2018 Conclave with Hands on Course on biopsy diagnosis of Hirschsprung’s disease Departments of Pathology St. John’s Medical College, Bangalore 16th and 17th August 2018

Report of the Conclave

This Conclave with Hands-on Course was organised by the Department of Pathology, St. John’s Medical College (SJMC), Bangalore. Our registration desks opened at the Pathology Demonstration room of the Golden Jubilee Block at 7:45am on the morning of 16th August 2018. Delegates and faculty came in and following breakfast the Conclave took off with delegates filling the Pre-Test questionnaire. We started with a brief session from 8:15-8:45am on the ‘Introduction to the workshop’ followed by a session on the ‘Basics in Hirschsprung Disease (HD): A must know’ by Dr. Usha Kini, the Course Director.

The academic program continued with the session on the ‘Hirschsprung Disease: What is wrong and why? Mystery demystified’ by Dr. Nandeesh BN, Assistant Professor from NIMHANS; from 8:45 – 9:30am. This was followed by a lecture titled ‘How do pathology reviews help in patient management’ by Dr. Sanjay Rao, Pediatric Surgeon from Narayana Hrudhalaya, Bangalore; from 9:30 – 10:00am.
The inaugural program was from 10.00 – 10:30am which started with a prayer song by the Pathology Postgraduates. The lighting of the lamp was done by the dignitaries Dr. George D’Souza, Dean of SJMC; Dr. Tony Raj, Dean of SJRI; Dr. Sanjiv Lewin, Chief of Medical Services; Dr. Marjorie Correa, Registrar of SJMC; Dr. Julian Crasta, Head of Dept. of Pathology; Dr. Usha Kini the Course Director & Dr. Maria Bukelo the Course Coordinator. Dr. Usha then gave an overview of the Conclave along with its history. We had the release of the unique feature of this Conclave i.e the Slide boxes and CDs with course content by the Dean of SJMC who also gave us his message and welcomed the delegates to St. John’s. The vote of thanks was given by Dr. Maria Bukelo. This was followed by a group photograph and high tea.

After the tea break, Dr. Usha Kini delivered a lecture on ‘An approach to mucosal biopsies for gut motility disorders with AChE histochemistry & IHC’ from 10:30 – 11:30am. This session included a video demonstration of the ‘Improvised double embedding technique of biopsies’ conducted by the Dr. Lokendra Yadav PhD, through which the delegates were taught how to rapidly process multiple small biopsies at one time. This session also had inputs on ‘Immunohistochemistry in HD’ by Dr. Maria Bukelo, Assistant Professor of Pathology, SJMC. This was followed by a session on Characterisation of Rectosigmoid HD by Dr. Usha Kini from
11:30 to 12:30pm. Dr. Suravi Mohanty, Associate Professor of Pathology then spoke on ‘Long segment HD & Total colonic aganglionosis’
The lunch break was from 12:30 to 1:30pm followed by the hands-on part of the Conclave from 1:30 to 3:30pm where the delegates had an opportunity to witness the processing of a fresh biopsy for frozen section being conducted live. The delegates were then provided with 2 slides having fresh tissue sections and printed handouts having the protocols to do the rapid H&E staining and AChE staining. Also displayed were 10 prototype histopathology slide sections of various AChE staining patterns and immunohistochemistry stains used in HD. A tea break was taken from 3:30 to 3:45pm. Later 7 case scenarios with the corresponding histopathology slides were given to the delegates for reporting which was to be discussed on the following day. The first day of the workshop ended with demonstration of resected specimens of the various phenotypes of Hirschsprung Disease.

Day two of the Conclave started at 7:30am with a sumptuous breakfast followed by a minute of silence observed in memory of the late Prime Minister of India, Mr. Atal Bihari Vajpayee. The first session of the day was by Dr. Raj Kapur on ‘Chronic intestinal pseudo-obstruction: How do I tackle it?’ from 8:00-9:00am through webinar. This was followed by a session by Dr. Maria Bukelo & Dr. Divya P. where 6 cases of constipation in adults were discussed.

A tea break from 10:30 – 11:00am was followed by a unique Interactive Microscopy session by Dr. Usha Kini where the 7 case scenarios and histopathology slides given to the delegates on the previous day were discussed from 11:00 to 12:30pm This session covered rectal biopsies from neonates as well.

After the lunch break from 12:30 to 1:30pm, we had the much-awaited panel discussion moderated by Dr. Usha Kini on ‘Perspectives from the practice of perfectionists: Currents trends in the diagnosis and management of HD’ which sparked many discussions from 1:30 to 3:30pm. The panelist included the following Pediatric Surgeons: Dr. Santosh Kurbet from KLE hospital, Belagavi; Dr. Gowri Shankar, Indira Gandhi Institute of Child Health, Bangalore; Dr. Anthony Robert, Rainbow Superspeciality Hospital, Bangalore; and Dr. Shubha AM from St. John’s Medical College Hospital, Bangalore.

A tea break from 3:30 to 4:00pm was followed by post-test and a feedback session from the delegates. The workshop winded up the distribution of certificated to the delegates at 4:30pm. On the whole the session was a great success.