Scientific Program

Day 1 :

Keynote Forum

Edna Adan Ismail

Director & Founder of Edna Adan Hospital

Keynote: Safer Motherhood in Somaliland

Time : 10:00 - 10:40

Biography:

Edna Adan Ismail is the former Foreign Minister of Somaliland Republic. She held this office from 2003 until 2006, and had previously served as Somaliland's Minister of Family Welfare and Social Development. She is the director and founder of the Edna Adan Maternity Hospital in Hargeisa and an activist and pioneer in the struggle for the abolition of female genital mutilation. She is also President of the Organization for Victims of Torture.

Abstract:

Following a long and devastating civil war with Somalia, Somaliland emerged from that war in 1991 with its infrastructure totally destroyed, the majority of its health professionals killed, and no resources available to address the health problems of the people. In addition to this, the lack of international recognition of Somaliland was another obstacle that hampered the provision of adequate health care and education that were needed to recover from the human rights violations they faced during the war.

In light of these problems, Dr Edna Adan Ismail, a nurse and a midwife herself, made a decision that initially focused on building a maternity hospital to care for the needs of women and their babies. Since the hospital was opened in 2002, it steadily grew to become a regional referral and teaching hospital which has helped to reduce by 3/4 the alarming rates of maternal mortality and morbidity in Somaliland ( 63 maternal deaths among 22,000 deliveries that were assisted during the past 16 years= MMR of 280/100,000) . Being a referral hospital, this reduction became possible through the set-up of a facility that has a 24/hour readiness to deal with obstetrical emergencies, including fully functional operating theaters, a resident Anesthesist, blood bank, laboratory, and the accelerated training of Midwives that could be deployed to hospitals as well as to all corners of Somaliland where communities had never had health services nor ever seen a trained health professional.

Finally, in order to improve education, training and therefore services, Dr Edna Adan Ismail also founded her own university in 2011 which trains doctors, midwives, nurses, laboratory technicians, dentists, veterinarians, pharmacists, nutritionists and public health specialists. As women had been previously excluded from education, the Edna Adan University favours applicants from young women as well as students from a disadvantaged background

Keynote Forum

S Chhabra

Mahatma Gandhi Institute of Medical Sciences, India

Keynote: Women's Health Journey Is On Slippery Road

Time : 11:40- 12:20

Biography:

S Chhabra is a Director Professor of Obstetrics and Gynecology in the College of Mahatma Gandhi Institute of Medical Sciences, India and CEO of Akanksha Shishu Kalyan Kendra and OSD in Dr. Sushila Nayar Hospital, Sewagram.

Abstract:

Women suffer globally, with variations in the burden of sufferings of their body and mind. On one side their body structure, functions, make them vulnerable to various disorders, on the other side, there are society’s gender inequalities and norms. The extent of the disorders with which they suffer is mammoth. In India with world’s 15% population, bias starts with attempts at prevention of a girl’s entry into her mother’s womb and female foeticide, infanticide, problems of inequalities in childhood and during adolescence are persisting. Women suffer during reproductive life and beyond. There is growing burden of infertility because of various reasons with sequale of work up, therapy, under assisted reproduction (ART) and surrogacy also. Here also it is women who suffer all the dangers of surgeries, hormones and mental trauma. Pregnancy and birth related disorders, dysfunctions continue to kill women around the world. Preventable maternal deaths and severe illnesses continue in resource poor countries and woman’s life is at stake with each pregnancy. Maternal mortality, severe morbidity have increased even in affluent America. There are consequences of reproductive health events, even with normal functions, more so with dysfunctions as they age, be it Genital prolapsed or Stress continence. Gynaecological cancers are common with challenges of early diagnosis and management. Cervical cancer almost preventable continues to kill women. Other gyn. cancers also continue to affect woman’s life around the world with delayed diagnosis and complicated therapies. Over all women have to walk on the slippery road of their health journey from prebirth to death, Womb to Tomb. All attempts need to be made to make the health journey of a woman as safe as possible by preventing preventable and for others appropriate, affordable, accessible and timely therapies.

Keynote Forum

Danielle K Miller

Infor Healthcare, USA

Keynote: Leveraging technology to increase care coordination in healthcare

Time : 10:40- 11:20

Biography:

Experienced Chief Nursing Officer with a demonstrated history of healthcare subject matter expertise working in the computer software industry. Skilled in Healthcare Management, Hospital operations, Patient experience, Customer Service, Nursing Education, and Board certified in Obstetrics. Holds a BSN and MSN and entering the dissertation phase of her Doctor of Philosophy (Ph.D.) focused in Nursing Education from Capella University.

Abstract:

Health information technology (HIT) offers hospitals and healthcare systems the tools that integrate data from a clinical, financial, and operational perspective that yields analytical insight into their healthcare organizations. Leveraging technology to manage labor costs can be used by collecting the data from the electronic medical records that drive clinical staffing and clinical assignments to deliver superior patient, clinical and financial outcomes. Technology can be leveraged by healthcare organizations as they pursue the Quadruple Aim, which includes adding the goal of improving the work life of health care providers, comprising clinicians and staff, as well as seeking better cost, quality and outcomes. This allows for an increase in the coordination of care across all continuums.Healthcare organizations need a strategic clinical and operational plan to assist them in their efforts to optimize patient outcomes, improve employee satisfaction and maximize revenue. This can be accomplished by leveraging technology to increase the care coordination received in patient care. Implementing a solution will allow your organization to operate at maximum efficiency. Increased engagement with the patient throughout their continuum of care and increased communication amongst the entire healthcare team leads to better patient outcomes.The increasing advances and development of technology in health care offer the opportunity for increased availability of data to drive operations and the potential to support evidence-based management decisions (Hyun, et al, 2008). As challenges continue to rise, there is an enormous opportunity to leverage technology to provide better patient care to patients and improve clinical outcomes using real time, actionable data.Combining the best science-driven processes with patented technology and years of experience provides a solution that allows you to decrease turnover, improve performance, streamline hiring processes, and reduce risk.

