateral mastoid of 70 normal ears, mastoid was pneumatized in 30 (42.86 %) diploic in 22 (31.43 %) and sclerotic in 18 (25.71 %) ears. Most of the diseased ear demonstrated non pneumatized mastoid (98.08 %) whereas contra lateral mastoid of 70 normal ear, showed significantly more pneumatization This difference is statistically significant (P value < 0.0001). Significantly more sclerosis and non pneumatization in the ear with COM of squamousal type than the healthy contralateral ear supports the environmental theory.

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It has been recognised for some time that many disorders such as vascular malformations, hypertension, collagen vascular diseases, tumours, eclampsia, central nervous system infection, bacterial endocarditis and blood dyscrasias can cause non-traumatic intracerebral haemorrhage in young adults. Factor XIII deficiency is a rare cause of intracranial bleed. The impressive clinical signs with bleeding starting in the neonatal period (prolonged bleeding from the umbilical cord), followed by severe, life-threatening episodes of intracranial haemorrhage should raise the clinical suspicion of factor XIII deficiency. Tests for factor XIII deficiency in high index clinical suspicious cases despite negative coagulative screening tests are essential for diagnosis. The diagnosis of factor XIII deficiency is difficult but has important therapeutic consequences. We are reporting here the clinical outcome of a young woman with intracranial bleed due to factor XIII deficiency. The patient was managed successfully with fresh frozen plasma transfusion and supportive treatments. The prophylactic substitution therapy of factor XIII (recombinant factor XIII, cryoprecipitate and fresh frozen plasma) enables patients to live normal lives, free from catastrophic bleeding episodes.