We have helped many thousands of women since Adharshila was formed in 2004.
Women Health Centre (General Physician)
Legal/ Lee Awareness Session
Basic Fashion Design
Beauty & Wellness
Advanced Fashion Design
Non Formal Education
Spoken English Program
Self Defense Training
Disaster Management Training
First Aid & Home Nursing
Training of SC/ST
Self Help Groups
General Duty Assistant
Dec 2011 - March 2018
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Jan 2005 - March 2018
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April 2012 - March 2018
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July 2010 - March 2014
2005 - March 2016
2009 - Dec 2011
2009 - Dec 2011
2009 - October 2014
2010 - March 2012
October 2015 - Sept 2016
8 groups (151 women)
I am 20 years old and my father would not allow me to study beyond grade 12. Ever since I was little, I have wanted to do fashion design but my father and brother prohibited it. I heard about Adharshila and finally had the chance to pursue my dreams but instead, my father wanted me to marry a man who is 10 years older than I am. This man was also demanding a dowry of 70 Lakhs, more than my family could afford. He claimed he was a doctor in his village but my family never verified his credentials. My father was ready to sell their home in order to pay the dowry, but my mother refused and was beaten every day because of her opposition. My mother allowed me to take classes at Adharshila, but I had to lie to my family about the duration of the program so they would allow me to enroll. After 3 months, my family thought the program was over and no longer payed for the fees. Luckily, I started to receive orders and was able to pay for my own course fees and training material with the money I was earning. My unsupportive brother would raise suspicions to my family and taunt me, but my younger sister looked up to me. Despite all of the obstacles I faced, I was able to overcome these hardships and am making enough money to support my younger sister, who is inspired by my perseverance. She ties ‘Rakhi’ on my wrist instead of my brother’s wrist because she is inspired by my determination and knows that I will be the one that supports her in all of her endeavors.
My parents got married when my father was 7 years old and my mother was 4 years old. My mother was terminally ill but despite her illness, she was able to give birth to me and my three siblings. Because my father was a migrant, he worked as a daily wage labourer until he passed away in 2016. He was only earning Rs.750 per month and my mother was not able to work because of her illness. I remember when I was in school, I had dreamed about being a teacher. I loved learning but this was no longer possible when my family did not have enough money to buy me notebooks for school. Even though they only cost Rs.2, this was more than my family could afford. My grades plummeted because I was unable to write down the information I was learning, and my hopes of being a teacher shattered. After I finished high school, I began working at a local NGO and taught a sewing class to 80 students every day. I was making Rs.1000/- month and was the sole supporter of my sick mother and younger brother. While I was working at this NGO, I heard about Adharshila’s fashion design program and decided to enroll. Because of the money I was earning while taking the MasterG course, I was able to enroll a university program and I just passed my second exam for the Bachelor of Arts while doing a full time job at MasterG to support my family. Many people ask me how I was able to do all of this, but I didn’t know anything else. My family had no other option so I took on these challenges and made the most of every opportunity. I am so grateful to Adharshila and the MasterG program for giving me the skills necessary for a good job and a far wage. I am now able to comfortably support my mom and my brother and am very proud that I was able to attend a university.
I spent my childhood seeing my father brutally abuse my mother, physically and mentally. She wanted to leave my dad but was unable to because of my siblings and me, and every day she would come home only to face violent attacks from the man she married. One day, my father broke her leg and from that day on, my mother could no longer return home to the abusive household. After the abandonment from our mother, at the age of eight and six, my little sister and I were left alone to cook and manage the house. Our aunt helped us occasionally, but my father and grandparents refused to help. My father’s family did not allow me to study past 9th grade and did not want me to attend classes at Adharshila. Despite this opposition, I was able to convince them to let me take classes. I borrowed my first fee from my friend, and quickly started learning, working, and earning money to pay my friend back and purchase more materials. Because of this incredible opportunity, I now earn Rs. 10,000 per month and with my savings, I have bought a machine and a gold pair of earrings to give to my aunt because she was the only one that supported me. I am also supporting my little sister so one day she can grow up and be financially independent. I was also able to purchase a smartphone, which is an important item for my business. One day, I want to be a successful fashion designer like Gayatri Madam. Her confidence and skills inspire me, so I one day hope to be like her.
My father was the breadwinner in a family of six so he could not afford to pay for all of our education. After grade 12, I had to stop my schooling and my parents wanted me to marry as soon as possible so they could be free of their responsibilities. I got married at the age of 20 but was not ready to shoulder the responsibility of a big family. In my spare time at home, I would stitch my clothes and so when my sister in law introduced me to Adharshila, I was very happy. As I learned better finishing techniques, my interest in fashion design grew and so did the number of orders I received every week. I started earning Rs.4000 per month but after I finished my course, I worked in a boutique and earned Rs. 8000 per month. I have now trained over 100 girls at home for a small fee, so they can also be financially independent. With the support of Adharshila and MasterG, I have now opened a shop and my husband supports me in this venture.
At the age of 11, I started making clothes for my dolls with leftover fabric from my moms stitching and staples I found around the house. My mother was my inspiration and my dream was always to become a fashion designer. I started looking for institutes that offered these courses, but the cost was too high for my family. I was very discouraged until I received Adharshila’s pamphlet which gave me a new ray of hope. My mother and I walked to the center and we were convinced that this course was going to be beneficial to my success. She supported me for six months and after that, I started earning enough to pay for my own fees. I offered my first earnings to my mother but she told me to save it to fulfill my dreams. After the course finished, my teachers helped me get a job in a boutique for Rs.10,000 per month. Initially my father was worried about the conditions and safety of the workplace but after visiting the shop regularly, he allowed me to work there. Recently I got engaged and I convinced my fiance to allow me to open my own boutique in Allahabad after the wedding.
My mother married at the age of 16 and was mentally and physically abused by her husband. She would repeatedly leave her husband’s house and seek shelter at her parent’s home but they were not keen to support her. One day, she took my siblings and me and left. In order to support us, she worked as a maid and at the hospital cleaning toilets. Later, she got a job in an expatriate’s house where she earned a better wage. Under the influence of our father, one day my brother beat my mother so badly that she made him leave our home permanently. Because of all of the abusive behavior from the male figures in our lives, my mother realized the importance of making me and my sister financially independent. My mother enrolled me in a pattern design institute, but I was not happy with the curriculum, so when I heard about Adharshila, I enrolled with the dream that one day I will open up my own boutique.
A 30 year old lady came with a history of recurrent abortions. She had been married for 12 years and had a history of 5 previous abortions, all at around 6-8 weeks of pregnancy. She had undergone some tests for infertility and they had been found to be normal. Dejected, she had stopped all treatment. She was treated with a course of antibiotics and given preconception folic acid for a month. She conceived but was very apprehensive about pregnancy. However, she came regularly for checkup and followed advice given to her. She underwent routine investigations and was started on prophylactic aspirin. Anaemia and intrahepatic cholestasis of pregnancy were managed. We were very anxious when she developed preeclampsia at 35 weeks of gestation, though BP remained in control with anti-hypertensive medication. Then, the patient developed chicken pox at 38 weeks of gestation, which can be dangerous for both the mother and the baby. She went into labor 5 days after the onset of lesions and delivered a boy baby weighing 2kg.
The patient is very thankful to Adharshila the medical staff at Adharshila centre for supporting her throughout her pregnancy giving her advice virtually at her doorstep, and finally bringing a smile to the whole family.
A 21 year old second gravida with a previous normal delivery came for a routine antenatal checkup. On examination, she looked anemic at about 16 weeks of gestation. She was investigated and found have A Rh-ve blood group. Her hemoglobin was only 6g%. She was counselled that her pregnancy was high risk in view of severe anemia. Her Rh-ve status would make it more risky in case she required blood transfusion as Rh-ve blood is more difficult to procure when required. She was given advice on her diet, dewormed and started on oral hematinics. After a month, a repeat Haemoglobin was done to gauge her improvement. Her Haemoglobin was 7g%. She was now counselled for parenteral iron injections. She came regularly for review. After another 2 months, her HB had only improved by another 1g% to 8g%. She was at 28 weeks of gestation at the time. After having taken 10 painful iron injections, she was reluctant to take any more. She was hence motivated to take oral iron and a good diet rich in proteins and iron. She was called for review every week so that she was under constant monitoring and counselling. At 34 weeks, her HB improved by another 1g% and finally at term she reached a Haemoglobin of 10.3g%. She delivered a healthy baby girl on 25 July 2012. Both mother and baby are doing fine.This case showed us that both regular antenatal checkups for almost 5 months along with high motivation level in the patient were required to improve the general condition and the Haemoglobin level of the patient.
A young woman came into the Tigri Healthcare center when she was 18 weeks pregnant and the ultrasound revealed that she was having twins. To prevent any complications the Adharshila doctor put her on protein supplements to promote healthy growth of the babies. However, at 30 weeks the patient developed obstetric chastises, a condition in which the liver function becomes deranged and liver enzyme levels rise to fatal levels. She was immediately advised to take liver protective medicine. Due to the antenatal care provided by Adharshila, her pregnancy continued smoothly thereafter and she delivered two healthy baby girls.
