State Consumer Disputes Redressal Commission
Sobhag Singh S/O Hajari Singh vs Sigma Diagnostic & Ct/Mri Scan Centre on 10 April, 2023
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mifLFkr%& 1- izkFkhZ dh vksj ls Jh ,l-ih- xka/kh] vf/koDrkA 2- vizkFkhZ la[;k 1 dh vksj ls Jh izrki flag vk;Z] vf/koDrkA 3- vizkFkhZ la[;k 2 dh vksj ls Jh izeksn dqekj] vf/koDrkA 4- vizkFkhZ la[;k 3 dh vksj ls Jh foTth vxzoky] vf/koDrkA fu.kZ; fnukad%&10-04-2023 jktLFkku jkT; miHkksDrk vk;ksx] t;iqj [}kjk Jh fueZy flag esM+roky lnL; ¼U;kf;d½] 01- ifjoknh lkSHkkx flag us ;g ifjokn foi{khx.k ds fo#) bl vk'k; dk izLrqr fd;k gS fd izkFkhZ dh iRuh dh xHkkZoLFkk ds 18osa lIrkg esa nnZ gqvk rks mls fnukad 10-02-2016 dks vizkFkhZ la[;k 3 feÙky vLirky ,oa fjlpZ Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 lsVa j esa HkrhZ djk;k x;k] tgka ij MkWDVj rkjk [kUuk dh ns[kjs[k esa ,d gh fnu esa mldh iRuh dh rhu vYVªklkm.M ¼lksuksxzkQh½ dh xbZ] ftlesa mlds isV esa iy jgs cPps dh ukWeZy fjiksVZ crkbZ xbZA mldh iRuh dks feÙky vLirky ls fnukad 13-02-2016 dks fMLpktZ dj fn;k x;kA xHkkZoLFkk ds 22osa lIrkg esa izkFkhZ dh iRuh dks nnZ dh f'kdk;r gksus ij mls iqu% vYVªklkm.M@lksuksxzkQh djkus dh lykg nh xbZA bl ij flxek Mk;XuksfLVd ¼vizkFkhZ la[;k 1½ ij fnukad 15-03-2016 dks mldh iRuh dh lksuksxzkQh dh xbZ] ftlus viuh fjiksVZ esa cPps dks ukWeZy crk;kA foi{kh la[;k 1 dh fjiksVZ dks MkWDVj rkjk [kUuk dks fn[kk;k x;k rks fjiksVZ dks lansgkLin crkrs gq;s iqu% lksuksxzkQh djkus dh lykg nh] ftl ij foi{kh la[;k 3 feÙky vLirky esa mlh fnu izkFkhZ us viuh iRuh dh lksuksxzkQh djkbZ xbZ ftlesa isV esa iy jgs cPps dks gkbMªksflQfyl gksuk crk;k x;k] ftl ij izkFkhZ nax jg x;k] D;ksfa d vc rd djkbZ xbZ lksuksxzkQh tkapksa esa cPps dks ukWeZy crk;k x;k FkkA izkFkhZ }kjk feÙky vLirky ds U;wjksltZu MkWDVj fl)kFkZ oekZ ls lykg yh xbZ rks crk;k x;k fd cPpk iw.kZ fodflr gks x;k gS] blfy, vc fMyhojh gksus ds ckn gh gkbMªksflQfyl dk bykt djkuk mfpr gksxkA 02- izkFkhZ us viuh iRuh dh xHkkZoLFkk ds 39osa lIrkg esa fnukad 02-06-2016 dks xtdsljh gSYFk ds;j esa viuh iRuh dh vYVªklkm.M@lksuksxzkQh djkbZ rks feÙky vLirky dh fjiksVZ ds vk/kkj ij ml fjiksVZ esa gksus okys cPps dks gkbMªksflQfyl crk;k ,oa vU; dksbZ deh ugha crkbZA izkFkhZ dh iRuh dks fnukad 13-06-2016 dks vpkud nnZ gksus ij vizkFkhZ la[;k 3 feÙky vLirky esa HkrhZ djk;k] tgka fnukad 14-06-2016 dks izkr% 7%24 cts izkFkhZ dh iRuh dh fltsfj;u fMyhojh gqbZ] ftlesa ,d fnO;kax cPph dk tUe gqvkA mlds gkbMªksflQfyl] euhUtkslhy rFkk dej ds uhps dk iwjk fgLlk [kjkc gksuk crk;k x;kA cPph ds ?kqVus mYVs rFkk iSj lh/ks gSA iSj dk vkdkj ;w 'ksi esa gS] og u cSB ldrh gS u mB ikrh gS vkSj u gh py ldrh gSA vizkFkhZx.k }kjk lksuksxzkQh dh xyr fjiksVZ nsus ds dkj.k izkFkhZ dh iRuh us 100 izfr'kr fnO;kax cPph dks tUe fn;k gSA ;fn vizkFkhZx.k lgh fjiksVZ nsrs rks vckW'kZu djk fy;k tkrk vkSj fnO;kax cPph dk tUe gh ugha gksrk] ftlds fy;s vizkFkhZx.k fpfdRldh; ykijokgh ds ftEesnkj gSA fnukad 14-06-2016 ds i'pkr~ fnukad 27-06-2016 rd izkFkhZ dh cPph dks vizkFkhZ la[;k 3 ds 2 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 vLirky esa ,u-lh-;w- esa HkrhZ j[kk x;k vkSj rRi'pkr~ gk;j lsVa j ij bykt o lykg ysus ds fy;s jsQj dj fn;k x;kA blds i'pkr~ izkFkhZ viuh cPph dks vkehZ gkWfLiVy fjlpZ ,aM jSQjy vLirky] ubZ fnYyh ys x;k] tgka mlds vkWijs'ku fd;s x;s] rRi'pkr~ feÙky vLirky esa Hkh fnukad 20-07-2016 dks HkrhZ djk;k x;k] tgka mls fnukad 06-08-2016 dks fMLpktZ dj fn;k x;kA mldh cPph dks t;iqj fLFkr esVªks ekul vkjksX; lnu vLirky esa Hkh HkrhZ djk;k x;kA bl izdkj izkFkhZ us viuh cPph dks fnukad 10-07-2017 rd fofHkUu vLirkyksa es]a ubZ fnYyh esa HkrhZ djk;k gS vkSj vc Hkh gj nks eghus esa tkap ds fy;s mls fnYyh ds vLirky esa cPph dks ys tkuk iM+ jgk gSA vr% izkFkhZ us vizkFkhZx.k ls {kfriwfrZ ds 45]00]000@&:i;s] ifjokn O;; ds 55]000@&:i;s fnyk;s tkus dh izkFkZuk dh gSA ifjokn ds lkFk ,d izkFkZuk&i= izLrqr dj ifjokn izLrqr djus esa gq; s foyac dks {kek djus dh izkFkZuk dh xbZA bl ij mHk;i{k dks lqudj fnukad 18-02-2020 dks izkFkZuk&i= Lohdkj fd;k x;kA 03- foi{kh la[;k 3 us bl ekeys esa ifjokn dk [kaMu djrs gq;s bl vk'k; dk tokc izLrqr fd;k gS fd ifjoknh us laiw.kZ ifjokn esa mldh iRuh dk uke vafdr ugha fd;k gS] u gh mls crkSj lg&ifjoknh i{kdkj cuk;k x;k gSA ;g Lohdkj fd;k x;k gS fd fnukad 10-02-2016 dks izkFkhZ dh iRuh dks muds vLirky esa fuEu f'kdk;rksa ds lkFk HkrhZ dok;k x;k Fkk%& CHIEF COMPLAINTS
- Amenorrhoea 4 1/2 months (conceived after treatment)
- C/o Pain in lower abdomen esp. Rt. side since 3 days
