Amid cheers, applause and much fanfare from faculty and delegates, the virtual conference of IAPCON 2021, concluded with the hope of meeting one’s friends and colleagues, in person, in February 2022, at Jaipur, the Pink City of India, the venue of IAPCON 2022.
“I had the confidence that Dr. Umesh Badani and his team could successfully achieve this, and they have proved it” said Dr Sushma Bhatnagar, President, IAPC, full of pride, during the valedictory function of IAPCON2021 on Sunday night at 9.30 p.m. Dr Bhatnagar congratulated the organizing team and the scientific committee led by Dr Umesh Badani and Dr Chandni Sinha, for their hard work towards making the virtual conference a huge success.
Dr Badani mentioned that “my team and I were apprehensive, as there was no role model kind of thing for us to fall back on.. so we were anxious.. but we did it.. we strived to make the scientific sessions innovative, informative and research oriented, while also providing a balance between eduation and enjoyment”.
The conference was organised by Department of Anaesthesiology, AIIMS, Patna under the leadership of Dr Umesh Badani, Dean& Head of the Department of Anaesthsiology. Dr Badani, and his collegues received prodigious support from two other renowned health care institutions in Patna, Indira Gandhi Institute of Medical Sciences and Mahaveer Cancer Sansthan. He expressed profound gratitude to Prof. Prabhat Kumar Singh, Director, AIIMS, Patna; Prof. N R Biswas, Director, IGIMS, Patna; Mr. Kishore Kunal of Mahavir Mandir Nyas Samti, and the innumerable others those who had worked behind the scenes, to ensure that the event proceeded smoothly and without any glitches.
Dr Badani thanked Mr Anurag and Dr Fernandez from Cipla Foundation for their support to make the event a success. He also thanked Troikaa, Modi Munid Pharma, Rusan Healthcare and Verve and the several other medical companies for their support.
Dr Bhatnagar thanked Alpcord Network Event & Conference Management Co for their incredible support towards hosting this virtual event.
The concluding day of the conference was also packed with enlightening and invigorating scientific sessions between 4 and 8 p.m., followed by an excellent free paper presentation session.
Session summaries from Day 3, Concluding day of IAPCON 2021
The scientific sessions for Day 3 began with the session on breathlessness, one of the most common and distressing symptoms seen among several advanced diseases. The session was led by Dr Sunita Daniel, Specialist Medical Officer, Palliative Medicine, National Health Mission, Ernakulam, and was delivered by three distinguished researchers who have done some outstanding work in the field of breathlessness in palliative care.
Prof. David Currow, Professor of Palliative Medicine, Faculty of Health, University of Technology, Sydney, Australia, enlightened with audience as he presented the evidence base for the use of opioids for breathlessness. His presentation also highlighted that guidelines from The American College of Physicians, Chest Physicians and Thoracic Society, which convey the need for using opioids in breathlessness. Dr Currow, said that “Evidence from double-blind randomized trials, of use of Morphine in breathlessness due to COPD and pulmonary artery hypertension, also studies on adverse effects and lack of evidence of other opiates”. Dr Daniel shared that Dr Currow’s talk was so enlightening as he reminded participants of the invisibility of breathlessness, and how people give up activities to avoid breathlessness.
Prof. Miriam Johnson, Professor of Palliative Medicine at Hull York Medical School, UK, talked about the evidence base for cool facial airflow in management of breathlessness including the biological rationale, results of systematic review and meta-analysis as well as findings from various qualitative studies.
Prof. Morag Farquhar, Professor Of Palliative Care Research, School Of Health Sciences University Of East Anglia, UK, spoke about supporting Informal Carers Of Patients With Breathlessness. She presented the results of the ‘Learning About Breathlessness 2 (LaB2)’ study, which is an educational resource developed to help informal carers to support someone with breathlessness in advanced diseases.
Social work and volunteers
The interesting session was lead by MR Ganapathy KV, CEO, JESCAP, and delivered by 5 very enthusiastic social workers / volunteers from the field of palliative care. The session showcased the work done by 4 NGOs and volunteers.
The engaging session filled with practical insights, highlighted the important role of psycho social rehabilitation in palliative care and how these NGOs complimented the services of cash strapped palliative care facilities.
Mr Ganapathy applauded the way the 4 NGOs “went out of their ways ,during lockdown, to bail out the patients in their areas by meeting their daily requirements ftom ration to medicines, offered tele consultation, empowered caregivers through skill building, and provided an interface between private physicians and those patients who could not visit the hospitals due to the restrictions imposed by the government”.
Ms Aneka Paul, Golden butterflies, Chennai mentioned how in addition to providing services, they also facilitated access to service by actually remunerating families to avail their online group therapy sessions by either paying for their bandwidth or towards purchasing a smart phone.
Dr Gayathri Gogoi from Pratisruti, Dibrugarh, highlighted how effective co-ordination between various agencies including government agencies and consultation from various groups helped facilitate access to care during challenging times imposed by Covid.
Dr Priya Kumari from Pain and Palliative Care Society, Hyderabad, and Ms Satya Shree and Ms Jyothirmai from Age Care Foundation, Vishakapatnam expressed how they were both able to continue providing services not only due to the presence of committed volunteers but also due to the support extended by an equally committed team.
Supportive care in Cancer
Dr Priti Sanghavi, Professor and Head, Dept. of Palliative Medicine, Gujarat Cancer & Research Institute, Ahmedabad, was theme leader for the session. The session was delivered by three eminent experts who covered topics related to oncological emergencies and supportive care.