  • Gynecology and Obstetrics| Maternal Fetal Medicine| Midwifery

Session Introduction

Ola Hadaya

Robert Wood Johnson Medical School, USA

Title: Abnormal dopplers in monochorionic twins-Is TAPS or maternal anemia at play?
Speaker
Biography:

Ola Hadaya is a second year resident in obstetrics and gynecology at Robert Wood Johnson Medical School. She graduated from Rutgers School of Arts and Sciences and then proceeded to obtain her Doctor of Medicine degree from Wayne State University School of Medicine. She completed medical school before most people complete their undergraduate studies. She entered her medical program early because she skipped the third, fifth and seventh grades, according to a university spokesperson.She was just 11 when she started high school in New Jersey. By 15, she'd graduated high school, having taken enough advanced placement courses to have shaved off a full year of college credits from her to-do list. She'd also completed a chemistry course at Princeton while attending high school. When she graduated from Rutgers with an undergraduate degree in Middle Eastern studies and a minor in biology, she then applied to Wayne State.She was one of fewer than 300 accepted to the school that year. Hadaya will follow in the footsteps of her father, also a doctor. 

Abstract:

Abnormal middle cerebral artery peak systolic velocities (MCA-PSV) in monochorionic twins raise concern for twin twin transfusion syndrome (TTTS) and twin anemiapolycythemia sequence (TAPS) as well as other causes of fetal anemia, including infectious and alloimmunizing etiologies. Rarely is severe maternal anemia considered the culprit behind the abnormal dopplers. We present a case of a 32 year old primigravida with monochromic diamniotic twins found to have an elevated MCA-PSV of initially one and then both twins, with no other ultrasonographic evidence suggestive of TAPS. Her workup was negative for parvovirus infection and alloimmunization but remarkable for severe maternal iron deficiency anemia. Treatment with IV iron was initiated, and the MCA-PSV’S normalized. A comparison of hemoglobin levels of the twins following delivery did not fulfill TAPS post-natal criteria. The significance of this case report is that presents a unique case, not before described in the literature, of severe maternal iron deficiency anemia resulting in abnormal fetal MCA-PSV’s. The fetus may not be as impervious to maternal iron deficiency anemia as has long been believed, but these effects appear to be reversible with treatment.

 

 

Speaker
Biography:

Dr. Fatmah Alsharif is an Assistant Professor of Nursing.  She currently serves as the at the Department of Medical and Surgical, College of Nursing, King Abdulaziz University. Her research interest is in the areas of Complementary and Alternative Medicine, Oncology, Symptom Distress, and Health related Quality of Life. She is specializing in teaching the undergraduate nursing students related to fundamental of nursing. She has an experience in quantitative methods research. Her pervious study was to explore the use of complementary and alternative medicine by women with breast cancer in Saudi Arabia. Dr. Alsharif is particularly interested in the Saudi population. She holds a Bachelor of nursing degree (2008),  Master of Nursing degree from Case Western Reserve University, Frances Payne Bolton School of Nursing (2014), and PhD in Nursing degree from Case Western Reserve University, Cleveland, Ohio, USA (2017). She is an active member Sigma Theta Tau International and Honor Society of Nursing

 

Abstract:

Breast cancer is a significant problem and is the main cause of cancer-related mortality in Saudi Arabia. It is estimated that the agestandardized incidence rate for breast cancer was 22.4 per 100,000 women in 2008, and the age-standardized mortality rate was 10.4 per 100,000 women. Symptom distress is common and health-related quality of life (HRQOL) is negatively impacted. Although the use of complementary and alternative medical (CAM) therapy is common among breast cancer patients in the US, the use among women with breast cancer in Saudi Arabia is not well understood. Therefore, the purpose of this study was to explore the association among the types of CAM use, the demographic, and clinical factors among women with breast cancer in Saudi Arabia. The Symptom Management Theory was used to guide this study. A descriptive cross-sectional study design was used and convenience sample of 85 women with breast cancer who were undergoing active cancer treatments was obtained from the in the oncology department at King Faisal Specialist Hospital and Research Centre, in Jeddah, Saudi Arabia. The Use of Complementary Therapies Survey (UCTS) was used to measure CAM use. SPSS was used to run descriptive statistics and univariate and multivariate analyses was used to explore relationships among the types of CAM use, the demographic, and clinical factors. The findings show that all women had used at least three methods of CAM. The personal characteristics can influence symptom management strategies (CAM use). Positive correlations between time since diagnosis and specific CAM types maybe explained that’s some types were explained by low cost. The results of this study will guide future studies examining the efficacy of CAM on symptom management in Saudi Arabian women with breast cancer. These findings will serve as basis for future research examining CAM use in symptom management of breast cancer and other types of cancer.

 

  • Reproductive Medicine | Infertility
Speaker
Biography:

After completing medical school and residency at Alexandria  University,College of medicine, Soha remained for advanced training in laparoscopy and oncogynecology.In late 2011, Dr. Soha joined the national program for primary healthcare  of Obstetrics and Gynecology, and Reproductive Sciences at ministry of health and population. She has worked towards improving the access to gynecologic care for the underserved through the Women’s Center at Alexandria. As a specialist  of the resident gynecologic onco surgical practice at Alexandria Military Hospital, she kindled her passion for surgical and clinical research work. In this role, she participated in many eminent Gyn.& Obs. national and international conference. Moreover, Dr. Soha is committed to creating systems for constant self-assessment and improvement within medicine. She serves as co-assisstant of the Gynecologic Practice Quality Assurance Committee at MOHP with special interests in chemotherapy targeted drug development, patient quality of life programs and early cancer detection within the OB/GYN department. On the clinical side, Dr.Soha enjoys providing exceptional, individualized, comprehensive care to patients, bringing together multi-disciplinary clinical teams to achieve the best outcomes. She is passionate about advancing the field of gynecologic oncology through innovative scientific research and hopes her discoveries will lead to better treatments for patients.

Abstract:

Background: Hyperandrogenism is present in up to 70 % of PCOS patients in the form of hirsutism and others. Serum PSA concentrations were found to be higher in hirsute than in non hirsute males, suggesting that, also in females, PSA may be regulated by androgens. Serum PSA levels also vary during menstrual cycles and increase in women with excess androgen. Aim: Demonstrate correlation between PSA and hirsutism in women with PCOS and the cut off value of PSA in diagnosis of PCOS. Methods and material: Fifty women in their reproductive age (20-40) years old, who had been diagnosed as PCOS and Fifty non-PCO women were served as control. the measurements were age, marital status, obstetric, medical histories, BMI, w/h ratio, waist and hip circumference, fat distribution, serum PSA and testosterone and their correlation with modified Ferriman-Gallwey scale and the cut off value of both PSA and testosterone.Results: PSA with the cut off value is an important indicator of diagnosis of PCOS with sensitivity 98.0% and specificity 96.0%, positive correlation between serum PSA and hirsutism in PCOS patients.

