OGSSI Thinnai Debate Webinar Series Episode-1

Added: 2026-05-08

[00:00:00]26 to 27 of Oxy to you all. As we kickstart the team's engine in this auspicious Mayday, I welcome our esteemed president of Oxy, Dr. MG Danalakshmi, an academic rainfall we have all been witnessing to deliver her welcome address. Madam is our esteemed president, a vibrant personality and a great teacher. as we all know that she is a professor and senior consultant in Shrihar Chennai. Ma'am, you're welcome address.

[00:00:33]>> Yeah, thanks Sati. I'm happy to kickstart the entire 10 years proceedings with your famous Tina series. You started in the last back end of the last 10 year and it's continuing and you almost kind of standardized it. So people are looking forward to your art series. So that uh shows how much uh hard work you have put into it and uh to help you in this I'm sure like Dr. Dr. Vijakand Sami you are joined as a co-chair person we'll also pitch in your absence if at all you're going to be absent because it's online series so it shouldn't be interrupted at any time and we are looking forward to the great debate between Rahul and Alakman and let's see but anyway everything is learning points whether it's for or against both are learning points as far as teaching profession is concerned as far as our uh practicing clinician is concerned let us hear what both of them have to All the best to both of you.

[00:01:31]>> Thank you ma'am.

[00:01:32]>> Next slide please.

[00:01:37]I now welcome uh for delivering the oxy prayer Dr. Malar Raj our esteemed secretary of oxy. Next slide.

[00:01:47]Dr. Malar Raj is the secretary of oxy.

[00:01:51]She's also the vice chairperson of IG Tamil Nadu chapter and a vice president of Chennai Menopause society and she is a managing council member of IG and our own dear person who made this possible to have the IG Tamil Nadu chapter having been the founder secretary of it Dr. Malaraj.

[00:02:12]>> Yeah thank you so much uh Dr. Sumati for those kind words. So good evening everybody respected seniors and my dear friends. uh so uh it gives me so much of pleasure and also a deep sense of responsibility to welcome you all to this academic webinar of our new team.

[00:02:30]In fact, it is our we are very fortunate to have a very vibrant president Dr. MG Jan Lakshmi madam who's heading this entire tenure and then we all know about her energy level and her dynamic um uh work what she generally contributes to any of the activities which she has been interested on. So as I take over as a secretary, I would also like to express my heartfelt gratitude for the trust and confidence placed in us and also we know that Oxy is stood for his academic excellence, professional integrity also and it is truly an honor to serve this vibrant organization. As we start with this very interesting and very informative webinar and especially the debate by our young colleagues which is always interesting for all our all of us. we come to know many many in fact inputs when they strongly debate on a particular topic. So we'll welcome this uh tenure with this wonderful webinar the by the public awareness.

[00:03:43]Oh her screen got frozen.

[00:03:45]>> In gratitude we pray for your blessings to pass on the reborn. The courage to deal with it all when things are not perfect and to remember that we are but messengers and to keep your kindness and make Okay. Thank you Dr. Mala.

[00:04:19]Thank you.

[00:04:23]So, uh, next slide please. Yeah. So, it gives me a great honor and pleasure to introduce my beloved friend Dr. Sumati Premanand, the current treasurer of Oxy, the key person who make going to make sure that the Oxy runs full-fledged without any difficulty when we have so many programs lined up in Akiti. So she is the current medical director of Darian fertility and women's medical center honorary treasurer of course sen coordinator of public awareness committee Foxy past co-chair of the women's doctor wing IMA past secretary council member of IMA speaker at various national and international conferences and her special interest are in reproductive medicine. So aa a apart from her academic acumen she is a good poet a traveler and also a blogger which all of you would have um experience the tinge of it in our oxy uh groups that is the nonacademic groups where you can see her multifaceted personality of the um of Dr. Sumiti Preman. So over to Dr. Man. That is so kind of you take over the webinar. Yeah thank you. That is so kind of you. Uh thank you Dr. Malaraj for coming and joining us during your work. And now as we go can we have the next slide? Yeah. So the tagline of the public awareness committee is ignite influence and impact which we very strongly intend to do in this vital arm of PAC which is the thin debate webinar series which was launched last year and has a widespread loyal audience who log in to watch the tough debates. Thini as in the raised platform or veranda is found in the traditional south Indian homes. It serves as a social transitional space for interesting conversations and sparkling debates. We are going to experience the same here.

[00:06:17]Can we have the next slide? This time we are going to have a very very interesting topic and this time we are so happy to have a co-chairperson in Dr. Dr. Vijay Lakshmi Kandasami who is the professor of Chhattinard Hospital and research institute in the department of obstetrics and gynecology. She is she is our beloved joint secretary of oxy and is also an EC member of the Chennai menopause society. Next slide. And then we have with us our uh moderator Dr. Deepti Jami. She is the director and director and fetal medicine consultant in Jami scans and is also a senior fetal medicine consultant in Anurada maternity center and a and cavary hospital. Such vibrant personalities are joining us today. Next slide we have with us our chairperson Dr. Dya Rabikumar who is the director of the link fetal medicine and imaging center in Chennai. Both Dr. Deepti as well as Dr. Diva are our uh nexus oxy uh pack members and now we have uh our proponent who is Dr. Lakshman Sati Kumar who is a senior resident of department of OBJ Ramchandra and then we have our opponent who is Dr. Rahul Lan Kaga Sabapati who is the assistant surgeon of government Kamraj Hospital Chidamarram Tamil Nadu. They have been giving us tough fights all these months fighting amongst themselves and giving us a lot of information as well as a bit of fun over it but deep felt knowledge. So glad to see you all.

[00:07:51]Let the proponent begin.

[00:08:10]One moment.

[00:08:12]>> Yeah, we are able to see the full screen.

[00:08:15]>> All right. Okay. Thank you for that. And I'm so happy to start off the first uh webinar and the first series of debates for with under team Oxy 2026 and 2027.

