Day 1 :
Apollo Hospitals, Guwahati, Assam, India
Dr. Himleena Gautam is a Consultant Obstetrician & Gynaecologist working at Apollo Hospitals, Guwahati, Assam. She has keen interest in improving the maternal and neonatal outcome of HIGH Risk Pregnancy and pregnancies with medical disorders. Academically she has been the Best Graduate and Best PostGraduate in her University and has been presenting talks, papers and posters in various Zonal, National and International Conferences. Also she has published papers in various journals. She has attained training in Laparoscopy and Colposcopy. She wants to work for the betterment of the underprivileged section of North East India.
INTRODUCTION- Peripartum cardiomyopathy(PPCM) is a type of dilated cardiomyopathy presenting with heart failure secondary to left ventricle(LV) systolic dysfunction towards the end of pregnancy or in the puerperium, where no other cause of heart failure is found. The incidence of PPCM is around 1 in 2000. It is seen in 2-68% parturients with preeclampsia, but the reason is not known. Acute kidney injury(AKI) in pregnancy is a clinical challenge with significant morbidity and mortality. Studies suggest 1,5-2% incidence of AKI in preeclampsia. Managing PPCM with severe preeclampsia is very challenging and needs combined effort of cardiologist, obstetrician, intensivist, anesthesiologist, and neonatologist.
CASE REPORT- We present a case of a 34year old woman at 35weeks post IUI pregnancy who presented with severe preeclampsia and pulmonary edema. Investigations revealed multiorgan involvement and patient was managed in intensive care unit. Supportive management was done with a multidisciplinary approach. Echocardiography showed moderate LV systolic dysfunction and ejection fraction of around 35%, thus suggesting PPCM. Antepartum fetal surveillance was done throughout her stay. On 10th day of admission, she went into labour. She developed acute respiratory distress with anuria and was diagnosed as acute LVF. Emergency LSCS was done under general anaesthesia with cardiac monitoring. A 1.9kg IUGR female baby was delivered. Patient was kept under mechanical ventilation postoperatively. She developed cardiogenic shock, but resuscitated. Hemodialysis was done to improve renal function. Gradually she improved clinically, and was discharged on 10th post operative day.
CONCLUSION- A high index of suspicion is required to diagnose PPCM, specially in cases of preeclampsia as it is difficult to diagnose whether the patient with dyspnea or edema has heart failure. Early diagnosis and treatment may prevent or lessen symptoms of PPCM and improve maternal and fetal outcomes. A cardiac evaluation is very much necessary even in slightest suspicion in these cases.
Dr Debkalyan Maji is an alumnus of RG Kar Medical College, Kolkata and presently working as Graded Specialist (Obs And Gyn) at Military Hospital, Gwalior. He has completed his Post graduation from Armed Forces Medical College, Pune. His area of interest is High risk obstetrics and Gynaecological Endoscopic surgery
Introduction: Abruptio placentae generally presents as a obstetric emergency with poor fetal outcome and significant maternal morbidity and even mortality.
Description: 29 year G2P1L1 at 24 Wk 5 Day period of gestation reported to our hospital with history of loss of fetal movement for last 2 day with abdominal discomfort and low back ache. There was no bleeding per vaginum. On examination, she was conscious alert and coherent. Pulse - 110, BP 116 / 70 mg of HG. Per abdomen examination revealed fundal height of uterus - 32- 34 was, no fetal part palpable, non tender, FHS - absent. USG carried out and confirmed IUFD, with 19 X 13 cm placental thickness, AFI- 1. Her HB - 5.2 gm%. TLC - 16200/mm3, PT - 15/12, APTT -32/28, INR - 1.28. Per vaginal finding - 1.5 cm, 30 % effaced. Delivery was planned, initially labour induction followed by emergency caesarean delivery. Patient was managed successfully in post operative period by multidisciplinary team with blood and blood component. She recovered fully and subsequently discharged from hospital. She was diagnosed as a case of chronic abruption-oligohydramnios sequence.
Conclusion: Chronic abruption- Oligohydramnios sequence is a rare type of clinical condition found during pregnancy. Early recognition and management leads to successful maternal outcome.
Faculty member of department of nursing science, University of Nigeria
Chisom Joy Mbadugha is a faculty member of department of nursing science, university of Nigeria. She is a polyvalent nurse who has practiced in variety of health care settings with expertise in psychiatry, midwifery and public health nursing. She has a Masters degree in Psychiatry-mental health nursing and currently pursuing a PhD program in same specialty. She has research interests in rehabilitation of drug addicts and the mentally ill; child and adolescent health and, concerns during pregnancy and childbirth. She has bagged numerous academic awards and honor with career objectives to reach the zenith of nursing profession, contribute to nursing knowledge and be among the policy makers in nursing through active involvement in research. She has written scholarly articles in both local and international journal and is married with four children.