A 24 year old gravida 5 with history of 1 previous preterm delivery 4 years ago (live issue) and 3 abortions thereafter presented in the OPD at about 6 weeks of gestation. She was very anxious and wanted to continue the pregnancy. On examination, she was underweight and pale. She was anemic on investigation, though at 10g%. She was advised rest at home and counseled about her diet and the importance of having a positive attitude. It lasted till 14 weeks of gestation when she came in one morning very worried because she had developed vaginal bleeding the night before. The cervix was closed on examination and she was found to have a low lying placenta on ultrasound examination. She was reassured and advised rest. At 20 weeks, her HB was 9g% and she had no more bouts of bleeding. At 28 weeks, she was clinically found to have moderately growth restricted baby. So, she was given protein supplements and hematinics. An ultrasound for growth profile revealed that placenta had moved up and there were no gross anomalies in the fetus. She was regular in her checkups and followed advice religiously. She was happy to deliver at term a healthy baby boy weighing 3kg.Tender loving care and regular follow up play an important role in improving maternal and fetal well being and thus decreasing maternal and infant mortality.
This 16 year old girl came to the OPD with complaint of never having had periods.. She also gave a history of blood transfusions for anemia two years ago. There was no family history of anyone having a similar problem. O/E- she was short-145cm and weighed 41kg. There were no markers of chromosomal abnormalities. She was very pale. Secondary sexual characters were well developed,. She was investigated. The reports showed that she was severely anemic. Her Hemoglobin was only 4.6g%. She had a high eosinophil count of 20. The thyroid and other hormones were in the normal range. Her Ultrasound report was also normal. She was dewormed and given dietary advice. She was started on iron and folate therapy for correction of anemia. She followed advice and took medication regularly. Her repeat Hemoglobin was 9.4%. She attained menarche when her Hemoglobin levels improved. We are left wondering whether it was only the severe anemia which prevented her from attaining menarche.
This 24 year old lady, came to the OPD at 8 weeks of pregnancy. She had 1boy aged 8 years. She had delivered a baby boy 6 years back with congenital spinal problems but had lost the baby. She had had a stillbirth 3 years back. She had jaundice during the pregnancy. She had undergone cholecystectomy 4 years back. On examination she was pale. She was investigated and found to have anemia and a urinary tract infection. She was treated for the same and followed up. At 16 weeks gestation, she had low serum proteins. She was advised a high protein diet, protein supplements and hematinics. Her HB levels improved. At 28 weeks gestation, she developed itching all over the body and mild jaundice. Her bilirubin levels were marginally raised and also the liver enzymes. In view of the previous bad pregnancy outcome, she was treated as a case of intrahepatic cholestasis of pregnancy and monitored very carefully. The foetal Doppler also showed a high resistance flow in circulation indicating that the baby was receiving less blood. However, she was managed till term when she had a normal delivery. Baby weighed 2.6kg.Her postnatal recovery was normal and her liver function became normal at 6 weeks postpartum.
This 22 year old lady, married for 3 years came for investigations for recurrent abortions. She had a spontaneous abortion 2.5 years ago and another one 2 years ago. Thereafter, she could not conceive. She was investigated and diagnosed to have endometrial tuberculosis. She was started on antitubercular medicine. She conceived after 2 months and followed up regularly. She was advised protein and iron supplements and iron rich diet. She went into a preterm labor at 35 weeks of gestation and underwent a caesarean section for a breech presentation. Both mother and baby are doing well.
A 78 year old lady presented to the OPD with history of itching in the genital region for many years. She had not taken any treatment for it. She was postmenopausal for past 30 years. She was hypertensive, but not taking any treatment. She had no systemic findings on examination. Locally, there was hypo pigmentation of vulval area with thickening of the skin due to the constant scratching for so many years. She was treated with local antibiotics for local infection. She was also given local oestrogen cream for few weeks followed by topical steroids over the next few months. She has had immense relief and now requires only intermittent treatment for the same. She is happy to be in control of the intensely embarrassing problem as she perceived it.
A 27 year old lady came to the OPD with inability to conceive after one year of marriage. She was treated for vaginitis and then given preconceptional counselling. She conceived spontaneously and progressed well till 24 weeks of gestation when she developed fever with chills and rigors. She had pain in the right lumbar region and an increased frequency of urination. Her urine routine showed a field full of pus cells. An USG done showed dilatation of the right ureter and renal pelvis. In view of an ascending urinary tract infection she was advised admission to a hospital, but as she improved symptomatically with oral medication, she continued treatment here. Her repeat urine examinations after 2 weeks and four weeks of treatment also showed infection. Hence she was treated for the same and further put on prophylactic antibiotics throughout pregnancy in view of higher risk for preterm delivery, and growth restriction etc. She was monitored closely, but had a preterm rupture of membranes at 36 weeks. She was delivered by caesarean section in view of non-progress of labor. She had a baby boy who weighed 2.6kg at birth. Mother and baby are doing fine.
A 23 year old lady came to the clinic with anxiety to conceive. She had been married for 3 years. She had delivered a baby 2 years ago but the baby had died immediately after birth. She was obese and anemic. She was advised diet modification and regular exercises. She lost 5kg and conceived spontaneously and is coming for regular antenatal check up.
A 35 year old lady, presented 6 months ago with pain lower abdomen and increased frequency of periods since 6 months. She was examined and found to have signs of pelvic infection. She underwent an USG examination which showed signs of pyometra (pus in uterus). She was treated with appropriate antibiotics and was started on cyclic hormonal pills for 3 months. She had symptomatic improvement in abdominal pain and now has regular menses since the past two months.
A 25 year old gravid 2 with no live issue presented to the OPD with pregnancy of 5 months duration. She had not gone for any antenatal checkups till then. She had delivered her first child at home who died within few hours of birth. She was pale. Uterine height was more than the period of gestation and uterus was tense. She was started on tocolytics and then investigated. USG revealed hydramnios (increased fluid around the fetus). She was monitored frequently to detect any complications. She developed bronchitis at 30 weeks and high blood pressure at about 35 weeks which was monitored and treated. She went on to deliver at 38 weeks, a healthy baby boy weighing 2.6kg.
A 13 year old girl was brought by her mother with history of onset of menses 4 months back. Since then, she had heavy, irregular and prolonged cycles lasting 10-12 days. On examination, she was a thinly built girl, 150cm tall weighing just 32kg. She was pale and had a haemic murmur in her heart. She was investigated to rule out any coagulopathies, endocrine or pelvic pathologies. As none were found, she was given medication to improve her general condition and regulate her cycles. She was also given advice on pubertal changes including diet and psychology. She was on hormonal therapy for 6 cycles. Then she was given locally acting medicines during menses for another 3 cycles. This has controlled her excessive bleeding. In the past one year, she has become a confident young lady with a positive attitude. Her height and weight have also improved – 156 cm and 38 kg.
A 26 year old lady came to the OPD with history of 26 days amenorrhea, pain lower abdomen and burning urination. She had a history of 3 abortions at 2.5 to 3 months amenorrhea, and had undergone D&C each time. O/E, her general condition was fine. Her vitals were stable and her abdomen was soft. The uterus was just bulky and the cervical movements were tender. With a differential diagnosis of UTI, PID and ?early pregnancy, she was given a course of antibiotics and asked to come for a review after a week. Her pregnancy test was positive. As she was very anxious, an USG was asked for, which showed a very early gestation. Fetal heart was not seen. This increased her anxiety levels. She was given reassurance on each visit. An USG after 2 weeks showed the presence of Fetal Heart beats which allayed her fears. However she persistently had pain abdomen.13 weeks USG for screening showed a posterior low lying placenta. She was advised rest at home. During regular follow up, she needed treatment for cystitis, vaginal infection and dental caries. Due to clinical suspicion of low weight, an USG for growth profile was done at 32 weeks. It showed growth restriction but Doppler studies were normal. She developed mild Preeclampsia (high blood pressure with protein in urine) at about 36 weeks and started on antihypertensives. She delivered a baby girl weighing 2.04 kg by caesarean section at 38 weeks.
A 25 year old lady 145 cm tall weighing 35 kg presented with infertility and general weakness. She had pallor and vaginitis on examination. She was given treatment for vaginitis, diet counseling and treated for anemia. She came back to us with early pregnancy in just 2 months. She came regularly for follow up thereafter. She progressed well till 27 weeks when she fell down the stairs and developed threatened preterm labor. She was managed conservatively with rest and tocolytics. She responded, but had recurrence of contractions at 34 weeks gestation. She was given antibiotics and steroid injection for fetal lung maturity. She continued pregnancy till term and delivered vaginally a 2kg baby girl.
A 32 year old lady came with a history of 3 months gestation. She was a gravid 5 with one live baby delivered by caesarean section followed by 3 abortions at 2 to 2.5 months gestation. She wanted to continue the pregnancy without mishaps but was unable to afford the costly injections Fraxiparine and Progesterone. She was only willing to take oral supplementation of progesterone. She was hence continued on this and oral iron treatment for anemia. She developed a constant pain abdomen throughout the pregnancy for which no particular cause was identified till delivery. She was treated for UTI, gastritis and threatened preterm labor and regular monitoring was done for fetal well being. Her HB levels hovered at around 8.5g%. She was finally delivered at term by LSCS – a baby girl weighing 2.6kg. She is very happy that she has finally been able to complete her family. Her HB has now come up to 10g%.
