cases
 
A case of PCOD
 
 

Prof. Dr.Madona Joseph
HOD Department Of Forensic Medicine and Toxicology.
Fr Muller Homoeopathic Medical College and Hospital
Mangalore-2.


    A young girl aged 18 years presented the following history



Past History -
No history of any illness
F/H MO: Cerebral hemorrhage. (died)

Patient as a person:

      Appearance : stocky
      Perspiration : moderately increased on back, legs
      Craving : Ice cream
      Aversion : spicy food
      Bowel & bladder habits : Normal
      Thermally chilly pt
      Menstrual history
   Attained puberty at the age of 15years.. Pain abdomen for the first 2 days,28 days cycles,
      Duration: 6 days.

General Physical Examination

  • No pallor
  • B.P : 120/80 mm of Hg
  • Wt: 57 kg


  • Local Examination

  • P/A : NAD
  • LIFE – SPACE INVESTIGATION

        Patient hails from middle class family. She has one brother and a sister. She did her schooling in her native place. She lost her mother. When she was in X std. After a year her father married again. Her relationship with her stepmother is good. She has no problem in the college. She is very mild by nature. Likes to be with friends always. Patient weeps very fast while speaking about her mother. After her mother’s death, Pt is indecisive, [which is been evident as she delayed in approaching the physician by 1 month even after the confirmatory USG report
    Please refer PlateI

    General Physical Exam:

        On exam no pallor, cyanosis, oedema, clubbing, lymph nodes, thyroid abnormalities.
        B.P - 120/80 Weight -57 kg

    Local examination

        Per Abdomen No visible / palpable swelling or tenderness

    Other systemic examination

        Within the normal limits. Since the patient had already brought the USG report dated 15/3/2002, and also with the clinical presentations it was diagnosed as PCOD.

    Constitutional Totality:

  • The mentals considered were Mild, Weepy, Indecisive, Likes company and consolations.

  • The physical generals for prescription were stocky appearance, increased perspiration, increased thirst, craving for ice-cream, prefers spicy food but disagrees her thermally chilly.


  • Characteristics particulars

  • Irregular and delayed menses.
  • Fullness of abdomen and mainly less by spicy food.
  • FM Sycotic (M)


  • Intercurrent totality:

    Hypertensive —> DM Sycotic PCOD, Irregular menses.

    First Prescription                        18 – 4 – 2002

    R/x
        1) R: Pulsatilla 200 (4) weekly HS start.
        2) 5 grain tab. 1-0-1 x 1 month

    Follow Up 1                                  22 – 4 – 2002

        L.M.P 19/4/2002
       R/x

  • Sl packet (15 p)
  • (IP) alternate days


  • Follow Up 2                                  27 – 5 – 2002

  • Menses expected on 19/5/2002
  • But she did not get her periods

  •   R/x   
      Puls 200 (IP) start
      5-grain tab 1-0-1

    Follow Up 3                                  13 – 6 – 2002
  • LMP: 30/5/2002
  • Flow: Moderate, no clots, bright red colour, duration 6 days. White discharge after menses, no itching or acridity. Distention of abdomen < pulses

  •   Rx
      1Thuja 200/2p(IP) 2 dayvwwws

    Follow Up 4                                  27 – 6 – 2002

  • Patient had to report today
  • Distension of abdomen: occasionally
  • Belching
  • Tongue: Central furrow, dry, Posterior: 2/3 rd coated white

  •     Rx:
        Puls 200 IP Hs. Today (IP) HS daily

    Follow Up5                                  4 – 7 – 2002

  • LMP: 2 – 7 – 2002
  • Flow: Moderate dark red blood
  • No other complaints

  •     R/x


    SL-7P (IP) daily

    Follow Up 6                                  18 – 7 – 2002

  • Throat irritation and itching of ear, sneezing
  • And coryza 1 day
  • Occ: Cough expectoration
  • O/e: Tonsils are congested

  •     Rx
        Sabadilla 30 TDS x 4 days

    Follow Up 7                                  25 – 7 – 2002

    No complaints LMP: 2 – 7 – 2002

  • No sneezing / cough

  •   R/x
      Thuja 200/IP start


      Asked to review USG 31/8/2002
    Please refer Plate II

    Follow Up 8                                  1 – 8 – 2002

  • Menses: regular
  • No Complaints
  • Generals: Good

  •     Rx
        5 grain tab 1-0-1 x 2 weeks
        Patient had reported to the OPD. She is getting regular menses since many months.

    Conclusion

    1. In the study it is mostly the young girls in the reproductive age group are affected.

    2. Sensitive issue in a girl’s life PCOD affects the person as a whole , as there is hormonal imbalance.

    3. The importance of diet and general management like weight reduction is well understood.

    4. Though acute symptoms can be taken care with help of specific, for permanent and lasting cure the constitutional and intercurrent remedies are needed.