INTRODUCTION: Male partners play a critical role during pregnancy and childbirth, and there is no gainsaying to the fact that their involvement in maternity care will significantly improve maternal and neonatal health indices in Nigeria. The purpose of this study was to assess adult male involvement in maternity care in Enugu South Local Government Area, Enugu State, Nigeria.
METHODS: This community based study adopted a cross-sectional descriptive survey design. Multi stage sampling technique was used to select one hundred and forty five (145) respondents from the population of male partners in Enugu state, Nigeria. Data were collected using researchers’ developed structured questionnaire and analyzed using descriptive statistics (frequencies, percentage, mean and standard deviation).
RESULTS: The study revealed a moderate knowledge of expected role in maternity care among the respondents. The level of involvement in maternity care was also moderate (2.99). The major identifiable barriers to male participation in maternity care were lack of enabling facilities (3.55), tight work schedule of the male partner (3.58). Other significant barriers were financial status of the male partners (3.33) as well as their cultural belief systems (3.0).
CONCLUSION: Although men’s knowledge of expected role and involvement in maternity in this study was moderate; men were restricted by tight work schedules and cultural beliefs systems that assumed that maternity care was exclusively women’s affair. This brings to fore the need to educate men on the importance of active participation regardless of existing cultural norms. In addition, civil service commission and other private employers should consider granting expectant fathers casual leaves to enable them accompany their partners to antenatal visits as well paternity leave to be with them during delivery and early puerperium.
Keywords: maternity care, male involvement, pregnancy, childbirth, male partners
Dr Shikha Aggarwal has her expertise in labour management and obstetrics and gynaecology and passion in improving the health and wellbeing. She has completed her MRCOG in year 2019 and presently working at Altnagelvin Hospital, Northern Ireland. Her area of interest are high risk obstetrics and minimal invasive gynae endoscopic surgery.
Introduction: Pregnancy with fibroid uterus is not rare but management of such cases are challenging and may be nightmare sometimes.
Aim& Objectives: To present the rare case of large anterior wall fibroid complicating pregnancy with successful outcome. The objective of this case report is to create awareness.
Background: Fibroid is most common tumour of uterus and female pelvis. The prevalence of fibroid with pregnancy is approx. 10.7% and almost in one third cases the fibroid increases in size with the advancement of pregnancy. Especially these cases are associated with increased morbidity and adverse maternal and neonatal outcome. Here we are presenting a case of pregnancy with large anterior wall uterine fibroid, managed successfully at our centre.
Case: 28 year G2P1L1 lady with post LSCS pregnancy was a registered to our ANC OPD at 13 wk POG. She has past history of 5.8 X5.4 X 4.4 cm intramural fibroid in anterior myometrium. It was her spontaneous conception and antenatal period was uneventful. However, the fibroid size increased upto 18 X15 X 9 cm at the time of delivery. She underwent classical caesarean delivery at 38 wk5 day POG and a live female baby was delivered. Intra op 18 X 15 X 9 cm large fibroid occupying entire lower segment of uterus was noted.Total Blood loss was approx. 1000 ml. Post Op period was uneventful and got discharged from hospital with healthy baby on 5th post op day in size.
Conclusion: Early pregnancy bleeding, preterm labor, post-partum haemorrhage and peripatum hysterectomy are commonly associated with pregnancy complicated by fibroid.Decision of doing myomectomy during caesarean delivery is controversial. Obstetrical decision making is most important key for successful management. However, myomectomy should be avoided during caesaren in case of large fibroid, to obtain less morbidity and favourable outcome.
West Bengal Medical Education Services, India
Aims and Objectives: With modification s during caesarean delivery minimized or control fatal obstetrics hemorrhage.
Type of Study: Clinical, interventional, prospective, randomized controlled Trial (RCT).
Place, Duration and Sample Size:- In the Dep’t of G and O, IPGME&R-SSKM Hospital Kolkata, West Bengal, India, More than one(1) year.
Methods and Materials: After getting ethics approval, more than one hundred (100 Cases) ante-partum hemorrhage patients selected, randomized and allowed into two groups for management point of view by Caesarean delivery like Gr.A (N=50)=CASES- MODIFICATIONS. Gr. B (N=50) =CONTROLS – CONVENTIONAL.
