Welcome Note: Shubhi Kulshrestha from Medical Learning Hub welcomed the esteemed speakers, Dr. Ajay Jain, Dr. Ashish Kumar along with all the participants.
Session 1 : Midodrine Plus Propranolol vs Propranolol Alone for Primary Prevention of Variceal Bleeding in Cirrhosis with Severe Ascites by Dr. Ajay Jain, Sr consultant & Head department of Gastroenterology at Shalby Hospital, Indore. Key Points of the session were:
ClinicalCases : In cirrhosis with severe ascites and high-risk varices, propranolol is often avoided due to hypotension, kidney injury, and risk of hepatorenal syndrome.
Proposed Solution: Combining midodrine with propranolol counters hypotension, increases MAP, and enables safer beta-blocker use.
Efficacy: Midodrine + propranolol reduced 1-year variceal bleed risk (8.5% vs. 27.1%) and achieved greater HVPG reduction.
Safety: Combination stabilized BP, improved tolerance, allowed higher propranolol dosing, and reduced hypotension-related complications.
Ascites Benefit: Better ascites control with higher resolution rates, reduced paracentesis need, and improved diuretic response.
Survival Advantage: Threefold lower bleeding incidence, fewer complications, and improved overall survival with combination therapy.
Holistic Benefit: Comprehensive improvement in portal pressure, ascites management, and clinical outcomes in decompensated cirrhosis.
Session 2 : Management of Hep B in pregnancy by Dr. Ashish Kumar, Professor, Senior Consultant & Teaching Coordinator at Institute of Liver, Gastroenterology, & Pancreatico-Biliary Sciences, GRIPMER, Sir Ganga Ram Hospital, New Delhi. Key Points of the session were:
Global Burden: HBV affects ~254 million people worldwide, causing ~820,000 annual deaths from cirrhosis and liver cancer.
Screening: All pregnant women should be screened for HBsAg early, with repeat testing at delivery if high-risk.
Maternal Evaluation: HBsAg-positive mothers need liver function tests, HBV DNA, HBeAg, coinfection screening, and fibrosis assessment.
MTCT Prevention: Newborns require hepatitis B vaccine + HBIG within 12–24 hours, followed by full vaccine series.
High-Risk Factors: MTCT risk rises with high maternal HBV DNA (>200,000 IU/mL) and HBeAg positivity.
Family & Follow-up: Mothers need counseling, families should be screened/vaccinated, and infants tested at 9–12 months.
Antivirals: Tenofovir disoproxil fumarate (TDF) is preferred during pregnancy for treatment and MTCT prevention.
Postpartum & Breastfeeding: Continue antivirals if maternal disease requires; safe to breastfeed even on TDF.
Complex Cases: Pregnant women with cirrhosis need multidisciplinary care, variceal management, antivirals, and delivery at tertiary centers.
Q&A Session: The session concluded with an interactive Q&A segment, moderated by Dr.Shubhi , where both the speakers addressed audience questions and shared their expert insights.
Closing Remarks: Dr. Shubhi concluded the session with a vote of thanks, appreciating the speaker and participants for their valuable contributions.
We wish you a great learning experience!
Sr. No. | Topic | Faculty | Mode | Time |
1 | Welcome address and introduction | Viatris | Online | 5 Mins |
2 | Midodrine Plus Propranolol vs Propranolol Alone for Primary Prevention of Variceal Bleeding in Cirrhosis with Severe Ascites | Dr Ajay Jain | Online | 35 Min |
3 | Management of Hep B in pregnancy | Dr Ashish Kumar | Online | 35 Min |
4 | Question and Answer, Panel discussion | Both faculty | Online | 20 Min |
5 | Vote of thanks | Viatris | Online | 5 Min |
Date : 11th September 2025
Time : 7:00 to 9:00 PM IST
- General Practitioners
- Hepatologists
- Gastroenterologists
