2nd World Congress on
Obstetrics and Gynecology
Scientific Program
Keynote Session:
Title: Understanding chronic pain: The mind-body connection
Biography:
James F. Zender is a clinical and forensic psychologist and psychotherapist whose practice focus is evaluating and treating patients recovering from auto and occupational injuries involving PTSD, TBI, depression and chronic pain.
Abstract:
This presentation will highlight some recent advances in the role of belief in chronic pain from the mind-body-trauma perspective. Topics of placebo (or remembered wellness), flow studies and polyvagal theory and their implications for chronic pain management will be emphasized.
Title: Harnessing the understanding and advancement in neurology and neurosurgery
Biography:
Richard Klein, DDS exclusively treats OSA and TMD. He has not practiced routine dentistry for 24 years. He has been teaching St. John Hospital residents monthly lectures for 15 years and is a Clinical Professor at Michigan State Osteopathic Medical School. He has Diplomat status in Obstructive Sleep Apnea from the American Sleep and Breathing Academy and the American Academy of Craniofacial of Pain Management, with TMD Mastership from both ICCMO and AACP and Fellowship in the Royal Society of Health (England). He has lectured in 14 countries, is published in multiple journals and has authored a chapter on TMD in the Anthology of Craniomandibular Orthopedics Vol IV. He served as Clinical Investigator, a study utilizing lasers for dentistry and pain management in 1988 and has been asked to speak in Washington DC to the Department of Transportation, the Federal Motor Carrier Safety Association as well as to US Senators and the US Congress.
Abstract:
Understanding the Relation of Neurology and Musculoskeletal Diagnosis; the human nervous system is described as one of the most complex systems in all of nature. It is responsible for coordinating thousands of processes, from muscle contraction while cutting wood to smiling and crying. Over 100 billion specialized neurons are found in the human brain. This lecture will discuss the multiple eye and ear symptoms that may be causally related to neurologic, musculoskeletal, otologic, ophthalmologic, or termpormandibular diagnoses, and it will differentially discuss the non-neurological causations that can confuse doctors or specialized fields. Anatomical consideration regarding blurred vision, retro-orbital pain, lacrimation photophobia, otalgia, ear congestion, itchy ear, subjective hearing loss, phonophobia, vertigo and tinnitus will be discussed with explanations of a cause that does not initiate neurologically
Title: The wellness purpose connectionâ„¢: Understanding how eating and exercise leads to happiness and purpose in life
Biography:
People are getting sicker, holistically. Data indicates that about 80% of the population is not satisfied with their current employment situation. Specifically, gathered data reveals that mid-career professionals in the U.S., particularly women, report being dissatisfied with their jobs, mental exhaustion, stress, lack of joy, mild depression and physical ailments such as being overweight, diabetes, and high blood pressure. They also reported poor family relationships, low self-esteem, lack of confidence, limited time to do the things they enjoy and dissatisfaction with their income. In short, these professionals, despite earning middle class incomes, experience limited wellbeing. Individuals who have received wellness coaching, however, have transformed these conditions to improve their quality of life. Furthermore, those coached begin to pursue more fulfilling careers or enhance their current roles and increase implementation of spiritual practices. To understand this phenomenon, a grounded theory approach is being employed with the aim of discovering how shifting one’s mindset and behaviors in the areas of diet and exercise influences a transformation in their overall wellbeing. At the time of this submission, the grounded theory approach process is in progress. An understanding of this phenomenon can guide the work of health coaches when helping clients to improve their health and happiness. The understanding can also help individuals reduce their instances of negative stress, panic attacks, and situational depression while improving their quality of life and joy factor. Once the theories have emerged, the results will be used to refine the wellness coaching process, create tools to enhance wellness coaching and connect with professionals who are challenged with limited perspective to transform their quality of life. Ultimately, the way in which the health and wellness industry talks about diet needs to shift from food and weight loss to elevating and integrating thinking and feeling for sustained improved wellbeing.
Abstract:
Sheron Brown is the Scholar practitioner and the founder of Sweet Eden, a wellness education company that works primarily with busy professionals to bring harmony between their personal and professional lives and improve their overall wellbeing. She reinvented her previous experiences in leadership development. She grew from helping leaders to solely focus on workplace performance to transforming their lives with a wholistic perspective. She has worked as an independent consultant and coach to school leadership teams using her experiences as a brain-based coach to help leaders transform. She holds a certificate for using the Insight Learning Foundation’s personality assessment system, a Results Coaching System certificate, a certificate for integrative health coaching and is a trained yoga teacher. Furthermore, She holds her PhD in Professional Studies in Education from Capella University
Title: The wellness purpose connectionâ„¢: Understanding how eating and exercise leads to happiness and purpose in life
Biography:
People are getting sicker, holistically. Data indicates that about 80% of the population is not satisfied with their current employment situation. Specifically, gathered data reveals that mid-career professionals in the U.S., particularly women, report being dissatisfied with their jobs, mental exhaustion, stress, lack of joy, mild depression and physical ailments such as being overweight, diabetes, and high blood pressure. They also reported poor family relationships, low self-esteem, lack of confidence, limited time to do the things they enjoy and dissatisfaction with their income. In short, these professionals, despite earning middle class incomes, experience limited wellbeing. Individuals who have received wellness coaching, however, have transformed these conditions to improve their quality of life. Furthermore, those coached begin to pursue more fulfilling careers or enhance their current roles and increase implementation of spiritual practices. To understand this phenomenon, a grounded theory approach is being employed with the aim of discovering how shifting one’s mindset and behaviors in the areas of diet and exercise influences a transformation in their overall wellbeing. At the time of this submission, the grounded theory approach process is in progress. An understanding of this phenomenon can guide the work of health coaches when helping clients to improve their health and happiness. The understanding can also help individuals reduce their instances of negative stress, panic attacks, and situational depression while improving their quality of life and joy factor. Once the theories have emerged, the results will be used to refine the wellness coaching process, create tools to enhance wellness coaching and connect with professionals who are challenged with limited perspective to transform their quality of life. Ultimately, the way in which the health and wellness industry talks about diet needs to shift from food and weight loss to elevating and integrating thinking and feeling for sustained improved wellbeing.
