14^th World Conference on Gynecology, Obstetrics and Women Health April 03-04, 2023 Barcelona, Spain

Biography:

Mehreen Sarwar is the Obstetrics & Gynecology Specialist at Zia Medical Center, Dubai, United Arab Emirates. Sarwar is a member of the Royal College of Obstetricians & Gynecologists (RCOG) London, UK and has over 30 years of experience at a number of reputable healthcare institutions in Pakistan, UAE and UK. Her main interests lie in ambulatory gynecology including scanning and outpatient hysteroscopy, early pregnancy and menopause. An expert in cosmetic gynecology and hormonal issues, Dr Sarwar is known for her caring, patient-centered approach, supporting all her patients by their side. She is also a well-known international speaker and an advisor to many respected consultancy companies in the medical industry. Dr Sarwar feels privileged in being able to help women through all aspects of their reproductive life.

Abstract:

Many medical disciplines, including dermatologists, cosmetic and reconstructive surgeons, urologists, and gynecologists, are interested in Nonsurgical Vulvovaginal Rejuvenation (NVR). There is evidence that supports energy-based, minimally invasive devices like radiofrequency are beneficial at tightening the vagina and reducing symptoms of vulvovaginal atrophy (VVA) and/or the genitourinary syndrome of menopause (GSM). Vaginal dryness (VD), vaginal laxity (VL), pain during sexual activity (SAPain), vaginal itching (VI), burning, pain, and symptoms in the urinary organs are all aspects of the genitourinary syndrome of menopause (GSM). A thorough history, examination, and discussion of goals of treatment can help identify suitable candidates for NVR. Patients with GSM report symptoms of laxity, dryness, itching, urinary incontinence, and even pain. These patients tend to be menopausal women, though GSM can occur at any age. Patients with VL will report experiencing vaginal laxity during intercourse and largely remains a self-reported condition. They are often premenopausal women with a history of vaginal childbirth. With the contraindications and limitations of standard therapy for GSM Non-ablative radiofrequency (RF) has emerged as a new alternative technique for GSM. It is a high-frequency current used for therapeutic purposes, based on the mechanism of heat production by conversion, that is, ionic and molecular mobilization, favoring oxygenation, nutrition, and vasodilation of tissues. The heating of the tissues also promotes the denaturation of collagen with a subsequent contraction of its fibers, retraction of fibrous septa, and activation of fibroblasts. Neocolagenization, neoelastogenesis, and reorganization of collagen fibers may occur, resulting in tissue remodeling. Intravaginal RF reduced the clinical symptoms of GSM in most patients, especially during T1, and women reported satisfaction with treatment. The technique showed no adverse effects, and there were positive therapeutic benefits on sexual disfunction and stress incontinence.

Biography:

Hiral Chaudhary is an expert in Genomics, SNP analysis, clinical Biochemistry, and molecular biology. Her focus is on enhancing the health and well-being of women. Her Tetra-ARMS PCR-based open contextual evaluation paradigm will pave the way for future advancements in reproductive health therapies. She developed this model after personally experiencing the psychological, social, and therapeutic weight of the syndrome; doing so illuminates the way to advance society and influence young females positively. With assistance from Gujarat University, she shaped this platform and received an award from CSIR-UGC-NET-JRF.

Abstract:

Polycystic ovary syndrome (PCOS) is a complex multifactorial endocrine condition affecting about 5- 10% of women of reproductive age. The etiopathogenesis of PCOS is not fully elucidated, but it seems that hyperandrogenism plays a key role in developing PCOS. Studies on PCOS patients have shown elevated levels of androgen due to enhanced ovarian steroidogenesis, which is mostly linked to altered expression of key enzymes (CYP19, CYP17, CYP21, CYP11A, HSD17, INSR) in the steroidogenesis. This study aimed to investigate the association between an exon rs700519 (C/T) variant of the CYP19A1 gene and PCOS. The present study recruited 200 subjects comprising 100 PCOS cases and 100 healthy age-matched controls. Blood samples were collected for genetic and hormonal analysis and Body mass index was measured for all cases. The assessment of the rs700519 (C/T) variant of the CYP19A1 candidate gene was done by the tetra-primer amplification refractory mutation system polymerase chain reaction (Tetra ARMS-PCR) technique followed by statistical analysis. The association between the rs700519 polymorphism and Gujarati-- women's propensity for PCOS was examined. According to the findings, 43% were homozygous for the wild-type (CC) genotype, 31% were heterozygous for the (CT) genotype, and 26% were homozygous for the mutant type (TT) genotype. This was also true for controls, which revealed that 13% were homozygous (CC) genotype, 50% were heterozygous with (CT), and 9% were homozygous with mutant type (TT) genotype. BMI was significantly different between PCOS women and healthy controls. We concluded that there was a lack of association between the rs700519 polymorphism and PCOS in the group under study. This calls for more research into other genes and SNPs to determine the prevalence of PCOS.