- C/o Frequency of mcturation since last 2 1/2 years HkrhZ ds le; mudh Medical vkSj Gestational History fuEu izdkj ls crkbZ xbZ Fkh%& Obstetric History G2 P0 L0 A1 G1- Abortion at 31/2 months, followed by Dilatation and Curettage in 2012 3 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 G2- Present Pregnancy (conceived after treatment of infertility for 11 years) Last Menstural Period- 25.09.2015 Expected Date of Delivery- 02.07.2016 History of-
Marital Life- 16 years Dilatation and Curettage With Diagnostic Laproscopy 2 times in 2005 and 2007 (details not available) Treatment for Primary Infertility since 2005 DM Type II since 2 1/2 years on HAI acc. to Blood sugar Hypothyroidism since 2005, on Tab. Thyrox 100mcg 10 D Left Kidney not seen (absent/ hypoplastic) Pregnancy Induced Hypertension last 3 months on Tab. Labelet 100mg 1 BD ;g crk;k x;k gS fd izkFkhZ dh iRuh dh fnukad 10-02-2016 dks iwjs isV dh lksuksxzkQh ,oa xHkZ esa iy jgs Hkwz.k dk Anomaly Scan djk;k x;kA izkfFkZ;k dh lksuksxzkQh dh fjiksVZ esa mldh ck;ha fdMuh ugha ikbZ xbZ Fkh] tcfd Hkwz.k ds Anomaly Scan esa fuEu fu"d"kZ ik;s x;s%& " FINDINGS Single intrauterine live fetus is seen in breech presentation at the time of study.
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Head and intracranial anatomy: Bilateral lateral ventricles are dilated. Citerna Magna is effaced. Posterior fossa is small in size.
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Lateral Ventricles: 12 MM EDD: 13-07-2016 4 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 IMPRESSION: Single live intrauterine fetus of average age 18weeks 4 days. Bilateral lateral ventricles are mildly dilated. Posterior foss of fetal brain appears small in size.
bl ckr dks xyr crk;k x;k gS fd izkFkhZ dh iRuh dh rhu ckj lksuksxzkQh djkbZ xbZ gS] cfYd lksuksxzkQh nks ckj gh djkbZ xbZ Fkh] ftudk o.kZu Åij fd;k x;k gSA ;g Hkh crk;k x;k gS fnukad 10-02-2016 dks izkFkhZ dh iRuh dh iwjs isV dh xbZ fjiksVZ lkekU; ugha Fkh] D;ksfa d mlesa ck;ha fdMuh ugha ikbZ xbZ FkhA 04- Hkwz.k dk Breech Presentation vius vki esa ,d Anomaly gS] lkFk gh Hkwz.k ds Lateral Ventricles: 12 mm dilated gksuk Hkh Anomaly gS] D;ksfa d ;g ÞFetal Cerebral Ventriculomegaly (VM) dks bafxr djrk gS ijarq mijksDRk fLFkfr dks Hydrocephalus dh laKk rHkh nh tk ldrh gS tc Lateral Cerebral Ventricle dh Atrial Width 15 mm ls T;knk gksA ;gha ugha] Jherh xaxk nsoh ds xHkZ esa iy jgs Hkwz.k ds ÞPosterior foss of fetal brain appears small in size" gksuk "Arnold-Chiari Malformation (ACM)" dks characterize djrk FkkA gkykafd ACM ds izdj.k esa Open Spina Bifida invariably present gksrk gS] ijarq Open Spina Bifida dh Ultrasound Examination esa Detection Rate ,d rks oSls gh dkQh Low gksrh gS vkSj orZeku izdj.k esa rks fQj Breech Presentation Hkh FkkA 05- blds vfrfjDr Jherh xaxk nsoh ds xHkZ esa iy jgs Hkwz.k "hydrocephalus ,oa ACM" ls ihfM+r gksus ds pyrs fod`fr dh laHkkouk ls voxr djk fn;k x;k Fkk ijarq fookg ds 16 o"kZ ,oa Jherh xaxk nsoh ds 37 o"kZ gks tkus ds mijkar Hkh ,d Hkh larku ugha gksus rFkk iwoZ esa ,d vcksZ'ku gks tkus ds pyrs rRle; xHkZ esa iy jgs Hkwz.k dks Jherh xaxk nsoh ,oa ifjoknh }kjk vius fy;s vR;ar gh ewY;oku crk;k x;k rFkk tkfgj fd;k x;k fd xkao esa yksxksa ds rkuksa ls cpus ds fy;s os fdlh Hkh voLFkk esa cPps dks tUe nsuk pkgrs gSaA 06- Hkwz.k ds "hydrocephalus ,oa ACM" ls ihfM+r gksus ds pyrs fod`fr dh laHkkouk ls voxr djk fn;s tkus ds ckotwn Hkh Jherh xaxk nsoh vkSj 5 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 ifjoknh }kjk mijksDr dkj.ko'k izsXusUlh tkjh j[ks tkus dh bPNk tkfgj fd;s tkus ij Jherh rkjk [kUuk }kjk fpfdRlk&izi=ksa esa fuEu Li"V dj fn;k x;k%& "Precious Pregnancy.... Elderly Primi ..... Patient wants to continue pregnancy with conservative management inspite of explaining consequences of hydrocephalus/ACM..... All consequences explained to Husband (mother and baby)" rFkk High Risk Consent ysus ds fy;s dgk x;kA rnqijkUr fu;ekuqlkj fnukad 10-02-2016 dks gh ejht Jherh xaxk nsoh dh Consent yh xbZA 07- fnukad 13-02-2016 dks Jherh xaxk nsoh dh fLFkfr esa lq/kkj gksus ij ifj.kkeksa dks voxr djkrs gq;s foi{kh la[;k 3 vLirky ls fMLpktZ fd;k x;kA lkFk gh ejht dks 5 fnu ckn] vFkkZr fnukad 18-02-2016 dks vkus dh fgnk;r nh xbZ] ijarq mldh vuqikyuk ugha dh xbZA 08- Jherh xaxk nsoh dh fnukad 15-03-2016 dks foi{kh la[;k 3 gkWfLiVy esa USG Obstetrics dh xbZ] ftlesa Congenital Anomaly vkSj Impression fuEu izdkj uksV fd;s x;s Fks%& CONGENITAL ANOMALY: Bilateral lateral ventricles are dilated. Diameter is 15 mm foetal posterior fossa appears small in size.
