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Fulltext ASGO's Fourth Biennial Meeting, November 12th to 14th, 2015

Kumarasamy S

J Gynecol Oncol, 2016 Jan;27(1):e10.
PMID: 26676383 DOI: 10.3802/jgo.2016.27.e10
Fulltext Combined pregnancy--a case report

Kumarasamy S, Arumugam K

Med J Malaysia, 1991 Sep;46(3):252-4.
PMID: 1839921

A case of combined intra- and extra-uterine pregnancy is reported. Awareness of this condition, a high index of suspicion, the proper interpretation of physical signs and ultrasound findings together with early resort to laparoscopy resulted in a favourable outcome.
Fulltext Early warning of fetal compromise--absent end diastolic flow?

Neoh HS, Kumarasamy S, Raman S

Med J Malaysia, 1990 Mar;45(1):37-41.
PMID: 2152067

This report deals with the use of a relatively new investigative technique (Doppler ultrasound) in the management of a case of early onset pre-eclampsia and discusses the benefit of this new technique over conventional methods of fetal monitoring.
Eco-friendly drying techniques: a comparison of solar, biomass, and hybrid dryers

Prabhu N, Saravanan D, Kumarasamy S

Environ Sci Pollut Res Int, 2023 Sep;30(42):95086-95105.
PMID: 37582893 DOI: 10.1007/s11356-023-28807-z

Solar energy provides desired thermal energy for diverse applications, including industrial heating, domestic cooking, power generation, desalination, and agri-food preservation. Despite extensive research on solar drying from the scientific community, there are limited practical applications for small-scale use. This review attempts to analyze the design features of three specific types of dryers for food drying applications: solar evacuated tube dryers, biomass dryers, and hybrid solar dryers. The thermal performance of the three dryers is evaluated in terms of drying time, moisture removal, and temperature attained during drying. The review also assesses the prospects of solar dryers, highlighting the need for further research into innovative designs and advanced drying capabilities. The study provides valuable information for enhancing dryer performance with various integrated solutions.
The recovery strategies to support cervical cancer elimination in lower-and middle-income countries (LMICs) following COVID-19 disruptions

Lee J, Ismail-Pratt I, Machalek DA, Kumarasamy S, Garland SM

Prev Med Rep, 2023 Oct;35:102291.
PMID: 37455756 DOI: 10.1016/j.pmedr.2023.102291

The COVID-19 pandemic has exacerbated the existing challenges to achieving the WHO target of eliminating cervical cancer as a public health problem by working towards the target of fewer than four cases per 100 000 women. We reviewed the literature to identify potential recovery strategies to support cervical cancer prevention programs in lower-and middle-income countries (LMICs) following COVID-19 disruptions and the extent to which strategies have been implemented. Utilising the WHO health systems framework, we mapped these recovery strategies against the six building blocks to examine their reach across the health system. Most recovery strategies were focused on service delivery, while leadership and governance played a pivotal role in the continuity of cervical cancer prevention programs during the pandemic. Leadership and governance were the drivers for outcomes in the building blocks of health information systems, financing and critical support in operationalising service delivery strategies. In the aftermath of the COVID-19 pandemic with strained health resources and economies, stakeholders would significantly influence the coverage and sustainability of cervical cancer prevention programs. The support from multisectoral stakeholders would accelerate the recovery of cervical cancer prevention programs. To achieve the WHO target by 2030, we call for future studies to understand the barriers and facilitators from the perspectives of stakeholders in order to support the decision-making processes and information required to implement recovery strategies in LMICs.
Fulltext COVID-19 and gynecological cancers: Asia and Oceania Federation of Obstetrics and Gynecology oncology committee opinion

Tse KY, Domingo EJ, Konar H, Kumarasamy S, Pariyar J, Tjokroprawiro BA, et al.

J Obstet Gynaecol Res, 2021 May;47(5):1643-1650.
PMID: 33650217 DOI: 10.1111/jog.14579

Since the outbreak of COVID-19, there have already been over 26 million people being infected and it is expected that the pandemic will not end in near future. Not only the daily activities and lifestyles of individuals have been affected, the medical practice has also been modified to cope with this emergency catastrophe. In particular, the cancer services have faced an unprecedented challenge. While the services may have been cut by the national authorities or hospitals due to shortage of manpower and resources, the medical need of cancer patients has increased. Cancer patients who are receiving active treatment may develop various kinds of complications especially immunosuppression from chemotherapy, and they and their carers will need additional protection against COVID-19. Besides, there is also evidence that cancer patients are more prone to deteriorate from COVID-19 if they contract the viral infection. Therefore, it is crucial to establish guidelines so that healthcare providers can triage their resources to take care of the most needed patients, reduce less important hospitalization and visit, and to avoid potential complications from treatment. The Asia and Oceania Federation of Obstetrics and Gynecology (AOFOG) hereby issued this opinion statement on the management of gynecological cancer patients during the COVID-19.
A questionnaire study on disparity of cervical cancer prevention programs in Asia-Oceania

Oncology Committee, Asia and Oceania Federation of Obstetrics and Gynecology, Tse KY, Ushijima K, Tan AL, Intasorn P, Pariyar J, et al.