Results and Analysis: The results of individual group (Gr.A&Gr.B) assessed (Pry and Sec. outcomes), analyzed, and represented with statistical significant accordingly showed better in modifications (Gr-A-CASES) which achieved 100% success to control fatal obstetric hemorrhage with zero mortality.
Conclusion: To minimize and or eliminate maternal and newborn mortality or morbidity during caesarean section in APH always perform by MODIFICATIONS techniques.
Key Word: APH-Caesarean Section- Modifications-Decreased-MMR&IMR.
Western Sydney University, Australia
Sahar Sobhgol, is a PhD candidate at Western Sydney University, Australia. Her expertise is midwifery and maternal and child health. She is also a lactation consultant. She has experience in research and teaching as well as clinical experience. She has developed intervention in this study and implemented it and the results of this study are about to be published. This study will provide more in-depth information about antenatal care.
Background: There is limited information about the effect of pelvic floor muscle exercise (PFME) on sexual function (SF) during pregnancy and childbirth outcomes. The purpose of this study is to investigate the effect of antenatal PFME on female SF during pregnancy and postpartum and also to investigate the effect of PFMEs on childbirth outcomes.
Methods/design: This is a randomised controlled trial. Eligible women who are less than 22 weeks’ gestation were recruited from the antenatal clinics of one hospital located in Western Sydney, Australia. A sample of 200 primiparous pregnant women who meet the inclusion criteria were randomised to either control or intervention groups. The duration of the PFME programme was from approximately 20 weeks’ gestation until birth. Data regarding SF symptoms and childbirth outcomes were collected via questionnaires.
Discussion: The findings of this study provide more information on whether antenatal PFME has any effect on female SF and childbirth outcomes. This study has been completed and the results are being processed. The initial assessment has showed that antenatal PFMEs should be part of antenatal care. More research is needed in this area.
Key words: Pelvic floor muscle exercise, Female sexual function, Childbirth, Randomised controlled trial
- Family Planning and Effects
Odesa National Medical University, Ukraine
Posokhova Svitlana Petrivna graduated from Chernovitskiy Medical Institute. postgraduate education in National medical University (Kiev). Chief of obstetrics department in Odessa Oblast Clinical Hospital. Assistant Professor in Odessa State Medical University. Associate Professor, Defended his dissertations: for the degree of Candidate of Science – in 1998, for the degree of Doctor of Science – in 2008. Beginning from 2009 until now she is professor of Obstetrics and Gynaecology Odessa national Medical University, director of Odessa oblast perinatal center (since 1994).
Scientific work of Posokhova are a significant contribution into the evolvement of national and world medicine in the fields of reproductive health, high risk pregnancy, HIV/AIDS, PMTCT and novel reproductive technologies. She international activities promote the recognition of Ukraine in scientific and social domains. She had 158 publications including 2 monographs
- Womens Health Nursing
Mutaa University, Jordan
Enaam Yousef Al-Ananbeh, has completed the PhD from The University of Jordan, School of Nursing. Her research interests include qualitative approach and phenomenology in specific. She has published some topics in nursing in different Journals. Her clinical experience in Nursing is around 24 years and nearly 5 years in the academic domain. Today she is working as an assistant dean of Princess Muna College of Nursing at Mutaa University. Her main responsibilities include the supervision and monitoring academic issues and affairs in the university.
Background: Patients’ involvement in health care decisions has been associated with improved treatment outcomes. Little is known about cardiac patients’ experiences regarding involvement in health care decisions in Jordan. Therefore, it is important to explore the level of involvement in health care decisions from patients’ perspectives.
To explore the subjective experiences of cardiac patients regarding their involvement in health care decisions in Jordan.
Design: Descriptive phenomenological approach has been selected to underpin this study.
Methods: A purposive sample consisting of sixteen cardiac patients who were admitted to cardiac center at one public hospital in Jordan were interviewed. Data were generated through semi-structured interviews. Data generation took place over a period of six months (December 2017-May 2018). Data were analyzed using a five - step technique proposed by Giorgi (1985).
Results: Findings revealed five major themes:1) Patients’ problems that require decision-making are being attended to by HCPs., 2) The approach used by HCPs in communicating with patients is comforting, 3) Information provided to patients is helpful, 4) patients preferences regarding D.M style vary, 5) Sociocultural influence and religious factors influence patient’s role in D.M.
Conclusion: Patients have positive attitudes toward active involvement and sharing role in health care decisions. Most patients preferred to rely on HCPs to take the final decision. Patients' preferences were influenced by communication, sociocultural and religious factors, as well as their health status. The differences in patients ‘preferences and values should be considered and recognized when considering patients’ involvement for best outcomes.
