Rupal Samal

Foetal fibular hemimelia with focal femoral deficiency following prenatal misoprostol use: A case report

Misoprostol is a well known abortifacient. It can cause teratogenicity like Mobius sequence and terminal transverse limb defects. We report a rare case of proximal focal femoral deficiency with fibular hemimelia in a woman who had attempted abortion with self-administered misoprostol and later continued the pregnancy. Though the absolute risk of congenital malformations with its use is low ∼1%, this should be clearly communicated to the women requesting abortion to help them make fully informed reproductive health decisions.

Peripheral arterial disease in a female using high-dose combined oral contraceptive pills.

The association between oral contraceptive (OC) pills and vascular diseases is well-known, although, the present generation of pills is considered to be relatively safer in this regard. Hormonal treatment for severe abnormal uterine bleeding is usually considered after ruling out malignancy, when such bleeding is resistant to all other forms of treatment. We report a case of severe peripheral arterial disease in a female, who had been on high-dose OC pills for an extended period of time for severe uterine bleeding.

Primary amenorrhea: a clinical review

Primary amenorrhoea is a symptom with an extensive list of underlying causes, the majority of which are rare. According to the definition it should present in adolescence, although some conditions are diagnosed in childhood may present with failure of menstruation. Many causes of secondary amenorrhoea can also present with primary amenorrhoea if they arise very early in life. A systematic, compartment based approach will cover the commoner causes of primary amenorrhoea and recommend a pragmatic but cost-effective approach to achieve correct diagnosis. Treatment must be directed at the specific cause but has often wider implications for life long wellbeing like weight management, hormone replacement, sexual health and fertility.