[00:08:27]And I'm sure this is going to be a very interesting topic, a topic which is very close to all of our hearts as doctors who have decided to treat only women specifically pregnant women as obstitricians. And I'm here to say that the PCP and DT act prior does prioritize documentation compliance and regulatory control over its core objective. As a society, we fall back on praying to female gods for prosperity, knowledge, safety, protection, peace and it's not just one particular faith or religion.

[00:08:59]It's something we see all around the world and we are always thankful and we celebrate uh women who have achieved let it starting from medicine to sports and world peace and freedom fighting the list is endless. But unfortunately and please keep in mind that we are a society where we are consistently taught to respect our mothers, grandmoms, aunts, sisters like gods.

[00:09:23]But unfortunately the same society does resort to murder of the female child either in the womb or after birth.

[00:09:31]Infanticide was first documented in 1789 by the British Raj and in 1871 they uh they have documented that the sex ratio was 940 females per thousand males. They subsel infanticide in 1870. However, there were difficulty enforcing this as most were home births and in 1970 with introduction of ultrasound there was a major drop in the gender ratio and it dropped to 800 females per thousand males and the government had to do something about it and they came up with the PCPND act in 1994. It was a decisive action which enact which was enacted to ban sex determination, regulate ultrasound. Later on, it was amended to incre in include the preconception sex selection and increase penalties.

[00:10:16]The PCP andd act is necessary. Please don't get me wrong. I am not anti-law.

[00:10:21]I'm just here to say that it does have a symbolic and deterrent value, but it needs a lot of reform as far as implementation is concerned. And I certainly do not feel that it focuses on the root causes.

[00:10:34]Looking at the sex ratio in India, we are now in 2020 and our country has grown by leaps and bounds. However, our sex ratio at birth is still 930 females per thousand males and we are yet to breach or improve on the 1971 uh sex ratio after nearly 30 years of strict PCP and DDT enforcement. India sex ratio is still at 929 and this is well below the natural range of 950 to 970 which is what recommends. So this is a failure at the level of birth and not survival because you need to understand that the overall sex ratio in India is almost even which means that women are surviving but girls are still being selectively prevented from being born.

[00:11:17]And what is the scale of female feticide? I did not expect the numbers to be so high to be uh very genuine.

[00:11:23]Preparing for this uh debate was very difficult and I had to find myself feeling a lot of anger a lot of disappointment. We are estimating 1 to 1.5 million sex selective abortions every year. This is in one year. And there estimates that there are 9 million missing girls from our Indian population between 20 to 2019. SRS 2023 estimates that 3.5% of our female population is missing. We are dealing with millions of millions as far as numbers are concerned but the enforcement still remains form ccentric.

[00:11:56]The UNICEF feels that there is a worsening situation in 80% of India's districts. The 2011 census claims that the ratio is 943 females per thousand.

[00:12:05]However, UNICEF contests this and says that it's only 914. So, is ultrasound the culprit? Well, if you ask me as an obstitrician, I believe that ultrasound is possibly the single most important advancement in obstetrics in the last 20 to 30 years. It has definitely been a gamecher probably leaving out medical conditions like PI and GDM. Ultrasound pretty much helps us diagnose everything as far as especially as far as the fetus is concerned. Lyker, placenta, you name it, ultrasound. We are highly reliant on ultrasound. It is integral and synonymous with obstitric and high-risisk obstitric. However, because of the act, we do have difficulty with reporting genital abnormalities. Though there is a provision to get a permission from the district medical uh director.

[00:12:48]Uh however, this may not be possible in all situations and the access may not be available for everyone. Ultrasound also has far-flung capabilities as far as all other fields of medicine are concerned.

[00:13:01]PCP anddt aims to prevent sex selection.

[00:13:04]However, in practice, it does emphasize on documentation, compliance and regulatory control at the cost of achieving its core objective. There is an intent versus implementation gap and it focuses on the process rather than the outcomes and we have drifted towards paperwork policing instead of preventing sex selection and feticide. The goal is to prevent misuse of ultrasound for sex determination and correcting the skewed ratio. But in reality we are focusing on form F completeness. Whether the forms are correct, whether all the data is there, whether registration technicalities have been followed and clerical errors carry criminal liability.

[00:13:42]And we are overcriminalizing the documentation error. It could be some something as simple as a missing address or a signature mismatch and small documentation lapses are treated as presumption of guilt. For a patient who comes for the scan, they sign the form because they want to get the scan done and go home. So minor clerical mistakes carrying severe penalties such as sealing of machine, suspension of registrations and criminal prosecutions.

[00:14:05]And these clerical errors do not necessarily mean that sex determination is happening. However, it is similarly punished and a regulatory overreach means there is fear-based practice, defensive medicine. People want to avoid obstetric ultrasounds. They feel it's a headache for them. There's reluctance to open and operate scan centers especially when we have such a high pop population and there is hence there because of this there is a reduced access to antal care and early early anomaly detections especially in peripheral areas.

[00:14:36]So it has had a weak impact on the actual sex ratio and we are not addressing the root causes such as the deep-seated patriarchy, social bias, socioeconomic pressures, the dowy system, people's delusion over the abilities of a boy, child, inheritance, rituals, preference for a son. However, none of these are addressed by documentation or form F or in the scan room or by auditing the number of scan machines which are there in a hospital, which room they are in, who is using it.

[00:15:04]We are trying to solve a cultural socioultural problem or pathology with clerical surveillance.

[00:15:12]We have misplaced the informance uh the enforcement priorities. We're monitoring the registers forms and machines while we're not monitoring the legal network, crossber sex determination, the unregistered operators and hidden ultrasound users. So it targets the compliant practitioners and it misses offenders.

[00:15:31]So compliance anxiety has increased and it has definitely had an impact on clinical responsibility. Hornest radiologists and obstitricians face inspection and raids. This is a very recent article from uh economic times where you read the synopsis and it says medical professionals must receive better ethical guidance. We are basically a profession from the beginning. We are we are taught to care for other people, stay up through the nights and work for them. And what does a leading tabloid write? It's really shameful that the tagline is medical professionals must must receive better ethical guidance as if we are the reason for so many mistakes which happen in the uh med in medical practice.

