OB Gynae Case Studies at Al Raas
1 - Infertility success at Level 1 Care Centre
Age and Profession: 41 year-old school teacher
Absence of monthly periods for more than 6 months; wondering whether she reached menopause
Married for 20 years, not conceived. Detected to have PCOD and hormone imbalance. All investigations and treatments done earlier at different fertility centres in Bombay & Dubai. As there was no positive outcome, the couple dropped the idea of further treatment for conception.
Treatment at Al Raas (Level 1 Centre):
After physical examination & urine pregnancy test to rule out pregnancy, progesterone was suggested as a challenge test. The patient responded, she had periods. With further treatment, Ovulation Stimulation and progesterone cyclically she started having regular periods.
The general feeling of well-being was so good the patient once told Dr. Sasikala, "Doctor, I would like to continue this treatment even if there is no pregnancy happening". The correction of hormones imbalance made the difference in her.
After 6 months of regular treatment, one fine morning, the patient reported to the doctor with a Positive Pregnancy Test.
At the age of 43 years, she gave birth to a lovely baby girl.
2 - Pregnancy
Age: 32 years old; Husband 40 years old.
The couple were concerned about their late marriage, and the probability of fertility problems.
Diagnosis and treatment at Al Raas:
On primary examination, the wife did not have any abnormalities; however, the husband was detected to have Oligozoospermia. Symptomatic treatment was advised.
After 6 months, the couple came back without any positive result re pregnancy. As they were planning vacation in India, it was suggested that the second stage of investigations be conducted in India (Hysteroscopy, Laparoscopy, Chromotubation etc.). Here, it was found that the lady had septum inside uterus which was surgically removed. The husband also underwent surgery for varicocele also.
Once they returned, they continued treatment at Al Raas with Dr. Sasikala, through regular monthly and cyclical follicular study and treatment for oligospermia.
After 6 months of regular visits, the patient conceived.
3 - Infertility success at Level 1 Care Centre
Couple married for 12 years
Concerns over infertility, with a history of all relevant investigations and treatment at various Fertility Centres including having failed IVF twice.
According to Dr. Sasikala, "The wife was just dropping the reports on my table - with a peculiar expression of desperation and frustration on her face."
Dr. Sasikala's diagnosis and treatment at Al Raas:
After proper analysis, Dr. Sasikala suggested only one test - Antisperm Anitbodies (ASA) which was omitted in the previous list of investigations. The result turned out to be positive. Accordingly, treatment was done.
After three more visits to the clinic, the wife reported a positive urine pregnancy test. She gave birth to twins - a boy and a girl.
Two-and-a-half years later once again she reported to the clinic with a positive pregnancy test, this time without any treatment.
4 - Breast Cancer
Female, late 40s, working.
Swelling in left breast which the patient had been noticing for a year, but which she neglected.
Diagnosis at Al Raas:
On examination, a hard mass of greater than 4 cms with overlying skin attached - classic symptoms of breast cancer.
The patient was urgently sent to India for urgent management but unfortunately, the doctors there could only provide palliative treatment as the cancer was in its 4th stage - it had spread to all the vital organs such as brain and liver.
She died after 6 months.
Note: This case confirms the importance of checking and clearing doubtful findings in the body before it leaves the doctors in a helpless condition.
5 - PAP Smear Testing
Age: 30 years
Profession: Marketing Executive
The patient, while attending our Gynae Clinic, showed abnormal PAP Smear report (metaplasia) and +ve HPV Test (Human Papilloma Virus Test).
Diagnosis at Al Raas:
The patient requested a second opinion. Repeat PAP Smear was done, which confirmed the diagnosis of Cervical Intra-Epithelial Neoplasia. She was sent back to India for immediate treatment. There, she got a Total Hysterectomy, but the doctors decided to keep her ovaries which appeared normal considering her age.
Two months later, the patient came back to Dr. Sasikala with pain in her right lower abdomen. A USG Exam showed cystic changes in the right ovary. She was sent to India once again, this time to have her ovaries removed. She is now on supportive medication. But she is back to work with full vigour.
Note: This case confirms the importance of screening tests such as PAP Smear.
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