CUTTING EDGE 2007 was acclaimed as one of the most stimulating scientific meets held in the recent past . Here are the glimpses of the feedback given by our International and National Faculty
A million thanks for your great hospitality and wonderful conference.
Usha Krishna – Mumbai
It was a great learning experience for me too and want to congratulate for the wonderful conference and above all for inviting to the conference.
I would once againg like to thank you , Dr Divakar, Dr Madhuri Patil, Dr Milind Patil and all those who helped you in organising the conference and look forward to continued association.
Dr Mandeep Singh (UK)
Thanks for every thing . I would love to be part of cutting edge family! Parag (Pune)
Dear Dr Divakar,
I was delighted to have participated in such a highly successful
meeting.
Thank you and your team again for the invitation. I should also
mention that the hospitality extended to me was second to none!
With kind
regards.
Isaac Manyonda (UK)
Dear Dr.Hema
I would like to thank you for giving me an opportunity to participate in one of the best organized conferences which i have attended in the recent past.The arrangements were superb and the scientific programmes was well delivered to the audience. Iam equally happy as you in participating in cutting edge and wish to actively participate in the future.
Dr GowriShankar ( UK )
hi thanks a million for the invite
I enjoyed the meeting will love to be back again a very receptive crowd a very good host .It was a fine time for me. excellent
regards
Dr Ramakrishna – Chennai
It WAS very good! and a pat on the back to u and madhuri!!
Udaythanawalla – Mumbai
13th March – Bellary
Optimising Labour & Delivery for safe motherhood
| ‘Concept of Programmed Labour’ ‘Safety Issues’ ‘Partograms & case illustrations ‘Management of PPH’ Interactive Session on ‘Reports & Implications’ Caspsules |
Dr. Hema Divakar Senior Vice President FOGSI Dr. Shankar, Bijapur Hubli Dr. Trishla, Bangalore member – Young Talents Committee Dr. Suchitra Pandit, Mumbai Chairperson-Young talent Committee. - Moderated by Dr. Hema Divakar - Speakers from Bellary. |
SOFEM SCIENTIFIC MEET - 24th October 2004
VENUE: Divakars Speciality Hospital.
THEME: FETO– Maternal Surveillance and Decision making in High Risk
Pregnancies.
The Session started at 10am with short presentations on the time tested Fetal Surveillance methods CTG by Dr. Parimala Devi and Bio Physical Profile by Dr. Chitra Ganesh. The details of how to perform these tests & the pitfalls and implications of results obtained were detailed.
The next session was on Materno – Fetal Surveillance in PIH / GDM & Intrapartum Surveillance. The Session was chaired by Dr. Narayanan and Dr. Susheela Rani.
The speakers included Dr. Hema Divakar on Fetal Surveillance in PIH, who made it clear that since no treatment option is available in PIH, except delivery at the appropriate time, Fetal Surveillance assumes great importance in deciding the optimal time for delivery.
Dr. Gita Arjun, our invited faculty from Chennai on Materno- Fetal Surveillance in GDM. Lack of standard protocols in testing sugars & monitoring the mothers was well brought out. Deciding for mode of delivery & anticipation of shoulder dystocia & expertise in wood cork screw maneuver was high lighted.
Intrapartum Surveillance by Dr. Latha Venkatram. Lack of correlation between CTG –pH of cord blood and Apgars with reference to immediate & long term outcomes of the fetus was brought out effectively & threw light on newer information in understanding fetal hypoxic sequence.
A presentation of update on Birth Defect Registry was made by Mrs. Chitra, the Co- ordinator for BDR.
Birth Defect Registry is a systematic mechanism for collection, storage and reporting of congenital anomalies. Birth defects are one of the leading causes of perinatal mortality in India. As per the statistics from developed countries, it could be 5 lakh babies born with some form of birth defects every year in the country. Fetal care Research Foundation founded the BDR of India in the year 2001 in Chennai. Many Nodal Centers of BDRI have come up in Tamil Nadu and they are whole heartedly supporting the cause.
Our Hospital Divakars Speciality Hospital was declared as a Nodal Centre on July 4th 2004 for the city of Bangalore and we have 12 participatory members who send their datas on a monthly basis. The datas are filled on form A & form B comprising information about the total number of deliveries & the details of the anomalies.
We began the trial run from the end of July from the 12 subcenters. There were 903 deliveries & 316 pregnancy terminations for the month of june, July and August. The total number of anomalies were 14 & the system wise distribution is shown with cardiac, Skeletal & Spinal anomalies ranking high.