[00:16:14]And speaking of another uh this some this is something which happened in Hana where the where the sex ratio was very less and the government has been working very hard and they have been improving the ratio. How we're looking at some one of the solutions that the medical officers have been asked to explain the reason for a low sex ratio at birth and the medical officers of three CHCs with the lowest sex ratio at birth will be chart sheeted. This sounds more like an incentivized based pattern where you are counting the number of forms and registration of some of the centers was canceled because of delay in re-registration or not having completed forms. There is always a chance that a patient goes to an illegal center or uses another method and has an abortion somewhere else and the medical officer has absolutely nothing to do with it.

[00:16:58]But however, you're still penalizing the medical officer. So filling form F does not change gender bias. It does not prevent sex determination. Documentation is definitely a record, but however, I really do doubt if it is a deterrent.

[00:17:12]So time and energy is rather spent on paperwork, legal compliance and fear management instead of patient care, counseling and ethical practice. So are we going to determine how many girl children we have saved by the number of forms filled or by the number of girls which are born. So when process repeats purpose even the best laws lose their way and if sex selection was truly controlled I believe that the sex ratio at birth would normalize and it certainly hasn't. We would see high detection, high conviction and elimination of illegal networks.

[00:17:40]However, we are seeing low reporting, low conviction, continued gender imbalance alongside increased scrutiny of documentation and this is misdirected enforcement.

[00:17:50]The National Family Health Survey 5 states that seven states in the country have a sex ratio at birth less than 915.

[00:17:57]There is a huge divide below 950. Pardon me. There is a huge divide between rural and urban populations and also among the states in our country. PCP and DT is definitely necessary but it has to be expanded and implementation has to be better. It targets the supply and not the demand which is societal bias. The problem is not just illegal ultrasound.

[00:18:17]It is the legal patriarchy that no one is standing up against. The same law produces very different outcomes across states proving that documentation is not the determining factor. The decline does correlate with the introduction of ultrasound but rather it's not the technology which is a problem. It's the misuse of the technology and a misuse of completely normal test results.

[00:18:38]When you compare between the states and different regions of our country, you will find that areas with better social development outperform strict enforcement.

[00:18:47]Tamiladu itself did have rampant female feticide and infanticide in the 80s and '90s. But now we have grown to have one of the better sex ratios in India. And this is because of social schemes, education, awareness, not just the PCP and DT. And it is also because of social interventions and a social change.

[00:19:06]This is an older paper in the British Medical Journal but it does uh it does mention that sex specific abortions could not be explained by availability of medical resources, religious backgrounds, economic growth, education or sex by bias and nality and there is a difference between the different regions of our country and the PCP. What about the enforcement data? We have only started tracking it in 2014. There is massive under reporting and there's a large gap between the cases registered versus convictions. Cases registered itself are less convictions are even less. So if enforcement is wrong why are convictions so so weak. These are the number of cases which have been registered for feticide less than almost 220 or 230 every year. So action pattern as already mentioned is sealing of machines suspension of registration raids and inspections. However, we have many illegal uh rackets which operate uh outside the uh the uh the boundaries of law. So the law is strict where it is visible and it is ineffective where it matters. The ars often includes doctors, technicians and clinical operators and there is no clear national data separating documentation error and the actual sex determination.

[00:20:20]And as already mentioned, sex abortion does happen outside the regulatory system. And we I have some more evidence for that. And the consequences for this are unsafe abortions. MTP becomes another problem. Not to forget in many areas of the country, we do see papaya stick and these kind of things happening which severely harm the life of the lady. We track paperwork, but we're not able to track the maternal harm which happens from illegal and unsafe abortions.

[00:20:46]There's also a preference even among unfortunately even among women uh for male childs. Two only 2% of mothers want more daughters than sons and at 85% of women want at least one son. Though the demand for a son has declined over four decades, someone preferring a daughter over a son has marginally increased or there has been no increase at all. Now let's look at this is an 2016 article in the times of India where the then union minister for women and child development Mrs. Mayaka Gandhi suggested that sex determination of the fetus must be made compulsory. That is you have to determine the sex of a fetus with a girl child. It did cause a storm at that time. But hypothetically think about it if we did make it mandatory in an anomaly scan that you mentioned the gender of a fetus. What could happen? It allows more regulation. We it does cut down. Nature has its way of balancing.

[00:21:37]We can cut down to 50% of target population who have to be monitored who have to be counseledled that both boy and girl child are the same and nothing is different. Probably we can even do we can say that women are superior in so many ways. It allows us to track monitor and it might not be such a bad thing.

[00:21:58]So since the implementation of PCP and DDT act over 20 years, we're seeing an average of 80 machines being sealed, 110 cases a year, average of 15 convictions and one conviction in every seven cases and an average of five medical suspensions and we're seeing a lot of centers which are shut down. So Hana shut down 300 uh MTP centers in 2025 and recently they have shut down more scan centers. What it and this is mainly because they didn't comply with the norms or forms were not filled.

[00:22:24]Unfortunately, these are registered centers and what happens is you are actually reducing the access of the patient who actually needs a medical care.

[00:22:32]So a pure research center does find that it's very it's really sad that only a slim majority of Indians say that sex selective abortion is unacceptable. 40% feel that it is strongly acceptable and slightly more uh Indians say it is important for families to have at least one son than at least one daughter. So these are all social bias all over the country and this is a since this is something to do with the law there are a lot of publications on law journals as well a 2021 2022 report by a parliamentary committee states that over 25 years of the law there's only 617 convictions 18 of the 36 states and union territories have not registered a single case this is the Indian parliament and please note that in September 2025 Five, the Karnataka Health Department together with the health department in Andhra Pradesh were able to track and dismantle an illegal network which was carrying sex selective abortions in the country.

[00:23:31]This was something which was completely outside the purview of the law. Not in any registered center but a bunch of people running an illegal criminal business. And they this the set of lawyers who wrote this paper also note that the effectiveness of the PCP andd act is hampered by several challenges and they feel it is crucial to adopt a multifaceted approach.

