A girl aged twenty one year had irregularity in periods since three years. She also complained unwanted hair growth over chin, upper lips, chest, abdomen and both limbs. She additionally had diffuse hair loss and headache periodically every week intervals < over exertion, spicy foods

H/o Present illness
She was suffering from periodical headaches since last five years. Her mother had brain tumour 10 years back, which was surgically treated, she was obsessed that headache would have resulted from tumour, probing deep since her mother had brain tumour.

· Plain X ray skull studied normal, Serum prolactin level was 22.6 ng/ml ( Refer Plate III )

· There was elevation in the serum testosterone level 260 ng/dl (Refer plate III) to remark hirsutism.

· Subsequently the Ultra sonogram of the pelvis revealed Bilateral Poly Cystic Ovaries (Refer Plate I)

Past History
She had tendency to catch cold and troubled with recurrent fever. He had broken her left arm following a fall while riding bicycle when 12 years old. She had been vaccinated for all communicable disease

Family History
Her maternal grandfather died following heart attack. Her father is hypertensive, Mother is on medication for post operative follow up.

Menstrual History

Menarche at the age of fourteen, menstruated regularly for three years, 28-31 days interval, 5 days flow. The periods prolonged, profuse, intermittent flow later years. Pain occasional, anaemic for many years following blood loss.

Physical Generals

· Complexion - Fair

· Stature - Tall

· Frame - Medium, masculine frame

· Appetite - Normal

· Thirst - Normal

· Stool - Normal

· Urine - Normal

· Sweat – More in Armpits

· Sleep – Normal

· Food Type - Non Vegetarian

· Desires - Spicy food

· Aversion: Onions,Tomato

· Has the habit of tea, coffee.

Mental Generals

    Mental, intellectual state of mind is irritable, anxious, very sensitive and emotional, and absent minded and apprehensive, cheerful, weeps easily, obsessed with some fixed ideas on health and habits

First Prescription                      30/12/1997
R/x
    Thuja 1M tds
    Pl for one fifteen days

Follow Up 1                               14/1/1998
LMP 13th Jan 1998, 7 days flow
No pain
R/x
    Radium Brom 200 tds
    Pl for fifteen days

Follow Up 2                              1/2/1998

Headache better
R/x
    Radium Brom 200 tds
    Pl for fifteen days

Follow Up 3                              15/2/1998

LMP 12th Feb 1998. 5 days flow.
R/x
    Radium Brom 200 tds
    Pl for fifteen days

Follow Up 4                              12/3/1998

The USG of the pelvis revealed normal study of Uterus and Ovaries (Refer plate II)
R/x
    Thuja 1M tds
    Pl for fifteen days

Follow Up 5                              29/3/1998

LMP 15th March 1998, 5 days flow
R/x
    Radium Brom 200 tds
    Pl for fifteen days

Follow Up 6                              21/5/1998
LMP 14th April 1998
Blood studies normal, Prolactin was 1.02ng/ml
Serum Testosterone 59 ng/dl (Refer plate IV)
For the further follow up the patient was prescribed with Thuja1m followed with Radium Brom 200

Discussion
    However the patient constitutionally and based on totality requires Pulsatilla, he was prescribed with Thuja understanding the miasmatic influence in this case. Radium Brom was prescribed as a follow up drug based on the increased neutrophils count. The patient was recovered totally from menstrual irregularities; subsequently the imaging studies also supported the symptoms. The Ultra sonogram was normal, Serum testosterone and prolactin levels came down. She got, married and delivered a female child after four months of her married life.