 

Speaker
Biography:

Caroline holds BS in nursing since 1988, certified in Infection Control (NYIC) as well as educator for NYIC certification. She is JCI certified educator for JCI education program “Safety in Surgical Services”.
She has more than 28 years’ experience in Nursing Management, Infection control and Health Care Quality, Accreditation Management and Elderly Care. She held the position of Director of Nursing Services at “Home Care Lebanon”, where she was leading the Health Care Team and responsible for Patient Safety, from 1997 to 2004. From 1994 to 1997 Caroline held the position of Operating Room Nursing Manager in Lebanon.
She is an active public speaker at international and national congresses for Patient Safety, Surgical forum, Hand Hygiene Campaigns and Infection Preventions summits in CEEMEA region.
Since she joined 3M in 2004, she has been working closely with Hospitals Management team, Infection Control and Patient Safety Committees all over the CEEMEA region to improve patient safety, Expectations and outcomes. Her contribution in creating awareness of the best practices and driving surgical safety solution, surgical pathway, clinical evidences and standards of care to prevent Hospital Acquired Infection as well as educating Health Care Staff in CEEMEA region is broadly recognized and appreciated. She has publication on the Reduction of Surgical Site Infections in Cesarean Section Deliveries by Implementation of a Surgical Care Pathway.

Abstract:

Caesarean section deliveries are an important surgical procedure that is used to improve both maternal and fetal outcomes in complicated pregnancies. In recent times however the convenience of the surgery for both mother and surgeon has resulted in an increasing global trend of C-section deliveries which according to the World Health Organization has now reached pandemic proportions. The nature of the surgery makes it a high risk procedure and the incidence of infection have been increasing in both well and under-resourced countries. Since the entire process is not limited to a single hospital department, a multi-disciplinary approach is needed to minimize the risk of infections. For this study a surgical care pathway was introduced as part of a performance improvement project to a private hospital in South Africa which resulted in C-section infection rates decreasing from 5.12 ± 0.82 % to 0.23 ± 0.15 % (p<0.0001).

 

Hussein Kandil

Fakih IVF Fertility Center, UAE

Title: Endocrinopathies and male infertility
Speaker
Biography:

Hussein Kandil, a urologist specializing in male reproductive, men’s health and sexual medicine,graduated from the division of urology at St. George Hospital University Medical Centre, in affiliation with Balamand university, Lebanon. He completed his residency at the division of urology at Pontoise regional hospital and Lens university hospital in France, and earned his Diploma in Urology in 2008. After completing his residency in 2009, he joined the division of urology at the University of Illinois at Chicago for a Fellowship in Andrology, sub-specializing in male reproductive medicine. In 2017, Dr. Hussein Kandil earned the Fellowship of the American College of Surgeons, and received the title FACS. His area of interest lies in in Microdissection Testicular Sperm Extraction in the management of Non- Obstructive Azoospermia, and has special interest in male reproductive endocrine disorders. Dr. Kandil authored and published on amazon a public manual in English and Arabic, called ‘The Male: Pearls of Hope in Male Infertility’, which is a manual that guides males through their journey of male infertility.

 

Abstract:

Male reproductive endocrinology has become a topic of great importance, aiming to manage the dramatic decline in male reproductive indices that took place over the last decades, negatively affecting male fertility, sexuality and general well being. Endocrinopathies remain to be a common finding that is linked to male sub fertility. And since stability of the endocrine system is a pre-requisite for a normal male reproductive function, a lot of research is focused on studying the reasons behind this unparalleled alteration, implementing better tools of investigation, and offering new pharmaceutical products to manage this complex and sensitive problem that reached an incidence of more than 30% in patients visiting fertility clinics. The learning objectives of the presentation include: highlighting on the importance of hormonal evaluation of the infertile male, interpreting the results based on the most up-to-date standards and references, discussing critical papers that pioneered hormonal manipulations in the context of male sub fertility, identifying the subgroup of patients requiring treatment, becoming knowledgeable about the different pharmaceutical agents commercially available, and finally, understanding the various hormonal manipulations and techniques used to boost spermatogenesis, improve fertility index, and most importantly improve the male well being.

 

Gopa Chowdhury

Rajendra Institude of Medical Sciences, India

Title: PCOS and Pregnancy Outcome
Speaker
Biography:

Dr Gopa Chowdhury, Rtd. Associate Prof, Obstetrics & Gynaecology, MD, FICOG, has her expertise in different areas of Gynecology and Obstetrics and is passionate about spreading her knowledge through papers, articles, Knowledge sessions and her work with patients in the rural region of Jharkhand. She is an Executive member of ROGS and has held different positions as Speaker, Panelist, Chair-person in ROGS and National conferences. Dr Gopa was also the Vice President – FOGSI ROGS (Ranchi Obst, & Gynae Society); 2013-2015 and is an ongoing active member of the group. Besides her work as Associate Prof., she Several Papers published in State, National, International Journals and has been an active participant in CMEs, Conferences (State, National, International): FIGO-SAFOG, RCOG, FIGO, AOCOG, SICOG (oral and paper presentation), National-YUVA-FOGSI, AICOG as delegate and faculty

Abstract:

Polycystic ovarian syndrome (PCOS), an intergenerational condition, is one of the most common endocrine syndrome affecting the reproductive system, encompassing metabolic, cardiovascular, dermatological, psychological conditions starting from adolescence. 4-8% prevalence in reproductive age. Effects manifest via deranged hormone profile with main complaints of menstrual irregularity, hirsutism, and infertility.

