Aug 2016 : Report on St.John's -AIPNA International Paed Path Conference and 6th Hands-on Workshop on Hirschsprung's disease"

The 6th  National Hands on Workshop on  Hirschsprung Disease was conducted by the Departments of  Pathology and  Paediatric Surgery , St.John’s Medical College Hospital  on 11th  August 2016. This workshop was held under the aegis of  Karnataka Chapter of the Indian Association of Pathologists and Microbiologists,  Medical Education Research Trust Karnataka, and Rajiv Gandhi University of Health Sciences,  Karnataka.

The workshop was attended by 35 National and international delegates from various medical colleges , national institutes and  corporate hospitals. A workshop kit was given to each delegate  ; it included a CD with Manual for the Workshop along with articles on Hirschsprung Disease and staining protocol for acetylcholine esterase stain

The programme started with a pretest, introduction to the workshop and introduction of the delegates. A brief inaugural ceremony was graced by dignitaries from the management of St. John’s National academy  of Health Sciences.

In the pre Lunch session, a number of lectures covered key topics including  understanding of the enteric nervous system, clinical brief and  investigations, surgical procedures, processing of biopsies and histological diagnosis of Hirschsprung disease and allied disorders. The post Lunch session was devoted to a  hands on session addressing  sample receipt, frozen section cutting and Acetylcholine esterase staining and wet specimen display . Difficult diagnostic arenas such as Hirschsprung disease in neonates, low level rectal biopsies, total colonic aganglionosis and long segment Hirschsprung Disease were also discussed.

There was a lot of interaction between the participants and faculty about diagnostic problems that they encounter in their practice. Eminent international pediatric pathologists includindg Dr.Vijay Joshi , Dr.S.Ranganathan and Dr.Irene Scheimberg with special interest in the field enlivened the proceedings. The workshop concluded with a post test, feedback and evaluation of the workshop.

All the lectures were graded as excellent and a few graded as very good. The sixth such workshop was a success with suggestions of organizing such workshops regularly.

2. Brief  report on the conference

The St. John’s AIPNA Pediatric Pathology conference was held on 12th and 13th August 2016 at the Pope John Paul Auditorium, St.John’s  Medical   College, Bangalore.

This conference  was held under the aegis of  Karnataka Chapter of the Indian Association of Pathologists and Microbiologists,  Medical Education Research Trust Karnataka, and Rajiv Gandhi University of Health Sciences,  Karnataka.

The conference was attended by 75 delegates of which 41 were consultants and 2 were international delegates . The International faculty for the conference included

•Dr. Vijay Joshi, Medical College of Virginia Richmond and Connecticut Children’s Medical Centre and Hartford Hospital USA

•Dr. Irene Scheimberg, Barts HealthNHS Trust, London,UK,

•Dr. S. Ranganathan, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, USA

•Dr. Anita  Gupta,Cincinnati Children’s Hospital Medical Center, OH,USA

•Dr. Veena Rajaram, Children’s Health/UT Southwestern Medical Centre,Dallas,Texas,USA

The National faculty included

•Dr. Hughbert  Dkhar,  Nazareth  Hospital,  Shillong ,  Meghalaya.

•Dr. Usha Kini Dr. Kanishka   Das, Dr. Suravi Mohanty  Dr. Poonam   Panjwani, and  Dr. Maria Bukelo of St.John’s Medical College, Bangalore.

On 12th August, the programme started with registration of delegates at 8.30am.Pediatric liver biopsies & neonatal cholestastic disorders was discussed by Dr.

Anita Gupta, followed by a slide seminar on liver transplants by Dr. Anita Gupta and Dr. S. Ranganathan.

Inauguration of the conference with invocation song and lighting of the lamp by dignitaries followed. The welcome address was delivered by Dr. Kanishka Das,Professor of Pediatric Surgery, St.John’s. Dr. Suravi Mohanty, Organising Secretary dwelled on the reason for organising the meet and the need to popularise

the subspecialty in India. Dr. Amanda Pinto proposed a vote of thanks.

The keynote address on the scope of Pediatric pathology as a subspecialty in general and in India in particular was delivered by Dr. Vijay Joshi. A series of lectures on select topics like  Intractable diarrheas of infancy (Dr.  S.Ranganathan) and   Practical approach to autopsies in children (Dr. Irene Scheimberg) followed.. A preliminary written quiz was conducted by Dr. Maria Bukelo and Dr. Poonam Panjwani  followed by lunch and poster viewing. Post lunch lectures included Introduction to  placental pathology (Dr.  Irene Scheimberg) , a discussion on  Case scenarios in Disorders of sexual differentiation (Dr. Kanishka Das) and update on Pediatric CNS  tumours (Dr.Veena Rajaram).