IMPRESSION: Findings are suggestive of single live fetus of GA 22 weeks.
Bilateral lateral ventricles are dilated suggestive of hydrocephalus with small posterior fossa."
fnukad 10-02-2016 dks laiUu Anomaly Scan esa Lateral Ventricle 12mm gh dilated Fkk] ijarq fnukad 15-03-2016 dh USG Obstetrics esa Lateral Ventricles c<+ dj 15mm dilated gks x;k Fkk] vr% xHkZ esa iy jgs Hkwz.k ds hydrocephalus ls ihfM+r gksus dh iqf"V gks xbZ FkhA lkFk gh] "foetal posterior fossa small" gksuk "ACM" dks characterize djrk FkkA bu ifjfLFkfr;ksa ds pyrs gq;s fod`fr dh laHkkouk ls voxr djk fn;s tkus ds ckotwn Hkh ifjoknh }kjk] mldh iRuh }kjk pregnancy tkjh j[kus 6 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 dh bPNk tkfgj dh xbZ FkhA vr% bl lanHkZ esa ifjoknh }kjk yxk;s x;s lacaf/kr vk{ksi fujk/kkj gSA 09- fnukad 14-06-2016 dks ckfydk dh MRI Lumber Spine djkbZ xbZ] ftldh fjiksVZ fnukad 15-06-2016 esa fuEu fu"d"kZ fn;s gq;s Fks%& "A wide spina bifida and meningocele seen in sacral region extending for a length of 3 vertebrae. Meningocele measures 12x 17 x 16 mm. Cord appears low lying and tethered.
10. tgka rd ckfydk ds meningocele ls ihfM+r gksus dk iz'u gS] ACM ds izdj.k esa Breech Presentation gksus ds dkj.k mls [kkst ikuk vR;ar eqf'dy gksrk gSA ifjokn dks foyac ls izLrqr djus ds dkj.k rFkk foyac ds laca/k esa mfpr dkj.k ugha gksus ls ifjokn dks fe;kn ckgj gksus ls fujLr fd;s tkus dh izkFkZuk Hkh dh xbZ gS] vr% ifjokn [kkfjt djus dh izkFkZuk dh xbZ gSA 11- foi{kh la[;k 1 dh vksj ls tokc bl vk'k; dk izLrqr fd;k x;k gS fd ifjokn esa ifjoknh us viuh iRuh ds uke dk mYys[k ugha fd;k gS] vr% bykt dk tks fjdkWMZ izLrqr fd;k x;k gS] og ifjoknh dh iRuh dk gS ;k fdlh vU; ejht dk] ;g lqfuf'pr ugha fd;k tk ldrk gSA foi{kh }kjk dksbZ lsoknks"k ;k ykijokgh ugha dh xbZ gS] fQj Hkh mls vdkj.k i{kdkj cuk;k x;k gS ,oa mls voS/k rjhds ls olwyh djus ds fy;s VsyhQksu dj CySdesy djus dh dksf'k'k dh xbZ] ftl ij mfpr dk;Zokgh djus dk vf/kdkj lqjf{kr j[kk tkrk gSA 12- izkFkhZ dh iRuh dk 2Mh lksuksxzkQh Ldsu fnukad 15-03-2016 dks mlds ;gka fd;k x;k Fkk] ijarq mlesa cPps dks ukWeZy ugha crk;k x;k FkkA bl fjiksVZ esa ;g Li"V :i ls uksV vafdr fd;k x;k Fkk fd 22osa lIrkg esa Hkwz.k dh fLFkfr Breech Presentation esa gksus ls vlkekU; fLFkfr Fkh vkSj bl dkj.k fo'ks"kK MkWDVj us mudh fjiksVZ dk voyksdu dj mlh le; nwljs Mk;XuksfLVd lsVa j esa tgka 4Mh vYVªklkm.M dh lqfo/kk Fkh] esa iqu% tkap djkbZ xbZ Fkh] ftl fjiksVZ ls ;g Li"V gks x;k fd Hkwz.k esa hydrocephalus jksx gksus ds ladsr FksA bl izdkj mÙkjnkrk ds ;gka izkIr fjiksVZ fnukad 15-03-2016 ds dqN ?kaVks ckn gh djkbZ xbZ nwljh vYVªklkm.M@lksuksxzkQh 7 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 ls ;g Li"V gks x;k Fkk fd Hkwz.k hydrocephalus jksx ls xzfLkRk gS vkSj bl izdkj mlds fo#) izLrqr ifjokn fujLr djus dh izkFkZuk dh xbZ gSA 13- foi{kh la[;k 2 us viuk tokc bl vk'k; ij izLrqr fd;k gS fd Jherh xaxk nsoh] mez 34 lky dh xHkkZOkLFkk ds 39osa lIrkg esa mlds ;gka ls lksuksxzkQh dh tkap djkbZ xbZ Fkh vkSj rc xHkZLFk cPps dks hydrocephalus ls xzfLkRk gksuk crk;k x;k FkkA mudh fjiksVZ esa ;g Li"V fy[kk Fkk fd Hkwz.k dk flj hydrocephalus dh otg ls cM+k gks x;k FkkA fu"d"kZ esa Hkh Hkwz.k dks hydrocephalus ls xzfLkr gksus dk ladsr fn;k x;k Fkk] vr% mlds }kjk nh xbZ fjiksVZ esa fdlh izdkj dh ykijokgh ugha dh xbZ gSA mlds ;gka lksuksxzkQh djkus ds 11 fnu ckn gh fnukad 13-06-2016 dks izkFkhZ dh iRuh us cPph dks tUe fn;k ftls hydrocephalus uked chekjh FkhA vr% ifjokn [kkfjt djus dh izkFkZuk dh xbZ gSA 14- ifjoknh dh vksj ls ÞBABY VANI BHATTACHARYA VERSUS DR. SURANJIT DUTTA,M.S" ( CONSUMER CASE NO. 974/2015) jk"Vªh;