Diagnostic criteria:

GDM-50-100 gm oral glucose tolerance test, PIH-BP >= 140/90 mm of Hg with Protinuria >= two by dipstick (>3gm / 24 hr.). Gestational age >= 20 weeks, premature delivery < 37 weeks

Results: Conception:

  • After Metformin 49% (1345)
  • After Ovulation induction with Clomiphene Citrate 37% (1016)
  • After Gonadotropin 0.3% (82)
  • No turn up 11% (303).
  • Women with PCOSare at higher risk for pregnancy complications. 69% (1686) delivered after 37 completed weeks. 23% (562) before 37 weeks. 8% (195) spontaneous abortion.
  • Significant obesity. BMI >= 25 present in 72% (1686)
  • Major pregnancy complications:
  • PIH 54% (1213), GDM 56% (1258), premature delivery 23% (517)
  • Caesarean delivery high in 32% (719) mainly due to GDM causes big baby and severe PIH 29% (652)

Speaker
Biography:

Dr. Aboubakr Elnashar is a Professor of Obstetrics and Gynecology at Benha University, Egypt. He is the President of clinical society of obs and gyn. He is the member of the board of Egyptian Society of Fertility & sterility from 2015 and till now. He is the editor of the Egyptian Fertility sterility Journal and the Benha Medical Journal. He is the Associate Editor of Middle East fertility Society Journal. He was the assistant secretary general of Egyptian society of fertility & Sterility (2002- 2006). Dr. Elnashar had many publications both national and international. He is managing and directing of many training courses in cytology, colposcopy, ultrasonography, foetal monitor, reproductive endocrinology and ART. Qualification includes, M.B.CH.B. (Very good with honor, 1978, Zagazig University) Post graduate qualifications 1. Master in Ob/Gyn (Very good, 1982), Zagazig University 2. Diploma in cervical pathology (1986, Barcelona, Spain) 3. Medical Doctora in Ob/Gyn (1989, Zagazig University) Post graduate appointments Registrar, assistant lecturer, Lecturer, Assistant professor Ob/Gyn in Benha Faculty of Medicine from January 1996. Appointments 1. Professor of Ob/Gyn, Benha Faculty of Medicine, Egypt, from March 2001 till now 2. Chief of early detection of cancer unit, Benha University Hospital, Egypt. 3. Consultant of IVF &ICSI in Delta Fertility Center & Benha Fertility Center, Egypt.

Abstract:

Main results and the role of chance: Three Cochrane SR and Three non Cochrane SR. Evidence was insufficient to support the use of pentoxifylline in the management of endometriosis in terms of subfertility and relief of pain outcomes. 2. There is some but limited evidence for the beneficial effects of vitamin D supplementation on menstrual dysfunction in polycystic ovary syndrome (PCOS) 3. Myo-inositol provided a beneficial effect for PCOS. 4. Antioxidants; were not associated with an increased life birthrate (LBR) compared with placebo or no treatment. 5. Combined antioxidants were associated with clinical pregnancy rate (CPR). 6. An association was seen between antioxidants and CPR in women with PCOS; however, heterogeneity was extremely high. 7. No association was seen between antioxidants and CPR in women with endometriosis or unexplained infertility. 8. Pentoxifylline was found to be associated with an increased CPR. Limitations, reasons for caution: Despite numerous advances in antioxidant, there is a need for further randomized controlled studies within a larger population to determine their efficacy and safety.Wider implications of the findings: Antioxidants are readily available, mostly unregulated. Significant number of infertile females is taking antioxidants in the expectation that this will improve their chances of conception

Speaker
Biography:

Wenxin Zheng, M.D., tenure Professor of Pathology and Obstetrics and Gynecology, American board certified pathologist, director of the Gynecologic Pathology and Molecular Pathology program at the University of Arizona, graduated from Shanghai Medical College Fudan University and trained at Columbia University, Cornell University, and Brown University Medical Centers in anatomic pathology and gynecologic pathology. Dr. Zheng is an internationally recognized gynecologic pathologist with expertise in hormonal etiology of sporadic ovarian cancer, type II endometrial carcinogenesis, and hormone replacement therapy.

Abstract:

Background: Ovarian low-grade serous carcinomas (LGSC) are thought to evolve in a step-wise fashion from ovarian epithelial inclusions (OEI), serous cystadenomas (SC), and serous borderline tumors (SBT). Our previous study showed that the majority OEIs are derived from the fallopian tubal epithelia (FTE) rather than from ovarian surface epithelia (OSE). This study was designed to gain further insight into the cellular origin of LGSC by differential gene expression profiling studies. 

Methods: Gene expression profiles were studied in 44 samples including 11 LGSCs, 7 SBTs, 6 SCs, 6 OEIs, 7 FTEs, and 6 OSEs. Correlation analyses of ovarian serous tumors including its precursor OEIs with FTE and OSE samples were performed by unsupervised hierarchical clustering. Rank-sum analyses and Pearson correlation tests were then applied to determine the likelihood of cellular origin of LGSC and its precursors. Final validation was done on selected genes and corresponding proteins.

Results: Gene expression profiles distinguish LGSC from OSE, but not from FTE cells. Furthermore, dendrograms produced by unsupervised hierarchical clustering showed ovarian serous tumors and OEIs were clustered closely in a branch, but separated from OSEs. After ascertaining the reliability of sequencing data, we found that OVGP1, WT-1, and FOM3 highly expressed in fallopian tube and OEI, and ovarian serous tumors, but not in OSE. In contrast, ARX and FNC1 were mainly expressed in OSE, but not in other studied samples.   

Speaker
Biography:

Dr. Tamer Hosny was born in 1980 in Egypt. He studied medicine at Alexandria University, Egypt  and graduated in 2003. He is a lecturer at the Department of Obstetrics and Gynecology at Alexandria university. In 2013, he was awarded the European Inter university Diploma of Advanced Operative Laparoscopy by the University Of Auvergne, France. In 2014, he got his Phd study in reprodcutive syrgery. ALso he got a fellowship in Chu Estaing, Clermont ferrand , France. At 2016 he awarded GESEA Diploma Special interests lie in the field of MIS in gynecology. 

