Day 3 :
Keynote Forum
Amany M. Shebl
Mansoura University, Egypt
Keynote: The Impact of Application of Multimodal Approach on Expected Clinical Outcome for Post Illues Patients after Total Abdominal Hysterectomy
Time : 09:30-09:55
Biography:
Amany M Shebl has completed her PhD from Cairo University, Egypt. She occupied several positions as (Head of Medical-Surgical Nursing Department, Vice-dean for Student Affair, Vice-dean for Post Graduate and High Studies Research Affair). Now she is occupying position as Dean of Faculty of Nursing, Mansoura University, Egypt. She has several papers in reputed journals. She is also a Reviewer of International Cancer Journal and she is very interested in scientific research. Her mission is to guide highly qualified nurses & provide distinguished intellectual and professional insight in providing nursing care to meet the national and international market.
Abstract:
Background: Oral fluids and food are traditionally introduced slowly after total abdominal hysterectomy (TAH). This study examined the effect and tolerance of early oral intake following this surgery. Postoperative ileus (POI) is broadly defined as a temporary impairment of gastrointestinal (GI) motility, it leads to patient discomfort, decrease the mobility and prolongs both convalescence and hospital stay. rnrnAim: The aim of the study was to evaluate the impact of application of multimodal approach on expected clinical outcome for post ileus patients after total abdominal hysterectomy. rnrnDesign: Quasi-experimental design was used. The study was conducted in the Obstetrics and Gynecology Department in El-Minia General Hospital from first of September 2011 to the last of February 2012. rnrnSample: Total samples of 40 female patient divided equally into two groups (control group and intervention group) were assigned to multimodal approach. rnrnResults: The results also revealed that early feeding could be tolerated well in patients undergoing total abdominal hysterectomy TAH. Also the results show that with improvements in postoperative nausea and vomiting and length of stay were noted in the early fed group with minimal medical benefits. rnrnConclusion: This study concluded that early feeding and hydration after major gynecologic surgery results in decreased nausea and vomiting and decreased hospital stay, promote wound healing, optimizing patient condition before, during and after surgery and reduce the length of hospital stay. rnrnRecommendation: This study recommended that more approaches such as chewing gum, antiemetic drugs and laxatives should be applied to relieve the postoperative complications especially ileus after the total abdominal hysterectomy.
Keynote Forum
AboTaleb Saremi
Sarem Women’s Hospital, Tehran, Iran
Keynote: Usage, Development & Effectiveness of a New Surgical technique for the Treatment of Svere Adenomyosis
Time : 09:55-10:20
Biography:
Abo Taleb Saremi obtained his MD from Jondishapour and Tehran Universities, Iran in 1975. He was trained at the Obstetrics and Gynaecology Department of Munster University, Germany, took a subspecialty in IVF at Vienna University, Austria from 1981 to 1986 and then participated in complementary assisted reproduction courses in the USA and Australia. His specialization includes laparoscopic surgery and his work lead to the birth of the first Iranian assisted reproduction child (by gamete intra-Fallopian transfer) in 1989. He founded his first IVF centre in Iran in 1993 and received the International Federation of Fertility Societies’ 30th anniversary recognition award in 1998. He is the President of the Sarem Women’s Hospital, which he founded in 2006, and the Sarem Cell Research Center.
