Scientific Program

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Day :

Session Introduction

Tjitte Verbeek

University Medical Center Groningen, Netherlands

Title: Eff ects of cogni ve behavioural therapy during pregnancy on perinatal outcomes: The promises randomised controlled trial

Time : 11:05-11:40

Speaker
Biography:

Tjitte Verbeek van Buuren has completed his MD-PhD at the age of 28 years from the University of Groningen and currently performs a postdoctoral study from the University Medical Center of Groningen. He is general practitioner in training in Groningen. He has published several papers in reputed journals and serves as medical advisor in Academic Science BV Groningen (academicscience.nl).

Abstract:

Antenatal anxiety and depressive symptoms are highly prevalent and have been associated with multiple adverse maternal and perinatal outcomes. Currently, international guidelines recommend that these symptoms are mostly antenatally treated using cognitive behavioural t herapy (CBT) because it is commonly believed that CBT during pregnancy, unlike antidepressants, has no adverse eff ects on perinatal outcomes. However, to date, no previous trials have been published on the eff ects of CBT during pregnancy on perinatal outcomes. We performed a multi-centre, single-blind randomised controlled trial in pregnant women with depressive and/or anxiety symptoms/disorders who visited one of the participating 109 midwifery practices or nine hospitals. We enrolled women with at least moderate symptoms of depression (Edinburgh Postnatal Depression Scale; EPDS≥12) and/or anxiety (State Trait Anxiety Inventory; STAI>42). Participants were randomised to receive either primary antenatal CBT or care as usual (CAU), stratifi ed by parity, and socio-economic status. Of the 1007 women invited, 282 (28%) were randomised to receive antenatal CBT (n=140) or CAU (n=142) between April 1, 2011, and Sept 1, 2014. No substantial baseline diff erences were observed. Off spring of participants in the CBT group showed overall a slightly lower birth weight and lower gestational age at delivery compared to the CAU group but diff erences were not statistically signifi cant. However, in participants with a present DSM-IV anxiety diagnosis (N=98), we found that the mean birth weight was over 275 grams lower (β=-275.4, 95% CI -530.6; -20.2) and that the mean gestational age was approximately a week lower (β=-0.978, 95% CI -1.872; -0.084) in the CBT group than in the CAU group. No diff erences in Apgar scores were observed.
Antenatal CBT seems to have a signifi cant negative eff ect on major perinatal outcomes when provided as treatment of antenatal anxiety during pregnancy. Further research is needed to assess whether the adverse eff ects of antenatal CBT are lasting

Speaker
Biography:

PushpaDahiya, completed her masters in obstetrics and gynecology from a premiere institute in India. She is working in a tertiary care hospital and a post graduate teaching institute; with a teaching experience of 25 years. She guided 15 post graduate students in National university of Oman and contributed more than 100 publications in various national and International journals. pushpadahiya

Abstract:

Cesarean section is the most common obstetric operation. Th e incidence of cesarean section varies world wide. As per World Health Organization (WHO) ideal rate of C-section should not exceed 10-15 per cent, but it’s far more than this especially in developing countries. Caesarean section  in second stage of labour accounts for one-fourth of all primary caesarean sections especially in tertiary care hospitals in India where the laboring women are transferred  once they fail to deliver vaginally. Th e second stage cesarean section with impacted foetal heads are technically diffi  cult and are associated with high rate of maternal and foetal morbidities. Diff erent techniques have been used for decades to extract fetal head in late second stage of labor to reduce the maternal complications like extension of uterine incision, hemorrhage and fetal morbidities. A prospective study was conducted over a period of two years  in tertiary care hospital to evaluate the effi  cacy of shoulder fi rst technique in women undergoing cesarean section in second stage of labor for any maternal/fetal indication and this technique was compared with the other methods of fetal head delivery in late second stage of labor.  At the end of study the observation was that with the shoulder fi rst technique the maternal and fetal complications were very less. Th e details of the study will be discussed at the time of presentation in the congress.
 

