Background:Glanzmann's thrombasthenia (GT) is a rare bleeding disorder, which is characterized by a lack of platelet aggregation. It is characterized by qualitative or quantitative abnormalities of the platelet membrane glycoprotein IIb/IIIa. Physiologically, this platelet receptor normally binds several adhesive plasma proteins, and this facilitates attachment and aggregation of platelets to ensure thrombus formation at sites of vascular injury. The lack of resultant platelet aggregation in GT leads to mucocutaneous bleeding whose manifestation may be clinically variable, ranging from easy bruising to severe and potentially life-threatening hemorrhages.Objective:To highlight this rare but potentially life-threating disorder, GT.Case Report:We report a case of GT that was first detected because of the multiple episodes of gum bleeding. The patient was an 18-year-old girl who presented with a history of repeated episodes of gum bleeding since childhood. Till the first visit to our hospital, she had not been diagnosed with GT despite a history of bleeding tendency, notably purpura in areas of easy bruising, gum bleeding, and prolonged bleeding time after abrasions and insect stings. GT was diagnosed on the basis of prolonged bleeding time, lack of platelet aggregation with adenosine di phosphate, epinephrine and collagen.Conclusion:GT should always be considered as differential diagnosis while evaluating any case of bleeding disorder.

The purpose of this paper is to report a rare occurrence of Stevens-Johnson/Toxic epidermal necrolysis (SJS/TEN) overlap syndrome after the use of aceclofenac. A 38 year old healthy adult male presented with rapidly evolving rash over face and upper body with ulceration of buccal mucosa and breathlessness after taking aceclofenac tablet. Naranjo score for this adverse drug event was six, thereby making it a probable adverse drug reaction. Despite aggressive fluid resuscitation and use of antihistamines and systemic steroids, patient's health rapidly worsened and died within six hours of presentation. Aceclofenac induced SJS/TEN overlap is an extremely rare clinical association previously reported only once in medical literature. To the best of our knowledge, this is the first case report of such an association in the Indian population. We are presenting this case to highlight the serious adverse reactions possible from a routinely prescribed drug.

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Introduction: PPIUCD is a very safe, reversible, long term contraceptive. The recommended interval between pregnancies is at least 24 months in order to reduce the risk of adverse maternal, perinatal and infant outcomes. In our district the usage of PPIUCD is 0.1% and 60% of deliveries take place in private health facilities. This preliminary study is conducted in a private teaching hospital with the aim to determine proportion of women accepting PPIUCD and to develop our own data regarding immediate complications to guide us in counselling the women and to implement PPIUCD services. Materials and Methods: This prospective feasibility study was done from July 2017 to January 2018. 100 women attending the for antenatal checkups were counselled for PPIUCD. The women who consented were inserted with PPIUCD. Results: Acceptance rate was 30% and most of the women who accepted PPIUCD were primiparae (58.3%). An analysis of the reasons for acceptance of PPIUCD showed that long term efficacy (33.3%), safety (20%), fewer clinic visits (16.6%) and non hormonal (13.3%) were the most common reasons for acceptance. Conclusion:The PPIUCD is safe having no reported incidence of perforation with low rate of expulsion, pelvic infection and few lost strings and these complications can be reduced further with training and practice. The acceptance and continuation rates can be improved with counselling and strategic follow up protocols in our district with very low rate of PPIUCD usage.