On 13th August, scientific sessions started at 8am with lectures on pediatric renal Tumours – a pathlogist’s perspective, (Dr.  S. Ranganathan), CNS malformations (Dr. Veena Rajaram), vascular anomalies in children (Dr. Anita Gupta) and Histiocytic disorders, (Dr. Vijay Joshi). Then followed   slide seminars on pediatric Lung diseases ( Dr. Veena Rajaram , Dr. Anita Gupta and Dr.  S. Ranganathan), bone  and soft tissue tumours ( Dr.  S. Ranganathan  Dr. Veena Rajaram), GI pathology ( Dr. Suravi Mohanty , Dr. Usha Kini) .

Dr.Hughbert Dkhar , a pathologist practicing in a remote hilly north eastern state of India (  Meghalaya) elaborated his journey in Pathology and social service. To foster more collaboration and interaction between those interested in the specialty, a ‘Pediatric pathology club /group’ was started with interested Pathologists and Pediatric Surgeons present in the hall.  It was decided that the Pediatric Pathology conference will be an annual event which will be organised by different Institutes in India.

The tea and lunch breaks were used for poster discussions with the presenters and six papers were presented as platform presentation. Dr. Ranganathan discussed the process of abstract selection for the conference after coding and  blinding (without names, institution affiliations) .He added that ones without results and proper conclusions were  rejected. Further, only 28 abstracts for posters and 6 for platform  presentation were  selected due to space and time constraints.

Final round of quiz was conducted by  Dr. Maria Bukelo and Dr. Poonam Panjwani. Prizes were distributed for platform presentation, poster presentation and quiz.

The  conference ended with the valedictory function and thanksgiving.

Prizes

Platform presentation: First prize

Name:    Dr. Antony

Title  Pediatric acute myeloid leukemia: a clinicopathological and diagnostic study

Institute : St John’s Medical College Bangalore

Platform presentation :  Second prize

Name: Dr. Deepthi

Title: Clues to  diagnosis of Langerhans cell histiocytosis in children: a study of 15 cases

Institute: St John’s Medical College Bangalore

 Poster (Case series)

First prize:

Name: Dr. Neetu Tony

Title: Disorders of sexual differentiation: A Clinicopathological and histological study

Institute: St John’s Medical College Bangalore

 Second prize

Name: Dr. Mukul Vij

Title: Pediatric hepatocellular carcinoma in multidrug resistance p glycoprotein 3 (mdr3) deficiency. report of two cases

Institute: Institute of liver disease and transplantation, Global health city, Chennai, Tamilnadu, India.

 Poster : prize for case report

Name: Dr. Anisha Manocha

Title: An Unusual cause of Intestinal Pseudo-obstruction in the  Eyes of the beholder: A report

Institute: St John’s Medical College Bangalore

 Quiz

First prize : shared by

Dr. Shrinidhi Nathanu, Dr. Nivedita Samanta(KMC, Manipal)

Dr. S Raasi, Dr. Sofia Tamilarasi( Madurai Medical College)

Feedback and evaluation

The majority found the conference very well organized & informative. They found the  academic programme excellent  and look forward to more such events  to be organised throughout India. Each of the sessions were scored excellent (score 5) with a few with score 4(very good). The food and accomodation were also scored excellent.

The following suggestions have been made by different delegates –

•To include discussions relevant to the Indian scenario.

•Allocate more convenient poster session time slots for both presenters and judges

•Time management of the sessions to be streamlined with strict adherence to time.

•Include more topics of specialities useful for postgraduates .

•Paediatric medical renal diseases could be covered.

•Set aside time for  discussion and interaction  between speakers and audience .

•Avoid too many  topics crammed in little time ; spread out talks

•Updates and recent developments in pediatric pathology.

•Suggested topics for the next meet:

Pediatric IBD- Indian scenario. Speaker Dr. Anna Pullimood

Cholestatic disorders. Speaker Dr. Srinivasan Jain . Yale University. USA

•To cover practical aspects in more detail  e.g. Perinatal topics – CNS malformation, 5 minutes could have been devoted to  examination and fixation of the  brain, manner of bitting .

•Slots to be allocated for participants to present their cases, maybe in the form of slide presentation for discussion of problematic cases.

•Share power point presentations of speakers.

•Increase the time for speakers and conduct the programme over three days