miHkksDRkk vk;ksx ds fu.kZ; fnukad 01-06-2021 ds fu.kZ; dh izfr izLrqr dh xbZ gS] ftldk voyksdu fd;k x;k gSA ifjoknh dh vksj ls fyf[kr cgl e; fpfdRlk lkfgR; ds lkFk izLrqr fd;k x;k gS] ftldh izfr foi{khx.k dks iznku dh xbZ] dk voyksdu Hkh fd;k x;kA 15- mHk;i{k dh cgl lquh xbZ ,oa i=koyh dk voyksdu fd;k x;kA 16- bl ekeys esa fookn dk fcanq ;g gS fd fnukad 10-02-2016 dks izkFkhZ dh iRuh Jherh xaxk nsoh ds isV dh vkSj mlds isV esa iy jgs Hkwz.k dh lksuksxzkQh Anomaly Scan ls ,oa foi{kh la[;k 3 ds fpfdRldh; nLrkostksa ls D;k ;g nf'kZr gks x;k Fkk fd isV esa iy jgs Hkwz.k ,sls jksxksa ls xzflr gS] ftlesa mlds vaxksa esa iw.kZ fodkl ugha gksxk vkSj viax cPpk iSnk gksus dh laHkkouk gksxh rFkk bl ckjs esa izkFkhZ vkSj mldh iRuh dks voxr ugha djk;k x;k rFkk fnukad 15-03-2016 dks foi{kh la[;k 3 ds ;gka ls djkbZ xbZ lksuksxzkQh esa xaHkhj jksxksa dh iqu% iqf"V dh tkudkjh izkFkhZ ,oa mldh iRuh dks ugha nsus ls fnukad 14-06-2016 dks viax cPpk iSnk gqvk FkkA bl dkj.k vizkFkhZx.k dh fpfdRldh; ykijokgh ds pyrs fnO;kax cPph iSnk gksus ls izkFkhZ] vizkFkhZx.k ls {kfriwfrZ dh jkf'k izkfIr dk vf/kdkjh gSA 8 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 17- bl ekeys esa ifjoknh us foi{kh la[;k 3 feÙky vLirky }kjk fnukad 10-02-2016 dks dh xbZ lksuksxzkQh dh fjiksVZ~l dks vius vfHkopuksa esa ukWeZy crk;k gS] tcfd ;g fjiksVZ~l ukWeZy ugha gSA bl laca/k esa bu fjiksVZ~l dk voyksdu fd;k x;k] ftlesa igyh fjiksVZ Jherh xaxk nsoh dh gS] tks mlds iwjs isV dh lksuksxzkQh dh fjiksVZ gS] ftlesa mldh ck;ha fdMuh ugha gks uk ik;k x;k gSA nwljh fjiksVZ Jherh xaxk nsoh dh dks[k esa iy jgs Hkwz.k dh Anomaly Scan dh fjiksVZ gSA ;g fjiksVZ Hkh fnukad 10-02-2016 dks 'kke dks 4%29 cts dh xbZ gS] ftlds voyksdu ls ;g nf'kZr gksrk gS fd Hkwz.k 18 lIrkg dk Fkk vkSj ml le; og dks[k esa mYVk Fkk vFkkZr mldk flj Åij Fkk vkSj iSj uhps FksA Head and Intracranial Anatomy esa ;g fy[kk x;k gS fd mlds Bilateral lateral ventricles dilated Fks] mlds Citerna Magna effaced Fks rFkk posterior fossa NksVk FkkA ;gh fu"d"kZ fpfdRld us fjiksVZ esa fudkys gSaA bl fjiksVZ dks MkWDVj [kUuk us vius bykt ds ipksZa esa fnukad 10-02-2016 dks fy[krs gq;s ;g vafdr fd;k gS fd bl fjiksVZ ds lHkh ifj.kkeksa ls izkFkhZ dks voxr djk;k x;k vkSj gkbZ fjLd dalsVa ysus dh ckr dgh xbZA izkFkhZ dh iRuh ds HkrhZ jgus ds nkSjku gh mldh bl vfHkLohd`fr dks Hkh fpfdRldh; nLrkostksa esa lfEeyr fd;k x;k] ftlesa ;g vafdr gS fd ejht viuh izsxusl a h dks tkjh j[kuk pkgrk gS] tcfd mls laHkkfor hydrocephalus or ACM uked chekjh ls mldk Hkwz.k xzflr gksus ckcr crk fn;k x;k gSA 18- fnukad 10-02-2016 dks gh gkbZ fjLd dalasV xaxk nsoh ls yh xbZ] ftlesa ;g fy[kk gS fd lc chekjh ds lkFk eka vkSj cPps ds ykHk&gkfu ds ckjs esa MkWDVj lkgc us gesa lc le>k fn;k gSA laHkkfor hydrocephalus/ ACM gksus ls cPps esa fod`fr dh laHkkouk ds ckn Hkh ge izsxusl a h tkjh j[ksx a sA bl lgefr dks ifjoknh ds fo}ku vf/koDrk us QthZ gksuk crk;k gS] ftlds laca/k esa fo}ku vf/koDrk foi{kh la[;k 3 us crk;k gS fd ekuuh; vk;ksx }kjk fnukad 11-01-2023 dks bl dalsVa dk ewy izi= U;k;ky; esa eaxok fy;k Fkk] ysfdu vkns'k fnukad 07-02-2023 ds }kjk ml ij xaxk nsoh ds gLrk{kj lkfcr djus ckcr ,Q-,l-,y Hkstuk U;k;ksfpr ugha ik;k x;k FkkA bl laca/k esa