[00:23:51]And though the authorities are given the power to investigate and conduct trade, they do not have the power to arrest anyone under this act. And the power to arrest only comes with the police which means that we do require more integration and uh uh and cohesion among the various departments of the law.

[00:24:10]So the sex ratio has is also falling in cases where there is one previous daughter it is only 720 per thousand boys and whenever someone has two previous daughters it is 178 per thousand. Whereas for someone with one previous son the sex ratio is, 2017 girls to thousand boys.

[00:24:30]Not to forget even other departments are affected because all their machines have to be registered under the law. And there was an an paper in the Indian journal of anesthesia saying that it is time to change the mindset rather than the law because all their machines also have to be have to be registered and they are not able to have easy access and that means that there is we are denying advancement of medical technology. Imagine if we could use these portable probes. Not only would it bring down the health care cost as the probes cost much lesser than an entire system, it would work wonders in for an emergency setup and also in peripheries where you can deliver uh uh immediate quick care to someone who needs it.

[00:25:12]And not to forget these are machines that you would probably see in an American series such as the pit or uh Grace Anatomy blah blah blah but it doesn't happen in our country. So patients lose a lot of time coming from home to the hospital and having to undergo the ultrasound. And speaking of our own legend Sur who himself recognizes that uniform implementation of the act has been challenging and the act has to be simplified without restricting spreading the knowledge of ultrasound and sex change or gender ratio alteration will only happen when we think out of the box. Doing ultrasound alone is never going to improve the sex ratio.

[00:25:50]And it's not just India's problem. Uh this is a problem in many part of the world. We do have a lot of gender bias in China, South uh other South Asian countries, in Africa and even in certain societies in the west.

[00:26:05]Unfortunately, this is something we'll never get to do. A gender reveal party which is supposed to be something which is beautiful where we celebrate the new life and welcome the new life and look forward to it. And it's time I think that we change our mindset and focus on what is rather important. I'm look forward to what my opponent has to say.

[00:26:24]Thank you.

[00:26:26]>> Thank you Dr. Lakshman. How what beautiful slides. I think um we were blessed by the presentation to start off this thing and you've done a great job.

[00:26:36]Now equally good and to give a tough fight. Now we call upon our uh opponent who is just waiting to jump into the arena to start off the fight. Dr. Rahul, are my slides visible? Madam, >> no, not yet. Maybe you have to reshare.

[00:27:17]I am sharing my screen.

[00:27:19]>> It said you are sharing the screen. Uh maybe it is coming up.

[00:27:28]>> Yeah, go full screen.

[00:27:39]Yeah, go full screen.

[00:27:43]One matter.

[00:27:44]>> Yeah.

[00:28:01]>> Is it visible now madam?

[00:28:03]>> Yes. Off you go.

[00:28:05]>> Yeah. Good evening everyone. After that wonderful uh proposition by Dr. Lakshman, I'll be taking over the opposition. So the core objective of the PCP and act is still prevention of prenatal sex determination and female feticide.

[00:28:19]So this is a snapshot from the news articles for the past 10 days. If the PCP act was weaker, what would happen in spite of having such a strong act? We have so many cases of prenatal sex determination happening. One in Rashidapur, one in Mandia, one in Fathabad, one in Indor. These are all are the news articles which were reported in the last 10 days. So many violations are happening and mind you these are not the illegal unqualified quack squad are doing. These are all qualified sonologists and gynecologists who are getting caught. So let us see what the act has to offer minute.

[00:29:17]not able to hear you Rahul.

[00:29:23]Your slide is there but we are not able to hear you.

[00:29:26]>> I think his screen has frozen and he's trying to work it out now.

[00:29:30]>> Yeah.

[00:29:31]>> Yes madam. So beyond documentation, so what is this PCP and act all about?

[00:29:37]It is about enforcement of prenatal sex, prevention of prenatal sex determination. And this argument should be more structured about what is the reality and what is the perception of the sonologist and the crux of the act is about protecting the girl child. So the regulatory design of the act matters a lot. So let us have some evidence-based arguments because a structured compliance will definitely strengthen deterrence to sex determination and increase the accountability from our side.

[00:30:09]So the core position of my opposition is going to be the following. Documentation is the backbone of enforcement. There is no other way we can trace and find out misuse. The law is a prescriptive law and it is preventive in all its aspects and strict compliance with the law will build deterrence towards sex selection.

[00:30:28]A weak execution of the PCP and act in its current form doesn't imply that the act itself has a flawed design. So what does this PCP target? It targets specifically the sex selection ecosystem and it precludes the misuse of technology. It aims at providing accountability from the providers and it uses the records as a surveillance tool.

[00:30:48]The deterrence is through visibility.

[00:30:50]That is why everywhere the PCP act is displayed in perview for the public and for the providers themselves. So why does documentation exist? The documentation will create a legible audit trail which we can defend in the court of law and it will link the patient to the indication of the ultrasound. It will enable inspection by the authorities at any given time of the day and it'll detect pattern. So whenever there is a reporting of sex selective abortions or a prenatal sex determination, we can jolly well go back to the scan center and verify the documentation and it will definitely help us in supporting prosecution and in defending our own providers. So without documentation what will happen? There will be no traceability. There will be no accountability and there will be absolutely no evidence. all these illegal scans will be hidden and the system will collapse on itself.

[00:31:38]So the law behind making this PCP entity as a preventive law is it aims at pre-violation control. So we want to catch them before the sex selection happens. So it is a very strict liability model and the punishments are very stringent because the aim is to deter sex selection through fear. It will it will reduce opportunity if it is strictly followed and it is framed with the overall public health in mind rather than a single provider. So moving on to the fall in sex ratio or the in despite having this PCP and the sex ratio hasn't significantly improved. The sex ratio fell because people did not have access to knowing the sex and consequently they couldn't do a feticide. So from the 1970s despite having the origin of the PCP and act the sex ratio started to rapidly fall but once the implementation started improving the sex ratio did show improvement and the sex ratio is just does not end at the selection phase itself. It is a multiffactorial problem.

