Scientific Program

Day 1 :

Keynote Forum

S Chhabra

Mahatma Gandhi Institute of Medical Sciences, India

Keynote: Reproductive health of adolescent girls, global challenges

Time : 10:00 to 10:40

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:

Around 1.2 million population of world is adolescents. They contribute to 16%of global population.  There are 340 million adolescents in South Asia and more than 50% of world’s population of adolescents live in Asia.  As nature and science help adolescents become survivors of risky infancy or childhood and they march towards adulthood, they face many challenges of right development and right functions. While even normal physiological functions affect adolescent’s life, there are possibilities of variations / deviations, trivial too dangerous in the development of reproductive health system, and   susceptibility to various dangers which affect their reproductive and   future health. 

The concept of health of adolescents, as a special group, characterized by many rapid, interrelated changes of body, mind, and social relationships is relatively new. Problems related to adolescence are being put in the agenda of policy makers, health planners and health professionals since recent past. The way adolescents experience the transition from childhood to adulthood and the advocacies of do and do not vary widely depending upon socioeconomic and environmental   milieu around their lives and the society they are part. Therefore, the social and cultural recognition of the concept and values during adolescence vary substantially between populations around the globe. For many girls in developing countries, the onset of puberty marks a time of heightened vulnerability to leaving school, marriage, sexual exploitation by relatives, employers, pregnancy, HIV infection, violence and so on. They face, many such problems related to sexuality, with too little factual information, too little guidance and too little access to health care. Due to stigma, of pregnancy, honor killings and suicides go on. There are variations in numbers but teenage pregnancy, safe / unsafe abortions, safe / unsafe births are global public health problems. Some countries have restricted laws others do not permit induced abortion. Girls are not immune to other disorders. Gynecological disorders including cancers are not uncommon with possibilities of major impact on reproduction and their future life.

Ideally adolescents should have significantly lower mortality rates, relative to older and younger age groups in both developing and industrialized countries. Consideration of mortality rates alone has resulted in young people being seen as predominantly healthy age group, so are accorded a low priority for health interventions because traditionally, mortality has been the main health indicator used by health planners, policymakers, and program managers. However, realities of adolescent’s health are far from it.   More than 33 percent of the disease burden and almost 60 percent of premature deaths among adults can be associated with behaviors or conditions that begin or occur during adolescence.  The absolute age specific death rates for young people are also much higher in developing countries, largely because of the combination of higher incidences of diseases and higher case fatalities.

Adolescence is a crossroad to the promotion of future health and should be   gateway.  The benefits, which occur in meeting the challenge of promoting health and development of adolescents, far outweigh the costs saved by neglect of adolescents needs. Their health is not only important for their sake, but for the health of communities and generations to come. However, despite urgent needs, program efforts have been slow surrounded by controversies. In some countries of the world there are still controversies in relation to information to unwed girls about sex related matters.  Sex education in many societies is often a challenging and difficult issue for both youth and adults. Little is known about overall reproductive morbidity, during and outside the child bearing, but is estimated to be of large magnitude. What is visible is only the tip of the iceberg. Adolescent cancer survivors need to have safe future. The need is of modalities of the rigorous implementation of health programs for the adolescents with concept of prevention, early case detection, cure, rehabilitation, and health promotion. Helping adolescents protect their own health should be a public health priority. Beyond benefiting young people, themselves, increased investment in adolescents sexual and reproductive health contributes to broader development goals, especially improvement in the overall status of women, eventually, reduction in poverty and further development.

  • Gynecologic Aesthetics

Session Introduction

Gopa Chowdhury

Professor Prof, Obstetrics & Gynaecology, MD, FICOG India

Title: Infertility – A Step Towards Prevention
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 (research paper presentation), National-YUVA- FOGSI, AICOG as delegate and faculty.

Abstract:

World is suffering from increasing population. Concerns about infertility is irrelevant but 10-15% couples are childless. Human infertility has been a source of social and emotional frustrations. WHO & ICMART” infertility is a disease of reproductive system defined by the failure to achieve clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Indian statistics show an increase by 50% in infertility since 1981, may be due to urbanization, change in life style and other factors.

  • Gynecology & Obstetrics

Session Introduction

Arthur Zaltz

Chief, Department of Obstetrics & Gynecology and Womens & Babies Program

Title: Group A Streptococcal Infections in Obstetrics and Gynecology
Speaker
Biography:

Dr. Zaltz is obstetrician and gynecologist-in-chief at Sunnybrook Health Sciences Centre. He is also the chief of the Women’s and Babies Program and is associate professor of obstetrics and gynecology at the University of Toronto.

Dr. Zaltz has been on staff at Sunnybrook since 1987. He practices general obstetrics and gynecology, and minimally invasive surgery. He is involved in the gynecological management of women with hereditary breast cancer in conjunction with the breast centre.

 

Abstract:

Lancefield Group A Streptococcus is an important global pathogen with the ability to cause significant disease and has particular implications in Obstetrics and Gynecology. Five to thirty per cent of the population are asymptomatic carriers. Invasive Group A Strep infections have become a leading cause of maternal mortality worldwide.  The incidence and virulence has been increasing for the past 30 years.

There are estimated to be over 75,000 deaths from puerperal sepsis annually. The highest death rates are in Asia, Africa and Latin America.  The incidence of infection ranges from 3-10 per 100,000 in North America.  There is a twenty fold increase risk in the risk of invasive infection in pregnancy and post-partum women.  Most post-partum infections arise in the first 24-48 hours after delivery, often when the mother has been discharged from hospital.  Gynecological invasive disease usually manifests as toxic shock or flesh eating disease.

Samara Tahreen Sabur

Junior medical doctor, Department of obstetrics and gynecology Northern Beaches Hospital

Title: Incidental intravascular leiyomyomatosis: a case report and review of the literature
Speaker
Biography:

Samara Sabur is a junior medical doctor, training in obstetrics and gynecology at the Northern Beaches Hospital in Sydney, Australia. She is currently completing a Master of Public Health through the University of Sydney and is an associate lecturer at the School of Medicine in University of Western Sydney. She has previously presented research at the European Congress of Obstetrics and Gynecology as well as the Australasian Gynecological and Endoscopy Society annual scientific meeting.

Abstract:

Intravascular leiyomyomatosis (IVL) is a rare smooth muscle cell tumour that is histologically benign with metastatic behaviour. The tumour arises from the uterus and grows within the venous system, extending to the inferior vena cava, right-sided cardiac chambers and pulmonary vessels. IVL can be fatal, resulting in thromboembolic events, congestive heart failure and intra-pulmonary leiyomyomatosis. There is also a risk of recurrence if the tumour is not completely resected.1 Presentation usually occurs after the disease has advanced with symptoms of haemodynamic instability, dyspnoea, palpitations, chest or abdominal pain.2 Typically, diagnosis is based on macroscopic description of worm-like tumour projections in the veins and/or microscopic evidence of intraluminal leiyomyomas.3 We report a case of a 44-year-old woman who underwent a total abdominal hysterectomy and bilateral salpingectomy for simple hyperplasia, diagnosed from uterine curettage performed for menorrhagia. Intraoperatively, increased vascularity and aberrant vessels were noted on the serosal surface. The macroscopic pathology examination was normal, however, the histopathology demonstrated smooth muscle tumours in 2 vessels, consistent with IVL. The patient underwent computed tomography imaging of the chest and abdomen to rule out metastases and is scheduled for yearly follow-up due to the risk of recurrence. This case highlights a rare but important diagnosis that gynecologists should be suspicious of when abnormal vascularity is seen on the uterus, especially due to the high risk of morbidity and recurrence with IVL. We review the literature and discuss management options for optimal outcomes of this disease.

Marion Ariadne C. Burgos

Far Eastern University-Nicanor Reyes Medical Foundation, Philippines

Title: First Trimester Post Abortal Placenta Increta: A Case Report
Speaker
Biography:

Marion Ariadne C. Burgos has completed her Doctor of Medicine degree from Far Eastern University-Nicanor Reyes Medical Foundation at age of 23. She is currently an obstetrics and gynecology resident at the same hospital institution.

Abstract:

Introduction: Obstetrical hemorrhage is one the leading causes of maternal morbidity and mortality in our country. It accounts for 298 out of 1,719 women (17.3 %).  Obstetrical complications such as hemorrhage may ensue once the placenta adheres into the myometrium and was not noted during placental delivery.

Case Report: This is a case of a 30-year-old, Gravida 3 Para 1 (1021) who had persistent vaginal bleeding post curettage due to missed abortion at 11 weeks age of gestation.

Case Discussion: Differential diagnosis included retained secundines, gestational trophoblastic neoplasia, uterine arteriovenous malformation, and placental accrete syndrome.  This could be differentiated by beta human chorionic gonadotrophic hormone and transvaginal ultrasound. 