Abstract:
Sheron Brown is the Scholar practitioner and the founder of Sweet Eden, a wellness education company that works primarily with busy professionals to bring harmony between their personal and professional lives and improve their overall wellbeing. She reinvented her previous experiences in leadership development. She grew from helping leaders to solely focus on workplace performance to transforming their lives with a wholistic perspective. She has worked as an independent consultant and coach to school leadership teams using her experiences as a brain-based coach to help leaders transform. She holds a certificate for using the Insight Learning Foundation’s personality assessment system, a Results Coaching System certificate, a certificate for integrative health coaching and is a trained yoga teacher. Furthermore, She holds her PhD in Professional Studies in Education from Capella University
Title: Personalized & precision medicine (ppm) as a model of healthcare services of the next-step generation to secure the national stability and the biosafety
Biography:
Sergey Suchkov was born in the City of Astrakhan, Russia, in a dynasty of medical doctors, graduated from Astra-khan State Medical University and was awarded with MD. Then maintained his PhD and Doctor’s Degree. And later was working for Helmholtz Eye Research Institute and Moscow Regional Clinical Research Institute (MONIKI). Dr Suchkov was a Secretary-in-Chief of the Editorial Board, Biomedical Science, an international journal published jointly by the USSR Academy of Sciences and the Royal Society of Chemistry, UK. At present, Dr Sergey Suchkov is: (i) a Director, Center for Personalized Medicine, Sechenov University, (ii) Chair, Dept for Translational Medicine, Moscow Engineering Physical University (MAPhI), and (iii) Secretary General, United Cultural Convention (UCC), Cambridge, UK. A Member of the: New York Academy of Sciences, American Chemical Society (ACS), American Heart Association (AHA), AMEE, Dundee, UK; EPMA, Brussels, EU; PMC, Washington, DC, USA and ISPM, Tokyo, Japan.
Abstract:
A new systems approach to diseased states and wellness result in a new branch in the healthcare services, namely, personalized medicine (PM). To achieve the implementation of PM concept into the daily practice including clinical cardiology, it is necessary to create a fundamentally new strategy based upon the subclinical recognition of bioindicators (biopredictors and biomarkers) of hidden abnormalities long before the disease clinically manifests itself.
Each decision-maker values the impact of their decision to use PM on their own budget and well-being, which may not necessarily be optimal for society as a whole. It would be extremely useful to integrate data harvesting from different databanks for applications such as prediction and personalization of further treatment to thus provide more tailored measures for the patients and persons-at-risk resulting in improved outcomes whilst securing the healthy state and wellness, reduced adverse events, and more cost effective use of health care resources. One of the most advanced areas in cardiology is atherosclerosis, cardiovascular and coronary disorders as well as in yocarditis. A lack of medical guidelines has been identified by the majority of responders as the predominant barrier for adoption, indicating a need for the development of best practices and guidelines to support the implementation of PM into the daily practice of cardiologists!
Implementation of PM requires a lot before the current model “physician-patient” could be gradually displaced by a new model “medical advisor-healthy person-at-risk”. This is the reason for developing global scientific, clinical, social, and educational projects in the area of PM to elicit the content of The new branch.
Title: Revise the caesareans, save women lives
Biography:
Christos Tsitlakidis has graduated from Hellenic Aristotle University School of Medicine. He is a Consultant Obstetrician and Gynaecologist in Pinderfields Hospital, MidYorkshire NHS Trust, United Kingdom. He has published more than 6 papers in reputed journals in UK and abroad and has been member of the RCOG.
Abstract:
Introduction: In 1882, Max Sanger, a 28 years old assistant at Leipzig, was the first surgeon to suture uterine wall and saved women from death. So many years after and bleeding during Caesareans remains life threatening. Amazingly the causes are considered same as for vaginal delivery. It is time now time to revise autonomously the causes of PPH during caesareans.
Purpose: To authenticate the surgeon, the most undefined factor. His expertise and improved techniques will alter the blood loss. To show that available devices from the market now showing to formulate an easier procedure and minimise bleeding.
The Facts: 1) The Surgeon remains the undefined factor for the bleeding. His expertise and methods are not included in the under evaluation factors. 2) The training for juniors to perform Caesareans seems basic, national guidelines do not embrace new techniques. 3) Caesarean rate increased to staggering five times from Sanger times. 4) The way the procedure performed remained unchanged 5) Uterine Compression can easily be applied but not evaluated adequately, (abdominal packs and exteriorisation of uterus). 6) No literature with regards how to perform complicated types of procedure. 7).The procedure nowadays becomes more complex than ever (obesity, repeated C/S, increased inductions). 8).Available devices from market now can formulate an easier procedure and yet very rarely used.
Conclusion: it is now for the first time since the expertise of a surgeon saved all women lives, to revise the bleeding causes during Caesareans to recognise the role of the surgeon. That will be a great contribution to our modern obstetrics, moving forward by looking back to Max Sanger.
Oral Session 1:
- Gynecology and Obstetrics | Medical Problems in Pregnancy | Gynecology Oncology
Chair
Sergey Suchkov
Sechenov University, Russia
Title: Title: Use of modern molecular biological methods for translational research and as tool for cancer patient stratifi cation
Biography:
The use of molecular biological methods especially droplet-digital PCR and NanoString technology offer several possibilities for translational research and cancer patient stratification. In this workshop some examples (not only limited to gynecological tumours) based on RNA or microRNA expression in solid tumours will be discussed. MicroRNAs are pivotal regulators for RNA silencing and post-transcriptional regulation of gene expression under physiological as well as pathological conditions. MicroRNAs can be detected in tissues and in most biologic fluids including serum, plasma and urines. Secreted microRNAs are either incorporated into micro-vesicles or circulate bound to proteins. In both cases microRNAs are protected from RNase degradation so that they may remain intact for long periods of time. Therefore they might represent potential new biomarkers. We analyzed expression of 800 miRNA’s using nCounter NanoString technology in cancer cell lines, formalin fixed paraffin embedded tissues and plasma from cancer patients. Potential clinical applications of microRNA detection for cancer patients’ management will be discussed
Abstract:
Jens Claus Hahne has received the PhD in biochemistry from the Albert-Ludwigs-University Freiburg. During his PhD work he was trained in virology, cell- and molecular-biology. During several postdoc positions [Department of Molecular Pathology at the University of Bonn (Germany), Charite Berlin (Germany), Department of Gynaecology and Obstetrics at the University of Wuerzburg (Germany)] he received a broad training and knowledge in molecular pathology and cancer research. At the moment Jens is working in the Department of Molecular Pathology at the ICR (London, UK). He has published more than 60 papers in reputed journals and has been serving as an editorial board member of repute.