Abstract:

Oophoropexy for ovarian torsion is easily done by many tools either by suturing to the lateral pelvic wall, plication of  the ovarian ligament, or even fixation to the back of the uterus, but it is a little bit difficult to do for pregnant women with less manipulation. We propose that using a trocar site closure needle can be an easier and faster technique to do  this. Seven patients presented with ovarian torsion; four of them were pregnant at 7, 15, 19, and 20 weeks of gestation,  two patients had ovarian hyperstimulation in IVF cycles, and one adolescent patient had a hemorrhagic cyst. They were diagnosed by clinical presentation and ultrasound with Doppler analysis and confirmed by laparoscopy where they underwent detorsion and fixation of the ovary using the trocar site closure needle. Follow-up of all the cases after 1 week showed improvement of the symptoms and then normal Doppler flow of the target ovary after 3 weeks by ultrasonography which revealed normal Doppler flow in the previously torsioned ovary. Two pregnant women underwent cesarean delivery where the operated ovary was observed during the delivery and was normal in shape and freely mobile with no adhesions. We propose that this technique is easier, faster, and more comfortable especially in ovarian torsion in pregnant women and torsion in hyperstimulated ovaries

Speaker
Biography:

Jónathan Hernández-Núñez is the Medical Director in Tshilidzini Hospital, South Africa. He is also a Specialist in the field of Gynecology and Obstetrics . His area of interest includes womens helathcare. he completed his master's degree in integral care for women from South Africa. His eminence in the field of Gynecology and Obstetrics helped him to prove his career as  an assistant professor and research associate in the corresponding field. 

Abstract:

Statement of the Problem: Prematurity continues to be one of the great problems of obstetrics due to the great morbidity and mortality associated with it; a clear prevention strategy to reduce preterm birth rates has not yet been reached. The purpose of this study was to identify the risk factors associated with preterm delivery. Methodology & Theoretical Orientation: A case-control study was conducted at Tshilidzini Hospital in South Africa and Mohamed Golliat Hospital in Algeria between January 2015 and December 2016. The universe was 97 patients with preterm delivery and the initial sample was matched with the universe for the group of cases, also a control group of 291 patients with term delivery were selected, all randomly selected from a list of random numbers following a 3:1 ratio; the sample was definitively made up of 89 cases and 255 controls. The data were collected through a form filled by review of the obstetric and hospital files; statistically we used the frequency distribution, mean, standard deviation, percentage, Ji square test, Student's test and Odds Ratio. Findings: The risk factors for preterm delivery were the maternal age of 35 years or older (OR = 2.94), single marital status (OR = 2.98), maternal obesity at the beginning of pregnancy (OR = 1.78 ), previous history of chronic hypertension (OR = 3.77), seven or more prior abortions (OR = 7.17), previous preterm delivery (OR = 3.46), preeclampsia-eclampsia (OR=5.99), urinary tract infection (OR = 3.41), multiple pregnancy (OR = 5.00) and oligohydramnios (OR = 6.06); not the cultural level, the toxic habits, the parity, nor the short interpregnancy intervals. Conclusion & Significance: There are multiple risk factors that predispose to preterm delivery and contribute to increase perinatal morbidity and mortality, many of which are susceptible to be modified from primary health care.

  • Uro- Gynecology | Gynecological Oncology

Session Introduction

Pravin Mhatre

Seth G.S. Medical college,K.E.M. Hospital and N.Wadia Hospital, India

Title: New Laparoscopic vaginoplasty developing normal vagina, Identification of the progenitor cell and Genetic decoding of MRKH syndrome.
Speaker
Biography:

Dr. Pravin Mhatre is the Scientific Director of Kedar Hopital which has already made its mark as one of the reputed hospitals for gynecology services in India. Dr. Mhatre is a consultant to the Breach Candy Hospital, N. Wadia Hospital in Mumbai. He  has done pioneering work in the field of Ovarian Transplant and has been credited with world's first successful "Ovarian Transplant".He has developed a new Vaginoplasty technique resulting in formation of normal Vagina and identification of Stem cell. He has performed more than 100 cases of Vaginoplasty. Dr. Mhatre has served as Honorary professor emeritus of Gyn/Obst at Seth G.S. Medical college / N. Wadia Hospital for 30 years.For more than 8 years Dr. Mhatre has conducted many rural tubal ligation camps all over India. For this honorary contribution in women's heath care his team has received Presidents Medal from government of India. Dr. Mhatre has delivered guest lectures in many international and national congresses and has been an invited Professor at Oxford University (UK), University of Georgia (Atlanta USA) & Colombo University.  Dr. Mhatre has been honored as first Gyn.Transplant surgeon by government. He has been Interviewed on BBC London / Asia live on 7th May 2002 and 18th December 2002 for the worlds first successful Ovarian Transplant. BBC World on 24th December 2002 declared this Ovarian Transplant as The significant medical achievement of the year 2002.He has started the First Ovarian Bank in 2005, currently in joint collaboration with NIRRH and TATA Hospital

Abstract:

Host of vaginoplasty techniques have been described. None has been successful in developing normal vagina. Modified laparoscopic peritoneal vaginoplasty (LPV) by Dr. Mhatre’s technique is performed in Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS) culminating in normal vaginal development.These serial metaplastic changes converting peritoneum to normal vagina are documented and the progenitor cell responsible for this change is identified.

  • This study aims to confirm normal development of neovagina by anatomical and functional parameters of histology, cytology, and ultrasonography (USG) with Doppler in LPV.
  • To identify peritoneal progenitor cell by OCT4/SOX2 immuno-histochemistry markers.
  • To demonstrate the metaplastic conversion of peritoneum to neovagina and the progenitor cell concentration, distribution pattern.

This is prospective experimental study, conducted at teaching hospital and private hospital. Seventy-five women of MRKHS underwent LPV followed by histology, cytology, pH, three / four dimensional USG along with Doppler blood flow of neovagina. Nine women underwent peritoneal biopsy for identification of progenitor cells with OCT4/SOX2 markers. One patient underwent serial biopsies for 4 weeks for histology and progenitor cell immunohistochemistry.Eighteen women of MRKH and fifteen controls were subjected for genetic workup. 

  • Health Related Behaviours in Women | Prenatal Diagnosis | Nursing and Healthcare
Speaker
Biography:

Zahra Salim Jessani is currently working as a Registered Nurse from past 3 years at Aga Khan University Hospital Karachi, Pakistan in the department of Post Anesthesia Care Unit. In addition, certified Bachelor in science of nursing with a valid Licensed from Pakistan Nursing Council. Multiple researches have been done in the field of Nursing. Written and submitted one scholarly article in i-manager Journal of  Nursing titled “Addressing Physical and Spiritual needs of a patient in End of life care”. Published two poster presentations in International Nurses Day and International day of midwifery on “Psychosocial effects of sexual exploitation on children and Addressing physical and psychological needs of patient in palliative care”. Moreover, Provided with thorough knowledge about “Psychosocial effects of sexual exploitation in children” via oral presentation at National and International Levels respectively. Thus, Iam much interested to attend the conference for research purpose.