[00:32:35]The cultural bias still persist. Child sex ratio is even worse than the sex ratio at birth. Why? Because female children are neglected. They don't get proper nutrition. They don't get timely healthcare. So the single law of the PCP act alone is insufficient. The lag effect exist way till puberty and even across marriage. So but still despite all of this regional improvements do exist even with the PCP and act alone.

[00:33:00]So let us take the example of Hana. In 2011 the sex ratio was 819. It improved in through decades in the next decade to 834 and in 2016 it reached 900 and in 2019 it became 923. That is a remarkable difference and this happened because of a strong enforcement and Laxman was so worried about the three medical officers of the bottommost uh sex ratio will be given a charge sheet. I would like to clarify that these are all legal terminologies and you cannot just charge the doctor just like that. You cannot even file an FIR.

[00:33:35]Let go to the extent of a charge sheet.

[00:33:36]A charge sheet is filed only after the investigation is complete and only when the police can clearly prove that there is ample evidence to suspect the medical officer involved only then will be he added as an accused and a charge sheet can be framed. It cannot just like that be randomly uh you know be given at the office level and the charge sheet can be named at the medical officer. It is there just to act as a motivation and just to act as a reminder that this is a very strict law and we are supposed to oversee the implementation of the act and we should take responsibility both moral, ethical and most importantly legal. So a result of combined inter interventions and a strict documentation enabled tracking and the state has definitely showed success from a sex ratio of 819 to an improved sex ratio of 923. I'm not claiming that it is optimal but still we have made progress and coming on to the harassment of doctors I I do agree I even read yesterday there was a case for which a judgment had come 19 years later a gynecologist scan center was closed her her license was withdrawn and she was undergoing so much turmoil the regional court ruled in against her favor so she had to go to the supreme court and from 2006 to 2026 it it took 19 years for the supreme court to acquit So again the premise was clerical error.

[00:34:56]Her signatures didn't match. So all these harassments do occur because they exist in pockets and these are due to process gaps and they are not an inherent design flaw of the act. This is more of an administrative issue that I would even go ahead and say that it is more of a human behavior issue. Whenever given power humans in inevitably tend to abuse it. Quoting Laxshman's favorite dialogue with great power comes great responsibility. So our administrators are the ones who need more training. The act in itself doesn't need any reformation. So what is the Supreme Court's view? Time and again repeatedly people have represented to give more leverage to the PCP act. But the Supreme Court has strictly held that the complaints should be upheld. It has still not relaxed any of the documentations and it has mandated that the form FB be completed in real time because this is in the interest of the public health at large. the all the courts including the Supreme Court the AEX body of regulations supports the act and make sure that the enforcement is valid. There is a delay in justice and this is not a systemic issue and neither is it PCP entity specific. Any issue you take it to the court of law be it civil or criminal has its own time. So for that we need to have fasttrack courts.

[00:36:08]Trust me even the most sensitive pox codes drag and even the courts where I go to give evidence are dragging till 10 12 years and still the verdicts haven't come. So the legal system needs reformation not the act in itself and the other specialists have also been included like the anesthesiologists have to get a license for giving blocks the cardiologists have to get a license for doing echoc cardiogram. So this creates a lot of disgruntlement against us as gynecologists and sonologists and against the laws legal system as well by the other specialist. This has to be taken with a pinch of salt because technology misuse risk is still there even if other specialists operate. You might remember the famous scandal that happened in Thirvan Malay a couple of months ago. The person involved was neither a gynecologist nor a sonologist.

[00:36:54]Any access point which has an ultrasound definitely matters. And this act including the other specialist will effectively close all loopholes. It all it ask is some more accountability, a little more dedicated time in filling forms and more transparency in cooperating with investigations. This ensures coverage and it strengthens our surveillance. So fast machine restrictions I really want to burst Laxman's bubble. These fast tag machines are definitely not going to come anytime in in the near future to our public sector where every patient like in my center a patient has to come 40 kilometers to get the conventional ultrasound. So let us be realistic. Let us address the more important issues.

[00:37:35]Let us take the elephant out of the fridge and then we can put the giraffe back inside. Portable use definitely will increase the risk. Mobility will lead to anonymity. So documentation is more critical. Fast machines, portable machines should have a stronger documentation and I feel that the regulation is justified. It might need a little bit calibration and tweaking but we will leave that to the legal authorities to decide. So the documentation versus intent just like the last two debate of quality the intent matters but documentation is the only proof of intent. It records intent as proxy. We can dedect patterns if we are documenting and missing data is viewed as suspicious and most importantly the documentation is a legal inference tool.

[00:38:17]There is a a point of contention between the MTP and the PCP entity act. They have different objectives and the overlap is definitely manageable. There does need a there is a need of a clarity between the protecting the constitutional right of the woman in the MTP act and protecting the unborn female child in the PCP and DT act. However, that doesn't call for a dilution of the documentary requirements and the regulatory framework of the PCP and act.

[00:38:42]Harmonization is required. More clarity and more awareness both from the providers and from the medical beneficiaries is definitely essential to understand the intricacies of the act.

[00:38:52]So, moving on to the infanticide argument. One might argue if the prenatal sex selection is banned, they will kill off the girl child. So, that is a separate crime and that has to be targeted at a social reform. That doesn't negate the need for the PCP and act. It has to run in parallel.

[00:39:08]Prevention of female feticide can be taken care of the PCP and act. We have a host of criminal laws for female infanticides. And this is a multi-level policy decision which will require all the stakeholders to combine together and come to a conclusion. Moving on to a global perspective, PCP is not specific to India. Many countries like China, Korea, Nepal, all of them, most of the Asian countries where this cultural prejudice against girl children exist have similar restrictions. Even in the UK where prenatal uh sex determination is still not illegal, but sex elective abortion is illegal. You cannot just go and claim that I have a girl baby, I want to abort. I'm not happy with the sex of the baby. And even in the United States, it is forbidden. So documentation is central to all ultrasounds everywhere around the world.