Title: Circadian rhythms of physiological functions of the pregnant woman and the fetus and the biological solemnity thereof
Biography:
Medea Zarnadze completed her PhD in 1985 from P.M. Buiko Scientific-Research Institute of Pediatrics, Obstetrics and Kiev. At present she works at K.V. Chachava Institute of Perinatalogy, Obstetrics and Gynecology, 38 Kosnava St. Tbilisi 0108, Republic of Georgia and Diagnostic department of JSC Academician O. Cudushauri national medical Department of Obsetrics & Gynecology. She is engaged in a massive investigation of fetal and maternal biorhythms. She has published 12 articles in reputed journals. She has participated in numerous Scientific Conferences and Congresses (8) devoted to these problems.
Abstract:
The present study is the result of a long- way reflection and search resulted in a non-ordinary approach to the analysis of fetal FHR. Is the property found in the fetal organism intrinsic or the rhythmic organization of biological systems is determined by periodic changes in the external environment? Place and the role of the rhythmic organization? Hence, a digital analysis of fetal and maternal heart rate was performed for 24 hours, uninterruptedly
Preliminary analysis: During the period of pregnancy the mother retains a clearly expressed daily rhythm of cardiac activity. Depending on the predomination of this or that type of cardiotachogram in fetal ECG, “quiet (sleep-like condition)” hours (4am-9am and 2pm – 19pm) and “active” hours (9am – 2pm and 7pm-4am) were singled out. Both, in the mother and the fetus, alternation of increase and decrease periods in the physiological functions can be observed: “active” hours of the fetus coincide with maternal “quiet” hours, while fetal “quiet” hours fall on “active” hours of the mother. Fetal movements can be observed at 10pm-4am. High fetal activity (10pm – 4am) does not affect the night sleep of the mother. In fetal “quiet “hours (4am -9am) the motor activity decreases 6-7 times. The maximal number of FHR indices below 120 bpm were revealed in fetal “quiet” hours
Conclusion: We revealed 24- hour rhythms of the fetus. Functioning of fetal physiologic systems coincides with that of maternal organism, being, however, in a reverse phase.
Presumably, the fetus needs to maintain a relatively constant homeostasis: fetal activation during the “quiet “maternal hours and deceleration of fetal physiologic intensity (sleep-like condition) when the mother’s physiologic activity is increased.
Title: Hypertensive disorders of Pregnancy (HDP) in women attending L and D, JNH, Jeddah, KSA
Biography:
Gulnaz Haroon Rasheed hails from India and was graduated from the most prestigious University of Mysore , India in 1990 and then pursued her career in Obstetrics and Gynaecology, obtaining Diploma in Obstetrics and Gynaecology from the College of Physicians and Surgeons from Bombay, now called as Mumbai. Later on, moved to Jeddah , Saudi Arabia and continued to study aiming to achieve International qualification and was awarded Membership from the most prestigious Royal college of Obstetrics and Gynecologists, London in 2017.Since graduation, she has worked as an Obstetrician and Gynecologist in India and overseas for more than 29 years with a successful proven track. She also worked as the Hospital Director at Dr. Hassan Ghazzawi Hospital, Jeddah from December 2007 to December 2009.From 2013 to 2015, led the Operation Theatre / Delivery Room and NICU as Manager in the above Hospital. Since 2016, she is working at Jeddah National Hospital.
Abstract:
To reduce maternal and perinatal complication and ensure both pregnant women and infants to be healthy and safe and to determine the risk factors of hypertensive disorders in pregnancy.
Materials and Methods: A retrospective study was conducted in laboring women aged 15 years and above who were attending laboring and delivery (L and D) unit at JNH hospital, Jeddah. Even in 21st century maternal mortality and morbidity is very high in certain communities with highest birth rate in the lives of women due to traditional values like more the children merrier is the family, especially where polygamy is not restricted up to four marriages. The married life starts at 14 years till 50 years. A single woman can produce 20-25 children in her lifetime, surprisingly even at 50 years of age. This study is based on a single unit having births around 3500 per year. This study is shown to reveal the risk factors for HDP who attended the center for delivery from January 2018 to December 2018. Predisposing factors included are anemia in women, no antenatal care, pregnancy in unmarried young girls, illegal immigrants from neighboring countries where abortion law is abandoned, black race, refugees from Myanmar, low socioeconomic status, personal history of diabetes, history of hypertension in previous pregnancy, family history of hypertension, grand multiparity, multiple pregnancy (twins, triplets, quadruplets), advanced maternal age, overweight and obesity.
Results: Gestational hypertension-10%, Pre-eclampsia with proteinuria-6-8%, Eclampsia-4% and Chronic hypertension in pregnancy-3%. Intrauterine fetal deaths, Preterm births, Postpartum hemorrhage (PPH). PPH led to anemia and sometimes hysterectomy, increased caesarian section rate compared to vaginal deliveries. Neonatal outcome included preterm birth, increased admission rate to neonatal intensive care unit.
Conclusion: The risk factors confirmed in this study are useful for early diagnosis of HDP with appropriate treatment and prevention of complication leading to safe motherhood and healthy neonates.
