CPD Accredited 10th World Congress on Women Health, Gynecology and Breast Cancer Research

Rome, Italy

December 15-16, 2021

Speaker

• Optimizing future excellence in hematology diagnosis and transplantation
  

  Ayesha Junaid

  Shifa International Hospital, Pakistan

  Pakistan

  Biography

  Ayesha Junaid qualified as a Medical Doctor at the age of 23 years from King Edward Medical University, Lahore. She passed her membership and fellowship examinations in year 2002 and 2003 from CPSP Pakistan after completing four years of rigorous training. She got training in cytogenetics and FISH techniques from UCLA, USA in year 2008 for the diagnosis and prognosis in hematological malignancies. She became Professor of pathology in year 2011 after 12 years of undergraduate teaching. She cleared her qualifying examination from council of Canada in year 2012. She is presently working in a JCIA accredited tertiary care hospital as Consultant Hematologist since 2008. With over 25 publications in national and indexed journals, she is a supervisor and program director in the subject of Haematology, College of Physicians & Surgeons Pakistan, since 2013, and has the credit of training six young hematologists, while supervising six more doctors for fellowship training

  Abstract

  Abstract Hematological malignancies are complex, not only towards diagnostic end but towards defining prognostic groups and available treatment options. In the recent past with a huge influx of newer options, the things are improving at the management end of the hematological cancers. The diseases which were labeled as "Death warrants" have now become "chronic ailments". Though there still exists a wide gap between a "Good productive life" and "Increased survival ship" after the diagnosis of a hematological cancer, the distances are definitely bridged. With an individualized approach now, after defining genetic lesions, newer immune, targeted and vaccine therapies are now in the market to hit the cancer from different angles. At the same time affordability, after the technical provision of a treatment modality remains the highest concern for the fatally affected patients. Peripheral blood stem cell (PBSC) transplants, remain one curative option for the developing world like Pakistan, where CART-T and Immune therapies are simply not financially realistic. Author has performed 183 autologous and allogenic PBSC transplants in our tertiary care hospital for various hematological malignancies including acute leukaemias, Multiple myeloma and lymphoma. While autologous showing better overall three and five-year survival as compared to allogenic transplants, this modality is a ray of hope for the longer survival in AML like otherwise fatal disorders. They started transplant services in year 2013, with the ideal inclusion criteria of "disease in first remission" after the diagnosis of a blood malignancy, but over a course of five years had to include many young patients with multiple relapses and without initial prognostic genetic profiling. Two methods for cryopreservation of the harvests at -800C were used. One with DMSO and Saline only and the other with addition of 6% albumin. A review of survival ship and engraftment shows better results with the first method.

• Post-Partum Ovarian Vein Thrombosis extending to Inferior Vena-cava: A rare case report
  

  Houda Al Yaqoubi

  Ibri Regional Hospital, Oman

  Oman

  Biography

  Houda Al Yaqoubi, a feto maternal medicine consultant, having total 15 years of experience in the field of Obstetrics & Gynecology. Currently she is working as a consultant in the Department of Obstetrics & Gynecology under Ministry of Health Oman. She had fellowship in Feto-Maternal medicine from the University College Hospital London UK, St. George Hospital UK and National University Hospital Singapore. She is actively engaged in various research activities, workshops and CME programs. She has couple of publications in international peer reviewed journals. Her future plan is to work more on antenatal and postnatal maternal co-morbidities and complications management.