[00:39:53]And traceability is made as a standard.

[00:39:55]India has aligned with the globe in this perspective and high-risisk control of prenatal sex determination is paramount in India with the falling sex ratio compared to the other laws. See every law will have its own loopholes. Given any law the human mind instantly criminalizes and look for looks for black holes and tries to criminalize.

[00:40:15]Drugs are banned in India. You think cannabis is inaccessible. Look at the organ transplantation act. It has a very strict 30page form. You think trafficking doesn't happen in that area.

[00:40:24]The nako is very strict. MTP is so strictly regulated. What about septic abortions? They are the fourth leading cause of maternal mortality in India.

[00:40:32]The what all these laws have in common is compliance right from the provider and from the public. The public compliance will take time with awareness campaigns like our own thin series webinars to happen. But the provider [laughter] compliance can be a bit more faster and it all requires all that requires is a change in perspective. The high stakes in all these acts including the PCP act justify the rigorous documentation that is expected from us. So misuse happens in all laws. Loopholes exist. The miscreants adapt and the law also adapts and evolves to handle this miscreants.

[00:41:07]So this is an ongoing process which will go on and on and on till the limit of human intelligence that doesn't call for dismantling the act and reducing the documentation integrity. All we have to do is strengthen the monitoring and increase the provisions of the law. The documentation is there to protect doctors. It is a legal defense. It shows indication. It prevents registers from getting accused in false cases and it shows a transparency. We can be proud of our documentation and once it becomes standard practice, it will not seem as an extra burden. Come on, we have been using UPI right, left and center.

[00:41:41]Imagine how it was when it was implemented. It was very difficult to adapt. But now every flour vendor and every milk vendor uses UPI for their transactions. The documentation also once it falls into routine practice will be adaptable and it will not be as difficult as my dear Laxman portrays it.

[00:41:56]I do agree operational gaps like in any other system also is there in PCP andd act. There is an inconsistent enforcement. There is a poor training.

[00:42:04]Manual errors are bound to happen.

[00:42:06]Clerical [clears throat] errors are bound to happen. But we should be in a position to explain ourselves and establish our innocence. delays right from the judicial system to the administration also happens and we are far far far away from digitalization.

[00:42:19]This pen and paper trail is still a very big menace and a nuisance to us. So what are all these strategies and reforms we can do? Instead of diluting the act, we can opt for a digitalization of the farmf and we can use the artificial intelligence to do a tracking and the inspections can be risk based instead of random uh inspections and in instead of having personal vendetta against a particular provider. Standardized protocol should be given to the administrators and they should assess it with a sense of clarity and purpose and not merely with a sense of vengeance and punishment. The guidelines should be more clearer and periodic seminars and symposias and continuing medical education program should be given to all the providers both in the public sector and in the private sector to improve and administrative accountability.

[00:43:05]The administrators and the inspectors who are in charge of enforcing that should apply their mind. They should distinguish real lapses from minor clerical errors and the penalty should be proportional. You cannot just close down a scam center for so many years together and the internal review should happen. Even the courts have agreed that the administrators should apply their mind before identifying and penalizing the providers and arbitrariness should be reduced with internal reviews. Graded penalty should be offered to the providers who commit lapses minor or major. A warning should be issued first.

[00:43:37]Monetary compensation can be asked for next and for repeat offenders suspension can be charged and if the intent is criminal they can be penalized. So this will ensure a fair and transparent system.

[00:43:49]And uh why are the conviction rates so low? Come on. The convictions rates are so low across all crimes. Take sexual offenses. Even then only 2% of sexual offenses cases are getting convicted.

[00:44:00]The law especially Indian law sincerely believes that thousand criminals may go scot-free but one innocent should not be punished. So that is why the system is still struggling. So that calls for a legal reformation rather than a reduction in documentation. So we should improve our capacity building. We should train our administrators. We should train our clinicians to understand the nuances of the law. It is no longer a separate topic. It is should be embid in medicine right from the undergraduate curriculum. And the checklist like Atul Gawande clearly says the checklist and his checklist manifesto. An audit checklist will enable us to clearly identify any lapses. Legal literacy is very mandatory because the survey conducted among providers 80% of them were not aware of the nuances of the law. That is no excuse. The moment a bill is passed as an act in the upper houses, every Indian citizen irrespective whether he's a medical beneficiary or a provider is expected to know the law. I do not know I did not realize that this law was in place is no excuse. Even if the law is implemented yesterday night, we have to be aware of it by today. That is what the system expects us. This capacity building will reduce the conflict at all interfaces right from the interface between the patient and the sonologist from the sonologist and the administrator and the administrator and the legal system. So digitalization as I already told is a very valid tool. We can make it online.

[00:45:16]We can make it uh we can use take the use of softwares and get it auto validated. This digitalization will help us in building dashboards which will help us to do real-time tracking and this can reduce errors mainly these clerical errors. And once we have a central database, our senses also will be better. So moving on to a societal bias, the gender bias is very deeply rooted. Eliminating patriarchy is going to take few more decades. We are slowly progressing but still there are pockets which need our specific focus. Economic empowerment of women is still happening but behavioral change does hap have [laughter] to happen and our generation should be the flag bearers of this change. The community's role is very very important because most of these sex activities and in infanticide have a strong role of societal pressure. So as providers it is our medical duty to prevent misuse and to comply with the PCP entity act regulations to earn the patients trust and to offer social accountability and ultimately ends up in our ethical responsibility. So my final position will be documentation is quintessential according to the PCB and act and it will go a long way if not in upholding at least in balancing the uh sex ratio. The design is sound the operational issues are existing reformation is needed but this does not call for a weakening or a slackness in the PCP and act to close my argument.

[00:46:41]The PCP and act is protective the enforcement however is imperfect. That's because the society at large itself is imperfect. We are all mere mortals. So a structure is needed and accountability is the vital crux point of the PCP act.

[00:46:55]Documentation is the memory of the law.