- General Health Issues
City of Laredo Health Department, Texas, United States.
Viviana Martinez-Gómez is a PhD Candidate in Organizational Leadership at Northcentral University in the United States. She has published multiple papers and co-wrote a chapter on collaboration and evaluation of collaborative programs along the South Texas-Mexico Border. She is a seasoned administrator and consultant with experience in the IBH model; specializing in integrated best practices. Her research interests include cultural competency, trust among collaborators, collaborative partnerships, leadership succession, and staff development. She has over 10 years’ administrative experience and over 14 years’ experience in prevention, intervention, and treatment of behavioural health disorders (mental and substance use) both in outpatient and residential settings working with special populations ages 5 and over. As the former Director for the Si Texas Juntos for Better Health Project she oversaw a four year research study for non-compliant patients with Diabetes and/or Depression and integrated health programs looking at best practices.
Integrated behavioural health (IBH) represents a paradigm shift for both primary care (PC) and behavioural health (BH) settings. IBH requires a shift towards more routine attention of behavioural health among primary care providers (PCP) and other medically trained staff. City of Laredo Health Department (CLHD) data aligns with research data which indicate approximately a third of the general population have a common mental health disorder. Furthermore, upwards to 20% of the general population will seek primary care for BH (mental/substance use) problems. Research supports PCPs deal with patients’ untreated psychological problems – identified or not, taking up PCP time regardless of degree to which problems are explicit focus of practice. Data indicates that 84%-93% of the general population will refuse referrals to BH organizations resulting in high utilizers with unexplained physical symptoms. Furthermore, data indicates patients prefer to receive BH services in PC as it is not perceived as “behavioural healthcare”; thus removing the stigma associated with BH. As a result and in response, the CLHD has adopted the Juntos Integrated Behavioural Health Model which employs a highly team-based approach to address behavioural health among clinic patients. This model is employed on-site and with traveling healthcare teams providing services in remote areas of the region. IBH improves identification and treatment of behavioural health problems and chronic disease in the PC setting, generating better health outcomes for patients and decreasing the use of unneeded emergency services.
Reproductive and fertility research center, Canada
Fatemeh Aminmarashi is a DVM ( doctor of veterinary medicine) from Iran and I have a master degree in reproduction biology (CRRF) Reproductive and fertility research center from canada, and my project it is about:
- Extract ovarian granulosa cells using various cell culture techniques
- Analyze the effects of various proteins on granulosa cells
- Identify apoptotic proteins using Western blotting and mass spectrometry.
- Extract ovarian granulosa cells using various cell culture techniques
- Analyze the effects of various proteins on granulosa cells
- Identify apoptotic proteins using Western blotting and mass spectrometry.
Fibroblast Growth factors (FGFs) are growth factors which have diverse biological activities including broad mitogenic and cell survival activities. FGFs constitute a large family of 22 distinct polypeptide growth factors varying in size from 17 to 34 kDa and have between 13 to 71% sequence homology. More specifically, FGF8 and FGF18 are both important modulator of granulosa cell functions. FGF8 and FGF18 are homologous factors which possess similar sequence homology, but we hypothesized they may interact to FGFRs differently leading to distinct effects, particularly on granulosa cell growth and induce proliferation following a short period of exposition. This study was performed to investigate the effects of FGF8 and FGF18 on ovine granulosa cells proteome. Ovine ovaries were obtained from adult sheep’s irrespective of stage of estrous cycle and were cultured using a standard protocol. Granulosa cells were harvested from follicles then, seeded and cultivated. After, they were exposed to 10 ng/mL of FGF8 or FGF18. Cell proteins were extracted, cysteine bonds were reduced and acetylated and proteins were digested with trypsin. Tryptic peptides were analyzed using a bottom-up proteomic approach, mass spectrometry and a label-free quantitation method. The results obtained revealed following treatment with FGF8 or FGF18 for 30 minutes, an important shift toward upregulation for the entire granulosa cell proteome was measured. Additionally, several proteins, including ATF1, STAT3, MAPK1, MAPK3, MAPK14, PLCG1, PLCG2, PKCA, PIK3CA, RAF1, GAB1 and BAG2 were significantly upregulated (> 1.5-fold; p < 0.01). Results are suggesting the activation of the MAPK/ERK pathway as expected. However, it is important to note that ATF1 and STAT3 are important transcription factors involved in cell growth, proliferation and survival and consequently can hamper or rescue the normal ovine reproductive system function. Both are strongly interacting with the MAPK/ERK pathway. They are directly involved in the growth, proliferation and mechanisms of cell survival. This very significant increase of STAT3 and ATF1 could have important consequences on the viability of the oocyte.