A 40 year old lady came to the OPD with pain in the left lower abdomen radiating to the thigh, with the pain increasing during menses. She had burning urination and was on homeopathic treatment. She had been operated twice for swelling in the breasts–benign lesion and treated for pulmonary tuberculosis 2 years ago. She was very anxious as her mother had died of some cancer in the abdomen (she did not know whether it was ovarian tumor). She did not have any menstrual complaints. She was examined and found to have a swelling in the left fornix. Her ultrasonography revealed a left ovarian cyst with low level echoes measuring 44.6* 46.2* 49.2cm in left ovary, with a provisional diagnosis of endometriotic cyst. She was counseled that medication would be tried for 2 months. If symptoms worsened or new symptoms appeared, she would be further investigated and further treatment advised. She was given antibiotics and hormonal tablets for 2 cycles. Her repeat ultrasound showed a decrease in size of the cyst to 1.1* 1.2cm. She has been given medication for another 1 cycle to ensure complete resolution of the cyst. She was very relieved that she did not need surgery and that the cyst was not cancerous. She will be under regular monitoring for any recurrence of symptoms.
A 46 year old lady presented to the OPD with C/O bleeding per vaginum for 15 days. She had a history of irregular cycles every 15 – 20 days. She had taken treatment for it a year ago. She had 3 children, with one cesarean section and one surgery for ectopic pregnancy with concomitant sterilization 8 years ago. On examination, she was pale, and had a bulky uterus on palpation. Her USG and thyroid function tests were normal. An endometrial biopsy revealed a hormonal disbalance. She was then tried on medical hormonal treatment for 3 cycles. But she did not have relief in her symptoms. She was hence counseled for surgery and sent to the government hospital for the same. She underwent hysterectomy about 8 months ago. She now comes regularly for follow up. She is very happy to be relieved of her symptoms.
A 19 year old girl with a slightly lower IQ presented at the clinic with complaints of infertility. She had been married for 1.5 years and was troubled by the fact that she had not conceived so far. She was a short-statured, thinly built girl, 142cm in height and weighing only 30kg. She was investigated and found to be severely anemic. Her hemoglobin was 6g%. She was given preconception counseling, dietary advice and dewormed. She was then started on hematinics. With some improvement in her Hb status, she conceived spontaneously. She came for irregular follow up as her husband was not keen that she went for checkups. However, she tried to follow the advice that we gave. She delivered at around 36 weeks of gestation, a baby girl weighing 1.8kg, at home. She came back for review with her baby. She was very happy and agreed to take a good diet that she was advised.
A 22 year old lady married for 2 years, nulliparous, presented with complaints of dysmenorrhoea and irregular bleeding per vagina since 10 days. On examination, she was very pale. All other systemic findings were normal. Her hemoglobin was 6.2g%. Her thyroid profile and ultrasound findings were normal. She was given locally acting anti-fibrinolytics, antibiotics, hematinics and deworming. Dietary counseling was done. She came back for review and iron tablets were continued for 2 months. With just regular hematinics and correction of her diet, her cycles became regular. She conceived spontaneously. Her hemoglobin level was 9.2g% at this time.
A 26 year old lady presented with 10 weeks of amenorrhea and severe nausea and vomiting. O/E, she was mildly dehydrated. She was treated symptomatically. An ultrasonographic examination showed a single live fetus of 8-9 weeks. She progressed well till 18 weeks gestation when she presented with bleeding per vaginum. She was detected to have a low lying placenta with inferior margin 1 cm away from the os. She was advised rest. At 24 weeks gestation, she had cough,epigastric pain & hepatomegaly. She was treated with ursodeoxycholic acid and medications for gastritis. Pain remained under control, though persistent. By 34 weeks of gestation, her liver enzymes rose sharply. We were worried whether her liver function was getting so compromised that her blood coagulation would also get affected. However, the aim was to take the pregnancy as close to term as possible so that the baby, when born, would have fewer complications. With close monitoring and medication, she reached 37 weeks when she went into spontaneous labor. A cesarean section had to be done for non-progress of labor. A baby boy weighing 3.25 kg was delivered. She had a good post-operative recovery with her coagulation system also functioning well (which we were so tense about). Her liver enzymes have also reverted to normal. Baby is doing fine.
A 22 year old lady presented in the OPD with C/O discharge per vaginum with pain lower abdomen. She had had 2 previous spontaneous abortions at 2 months amenorrhea, last one and a half years ago. She was also anxious to conceive. She was treated for pelvic infection. As symptoms recurred, both partners were again treated. She then conceived spontaneously in the next cycle. She was comfortable till 8 weeks gestation when she developed pain lower abdomen with mild bleeding. She was highly anxious as she had already lost 2 pregnancies. She was investigated and treated with rest and progesterone supplementation for threatened abortion. She progressed well till 22 weeks gestation when she had a respiratory infection. This was treated but there was persistent residual cough which required bronchodilators. At 29 weeks, she had blood in sputum. Hence, further investigations were carried out, and another course of antibiotics was required to be given. She needed bronchodilators due to mild bleeding per vaginum due to cough. Luckily, she did not go into labor till term. She delivered a live female baby at the Government Hospital. Mother and baby are doing well. She is very grateful that she got good antenatal care at Adharshila and is blessed with a live and healthy baby.
A 26 year old patient, G5P4L2 with h/o recurrent preterm labor came with h/o early pregnancy. She had 2 daughters aged 8 and 5 years. Both were born at 8 months of gestation. Then she had a preterm labor at 6 months gestation and the baby died after 1 day. In the next pregnancy, she came to our clinic at 19 weeks gestation for antenatal care. Her weight was 37kg, she had vaginal infection and her hemoglobin was 6g% - all causes of preterm labor. She was counseled about diet. Her anemia and infection was treated. But she was irregular in treatment and went into labor at 32 weeks. She delivered at home and lost the baby. She conceived again after 5 months, but again did not come for review till 19 weeks gestation. When she came, the importance of regular antenatal care was reinforced at each visit. She started coming for regular checkup when she understood the importance, especially in a high risk case like hers. Her general health was improved, anemia and vaginal infection was treated and she was advised adequate rest repeatedly. She went up to term and delivered at the government hospital – a girl baby weighing 2.5kg. She came back for postpartum care. She is very happy to have a healthy baby. Both are doing well.
A 25 year old lady had come on leave from Kolkata. She came to us with a history of irregular periods with scanty flow since two years. She had menses for 1 day every 20 – 60 days. She was married for the past 2 years and was anxious to conceive. O/E, she was found to have vaginal infection and fullness in the right fornix. On investigation, she had urinary infection and a right ovarian endometriotic cyst of 3.5*2cm size. She was treated with antibiotics to cure the urinary infection and pelvic infection. She was given hormones to suppress the cyst and regularize the cycles. She has now gone back to Kolkata and will hopefully conceive soon.
A 22 year old primigravida came to our OPD with C/O 6 week’s amenorrhea and burning sensation while passing urine. She was investigated and treated for urinary tract infection. She became asymptomatic and then went to her village for 2 months. When she came back, she was about 22 weeks gestation. Since uterine height was less than the period of gestation, an ultrasonography examination was done which revealed a gross decrease in the amniotic fluid around the baby, but no gross congenital anomalies. The patient was prepared for a grim prognosis. However, she was managed aggressively with high proteins and fluid therapy. A repeat USG after 3 weeks also showed decreased fluid. But since the fetus was doing well, this line of therapy was continued. Antenatal steroids were given for lung maturity. Doppler studies were done which were normal. The NST was also reactive at 36 weeks. She went into normal labor at term 37 weeks and delivered baby girl weighing 1.8kg. Patient is doing well.
This 26 year old primigravida came to the OPD with C/O amenorrhea of approximately 30 weeks. She had not gone for any antenatal checkup before this. On examination, her vitals were normal. Her uterine height was only 2 weeks. She was investigated and found to have mild anemia. Fetus was of 23 weeks size. Cervix was long and internal OS closed. After 1 week, she had complaints of pain in the abdomen. She was started on tocolytics as uterus was contracting. Pain persisted and hence a repeat ultrasound of the abdomen was done. The cervical OS was now seen to be open with shortening of the cervix. There was cervical incompetence and the patient was in threatened preterm labor. She was advised bed rest and treated with antibiotics for infection, tocolytics and steroids given for lung maturity. She came for weekly review. Pain decreased in intensity and cervical dilatation remained at 2cm. she ruptured membranes at term, and progressed well in labor. She delivered a baby weighing 2.48kg with good Apgar score. Mother and baby are doing well.
A 32 year lady had come from the village for treatment of loss of vision from her right eye. She came to our OPD with complaints of missing her menses. She was G4 with one daughter aged 7 years and 2 spontaneous abortions thereafter. Hence she was keen to continue this pregnancy. Her investigation reports were normal. She was referred to the eye OPD and was diagnosed to have cataract in both the eyes- right more than left. She was advised surgery in the 5th month of pregnancy. When we got her ultrasound done for fetal anomalies in the 5th month, we found that the placenta was low-lying and covering the cervical opening. This is risky as there is a chance of bleeding, putting both the mother’s and baby’s life in danger. So, with this in mind, she underwent surgery but took a lot of care to make sure that she did not strain herself. The placenta moved up as pregnancy progressed and she was also able to see well. She developed a high pulse rate and high blood pressure at around the 32nd week for which she was given medicines. She went on to deliver a girl baby at term. She came back for a review before going back to her village. She was extremely happy to have a baby as well as being able to see.