Abstract:

Introduction: Giving birth is a life-changing event. It is a crucial phenomenon in the women’s life. To be care, and to be cared for should be the motive for every health care professional’s mind. Good communication, support, clean and aseptic usage of equipment during compassion from staff, and having her wishes respected, can help her feel in control of what is happening and contribute to making birth a positive experience for the woman and her birth companion.

Objective: To describe the importance of the holistic care during delivery. The aim is to motivate health care professionals to provide holistic care during deliver in order to enhance patient’s well-being by preventing them from complications.

 Methods: Literature review conducted to explore “Importance of Holistic care during delivery and its effects on maternal health”. Different electronic engines were explored from 2003 to 2013.Electronic engines includes authentic websites, research based articles and journals.

 Results: Literature suggests that lack of enforced aseptic techniques can lead to a host of problems for patientsMoreover, lack of privacy could become hindrance in providing holistic care because human dignity is one of the basic principles considering patient’s rights. Furthermore, literature states that patient advocacy is an imperative situation, where health care professional dealt with it effectively and can provide care in a holistic manner.

Conclusions and Recommendations: To provide complete care, one should be competent enough to maintain the boundaries in a holistic manner. Teaching session about the importance of privacy and aseptic practices should be provided in order to empower staffs to prevent patient from harm. Accommodation and negotiation with the system will help to provide quality care towards patient.

  • Young Researchers

Session Introduction

Feriha Fatima

Liaquat University of Medical & Health Sciences, Pakistan

Title: VEGF A2578C Polymorphism & Serum Soluble VEGFR1 Levels in Preclampsia
Speaker
Biography:

Dr Feriha Fatima is PhD scholar at molecular biology and genetics department LUMHS and lecturer at biochemistry department of same institution. Her research interests are various genetic and biochemical factors involved in preeclampsia.

Abstract:

Vascular endothelial growth factor (VEGF) gene is protein encoding gene involved in angiogenesis, vasculogenesis, cell migration and endothelial cell proliferation. It has been found that its expression is upregulated in certain tumours. VEGF A2578C (rs699947) is functional polymorphism having influence on promoter function and regulates expression. VEGF A2578C denotes point mutation transitions of A/C at nucleotide position −2578 that is taken relative to the translation start site. It has been studied in association with various disorders including preeclampsia however it has not been studied in Pakistani pregnant women previously. Present study aimed to find out genotypes of VEGF A2578C and serum levels of soluble VEGFR1 in preeclamptic women in comparison with normal pregnant women. Methodology: We conducted case control study at Liaquat University of medical and health sciences (LUMHS) Jamshoro. Study subjects included 80 preeclamptic women and 80 matched gestational age normal pregnant women. Venous blood sample was collected for serum and DNA extraction. VEGF A2578C polymorphism genotyping was carried out by tetra-primer ARMS–PCR method (designed and optimized at molecular biology and genetic department, LUMHS). Serum soluble VEGFR1 was determined by ELISA method. Results: The homozygous CC genotype was found in 30% of cases and 25% of control group, heterozygous AC genotype 47.5% among cases and 56.25% among controls whereas homozygous AA genotype distribution was 22.5% among cases and 18.75% among controls.. Serum soluble VEGFR1 levels were significantly higher among cases as compared to controls. Conclusion & Significance:. We did not find significant association of VEGF A2578C polymorphism in development of preeclampsia in our population. However raised serum soluble VEGFR1 levels in preeclampsia may direct alteration in levels of angiogenic and anti- angiogenic factors in disorder

Day 2 :

Keynote Forum

Mamta Ratt Datta

Gynecologic Specialist

Keynote: Efficacy of 1st trimester ultrasound parameters for prediction of early miscarriage

Time : 10:00 - 10:40

Biography:

Mamta Rath Datta is the Head Consultant the department of obstetrics and gynecology  at Tata Main Hospital, Jemshedpur, India since 1996. She was also the past president of Jemshedpur ObGyn Society. She is qualified with M.D in Obs & Gyn in 1994, FICMCH, FICOG, FMAS. Her area of interest includes laparoscopy. Her major publications includes, ‘Magnesium Sulphate in Eclampsia: a safe, efficient and cost effective approach’- published in ‘The Journal of Obstetrics and Gynaecology of India’ in the May/June 2002 issue; ‘Heterotypic pregnancy – case report of two cases’ – published in ‘The Journal of Obstetrics and Gynaecology of India’ in the Mar/Apr 2003 issue; Paper titled as ‘Rupture uterus presenting as fecal fistula – a case presentation’ has been published in ‘The Journal of Obstetrics and Gynaecology of India ‘May – June 2005; Induction of labor with oral misoprostol in women with prelabor rupture of membranes at term: Datta Mamta Rath, Kabiraj Manas, Tata Main Hospital, Jamshedpur – 831001; J Obstet Gynecology India November/December 2007; ‘Book of Proceedings’ book released during AICOG 2007 – Convulsions in Pregnancy. Her international publications includes the following, BMJ Case Reports 2015; doi:10.1136/bcr-2014-207175,Cardiac arrest following acute puerperal uterine inversion Deb Sanjay Nag1, Mamta Rath Datta2, Devi Prasad Samaddar3, Binita Panigrahi1 Published 18 February 2015; Non-puerperal uterine inversion in a patient with intracranial sigmoid sinus thrombosis and facial palsy -Mamta Rath Datta1, Deb Sanjay Nag2, Manas Kabiraj1 , Published 12 May 2015; Open Journal of Obstetrics and Gynecology, 2015; Mid Trimester Transvaginal Ultrasound Assessment of Cervix for Prediction of Primary CaesareanSection; Efficacy of first-trimester ultrasound parameters for prediction of early spontaneous abortion. Datta, M. R. and Raut, A. , Int J Gynaecol Obstet. 2017 Sep;138(3):325-330. doi: 10.1002/ijgo.12231. Epub 2017 Jun 30; Contributed a chapter  titled ‘Thyroid diseases in Obstetrics and Gynecological Practice’in  a book “Management of Thyroid  Disorders’ published by Jaypee Brothers in 2009.

