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Polycystic Ovarian Disease (PCOD)
Presenting Complaints with severity and episode duration
1. Complaints of rough coarse hair over chin
2. Scanty menstruation with spotting for the first two days associated with pain and clots, the menstrual cycle is for 4-5/50 days cycle , with blackish discoloration on Menstrual blood
3. Passing of hard stools once in 3 days
Family History:
Patient’s mother also has the same complaint of PCOD since her Menarche, later after hysterectomy the clinical symptoms have subsided.
Clinical Status
| Allopathy | Ayurveda | ||||||
|---|---|---|---|---|---|---|---|
Vital Parameters
| Asta Sthana Pariksha
| ||||||
Examinations
| Dasa Vidha Pariksha
| ||||||
| Rogi Bala- Madhyama | |||||||
| Roga Bala- Balwan | |||||||
| |||||||
NidanaPanchaka
| |||||||
Differential Diagnosis with reasoning
PCOD(polycystic ovarian disease) Menstrual Irregularity Infertility Hirsutisn acne etc Obesity | Differential Diagnosis with reasoning
Medavruta vata leading to arthava dusti
All the bold markedabove symptoms are present in the patient, so its diagnosed as Medavruta Vata leading to Arthava Dushti. | ||||||
Evidence Based Diagnosis: | Evidence Based Diagnosis: Medavruta Vata leading to Artava Dushti Chikitsa Vivechana: Type – OPT/IPTDuration – 8 days Primary Treatments: Deepana and Pachana: Panchakola Choorna 1tsp twice a day for 3 days Main Treatments:Snehapana: Guggulu Tiktaka Ghrita for 3 days in Arohana Karma, with 30ml on day 1 of Snehapana, 60ml, 90ml and 110ml on the consecutive days. Swedana: Sarvanga Abhyanga by Dhanwantara Taila and Bashpa Sweda for the next three days Virechana: On the third day of Swedana, Virechana Aushada with Mishraka Sneha 40 ml followed by Triphala Kashaya 150ml was given and advised patient to observe for the Vegas. Vegas: Pittanta virechana with 10 vegas. Post Treatments: Chikitsa Paddhati with details of dose of medicine: After virechan
The above medicines were continued for a period of one month followed by virechana Later a rescan was adviced, the reports of which are attached. Arthava pravritti after treatment showed normal colour of arthava with no pain during menstruation , malabaddata was totally recovered with passing of stools once a day | ||||||
| Referral Opinion Sought if any: Patient after the rescan after one month was advised to take the opinion of the surgeon for the persisting endometrial cyst. For the same patient was advised to undergo laparoscopic excision of the same. The same was advised to be followed as the cyst was large enough. | |||||||
| Integrated View: PCOD is a disease which is said to be manifested as the result of medavruta vata leading to artava dushti manifested as a result of altered vata kapha and rasa rakta, artava and medovaha sroto dushti. | |||||||
- Specific Outcome scale used-
| USG : BEFORE TREATMENT | AFTER TREATMENT |
|---|---|
Before treatment USG report: The uterus is normal in size and echo pattern The uterus, measures 59.4 *27.5* 38.1mm The endometrium thickness is 5.9mm hyperechoic Both ovaries have polycystic ovarian pattern Right ovary is bulky with hypoechoic, poorly vascular cyst approximate 54.1*40.9*51.3mm and 59.4 cm3 vol The right ovary measures 63.5* 51.4*59.0 mm and 100.8 cm3vol The left ovary measures 52.2*26.2*20.2 mm and 14.5cm3 vol No free fluid is seen in the pelvis | The uterus is normal in size and echo pattern The uterus, measures 62.8 *24.7* 41.6mm The endometrium thickness is 4.4mm trilaminar Both ovaries have apolycystic ovarian pattern Right ovary is bulky with large poorly vascular hypoechoic cyst? Endometriotic heamorrhagic corpus luteum? Nature : measures approximate 78.5*58.3*78.2mm and 187 cm3 vol Occupy entire ovary right side |
Samyak Lakshanas achieved (Reference- Control Charts)
| # | Outcome Parameters / / Date-Time: | TSD | TED | R |
|---|---|---|---|---|
| 19/10/2014 | 24/10/2014 | 8/11/2014 | ||
| 1 | Sleep (Nidra) | Disturbed | Sound | Sound |
| 2 | Appetite (Agni) | Manda | Sama | Sama |
| 3 | Bowels (Mala) | Constipated | Samyak | Samyak |
| 4 | Urination (Mutra) | Samyak | Samyak | Samyak |
| 5 | Stress (Manas) | Low | Low | Low |
| 8 | BP | 90/60 | 110/70 | 120/80 |
| 9 | Pulse | 62/min | 70/min | 75/min |
| 10 | Weight, Kg | 59.8 | 57.8 | 57.5 |
Patient’s Outcome Scale
| # | Presenting Complaint | Status_TSD | Status_TED | Status_2 Month |
|---|---|---|---|---|
| 1 | Hirsutism | present | present | Present |
| 2 | Scanty menstruation | Present for 4-5 days with spotting for first 2 days. | present | Absent |
| 3 | Painful menstruation | present | present | Absent |
| 4 | Colour of the menstrual blood | Black | Dark red | Normal |
| 5 | Hard stool | Once in 3 days | Regular, once daily | Regular, once daily |
| 5 | Menstrual cycle | 4-5/50 days cylce | - | 4-5/35 days cycle |
Attachments
| Lab Reports | At the start of Treatment 24/09/14 | Post treatment 24/11/14 |
| Lab Reports |  |  |
| Other reports Ca 125 ovarian cancer marker serum | Nil |  |
At the end of the classical Ayurveda treatments complete improvement in left ovary with multifollicular pattern and normal size restoration of the ovary was achieved. Clinically it was evident from the fact that the menstrual period was regular and normal – without pain, and normal in colour and amount. There was an improvement in meda dhatwagani which is evident from the fact that patient has lost 2kgs of weight during the course of treatment.
Disclaimer: * Outcomes may vary from person to person