Title: Modifying the caesarean seven years on
Biography:
Christos Tsitlakidis has graduated from Hellenic Aristotle University School of Medicine. He is a Consultant Obstetrician and Gynaecologist in Pinderfields Hospital, MidYorkshire NHS Trust, UK. He has published more than 6 papers in reputed journals in UK and abroad and has been member of the RCOG
Abstract:
Introduction: Caesarean carries the legacy of an Emperor. It is the procedure that more than any other complicated by bleeding and infection. Modifying the procedure in several areas came out of necessity to respond to new challenges that appear over last decades. Are we learning as fast as Midwifery changing, we should move to Modern Obstetrics, supporting ideas old and new ones, till we find those that work.
Principles: Minimise the need for assistance. Create a clean and dry procedure. Eliminate bleeding. Operate in a controlled and calmed environment. Try and achieve natural birth simulation. Involve parents. Eradicate risk of post natal infection
Methods: Retraction tapes. Large intrabdominal packs. Stage stitch onto the middle of lower segment. Use of suction to drain amniotic fluid. Opening lower segment high and cutting slightly upwards laterally. Fetal pillow to disengage head. Kiwi cup for high or low head. Natural birth simulation and delay in delivery through tight incisions. Invite parental couple to observe, delivery straight to mother, delay cord clamp. Repair of lower segment in one of four appropriate ways, one applies additional compression. Cleaning scar with normal saline and vaginal toilet with antiseptic.
Conclusion: Caesarean still remains a ferocious procedure that can claim lives. Should we do not recognize the challenges from a changing world, the furies could become the Nemesis of our practise. Let’s credit the future with success.
Title: Performance of the CTG (cardiotocograph) and its analysis
Biography:
Gulnaz Haroon Rasheed hails from India and was graduated from the most prestigious University of Mysore , India in 1990 and then pursued her career in Obstetrics and Gynaecology, obtaining Diploma in Obstetrics and Gynaecology from the College of Physicians and Surgeons from Bombay, now called as Mumbai. Later on, moved to Jeddah , Saudi Arabia and continued to study aiming to achieve International qualification and was awarded Membership from the most prestigious Royal college of Obstetrics and Gynecologists, London in 2017.Since graduation, she has worked as an Obstetrician and Gynecologist in India and overseas for more than 29 years with a successful proven track. She also worked as the Hospital Director at Dr. Hassan Ghazzawi Hospital, Jeddah from December 2007 to December 2009.From 2013 to 2015, led the Operation Theatre / Delivery Room and NICU as Manager in the above Hospital. Since 2016, she is working at Jeddah National Hospital.
Abstract:
Background: In the recent Obstetrics and Gynecology departmental meeting, it was decided to have a procedure room in the Out-Patient department of OBG wing. This will streamline and standardize the procedure to perform CTG in the procedure room. Earlier, patients had to go to the Ante natal ward to perform CTG causing enormous delay in the process and dissatisfaction amongst the patients.CTG is one of the most important procedures to ensure fetal well being and facilitates further management and treatment particularly in high risk pregnancies. This is a significant process with potentially severe outcomes should the process fail.
Methods: HFMEA was done on the process of performing/recording the graph and analyzing the CTG, making it more systematic and phenomenal for all the OB Gynae staff including physicians and nursing staff to ensure utmost patient’s safety to achieve the three international patient’s safety goals, which are 1. Correct Patient Identification.2. Improve Effective communication 3.Ensure Correct procedure for Correct patient. It is a pro-active approach of risk assessment and prevention of the system failure in recording and analyzing the CTG process which could avoid sentinel or catastrophic incidents. Multidisciplinary team representatives from Continuous quality improvement department, Nursing department and OB and gynae Physicians, representative from Biomedical Engineering department participated in this project. Five steps were identified, in order, to establish a standardized process for the performance of the CTG in the procedure room. Each step with the main process and sub process were consecutively numbered and described graphically. After selecting the topic and the team, the process flow chart was developed. Once, the physician orders the CTG, the patient gets the invoice from the reception and goes to the procedure room, gets a CTG done and then the CTG is analyzed and reported to the Physician and recorded in the patient’s medical record. The most critical and vulnerable step in this process which is recording/obtaining the graph and analyzing the CTG was studied and subjected to HMFEA. After the hazard analysis was conducted, actions and outcome measures were established to ensure patients safety.
Results: Healthcare Failure Mode and Effect Analysis were utilized to identify a system failure in the recording/tracing and analysis of the CTG in the new procedure room. Ten sub processes were identified in order to establish why there was a system failure in the systematic approach of recording and analyzing CTG trace and reporting it to the obstetrician who ordered it. Hazard scoring analysis was done for each step and recommended actions were put in place. Use of the HFMEA allowed members of the multidisciplinary team to identify problems within the system and helped to design required countermeasures to improve patient safety with particular emphasis on achieving three important international patient safety goals.
Keynote Session:
Title: Immediate healing for personality development
Biography:
Hadi Eltonsi a medical graduate trained in group psychotherapy, hypnosis, silva mind control, NLP, Reiki Master, Pranic Healing, Life Coach, Mantra Yuga meditation among others courses for psychic powers, family constellation thru his medical study and practice then as a diplomat and Ambassador. He performed many TV, Radio interviews and seminars apart of two short American films about his work or inspired by his skills which were shown in international film festivals; the second got an award in Venice 2017.
Abstract:
Purpose of the treatment: Achieving immediate non medicinal effortless painless healing without complications. For personality development, relief of neurotic disease, psychosomatic symptoms and diseases, treating emotional obesity and smoking.
Method: After joint analysis with Client and definition of psychological and physical goals of treatment, the healer as a trained behavioral, cognitive and logo psychotherapist arrives with client to a new corrected understanding of the case and roots of conflicts in childhood, taking around 2 hours, then in less than an hour performs non-verbal interpersonal hypnosis with transfer of energy and telepathy to client till deep sleep when he implants the required personality , ideas, emotions, motives and attitudes into the subconscious embodying the required state. The subconscious and conscious mind will have same agreed upon analysis and targets for immediate results in that session of 3 hours.