Abstract:
Advised treatment of the severe forms of adenomyosis is hysterectomy but for the patients those who want to preserve their uterus, conservative surgery named adenomyomectomy for removal of endometrial tissue from the myometrium can be performed. This technique must be developed for reduction of the spontaneous uterine rupture, adhesions and recurrence rate. So, this study is to investigate the safety and therapeutic outcomes of different and novel adenomyomectomy technique. Prospectively, 103 Iranian patients with documented severe adenomyosis were candidates for adenomyomectomy over a period of 7 years (April 2004-March 2011). The surgical procedure is the resection of adenomatous lesions with the thin (0.5 cm) margin, wedge shaped in two sides of the uterus wall, with sagittal incision on the body of the uterine and reconstruction of the layers and inverted suture for the serosa layer ends. Out of 103 patients, 57 cases (55.34%) were presented with infertility, 17 cases (16.5%) with IVF failure, 9 cases (8.74%) with recurrent abortion and 20 cases (19.42%) with abnormal vaginal bleeding (AUB). Out of 70 patients that wish to bear child, 21 persons (30%) became pregnant spontaneously (7 cases) or by ART technique (14 cases) and 16 pregnancies became full term and candidates for cesarean section (C/S). There was a significant reduction in both dysmenorrhoea and hypermenorrhoea. Only one case had relapsed adenomyosis. Adenomyomectomy is the conservative and effective option on treatment of adenomyosis. The described procedure in this study can be an efficient procedure for the treatment of severe adenomyosis.
- Family Planning, Epidemiology in Obstetrics & Gynecology, Menopause, Operative Gynecology, Infertility, Health Related Behaviour in Women, Maternal Suppliments
Location: Texas C
Chair
Elliot M. Levine
Illinois Masonic Medical Center, USA
Co-Chair
Teng Xiao Ming
Shanghai Medical Association, China
Session Introduction
Heba M Mahdy
OBGYN Specialist, Canada
Title: Obstetric Forceps – Is it really a dying art?
Time : 10:20-10:40
Biography:
Heba M Ismail Mahdy is an OBGYN Specialist & Clinical fellow of Gyne-oncology at KAAUH. He has completed MBBCh, DOWH, MRCPI and a diploma in Women’s Health & Obstetrics, RCPI. He is a Certified member of the RCPI (Royal College of Physicians of Ireland), Academic Instructor SOGS (Saudi Obstetrics & Gynecology Society), ALSO & BLSO Instructor (Advanced & Basic Life support in Obstetrics) and CTG tutor. He worked for 6 years as Clinical & Academic Instructor, 3 years as OBGYN Specialist and 4 years as OBGYN Resident. He is fond of medical education, teaching and innovative in teaching approaches.
Abstract:
Use of forceps in delivering babies is on the decline. Although physicians continue to be trained in how to use forceps while they are in medical school and residency, they have fewer opportunities to practice the technique, especially in emergency situations. The aim of this talk is to critically appraise the role of obstetric forceps in modern practice and to emphasize its importance in the modern obstetric practice in certain obstetric situations. Increased rates of cesarean sections are currently very alarming worldwide. Bringing this topic for discussion is going to raise awareness among healthcare professionals, commissioners and stakeholders to revisit the importance of keeping this amazing skill in the hands of the currently practicing obstetricians. It will not only help to save babies, but also helps to save mothers from unnecessary caesarean sections in certain situations. On the other hand, discussing how to avoid complications related to the use of obstetric forceps was the main reason behind declining the use of obstetric forces. Using newer biomedical technology to manufacture less traumatic obstetric forceps to gauge pressure on the fetal head may be another influencing factor in the decision making process to bring obstetric forceps into modern practice again. In conclusion, obstetric forceps should never been a dying art. And we need to maintain the skills with a great emphasis on safety.
Nasrin Matinnia
Islamic Azad University, Iran
Title: Why do primigravidae request caesarean section in a normal pregnancy? A qualitative study in Iran
Time : 11:00-11:20
Biography:
Dr. Nasrin Matinnia started working at Department of nursing, college of science, hamedan branch' islamic azad university', Hamedan'/ Iran and she transferred and working as resident in PhD of Community Health, University Putra Malaysia, Malaysia.
