H/o tuberculosis 18 year girl complain upper abdomen pain,, heavy bleeding menses with pain 7 days continue DX AND RX suggest



Menorrhogia with polycystic ovarian disease, advised anti spasmodics during menses.

put this girl on a combination of cypoterone acetate and ethanil estradio l ie krimson 35 for 21 days and break for 7 days continue this therapy for 3-6 months with adv to do exercise and diet modifications she will respond add trenexa during menstrual cycle for heavy flow.But try to rule out activation of genital TB which is difficult to diagnose perse .

recurrence of genital tuberculosis ,start her on 5,drug regime with streptomycin .750 alt day

for 2mths

This looks like a case of pcos... Call for TSH.,FSH, LH, DHEAS, serum testosterone levels, at appropriate times of cycle... For relief of menorrhagia prescribe tranxemic acid preparation and put the patient on metformin or /and myoinositol for pcos... Send menstrual blood for TB PCR and culture to confirm any tuberculosis.... USG findings though consistent with PCOS, it mostly presents with oligomenoerrhoea rather than menorrhagia.... Proper menstrual history should be elicited as to if the patient gets cycles regularly or not....

rule out t.b and other infections. control bleeding with inj etasylate I'm or inj Revicii.antispasmodicshould b given.tab kstat t.d.s to b given.Haematinics can help.after abd.t.b ruled out.treatment for t.b for one year .

rule out genital tb by tb pcr of menstrual blood. for pcod get lh and fsh levels to see hormonalstatus. tb. trapic mf 650 mg bd to control bleeding. in usg et is high which suggest amenorrhoea followed by heavy bleeding. reconfirm history. high dose ocpill for 3 m th for irreegular peroids

genital t.b. never leads to increse bleeding in fact it causes oligo. complain is upper abdomen pain get usg whole abdomen and cbc with esr it may be other bleeding disorder picture will clear after these simple investigation pcod in fact not a cause of heavy bleeding and pain upper abdomen get usg whole abdome and cbc esr first

its PCOD. cause of AUB is hyperestrogenic status..tab norethisterone 10 mg bd for 20 days with tranexa-vit k combo tab bd for 5 days.next cycle start high dose oc pill with hematinincs.if pt anemic then give inj FCM 1gm..counselling regarding compliance and patience ..

before 1 year Tuberculosisof treatment complete regular

its pcod ,do CBC ,ESR,TSH control bleeding with tranexa vitamin k ,give haematinic if bleeding not controlled start progesterone or high dose oc pill

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