This 28 year old lady came to the OPD with C/O vaginal infection. She was treated for it and she conceived in the same cycle. She was gravida 7, had one abortion at 4 months gestation due to bleeding and delivered 6 times. However she had only one living child. Her first child was 12 years old and she had lost all the babies thereafter. At presentation, her BP was 140/90 mmHg. She was investigated and found to be Rh negative. She gave a history of being given Anti-D injection only once. With a suspicion of having increased amount of negative blood group antibodies in her blood her indirect coomb test was done. It was negative. She came with h/o bleeding at 7 weeks of gestation. Ultrasound revealed a small retroplacental clot. She was advised rest, progesterone supplementation and started on antihypertensive. She was monitored carefully throughout. Baby was having retarded growth on clinical examination. At 34 weeks gestation, she developed itching all over the body. She was started on medication for intrahepatic cholestasis of pregnancy along with the other medicines. She went into spontaneous preterm labor at 35 weeks of gestation and delivered a baby girl weighing 2kg. She came to the OPD with the baby 2 weeks after delivery. Baby is very active. She is very happy to have completed her family. We have counseled her to use some contraceptives and avoid any more pregnancies. Her BP has also settled now.
This 21 year old, gravid 2 with one previous abortion presented with 1.5 months pregnancy. Her periods were regular. O/E, there were no significant findings. She was routinely investigated and followed up. Her level 2 ultrasound at 20 weeks of gestation was normal. At 24 weeks, she complained of vaginal infection. She was treated for the same and advised a high protein diet. But at 27 weeks, the uterus seemed small for dates. When she returned for her next visit, the baby size was distinctly small. On doing an ultrasonographic examination, there was evidence of asymmetric intrauterine growth retardation with almost no fluid surrounding the baby. She was treated aggressively with fluids, proteins and antioxidants. She took medication regularly. The fluid around the baby improved and the uterine size also increased. At 36 weeks of gestation, a repeat ultrasound was done. The fluid was almost normal, though the baby was still small – just 2kg. She delivered at 38 weeks – a baby boy weighing 2.2kg. She came back for a review. Mother and baby are doing fine.
This 20 year old lady came to our OPD with complaints of increased bleeding during menses. She had an intrauterine contraceptive device inserted and removed in that cycle due to heavy bleeding. She was given symptomatic treatment. She came back after 4 months with history of missed periods. She had conceived in the same cycle after removal of IUD. On examination, she was a short statured lady with uterine size more than the period of amenorrhea. Hence, an ultrasonography was prescribed, which showed a fetus corresponding to the gestational age but with increased fluid around the fetus. There were no anomalies detected. So, she was sent home with routine medications and asked to come for regular follow up. After a month, the uterine size had increased and was more than expected. Another follow up scan was carried out which showed more increase in the fluid around the baby. This causes a concern due to the discomfort in the mother and an increased risk for early delivery, as well as increase in fetal anomalies. However, no cause was found. She was not very uncomfortable and hence was just followed up. She came with history of severe cough and abdominal discomfort at 30 weeks of gestation. She had a bronchial infection which was treated. When cough subsided, her abdominal discomfort was relieved partially. The uterus remained over distended at 34 weeks of pregnancy when she decided to go to her village for delivery. She delivered at home at 38 weeks – a baby boy. She came to our centre with her baby when she returned to town. Mother and baby are healthy. She has been given postnatal advice and contraception advice.
A 26 year old lady, came with her fourth pregnancy with history of three previous abortions at 10 weeks of gestation. She had been on treatment from elsewhere and on regular progesterone supplementation. Her previous three pregnancies had ended in abortions at 2–2.5 months gestation. She was hence very anxious and tense. On examination, uterine size corresponded to period of pregnancy and fetal sounds were well heard. Thus reassured, she underwent investigations. She was found to have urinary infection, which also can complicate pregnancy leading to abortions, preterm labour and a small sized baby, and also flaring up and spreading of infection to kidneys and all over the body. She was hence treated and kept under surveillance. Her anomaly scan was normal. But at 30 weeks, she had repeat urinary infection. Klebsiella was isolated. She was treated with antibiotics and put on preventive medication due to recurrence of infection. At term, she had hypertension and needed medication for the same. She went on to deliver a baby girl at 40 weeks weighing 2.5kg.
A 23 year old lady came to us with 2 months of gestation and mild bleeding per vaginum. It was her fourth pregnancy. The first and third had ended as abortions. She had conceived the second time with some infertility treatment and was delivered by caesarean section 2 years ago at 7 months gestation due to preterm rupture of membranes. She had conceived spontaneously this time. She was found to have a BP of 140/100 mmHg and weighed 83kg. She was advised an ultrasonographic examination which showed a live pregnancy at 8 weeks. She was given reassurance, progesterone supplementation and followed up. Her BP at the next visit was normal and remained so till at 18 weeks it rose to 130/90 mmHg. She was called after another few days for follow up, when BP was 140/100 mmHg. She was hence started on antihypertensive medication. With that, it remained under control. She gained a lot of weight reaching 98 kg by term. There was also a lot of swelling on legs and on abdominal wall. Her investigations showed some protein in the urine, but the kidney and liver function tests were repeatedly normal. The baby continued to present as breech at term. In view of previous cesarean section and the complications of hypertension and obesity, she was delivered by a repeat cesarean section. She has a lovely baby girl. The family is very happy. Her BP and Swelling have come down.
This 35 year old lady presented to the OPD in her third pregnancy with about 11 weeks of gestation. She was investigated and found to have an RH negative blood group. The indirect Coombs test was negative showing that she was not is immunized with the formation of negative antibody in reaction to fetal positive antigen. The anomaly scan was normal. At 23 weeks of gestation, she reported high colored urine and fever. She had jaundice. On investigation, her bilirubin was increased to 10 mg/dl. The liver enzymes were also very high. On antibody testing, she was detected to have Hepatitis E in pregnancy. Hepatitis-E runs a very fulminant course in pregnancy. It can cause many complications including bleeding, acute liver or kidney failure, and even fetal or maternal death. As there is no specific treatment, she was given supportive treatment and advised absolute rest after a physician’s review. She came for follow up after 1 month when she was symptomatically better. Her bilirubin level had decreased to 1.07mg/dl. The enzyme levels were normal. She was followed up and monitored till she delivered at term. Baby was small, at 1.6kg. Baby has been healthy and gaining weight after birth and is doing well. She was a very lucky lady to have survived hepatitis in pregnancy.
A 23 years old lady, third gravida who had delivered twice but had no living issue presented with pregnancy of 5.5 months duration. She was not booked anywhere as her family was not in favor of hospital delivery. According to her history, she had had 2 breech deliveries previously. Both were home deliveries in the village and both babies died at birth. On examination, uterine height was 26 weeks and fetus was found to be in transverse position. In the next visit, the baby was in breech position and remained like that in subsequent visits. It was strongly suspected that there was an uterine anomaly. It took a lot of convincing and repeated reinforcement that she needed a hospital delivery, maybe a cesarean section too, if the baby remained in breech presentation. However, after 2 months, she decided to deliver at Agra. When she was asked to go to Agra at least 4-6 weeks before her due date, she decided to deliver in Delhi itself. She and her family were counseled to go to Safdarjung Hospital and get her self booked there. She did so and even reached hospital in early labor. The family agreed for surgery. A baby girl was born to her on 27-07-2013 at 4:03 am weighing 3kg. The couple is glad that due to the repeated counseling, they in turn were able to get the elders to understand the need for hospital delivery and now they are blessed with a beautiful daughter.
A 27 year old lady came with h/o pain in lower abdomen. She had been to another hospital and been treated for pelvic inflammatory disease. However, as the symptoms did not subside, she came to the OPD. On examination, there was a mass arising from the pelvis upto 16 weeks size and tender. There was a foul smelling discharge per vaginum. Hence, she was started on a course of antibiotics and investigated. On USG, there were bilateral ovarian cysts, right more than left, largest 6.5 * 5.3cm with low level echoes and internal septae. She was referred to the government hospital with a provisional diagnosis of endometriotic cysts. She underwent surgery. On histopathological examination, it was a tumor – mature cystic teratoma. She is now relieved of her symptoms and is very thankful that we were able to diagnose and refer her in time for correct treatment.
A 20 years old Primigravida was brought by her sister-in-law with h/o 28 weeks of pregnancy. The attendant told us that she had developed a mental problem during the pregnancy for which she was on medication from a government hospital. As it was difficult to take her to a hospital OPD and wait for a long time, it was decided that she would be brought to our center for antenatal care. On examination, patient was not well oriented to the surroundings and did not understand or respond completely to the instructions. The uterine height corresponded to the period of gestation. All her routine investigations were normal. Her pregnancy progressed normally. However, her mental condition did not show much improvement even though she was on regular medication. She was careless about her food and her dressing. At full term, she was referred for delivery. She needed to be delivered by cesarean section as she did not progress well. She did not breast feed the baby. But, soon after delivery, her mental condition showed dramatic improvement. She has been taken off medication since one month after delivery. She has come for follow up and is happy and cheerful. She is well oriented and is looking after her baby well. Psychosis in pregnancy is a known disorder which can lead to bizarre behavior by the mother, rarely even to the extent of killing herself or the child. It needs to be recognized early and appropriate treatment initiated.