What made the case interesting is the dilemma in the diagnosis.  In a case of persistent vaginal bleeding after curettage and with a history of cesarean delivery, one will initially think of placenta accrete syndrome.  But then, initial diagnostic tests pointed out to uterine arteriovenous malformation.  Due to the dilemma of the service team in clinching the diagnosis for a single disease entity, pelvic magnetic resonance imaging with contrast was done revealing a possible placenta accreta, but cannot totally rule out vascular tumor.

Since patient was initially desirous of future pregnancy, medical management was started and was scheduled for CT angiography. However, due to persistent vaginal bleeding, she underwent Total Abdominal Hysterectomy.  Histopathology result revealed a placenta increta.

  • Primary Healthcare in Women

Session Introduction

Harwinder Kaur Cheema

Punjab Institute of Medical Sciences, Jalandhar, India

Title: TO STUDY THE PREVALENCE OF PRE-CANCEROUS CONDITIONS OF CERVIX- A HOSPITAL-BASED STUDY
Speaker
Biography:

Harwinder Kaur Cheema is currently working as an Associate Professor in the Department of Obstetrics & Gynaecology at Punjab Institute of Medical Sciences, India. She worked as an Assistant Professor, in the same institution. She has completed her MBBS at Guru Gobind Singh Medical College, Punjab, India and; Master’s in Obstetrics & Gynaecology at Govt. Medical College, Patiala. Currently, she is pursuing advanced course in Medical Education (ACME), approved by the Medical Council of India. She has six original research article publications, in various international research journals. She is a Reviewer of two international research journals related to medical research.

Abstract:

Carcinoma of the cervix is the 3rd most common carcinoma of women. It is a leading cause of morbidity and mortality in India. About 86% of cases occur in developing countries and 88% deaths occur due to cervical carcinoma in developing countries. Pap smear is a simple, non-invasive, cost-effective tool in every Gynaecological OPD which can detect abnormal cytological findings of cervix. It can detect pre-cancerous lesions of the cervix at the earliest and effective early treatment can save women from morbidity and mortality.

Aims and objectives of the study were to determine the prevalence of pre-cancerous conditions of the cervix in a hospital-based population in Punjab Institute of Medical Sciences, Garha Road, Jalandhar, Punjab.

  • Assisted Reproductive Technology

Session Introduction

Saurabh Kapoor

Asst. Embryologist in a fertility centre located in Jalandhar city (Punjab, India).

Title: IDENTIFICATION AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF BACTERIA, ISOLATED IN IUI/IVF/ICSI (ART) LABORATORY
Speaker
Biography:

Mr. Saurabh is working as an Asst. Embryologist in a fertility centre located in Jalandhar city (Punjab, India). I have done my masters in Clinical Microbiology. I have done hands on as well as theoretical course in Comprehensive Andrology and Male Infertility  from Delhi Gynaecologist forum’s IVF- Infertility Committee, Delhi and Intensive hands on training in Clinical Embryology from Asia Pacific Institute of embryology, Mysore,  India. Worked as a team member in many events of life science/biological science. Pursuing Ph.D in (Life Science).

Abstract:

The present study was carried out to isolate, identify and to find out the Antibiotic Sensitivity Pattern of Microorganisms by which we can improve the fertilization rate as well as pregnancy rates. The mentioned study was carried out in the ART laboratory from April 2018 –September 2018 to identify various bacteria, grown in the samples and in media used in the Embryology Laboratory. Rarely, bacterial contamination occurs in the IUI/IVF/ICSI programme because IVF/ICSI laboratory and OT is maintained with filtered air by using air filtration unit. In case of disturbance or any other technical problem in the air filtration unit there are chances of bacterial infection. Bacterial growth in the media occurs only due to improper storage/handling (whenever used during the specific type of procedure).The main source of contamination is not only the environment in which work is done, patient’s body fluids like follicular aspirates, semen, vaginal, cervical regions, collected oocytes and handling of Gamets are also the potential sources of bacterial contamination.

Total 450 samples were observed/examined. Out of 450 samples, total (42, 09.33%) samples were found as positive (bacterial growth) and (408, 90.66%) Negative or with no growth after 24 hours of incubation in bacteriological incubator. Total 5 bacterial genus were identified (n = 02, 40%) gram positive and (n = 03, 60%) gram negative bacteria. In gram positive bacteria Lactobacillus spp. (10, 23.80%) and Staphylococcus aureus (12, 28.57%) and gram negative bacteria E. coli (08,

19.04%), Klebsiella spp. (06, 14.28%), Pseudomonas spp. (06, 14.28%) were identified. The presence of bacterial contamination on catheter tips during embryo transfer is evidently limited and does not significantly affect the cycle outcomes. End point measures are not affected by commensal contamination due to presence of different types of antibiotics in medium.