Biography:

Jalpa Patel is a second-year Doctoral Fellow at Gujarat University in India, working under the direction of Dr. Rushikesh Joshi. The importance of metabolites associated with hyperandrogenism in polycystic ovarian syndrome is examined in her doctoral thesis. She graduated from Gujarat University with an M.Phil. in Biochemistry and a P.G. Diploma in Clinical Embryology and ART. She is an expert in both molecular biology and clinical biochemistry. Future developments in reproductive health therapies will be enabled by her HPLC and LC-MS-based open contextual evaluation paradigm. Her research is supported by the Scheme of Developing High-Quality Research (SHODH). She is incredibly talented, thoughtful, and enthusiastic about her calligraphy and art.

Abstract:

Polycystic ovary syndrome (PCOS) is a complex multifactorial disorder with unknown pathogenesis in which genetic and environmental factors contribute interdependently to its phenotypic manifestations. Endocrine disruptors (EDs), a class of common pollutants found in the environment and consumer products, can disrupt normal endocrine signals. Phthalate esters are widely used in flexible plastics and consumer products and have become prevalent contaminants in the environment. There are some significant findings in animal and in vitro studies that suggest di-2-Ethylhexyl phthalate (DEHP) and/or mono (2-Ethylhexyl) phthalate (MEHP) may play a role in the development of polycystic ovary syndrome (PCOS). There are only a few human studies in the literature that investigate the relationship between PCOS and phthalates. We aimed to investigate the possible role of the endocrine disruptors phthalates, di-Ethylhexylyl phthalate (DEHP) and mono (2-Ethylhexyl) phthalate (MEHP), in polycystic ovary syndrome (PCOS) aetiopathogenesis. We also wished to evaluate the relationship between phthalates and metabolic disturbances in women with PCOS. A total of 75 women were included. Phthalate esters levels were determined by highperformance liquid chromatography. All the clinical parameters of participants were evaluated. Forty-two PCOS and 33 controls, (mean age 28±4.4 vs 25±5.7) were enrolled. Results showed PCOS women had a significantly high level of MEHP than those in the control group (24.96±8.6 vs 16.04±6.59 ug/ml) with a pvalue of ˂0.001, whereas serum concentration of DEHP is lower in PCOS women than the control group (4.13±6.89 vs 22.36±24.75 ug/ml). Serum androgens levels were higher in the PCOS group than in controls. Our findings imply that phthalate esters may play a role in the etiology of PCOS. It also suggests the way forward to integrate biomonitoring studies and metabolomics to emphasize the role of phthalate in PCOS pathophysiology.

Biography:

Abstract:

Uterine leiomyomas decrease the quality of life by causing significant morbidity among women of reproductive age. Histologically various types of leiomyoma's can be differentiated. We have analysed th histopathological,proliferation,apoptotic and hormonal profile in different types of leiomyomas. Study included altogether140 cases distributed into following groups: group I-normal myometrium (20cases), group II-classic leiomyoma (69 cases), group III-cellular leiomyoma (15 cases), group IV-bizarre cell/atypical leiomyoma (22cases), group V-smooth muscle tumors of uncertain malignancy potential (STUMP) (8 cases) and group VI-leiomyosarcoma (6 cases). Together with classic histopathological features such as nuclear atypia, cellularity, presence of mitoses, vasculature and necrosis, immunohistochemical phenotype using antibodies against Ki67,Cas3,ER and PR were analysed.

The results of our study showed that leiomyomas are charterised with variable histopathological and immunohistocthemical phenotype. Histopathological parameters mainly correlate with the degree of malignancy except two bizarre/atypical leiomyoma and STUMP, where two distinct subgroups could be identified. In bizarre/ atipycal leiomyoma 31% of cases are characterized with the features of classic leiomyoma, whilst rest of the cases reveal more atipycal phenotype.  In STUMP 37.5 % of cases are characterized with the features of atipycal leiomyomas.

The result of immunohistochemical study also reveald that half of bizarre/atipycal leiomyomas are characterized with the low proliferation index, high apoptotic index and high ER and PR index, whilst another half is characterized with high proliferation index, low apoptotic index and low ER and PR index. Similarly, part of the STUMP cases are characterized with low proliferation index, high Er and PR index  and whilst part of the cases are characterized whith high proliferation index, low apoptotic index and low ER and PR index.

The results of histopathological and immunohistochemical study indicate that these two entities represent the heterogenous group of diseases, which might be the explanation of their different prognosis. Presented histopathological and immunohistochemical features should be considered in the diagnosis of myometrial smooth muscle tumors.  