Abstract:
Objective: To gain a deeper understanding of why Iranian primigravidae request caesarean section without any medical indication. Design: A qualitative study was undertaken. Data were gathered through semi-structured interviews, and thematic analysis was undertaken. Setting: Four health care centers at Hamadan University of Medical Sciences, Hamadan, Iran were considered for the study. Participants: 14 primigravidae who requested caesarean section without any medical indication. Findings: Reasons for requesting caesarean section were related to fear of childbirth (labour pain, injury to mother or infant), complications after vaginal delivery (vaginal prolapse, urinary incontinence, sexual dysfunction), trust in obstetricians, and lack of trust in maternity ward staff. Key conclusions and implications for practice: The main reasons given for requesting caesarean section shows that there is an urgent need for effective antenatal assessment to enable pregnant women to ask questions and express their concerns. In order to promote vaginal birth, there is a need to develop antenatal education and strategies to enhance women's knowledge, confidence and competence about vaginal birth. Health care providers should be re-educated about the observance of medical ethics and professional rules in their practices, and change their attitudes and behaviours to vaginal birth. Evaluation, improvement and change in maternity care policies are recommended to promote natural childbirth.
Biography:
Dr Masood ur rehman born on 14th Jan 1986 in Muzaffarabad Azad Kashmir Pakistan. I am graduated from the medical school in March 2011. I passed my entrance exam of fellow ship in surgery from college of physician and surgeon Pakistan in 2012. Now I am in 3rd year of my residency .I passed membership exam of royal college of surgeon Edinburgh in 2015. I participated in number of conferences across the Pakistan attended multiple workshops .I am working on multiple research papers in Pakistan .My aim is to be the best surgeon and researcher of the world so that I make my parents and country proud.
Abstract:
Bezoar is defined as the accumulation of undigested foreign bodies or nutrients in the gastrointestinal tract. These foreign bodies can be hair (trichobezoar), fibers or seeds of vegetables and fruits (phytobezoar), or remnants of milk (lactobezoar), undigested medicine (pharmacobezoar) and stones (lithobezoar). Lithobezoar, the accumulation of stones in the digestive tract, is commonly seen in stomach. Primary colonic bezoar is an exceptionally rare situation. In this paper, a 33-years-old married lady with colonic lithobezoar who presented with generalized pain abdomen, vomiting multiple episodes, anorexia, absolute constipation, bleed per rectum one time and the history of pica was successfully treated by the extraction of the stones under general anesthesia Discussion Bezoar is accumulation of undigested foreign bodies or nutrients in the gastrointestinal tract .These foreign bodies can be hair (trichobezoar), fibers or seeds of vegetables and fruits (pythobezoar), or remnants of milk (lactobezoar) and stones (lithobezoar). The various non food items include amylophagia (laundry starch, corn starch), geophagia (clay, sand and dirt), lithophagia (stones, gravel and pebbles), pagophagia (ice), trichophagia (hair) and coprophagia (feces) . Until 2004 the number of cased reported in literature are twelve ,of which only three had colonic lithobezoars. only four colonic lithobezoars had been reported in the literature till 2007. bezoars is rarely seen in colon but stomach is the predilection site. Colonic lithobezoar can be seen as a result of pica . Pica is characterized by persistent craving and compulsive eating of nonfood substances such as clay or soil, ice, and stone. The etiology of pica is multifactorial including iron deficiency anemia, mental retardation, poverty, pregnancy, traditional eating habits, parental neglect, and low socioeconomic status. Pica has been reported to be associated with severe iron deficiency anemia in up to half of patients; however, it is unclear whether pica causes or is the result of iron deficiency anemia . They may present with the sign and symptoms of the bowel obstruction .on abdominal examination a palpable abdominal mass may be found on rectal examination “colonic crunch sign “ may be found .colonic crunch means the palpation of the prickly mass in the rectum It is important to have plain abdominal radiograph in the diagnosis of any kind of suspected intraluminal colonic mass. The scattered radio opaque nature is typical of lithobezoar. It also has a unique picture on the plain abdominal radiograph known as ‘corn on the cobâ€.Anal dilatation under general anesthesia also helps in the dislodgement of the mass. Conclusion We conclude that litho bezoar due to pica is not a rare disease now a days and they may lead to number of life threatening complications if ignored. This disease can be managed by conservative measures but if the complications occur then surgical intervention may needed. Lastly these patients should be kept on strict follow up and psychiatric assessment. The single most important factor which is to be considered to decrease the incidence of this disease is strict parental supervision.