Results: The healer got patent in Egypt 2016 for his discovery of The Immediate Healing for Personality Development and for mentioned purposes. Up till now treating more than 700 cases aging between 12 and 80 years with relief of more than 80% of cases either totally or mostly.
Conclusion: immediate non medicinal revolutionary life transforming healing for a wide spectrum of cases achieving higher grades of maturity, insight, harmony and efficiency saving client time, effort, interests and complications. Also used to maturate community leaders to be a trouble shooter model efficient leaders with team spirit.
Title: New Lifestyle: Coping support technics and positive psychology as best prevention dealing with stress
Biography:
Javier Fiz Perez is the Psychotherapist and Professor of Psychology at the European University of Rome, where he cooperates also as Delegate for the International Research Development. He is Co-Director of the Laboratory of Applied (Business and Health Lab). Graduated in Philosophy, Psychology and Social Bioethics, getting also a specialization in Executive Business Administration (EMBA) after the PhD He’s a Member of the Advisory Board of the Academic Senate of the Academia Tiberina. He is the Coordinator of the Scientific Committee of The International School of Economics and Ethics (Italy) and collaborates with the International Academy for Economic and Social Development (AISES) of which he has been Vice President for Spain and Latin America. He is also the Scientific Research Director of the European Institute of Positive Psychology at Madrid (IEPP) being also a Member of the Scientific Committee of International Institute Jacques Maritain. He is also a Member of several Committees of Scientific Journals and the Director of the International Network for Social and Integrated Development (INSID). He has more than 150 national and international publications.
Abstract:
Stress is no longer a phenomenon that concerns adults exclusively. For this reason, we have decided to include teenage stress in our research. We have been submitting a survey on stress to a group of 671 teenagers with an average age of 16 years and 7 months. The survey was focused on two different aspects: stress perception and stress causes. Family Support Coping Questionnaire was also submitted. The main finding of this study is that 38% of the sample defines them as stressed, with no gender related differences. Subjects that consider themselves stressed indicate as causes lack of time (31%) and excessive commitments (23%). Almost all the subjects say school (48%), family (21%) and sentimental relationships (8%) are the main sources of stress. From the analysis of the open answers, it is clear that family and school expectations are the greatest sources of stress – even if significantly more so for females than for males. Subjects were asked to assess the level of stressed originated by finishing school and the need of choosing and planning their future. This finding is meaningful when measured up to the percentage of subjects that has stated to have already made the decision of what to do when they finish studying. As it is seen in the graphic (we asked the subjects to state if they had already decided what to do after school) the greatest levels of uncertainty are found in year IV. The intersection of these data does not seem, however, enough to explain levels of stress, as the high percentage of students who have decided should cause a significant reduction of stress in year V. Most likely, stress concerning the post high school choice is the nonlinear combination of two factors: on one hand, uncertainty regarding the choice, on the other hand, the immediacy of the event. Comparing stress levels amongst subjects that count on strong family support and subjects that count on scant family support there are significant differences. The subjects that count on strong family support seem to register lower average stress levels, regarding their post high school choices. Furthermore, this kind of support seems to reduce stress as the event comes nearer, facilitating the decision-making.
Title: Molecular and cellular mechanisms of synaptopathies in autism
Biography:
Afaf El-Ansary has graduated from biochemistry department, Ain Shams University, Egypt in 1974. She worked in the National Research Centre, Egypt from 1976-2000. Since 2016- till now, she joined the Central laboratory as senior scientist to supervise the Biochemistry, Proteomic and biomarkers units. She is member in number of national and international societies and she is recorded as reviewer in many international journals.
Abstract:
Autism is a complex neurodevelopmental condition that includes impairments in social interaction poor language and communication skills together with repetitive behaviors. Synapses are essential components of neurons that needed for the travel of information throughout the nervous system to adjust different behaviors. Thus, optimal synaptic communication is required for proper brain physiology, and slight deviation of synapse function early in life can lead to neurodevelopmental disorders among which is autism. Synaptopathy arises from alterations that affecting the integrity and/or functionality of synapses, can contribute to synaptic pathologies as etiological mechanism of autism. Based upon the blood biomarkers of autism, increased platelet serotonin (5-HT), suggest that increased 5-HT uptake or storage in the presynaptic neuron would lead to decreased brain 5-HT. A relationship between autistic behavior and dysfunctions in the midbrain dopaminergic system was also hypothesized. While dysfunction of the nigrostriatal circuit leads to stereotyped behaviors, a dysfunction in mesocorticolimbic circuit leads to social deficits. Additionally, imbalanced GABAergic/glutamatergic neurotransmissions in plasma of autistic children demonstrates glutamate excitotoxicity as etiological mechanism of this disorder. Our most recent study proved that GABA synaptopathy promotes caspase 3 and caspase 9 as pro-apoptotic markers. In this talk, relationship between synaptopathies, apoptosis, mitochondrial dysfunction, and impaired gut microbiota as etiological mechanisms of autism will be discussed. Understanding common causes and mechanisms of autismâ€associated synaptic dysfunction could offer novel clues toward synapseâ€based treatment strategy and early intervention of autism.