The Scope of such data collection will facilitate the government toformulate plans & build strategies to combat the problems of birth defects. This will help the Clinicians and consultants to provide accurate information to parents during counseling.
We use this opportunity to thank the following doctors:
Leela Rao, Parimala Devi, Sreemani R, Geetha Shanbhag, Malathi Rao Sheela Mane, S.Gunasheela, Reeta Biliangady, Nagalakshmi and Latha Venkataram who extended their co-operation in helping us to provide the datas to the central registry in Chennai. The use of our Website “ divakars.com” to download the forms was informed, which is also a platform to share & discuss the management of intereting cases in the section on “Case for the Fortnight”
The Final session was a Interactive case Discussion, moderated by Dr.Gita Arjun. The case included APLA syndrome, Twin pregnancy.
The Panelist were Dr.Malathi Rao, Dr. Gomathy Narayanan, Dr. Prakash Mehta, Dr. Aravind Shenoy, Dr. Priti Venkatesh. The session brought forth the controversies & challenges in managemant & focused on evidence based management of HRP. The meet was well attended by over 200 delegates who were very involved & interactive. They appreciated the practical information that was shared & enjoyed the Scientific delibration, the ambience & the Lunch.
The session was followed by Lunch sponsored by Zydus Recon.
Installation Ceremony – Dr. Hema Divakar installed as Senior Vice President of the All India ObGyn. Federation at National FOGSI Conference, Arunghabad January 2005.
Message:
‘Optimising labour and Delivery for safe motherhood’ is the theme of FOGSI for the current year - . It is a journey of introspection for every obstetrician in the country – to audit and analyse the labour and delivery practices and an opportunity to exchange experiences and plan a programmed statergy to contribute in making the delivery process supervised, painless and safe for every women in the country.
Delivering health care in India is indeed a challenge, owing to the diversity in infrastructure, resources, cultures, patient awareness, expectations, affordability and compliance. One may be called up to deliver a woman in a setting where the best of technology and expertise is available (and patients expect miracles to happen) to another extreme where even basic facilities like electricity is unavailable and you are literally left in the dark (and you expect miracles to save the patient)
By being involved in the ‘Programmed Labour Workshops’ across the length and breadth of the country, I have had a chance to experience this reality. This has made me realise how much wisdom & flexibility we need, in order to apply the knowledge & use our expertise for delivering the best of care in a given situation. ICOG has already initiated a certification course in Rural Obstetrics and a fellowship course in Perinatology is in the pipeline. This indeed is a great attempt to build an acedemic skill transfer to cater to a range of circumstances from rural centers to tertiary care centers where the obstetrician could be called upon to lend his /her expertise.
I appeal to every member of FOGSI –ICOG to apply their knowledge with wisdom & commonsense to offer a cost - effective health care, both in the resource poor settings as well as in the best of the centers in the country – Make India a special place for women, who can trust you for the best of health care, integrating medical science with the art of human care & compassion.
Programmed Labour Workshops being conducted all over the Country
Programmed Labour is an indigenously developed protocol for labour management (Daftary et al 2001), developed with the dual objective of providing pain relief during labour and reaching the goals of safe motherhood by optimizing obstetric outcome.
Introduction:
Normal labour is the result of optimal integration of the Three ‘P’s. namely, the “Powers” or driving forces provided by the uterine contractions, “Passenger” or the foetus of optimum size and in favourable presentation and position, “Passages” or the birth canal made up of the soft tissues and the bony pelvis being adequate in capacity. Pain relief during labour spells a humane approach to delivery. Experience has shown that providing pain relief to the mother allays fear and anxiety, and provides a more favourable environment for improved obstetric outcome. Labour analgesia ensures relief from pain, controls alterations of placental circulation thereby safeguarding the foetus against hypoxia and depression at birth. Pain relief prevents maternal hyperventilation and undue muscular efforts which exhaust the mother, ensures periods of restful sleep and willing co-operation with her attendants in labour. Pain relief favours cervical dilation resulting in labours of shorter duration, less traumatic and requiring lesser obstetric interventions. Shorter labours are also associated with a lowered incidence of intrapartum infections. For the foetus, programmed labour confers the benefits of shorter and less traumatic labours and freedom from obstetric interventions necessitated by maternal distress. The obstetrician is benefited by having a better control over the events of labour, reduced pressure from the patient and her relatives to intervence because of unbearable pain, and lastly programmed labour ensures prevalence of optimum conditions at the time of delivery.
Although Epidural Analgesia offers the best method of providing pain relief, one must accept the fact that services of trained anaesthesiologists are not universally available, and beyond the reach of a large section of our population. Hence the adoption of an analgesia protocol which can be easily followed by the attending obstetrician has much to recommend for wider acceptance by the profession in all parts of our country.