Speaker
Biography:

Mingwei Yuan has graduated from Tianjin Medical university majoring in clinical medicine and now is a postgraduate student majoring in gynecology and obstetrics in West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China. She has published 1 paper in SCI journals and has joined 5 scientifi c programs

Abstract:

The programmed cell death 6 (PDCD6) gene, originally identi ed as a proapoptotic gene, has recently been reported to have contradictory roles in diff erent diseases and may promote cell proliferation. Here, we exam-ined whether single nucleotide polymorphisms (SNPs) in PDCD6 were associated with endometrial cancer (EC). Th e genotypes of these two SNPs (rs3756712 and rs4957014) in PDCD6 were distinguished by polymerase chain reaction-restriction fragment length polymorphism in 238 patients with EC and 518 controls. Brie y, the T allele of rs3756712 was found to increase EC risk (P = 0.028, odds ratio [OR] = 0.747). Moreover, EC risk was associated with these two SNPs in diff erent genetic models (P = 0.031, OR = 1.42 for rs3756712 in the dominant model; P = 0.019, OR = 0.63 for rs4957014 in the codominant model; P = 0.0073, OR = 0.65 for rs4957014 in the dominant model; P = 0.0076, OR = 0.66 for rs4957014 in the overdominant model). Results of strati ed analyses revealed that rs4957012 was linked to body mass index (BMI) and parametrial invasion and that rs4957014 was associated with BMI, although this associated was not statistically signi cant (P = 0.065, OR = 4.42, 95% con dence interval = 1.06-18.51). Our results indicated that these two tag SNPs in PDCD6 were associated with EC, suggesting that PDCD6 may play a crucial role in the tumorigenesis of EC
 

Hemantha Dodampahala

University of Colombo, Srilanka

Title: Morbidly adherent placenta lessons from Srilanka

Time : 12:40-13:10

Speaker
Biography:

Hemantha Dodampahala received the MBBS(Hons) and MD (Obstetrics and Gynaecology) from University of Colombo, Sri Lanka. He also obtained FRCOG and FRCS from United Kingdom. He is also a member of International Representative Committee RCOG. He holds the post Chairman Global relations at SLCOG and also a member of International Society of Ultrasound in Obstetrics and Gynaecology. He has over 311 citations forhis research work in areas of fetal brain activity, fetal disorders, interventional fetalsurgery, high risk Obstetrics, recurrent miscarriages, polycystic ovarian disease and subfertility. He ranks the 18th position in world ranking for research citations in fetal medicine and he has been continuously awarded the best University of Colombo Srilanka

Abstract:

Morbidly adherent placenta (MAP) is an umbrella term used to refer to abnormally invasive placentation further divided as placenta accrete, increta and percreta. In the presence of MAP, normal placental separation may fail to occur leading to increased per-partum blood loss and hysterectomy. With the increase in cesarean deliveries, the main risk factor for MAP , the incidence of the condition has increased and likely continue to do so in the near future. In this case series we describe the management and outcomes of 14 patients with MAP presenting to a single unit at a tertiary care hospital in Sri Lanka. Antenatal diagnosis using history and ISUOG ultrasound diagnostic criteria, preparation of detailed management plans in accordance with latest international recommendation and close supervision of the Consultant Obstetrician during operative management were the mainstays of management. Th rough this, the unit was able to maintain 100% maternal survival. We would also like to present  a clear series of pictures explaining how we operated on these patients

Speaker
Biography:

Aidana Amangeldiyeva is a 3rd year medical student at NU School of Medicine, which is a US-style school of medicine in Astana, Kazakhstan. She did her bachelor degree in biological sciences at NU School of Science and Technology and had experience of working at National Laboratory of Astana in the area of personalized medicine. Currently, she is doing clerkship at National Research Centre of Mother and Child, where she is training in diff erent specialties including Gynecology and Obstetrics

Abstract:

Human papillomavirus (HPV) is responsible for almost all t he cases of cervical cancer, which, in turn, ranks as the fourth most common female malignancy worldwide, accounting for 11% of woman deaths due to cancer. While the trends of mortality due to cervical cancer has been improved along the introduction of screening and HPV vaccination programs in many developed countries, Central Asian countries are still experiencing increases in mortality rates for the latest 10-year period. Despite the availability of the cytology-based cervical cancer screening program in Kazakhstan that was established in 2008, the country is estimated to have the second highest age-standardized mortality rate (9.8 per 10,000 women per year) across Central Asia. Th is situation is most probably associated with lack of quality assurance structures, which also results in limited data on the reliability of available screening tests. In Kazakhstan, both conventional cytology (CC) and liquid-based cytology (LBC), a comparatively new and expensive technology, are used as primary screening tests. Originally, LBC has been developed to off er improvements over CC such as increased sensitivity presumably due to more accurate preparation of the material as well as the ability to perform HPV testing on the same sample when indicated. Despite the number of institution-based reports and clinical trials suggesting these advantages of LBC, there are also studies showing insignifi cant diff erence in sensitivity of these two tests. Some studies also showed decreased specifi city of LBC, which makes this test overall to be less cost-eff ective. Th e goal of this research is to compare the performance of CC and LBC in Kazakhstan by studying their reliability as one of the steps to optimize the cytology screening

Methods: Cervical materials were obtained from 107 consenting female patients aged 30-60 in Kazakhstan who went through the cervical cancer screening. Th e material was obtained by cyto-brush, which was initially used to prepare pap smear samples for the CC test. Th e brush was then placed in a special fl uid and used for the LBC test. A total of 214 samples were obtained and the CC and LBC reporting was done using Bethesda system. Samples were analyzed independently in two laboratories in Astana; one at the Republican Diagnostic Center and the other conducted at a private laboratory. Th e statistical analysis was performed by using STATA soft ware. Results: Th e mean age of the patients was 43.5±9.3 years old. Th e number of unsatisfactory results was 4.7% when performed with CC and 8.4% with LBC. Th e overall detection rate of abnormal cytology was signifi cantly higher in CC than in LBC (33.3% vs. 18.3%, p<0.02). Th e low-graded squamous lesions (ASCUS and LSIL) were more detectable by CC method (24.5% vs. 19.4%, p<0.02). Conclusion: Th e results suggest that LBC did not outperform CC in the detection of precancerous lesions in terms of clinical accuracy, which correlates with a number of previous studies. Moreover, LBC resulted in lower sensitivity, which questions its adequacy as a primary screening test

Speaker
Biography:

Myka Janine Villarroya is a Second Year Obstetrics and Gynecology Resident in Far Eastern UniversityNicanor Reyes Memorial Medical Center. She fi nished her Medical School in the year 2015 from the same institution

Abstract:

Surgical management of Classical congenital adrenal hyperplasia is associated with few immediate postoperative, infectious and urinary complications as well as unwanted permanent outcomes such as Vaginal stenosis and the like. Th e objective of this report is to present a case of a 22 years old. Nulligravid who was diagnosed with Congenital Adrenal Hyperplasia and Clitoromegaly. Surgical treatment of ambiguous genitalia has evolved continuously and several types of repair exist. Th e exact method of reconstruction depends on the anatomy of the patient. However with regards in our case, late consultation had been made so the dilemma in reconstructive surgery was to perform it despite of its complications that may happen postoperatively that would aff ect not just the physical aspect but as well as the mental and psychological aspects of the patient. Th e Primary goal of treatment is to reduce the excess androgens production and replace the defi cient hormones. Female classical CAH patients also have the option of surgery to correct the appearance of ambiguous genitalia. Usually surgery is thought to be easier when performed within 2-6 months aft er birth

Speaker
Biography:

Samantha Quennie Wanasen-Razon has completed her Degree of Medicine at the age of 24 years from Far Eastern University- Nicanor Reyes Memorial Foundation Medical Center. She is currently a Third year Obstetrics and Gynecology Resident in the said institution

Abstract:

Cases of uterine rupture induced by placenta percreta in an unscarred uterus are rare. Th is is a case of 30-year-old, Gravida 2 Para 1 (1001) Pregnancy Uterine 31 Weeks and 2 days age of gestation with persistent generalized abdominal pain found out to have uterine rupture secondary to placenta percreta. Th is paper aims to discuss the diff erential diagnoses for cases of third trimester abdominal pain, the appropriate diagnostic modalities and the best management for such case. Uterine rupture should be considered in the diff erential diagnosis in all pregnant women who present with acute abdomen even if there are no risk factors. Exploratory laparotomy was done to investigate the cause of the patient’s severe abdominal pain on top of intrauterine fetal bradycardia. During the procedure, uterine rupture with massive bleeding was detected; therefore, subtotal abdominal hysterectomy was performed. Th e patient was discharged without any complications. Pathological analysis of the uterine specimen revealed placenta percreta to be the cause of the rupture

Hemuka Jane Ngozika

University of Wolverhampton, United Kingdom

Title: Men’s percep on toward female genital mu la on in Nigeria

Time : 15:30-16:00

Speaker
Biography:

Ngozika Hemuka has completed her Masters in Public Health and is currently a PhD student from the University of Wolverhampton. She is a member of Violence Against Women and Girls Research Cluster (VAWGRC) and the Institute for Community Research & Development (ICRD). She is director of Women Children and Community Health (WCCH

Abstract:

Female Genital Mutilation (FGM) is the cutting of the external female genital organs for non-medical purposes. It is a public health problem that is widespread in Nigeria.  Th e views and attitudes of women about the practice are widely researched and known however, very little empirical research has been conducted to attempt to explain the views of men about the practice. Th is study aims to investigates men’s knowledge and perceptions toward FGM in a local Igbo community in Nigeria. Methods: A mixed method study was conducted in Uturu Abia State, Nigeria from August to September 2017. A convenience sample of 258 men were invited to take part in a survey while a total of ten men participated in the individual interviews. Results: Out of the 258 men who responded to the invitation, 215 respondents completed the questionnaire and returned them. Response rate was at least 83%. Th e fi ndings of the study revealed that 100% of the men have heard of FGM however, only 69% have knowledge of any health consequences related to FGM. 58% of the men think that FGM is harmful to women and as a result, 58% of the men thinks that it is a bad practice and that it should be discontinued (63%). Conclusion: Although this study provide evidence on the positive attitude toward the abandonment of FGM among men in Uturu Nigeria, there is a need to educate men about the health consequences of the practice and increase the knowledge on policies regarding FGM in Nigeria.
 

  • Gynecology and Obstetrics Pathology
Speaker
Biography:

Husham Bayazed has completed his PhD from University of Mosul, College of Medicine. He is now Consultant at the Scientifi c Research Center, University of Zakho / Kurdistan Region, Iraq. He is specialist and consultant in Microbiology & Immunology and has published more than 25 papers in reputed journals and has been serving as scientifi c reviewers of many local and international medical journals. In addition he has a Fellowship of ISC, Infection, Cancer, Immunology Advisory Board Member (EUROMDnet) (Belgium), Membership of World Stroke Organization, Membership of Metabolomics (USA), and Membership of American Association of Science & Technology with more than 20 participations in international scientifi c meetings all over the world.

Abstract:

Objective: Th e present study was performed to assess the immune response in women with HPV DNA positive and negative cervical lesions. Methods and Patients: Eighty women with cervical lesions (age range of 25-70 years) were studied. Th e lesions were cytologically classifi ed into 4 groups: ASCUS (20), CINI (30), CINII-III (16), and cervical carcinoma (14) prior to HPV DNA detection. Estimation of IL-10 and TNF-α cytokines was performed via Enzyme linked immunosorrbent assay (ELISA) technique in cervical secretions and serum and PCR screening kits were utilized to detect HPV DNA on cervical smears. Results: Th e detected levels of IL-10 (mean ± SE) concentration in cervical secretions of patients with HPV DNA positive and negative states and control group were 88.73 ± 16.90 pg/ml, 24.00 ± 2.84 pg/ml and 8.27 ± 0.59 pg/ml respectively with signifi cant diff erences (p<0.05), while levels of TNF-α in cervical secretion of the studied groups were 12.18 ± 3.49 pg/ml, 9.90 ± 0.73 pg/ml, and 7.90 ± 0.87 pg/ml respectively with non signifi cant diff erences. Th e detected levels of IL-10 in cervical secretions of HPV DNA positive cases (88.73 ± 16.90 pg/ml) were signifi cantly higher than in the sera (13.69 ± 2.41 pg/ml) (p<0.05), while the levels of TNF-α in their cervical secretions (12.18 ± 3.49 pg/ml) was slightly raised than in their sera (11.5 9 ± 3.14 pg/ml) with non signifi cance diff erences