Title: The PI3K/AKT/mTOR-signalling pathway offers therapeutic options and is the reason for chemoresistance in gynaecological cancer
Biography:
Jens Claus Hahne has received the PhD in biochemistry from the Albert-Ludwigs-University Freiburg, Germany. During his PhD work Jens was trained in virology, cell- and molecular-biology. During several postdoc positions [Department of Molecular Pathology at the University of Bonn (Germany), Charite Berlin (Germany), Department of Gynaecology and Obstetrics at the University of Wuerzburg (Germany)] he received a broad training and knowledge in molecular pathology and cancer research. At the moment he is working in the Department of Molecular Pathology at the ICR (London, UK). He has published more than 60 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
Drug resistance is a common problem in tumour therapy. It is characterized by reduced drug efficacy caused by gene mutations, increased DNA repair, and enhanced drug clearance and detoxification. However, up to now the complex molecular mechanism of chemoresistance is still not well understood. Increasing evidence points towards AKT over-expression and alteration of the PI3K/AKT/mTOR-cascade as a central mechanistic reason for this resistance. The effects of over-expression and down-regulation of AKT on the sensitivity to treatment as well as the role of AKT expression level have been analyzed. Given the fact that survival of cancer patients is strongly influenced by immunological parameters, immunotherapeutic strategies appear promising. Therefore a better understanding of the interaction between tumour cells and cells of the immune system is a necessary prerequisite. The interaction of ovarian and breast cancer cells with immune cells has been evaluated in relevant in-vitro co-culture systems. It was possible to correlate the AKT expression level in tumour cells with the killing efficiency of tumour cells by NK-cells. Furthermore the molecular basis for resistance mechanisms against NK-cell mediated killing has been analyzed. Due to the fact that the PI3K/AKT/mTOR-pathway is involved in cancer tumourigenesis members of this pathway are regarded as attractive candidate for therapeutic interventions. Several inhibitors for the PI3K/AKT/mTOR-pathway have been analyzed in in-vitro models for ovarian and breast cancer. Results of the pre-clinical in-vitro studies will be presented.
Oral Session 1:
- Obstetrical Complica􀆟 ons | Labor and Delivery | Female Pelvic Medicine and Reconstruc􀆟 ve Surgery | Lifestyle and Being Obese
Chair
Sergey Suchkov
Sechenov University, Russia
Title: Which place for bariatric surgery
Biography:
Natalia Leston has her expertise in evaluation and passion in improving the health and wellbeing of overweight /obese Patients. She was born in Argentina, but she made her medical training in Endocrinology and nutrition in France, Lyon. After a Master degree in Health system, she worked 6 years in clinical research (international project manager in Diabetes and metabolism in the Pharmaceutical industry), and she returned to the clinical practice five years before. Actually she’s preparing a project of nutritional information and training for patients, to improve their quality of life and wellbeing, and in in a multidisciplinary group
Abstract:
In France the prevalence of obesity is less than in United-States, England or Eastern Europe, but there are a progressive augmentation, especially in 35-55 years old people and in the North and East of France, in cities and the poor localizations. Careful patient selection and preoperative work-up are extremely important and now very well codified by ANAES recommendations that are carefully follow-up by national social security.If patient cannot lose weight with traditional methods, because of morbidity and late term complications, surgery should be considered. Bariatric surgery is most time safe and effective method for achieving durable weight loss for patients with morbid obesity. Different interventions include long-limb gastric diversion with duodenal switch. The principal indications are the morbid obesity (BMI >40 kg/m2) resistant to medical treatment, obesities with BMI between 35 and 40 kg/m2 with comorbidities, and with a multidisciplinary decision (psychologist, nutritionist, bariatric surgeon). This kind of surgery is not indicated in the cases of social, familiar, psychological difficulties, and the impossibility of the patient to follow-up the post-surgical protocol. The benefits of the lost weight are important (biological and quality of life parameters are described). Adverse events have been reported for all kind of surgery. A careful selection of the patients should be done to minimize the complications of surgery.
Title: Assosation between Serum Leptin and anthropometric profile, fasting serum insulin and glucose level in women with polycystic ovarian syndrome
Biography:
Tarek S. Elaraby is a experienced Quality Specialist with a demonstrated history of working in the medical practice industry. He is skilled in Healthcare Consulting,Obstetrics and gynecology , IVF , Oncology, Emergency Medicine, and Healthcare Information Technology (HIT). He is a strong quality assurance professional with a High postgraduate Diploma focused in Hospital and Health Care Facilities Administration/Management from The American University in Cairo.
Abstract:
Introduction In 1935 Stein & Leventhal described seven women presenting with oligomenorrhea combined with the presence of bilateral polycystic ovaries (PCO) established during surgery. The progress in defining the role for leptin in human obesity may be shadowed only by the even faster rise in our awareness of the role of leptin in reproduction. Leptin appears to be the missing link between fat and fertility. When controlled for body weight, no difference is seen between women with and without PCO, however leptin is still involved, and as insulin sensitizing agents may decrease leptin gene transcription. Leptin stimulates all levels of the reproductive axis, i.e., hypothalamus, pituitary and ovary. The study was conducted on 40 patients classified in to two groups Group (1): 20 PCOS female patients with different body mass indices, Group (2): 20 Non PCOS control female patients healthy with normal cycles and matched BMI. Full history, general and anthropometrics data (age, age of menarche, BMI, duration of infertility ,W/H ratio and parity) were recorded also fasting venous blood sample were collected dry tube and glucose level was measured then blood was left till clotted then centrifuged and stored frozen -20 c till the assay analysis time. The aim of this work was to find the association between fasting serum leptin level in women with polycystic ovarian syndrome in relation to their anthropometrics profile and fasting serum insulin. The results of the study showed that In PCOS cases group statistically significant Positive correlation (p=<0.05) was found between leptin versus BMI (r = 0.30) and duration of infertility(r= 0.31) among the studied cases by using correlation co-efficient test ,while there was no statistically significant correlation found between leptin and anthropometric and general data (age, age of menarche, W/H ratio and parity). Statistically significant positive correlation was found between leptin and glucose (r=0.38, p <0.05), leptin and LH (r = 0.40, p <0.05) but negative correlation between leptin and insulin (r = -0.42, p <0.05).The ROC curve of fasting serum leptin the area under curve was 75% and the best cut of value for leptin was 14ng /ml with specificity (85%), sensitivity (55%) and accuracy was 70%. In conclusion, PCOS screening test using serum leptin can be used as good negative screening test but not be used alone as good positive. It has a positively correlated to BMI, duration of infertility, glucose and LH. While, inversed correlated to insulin. No statistically significant correlation was found with other general and anthropometrics data, testosterone and FSHv
Title: Unusual presentation of placenta increta
Biography:
Howaida Zahar is a consultant Ob, gyn . She is the director of the department King fahad armed forces hospital
Abstract:
Introduction: Placenta increta is one of life-threatening situation that best managed by multidisciplinary approach. We describe a case leading to rupture of unscarred uterus in the second trimester that leading to massive intra-abdominal hemorrhage.