A 19 year old lady presented to our OPD at one and a half months amenorrhea. She had lost her previous baby at 4 months of age due to fever in the village. She was highly anxious as she had conceived after trying for over one year. On examination, she had a squint. She had never been treated for it. Systemic examination was otherwise normal. She underwent routine investigations, medications and follow up. At 3 months gestation, she developed urinary infection. She was treated for the same and advised diet and fluid intake. At 25 weeks, she developed increased fluid around the fetus. No cause for this was found. Maybe due to over distension, she had threatened preterm labor. However, with medication, she did not progress to preterm labor. She was monitored carefully. She went on to deliver a healthy baby at term. She came for routine postpartum check up where contraception and diet advice was given to her. She is very happy to have received continued care at the clinic.
A 23 year old female tested with complaint of weight gain. She was emotionally very disturbed due to this fact and her husband started nagging her for the same and this had become an issue of marital discord. She also complained of feeling lethargic and disinterested in her routine work. She was diagnosed with hypothyroid, medication was given and she is feeling much better and stopped gaining weight.
A 18 year old female college going student complained of weight gain, irregular periods, hair on the face, lethargic, her routine checkup revealed deranged lipid profile and increased fat in her blood levels. USG revealed polycystic ovaries, she was treated for PCOS and counseled regarding diet and exercise. She is responding well to the medication.
A 27 year old, with 2 previous abortions, presented with complaints of burning urination and pain lower abdomen. Her previous abortions had been at 2 months gestation. On examination, she was febrile. With provisional diagnosis of urinary tract infection, she was asked to get back with investigation reports. Meanwhile, she was started on broad spectrum antibiotics. She was asymptomatic for 3 weeks but returned with recurrence of symptoms. Her urine was packed with pus cells. Urine culture was repeated. An ultrasound examination revealed a left renal stone 5.2mm size in upper pole. She was advised to have plenty of fluids and put on prophylactic antibiotics to prevent recurrent UTI in pregnancy and the complications of kidney infection and systemic spread or preterm labor. She remained asymptomatic, with occasional pain relieved with painkillers. She, however, went into labor at 36 weeks and delivered a 2.5kg boy baby. Definitive treatment for the stone was done thereafter. The couple is very happy now.
A 21 year old lady first came to us in June 2012, with history of 3 months gestation. She had one son aged 5 years. She had since been widowed. Then she had remarried and lost a pregnancy at 2 months gestation. This was her third pregnancy. She was routinely investigated and advised regular follow up. However, after 3 weeks, she reported back with history of being beaten up by her spouse, leading to her undergoing an abortion. On examination, the placenta was retained. This was evacuated. She was then lost to follow up for 9 months, when she returned one day with 5 weeks amenorrhea. She revealed that she had gone back to the village, but reconciled and returned a month before. She now had severe pain in the upper abdomen. When she did not respond to treatment, she was admitted in a tertiary hospital. However, no cause was found. She was treated symptomatically and slowly recovered. At 18 weeks gestation, she came with bruises all over – allegedly beaten up by her spouse. But she again reconciled. They shifted to a village near Badarpur, but after one check up there, she was not satisfied. She kept returning to us for antenatal care. She was treated for urinary infection and anemia. She delivered at term, a healthy baby boy. She came for postnatal care and is extremely grateful for all the support and care she got at Adharshila. Everyone here lent a patient ear to listen to her problems in life. This gave her the strength to overcome these and be positive. Domestic violence is a pressing problem in people belonging to the community that we cater to. Often these women are scared to disclose facts about the physical violence faced by them and therefore cannot be treated adequately. However this patient's disclosure helped us to treat her better with empathy and this improved her obstetric outcome.
A 25 year old lady, G6P5L3 (sixth pregnancy with three living children) came to our OPD with complaints of about 5 months gestation. She gave a history of one stillbirth followed by three live births and then one stillbirth at 7 months gestation due to antepartum bleeding. All had been home deliveries at her village. On examination, she had pallor. She had numerous dental caries and bleeding gums. The uterine height corresponded to her period of gestation. On investigations, she was found to be severely anemic. Her hemoglobin was 7g%. She was started on iron, folic acid, vitamin and protein supplements. However, even after one month, there was insignificant improvement in her hemoglobin level. Hence, she was counseled for injectable iron injections. This brought up the hemoglobin levels to 10g% by the third trimester. The bleeding from the gums also stopped. There was general improvement in her health with the constant counseling about diet and hygiene that she received at each visit.
A 26 year old lady came to our OPD with difficulty in conceiving for the previous 2 years. She had a daughter aged 5 years whom she had conceived after taking some treatment. She was investigated and found to have polycystic ovarian syndrome. In this, patient has disturbance in ovulation cycle and at times needs some medication and monitoring to help conceive. Hence, after counseling, patient was started on medication. However, even after 5 months, patient had not conceived. She was getting highly anxious. High stress levels also are found to decrease conception chances. So, she was advised a rest cycle where no medicines were given to her and asked to get back after a month. She conceived in this cycle and came back with early pregnancy. This was probably as the anxiety levels must have been less. Also, the hormonal milieu would have been favorable after 4-5 months of continuous treatment. She is now coming for regular follow up. Her pregnancy has been without any complications so far.
A 30 year old lady had come to our OPD in August 2012 with history of pain in the left leg on movement since one year. She had been investigated and MRI had shown prolapsed intervertebral disc at L3-L$ vertebra with compression over the nerve roots. She wanted opinion as to whether she could go through another pregnancy. She was given medication and was advised physiotherapy. Once she was symptomatically better, she was told that all through pregnancy, she would need more care and rest so as to not strain her back. When she conceived, she was given routine antenatal care, with symptomatic therapy whenever her symptoms worsened. At the targeted scan at 19 weeks, the placenta was found to be very low. Hence, her requirement for rest increased. The patient was very compliant and took good care. At 28 weeks, the placenta had moved upwards. But pain in the limbs and tingling increased due to more pressure in the area. Symptomatic treatment was what was given. She delivered a girl baby at term weighing 3.5kg. Postnatally, her symptoms have decreased. She is very happy that she has completed her family. Such patients, when they are mentally prepared are well motivated to accept the changes that occur due to pregnancy and bear the symptoms with patience and fortitude. All their pain turns to sheer joy when they have a little bundle of joy in their hands.
A 30 year old lady came with complaints of difficulty in conceiving. She had been trying for pregnancy for the past 10 years. She had one daughter aged 12 years, delivered normally. She had taken treatment from several places for this with no success. She was examined and local infection was seen. She was treated for the same. Routine basic workup for infertility did not reveal any major problems. She was advised on the fertility period of the cycle and given ovulation induction drugs. She conceived in the second cycle and now has an ongoing pregnancy. She is very happy to have conceived after waiting for 10 long years. Sometimes, just basic investigations and advise helps subfertile patients to conceive and should be tried before moving on to more expensive tests and medication.
A 22yr old lady came to Adharshila in March 2014 with history of inability to conceive for last 3 years. After preliminary investigations she was found to have eosinophilia which was treated. Following that she was given 2 cycles of ovulation induction.She did not conceive during these 2 cycles so was asked to discontinue the medications and try spontaneously for three months. She did not conceive in these 3 months and so one more cycle of ovulation induction was given to her in November. In December Pammi came back to us with her pregnancy test positive. Not only had she conceived but her level 2 scan done on 12th March showed that it was a twin pregnancy. Her pregnancy is continuing smoothly and she is now at 21 weeks of gestation. She is very happy to have conceived after 3 years of constantly trying for pregnancy.
A Patient 30 years old came to us on 18.02.15. with history of two and a half months of pregnancy. Her previous history revealed 4 recurrent spontaneous abortions all at 2 to 3 months duration. She was extremely anxious about the wellbeing of her baby. An early pregnancy scan revealed a live fetus of 9 weeks and therefore she was put on Aspirin and hormone supplements to sustain her ongoing pregnancy. At 12 weeks she had a bout of bleeding along with pain abdomen. An emergency ultrasound showed that her baby was doing well and no reason for her bleeding could be found. She was advised complete bed rest and was given 2 injections of progesterone(hormone) 7 days apart. Her bleeding completely resolved.At 19 weeks she had a level 2 scan which showed a normally developing baby. She is presently at 21 weeks of pregnancy and doing very well. Most of the time patients with history of recurrent abortions only need extra care and some hormonal supplements to sustain their pregnancy.
This is a continuation of a success story sent in April 2015 of who came to us with her fifth pregnancy with a history of previous 4 miscarriages. In April she was 21 weeks and her pregnancy was continuing smoothly as a result of hormonal support and nutritional supplements. She was also put on uterine relaxants from 30 weeks so that her pregnancy continues till full term. She finally delivered at 40 weeks normally in Safdarjung hospital on 20th September a live healthy baby girl.
A 23 years came to this centre in October 2014 with 9 weeks pregnancy. The level 2 scan at 18 weeks revealed twin pregnancy and normally developing fetus. She was put on protein supplements to promote optimum growth of the babies and her pregnancy was closely monitored. At 28 weeks another ultrasound was done and both the babies weight was found to be optimal. At around 30 weeks she developed a condition called obstetric chastises in which due to pregnancy liver function becomes deranged and liver enzyme levels rise. As this condition can sometimes cause sudden death of the baby she was immediately put on liver protective medicines and was closely monitored. Her pregnancy continued smoothly thereafter and she delivered normally at 36 weeks on 4th May 2 female babies one weighing 1.7 kg and the other weighing 2 kg.