The First workshop for the year 2005
JAMSHEDPUR – OLW (OPTIMISING LABOUR WORKSHOP)
30th January at Tata Main Hospital Jamshedpur
Faculty: Dr. Hema Divakar, Dr. Uday Thanawala
Delegates: 80.
The Conference was started with Dr. Dasguptas inaugral address, followed by lectures on the subject by faculty. 5 primi gravidas were taken on the protocol – 1 who refused vedio recording was kept as control!
4 of the primis had progressed and delivered before 1 pm and the last one was 9 cms before we closed the relay at 1.30. ketamine was demonstrated in 2 cases.
All patients were happy with the protocol and all babies were fine requiring no resucitation.
The Control had not progressed beyond 3 cms and was literally asking to be put on the protocol – seeing the rapid progress and less pain in the neighbors!
Excellent interaction with delegates and plenty of questions. They were encouraged to interrupt and ask questions freely.
Dr. Neelam and Dr. Richa the young doctors in the labour room were very impressed with the protocol and should be taken in as members of young talent committee so that they can join insimilar activities in the surrounding areas.
More to Follow:-
Lucknow, Bhopal, Allahabad
Chidambaram, Povdichery, Bellary
Bhubaneshwar, Kalyani, Ranchi
Trichi, Erode, Bangalore
Kakinada, Rajmundri, Vijaywada
Hyderabad, Karim Nagar, Rewari
Guntur, Salem, Tirunelvelli
Bijapur, Hubli, Belgaum and so on.
Through the length and breadth of the country, the programmed Labour Workshop will happen throughout the year.
SOFEM - Society for Fetal Medicine and Genetics
Scientific Meet jointly organized by SOFEM & BSOG on
Sunday, 4th July 2004
Delegate Strength –156
Session I - 09:00 a.m. - 10:15 a.m.
Chairpersons - Dr. Mohini Prasad / Dr. Hema Divakar
(a) Does use of colour Doppler improve fetal outcome? - Dr. Rama Murthy
(b) The 11 –14 wks scan current concepts - Dr. S. Suresh
Inauguration: Birth Defect Registry & Antenatal Screening
Programme
Coffee Break –10:45 a.m. - 11: 00 a.m.
Session II 11: 00 a.m. - 01:00 p.m
Chairpersons: Dr. Susheela Rani / Dr. Latha Natarajan
(a) Case Presentation – Twin to Twin Transfusion Syndrome –Dr.
P. Chitra
(b) Fetal Hypoxia & CTG –Dr. Prakash Mehta
(c) Fetal Hypoxia & Cerebral palsy –Dr. Ranjan Kumar
Panel Discussion – “Fetal Testing in HRP ”
Moderators –Dr. Hema Divakar
Panelists –Dr. S.Suresh / Dr. Malathi Rao / Dr. Latha Venkatram
/ Dr. Sheela Mane / Dr. Parimala Devi
Lunch : 01:00 p.m
This programme was sponsored by Avishkar –A wing of Divakars Service
Trust
Venue:
AVISHKAR Centre
DIVAKARS SPECILAITY HOSPITAL
# 220, 9th Cross,
J.P. Nagar 2nd Phase,
Next to S.S. Hall, Bangalore 560 078.
Highlights
Guest speakers-Dr. Ramamurthy-leading sonologist & director of Srinivasa ultrasound center addressed the delegates on “Doppler in Obstetric outcome”.
The crucial role of Doppler findings in a high risk pregnancy determine
optiomal time of interference was clearly outlined & the topic stimulated
a lot of clinical discussion.
This was followed by another guest lecture on “11-14 weeks Scan” by Dr. Suresh from Chennai, the privilege of his presence and participation was a joy with much information shared on the newer perspectives in offering a venture early pregnancy scan & nuchal…Transclucency
study in this period of gestation.
Case of stuck twin phenomenon in twin-twin transfusion syndrome was presented
by Dr. Chitra from Divakars Speciality Hospital & the good outcome shown in this case would serve as a motivation for the clinician’s
to offer multispeciality care as a team of specialist who would benefit
the patient by mutual interaction.
Dr. Prakash Mehta on the importance of CTG in detecting fetal hypoxia
and Dr. Ranjan Kumar (neonatologist, KR Hospital) on the topic of cerebral
palsy and fetal hypoxia was indeed very interesting & informative.