J Obstet Gynaecol Res, 2023 Apr;49(4):1230-1243.
PMID: 36726190 DOI: 10.1111/jog.15566

BACKGROUND: Despite the introduction of cervical cancer screening and human papillomavirus (HPV) vaccines, the utilization pattern was not standardized. The aim of this study was to elicit the current prevention care in Asia-Oceania.
METHODS: An online questionnaire was circulated to different countries/cities in Asia-Oceania. The primary objective was to evaluate the coverage of HPV vaccination and cervical screening programs. The secondary objectives were to study the structures of these programs. Five case scenarios were set to understand how the respondents manage the abnormal screening results.
RESULTS: Fourteen respondents from 10 countries/cities had participated. Cervical cancer ranked the first in Myanmar and Nepal. About 10%-15% did not have national vaccination or screening program. The estimated coverage rate for vaccination and screening varied from less than 1% to 70%, which the coverage ran in parallel with the incidence and mortality rates of cervical cancer. All regions approved HPV vaccines, although only four provided free or subsidized programs for nonavalent vaccine. Cervical cytology remained the most common screening tool, and 20%-30% relied heavily on visual inspection using acetic acid. The screening age groups varied in different regions. From the case scenarios, it was noted that some respondents tended to offer more frequent screening tests or colposcopy than recommended by international guidelines.
CONCLUSION: This study revealed discrepancy in the practice of cervical cancer prevention in Asia-Oceania especially access to HPV vaccines. There is an urgent need for a global collaboration to eliminate cervical cancer by public education, reforming services, and medical training.
Fulltext Asian Society of Gynecologic Oncology International Workshop 2014

Park JY, Ngan HY, Park W, Cao Z, Wu X, Ju W, et al.

J Gynecol Oncol, 2015 Jan;26(1):68-74.
PMID: 25609163 DOI: 10.3802/jgo.2015.26.1.68

The Asian Society of Gynecologic Oncology International Workshop 2014 on gynecologic oncology was held in Asan Medical Center, Seoul, Korea on the 23rd to 24th August 2014. A total of 179 participants from 17 countries participated in the workshop, and the up-to-date findings on the management of gynecologic cancers were presented and discussed. This meeting focused on the new trends in the management of cervical cancer, fertility-sparing management of gynecologic cancers, surgical management of gynecologic cancers, and recent advances in translational research on gynecologic cancers.
Oncologist-led BRCA counselling improves access to cancer genetic testing in middle-income Asian country, with no significant impact on psychosocial outcomes

Yoon SY, Wong SW, Lim J, Ahmad S, Mariapun S, Padmanabhan H, et al.

J Med Genet, 2022 Mar;59(3):220-229.
PMID: 33526602 DOI: 10.1136/jmedgenet-2020-107416

BACKGROUND: Identifying patients with BRCA mutations is clinically important to inform on the potential response to treatment and for risk management of patients and their relatives. However, traditional referral routes may not meet clinical needs, and therefore, mainstreaming cancer genetics has been shown to be effective in some high-income and high health-literacy settings. To date, no study has reported on the feasibility of mainstreaming in low-income and middle-income settings, where the service considerations and health literacy could detrimentally affect the feasibility of mainstreaming.
METHODS: The Mainstreaming Genetic Counselling for Ovarian Cancer Patients (MaGiC) study is a prospective, two-arm observational study comparing oncologist-led and genetics-led counselling. This study included 790 multiethnic patients with ovarian cancer from 23 sites in Malaysia. We compared the impact of different method of delivery of genetic counselling on the uptake of genetic testing and assessed the feasibility, knowledge and satisfaction of patients with ovarian cancer.
RESULTS: Oncologists were satisfied with the mainstreaming experience, with 95% indicating a desire to incorporate testing into their clinical practice. The uptake of genetic testing was similar in the mainstreaming and genetics arm (80% and 79%, respectively). Patient satisfaction was high, whereas decision conflict and psychological impact were low in both arms of the study. Notably, decisional conflict, although lower than threshold, was higher for the mainstreaming group compared with the genetics arm. Overall, 13.5% of patients had a pathogenic variant in BRCA1 or BRCA2, and there was no difference between psychosocial measures for carriers in both arms.
CONCLUSION: The MaGiC study demonstrates that mainstreaming cancer genetics is feasible in low-resource and middle-resource Asian setting and increased coverage for genetic testing.