ABSTRACT
Polycystic ovarian disease is highly prevalent hormonal and metabolic disorder among reproductive aged women worldwide characterised by hyperandrogenism, chronic anovulation and polycystic ovaries. Insulin resistance is now recognised as a basic underlying pathology of PCOD and found in approximately 50-70% of patients. It is defined as a state in which greater than normal amounts of insulin are required to produce a quantitatively normal response. It is associated with an increased risk of various metabolic disorders including type 2 diabetes mellitus, hypertension, dyslipidaemia and cardiovascular diseases, which indicates that timely therapeutic intervention in PCOS could prevent or at-least delay the onset of type 2 diabetes mellitus and other long-term health risks. Most of the features of PCOD associated with insulin resistance can be found under Santharpanajanya vyadhis with involvement of three Doshas and Dhathus like Rasa, Raktha and Medus. Here is a case report of 18-year-old female who presented with irregular menstruation, rapid weight gain and blackish discoloration of back of neck. Her USG findings shows bilateral polycystic pattern of ovaries. Based on clinical features and laboratory values, treatment principles adopted are Agni deepana, Ama pachana, Vatha-kaphahara and Lekhana. Varanadi kashyam and triphala choorna with takra given internally for 3 months and Udwartana was done externally for 14 days. After 3 months of treatment considerable reduction in weight and improvement in insulin resistance were noticed and her menstrual periods were normal with normal USG findings. The present case signifies the importance of Ayurvedic management in insulin resistance of PCOD to prevent forthcoming complications.
ABSTRACT
Polycystic Ovarian Disease (PCOD) is an endocrine disorder that causes metabolic changes in women of reproductive age. PCOD has evolved into a lifestyle disorder as a result of sedentary habits, fast food consumption, and a poor lifestyle. The precise cause of PCOD is mysterious, but high levels of insulin, hyper androgen, and LH are the main causes. PCOD symptoms include irregular menstruation, oligomenorrhea, acne, hirsutism, hair loss, obesity, and constipation. PCOD is not directly stated in the Samhita, but clinically it is similar to Aartavavaha strotas dushti, Nastaartava, Granthi, Santarponnth vyadhi, and Yonivyapad. In this present case study, a 22 year old female patient came with symptoms of irregular, delayed menstruation, scanty menses, acne on the face and hair fall. The USG report reveals polycystic patterns of both ovaries with Right ovary volume 11.6cc and Left ovary volume 11cc, both ovaries are bulky in size with increased stromal echogenicity and multiple (10-12) small follicles (2-5mm) arranged in peripheral distribution. She had taken the medication so many times but she had not been completely cured. As a result she came to our hospital for Ayurvedic treatment. Result was made on the basis of Clinical symptoms relief and USG report. So in this case study, we will look at an Ayurvedic approach in the management of Polycystic Ovarian Disease.
ABSTRACT
Background: Polycystic ovarian disease (PCOD), a common endocrine disorder with multisystem affection, is the most common cause of anovulatory infertility. Our objective is to evaluate the effect of using clomiphene citrate (CC) plus N-acetyl cysteine (NAC) versus letrozole in ovulation induction in infertile patients with PCOD.Methods: Reproductive-aged infertile women either primary or secondary diagnosed as PCOD according to Rotterdam criteria, 2003 were considered for enrollment. Eligible women for were recruited and randomized (1:1) to receive either CC 100 mg plus NAC 600 mg (CC+NAC arm) or letrozole 5 mg (NCT03241472, clinicaltrials.gov). All medications were started from day 3 of the menstrual cycle for 5 days. The primary outcome was the ovulation rate in both groups. Secondary outcomes included the mid-cyclic endometrial thickness, ovarian hyperstimulation, and clinical pregnancy and miscarriage rates.Results: One hundred ten patients were enrolled and randomized to CC+NAC arm (n=55) or letrozole (n=55). The ovulation rate in patients in letrozole arm was significantly higher than CC+NAC arm (71.8% versus 53.2%, p=0.01). Additionally, endometrial thickness was higher in letrozole arm (mean±SD: 11.46±1.61 versus 9.0±1.13, p=0.031). However, no statistical significant difference with regarding the ovarian hyperstimulation rate (1.8% versus 3.6%, p=0.157), clinical pregnancy rate [3/19 patients (27.3%) versus 19/55 (34.5%), p=0.409] and miscarriage rate [4/15 patients (26.7%) versus 19/55 (15.8%), p=0.317] in CC+NAC versus letrozole groups respectively.Conclusions: Addition of NAC to CC in ovulation induction leads to comparable pregnancy rate as letrozole. However, letrozole produces high ovulation rate and the better mid-cyclic endometrial thickness.
ABSTRACT
Background: To evaluate the result after medical treatment and laparoscopic ovarian drilling in PCOS patients and to compare the results of these two methods.Methods: In this prospective study 50 women with polycystic ovarian disease, were divided into two group,25 women received medical treatment and 25 women received surgical (laparoscopic ovarian drilling) treatment. Effect of treatment on ovulation, menstruation, fertility and androgen level was determined 3 month after therapy.Results: There was significant increase in ovulation and fertility, decrease in androgen levels and decrease in LH/FSH in individual groups when compared with pretreatment levels but difference between groups A and B was not statistically significant for these parameters.Conclusions: Medical treatment and laparoscopic ovarian drilling are equally effective in treating the women of polycystic ovarian disease. Result of both the treatment are similar in this study. However medical treatment should be the first line therapy, it has significant benefit for use in OPD, low cost, no hospital stays and convenience to the patient.
ABSTRACT
Tuberous Sclerosis Complex (TSC) is an autosomal dominant genetic disorder characterized by hamartoma formation in multiple organs, particularly the skin, Brain, Eye, Kidney and heart. TSC is caused by mutation of two genes TSC1, and TSC2 which encodes for Hemartin and Tuberin. The case of 19 year old female with TSC is reported here since it is associated with Angiomyolipomas of kidneys, Dentigerous cyst, and polycystic ovarian disease, calcified subependymal nodules in the lateral ventricles of brain and multiple radial lens opacities in the eyes. Methodical systemic examination with appropriate investigations is mandatory to diagnose a case of Tuberous Sclerosis Complex.
ABSTRACT
Healthy skin sources from sex hormone, the reproductive health is closely related with skin, they grow and decline together. The methods of regulating menstruation and whites, nourishing kidney for pregnancy clinically can make patients’ skin regain brilliance in the meantime of curing sterility, menstruation disease and pelvic inflammation, from this we can know TCM has broad prospect in beautification.
ABSTRACT
A 19 year old female patient presented with diffuse alopecia as her chief medical complaint. A clinical examination revealed hirsutism limited only to the on midline lower abdomen with elevated DHEA-S(dehydroepiandrosterone sulfate) and total testosterone levels. Polycystic ovarian disease (PCOD) was diagnosed during the treatment with dexamethasone and spironolactone, which was effective to improve her alopecia. We believe that, with increasing, concerns about hair conditions of teen-age girls there should be increasing chances for dermatologists to care for patients of PCOD first before other specialities in medicine.