Keywords: Proteomics, mass spectrometry, ovary, granulosa cells, fibroblast growth factors, protein kinases, transcription factors, proliferation
- Menstrual cycle and irregularities
Head of the Nursing Care Department of Zhytomyr Nursing Institute
Vitaliy Zabolotnov, MD, professor, head of the “Nursing Care” Department of Zhytomyr Nursing Institute (Zhytomyr Medical Institute). He had published many of his articles in many reputed journals which proves his innovative research work.
Considering that there are no diagnostic criteria for diagnosing the insufficiency of the luteal phase, and the very concept of insufficiency of the luteal phase in infertility (miscarriage) does not reflect the essence of pathophysiological changes, since the ovaries do not function in isolation, but work under mutual influence with the hypothalamus and pituitary gland, forming the hypothalamic-pituitary-ovarian axis, the concept of insufficiency of the luteal phase is currently to be abandoned.
In infertility (miscarriage), when etiological factors are not clear, but symptoms indicative of endocrine disorders are determined, it is advisable to diagnose hypothalamic-pituitary-ovarian dysfunction.
Treatment of hypothalamic-pituitary-ovarian dysfunction with infertility (miscarriage) should be aimed at correcting any underlying disease that caused dysfunction, namely: hyperprolactinemia, pathology of the hypothalamus, thyroid gland, polycystic ovary syndrome, stimulation of ovulation. In infertility (miscarriage), with limited reliable data on the cause of the pathology, comprehensive empirical treatment of hypothalamic-pituitary-ovarian dysfunction should be carried out: reduce stress, use herbal medicines - Vitex agnus-castus, melatonin, vitamin B6, using acupuncture, stimulation of ovulation.
Keywords: insufficiency of the luteal phase, ILF, progesterone, Vitex agnus-castus.
- womens Health
Obstetrics and Gynecology Department, Dr. Arab Medical Center, Jeddah, Saudi Arabia
Dr. Hisham Arab graduated from King Saud University in Riyadh, Saudi Arabia and completed his postgraduate training in obstetrics and gynecology in Canada. He is now a Senior Consultant Obstetrician Gynecologist and Perinatologist and Director of the Women and Fetal Health Program at the Dr Arab Medical Center, a private practice in Jeddah, specializing in Maternal Fetal Medicine, reproductive endocrinology and infertility, and minimally invasive surgery.
Dr Arab is a Founder and Former Secretary General of the Saudi Obstetrics and Gynecological Society, Executive Board Member of the International Society of Gynecologic Endoscopy, Chairman, Arab Maternal Fetal Medicine Expert Group, Chairman of the Saudi Endometriosis Group.
He Led 4 Guidelines Committees ended with publication on: 1) Female Genital hygiene in the Middle East and Central Asia, 2) Management of Miscarriage in Saudi Arabia, 3) The Saudi Algorithm for Ob/Gyn Thromboprophylaxis, and 4) Management of Iron Deficiency in women in Saudi Arabia.
It is well known that progesterone plays a major role in the maintenance of pregnancy, particularly during the early stages. The management of pregnant women at risk of a threatened or idiopathic recurrent miscarriage is complex and critical. Therefore, a group of obstetricians and gynecologists practicing in Saudi Arabia gathered to update the 2014 Saudi guidelines for threatened and recurrent miscarriage management. In preparation, a literature review was conducted to explore the role of oral, vaginal, and injectable progestogens: this was used as a basis to develop position statements to guide and standardize practice across Saudi Arabia.
Position Statements: Threatened Miscarriage 1. For women presenting with a clinical diagnosis of threatened miscarriage, dydrogesterone may reduce the rate of miscarriage. â€¨2. Oral dydrogesterone should be offered. Manufacturer dosage: 40 mg loading, then 30 mg once daily until symptoms (bleeding) remit. If symptoms persist/ recur, increase dose by 10 mg three times a day. Maintain effective dose for 1 week after symptoms have ceased and then gradually reduce dose. Immediately resume treatment at effective dose, if symptoms recur.â€¨ Recurrent Miscarriage 1. Thorough investigations are warranted to rule out other causes of miscarriage. Once ruled out, a diagnosis of idiopathic recurrent miscarriage is confirmed. 2. For women presenting with a clinical diagnosis of idiopathic recurrent miscarriage (having experienced two or more), there is a reduction in the rate of miscarriage with the use of dydrogesterone. 3. Dydrogesterone should be administered as early as possible, at the diagnosis of pregnancy or during the luteal phase, in stimulated cycles. 4. Oral dydrogesterone should be offered. Manufacturer dosage: 10–20 mg daily, until the 20th week of pregnancy. Treatment should preferably start before conception. If symptoms of threatened miscarriage occur during treatment, continue treatment as stated for that indication.