foi{kh la[;k 3 ds fo}ku vf/koDrk }kjk dh xbZ cgl egRoiw.kZ gS fd xaxk nsoh dk uke ifjoknh us iwjs ifjokn esa vafdr ugha fd;k gS] 9 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 ftlls ;g nf'kZr gks lds fd bykt ds tks iUus izLrqr fd;s x;s gSa] os mldh iRuh xaxk nsoh ds gks] Jherh xaxk nsoh dk dksbZ 'kiFk i= Hkh izLrqr ugha fd;k x;k] ftlls ;g nf'kZr gksrk gks fd bl dalsVa esa fnukad 10-02-2016 dks mlds gLrk{kj ugha gSA xaxk nsoh ds vkSj dksbZ Lohd`r gLrk{kj bl vk;ksx ds le{k izLrqr ugha fd;s x;s gSa A bl gkbZ fjLd dalVsa ds izi= ds ckjs es]a vfHkopuksa esa ifjoknh us dksbZ rF; vafdr ugha fd;k gS] vr% bl dkj.k gkbZ fjLd dalsVa QthZ gksuk nf'kZr ugha gksrk gSA blds vfrfjDr fpfdRldh; bykt ds dkxtksa esa fnukad 10-02-2016 dks izkFkhZ dh iRuh dks gks'k esa gksuk vkSj oriented gksuk crk;k x;k gS vkSj ;g vafdr fd;k x;k gS fd Hkwz.k dh Anomaly Scan vkSj mldh lksuksxzkQh fjiksVZ ds ifj.kkeksa ds ckjs esa crkus ds ckotwn xaxk nsoh izsxusl a h dks tkjh j[kuk pkgrh gS] tcfd Anomaly Scan ls lkfcr gks pqdk Fkk fd Hkwz.k esa laHkkfor hydrocephalus ,oa ACM uked fod`fr;ka efLr"d esa fo|eku gSA gkbZ fjLd dalVsa ij fpfdRld ds gLrk{kj dh frfFk esa cutting dh gqbZ gS vkSj ;g nLr[kr MkWDVj rkjk [kUuk ds fnukad 11-02-2016 dks djus crk;s x;s gSa] bl vk/kkj ij bls QthZ gksuk crk;k x;k gS] ysfdu gekjh jk; esa lksuksxzkQh dh fjiksVZ vkus ds Ik'pkr~ vkSj ml ij MkWDVj dh jk; dks fpfdRldh; nLrkostksa esa lfEeyr dj nsus ls dsoy bl vk/kkj ij ;g fjiksVZ QthZ ugha ekuk tk ldrh gS fd ml ij fnukad 11-02-2016 dks fpfdRld us gLrk{kj fd;s] tcfd xaxk nsoh ds gLrk{kj ml ij fnukad 10- 02-2016 dks gh dj fn;s x;s gSaA ifjoknh us bl laca/k esa dksbZ vfHkopu vius ifjokn esa ugha fd;s gSaA ifjoknh us cgl dh voLFkk ij MkWDVj rkjk [kUuk ds gLrk{kj] tks mlds }kjk izLrqr 'kiFk i= ij fd;s x;s gSa vkSj gkbZ fjLd dalVsa fnukad 10-02-2016 dks fd;s x;s gSa] esa varj crkrs gq;s Hkh dalVsa dks QthZ crk;k gSA bl lac/a k esa Hkh muds }kjk dksbZ vfHkopu ugha fy;k x;k gS vkSj igyh ckj cgl esa ;g rF; mBk;k x;k gS] tcfd fpfdRld us vius 'kiFk i= esa bl ij vius gLrk{kj gksuk crk;k gS vkSj bl nLrkost dh dksbZ ,Q-,l-,y- ls tkap Hkh ugha djkbZ xbZ gS] D;ksfa d ,slh izkFkZuk vLohdkj dj nh xbZ gSA Lo;a xaxk nsoh us Hkh gkbZ fjLd dalsVa ds i= esa vius gLrk{kj ugha gksus ckcr viuk 'kiFk i= izLrqr ugha fd;k gSA vr% bl dkj.k gkbZ fjLd dalsVa foi{kh la[;k 3 fpfdRlky; }kjk mfpr :Ik ls izkFkhZ dh iRuh ds Hkwz.k ds efLr"d esa gqbZ fod`fr;ksa ls voxr djkrs gq;s izk Ir 10 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 fd;k vkSj izkFkhZ dh iRuh dh lgefr bl ckjs esa izkIr dh fd og viuh izsxusl a h dks tkjh j[kuk pkgrh gSA 19- ifjoknh ds fo}ku vf/koDrk dh ;g Hkh cgl jgh gS fd gkbZ fjLd dalVsa esa vVsaMsaV ds signature ugha djk;s x;s gSa] tcfd vLirky esa HkrhZ gksrs le; lkekU; lgefr ij izkFkhZ ds gLrk{kj djk;s x;s gSaA gekjh jk; esa tc Jherh xaxk nsoh iw.kZ :Ik ls gks'k esa Fkh vkSj og gkbZ fjLd dalsVa nsus dh fLFkfr esa Fkh rks mlds gh gLrk{kj ml dalsVa ij djk;s tkuk] fdlh izdkj ls vuqfpr ugha dgk tk ldrk] tcfd lkekU; lgefr ysrs le; Jherh xaxk nsoh ds isV esa nnZ Fkk vkSj bl dkj.k izkFkhZ ds gLrk{kj ml ij djk;s tkuk nf'kZr gksrk gSA vr% fo}ku vf/koDrk ifjoknh dh ;g cgl Lohdkj fd;s tkus ;ksX; ugha gS fd gkbZ fjLd dalsVa ij vVsaMsaV ds nLr[kr ugha djkus ls Hkh LosPNkiw.kZ nh xbZ vfHkLohd`fr ugha gSA 20- blds vfrfjDr fpfdRldh; nLrkostkr ls ;g Hkh nf'kZr gqvk gS fd izkFkhZ dh iRuh ds 16 lky rd dksbZ cPpk&cPph ugha gqvk Fkk vkSj bl nkSjku ,d vcks'kZu Hkh gqvk FkkA mldh vafre egkokjh fnukad 25-09-2015 dks vkbZ FkhA vfHkopuksa esa ;g rF; vk;k gS fd xkao okyksa ds rkuksa ls cpus ds fy;s izkFkhZ dh iRuh viuh izsxusl a h dks tkjh j[kuk pkgrh Fkh] tcfd mls ;g crk fn;k x;k Fkk fd mlds xHkZ esa iy jgs cPps ds efLr"d esa xaHkhj jksx gS vkSj mlds tUe ds le; fod`fr;ka vkus dh laHkkouk gSA vr% ;g rF; Hkh ;g nf'kZr djrk gS fd ifjoknh dh iRuh fnukad 10-02-2016 dks vius vkSj vius Hkwz.k dh lksuksxzkQh gksus ds ckn Hkh mls laHkkfor ykHk&gkfu ds ckjs esa crkus ij Hkh mlus viuh izsxusl a h dks tkjh j[kus dh bPNk O;Dr dh FkhA lk{; ls ;g Hkh nf'kZr gqvk gS fd izkFkhZ dh iRuh ds ;g xHkZ bl laca/k esa djk;s x;s bykt ds Ik'pkr~ Bgjk FkkA lk{; ls ;g Hkh nf'kZr gqvk gS fd izkFkhZ ds Lo;a ds ,d fdMuh ugha Fkh vkSj og hypothyroid dh xaHkhj chekjh ls xzflr Fkh] tks mls o"kZ 2005 ls FkhA 21- lk{; ls ;g nf'kZr gqvk gS fd izkFkhZ dks fnukad 13-02-2016 dks bl fgnk;r ds lkFk Lo;a dh izkFkZuk ij fMLpktZ fd;k x;k Fkk fd og 5 fnu ckn ekeys dks iqu% fjO;w djk;saxsA fMLpktZ djrs le; Hkh fpfdRldh; nLrkost ds vuqlkj Jherh xaxk nsoh dks izsxusl a h tkjh j[kus ds ifj.kke 11 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 le>k fn;s x;s Fks] ysfdu mlds ckotwn 5 fnu ckn ifjoknh viuh iRuh dks ysdj feÙky vLirky esa ugha x;k FkkA 22- lk{; ls ;g tkfgj vk;k gS fd fnukad 15-03-2016 dks foi{kh la[;k 3 ds ;gka Jherh xaxk nsoh ds USG Obstetrics iqu% djkbZ xbZ] rc Bilateral lateral ventricles dilated Fks vkSj mldk diameter 15mm rd c<+ x;k Fkk] tcfd og iwoZ esa 12 mm dk FkkA ;g lksuksxzkQh djkbZ xbZ] rc Hkwz.k dh mez 22 g¶rs dh Fkh vkSj vc Hkwz.k esa hydrocephalus uked chekjh gks xbZ Fkh vkSj mldk posterior fossa NksVk Fkk] ysfdu blds ckotwn Hkh izkFkhZ us viuh iRuh dk vcks'kZu fpfdRldh; :i ls djkuk mfpr ugha le>k vkSj fpfdRld fl)kFkZ oekZ dks crk;k] ftlus dgk fd pwfa d vc cPpk iw.kZ fodflr gks pqdk gS] vr% fMyhojh ds ckn gh hydrocephalus dk bykt djkuk mfpr gksxkA bl izdkj ifjoknh vkSj mldh iRuh }kjk tkucw>dj ,d ,sls cPps dks tUe nsus dh rS;kjh dh xbZ tks efLr"d ds xaHkhj jksxksa ls xzflr Fkk vkSj bl dkj.k mlds flj ,oa 'kjhj esa fod`fr;ka vkuh laHkkfor FkhA fnukad 14-06-2016 dks Jherh xaxk nsoh ds ,d cPph us tUe fn;k] ftls Multiple Congenital anomalies gksdj Meningomyelocele + lower limb deformity and paraplegia vkSj ACM uked chekjh FkhA bl thfor cPph dk Hkh NCCT djk;k x;k Fkk] ftlesa Hkh mlds efLr"d laca/kh fod`fr;ka crkbZ xbZ gSA bruk gksrs gq;s Hkh ifjoknh us iqu% viuh cPph dks tqykbZ]2016 esa feÙky vLirky esa gh HkrhZ djk;k Fkk vkSj ogka ls gk;j lsVa j ij jsQj dh xbZ FkhA vr% bu rF;ksa ds en~nsutj bl ekeys esa ifjoknh dk vius vfHkopuksa esa ;g fy[kuk fd fnukad 10-02-2016 dks tc mldh iRuh vkSj mldh iRuh ds isV esa iy jgs Hkwz.k dh Øe'k% lksuksxzkQh ,oa ,ukeyh Ldsu gqvk] rc cPps dh fLFkfr ukWeZy crkbZ xbZ Fkh] lgh izrhr ugha gksrk gS vkSj dsoy {kfriwfrZ dh jkf'k izkIr djus ds fy;s ;g ifjokn izLrqr fd;k tkuk nf'kZr gksrk gSA 23- fnukad 10-02-2016 ds i'pkr~ bl ekeys esa ifjoknh }kjk viuh iRuh dh lksuksxzkQh foi{kh la[;k 1 ds ;gka Hkh djkbZ xbZ Fkh] ftldh fjiksVZ fnukad 15-03-2016 dks i=koyh ij miyC/k gS] ftlesa eq[; :i ls ;gh crk;k x;k gS fd cPpk cPpsnkuh esa mYVk gSA blds vfrfjDr vU; dksbZ ifjfLFkfr;ka blesa ugha crkbZ xbZ] tcfd mlh fnu foi{kh la[;k 3 ds ;gka izkFkhZ dh 12 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 iRuh dh iqu% lksuksxzkQh djkbZ xbZ] ftlesa