Dr Seema Mishra, Professor, Department of Onco-Anaesthesia and Palliative Medicine, Dr B.R. Ambedkar, IRCH, AIIMS, New Delhi, beagn her session by highlighting the various types of oncological Emergencies and the need for supportive care for oncological emergencies. Dr Mishra then discussd the barriers and challenges in providing supportive care before concluding with ways of overcoming these challenges by integrating supportive care with emergency departments at cancer institutes.
Dr Darshit Thaker, Medical Oncologist, Palliative Medicine Physician, Queensland Health, University of Queensland, Australia, delivered an excellent presentation on “Cancer and Thrombosis: Prevention and Treatment of VTE in Cancer Patients”.
Dr Sanghvi mentioned that Dr Thaker clearly explained the details of risk of VTE associated with cancer, the consensus among guidelines regarding management of VTE in cancer patients, and also identified the greyareas regarding prophylaxis and treatment of VTE in cancer patients, which is very much helpful in one’s day-to-day practice
Dr Geeta Joshi, CEO, Community Oncology Center, The Gujarat Cancer Society, Ahmedabad, delivered a session on “Importance of Prognostication in Cancer Patient”. Dr Joshi defined prognostications, its basis, its dimensions, and factors influencing prognosis using an example of case report. She also touched upon medical decision making regarding prognosis from a legal and health policy perspective.
Quality Improvement (QI) session
The final session for IAPCON2021 was the Quality Improvement (QI) sessionled by Dr. Nandini Vallath, Director, QI HUB, National Cancer Grid, Tata Memorial Centre, Mumbai.
Dr. Vallath began the session with a brief history of how the EQuIP-India (Enable Quality Improve Patient Care) QI hub began. Dr Vallath was also happy to share that the Indian Journal of Palliative Care was going to bring out a supplementary edition, to showcase the quality improvement projects completed by the various teams in India through this QI collaborative.
Mr. Jake Mickelsen, Principal Consultant, Improvement Team, Stanford Health Care, USA, shared his experiences of being a part of QI-hub, India, as a trainer and the impact this initiative had on strengthening India’s health system. Mr Mickelsen mentioned that “Through this QI collaborative, 22 Oncology/Palliative Care teams now had in-house competencies in leading QI projects. 66 physicians and administrative leaders have received training and completed their QI projects and 10 publications have been completed or in review in India and US-based medical journals.”
The session progressed with three leaders from the quality improvement team, presenting their QI project and the impact it had on their respective institutions.
Dr. Shirley Salins, Radiation Oncologist,Manipal Comprehensive Cancer Care Centre, Manipal shared that her team was able to improve pain management for patients receiving curative intent radiotherapy. Through this presentation, Dr. Shirley mentioned how her team was able to alleviate the pain of patients undergoing radiotherapy and sustain their efforts towards continuing the same.
Dr. Rajashree KC, Faculty,Institute of Palliative care, Thrissur, presented how the lack of prognostication affected their patient care services. Their QI project focused on how improving the documentation of prognostication led to improved team interactions, improved confidence among their staff towards discussing prognosis which resulted in overall staff satisfaction.
Mr. Terrymize Immanuel, Nursing faculty from the Institute of Palliative Medicine, Kozhikode presented the third QI project which focused on improving the assessment of the death and dying experience of their in-patients. He mentioned that through this project, they were able to develop a culturally appropriate quality of death and dying assessment, for the Indian population, improve End of life care, and train healthcare professionals in the assessment of death and dying experience.
IAPCON 2021 provided 6 enthusiastic and knowledgeable young researchers with an international platform to present their work.
Dr Jayanthi Iyengar, Department of Palliative medicine, Tata Memorial Hospital, Mumbai presented her work on ‘Parents experiences with prognosis communication about their children suffering from advanced cancer: An experience from a tertiary cancer center in India’.
Dr Amanpreet Kaur, George Institute for Global Health India, presented her work on ‘Effects of Mindfulness Integrated Cognitive Behavioural Intervention (MICBI) with Cancer Palliative Care Professionals: A pilot intervention study from South India’.
Dr Rabiya Abdu Razak Malayil, Junior Resident, MD Palliative Medicine, AIIMS, NewDelhi, presented her study on ‘The Clinical Correlation Between Chemotherapy Induced Peripheral Neuropathy (Cipn) With Deficiency Of Vitamin B12 And Vitamin D3’.
Dr. Nengneivah Haokip, AIIMS, New Delhi presented his study on ‘Effect of oral morphine on dyspnoea in cancer patients presenting to departments of onco-anaestheisa and palliative medicine and pulmonary medicine in a Tertiary hospital, India’.
Dr Sapna Mathew/Joseph, Banglore Baptist Hospital, Bangalore presented her work on ‘The palliative emergency kit, an effective way to manage anticipatory symptoms in patients nearing the end of life in a community palliative care setting’.
Dr Adumala Aruna, ESIC Medical College Hospital, Telangana presented on ‘Methadone versus Morphine for Neuropathic Pain Management in Cancer Cervix: A Randomised Controlled Trial’
Dr Amanpreet Kaur secured the first place in the paper presentation category, Dr Sapna Mathew secured the second place and Dr Rabiya was awarded third place after successfully navigating a deluge of questions from the panel of expert palliative care specialists.
Dr Badani declared the winners from the art category. The ‘Break the chain, break the pain’ artwork secured Dr Wasim Hoda the first place in this category, with the ‘Fight of human kind with the microorganisms’ artwork ensured that Dr Umesh Badani secured the second place in this category.