  Abstract

  Abstract (297 words) Introduction: Postpartum ovarian vein thrombosis (POVT) is rare but life-threatening complication of puerperium. It is seen in 0.05 - 0.2 % deliveries. Nearly 80-90% of POVT occurs in the right ovarian vein, possibly explained based on its anatomic position and blood flow dynamics. An extension of POVT to inferior Vena-cava is relatively rare and very few cases are reported in literature. Case: A 28-year-old woman, para 01 presented 4 days after an uncomplicated cesarean delivery to our emergency department with the history of sudden onset of right lower abdominal pain accompanied by high-grade fever. On examination, the patient was average built and weighed 65 kilograms. She was febrile with rectal temperature 38 °C, pulse 102 beat/min and BP 118/70 mm of Hg. Physical examination revealed localized tenderness in the right lower abdomen. Pelvic examination was otherwise normal. Ultrasonography (USG) abdomen revealed a cord-like structure in the lower right abdomen arising next to the right ovary. Computed tomography (CT) of the abdomen with contrast showed dilated right ovarian vein (1.8 cm in diameter) with complete thrombosis measuring 1.8 cm x 0.8 cm x 0.6 cm and extending into the inferior vena cava (IVC). Based on CT, she was diagnosed with postpartum ovarian vein thrombosis and immediately started on a dose of low molecular weight heparin (LMWH) and antibiotic (ceftriaxone 1 gm BID for 5 days). LMWH was discontinued after the normalized ratio (INR) had attained therapeutic levels (INR level: 2-3). Warfarin was started and continued for three months. She had an uneventful recovery, with repeat imaging after three months showing complete resolution of thrombus. Conclusion: POVT is a rare but serious complication of puerperium. Early diagnosis is crucial to prevent unnecessary interventional procedures. Multidisciplinary management strategies, starting with early anticoagulation, will significantly reduce the patient morbidity and mortality.

• Title: Awareness on cervical cancers and utilization of pap-smear (papanicolaou) test among adult women: A hospital based study
  

  Arun Kumar Koirala

  Pokhara University, Nepal

  Nepal

  Biography

  Arun Kumar Koirala is presently working as a professor at Department of Health and Allied Sciences, Pokhara University, Nepal. He had many publications in his career. His main research areas are behavior, pregnancy & childbirth.

  Abstract

  Abstract: Cervical cancer, a major public health problem is the most common and stood in 2nd position among other cancers in women and accounts more than 84% new cases worldwide and more than 85% death from middle and low income countries. It can be prevented by vaccination, Screening and treatment before progression along with health education are the most efficient and cost effective way of controlling the cervical cancer, unfortunately it is very low and it ranks as the 1st most frequent cancer among women of age 15 to 44 years in Nepal. Therefore, the aim of the study is to assess the awareness on cervical cancer and screening test and its practice among women in Nepal. A cross sectional study was conducted at the Gynecology Out Patient Department (OPD) of Helping Hands Community Hospital Kathmandu from June 2017 to August 2017. The participants were the women visiting the Gynecological Department for various other gynecological problems. A total of 409 sample was taken through purposive nonprobability sampling method and data were analyzed. Mean ? SD age of the women was 33.52 where minimum age was 17 and maximum age was 67 years and 347 (84.8%) married and among them more than 3/4th (78.5%) were married before the age of 20 years. Among total respondents, 32.8% heard about cervical cancer and among them only 13.4 per cent of them had knowledge of causative agent the HPV and about 21.1% of them had an idea about vaccine. Women who had heard about cervical cancer, less than half (47.8%) had an idea about the screening test and, only 13% had knowledge on Pap smear test, but most of them (89.7%) had no idea when to be performed. Among the women who have heard about cervical cancer, only 23.9% (32 persons) of them had experienced on Pap smear test. Among the women who had knowledge on cervical cancer (134), only 9.7% (13) of them had heard about the HPV vaccine and only (1) 7.6% of them had inoculated HPV vaccine. This study showed that heard about cervical cancer, knowledge on Pap smear test and knowledge of the HPV vaccine are significantly associated with the education level of the respondents (P<0.01). Enrollment of women in academic education and adequate information through different media targeting eligible women is needed to raise awareness to change their behaviors to utilize the screening facility.

• How to preserve game changing medical breakthroughs by remembering ancient knowledge of health
  

  Arun Subburayalu

  Health Center Elten, Germany

  Germany

  Biography

  Arun Subburayalu is a GMC-registered GP working self-employed in his own surgeries in Emmerich am Rhein and Isselburg for almost 15 years. The emphasis of his work is lifestyle improvement, sleep disorders and the Ayurvedic approach to coping and mastering the challenges patients face every day. He delivers education to colleagues and laymen likewise and is renowned for his keynotes.