Hkwz.k ds efLr"d esa xaHkhj mYysf[kr jksxksa dk gksuk crk;k x;kA foi{kh la[;k 1 us viuh fjiksVZ esa mu xaHkhj efLr"d dh chekfj;ksa dk mYys[k ugha gksus ds dkj.k ;g crk;k fd mlh fnu fo'ks"kK dh fuxjkuh esa feÙky vLirky esa izkFkhZ dh iRuh dh lksuksxzkQh djkbZ xbZ Fkh vkSj mlesa cPps ds efLr"d ls laca/kh chekfj;ka tkfgj vk xbZ Fkh vkSj bl vkM+ esa Lo;a dks cpkus dh dksf'k'k dh gS fd cPps dh fLFkfr mYVh gksus ds dkj.k Hkwz.k dh 'kkjhfjd fod`fr;ka ugha fn[k ikbZ FkhA gekjh jk; esa foi{kh la[;k 1 }kjk tks tokc fn;k x;k gS] og mudhs Lo;a dh lksuksxzkQh djus esa izFke n`"V~;k dh xbZ ykijokgh dks nf'kZr djus ds fy;s i;kZIr gS] ysfdu gekjh jk; esa mlh fnu foi{kh la[;k 3 ds ;gka lksuksxzkQh gksus ls mldh fjiksVZ dh egRrk vkSj dh xbZ ykijokgh fopkj.kh; ugha gSA 24- rRi'pkr~ izkFkhZ us viuh iRuh dk fnukad 02-06-2016 dks fMyhojh ls 12 fnu igys ,d lksuksxzkQh foi{kh la[;k 2 ds ;gka Hkh djkbZ xbZ Fkh] ysfdu mudh fjiksVZ esa hydrocephalus uked chekjh ls xzflr gksuk crk;k x;k gSA blesa ;g Hkh crk;k x;k gS fd Hkwz.k ds lateral ventricles ldy :i ls dilated Hkh gSA vr% gekjh jk; esa foi{kh la[;k 2 us lkjHkwr :i ls izkFkhZ dh iRuh ds xHkZ esa iy jgs cPps dh fod`fr;ksa ds ckjs esa viuh fjiksVZ esa mYys[k dj fn;k FkkA 25- foi{kh la[;k 3 ds fo}ku vf/koDrk }kjk izLrqr SECOND EDITION ULTRASOUND OF CONGENITAL FETAL ANOMALIES, Differentuial Diagnosis and Prognostic Indicators:- Dario Paladani (Head, Fetal Medicine and Surgery Unit, Gaslini Children's Hospital, Genoa, Italy), Paolo Volpe (Head, Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospitals Di Venere and Sarcone, Bari, Italy) esfMdy lkfgR; dk voyksdu fd;k] ftlds voyksdu ls ;g nf'kZr gqvk gS fd lateral cerebral ventricles ;fn 10mm ;k mlls vf/kd gks rks ,slh fLFkfr esa Hkwz.k esa gYdh ventriculomegaly nf'kZr gksxhA Hydrocephalus dk jksx lateral cerebral ventricles ds 15mm ls vf/kd gksus ij Mk;Xuksl gks tkrk gSA orZeku ekeys esa fnukad 10-02-2016 dks tc Hkwz.k dh Anomaly 13 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 Scan djkbZ xbZ Fkh] rc mlds lateral ventricles 12 mm ds FksA 10mm ls vf/kd gksus ds dkj.k mlesa gYdk ventriculomegaly dk y{k.k vk x;k Fkk vkSj rHkh ;g rF; izkFkhZ vkSj mldh iRuh ds lkeus yk;k x;k Fkk fd ;g fod`fr Hkwz.k esa mRiUu gks pqdh gS vkSj blds ykHk&gkfu ds ckjs esa Hkh mUgsa crk fn;k x;k FkkA 26- fnukad 10-02-2016 dks gqbZ Anomaly Scan esa Hkwz.k dk posterior fossa Hkh NksVk crk;k x;k Fkk] tks efLr"d dh ,d fod`fr gS vkSj bldh otg ls mRiUu gq;s spina bifida dk lksuksxzkQh esa vkuk vR;ar gh nqyZHk gS] ftlds dkj.k orZeku ekeys esa Hkwz.k dk Breech Presentation dh fLFkfr esa gksuk gSA Posterior fossa ds NksVs gks tkus ls c<+rs gq;s brain stem or cerebelum mlesa ugha vk ikrs gSa vkSj bl dkj.k efLr"d dh fod`fr ds dkj.k 'kjhj esa vU; Hkh fod`fr;ka mRiUu gks tkrh gSA efLr"d dh ;g fod`fr 68 ijlaVs ekeyksa esa 24 g¶rs igys nf'kZr gks tkrh gS] tks bl ekeys esa gksuk nf'kZr gqbZ gSA vr% bl lkfgR; ls Hkh ;gh nf'kZr gksrk gS fd foi{kh la[;k 3 ds ;gka gqbZ lksuksxzkQh fnukad 10-02-2016 dks gqbZ Anomaly Scan esa izkFkhZ dh iRuh ds Hkwz.k dh fLFkfr ls laHkkfor hydrocephalus ds y{k.k ,oa ACM ds jksx gksuk nf'kZr gq;s Fks] ysfdu mlds ckotwn Hkh izsxusalh dks tkjh j[kk x;k vkSj tc cPpk iSnk gqvk] rc mlesa vU; cgqvk;keh Congenital anomalies Meningomyelocele + lower limb deformity and paraplegia rFkk laHkkfor ACM ds jksx nf'kZr gq;s FksA vr% fpfdRldh; lkfgR; ls Hkh ;g nf'kZr gksrk gS fd