[00:46:58]Every entry in a register is not a burden. It is a barrier against exploitation. So quoting Gangu Katyawadi. So pardon my Hindi because it's not my native language. She says in a scene which roughly translates into so this comes from a marginalized commercial sex worker. Even she is proud of her femininity. So we as providers should put our pens down and please fill that form F and ensure no documentary lapse happens. I would gladly fill thousand form FS if one unborn girl child lives and becomes a gynecologist in the future. So I leave you with that thought. Thank you.

[00:47:47]>> Wow. So this is a good fight and a good fight is always great to watch. Your opposing views are very enthralling and uh we are very as impressed as how we were impressed with the proponents uh views. Both of you are such powerful speakers. And now let us listen to the proponent's rebuttal on what you have told. Lakshman, >> I'd like to appreciate my opponent for the lines of his uh uh of of how he handled his talk and all the points he had. Please take the background in this with a pinch of salt.

[00:48:25]I just uh found the loud uh the lighter side of it and I put it up as a background. Starting uh with I first want to appreciate certain things. I would like to thank uh Dr. Rahul for mentioning digitalization, AI tracking, proportional penalty. Yes, I believe in all of this and maybe I might also add what about uniform pregnancy monitoring.

[00:48:46]We have 27 million deliveries probably you add the MTPs and all that probably there's another 10 million more or so instead of a statewide registration have a common national registration and also uh have the formats monitored on that have the scans monitored on that. It is possible to do it when we are very successfully implemented as you said UPI Aadhaar PAN card I'm pretty sure we will be able to the government of India does have the capacity to do that so capacity building does become important however I do not agree with many of the other things you said you did say we are all mere mortals at the end yes we are mere mortals but I don't see how murder or uh you know that's what I would like to call it I'm sorry if you know someone does not agree with the term but how murder is justified in any form. Uh and most and I also want to point out in many parts of the debate where you spoke about dismantling the law, you you had such a defensive tone and you yourself do realize that though the law is necessary in its current form, it has just not done enough. The numbers are not good enough and it has certainly not done enough and the government also realizes that. That is why in 2015 they launched the save the girl child educate the girl child the bi bacha bi paraw in English. Might I add you should really consider translating Hindi into Tamil because I have absolutely no idea of any of the words in a single word in Hindi.

[00:50:10]And you did point out some examples of someone being acquitted after 19 years which is basically their entire career.

[00:50:17]At least this particular person got their justice after 19 years. Think about the number of people who have been wrongfully uh convicted and they have going through the punishment for it and they're carrying the u and they're carrying so much of insult and and they're being neglected from society.

[00:50:38]So strict documentation is necessary to prevent misuse. However, disproportionate punishment is irrational. We have to differentiate clerical error and chem criminal intent.

[00:50:48]As you already mentioned, regulation should be intelligent and not discriminate. Sex ratio has improved due to the act is not uh right. It is multiffactorial. Dr. Rahul, let me ask you a question. Both you and I have gone to school, college, the kind of society that we have gotten to grow up in to interact with. Do we feel that gender bias is an actual thing? Honestly, I don't feel it ever existed in whatever part of society that I have grown up in, which just means that our society has so much of a difference. And it's very unfortunate that even now with all those media platforms and all the uh female achievers all around the world, most of our teachers in school are women, all men and uh all boys and girls alike are taught by uh by female teachers. Most of the time we owe our knowledge to them, not just to goddess Saraswati. However, most of the time I still feel that it is a social problem. And where is the direct evidence linking form of compliance to improve sex ratio? You're filling a form, you're submitting it to the government. Yes, agreed. And of course, when the patient comes to the scan room, they see the big articles everywhere that it is wrong to determine the uh gender of a child. Instead, why not start putting up both saying why girl child and guy child are the same?

[00:52:01]Why is that so wrong? Because we feel that if we put that, we are agreeing that our society has a bias. Why not agree that we the society does have a bias towards the ma between the male and female child and that has to be corrected. Why not we start talking to our patients that see whether it is a boy or a girl it is the same. How many times as obstitricians have we delivered a child the patient sees it and the reaction greatly varies between a a male baby and a female baby. And so many times I find myself telling the patient they're all the same. your girl will probably love you more than the guy.

[00:52:35]Without strict control, misuse will increase. And the current system already fails to catch the real offenders. And if you've played video games, especially first person shooters, you'll come into something called as search and destroy, which is what we need. We need more coordination between stronger law enforcements. We have we need intel. We need to track. We need to act because most of the time most of the crimes happen in the most illegal places. Yes, you did mention some medical practitioners who are committing an illegal crime. They're not obstitricians. They're not sonologists.

[00:53:05]Yes, I in no way do I support any criminal irrespective of their uh profession or their uh degree. And these people are right to be punished severely by the law. However, we cannot uh target uh people who just mean good.

[00:53:22]Accountability does not mean harassment.

[00:53:24]Accountability has to be evidence-based and it has to be proportionate.

[00:53:30]And from a legal philosophy angle, the law should target the intent. Yes, we do need a law to monitor what is happening in the scan room. But let's think back about what uh Mrs. Meaka Gandhi said when she was the minister. If we remove the law, I mean not remove the law. When you make certain amendments in the law, it allows us to regulate better. Let's let me quote an example. Uh I think probably 10 years back Portugal went and uh they uh uh they legalize all the drugs and I was probably a school kid in 11th or 12th and I thought what a dumb thing to do. But believe me or not in the next two three years it became one of the biggest success stories because by legalizing all the drugs they were able to openly treat everyone and solve the root problem. Of course in a society like Singapore which is a small country it is very easy to keep drugs out of the system. probably in a bigger country uh it uh legalizing it and then trying to moderate it might be the better choice.

[00:54:25]I hope you are able to apply this to the uh uh the gender ratio in our country and we often end up punishing the procedural labs. Someone comes, you file the form, right? You have, you're running a scan center, you're seeing 100 patients, you are making them sign the form correctly, you're submitting it to the government, the government is happy.