  Abstract

  Abstract Modern medicine has crossed almost every boundary author imagined being eternal mere years ago. They can achieve results that never imagined possible. Uncurable diseases have become manageable, some even can be cured. However, basic principles of preserving patient health and of regaining it unfortunately seem to have been forgotten or even worse ignored. Invest 30 valuable minutes in remembering ancient news and commonplace knowledge and reflect upon yourself. Do you care enough about you? Could you easily contribute to the health of your loved ones and last not least your patients? Thirty minutes of precise recommendations will empower you to add the foundation to persisting health to whatever therapy your patient is undergoing. Ignoring these basic principles will inadvertently diminish and jeopardize patient outcome, morbidity and life expectancy

• Prevalence of haemoglobinopathies in young adults from screening camps in Karachi: The importance of using simple thalassemia screen tool for carrier detection in a resource-constrained region
  

  Maliha Sumbul

  Sindlab Clinical Laboratory, Pakistan

  Pakistan

  Biography

  Maliha Sumbul has completed her Membership in Pathology in 2003 and Fellowship in Haematology in 2015 from College of Physicians and Surgeons Pakistan. She did her Post-graduate Diploma in Healthcare Management in 2017 from Institute of Business Administration, Pakistan. She is the Chief Pathologist of Sindlab Diagnostics, Pakistan. She is also a Faculty of Institute of Lab Medicine, Karachi and is actively involved in conducting Technical Workshops and Demo on Learning Lab Software, accredited by AACC. She has extensive teaching experience in the field of Medical Technology and has worked as Senior Lecturer/Assistant Director Medical technology program at Dow and Ziauddin University respectively. She has published articles in Evidentia, UK and Journal of Royal College of Physicians and Surgeons Edinburgh, UK during her work experience in UK, 2005 to 2008. Moreover, she has presented posters in Oxford, London and Brighton Conferences on Malaria audit conducted at Bradford Royal Infirmary, UK.

  Abstract

  Abstract Introduction: Pakistan has a high prevalence of Beta Thalassemia with 5-8% of the population with thalassemia minors, thus there are about 9.8 million carriers. It is estimated that approximately 5000 children are born with thalassemia major, each year. Pakistan’s total burden of Thalassemia major affected children may be over 50,000. The expected actual figure is much higher due to unregistered thalassemics living in rural areas. There is lack of national screening program for thalassemia in Pakistan. Simple tools to identify cases which can later be tested by diagnostic methods is the solution for a developing country with financial limitations. A cross sectional observational study was done in collaboration with Sindlab Diagnostics and JIBA International, Karachi. Total 497 adults were screened using Thalassemia Screening Tool, of which 129 cases were tested for Hb electrophoresis by High Performance Liquid Chromatography (HPLC). Methods: Complete blood count (CBC) in venous EDTA sample was performed on all subjects. HPLC was later performed on selected subjects using Thalassemia Screening Tool. Results: A total of 497 subjects were inducted, 21 males and 108 females, mean age 24.5 ± 6.0 years. Normal cases on CBC were 368, and 129 (26.0%) selected for HPLC. Overall prevalence of Haemoglobinopathies was 8.7% (2.2% Beta thalassemia minor, 0.8% Sickle cell trait, 0.2% Hb D Trait, 0.2% Hb E trait and 5.2% Suspected Alpha thalassemia trait). The Positive Predictive Value (PPV) is 81.1% for the CBC tool used to detect Haemoglobin disorders, excluding confirmed cases with iron deficiency anemia as nutritional deficiency states hinders electrophoretic diagnostic efficacy. Conclusion: Thalassemia, a major public health concern, is a preventable disease with effective screening programmes. Serious efforts to create preventative measures with Public/Private partnership is the answer. Emphasis on screening with a simple screening tool in schools and colleges may show promising results in a financially restrained country.