Case report: A 37 year old, gravies 11 para 9+1 with previous all Spontaneous vaginal delivery and one abortion managed by uncomplicated ERPC, presented to our emergency department with rupture of membrane. While in hospital, she developed tachycardia and significant drops in the hemoglobin level.Also she had been diagnosed to have intrauterine fetal demise. Rupture uterus suspected and the ultrasound confirmed the diagnosis by showing hemoperitonium. After starting the resuscitation procedures, Emergency laparotomy performed which showed uterine rupture along with placenta increta for which the patient underwent subtotal hysterectomy. Pathological analysis showed chorionic villi invading the myometrium supporting the diagnosis of placenta increta.
Conclusion: Though the occurrence of placenta increta is rare with unscarred uterus, and uterine rupture also rare with unscarred uterus and in the second trimester, high index of suspicion should be raised in grand-multi para even when this was the only risk factor for these serious problems as missing the diagnosis is fatal to the patient.
Title: Improving the predictive accuracy for pre-eclampsia by combining clinical risk factors with biochemical indicators
Biography:
Ana Daneva Markova is a specialist with a demonstrated history of working in the medical practice industry. She is skilled in Clinical Research, Medical Education, OB/GYN, Gynecolog. She is a strong professional with a Phd MD of medical science focused in Perinatology from Medical School
Abstract:
Objective: To determine whether previously identified risk factors are associated with the development of the severe form of pre-eclampsia in a heterogeneous cohort of women, and the predictive values of this risk factors when combined with certain biochemical indicators.
Study design: Systematic review of data collected for a doctoral case-control study plus the examination of the indicators of preeclampsia and maternal IL10 levels. This examination was conducted in 100 women with pregnancies complicated by varying degrees of preeclampsia and in 80 normotensive patients, hospitalized at the University Clinic of Gynecology and Obstetrics, Skopje, Republic of Macedonia. Patients with preeclampsia were categorized into moderate (m PE) and severe (s PE) preeclampsia group according to the degree of preeclampsia. The severity of preeclampsia was determined according to the definition of the World Health Organization, Handbook for guideline development from 2010.
Results: The regression analysis applied in this study showed that elevated systolic blood pressure of 160 mmHg or higher, diastolic blood pressure of 100 mmHg or higher, pregnancy at older age, nulliparity, persistent proteinuria in pregnancy, the serum LDH concentration of 450 U/L or higher and reduced serum concentrations of IL10 as significant predictors of severe preeclampsia in pregnant women. While other variables predicted a higher likelihood for the development of severe preeclampsia, IL10 decreased such likelihood. IL10 was also found to be negatively correlated with proteinuria, and positively correlated with blood platelets. Significantly higher concentration of IL10 was confirmed in patients with a higher number of platelets in the blood, and vice versa. On the other hand, the serum concentration of IL10 was significantly lower in patients with a higher amount of proteins in the urine, and vice versa.
Conclusions: Examination of clinical risk factor combined with biochemical markers can improve the predictive success of pre-eclampsia and has important clinical values in improving the prognosis of pregnant women and foetuses
Title: A prospective randomized-controlled trial comparing two oral solutions for maternal hydration in the management of borderline oligohydramnios in a tertiary medical center
Biography:
Anna Rea Agbada has completed her degree in Doctor of Medicine from Far Eastern University-Nicanor Reyes Medical Foundation, Philippines in year 2011. She obtained her residency training in Obstetrics and Gynecology at FEU-NRMF Medical Center, Philippines and graduated in year 2017.
Abstract:
Amniotic fluid is important for the maintenance of good fetal well-being. The current recommended management for isolated oligohydramnios without maternal and fetal complications is maternal hydration through intravenous or oral solution to increase the amniotic fluid volume. This study was conducted to determine the efficacy of oral isotonic versus oral hypotonic solution for maternal hydration in the management of borderline oligohydramnios. This is a prospective open label randomized-controlled trial with 123 participants, 18 to 38 years old, singleton pregnancies, 32 to 35 weeks age of gestation, with borderline oligohydramnios without maternal and fetal complications seen in a tertiary medical center. There were 62 participants who took 2 liters of isotonic solution and 1 liter of hypotonic solution, while 61 participants drank 3 liters of hypotonic solution. Repeat AFI was done by ultrasonography after 24 and 48 hours post-hydration therapy. Results revealed no significant difference with regards to comparison of the amount of fluids taken between the two treatment arms. However, when the AFI was measured 24 and 48 hours post-hydration therapy, the isotonic solution showed a significantly higher AFI. Furthermore, the participants on the isotonic solution group showed a significantly higher mean difference in the AFI from the baseline for both 24 and 48 hours post-hydration. Maternal oral hydration therapy using isotonic solution is an efficacious treatment among pregnant women with borderline oligohydramnios. It is readily available and offers low cost management since it does not require hospitalization. With compliance to oral hydration therapy, improved perinatal outcomes can be expected.
Title: Comparison of the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of iron deficiency anemia among pregnant women seen at the out-patient department of a tertiary medical center
Biography:
Ma Agnes Ablay Santiago completed her Degree of Medicine in Far Eastern University - Nicanor Reyes Medical Foundation on year 2011 and obtained her Physician Licensure Examination last 2012. She had her Obstetrics and Gynecology specialization in the same institution from 2014 to 2017. She was the Chief Resident during her final year of training where part of her administrative work is to teach Medical students for the subject Physiologic and Pathologic Obstetrics and Gynecology. This study was conducted during her residency training. She aims to lessen the burden of anemia as one of the leading cause of morbidity in their institution hence this study was pursued.
Abstract:
Statement of the Problem: Pregnant women with iron deficiency anemia (IDA) need effective management to prevent adverse pregnancy outcomes. Ferrous salts are the preparation of choice, recommended for prevention and treatment of IDA. Oral iron supplementation is challenged by gastrointestinal poor gastrointestinal and disturbances. Improving formulation was done by many companies using chelated minerals. Mineral absorption from supplements has been a contested issue in the supplement industry. Validating these claims has often been difficult due to insufficient or conflicting research. This study aims to address the controversy and establish the state of scientific knowledge about mineral absorption from supplements. This will compare the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of IDA during pregnancy.