foi{kh la[;k 3 ds fpfdRld MkWDVj rkjk [kUuk }kjk izkFkhZ dh iRuh dh lksuksxzkQh ,oa Hkwz.k dh Anomaly Scan dh fjiksVZ vkus ds ckn mUgsa Hkwz.k esa gksus okyh fod`fr;ksa ds ckjs esa crk fn;k x;k Fkk] ysfdu fQj Hkh mUgksua s viuh izsxusl a h dks tkjh j[kuk pkgk vFkkZr os vcks'kZu djkus ds fy;s rS;kj ugha Fks] vr% bl dkj.k ifjokn esa ;g fy[kk tkuk fd ;fn mUgsa fpfdRld }kjk le; ij crk fn;k tkrk rks os vcks'kZu djk ysrs] gekjh jk; esa bl ekeys esa fy;s x;s gkbZ fjLd dalVsa ds tfj;s foi{kh la[;k 3 ds fpfdLrd ds }kjk fnukad 10-02-2016 dks gh izkFkhZ }kjk mldh iRuh dks muds Hkwz.k esa mRiUu gqbZ fod`fr;ksa ds ckjs esa le>k fn;k x;k Fkk] ysfdu mlds ckotwn izsxusl a h dks tkjh j[kk x;k] vr% blesa foi{kh la[;k 3 dh fdlh izdkj dh fpfdRldh;
14Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 ykijokgh nf'kZr ugh gqbZ gS A pwfa d foi{kh la[;k 2 }kjk izkFkhZ dh iRuh dk USG fnukad 02-06-2016 dks fd;k x;k Fkk] tks Anomaly Scan ugha Fkk rFkk mlesa Hkh foi{kh la[;k 3 dh fjiksVZ ds vuqlkj Hkwz.k dks hydrocephalus uked fod`fr ls xzflr gksuk crk fn;k x;k Fkk] vr% mudh vksj ls Hkh dksbZ fpfdRldh; ykijokgh gksuk lkfcr ugha gksrh gSA pwfa d foi{kh la[;k 1 }kjk lksuksxzkQh fnukad 15-03-2016 dks fd;s tkus ls iwoZ gh foi{kh la[;k 3 us Hkwz.k dh chekfj;ksa dk izdVhdj.k dj fn;k Fkk vkSj mlh fnu fnukad 15-03-2016 dks foi{kh la[;k 3 }kjk fnukad 10-02-2016 dks fudkys x;s fu"d"kZ dh iqf"V lksuksxzkQh esa dj nh xbZ Fkh] blfy;s foi{kh la[;k 1 dh lksuksxzkQh esa Hkwz.k esa mRiUu gqbZ fod`fr;ksa dk ugha crk;k tkuk egRoiw.kZ ugha jg tkrk gS] tcfd mUgksua s Li"Vr% nf'kZr dj fn;k Fkk fd Hkwz.k dh Breech Presentation ds dkj.k og vU; fod`fr;ksa dks ns[kus esa vleFkZ gSA 27- foi{kh la[;k 3 dh vksj ls izLrqr uthj dk voyksdu fd;k x;k] mlesa Hkh tUe ds le; cPps esa hydrocephalus uked efLr"d dh fod`fr Fkh] ftls fpfdRld us efLr"d esa 'kaV yxkdj fluid dks ckgj fudkyk FkkA bl ekeys esa ;g ik;k x;k Fkk fd 16 g¶rs ds ckn patient iqu% muds ikl ugha vk;s Fks] tcfd orZeku ekeys esa fnukad 10-02-2016 dks tc 18 g¶rs dh izsxusl a h Fkh] mlds 5 fnu ckn cqyk;s tkus ij Hkh patient muds ;gka ugha vk;k vkSj fnukad 15-03-2016 dks vk;s Fks rc 22 g¶rksa ls vf/kd dk le; xqtj pqdk Fkk] tcfd 20 g¶rs dh izsxusl a h dks gh dkuwuh :i ls terminate fd;k tk ldrk gSA ml ekeys esa foi{kh fpfdRld us izsxusl a h ds nkSjku mfpr VsLV djkus dh lykg nh xbZ Fkh] tcfd orZeku ekeys esa rks gkbZ fjLd dalVsa izkIr dh xbZ Fkh] ftlesa Jherh xaxk nsoh us izsxusl a h dks tkjh j[kus dh lgefr nh Fkh] ftlls iwoZ mUgsa eka vkSj cPps ds ykHk&gkfu ds ckjs esa mUgsa iw.kZ :i ls le>k fn;k FkkA vr% bl uthj esa izfrikfnr fd;s x;s fl)kar ds enn~sutj Hkh lksuksxzkQh djus okys fpfdRld dh bl ekeys esa fdlh izdkj dh fpfdRldh; ykijokgh gksuk lkfcr ugha gksrh gS D;ksfa d muds }kjk izkFkhZ vkSj mldh iRuh Jherh xaxk nsoh dks cPps esa mRiUu gqbZ ekufld fod`fr;kas ds ckjs esa crk fn;k x;k FkkA vr% ;g ,d ,slk ekeyk gS] ftlesa fpfdRldh; ykijokgh dk dksbZ ekeyk izkFkhZ lkfcr 15 Jh lkSHkkx flag cuke flxek Mk;XuksfLVd lasVj ,oa vU;
ifjokn la[;k& 34@2019 djus esa lQy ugha jgk gSS] vr% ifjokn [kkfjt fd;s tkus ;ksX; ik;k tkrk gSA vkns'k izkFkhZ lkSHkkx flag }kjk vizkFkhZx.k flxek Mk;XuksfLVd ,aM lh-Vh- Ldsu@,e-vkj-vkbZ- Ldsu lsaVj] xtdsljh gSYFk ds;j ,oa feÙky gkWfLiVy ,aM fjlpZ lsaVj ds fo#) izLrqr ;g ifjokn [kkfjt fd;k tkrk gSA [kpkZ i{kdkjku viuk&viuk Lo;a ogu djsx a sA ¼fy;kdr vyh½ ¼fueZy flag esM+roky½ lnL; lnL;¼U;kf;d½ @lk{kh ikjhd@ 16