• Title: Reliability of imaging as compared to histology in breast cancer valuation
  

  Rozhan Omar

  Hiwa Cancer Center Sulaimanyah, Iraq

  Iraq

  Biography

  Rozhan Omar is a specialist of Oncology and Clinical Hematology at Hiwa Cancer Center. She received her Medical Degree from the University of Sulaimanyah in 2008. She completed her High Diploma Degree in Oncology and Clinical Hematology in 2016. Her main interests are Breast and Gynecological cancers. She is a Member of the American Society of Clinical Oncology and the European Society of Medical Oncology.

  Abstract

  Abstract Background: Breast cancer affects one in every eight women in the Unites States and one in nineteen women locally. More than three quarters of patients are currently cured with modern therapy; this fact has been reproducible at our Hiwa Cancer Center, the only tertiary care oncology center in Sulaymaniyah, a city of two million population in Kurdistan. Evaluation of patients properly is the cornerstone upon which the rest of the management paradigm is based. Discrepancy in clinical, imaging and histological outcome in many patients has led us to consider this comparative study between what we perceive clinically, find radiologically and deliver from the histopathology department as the final and ultimate outcome. Undoubtedly decision making in the early management of this common cancer depends on the interaction between these diagnostic modalities. Patients & Methods: This is a retrospective and prospective study analyzing data obtained from clinical findings and imaging studies and comparing them with the histological report obtained from Shorsh hospital histology department, a reputable and well-staffed department working as an integral part of a multidisciplinary arrangement between the cancer caring departments in the city. All breast cancer patients managed from the inception of the hospital in 2007 will be studied retrospectively. Every patient who will be managed from the beginning of this study until the deadline for the postgraduate study period will also be prospectively studied and personally followed up. Data obtained will be critically analyzed and correlation between these findings will be made.

• Haploidentical hematopoietic cell transplantation: Current status and future prospects
  

  Suparno Chakrabarti

  Manashi Chakrabarti Foundation

  India

  Biography

  Suparno Chakrabarti is the Head of the Dept for Blood and Marrow Transplantation and Hematology at Dharamshila Narayana Hospital and Research Centre, and Cellular Therapy & Immunology at Manashi Chakrabarti Foundation, India. He initiated the first Haploidentical BMT program in India and along with Dr. Sarita Jaiswal and has developed this as a sustained alternate donor program with over 125 Haploidentical transplants in the past 8 years. They have innovated newer methods of carrying out haploidentical BMT in patients with advanced leukemia as well as aplastic anemia with excellent results. His key area of research is Transplant immunology in relation to Haploidentical BMT. Dr. Chakrabarti trained in Internal Medicine at PGIMER, Chandigarh in India. Subsequently, he spent 13 years in the UK, initially as a research fellow and subsequently as a consultant in the field of BMT. During this period, he played a substantial role in developing Campath-1H based T cell depletion and reduced-intensity conditioning. The bulk of his research also focused on post-transplant virus infections and immune reconstitution. Dr. Chakrabarti received FRCPATH based on his published work. He has over 100 publications to his credit. He also runs a charitable organization for children with blood diseases. Key areas of Research: Haploidentical HCT; NK cell Biology; Post-transplantation Immune reconstitution; Transplantation tolerance.