A 25 year old women came to us with the history of inability to conceive after 1 spontaneous abortion in 2012.She was initially treated for vaginal infection and was given a course of antibiotics as her blood counts were high. Her investigations were normal and so she was given one cycle of ovulation induction medicine. She conceived in that cycle and came to us for her first ANC check up at 7 weeks. Her pregnancy continued smoothly with hormonal support and at 20 weeks her level 2 scan showed a normally developing baby but with a low lying placenta. She was cancelled regarding the complications of low lying placenta like bleeding or emergency operation. At 8th month a repeat ultrasound was done which showed that her placenta had migrated up and was no longer low lying. She finally delivered by emergency caesarean section in Safdarjung Hospital in view of raised blood pressure just before delivery. Both mother and baby are fine and she is very happy to have a baby after battling infertility for 5 years.
A Patient came to us on 17th November 2014 with severe anemia at 6 weeks of pregnancy. Her Hemoglobin was 6 gm. She was put on twice daily dose of iron tablets and her hemoglobin gradually increased to 10. gm. Her pregnancy there after continued smoothly but at 31 weeks she presented with intense itching and large reddish lesions on both legs. She was put on steroids after which her lesions gradually disappeared. At 32 weeks she presented with bilateral leg swelling blood pressure was still normal. At 34 weeks she presented with high blood pressure of 150/100. On repeat measurement her BP was still high so she was put on antihypertensive(alpha Dopa). She was called every alt day for BP check. In spite of maximum dose of antihypertensive BP remained more than 150/100 although her blood inv remained normal. She was then put on second drug labetalol. With 2 medicines her BP remained in control and she finally delivered by caesarean section at 36 weeks.
File No. 4009 came to Adharshila at 5 weeks of gestation with history of previous 3 spontaneous miscarriage. On her first visit she was put on hormonal support in view of her bad obstetric history. At 7 weeks she had an episode of vaginal bleeding with pain. An urgent ultrasound showed a live baby but no cause of her bleeding was found. Her hormonal support continued and she was also put on ecosprin. At 16 weeks she again had another episode of bleeding with passage of clots. As her babies heartbeat was audible she was put on absolute bed rest and an ultrasound showed a normally developing baby with a properly placed placenta. Her pregnancy continued smoothly and at 27 weeks she was put on uterine relaxants as these types of patients have a tendency of going into preterm labour. She finally delivered at 36 weeks by caesarian section a live female baby of 2.5 kg. Both mother and baby are doing well.
A Patient came to us in March 2015 with history of previous two abortions followed by inability to conceive. She had been previously treated for infertility elsewhere with ovulation induction which failed. She was advised basic investigations for infertility and ultrasound revealed polycystic ovarian disease. She was put on medications for a month. In May, patient came back to us with a pregnancy test positive. She was put on progesterone support and an insulin sensitizing medication for three months. Her pregnancy continued uneventfully till 37 weeks when she presented with facial swelling and both leg swelling. Her urine test did not reveal any protein but her blood pressure was marginally high at 133/92. Since this did not warrant medication, she was advised BP monitoring at home for 48 hours. She came back after 48 hours with BP charting which showed BP more than 130/90 on all occasions. In the clinic, BP measured was 160/120. She was immediately given BP lowering medications and referred to Safdarjung hospital. At Safdarjung, she was admitted and her labor pains were induced and patient delivered the next day normally a healthy baby boy. Both mother and baby are doing well.
File No 4534 came to us in July with a past history of three recurrent abortions. Her last abortion was 2 years back after which she was unable to conceive. Basic blood investigations done showed that she had moderate anemia with eosinophilia. She was put on iron supplements and anti allergic medications for three weeks. An ultrasound done showed bilateral polycystic ovaries. She was then put on metformin and folic acid for a month. In November she came back to us with her pregnancy test positive. A scan done at 7 weeks showed a live fetus and so she was put on hormonal supplements and ecosprin in view of her bad obstetric history. She is now 16 weeks pregnant and her pregnancy is continuing smoothly. In certain cases of secondary infertility where patient has been diagnosed with polycystic ovarian disease regularizing their cycles and putting them on insulin sensitizing medicines which can result in successful conception.
Patient came to us on May 2015 with history of previous 6 abortions and 1 live birth. Her last child birth was 3 years back and she was eager to conceive again. Her baseline investigation revealed eosinophilia so she was put on anti-allergic for 3 weeks. After her full course of anti-allergic she was given ovulation induction medications as her first baby was also born by ovulation induction. She came back in the next cycle with her pregnancy test positive. She was immediately put on hormonal supplements in view of her bad obstetric history. She was sent for a level 2 scan at 19 weeks which showed twin babies with one baby having a mild problem with one kidney (congenital hydronephrosis) she was immediately referred to the fetal medicine department of safdarjung hospital where a repeat scan showed the same defect. She was then counseled regarding the need of serial ultrasound and the consequences of the abnormality. An ultrasound was repeated at 28 weeks to monitor the growth of the fetuses and to diagnose any deterioration of the renal problem. The defect persisted in the same degree. Her pregnancy continued smoothly but she went into labour at 34 weeks. She delivered normally in the hospital on 3rd march a boy weighing 1.4kg and a girl weighing 2 kg. Both babies are doing well. The defect of the kidney was found to be minimal at birth and the male child has been told for regular follow up in the pediatric department.
File No 5874 came to us in January 2016 with history of trying to conceive for last 6 years. Her basic investigations revealed that she had Hemoglobin of 8 gm% and a small polyp in her uterus of minimal significance. After correction of anemia she was put on fertility inducing medicines. She did not conceive in that cycle so the dose of medicine was doubled in the next cycle. In April the patient came back with her pregnancy test positive along with the history of one episode of vaginal bleeding .Her ultrasound was done immediately and it showed twin pregnancy with one live baby and one empty gestational sac. She was counseled regarding increased risk of pregnancy loss and was immediately put on hormonal support and bed rest. After 2 weeks of bed rest and medicines a repeat USG was done which revealed a single live baby with complete disappearance of the empty sac. She had a normal delivery and was blessed with a baby girl.
File No 4398 came to the clinic in June 2015 with history of secondary infertility. She had a previous history of one normal delivery 4 years back and was trying to conceive for last 3 years. She was thoroughly examined and treated for vaginal infection initially. Her basic investigations and ultrasound revealed bilateral polycystic ovaries. She was then put on metformin for 1 month followed by ovulation induction with clomiphene for 1 month in September. She came back in November 2015 with her pregnancy test positive. Her antenatal investigation revealed that she was blood group negative and her husband was positive. So an indirect coombs test was done to detect whether her baby was in danger of being affected by jaundice. She had a normal delivery and was blessed with a baby boy.
A Patient came to Adharshila in December 2016 with history of inability to conceive since last 1 and half years. She had previously had 2 full term normal delivery. She had a significant past history of genital tuberculosis which was followed by fallopian tube blockage. She had undergone an operative laparoscopy to open the blockage after which she had successfully conceived the last time. After she came to me her baseline investigations were done and an ultrasound was advised. Both reports were within normal range .Both husband and wife were given a course of antibiotic and in February and March she was given ovulation inducing medicines. She conceived in March. She delivered a female child by caesarean section November 2017.
File No 4565, came to Adharshila in July 2015 with history of inability to conceive for the last 5 years. Baseline investigations revealed no abnormality in either husband or wife. She was counseled regarding the need for ovulation induction and its success rate. After 3 cycles of ovulation induction she came back to us in February 2016 with pregnancy test positive. Her level 2 ultrasound at 20 weeks revealed a normally growing fetus and a healthy pregnancy. She delivered through caesarean section in the hospital a male child.
File No 3831 has been showing in Adharshila since 2014. She had a history of three miscarriages all at early weeks. She presented to me with history of irregular cycles. In her next visit she came to me with positive pregnancy test. An early scan showed no intrauterine pregnancy. However her blood test for pregnancy marker came to be positive but before the titre could rise significantly she started with her cycles proving that it was a biochemical pregnancy only. In December Anju came back with complains of irregular cycles and inability to conceive. She was first put on metformin, once her cycles regularized she was given ovulation induction. After 2 cycles of ovulation induction she conceived. As she had such bad obstetric history of previous 4 miscarriages she was put on hormonal supports from the start. In June an ultrasound for cardiac activity showed a fetus of 7 weeks Level 2 USG at 18 weeks showed a normally developing baby. She delivered a baby girl through normal delivery at Safdarjung hospital
File no 6644 came to Adharshila with complain of inability to conceive for last 3 years and irregular cycles. An ultrasound done showed bilateral polycystic ovaries and husband’s semen analysis showed reduced sperm count. The patient was put on Metformin and husband was put on medications. After taking the medications for 1 and half month patient conceived and she is now in her second trimester. She delivered a baby girl through caesarean section at Safdarjung hospital.
