12/8/10

Successful Management of Poly cystic ovaries at rVita health center

Case study Poly Cystic ovarian syndrome (PCOS)
History: 28 years old unmarried girl history of delayed menses, additional hair growth in the face, weight gain, mental irritability since 2 years
Personal History

Diet
Vegetarian
Appetite
Good, Able to take little quantity, often feels hungry
Bowels
Normal
Urine
Normal
Sleep
Normal
Prakruti
Pitta and Kapha
Desired taste
Spicy, salty, warm foods and drinks


Patient details

Registration date
22.01.2010
Family history
No relevant family history (One girl child)
Disorder history
Diagnosed with PCOD with USG
Medication history
Ovaral –G (Combination of estrogen and Progesterone) – one tablet daily for 21 days with a gap of 7 days for six months. Menses were normal in this period but general health conditions were not improved.
Menstrual history
Menarche at the age of 12 years.
Past MC – 4-5/ 28-30 day cycle; Moderate flow and mild pain
Since last six month menstrual cycle – 2-3/ 40-45 days, scanty flow and sometimes pain
Last menstrual cycle: 29.11.2009


Physical examination

General examination
Build & Nutritional status: satisfactory
Pallor: Mild
No evidence of thyroid enlargement
BP 120/80 mm/Hg / Pulse 72 per minute
Height: 156 cm
Weight: 69 Kg
Respiration rate 19 per minute
Systemic examination
Cardio Vascular system
Heart sounds (S1, S2) – Normal, No added sound, HR-62 per minute
Respiratory system
Clear, equal air entry, no added sound
Per abdomen
Soft, No palpable mass and no organomegaly, No abnormality detected
Investigations
Hemoglobin – 12.6 mg/dl (11 – 14 gm/dl)
TLC, DLC and ESR, within normal range

Hormone profile
Prolactin – 18.12 ng/ml (3.24-29.15 ng/dl)
L H – 3.09 mIU/ml (1.00-18.00 mIU/ml in follicular phase)
PSH – 6.34 mIU/ml (4.00 mIU/ml/ml in follicular phase)

Thyroid profile
TSH – 3.2 mU/ ml (0.49-4.67 mIU/ml)
Thyroxin – 0.87 ng/dl (0.71-1.85 mg/dl)
Tridothyrixine – 2.36 pg/ml (1.45-3.48 pg/dl)
Insulin – fasting – 4.9qU/ml (0-9 qU/ml)
Radiology
USG – 20.12.2009 – Enlarged ovaries with multiple small follicles in peripheral distribution with increased stromal echogenecity suggestive of poly cystic ovaries

Follicular study 29.11.2009 – Anovulatory cycle

X Ray – PA view – No abnormality detected


Clinical evaluation of the patient on clinical and biochemical basis on frequent follow ups


Clinical findings
On registration date
 (22.01.2010)
2 nd follow up
 (07.03.2010)
5 th follow up
(01.11.2010)
Lethargy
++++
++
Nil – Fresh and Energetic
Pallor
++
Nil
Nil
Irregular periods
Last menses on 29.11.2009 (3 days, scanty and painful)
On 40 th day (01.03.2010), 3-4 days
Every 30 th day, regular for 4-5 days
Amount of menses
Scanty
normal
normal
Weight
62 Kg
59.2 Kg
50 Kg (Unchanged since 4 months)
Investigations
07.03.2010
18.05.2010
25.10.2010
Hb gm%
11.6 gm/dl
12.1 gm/dl
14.6 gm/dl
Prolactin
16.12 ng/dl
18.11 ng/dl
15.46 ng/dl
LH
Normal
Normal
Normal
PSH
Normal
Normal
Normal
Free Testosterone
Normal
Normal
Normal
Thyroid profile
Normal
Normal
Normal
Ultra sound scan
Enlarged in volume, Increased number of cyst (Peripherally )
Ovaries enlarged with fair amount of cysts with mild stromal thickening
Ovaries normal, no visible cyst mass, No stromal thickening, Normal study
Follicular study
Anovulatory cycle
Anovulatory cycle
Ovalatory cycle, Ovulation occurs at Day 16


Diagnosis
Anemia and thyroid disorder are ruled out. Hormonal studies and USG exhibits Poly cystic ovarian syndrome (PCOS)

Management Done
Food – Green gram, Red rice, wheat, Green, fresh vegetables, Milk etc
Avoid – spicy, salty, fermented foods and drinks, canned foods and drinks, curd
Exercises- 30 minutes walk every day with Pranayama and meditation for 10-15 minutes
Medicines advised
1.       Saptasaram Kashayam Tablets
3 tablets – with warm water 30 minutes before breakfast and Dinner
2.       Kalyanaka Kshara (21)
250 mg after food with curd water thrice daily after food
3.       Satavari gulam
5 gm at bed time followed by 200 ml of warm milk
Conclusion
In PCOS is a condition caused by abnormalities of hypothalamic – pituitary axis and ovarian or adrenal steroidogenic pathway.
Ayurveda names this condition as ‘Arthava Dushti’ – means abnormalities in the functions elements of the menstrual cycle. This condition is termed under easily treatable disorders section.
At rVita we combine best of the ancient Indian systems like Ayurveda and Yoga with modern diet and nutrition plans with a unique personalization based on the bio energy or Prakriti analysis. This helps the person to attain the self healing in due course of time and the disease is cured permanently.
rVita currently enrolling patients for PCOD program (Women health) with unique Online patient Management system which enables to upload all the medical records and monitor health etc online.
For more details about the Online PCOD program (Women health) please feel free to call 1800 425 4325 (India Only) / 00 91 9500123412 / visit www.rvita.com and click the ‘rVita personalized consultation’ tab
Alternatively, please visit our flag ship rVita health center at No.2, Krishnamacharya Avenue, Adayar, Chennai 600020, (Opposite to Adayar Ananda Bhavan Sweets), and India. For appointments please call 044 42187226 / 1800 425 4325 (India Only) / 9500123412 / gowthaman@rvita.com

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