  Abstract

  Abstract HLA-Haploidentical HCT has emerged as a front-runner for alternate donor transplantation for hematological malignancies over the past decade. The primary reason has been the employment of post-transplantation cyclophosphamide (PTCy) as GVHD prophylaxis, which by dint of both its ease of application and impressive outcomes, has made haploidentical HCT feasible across the globe. Large registry-based studies have confirmed the equivalence of this approach as compared to matched related and unrelated donor sources in acute leukemia as well lymphomas, with low incidences of both acute and chronic GVHD. However, the risk of relapse has remained unchanged across the donor sources depending on the nature of the underlying malignancy. Moreover, the suitability of this approach remains questionable in younger children and those with non-malignant disorders. Adoptive immunotherapy following haploidentical HCT has barely been used due to concerns related to GVHD. However, several recent studies have shown that early G-CSF mobilized donor lymphocyte infusions (DLI) can reduce the relapse risk in relapsed/refractory leukemia. The use of T cell costimulation blockade with CTLA4Ig in conjunction with PTCy has shown to improve reconstitution of Tregs early after haploidentical HCT in children with aplastic anemia. The same approach when used in children with leukemia was not associated with increased relapse. Interestingly, CTLA4Ig does not block natural killer (NK) cell activation and might even potentiate its cytotoxicity. Based on this principle, employment of CTLA4Ig-primed DLI in patients with advanced leukemia showed marked proliferation of mature NK cells which correlated with disease-free survival with low incidences of GVHD and non-relapse mortality. This approach has been shown to be effective in both lymphoma as well as myeloma in pilot studies. However, the success of any such approach rests on the appropriate selection of the donor vis-à-vis graft composition. It remains to be seen whether haploidentical HCT with unique approaches to NK cell mediated immunotherapy post-HCT might re-position this as a preferred option for advanced malignancies. This approach with universal donor availability might pave the way for innovative immunotherapies for solid tumors as well.

• Knowledge and perception towards cervical cancer among females of Kolkata, India
  

  Arup Ratan Bandyopadhyay

  University of Calcutta

  India

  Biography

  Professor Arup Ratan Bandyopadhyay is Professor and Former Head of the Department of Anthropology, University of Calcutta. He did M.Phil and PhD from University of Calcutta, India. He is the recipient of UGC Research Fellowship (for pursuing PhD, qualifying National Eligibility Test), Merit Award and Young Scientist Award. He was President of Anthropological and Behavioral Sciences section of the Indian Science Congress in its centenary year. He received seven national extra-mural research grants as Principal Investigator, including a grant from the British Council for collaboration with the Roslin Institute, University of Edinburgh, UK. He published more than 100 anthropological research articles in national and international journals on evolutionary biology, forensic anthropology, dental anthropology, public health in relation to medical genetics, cytogenetic and anthropometry of non-communicable disease, dermatoglyphics in medical and psychiatric disorders, and population genetics and human rights issues. He has delivered many invited Lectures / Keynote addresses and organizing committee members recently (January 5-7, 2018 – Bangkok, Thailand) in International Conference in Gynecology, Obstetrics and Reproductive medicine (GORM2018), World Congress on Gynecology, Obstetrics & Reproductive Health (July 16-17, 2018 – Bangkok, Thailand) and in 1st World Congress on Breast Cancer, Gynecology and Women Health (September 6-7, 2018 - Bangkok, Thailand)

  Abstract

  Abstract Background: Cervical cancer is a global public health problem with day by day increasing rates. Risky behaviors, lack of knowledge and preventative measures in young women, increase the risks of cervical cancer later in life. Up to date, there is scarcity of study on level of knowledge and perception towards cervical cancer among young women in India. This study was aimed to determine the level of knowledge and perception toward cervical cancer among the women aged between 20 and 30 years living in Metropolitan area of Kolkata, India. Methods: The present study has been carried out among the 300 apparently healthy working women of Kolkata. Only the women have been considered for this cross-sectional study aged between 20 and 30 years living in the metropolitan area of Kolkata. Data for the present study has been collected by using specially prepared and pre-tested schedule. Short term interview has been taken on the cervical cancer knowledge and awareness among the participants of the study. Results: Among the participants 88% of them reported to have known the name of Cervical Cancer, however, 52.27% of them, knew that HPV is a sexually transmitted infection (STI) and that it can cause cervical cancer. Fifty-nine (59%) of the respondent state the contamination occurs through unsafe sex practices. Furthermore, thirty-eight percent (38%) of interviewees mentioned the preventive character of vaccines. Age and education were the two variables that were statistically associated with the outcome. 84% respondents who are aware about the disease have passed graduation or more. Conclusions: The level of knowledge towards cervical cancer and perception of acquiring the disease was poor. Health education interventions are needed to improve the awareness and health seeking behavior in youth women thereby preventing cervical cancer related morbidity and mortality.