Public Health Regional Institute, Ouidah, Benin
Context: Solving the problem of unmet need for family planning is an important challenge for improving the health of women, especially those in the postpartum period. This study was conducted to determine the extent of unmet need during the postpartum period and its associated factors in the general population in Parakou, a city in northern Benin.
Method: A cross-sectional community study was conducted with women in the postpartum period living in the commune of Parakou. They were selected by the two-stage random sampling technique. Explanatory variables included socio-demographic characteristics and reproductive history. We used a logistic regression model to identify the factors associated with unmet need.
Results: The study included 453 women aged 27.1 years ± 6 years. The unmet need for contraception concerned 340 women (75.06%; 95% CI: 71.1% - 79.0%). The prevalence of the unmet need for contraception decreased significantly depending on the education level of the spouse. Other associated factors included the absence of a history of contraceptive use (ORA = 4.1; 95% CI 2.5 - 6.9), failure to resume sexual practices (ORA = 2.1; IC95 %: 1.3 - 3.4) and the need for the husband's authorization before adopting a contraceptive method (ORA = 2.2; 95% CI: 1.3 - 3.6).
Conclusion: In Parakou, three-quarters of women during the postpartum period have unmet need for contraception. Contextualized interventions aimed at reversing this trend must be thought of to reduce maternal, perinatal and neonatal morbidity and mortality in Parakou.
Keywords: Unmet needs, contraception, Postpartum, Associated factors, Benin.
Statement of the Problem: Problem statement: there is an opinion that women are weaker, but this is not the case . The researchers reported that women were more resilient than men in long-term physical activity, they hope that the data will be useful in evaluating athletic performance, and suggest reducing the load on men so that their endurance is equal to women's. In 1967, Katherine Schwitzer became the first woman to run the Boston marathon. She got this opportunity thanks to the inattention of the judges, who decided that her name in the list of participants belongs to a man — in those years, women were forbidden to participate in marathon races. A study by a Professor of neurophysiology at the University of British Columbia found that prolonged physical activity is much less tiring for women than for men of the same age and fitness level. Previously, it was known that women are more resilient than men during isometric tests, scientists wanted to find out how true this is for dynamic, more everyday movements .And the answer is clear: women feel significantly less exhausted after dynamic muscle exercises, compared to men of similar age and physical abilities. Conclusion and meaning: these studies prove that women are physically fitter than men.
- Womens Oncology
Department of Community and Family Medicine, The university of Zambia
Twaambo E Hamoonga is a lecturer at the University of Zambia’s School of Public Health with a Bachelor of Arts in Demography and a Master’s degree in Public Health. She has two years working experience as an academic tutor at the University of Zambia’s School of Humanities and Social Sciences (2012-2014) and three years working experience as a lecturer in the School of Public Health. Her research area of interest is in women’s sexual and reproductive health with three peer reviewed publications. Ms. Hamoonga has also worked with Population Council on the Adolescent Girls’ Empowerment Project (AGEP), the Care Giver’s study, and also on the NIH funded Mobilizing Access to Maternal Health Services in Zambia (MAMaZ) study. She is currently a PhD fellow under the UNC-UNZA-Wits partnership for HIV and Women’s Reproductive Health. Her PhD research focus is on HIV pre-exposure prophylaxis for pregnant and breastfeeding women in Lusaka, Zambia.