Biography:

 Pravin Mhatre is the Scientific Director of Kedar Hopital which has already made its mark as one of the reputed hospitals for gynecology services in India. Dr. Mhatre is a consultant to the Breach Candy Hospital, N. Wadia Hospital in Mumbai. He  has done pioneering work in the field of Ovarian Transplant and has been credited with world's first successful "Ovarian Transplant".He has developed a new Vaginoplasty technique resulting in formation of normal Vagina and identification of Stem cell. He has performed more than 100 cases of Vaginoplasty. Dr. Mhatre has served as Honorary professor emeritus of Gyn/Obst at Seth G.S. Medical college / N. Wadia Hospital for 30 years.For more than 8 years Dr. Mhatre has conducted many rural tubal ligation camps all over India. For this honorary contribution in women's heath care his team has received Presidents Medal from government of India. Dr. Mhatre has delivered guest lectures in many international and national congresses and has been an invited Professor at Oxford University (UK), University of Georgia (Atlanta USA) & Colombo University. 

Abstract:

Aims and Objectives: To study development of neo-vagina by metaplastic conversion of peritoneum, To identify translational Stemness markers using NANOG/OCT4/SOX2 from serial neo-vaginal mRNA, cDNA and to study role of WNT and HOXA genes in patients undergoing vaginoplasty.

Material and Methods: 75 MRKH Syndrome women underwent laparoscopic peritoneal vaginoplasty (LPV). Two patients underwent serial neo-vaginal biopsies on day 0, 7-9, 12-14, 21 and 33. Fifteen MRKHS and twelve controls were subjected for neo-vaginal biopsy to detect genes upregulation. Remaining patients were evaluated anatomically and functionally. Results: The translational stemness markers NANOG, OCT4 and SOX2 responsible for neo-vaginal formation were identified. Their appearance, concentration at different stages of conversion were demonstrated. The neo-vagina has shown up-regulation of these translational stemness markers. The study demonstrates expression of the specific genes (WNT4, WNT5A and WNT7A) and their role in formation of the neo-vagina. In the subjects stemness markers (NANOG, OCT4 and SOX2) appeared from day 9 to 14 of the neo-vaginal biopsies and after achieving the peak declined later. Genetic analysis showed low values in HOXA 9,10,11,13 and up-regulation of WNT 4A,5A,7 genes in neo-vagina.

Conclusions: Study shows peritoneal metaplastic conversion to normal vagina. Identified the translational stemness markers and genes responsible. The neo-vagina has shown up-regulation of these genes. The study demonstrates expression of the specific genes (WNT4, WNT5A and WNT7A) and their role in formation of the neo-vagina. Furthering this research, activating these genes may lead to treatment of developmental defects of Mullerian duct, obviating the need of transplant.

Biography:

Dr. Ghazala Shaheen completed her PhD in Reproductive Physiology from Quaid- i- Azam University Islamabad, Pakistan. Her research focused on the need of the day to find out cause of maternal and fetal death and to improve the reproductive health of women in Pakistan. She has worked on human physiology dealing with pregnancy hypertensive disorder (Preeclampsia) which leads into excessive maternal death in developing countries. Biochemical, histomorphological and genetic analysis was part of her research work. Her findings will enable the women, clinicians, and policy makers in future to make more informed decisions about care during pregnancy and childbirth.

Abstract:

Preeclampsia (PE) is hypertensive pregnancy disorder which is one of the leading causes of maternal and neonatal morbidity and mortality. Circulating factors or signals or impaired placental blood flow have been considered as links between the placenta and maternal vascular dysfunction which leads to PE.  The present study aimed to elaborate the role of epinephrine and histopathological assessment of placental villi in preeclampsia (PE) patients and normotensive pregnant women. Total 400 blood samples (PE=200, controls=200) and 100 placental tissue samples (PE= 50, controls=50), were included in the study. Blood samples were taken before delivery and placental tissue samples were recruited after simple vaginal delivery (SVD) and Caesarean section (C-section). Levels of epinephrine and thyroid hormones were analyzed through enzyme-linked immunosorbent assay and histomorphology and histomorphometric evaluation of stem villi were studied through histology. Data were statistically analyzed by independent sample t-test. Significantly increased concentrations of epinephrine (p<0.011) while non-significant difference in thyroid hormones was determined in preeclamptic women as compared to the normotensive group.  Histological changes determined abnormal villi, more syncytial knots (SK), intervillous spaces and a significant decrease in total area and circularity of VP in PE placentas as compared to the control group. The findings of this study suggest that epinephrine levels were elevated in preeclamptic women and may play a key role in the development of PE. Furthermore, histological placental evaluation provides probable clinical evidence of PE occurrence and new methods for PE screening to improve the reproductive health of women and infants in Pakistan.