File No 1472 came to us in October 2015 with history of 2 previous fetal deaths. One of her babies died after one day of birth due to congenital abnormality of both kidneys and the second one died at 28 weeks in utero due to sudden bleeding from placenta. She came with complaints of delayed cycles and inability to conceive since one year. USG showed bilateral PCOD for which she was given treatment for 2 months. She came back with Urine Pregnancy Test positive in March. In view of her bad obstetric history she was put on hormonal supplements and aspirin and advised bed rest. She suddenly reported vaginal bleeding in May. Urgent USG showed a low lying placenta and she was counseled and advised complete bed rest along with injectable hormones. Her pregnancy then continued smoothly and her level 2 scan was normal but her low lying placenta persisted. She again had an episode of bleeding at 30 weeks. USG was repeated again at 36 weeks to determine her route of delivery. USG showed that the placenta had finally migrated up. She delivered in a hospital on 15th Nov 2016 a healthy baby girl by caesarean section.
File No 4679 came to us in August 2015 with history of irregular cycles and prolonged duration of absent menstruation with inability to conceive. Her Baseline Investigations were done and it showed severe anemia with HB 6.3 and eosinophilia of 15%. She was put on iron supplement and anthelmintic and anti allergic. At the same time her husband's semen analysis showed low sperm counts. He was also advised medications. She also got an ultrasound done which showed bilateral polycystic ovaries and she was advised metformin. Her husband’s semen analysis was repeated after 3 months which showed improved sperm counts. In June 16 the patient was started on ovulation induction medicines and she conceived after 3 cycles of these medications. Early USG at 7 weeks showed a 5 week pregnancy but no foetal node. She was put on progesterone supplement and advised repeat USG after 2 weeks. At 9 weeks her USG showed an 8 weeks foetus with normal cardiac activity. In December 16 she had chicken pox and was given antiviral medicines. She was also counseled regarding the need for early USG to rule out any anomaly in the baby. At 17 weeks her level 2 was done and it showed normal foetus. She had a baby girl through normal delivery in safdarjung hospital.
File No 3240 came to us in October 2016 with complaint of inability to conceive since last 3 Years. Her baseline investigations showed gross hormonal imbalance with bilateral PCOD. She was put on medications to correct her hormonal imbalance and regularize her cycles for one and a half months. Following this course she was given ovulation induction Medications. Her follicular study showed positive response. She came back in February 17 with her pregnancy test positive. An early pregnancy scan was done which showed twin pregnancy but one sac had a live foetus while the other had no cardiac activity. She has been advised complete bed rest and has been put on injectable hormonal supplement and aspirin to support the pregnancy. The live foetus is doing well. She had a baby girl through normal delivery in the hospital.
File No 6791 came to Adharshila in Nov 2016 with complain of inability to conceive for 3 years. USG done in AIIMS in July 2016 showed bilateral polycystic ovaries for which she had been treated in AIIMS but did not conceive. After she came here she was put on Insulin sensitizing medications for 2 Months. In January she came back with her pregnancy test positive. She was put on hormonal support. At around 17 weeks she complained of severe pain abdomen for which she got an USG done. This revealed a uterine abnormality called double uterus where there are 2 cavities within the uterus and the baby grows within one cavity. As these patients are prone to threatened preterm labour so she was counseled accordingly and given medications. However repeat USG at 19 weeks from our organization failed to reveal any abnormality. She had a baby boy through normal delivery in the hospital.
File no 4757 came to Adharshila on February 2017 with history of two previous spontaneous abortions at 6 weeks and 8 weeks respectively. Her last miscarriage was on March 2016. She was very anxious in view of her recurrent miscarriages and wanted pre pregnancy advice. She was advised baseline blood tests and an infection profile and a thrombophilia profile. All her blood tests were normal. She was put on folic acid and calcium supplements and advised to try for conception. Anuj came back after 2 months with her pregnancy test positive. She was immediately put on oral progesterone and was advised an ultrasound at 6 weeks. Her early pregnancy scan showed live fetus. She was immediately put on injectable hormones weekly and on low dose aspirin and advised bed rest. At 12 weeks a repeat scan was done and baby seen to be growing normally. She has now finished her first trimester and with all the hormonal supplements that she has been put on her pregnancy is continuing smoothly. She delivered in the hospital through normal delivery a girl child.
A 40 years old woman presented at Adharshila suffering from joint pains and tiredness with fatigue since last 6 months. After general examination and blood examination she was diagnosed to have Rheumatoid arthritis with anemia. She was put on disease modifying anti Rheumatic drugs and Iron supplementation. She is currently pain free and is able to do her daily activities without any difficulty.
32 years old female presented at Adharshila O.P.D two years ago with headache and on Examination, she had high blood pressure. A quest to find out the reason for high BP at age of 30 was begun. Her blood on examination (KFT) showed increased blood urea and creatinine which are markers of renal disease. Ultrasound showed contracted kidneys. She was referred to higher centre for specialist opinion. Following that she has been on regular treatment of Blood pressure and anemia from Adharshila since last 2 years. She is able to continue her daily activities pain free and has a good quality of life.
A 70 years old female presented to the OPD Harkesh Nagar on 28th Sep for the 1st time. She presented with severe shoulder pain (Both Sides). She also had general complaints like Decreased appetite, fatigue and exertional breathlessness. On general examination, she also looked pale and emaciated .on local examination her shoulder movement was restricted. She was distressed physically and emotionally with her continuous pain. She was unable to bathe or change her clothes or comb her hair without help. I suspected her to have polymyalgia rheumatica connective tissue disorder. Investigations were done which showed Very High CRP, ESR, a high TSH and Low Hemoglobin all in favor of connective tissue disorder. She has responded very well to empirical therapy and is 75 % better.
A 46 year old female has been a patient of Adharshila, Harkesh Nagar since last 2 years. Diagnosed to have diabetes she had presented with uncontrolled sugars 2 years back. She was taking treatment from ESI earlier which she had to discontinue after her husband’s demise. After almost 2 years of diabetic medication, diet counseling, regular sugar monitoring and weight control she has now achieved optimal sugar control. This will now further decrease complications which she could have developed due to her diabetes. Hence with continuous support of Adharshila. She can lead a healthy life inspite of being diabetic
Patient came to us in April with history of recurrent miscarriages. She had 3 miscarriages previously at 3 months the last one in 2015.When she came to the centre she was around 1 and half months pregnant. An early ultrasound was done at 6 weeks to ensure a live fetus. She was then put on injectable hormones weekly for 4 weeks. After a month of injectable hormones she was given oral progesterone and aspirin to keep her blood flow to the placenta and uterus smooth. Level 2 scan was done at 19 weeks which showed a normally developing fetus. Her hormones were discontinued after the 5th month and only iron, calcium and ecosprin continued. She had a normal delivery in the hospital and was blessed with a baby boy August 2017.
File no 7602 came to us in early 2017 with history of recurrent abortion after her last child birth in 2010. She had 2 Spontaneous abortions in 2016 and early 2017 followed by inability to conceive and irregular cycles. She was given Hormones to regularize her cycle for 3 months which was followed by spontaneous conception in July 2017. In view of her bad obstetric history she was given early hormonal supplements and Ecosprin. Had a baby boy through Caesarean section.
File no 7463 came to us in August 2017 with history of 4 years of married life and inability to conceive. After doing her baseline investigations and her Husband semen analysis it proved to be a case of unexplained infertility. She was put on ovulation induction in September. She conceived after 2 cycles of ovulation induction. At present she is in her first trimester and early pregnancy scan has showed a normally developing intrauterine baby. She had a normal delivery in the hospital and was blessed with a baby baby girl.
File No 7481 came to us in August 2017 with history of secondary infertility. Her first child was delivered 4 years ago following which she was finding it difficult to conceive since last 3 years. All baseline investigations were done which revealed that the patient had Polycystic ovarian disease. Patient was put on Insulin sensitizing medicines for 1 month which let to regularized cycles .This was followed by Ovulation induction medicines for 2 months. Savita came back in November with her pregnancy test positive. An early ultrasound at 7 weeks showed a corresponding fetus with positive cardiac activity. She was immediately put on Injectable hormones. PCOS cases are on the rise due to poor living conditions, poor hygiene and poor nutrition. Polycystic Ovarian Disease is gradually becoming one of the leading causes of infertility but is to a large extent treatable by lifestyle modification and certain medications. However in spite of medications polycystic ovary patients have a high miscarriage rate as happened with this patient.
One HIV+i've patient reported with pregnancy. On repeated requests the husband was not willing to come for counseling and understand the impact of having babies. HIV+ patient she was sent to Safdarjung Hospital for further Test and Management in view of her high risk status. Junior doctors misbehaved with her saying no. this is her 4th pregnancy they will not deliver her and refuse to register her in the hospital. She came back to us and was then sent to the HIV testing center of Safdarjung Hospital. There both she and her husband were tested and turned out to be positive. She was then referred to the Obstetrics Department of Safdarjung Hospital by the HIV Centre of Safdarjung Hospital which ensured that they could not refuse. She had a normal delivery and was blessed with a baby girl.
File No: - 3289. Presented at Adharshila General OPD 6 months back was uncontrolled diabetes. Her Sugars were more than 350 mg/dl. Her HbA1C > 9.0 and the kidney function test were also deranged. With Medication Concealing and regular sugar monitoring, her sugar is well under control and HbA1C is now less than 7.0. Her risk of developing complications has decreased.