Statement of the Problem: Cervical cancer was the most commonly diagnosed cancer and the leading cause of cancer related deaths in 2013 among women in Zambia. We determined factors associated with vaginal douching with any solution and examined its role as a risk for abnormal cervical lesions among women in Zambian. Methodology & Theoretical Orientation: A retrospective cohort study of 11,853 women who had screened for cervical cancer from 6 provinces of Zambia. Investigator-led stepwise logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals. The primary and secondary outcomes were vaginal douching with any solution abnormal cervical lesion, respectively. Findings: About 8.1% (n=960) of study participants douched with a solution. Older women (35–44 and 45 years or older) vs young women (15–24 years old) (AOR 0.74; 95% CI: 0.57–0.97, p = 0.027 and AOR 0.65; 95% CI: 0.49–0.87, P = 0.004), respectively, and women in informal employment compared to housewives (AOR 0.72; 95% CI: 0.58–0.89, p = 0.002) were less likely to douche with a solution. Odds of douching were higher among women with secondary vs. no formal education (AOR 1.64; 95% CI: 1.15–2.35, P = 0.007), and among women who used condoms sometimes compared to those who never (AOR 1.19; 95% CI: 1.01–1.40, PP = 0.037). About 12.2% of study participants had abnormal cervical lesions. Using vinegar, ginger, lemon, salt or sugar solution was associated with increased risk of abnormal cervical lesions (AOR 7.37; 95% CI: 1.43–38.00, p = 0.017) compared to using water. Conclusion & Significance: Douching with a solution was associated with age, educational attainment, occupation and condom use. Vaginal douching with either vinegar, ginger, lemon, salt or sugar solution increased the risk of abnormal cervical lesions. We recommend sensitization of women on potential effects of vaginal douching, including risk for cervical cancer.
1Russian Society of Oncomammologists, Russia
Dr. Alla Bozhok has completed her PhD in oncology from N.N.Petrov Research Institute of Oncology – one of the oldest and the most famous institute in Russia in this field. She is an expert in the field of surgical and systemic treatment of breast cancer. Her main research interests are focused on breast cancer surgery, aesthetic and reconstructive surgery of the breast, systemic treatment of early and metastatic breast cancer. She is known for her research in the field of evaluating the effectiveness of various types of breast cancer systemic therapy including targeted treatment. Dr.Bozhok has published more than 90 papers in reputed journals, she is Board member and Academic Secretary of Russian Association of Oncomammologists. Recent years of professional work of Dr.Alla Bozhok have been devoted to the investigation of the effectiveness of surgery in metastatic breast cancer.
Breast cancer (BC) remains one of the most challenging problems in clinical oncology since it still has the highest incidence rate among all malignant tumors in women around the world. A significant number of breast cancer patients in the world (8.3%) and in Russia particulary (11.5%) are first diagnosed at stage IV.
There are many publications proving the feasibility of surgical treatment in certain patients with metastatic BC. To date, there is no clear understanding of the importance of cytoreductive surgery in treating BC dissemination.
Materials and Methods
This study covers the analysis of treatment outcomes in 608 patients with newly diagnosed advanced breast cancer between 1990 and 2015 as reported by 5 health care institutions in Russian Federation. The study and control groups were recruited retrospectively. The study group comprised patients with newly diagnosed ABC who underwent primary tumor surgery were receiving systemic anticancer therapy. Patients in the control group were receiving only systemic anticancer therapy. The groups were composed by pairwise matching, i. e. each patient in the study group was matched with a control patient of similar prognostic characteristics. As a result, groups comparable by localization and number of metastases, and tumor biological characteristics were created.
321 patients were included into the study group (surgical treatment and systemic therapy) and 287 patients were included into the control group (systemic anticancer therapy only).
The statistical analyses showed statistically significant differences in favor of study group.
The median survival was 35 months for the study group and 23 months for the control group (p < 0.01).
Surgical removal of primary tumor in newly diagnosed advanced BC results in statistically significant increase in the median survival from 23 to 35 months (p = 0.01).
The most impressive effect of surgical treatment is observed in patients with bone metastases, one or two metastatic lesions in one organ, positive response to systemic treatment, high expression of ER/PR and in cases where it is possible to attain clean resection margins.
Maharat Nakhon Ratchasima Hospital, Thailand
Mr.Panupan has completed his Bachelor’s degree from Mahidol University and Completed OB/GYN residency programs from Maharat Nakhon Ratchasima Hospital. He published this research first times.
Statement of Problem: To study the effects of comparison a complete course with an incomplete course of dexamethasone on the incidence of respiratory distress syndrome in newborn infants aged below 34 weeks Methodology & Theoretical Orientation: A retrospective cohort study conducted on 118 pregnant patients at 24-33+6 weeks of gestation. The sample was divided into two groups: the first group consisting of 63 pregnant patients who received an incomplete course of dexamethasone (< 4 doses) prior to delivery and the second group comprising 55 pregnant patients who received a complete course of dexamethasone prior to delivery (within 14 days after the first dose). Data were collected from electronic medical records to obtain information about the baseline characteristics of the sample, as well as the number of doses of dexamethasone received and the incidence of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), early-onset neonatal sepsis (EOS), and neonatal death. Findings: The rates of RDS incidence and neonatal death amongst pregnant patients who received a complete course of dexamethasone significantly decreased from 74.6% to 50.9% (AOR, 0.37; 95%CI, 0.17-0.84) and from 12.7% to 1.8% (AOR, 0.10; 95%CI, 0.01-0.98), respectively, when compared with pregnant patients who received an incomplete course of dexamethasone. Alternatively, there were no statistically significant differences between the two groups in terms of the incidence of IVH, NEC, patent ductus arteriosus (PDA), NICU admission within the first 7 days of birth, and surfactant requirement. Meanwhile, the incidence rate of EOS increased from 19% to 26.5% (AOR, 3.18; 95%CI, 1.13-8.97) Conclusion & Significance: The administration of a complete course of dexamethasone to pregnant patients with gestational age of less than 34 weeks is conducive to a decrease in the incidence of RDS and neonatal death, while contributing to an increased incidence of EOS.