Methodology: Included were women 18 to 40 years old, singleton pregnancies diagnosed with IDA without any co-existing fetal and maternal complications. Participants were randomly allocated to Iron Amino Acid Chelate and Ferrous Sulfate taken twice a day for 90 days. Baseline, days 30, 60 and 90 post-treatment complete blood count and serum ferritin levels were taken. Mean blood parameters were compared before and after treatment using T-test and Chi-square to compare adverse effects between two groups.
Results: No statistically significant differences in the mean blood parameters between iron amino acid chelate and ferrous sulfate on days 30 and 60 post-treatment. While significantly higher hematocrit and MCHC and lower RDW in chelate group on day 90 post-treatment. All CBC parameters on days 30, 60, and 90 post-treatment compared to baseline were significantly increased for both treatment arms. However, day 90 level of serum ferritin significantly increased in the chelate group.
Conclusion: Iron amino acid chelate and ferrous sulfate is comparable in improving CBC parameters and serum ferritin. Iron amino acid chelate offers improved bioavailability and absorption due to its unique formulation. It is superior to ferrous sulfate as it achieves optimum treatment response, even at a lower dose with lesser adverse effects. Improved tolerability leads to better compliance resulting to successful treatment outcome.
Title: Persistent gestational trophoblastic disease: Report of 20 cases and literature review
Biography:
Abstract:
Objective: This retrospective study aimed at discussing epidemioclinical criteria and therapeutic results of persistent gestational trophoblastic disease (PGTD) throughout a series of 20 patients treated between 2008 and 2015.
Patients and methods: We reviewed the epidemioclinical records of all the patients. After aspiration, pretherapeutic work-up, and hebdomadary dosage of plasmatic HCG, patients were divided into three prognostic groups according to the Gustave-Roussy Institute (IGR) classification (Hydatidiform mole, Low-risk tumors, and High-risk tumors). They were treated with different chemotherapy protocols: monodrug Methotrexate (MTX) therapy, AE protocol (Actinomycin and Etoposid), and APE protocol (Actinomycin, Etoposid, and Cisplatinum) adapted to each group.
Results: The mean age was 32 years (range: 20 to 49). Metrorrhagia and pelvic pain were the most frequent symptoms. There were 20 cases of PGTD (mole retention: three cases, invasive moles: 13 cases and choriocarcinoma: 4 cases). All the evaluable patients (18 patients) were cured with the first-line chemotherapy or after salvage chemotherapy in patients with considerable risk for the disease who showed a resistance to monodrug Methotrexate therapy. We recorded one toxic death with APE protocol.
Conclusions: The epidemioclinical criteria did not have any particularity. We confirmed the effectiveness of chemotherapy in PTGD. However, if we consider efficacy/toxicity ratio and the recent data of the WHO classification modified by FIGO, therapeutic deescalate may be justified at least in patients with good observance.
Title: What’s women know about their maternal health and what’s they practiced in an underprivileged community of Bangladesh
Biography:
Narayan Chandra Das, after passing the Examinations , SSC(1972) &HSC(1974) from Dhaka Board with distinction , he was admitted in Mymensingh Medical College under the Dhaka University, Bangladeh in 1976.He passed four professional Examinations regularly and obtained MBBS Degree in 1982.Then he had to undergone one year of strenuous in service training in Mymensingh Medical College Hospital, In Medicine, Surgery and Obstetrics & Gynaecology. After completion of inservice training and passing competitive Bangladesh Civil service(BCS)Examination under the Public Service Commision (PSC) in 1984,He obtained Government Service. One year training in Anesthesiology in Dhaka Medical College Hospital, Dhaka University, Bangladeh
b)Six Month training in Medical Ultrasonography and Obstetrics& Gynaecologcal Ultrasound under Bangladesh Society of Ultrasonography(BSU) and Jafferson University USA,I have been doing Ultrasonography practice for the last 18 years.
During this long period of Govt.Service I had been promoted from Medical Officer to Upazila Health & Family Planning Officer,Civil Surgeon(Administrative Head of a District),I retired in 2015 from the Govt. Service as Principal Scientific Officer (PSO), from the Institute of Epidemiology Disease Control & Research(IEDCR),Directorate of Health Services(DGHS) Mahakhali,Dhaka,Bangladesh.
Abstract:
Introduction: Every year around 5500 mothers are dying due to maternal complications in Bangladesh. A large number of deaths are still occurring in the marginalized community. Women living in the hard to reach tea gardens areas in Moulvibazar district are straggling with early marriage, adolescent pregnancy and poor health seeking behaviour during gestational period.
Aim: The study explored knowledge and practices on maternal health of women at reproductive age in the tea garden community of Moulvibazar district, Bangladesh.
Methods: A cross sectional study was performed. 25 gardens were selected purposively in Moulvibazar districts out of 92 gardens. 529 mothers aged between 15-49 years who had a live birth between 1 March 2015 and 29 February 2016 was enrolled. Structured pretested questionnaire was used for face to face interview. Descriptive analysis of findings was performed.
Results: The study revealed that over 56% of the women aged between 20-49 years did not know about antenatal care (ANC) during pregnancy, only 8% mothers aware of recommended four ANC. Whereas, 51% of women aged between 15-19 years also unaware of ANC and only 6% mothers aware of four ANC. 77% of mothers had their last delivery at home, 35% of them performed by the garden health care provider (paramedic) and rest of them conducted by untrained birth attendant. Only around 18% of the mothers had their post-natal care in the last pregnancy. 40% of the others don’t have any ideas of maternal complications during pregnancy.
Conclusions: Women living in the tea gardens are still behind of knowledge on antenatal, delivery and post-natal care. Specific intervention focusing improvement of knowledge and practices of women on maternal health issues can help to improve overall maternal health status of this marginalized group. This will reflect on overall reduction of maternal mortality to reach sustainable developmental goal by 2030.