• Allogeneic cell therapy as potential cure of hematologic malignancies
  

  Shimon Slavin (slavinmd@gmail.com)

  The Center for Innovative Cancer Immunotherapy & Cellular Medicine Weizmann Center

  Israel

  Biography

  Shimon Slavin, MD, Professor of Medicine, pioneered the use of personalized anti-cancer immunotherapy mediated by donor lymphocytes and innovative methods for stem cell transplantation for cure of malignant and life-threatening non-malignant disorders, including treatment of autoimmune diseases and induction of transplantation tolerance to bone marrow and organ allografts. More recently, Slavin pioneered the use of multi-potent mesenchymal stromal cells for multi-system regenerative medicine. Slavin authors 4 books, >660 scientific publications and serves on many editorial boards and many national and international advisory boards. Slavin received many international awards in recognition of his contributions for treatment of cancer and non-malignant disorders.

  Abstract

  Abstract In sharp contrast to existing immunotherapy procedures based on activation of patient’s own immune system, our working hypothesis was that optimal induction of immunotherapy may be accomplished using intentionally mismatched activated donor lymphocytes as the most effective approach for elimination of fully resistant malignant cells by a mechanism resembling rejection of an allograft. Using murine B cell leukemia (BCL1) and based on their pilot clinical experience, they proved that effective graft-vs-leukemia (GVL) effects following SCT and durable engraftment of donor lymphocytes could eliminate otherwise incurable heavy tumor burden but at the risk of severe GVHD. Accordingly, they developed an immunotherapy protocol based on the use of non-engrafting, Intentionally mismatched activated Killers (IMAK) activated in vitro for five days with IL-2 prior to cell infusion with five days activation in vivo following cell infusion with no prior SCT. They confirmed that curative GVL was induced by IMAK with no risk of GVHD due to consistent rejection of mismatched donor lymphocytes treated at the stage of minimal residual disease (MRD), elimination of leukemia and cure were accomplished by transient circulation of alloreactive donor lymphocytes consisting of T & NK cells combined, indicating that “the last” cancer cell was eliminated since even residual of 10 BCL1 cells can result in lethal leukemia. Using IMAK following non-myeloablative conditioning in parallel with suppression of regulatory T cells by cyclophosphamide and using alpha interferon for induced expression of cancer antigens, their first multiple myeloma patients as well as our first patient with AML and two with NHL remain disease free >25 years. Long-term progression-free survival was also reported in other patients with hematologic malignancies and even solid tumors since then but cure of cancer by IMAK depends exclusively on clinical application of successful immunotherapy at the stage of minimal residual disease.

• Title: Factors influencing tubal ligation acceptance in Rwanda
  

  Karegeya B Adolphe

  University of Rwanda, Rwanda

  Rwanda

  Biography

  He is a professor in the Unversity of Rwanda.

  Abstract

  Abstract Objective: This study was conducted to determine the factors that will influence the decision to take up a tubal ligation Materials & Methods: Cross sectional comparative study conducted at two large University Teaching Hospitals and five district hospitals participants were recruited 1st November 2017 to 30 January 2018. Women were recruited from those seeking a family planning consultation, and those also desiring BTL at the study sites. Women were given information on the different types of family planning and then made the choice between BTL or other method, data collection was done using a structured questionnaire, data analysis was done using descriptive statistics and binary logistic regression analysis, P-v 0.05 was used for statistical significance Results: 382 women were enrolled in the study. Results reveal that a quarter (27%) of the sample underwent BTL, thought majority (73%) opted for a different method. Although majority (73.6%) attended the district hospitals, a higher proportion underwent BTL at referral hospitals Older age (>35 years), higher parity and previous cesarean section had a positive association to BTL uptake. Communication between couples BTL (79%) and consensus with the decision on other method (63.8%) also had a positive association (p-v 0.000, p - v<.001). In contrast, there was a low BTL uptake if couples did not discuss and agree (15.2%). Women who felt well informed and knowledgeable about BTL and other methods, were not different significantly (97.1% vs 67.2% p 0.000 p - v<.001). Conclusion: There is strong association for BTL decision with older age, higher parity, previous cesarean, and good communication between the couple.