Day 1 :
Keynote Forum
Eboo Versi
Rutgers Robert Wood Johnson Medical School, USA
Keynote: Urgency urinary incontinence (UUI) and urgency void rates are better indicators of treatment efficacy for overactive bladder (OAB) than total urinary frequency
Biography:
Dr. Eboo Versi is Clinical Associate Professor at Rutgers Robert Wood Johnson Medical School in the department of Obstetrics, Gynecology and Reproductive Sciences. Previously he was Chief of Urogynecology at the Brigham & Women’s Hospital and Associate Professor at Harvard University. His research interests include pharmacology (drugs for overactive bladder, stress incontinence, sexual dysfunction, menopause and contraception), medical devices, investigative techniques and pathophysiology of lower urinary tract dysfunction. He has published over 100 scientific articles.
Dr. Versi received his bachelor’s degree and doctorate in reproductive physiology from Oxford University and his medical degree from Cambridge University in England.
Abstract:
OAB, a common condition, affects over 33 million Americans and is characterized by urinary urgency, with or without urge incontinence, usually with frequency and nocturia. It is assumed that urgency results in increased urinary frequency, however, this might be due to learned behavior, so called defensive voiding. This study aims to determine if reduction in urgency in patients with refractory OAB (rOAB) would result in a corresponding reduction in voiding frequency and symptom bother. A prospective dataset of women with rOAB (n=62, at completion) who underwent selective bladder denervation (SBD), or radiofrequency ablation of the sub-trigonal tissue, were analyzed. Main outcome measures included urgency and non-urgency voids, and urgency urinary incontinence [UUI]) from a 3-day voiding diary and quality of life (QoL) scores.
At 6 months post-treatment, UUI and urgency voids were lower (by 41%, p<0.001) but non-urgency voids were higher (by 33%, p=0.001) with improved QoL scores (p<0.001). At baseline and 6 months, symptom bother was correlated with urgency voids (p<0.05) but inversely correlated with non-urgency voids (p<0.001); while urgency and non-urgency voids were inversely related (p<0.0001). SBD resulted in a reduction in symptoms and an improvement in QoL. However, SBD did not result a marked reduction in overall voids. The decrease in urgency voids was offset by an increase in non-urgency voids suggesting that habit or defensive voiding drives frequency. The results indicate that defensive voiding reuslts in a QoL improvement, thereby suggesting that urgency voids rather than total voiding frequency should be monitored to assess treatment efficacy
Keynote Forum
Mabiala-Maye
University Of Nebraska Medical Center USA.
Keynote: Epidemiological profile of rural pregnant women: a case study in the republic of congo
Biography:
Dr. Grace is a dynamic, passionate, and hardworking medical doctor with excellent interpersonal skills motivated to improve maternal and child health in rural areas. From her academic background to her professional experience, she believes that her appropriate skills and qualities can help improve the healthcare system in rural Africa.
Abstract:
Introduction: Healthcare inequity remains a cause of great concern in the Republic of Congo. The impact on maternal health, particularly in rural areas, reflects this. Objectives: Assess the quality of maternal health in Congolese northern rural areas to provide an epidemiological profile and illustrate the health and well-being of rural pregnant women to inspire further research in the area. Patients and methods: Descriptive cross-sectional study from January to July 2020 at the Health Center of Bétou in Likouala, Congo. All pregnant women who received their first prenatal consultation were included. Data were collected from the registers and processed using MS Excel®. Results: A total of 2,897 women were included in the first prenatal consultation. Of these, 1,572 came at least to the third prenatal consultation (54.26%), 1,638 (56.54%) for birth. Pregnancies were pathological in 13.77% of cases (n=399). Sexually transmitted infections were found in 12.7% (n=368) of pregnant women. HIV test coverage was 11.63% (n=337) and positive cases were found in 0.37% (n=11). The cesarean section rate was 3.69% (n=107). Maternal and neonatal deaths represented 696/100,000 (n=9) and 23.4/1000 (n=22) live births, respectively. Conclusion: This work shows high morbidity and mortality among pregnant women in Bétou, low coverage of HIV testing, and low participation in prenatal consultations services. The availability of qualified human and material resources is a challenge
- Gynecology & Obstetrics
Location: Webinar
Session Introduction
Stephanie Arnold
AFE Survivor, USA
Title: The Patient Is Already Giving You the Diagnosis. Have patients? Be Patient.
Biography:
Pregnant with her second child, Stephanie Arnold had detailed visions and foreboding from the 20 week ultrasound to delivering her child. She told everyone. The test were normal, but she was not. She kept seeing she would die during the delivery. And the day she went into give birth, she flatlined for 37 Seconds. The only reason she is alive is because one doctor, amidst the 10 consultations she had, truly listened and incorporated measures in the OR at the time of delivery and that is what saved her life.
Stephanie is now an award-winning, international best-selling author and inspirational speaker on a mission to help others realize that finding your voice and advocating for yourself can not only enhance our lives, but can very well save them.
Abstract:
Patients sometimes know something is wrong with their health, yet clinicians aren’t always paying attention to what is being communicated. According to a General Internal Medicine study in 2020, physicians give a patient 11 seconds to speak before being interrupted. Sometimes drawing the wrong diagnosis. If a patient is able to advocate for themselves, they won’t be excluded from their healthcare decision-making. Research shows an extra 19 seconds with an educated consumer will save lives.For the past 8 years I have worked with clinicians and patients to understand the disconnect between advocating for yourself and being truly heard by your clinicians. I have hundreds of emails from people reaching out about how they knew something, they felt they weren’t heard, tried to share the information or regretted not speaking up. I’m here to change the conversation.You will never regret speaking up and being wrong, but you will if you don’t and you are dead right.
Abbas Majdi Seghinsara
Tabriz University of Medical Sciences, Iran
Title: Polycystic ovary syndrome (PCOS) and the role of neurotransmitters
Biography:
Abbas Majdi Seghinsara has completed his PhD at the age of 30 years from Tabriz University and start Anatomy and Embryology at Tabriz University of medical sciences.
Abstract:
Polycystic ovary syndrome (PCOS) is a disorder that supports endocrine abnormalities, characterized by an increase in GnRH and the ratio of LH to FSH. GnRH is the major molecule in reproduction that is affected by various intrinsic and external factors such as neurotransmitters and neuropeptides. PCOS is a highly inherited disease; Approximately 70- 60% of girls born from women with PCOS, exhibit PCOS phenotypes. Worldwide, 15-20% of women in reproductive age, have polycystic ovary syndrome. PCOS has severe and lifelong effects on women's health and wellness. Recently published international guidelines on PCOS state the need for clinical diagnosis of at least 2 of the 3 Rotterdam indicators: 1- Excessive levels of testosterone in the bloodstream or excessive body hair (hirsutism) 2- Absent or intermittent menstrual cycle 3- Polycystic ovaries on ultrasound Rotterdam indices create 4 PCOS phenotype models: Type A: HA + OD + PCOM Type B: HA + OD Type C: HA + PCOM Type D: OD + PCOM
The neurotransmitters inhibiting GnRH and LH, for example serotonin, dopamine, GABA and acetylcholine are all decreased, while glutamate, the main stimulus for GnRH and LH release, is increased in PCOS. The presence of an increased stimulus signal (glutamate) and a decrease in inhibitory flow (serotonin, dopamine, GABA, and acetylcholine) may indicate that the GnRH and LH are responsible and leading to an increase in the LH / FSH ratio observed in PCOS