The panel on fetal testing in High Risk Pregnancy moderated by Dr. Hema Divakar took us through various case situations such as
–Cystic hygrama
–Cystadenomatoid hyperplasia of the lung and
–Neural tube defects
– HIV & HbsAg +ve preganacies
And concluded with Dr. Narendra’s presentation on two interesting cases ref. for neonatal surgeries from Divakars speciality Hospital. The team of Paediatric Surgery at Sagar Apollo Hospital led by Dr. Ramesh highlighted the details of surgery for duodenal web and fetal suprarenal teratoma. The excellent outcome in these cases once again speaks for a good rapport & networking between sonologists, Obstetricians, neonatologist & paediatric
surgeons to offer the best of perinatal care bringing about the best
outcome.
Besides the feast of these scientific presentations another important highlight of the meet was the inauguration of Birth Defect Registry of Bangalore chapter, the Divakar Speciality Hospital as the nodal center.
The details about what is Birth Defect Registry, its objectives and methodology of its functioning is detailed below.
Please join hands with BDRI to accomplish the mission of ascertaining
the prevalence & reducing the birth defect in the country.
What is Birth Defect?
A birth defect is a functional or structural defect that presents in infancy or later in life and is caused by events preceding birth, whether inherited or acquired (March of Dimes Birth Defects Foundation, USA).
What is a Birth Defect Registry?
A Birth Defect Registry (BDR) is a systematic mechanism for the collection, storage and reporting of congenital anomalies.
The need for Birth Defect Registry
Birth Defects are one of the leading causes of perinatal mortality in
India. Our nation is undergoing an epidemiological transition i.e. many
neonatal infections are better controlled today, which eventually has
increased the proportion of birth defects as a cause of perinatal mortality.
As per the statistics from developed countries, about 2 3% of births
are associated with major congenital anomalies. In India 25 million births
occur annually. If prevalence rate of birth defects is taken as 2% (likely
to be much higher) in absolute number, it could be 5,00,000 babies born
with some form of birth defects every year in the country. However many
of these defects are preventable. It has been proved that “Periconceptional Folic Acid Supplementation”has
a high preventive value in some of the congenital anomalies such as Neural
Tube Defects, Cardiac anomalies, Anterior abdominal wall defects and
Oral clefts.
Planning and executing strategies to prevent birth defects or provide supportive care for the affected are essential, provided the magnitude of birth defects is known. An active birth defects registry will help assess the problem of birth defects within a population.
In India, there are statistics available on the prevalence of birth defects
from several hospital based studies. But this has not been estimated
at the population level. Hence, the burden posed by birth defects has
not been fully understood in our country. Fetal Care Research Foundation
( FCRF ) a not – for –profit charitable trust, founded the
Birth Defects Registry of India (BDRI ) in the year 2001. Chennai BDR
was the first step to assess the problems caused by birth defects in
Chennai Metropolis. Many Nodal Centers (branches ) of BDRI have come
up in Tamil Nadu and they are whole heartedly supporting the cause. More
centers are expected to get inducted all over the nation in future.
The data collected by the registry will facilitate the government to formulate plans and build strategies to combat the problem of birth defects. This will also help the clinicians and consultants to provide accurate information to parents during counseling.
Mission of BDRI
BDRI has planned to function in two phases. The mission for the first phase is to ascertain nationwide baseline prevalence of birth defects. The mission for the second phase is to reduce the incidence of birth defects and help to form support groups for various congenital disorders.
Objectives
Phase I
- To establish birth defects registries throughout India
- To monitor secular trends and clustering of birth defects
- To provide guidelines and assistance to the upcoming centers for uniform methods of data collection.
- To collect, analyze and disseminate birth defect surveillance data.
Phase II
- Plan strategies for preventive and supportive care such as creating awareness and educating the public regarding the problem of birth defects.
- Formation of support groups for those affected with various birth defects.
Membership
Any hospital from both government and private sector, with an interest and commitment to the above mission, can become a member. There is no membership fee.
Two types of memberships are available;1. Nodal 2.Participatory.
Participatory members should send their hospital data on births and birth defects to the nodal member assigned to their region. The job of the nodal member is to collect data from all participants in their region and forward it to the BDRI. Data should be furnished in prescribed forms provided by the central registry. The assignment of the nodal member is at the sole discretion of the BDRI. The center will provide guidance in all aspects for the functioning of both the participatory and nodal members, such as data collection and storage.
How to start a registry in your region?
To commission a birth defects registry in a city, part of a city, town, district or taluk, Team Effort is required. Registry collects Hospital Based Data. Obstetricians, Pediatricians and Neonatologists from a region should come to a consensus on starting a nodal center for reporting data on birth defects. When a group of hospitals agree to participate in the mission, central registry may be contacted for further guidance and action.