 

Abstract:

Of the 800 pregnancies studied, 140 had early miscarriage. Crown rump length (CRL), gestation sac diameter (GSD), fetal heart rate (FHR) values less than 5th percentile (OR 26.48, 26.94, 100.63 respectively) and yolk sac diameter (YSD) more than 95th percentile (OR 1.04) were significant predictors of early miscarriage. When these abnormal parameters   coexisted in any pregnancy, the miscarriage risk was significantly high (OR 35.27). A normal YSD could not significantly reduce the risk of miscarriage, if the other three parameters were below the 5th percentile (OR 35.27). Every 10 beats per minute (bpm) decrease in FHR below 130, there was a 26.73% increase in risk of miscarriage.. GSD-CRL   difference < 5mm was associated with significantly increased miscarriage risk (OR 4.88). 

Biography:

Shalani Andria, the Transformational Health Industry Analyst at Frost & Sullivan is a subject matter expert in Asia Pacific digital health market with thought leadership covering broad range of sectors within the digital health market including Video Telemedicine, Mobile Health, Remote Patient Monitoring, Home Care, Healthcare IT, Healthcare Big Data Analytics, Healthcare Interoperability and Internet of Medical Things. Shalani has extensive experience in strategy consulting, merger & acquisition, and public-private partnerships. She has advised top telehealth vendors, healthcare IT vendors, medical device vendors, hospital groups, and ministries on disruptive technologies, business model innovation, and sustainable ecosystem. She has been quoted in multiple industry magazines and journals. 

Abstract:

Asia-Pacific (APAC) is moving from centralized to decentralized care-delivery models, with the need for efficient healthcare services outside the hospital. There has been an increase in demand for remote patient monitoring (RPM) devices by both healthcare providers and consumers in the home but adoption and adherence is low. The major roadblock is funding for high-tech devices and care management platforms. Some of the key challenges include:

  • Absence of sustainable business models due to under-developed healthcare regulations and reimbursement mechanisms
  • Lack of an ecosystem strategy that includes sustainable partnerships between telecommunication providers, healthcare providers, insurance companies, governments or others for home monitoring.

Failure to address these challenges result in inability to monetize home health monitoring solutions, although the market is packed with unexplored opportunities. This presentation will highlight some innovative business models that address these issues, and educate stakeholders on how and why the models are successful.

Biography:

Dr Hussam AL-Nusair has completed his PhD in hospital administration from Nottingham University/UK and Master Degree in Advancing Critical Care from Kings College London/UK. He is the Chief Nursing Officer for Sheikh Khalifa Hospital Um Alquwain since 2016, prior to this in UK as chief nursing officer for over 6 years, and Chief Nursing Officer in Riyadh for 8 years. He has published more than 4 papers in reputed journals. Hussam Al Nusair have over 25 years of experience in the nursing field, his main interest is around staff engagement and recognition.

Abstract:

Having the right number of the right nurses is of course an important first step in ensuring that patient care is delivered in the most cost effective, quality-driven manner. However, overall engagement of these qualified staff members also plays an important role in improving quality across a health system. A wide variety of peer-reviewed studies, patient surveys, and data-driven reports have documented the impact nurses have on both patient satisfaction and health outcomes. For instance, a recent study showed that nurse engagement is the number one predictor of mortality variation across hospitals. This means that it’s not enough for hospitals to simply add more staff; instead, they must look closely at the engagement levels of current staff in order to maintain optimal care practices. Patient feedback solicited through other surveys has also documented the importance of nurses in the overall care experience. A peer-reviewed clinical study concluded that patient ratings of nursing care have the most direct correlation with ratings of overall quality of care and services. This demonstrates that when a less-thanengaged nurse has a poor interaction with a patient, the patient’s entire care experience can easily be tainted, regardless of his or her health outcome. In addition, surveys from both nurses and patients showed that patients cared for on units characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice as likely as other patients to report high satisfaction with their care.While much of this support happens “behind the scenes” of care practices, this is yet another direct link between the work environment of nurses and patient satisfaction. In fact, a Press Ganey report shows that while some aspects of nurse staffing, such as hours of care and skill mix, certainly influence outcomes, the work environment of nurses has a much more significant influence across most metrics. Hospital performance on patient experience scores within value-based purchasing models also increased with improved work environments for nurses. These facts provide substantial evidence for the idea that allocating time and resources to promote happier, more engaged nurses can deliver a measurable return on investment for hospitals. In addition to its clear impact on care quality and patient satisfaction, existing evidence also demonstrates the relationship between increased revenue, cost savings, and nurse retention. According to the Journal of Nursing Administration, when low engagement leads to nurse dissatisfaction and a lack of retention, hospitals will incur costs upwards of $82,000 to recruit one new nurse. That figure covers vacancy, orientation and training, the lowered productivity of a newly hired nurse, and advertising and recruiting costs. Other studies show that retaining just one nurse and utilizing the recommended nurse-patient ratios may result in savings of approximately $140,000 every year.

  • Midwifery | Gynecological Endocrinology
Speaker
Biography:

Dr. Ligia Patricia Rojas has completed her PhD at the age of 45 years from UNED University. She is Catedratical Professor and Researcher in the University of Costa Rica. She is the Coordinator of Evidence-based Nursing Research Collaboration Program in Costa Rica, Coordinator of Master's Degree in Gynecological, Obstetric and Perinatal Nursing in the Postgraduate in Nursing Sciences at the University of Costa Rica. Editor in Chief of the Current Nursing Journal of Costa Rica. She has published papers in international and nacional journals and participates as a peer reviewer in several nursing journals.