- Gynecological Disoders
Sr Consultant, INDIA
Hypertension is one of the common problems in pregnancy affecting about 10% of all pregnancies worldwide and an important cause of maternal and perinatal morbidity and mortality affecting women health,we have done a retrospective control study to estimates the prevalence of Hypertensive disorders of pregnancy and to assess the perinatal outcome at our medical college and hospital between July 2015- June2017 . For all cases demographic data of women and adverse pregnancy outcome like oligohydromnios,IUGR,Abruption,PPH,HELLP Syndrome,DIC,Preterm delivery and Neonatal data like birth weight,sex,APGAR score,NICU admission, were recorded and compared with the control group with normal Blood Pressure without any associated medical complications.In our study prevalence of PIH was 20% that was in accordance with the prevalence of preeclampsia observed in the study by G.B.Doddamani was approximately 10%.the complications were found higher in PIH than normal ANC patients.Almost half of these were delivered by LSCS (56.1%) which was found to be statistically significant (p=0.000) compared to controls (37.9%).Labor was induced in 60.8% of cases of them 60.3% required Emergency LSCS in view of fetal distress. Based on our results younger and nulliparous the prevalence is more with greater complications. Neonates required more of NICU care as a result of preterm birth, LBW and IUGR .It can be concluded from our study that the most common complications found were HELLP Syndrome,PPH,LSCS,in fetus were Preterm birth ,LBW,Abortions ,IUD,RD ,Sepsis etc.The unpleasant effect of hypertension in pregnancy warrant the need for routine prenatal care, early detection and treatment of hypertension at younger ages of pregnancy and follow up after delivery.
National Medical Research Center for Obstetrics, Russia
The doctor works in National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov in Moscow, in the Department of Aesthetic Gynecology and Rehabilitation. She has more than 30 publications. Now she is engaged in research work as part of the dissertation. Scientific adviser is Head of the Department of Aesthetic Gynecology and Rehabilitation, MD, professor, Apolikhina Inna Anatolievna. In 2018 Malyshkina Darya Andreevna together with the PhD Saidova Ayna Salavdinovna under the leadership of MD, professor, Apolikhina Inna Anatolievna took the research about pelvic floor muscle training for women after breast cancer. The doctor is the member of the ISSVD. The doctor represents the leading medical institution in the field of obstetrics and gynecology of the Russian Federation - National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov.
Statement of the Problem: The issue of pelvic floor muscle dysfunction (PFMD) is common in female population. In the world 3-5% of women report manifestations of pelvic organ prolapse. The frequency of pelvic organ prolapse varies from 2 to 28% in the structure of gynecological diseases. Up to 47% of women with pelvic organ prolapse are of working age. It causes severe moral suffering and reduces both social activity and a quality of patient’s life. In this regard PFMD management with modern methods for training of pelvic floor muscles using devices is the «first line» method.
The purpose of this study is to study treatment effectiveness and a quality of life in women with PFMD followed by radical treatment for breast cancer (BC), to describe the experience of training pelvic floor muscles in biofeedback mode among women who require postoperative rehabilitation.
Methodology & Theoretical Orientation: A prospective clinical study on clinical efficacy of a biofeedback method in combination with electrical stimulation of pelvic floor muscles using a device «Urostim» in patients with mild PFMD followed combined treatment fpr BC was carried out at Department of Aesthetic Gynecology of V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology. The study included 15 postmenopausal women.
Findings: It was established that 10 sessions of pelvic floor muscles training in a mode of biofeedback result in beneficial effects on for all clinical indicators.
Conclusion & Significance: PFMD treatment by training of pelvic floor muscles using devices is one of the most promising ways to reduce surgical interventions number in urogynecology and to provide a rehabilitation of women who had surgery for BC.