A 23 years unmarried women having weight 61kg.height 5.4 ..irregular menses with increasing weight

24 year old married obese girl with this classical finding on USG. patient is planning a child. lets discuss management and diagnosis

24 year old married obese girl with this classical finding on USG. patient is planning a child. lets discuss management and diagnosis

A 22 years old female c/o scanty menses for 3or 4 years. Menses short 2 or 3 days only. Menses blackish and cloted. No abdominal or back pain. No other symptoms related to menses. Leucorrhoea constant. Leucorrhoea thick. itching <sleep during. Offensive. Pt is mentally worried. She is late to sleep and late to wake up. Unwanted hair on face.mild hypothyroidism. Wt 70 kgs. Bilateral PCOD. USG report attached herewith. Please suggest Rx.

MY RESEARCH ARTICLE PUBLISHED IN INTERNATIONAL JOURNAL OF MEDICAL SCIENCES.. HAIR-AN SYNDROME WITH PCOS AND HASHIMOTOS THYROIDITIS: (CITE FULL ARTICLE : Kulkarni A, Srivastav SK, Susarla S, Kulkarni U, Ashok Kumar C, Chikkala S, Tabassum SM. Hyperandrogenism-insulin resistance- acanthosis nigricans syndrome with PCOS and Hashimoto’s thyroiditis: case report. Int J Res Med Sci 2015;3:2514-23.) Female hyperandrogenism is a frequent motive of consultation. It is revealed by hirsutism, acne or seborrhea, and disorders in menstruation cycle combined or not with virilisation signs. Several etiologies are incriminated but the hyperandrogenism-insulin resistance-acanthosis nigricans syndrome is rare. A 21-year female, having had a three- year-old secondary amenorrhea, known case of hypothyroidism since 4 years on medication. The exam revealed a patient, hypertensive with blood pressure at 170/110 mmHg with a Body Mass Index (BMI) at 40.08 (Obese Class-3, as per WHO 2004) and a waist measurement of 106cm, a severe hirsutism assessed to be 27 according to Ferriman and Gallwey scale, acanthosis nigricans behind the neck and elbows. The assessment carried out revealed testosteronemia at 1.07 ng/mL, which is more than twice the upper normal of the laboratory. Imaging studies revealed enlarged right adrenal gland, hepatomegaly with fatty infiltration of grade-1 also bilateral polycystic ovaries. The retained diagnosis is HAIR-AN syndrome with polycystic ovaries, hypertension, type-II diabetes mellitus, hypothyroidism since last 4-years and dyslipidemia and was provided with metformin 500 mg thrice daily, spironolactone 25 mg twice daily, atorvastatin 20 mg once daily, telmisartan 20 mg once daily with continuation of eltroxin 50 Mcg for hypothyroidism. To our knowledge this is the first case report of HAIR-AN syndrome in 21 year old female associated with Hashimoto’s thyroiditis, dyslipidaemia, hypertension and type-2-diabetes and this case also highlights about early diagnosis and management of HAIR-AN Syndrome with PCOS and Hashimoto’s thyroiditis which could help prevent long-term sequalae such as cardiovascular disease and endometrial cancer and with the advent of knowledge and availability of health resources we can prevent long-term adverse effects (threefold) on health of women. This woman should be observed for these ailments in later life.

A 35yr female wants weight loss.wt .98kg. thyroid profile report attach.H/o delayed menses once 2 month. plz suggest Rx.....