File No 2328 came to Adharshila on January 2018 with secondary amenorrhea on and off for last few years since her first child birth. She was also keen to conceive again. Baseline investigations were done which revealed bilateral polycystic disease along with Hyperprolactinemia. She was put on Cabergoline and Metformin for a month. Once her biochemical parameters improved she started having regular menstruation. She was then given ovulation induction in March and she conceived in the same cycle. Early foetal scan showed a normally developing fetus. She was then put on Injectable Progesterone and other supplements. She has delivered a healthy baby boy.
File no 5763 came to the centre in April 2017 with history of secondary infertility. Her previous obstetric history was that of delivering a congenitally malformed baby who died after a few hours of birth. Her baseline investigations showed that she had an ovulatory infertility. She was started on medicines for ovulation induction from July 2017 and she conceived in October 2017 after 4 cycles of medicine. Early pregnancy scan showed that she was carrying twins. She was then put on hormonal support and low dose Aspirin and her pregnancy was very closely monitored. Frequent scans were done to monitor growth and well-being of the fetuses. Her pregnancy continued smoothly till 37 weeks and she went on to deliver two healthy female babies normally in Safdarjung hospital on 26th July. Mother and both the babies are doing well.
File No.8076 came to Centre in April 2018 with complain of inability to conceive for last three years. In May 2018 she came back with spontaneous conception and pregnancy test positive. An early USG was done to check for cardiac activity which showed a rare congenital uterine malformation known as bicornuate uterus. The patient was extensively counseled regarding the need for bed rest, chances of miscarriage and increased incidence of preterm births. She was put on injectable hormonal supplements and was advised absolute bed rest till the end of 3rd month. USG was repeated at the end of 3rd month and no abnormality was seen in the fetus. Level 2 scan was also normal. She was then put on uterine relaxants from 6th month as they have very high chance of going into preterm labor. Patient delivered in Safdarjung Hospital 1 week before her expected date of delivery by caesarean section a healthy baby girl.
File NO. 2328 came to adharshila on January 2018 with history of secondary amenorrhea on and off and wishing to conceive. Baseline investigations were done which shown B/L PCOD and Hyperprolactinemia. She was put on metformin and cabergoline. With this medication she started getting regular periods. However as soon as cabergoline was stopped she developed high levels of prolactin. A head CT was advised to analyze the reason of raised levels, she was put on cabergoline her prolactin level came down within normal limits.She was given Ovulation induction in March and she conceived in that cycle. Early scans showed normally developing fetus. She was put on Injection progesterone and other supplements. Level 2 scan done at 20 weeks showed normal fetus. Her pregnancy continued smoothly and she delivered a healthy baby in December.
File No. 5763 came to adharshila in April 2017 with history of secondary infertility. Her baseline investigation showed that she had ovulation failure. She was started on medicine for ovulation induction .After 4 cycles of ovulation induction she conceived in October 2017 .Early pregnancy scan done showed her to be carrying twins. She was then put on hormone supplement and low dose aspirin and her pregnancy was monitored very closely. Frequent scans were done to monitor growth and well-being of fetuses. Laxmi delivered healthy female babies normally in Safdarjung hospital on 26/07/2018. Both mother and babies are doing well.
File No. 8076 came to Adharshila in April 2018 with complaint of inability to conceive after 3 years of marriage. However in May 2018 she came back with pregnancy test positive having conceived spontaneously. An early ultrasound was done to confirm cardiac activity which showed rare uterine malformation known as bicornuate uterus in the patient. Patient was counselled regarding the complications of this kind of uterine malformation namely recurrent miscarriages, preterm birth need for caesarean section, for delivery. She was put on injectable hormones and absolute bed rest, till the completion of third month of pregnancy .USG was repeated at the end of third month which showed no abnormality In fetus. Level 2 scan at the end of fifth month was also normal. She was then put on uterine relaxants from 6 months as these patients have high risk of preterm labour .Patient finally delivered in Safdarjung Hospital at 38 week by caesarean section a healthy baby girl.
When I was young, I used to stay very reserved. I didn’t talk much and when I did, I would stammer. Due to my stammering, many schools refused to give me admission. I was actually 7 years old when I got admission in the standard. When I finally joined the school, the kids would make fun of me because of my stammering and I got very disturbed. I was hoping that the teachers would support me and tell the students to stop making fun of me but just like everyone else, they laughed at me when I spoke. Even during class the teachers used to question me, just for their entertainment. But finally, due to God’s grace, my stammering stopped. After this my confidence inclined; I started writing poems and articles, which got published in various magazines and I was awarded with the “Best Writer Award” in a campus writing competition.
After school I was working as a social worker and I became very popular amongst the youth because of my command over my words and my motivational speeches. I am so much influenced by it that I always dream to open my own NGO to work in the interests of people and I will name it “Sab ki Khushi”.
Ten months ago I came to Delhi to further my studies. I heard about Adharshila and joined their computer program. Since joining, I have gained more knowledge about data entry, managing softwares and other technical computer skills. This knowledge has made me more confident and has led me to wonderful opportunities that will continue to further my career and help me accomplish my dreams.
He also wrote this poem for Adharshila that we would like to share:
From a very young age, my father worked as a plumber. Due to a lack of money, one of his siblings had to sleep without food everyday. Because of these struggles he experienced as a kid, when he got married, he would beat my mother. I did not understand what was going on when I was younger, but now I realize how abusive he was to her.
When I was in 3rd standard I got very sick and my parents used all of their savings and had to borrow money from my grandparents for my treatment. My mother had to start working and my sister had to stop her studies to take care of me.
I cleared my 6th grade exams without much effort but after that it was very hard to do well in school and recover from the illness. Despite the challenge, I finished my schooling and a friend of mine introduced me to Adharshila where I joined the basic computer course. My instructors were very accommodating and supportive of me and helped me get a job at “Mass Callnet pvt ltd.” I had such a great experience with the first course that I recently stopped working and enrolled in the advanced computer course so I can get an even higher paying job.
My father came from a large family and he was the eldest son. His family experienced a severe family crisis and they had no source of income. My father worked in a farm but was not earning enough money so he started working in a grocery shop near a railway station. When he moved to Manesar he only had Rs. 2800 and had to pay Rs, 1300 for rent. Since he had the knowledge of Pundit, he started conducting puja in companies and managed to earn Rs. 4300/- per month.
As I was growing up, I was admitted to a government school where I scored almost 100% every year. However, when I was in 9th standard, I started spending time with the wrong people and my school performance decreased. My mother noticed this and she worked with me and my teachers and they helped me get rid of that negativity so I could focus on my academics. Some of my teachers discouraged me because a few of my scores were not as high as they should be, but I got the opportunity to take part in the Pulse Polio mission and earned Rs. 10,000 Rs/-. The department noticed my hard work and named me “BEST PERFORMER OF THE YEAR” and promoted me to team leader of 10 teams in Delhi/NCR.
After that finished I was unsure of what to do, but when I heard about Adharshila’s computer courses I decided to enroll since almost all jobs require computer knowledge. After completing the first course, I immediately found a job at a cafe and look forward to continuing my career.
When I was younger, I did not want to study. I attended a private school and because my teachers gave me personal attention, I did not have to try that hard. My older sister was very supportive of me, but sometimes asked my father why he was spending so much money to send me to school when I did not put in much effort. Even though she did not understand my father’s decision to spend money on me, she still worked in a nearby company to help keep the family financially stable.
A little while later, my family went through a financial crisis when my father gave my uncle Rs 50,000 to make a new tube well in their fields. My father lied to my mother told her that he was going to buy property in a nearby village. My mother eventually found out and when my uncle did not name the tube after my father but named it after himself instead, my family realized that my uncle was not to be trusted.
I have now passed my 12th grade exams and dream to be a fashion designer. I realized that to be successful, I would have to know how to use various computer systems. I joined the basic computer course and have learned many important tools. I will then take the fashion design course and finally be able to achieve my dreams.
My family came to Delhi five years ago. My two eldest brothers came here in search of a job and they never returned back to our village. After a few years, my mother and youngest brother also permanently moved to Delhi. For a while, everything was going smooth but then one of my brothers fell into the wrong habits and started abusing alcohol. He moved away and it completely destroyed my family. Since my father was not in our lives, my two brothers struggled to provide for our family without the help from my other brother. About a year later, my youngest brother was diagnosed with blood cancer and my family did not have enough money to pay for the proper care. My family was in a financial crisis and I wanted to help in any way that I could. I heard about Adharshila and joined the computer basics course. After finishing, I immediately received a job working at “Crossroad pvt ltd.” My brother recently passed away and my family is very upset. I then joined the advanced computers course at Adharshila because I know my brother would want me to provide for my family. I am now able to support my mother and it is all because of the opportunities at Adharshila.
My parents had an inter-caste marriage and everyone was opposed to it. It was so bad that my mother had to live at church for two months because my father’s family wanted to kill her. My father would beat my mother under the influence of his family and they hid all of the the healthy food so she would not have a proper diet during her pregnancy. On the occasion of my brother’s birth, there was a celebration but my grandmother stole all of my mother’s gifts and money for herself.
Since I am a girl, there was no happiness or celebration when I was born. My aunt would steal my nice jewelry and blame my mother for it, but my mother would never get upset because it was the sacrifice she made for her family. My older brother got very ill and he told me that he wanted me to become independent and successful. He knew I had always dreamed of becoming a fashion designer and he told me to follow my dreams. Because of him, I enrolled in Adharshila’s basic computer course and have the knowledge necessary to design on my own.