 

Abstract:

Statement of the Problem: The training of nursing students in postgraduate studies has undergone an important evolution about their role and professional competencies based in the better available scientific evidence. However, postgraduate students place research in the background and this behavior that they bring to their clinical practice as specialists. The academy has made efforts to implement various teaching methodologies that improve the motivation and acquisition of knowledge and interest of the student for the research, that they appreciate it as a form of development of the nursing. Therefore, it is important to follow-up the pedagogical characteristics in student training in research that allow for curricular improvements based on scientific evidence. The purpose of this study is to analyze the pedagogical characteristics in the research training of the postgraduate student in nursing in two masters degree of the Postgraduate Program in Nursing of the University of Costa Rica to improve the processes of training in the research area. Methodology & Theoretical Orientation: It is a non-experimental study, long-term evolution of groups (cohort). Three cohorts will be carried out, in each cohort the following pedagogical characteristics will be measured: educational didactics, approach and learning strategies, learning assessment strategies, student participation, teacher support, quality of educational products, impact on clinical practice and scientific dissemination. Findings: The first cohort will be measured in June 2018, so there are no findings at this time. Conclusion & Significance: This protocol aims to have enough information to be able to assess the current pedagogical characteristics in the training of research in postgraduate student and improve them in order to have postgraduate institutions that have favorable environments for research, establish innovative and creative approaches for the research training and very relevant to the expectations and inspirations of students, linked to their ability to motivate themselves to acquire knowledge in research, use their internal locus of control, acquire and use available resources that allow them to improve their practice nursing based on scientific evidence.

Hussein Kandil

Fakih IVF Fertility Center, UAE

Title: Non obstructive azoospermia: management update
Speaker
Biography:

 

Hussein Kandil, a urologist specializing in male reproductive, men’s health and sexual medicine,graduated from the division of urology at St. George Hospital University Medical Centre, in affiliation with Balamand university, Lebanon. He completed his residency at the division of urology at Pontoise regional hospital and Lens university hospital in France, and earned his Diploma in Urology in 2008. After completing his residency in 2009, he joined the division of urology at the University of Illinois at Chicago for a Fellowship in Andrology, sub-specializing in male reproductive medicine. In 2017, Dr. Hussein Kandil earned the Fellowship of the American College of Surgeons, and received the title FACS. His area of interest lies in in Microdissection Testicular Sperm Extraction in the management of Non- Obstructive Azoospermia, and has special interest in male reproductive endocrine disorders. Dr. Kandil authored and published on amazon a public manual in English and Arabic, called ‘The Male: Pearls of Hope in Male Infertility’, which is a manual that guides males through their journey of male infertility.

Hussein Kandil, a urologist specializing in male reproductive, men’s health and sexual medicine,graduated from the division of urology at St. George Hospital University Medical Centre, in affiliation with Balamand university, Lebanon. He completed his residency at the division of urology at Pontoise regional hospital and Lens university hospital in France, and earned his Diploma in Urology in 2008. After completing his residency in 2009, he joined the division of urology at the University of Illinois at Chicago for a Fellowship in Andrology, sub-specializing in male reproductive medicine. In 2017, Dr. Hussein Kandil earned the Fellowship of the American College of Surgeons, and received the title FACS. His area of interest lies in in Microdissection Testicular Sperm Extraction in the management of Non- Obstructive Azoospermia, and has special interest in male reproductive endocrine disorders. Dr. Kandil authored and published on amazon a public manual in English and Arabic, called ‘The Male: Pearls of Hope in Male Infertility’, which is a manual that guides males through their journey of male infertility.

Abstract:

Non Obstructive Azoospermia (NOA), one of the most complicated challenges faced by most fertility professionals worldwide, with an estimate of 15 % among all patients presenting to a fertility clinic, and in 1% of the general population. Though the progress has been rendered slow in the past decades, yet recently scientific research started progressing, and have paved the way to higher level of understanding, and offered more diverse tools that help in the management of patients inflicted with NOA. Such emerging advances included the various forms of medical management and hormonal manipulations, in addition to the more complex surgical sperm retrieval. Learning objectives of the presentation include: clinic evaluation of the azoosermic patient, the clinical differentiation between obstructive azoospermia and non obstructive azoospermia, genetic evaluation of NOA patients, role of hormonal manipulations in the management of NOA, updates on the various forms of sperm retrieval techniques, including the microsurgical procedures.

 

 

  • Uro- Gynecology | Gynecological Oncology
Speaker
Biography:

Priyanka Mukherjee is working as    an Associate Specialist in the Department of Obstetrics and Gynaecology,  Tata Main hospital, Jamshedpur, India.She finished her undergraduate medical training from Gauhati Medical College in 2006. Thereafter she did her specialisation in Obstetrics and Gynaecology from TMH. She then worked as an Associate Consultant in Max Superspeciality Hospital, New Delhi.She is actively involved in teaching programme for the post graduate students, scientific research and presentations.An avid reader, she takes keen interest in mythology and history. She loves swimming and strongly believes in ‘being positive and happy’ and seeing life and each day as a blessing….a reason to smile.

Abstract:

The World Health Organization (WHO) factsheet revealed that 15 million babies are born too early every year and almost 1 million children die each year due to complications of preterm birth. Preterm birth, i.e. birth before 37 weeks of gestation period, an important obstetric problem, is the major cause of neonatal mortality and morbidity across the globe. This study was prospective observational study conducted in Tata Main Hospital, Jamshedpur from 1st November 2016 to 31st October 2017. The purpose of this study was to find role of cervicovaginal β hCG in prediction of preterm birth in asymptomatic high risk women. Antenatal investigations, first trimester USG scan and detailed anomaly scan was reviewed. Patient general and obstetrics examination was done. After taking consent and maintaining all aseptic precaution, per speculum examination was done and any clinical finding suggestive of infection of cervical and vagina was noted down and cervicovaginal secretion sample for β hCG was collected and sent to laboratory at same time. Level of β-hCG was measured by chemiluminescent immunoassay using commercial kit [Access 2 TOTAL βhCG (5th IS) Standardized to the WHO 5th International Standard for Chorionic Gonadotropin] in our institute laboratory. The data derived from this study suggested that cervicovaginal β hCG level at 24 – 34 week gestation age with cut off value of 36.45 mIU/ ml can be used as a biochemical predictor of preterm birth in asymptomatic high risk women for preterm birth with sensitivity 71.9% ,specificity 81.8%, positive and negative predictive value 74.5 % and 79.7% and diagnostic accuracy 77.6%. This test is having advantage of being inexpensive, noninvasive, easy to collect and widely available. Hence, being able to predict which women are likely to have a preterm birth is a prerequisite for the effective use of most interventions aimed at preventing preterm birth.

Keywords:  Preterm birth,  β-hCG, biochemical predictor.

 

 

Day 3 :