Conclusions: A raised levels of both IL-10 and TNF-α in secretions of HPV D NA positive women with diff erent cervical lesions were detected. However, the observed higher levels of IL-10 than TNF-α indicate down-modulation of tumor-specifi c immune response to HPV infected lesions via signifi cant raised concentrations of the fi rst cytokine than the second one. Th erefore, this phenomenon seems to provide a tumor progressive microenvironment by the immunosuppressant properties of IL-10 with minimal antitumor activity of TNF-α.
 

Mira Bajirova

Healthcare Medical Center Dubai, UAE

Title: Infertility caused by decreased oxygen utilization and jinn

Time : 11:40-12:15

Speaker
Biography:

Mira Bajirova, Associate Professor, Consultant IVF, Ob-Gyn from Paris, France. Born in Kazakhstan, moved to Moscow for Medical Studies and Scientifi c studies, PhD. After spending 13 years in Moscow, moved to Paris in 1989. Medical and PhD were not recognized.  New language. Started from the cleaner job, then caregiver, then studied to obtain the nurse Diploma and entered to the Paris University and after studying again 11 years, obtained 9 French Diplomas and Certifi cates. In Total 14 University diplomas and Certifi cates. In France worked with Prof Frydman who did the 2nd IVF in the World, with Prof Pouly, French IVF Society President. On the National Competition on the Country level in 2001 to become Assistant Professor was on 2nd place. Did National Scientifi c Study: ICSI and Children, which was preselected for European Award by ESHRE in 2001 and orally presented in Lausanne, Switzerland. Special interest in Alternative treatment by Negative Ions since 2010.  Miraculous eff ects of the Negative Ions on Female and Male Infertility, Premature Menopause, Infections, Cervical Dysplasia and even Cancer were published in 2017 and 2018 in International Journals. 34 publications, 5 Oral presentations, 1 poster. International experience: USA, UK, China, Vietnam, Russia, Kazakhstan, Pakistan, Kuwait, United Arab Emirates. Quran study since 2017. Ruqya treatment since January 2018.

Abstract:

There are two main causes of the Infertility. Infertility is caused by Decreased Oxygen Utilization and by Jinn. Decreased Oxygen Utilization is induced by Positive Ions. Positive Ions produced by man-made atmosphere: air Conditioning, air pollution, electrical and electronic devices, construction building materials, furniture, unhealthy food and drink, smoking, lack of sleep etc. Positive Ions induce the Acidity and Infl ammation in our body, leading to Decreased Oxygen Utilization and Multiple Organ Dysfunction, Infertility, Aging. Th e best treatment for Decreased Oxygen Utilization is the use of the Negative Ions, while Medicine is powerless in many cases. Negative Ions are abundant in Nature. Nature, created by God, has an amazing Healing Power. Th ere are many commercialized Negative Ions Products. Diagnosis of the Infertility caused by Jinn can be done by an experienced practitioner in this fi eld but also by using Negative Ions as they are disliked by hidden Jinn. Jinn were created by God before mankind creation, live in the parallel World and in their natural state they are invisible but they can take any physical forms. Jinn can create the Infertility through Jinn Possession, Black Magic, Evil Eye. Th e treatment of the Infertility caused by Jinn is only Ruqya, the Allah's words.