[00:54:43]End of story. What actually happens inside the scan room in the 20 minutes when the scan happens? And what does the patient do about it? Maybe the scan doctor is not saying they go out, they go to an illegal center, get an illegal scan and do something about it. So, female feticide is a social disease.

[00:54:58]This is not just a medical violation.

[00:55:00]Yes, people in the medical field who violate it should be punished. But you have to think about where most of the crime happens and system thinking the overregulation leads to compliance fatigue and system gaming. Everyone is just focused about filling the form and most hospitals and clinics now have a separate clerk who sits and actually maintains the form. So the form maintenance work is actually done by someone everywhere across all big institutions.

[00:55:28]So we are auditing paperwork and not preventing prejudice. The law has become formentric rather than girl childcentric and fear cannot replace ethics and compliance is measurable and but impact is what matters. And uh with that I conclude my rebuttal.

[00:55:45]Thank you. Thanks to Rahul, thanks to Lakshman for this wonderful uh debate.

[00:55:52]Now I invite Dr. Deepti Jami to moderate um the motion.

[00:55:58]>> Thank you so much ma'am. Uh both Dr. Rahul and Dr. Lakshman. Uh kudos to you.

[00:56:04]Completely well done. We were all for both of you when you were talking because it was um it was so um uniquely done because PCP and as much as it's a debatable topic right now, we feel bad that we are actually debating this topic truly. Um and as a fetal medicine person for more than 15 years now I I feel that a law which was started to save the girl child now it's burdening the clinicians with a comprehensive heavy regulatory form filling burden and are we are we actually preventing female feticide or reducing the social crisis into paper paperwork exercise for clinicians we are still not sure so now what we're going to do ma'am has given me 3 to four minutes I'm quickly going to because we've already uh spoken a lot about the scenarios and you've given examples.

[00:56:52]Very well done. I'm going to expect both of you to give me two line answers or quick answers in three scenarios which I'm going to give you because it's the most common scenario which we see day in and day out. So the first scenario a 20we scan done perfectly normal parents are happy couple are happy one form in form of is incomplete and the result when the PNDT officer comes the machine is sealed and it's done and you cannot operate in that place so Dr. Lakshman what do you think that we can do about this >> see as far as our country is concerned as Dr. Ra did mention we have a big backlog of legal cases. We it cannot be an immediate ceiling. Someone does have the right to represent and say this is what happened. Uh probably in many cases now counseling rooms are all audio taped because of the current medical legal system. Probably the form signing should be done in a place under a CCTV uh camera. It's just going to be more and more surveillance.

[00:57:52]>> I understand. So Dr. Rahul, your your take on this? Uh ma'am I feel that if such a thing happens I sincerely believe as a community we have strengthened numbers so we should immediately represent to our professional scientific body and get a legal advice and involve our own legal team and fight it out tooth and nail mad.

[00:58:11]>> Exactly. I think that's absolutely fine.

[00:58:13]Even we have two clinical staffs working only on this form of complaints and nothing else. Now let's go to round two.

[00:58:19]Second scenario is when she's coming to you with third pregnancy. She has previous two daughters. Of course, the doctor who is going to scan is going to refuse sex determination. The patient s simply okay thank you doctor thank you so much gets a report goes to an illegal setup like you've already mentioned and gets the sex determination done as early as 15 to 16 weeks or an early target scan time. So Dr. Rahul what do you think about this and do you think that for filling up form if in a properly uh doable area is going to change the scenario? Ma'am, I believe that form F is a small part of the regulatory compliance. PCP acts also has provisions to search and destroy the illegal actions also. So if such patients we I work in a public hospital. So when patients especially multigraas which previous two girl children come to us for MTPs even though they might not tell us that they have diagnosed it somewhere else we inform it to the district bureau and they do a field level surveillance.

[00:59:19]They have the people who are in the local area who can conduct a confidential inquiry and that is how these sex determination rackets are busted. Even in last week in near Kalakuchi they busted an illegal scan center where a midwife was doing these ultrasounds. So it has to there is a system in place for that. So all MTPs depending on the context we have the provision to represent to the district family welfare bureau and they have a system in place to do a field level tracking using confidential representatives and to find out these uh areas. But the problem is they are all politically so strongly connected legal ethical practitioners we have a very very so many hurdles at every given point. But these quacks who have mobile scan machines everything is mobile. So with the law becoming more stronger and the system becoming more aware the criminals are also upgrading themselves. No and also all the laws go against most of the medical professionals at some point of time rather than that wax in a very difficult way. Thank you so much Dr. Rahul. Dr. Lakshman, what's your say on this?

[01:00:25]>> I agree with whatever Rahul Sar had to said and I >> I'm glad you agreed. Now both of you are on the same page.

[01:00:30]>> No, we are usually on the same page most of the time which is opponents on the first Friday of every month and usually at the end of a debate I ask him for his opinion on how I did. That's how I validate if I did something well or not.

[01:00:41]Anyways, going back to your question, uh, in this particular case, there's very less that we can do. So, I think it has to be a long-term thing. We have so many maternity centers which now do birthing classes, pregnancy yoga, pregnancy physiootherapy. I think it's about time we took matters into our hand and we started taking it could sound ethical like an ethical class, but we have to start saying that it doesn't matter what gender your child is. It's all it's your child and it's the same.

[01:01:08]Nothing matters. And we have so many social media influencers now, so many gynecologists who post on so many topics. Uh maybe they should also start uh you know using their fame and their glory to support this uh these kind of causes which could make a lot of difference >> and I completely agree with you and I would like to end with two points. uh one uh when we were discussing with sur about formal filling and uh PCP and act what we thought was why don't we why don't we try retrograde version that is giving away xx and xy like how we can do in uh countries outside India telling all of them you are you have a boy you have a girl and follow up only girl children and see if they're going to deliver okay that was uh we are all discussing this was literally uh I would say 11 years back and still we are here discussing and debating about PCP and act and this uh topic is very close to me because um one reason uh why I readily accepted and I was very happy to talk about it is when my daughter who was just 10 years old who entered my clinic and he she saw those green boards and blue boards and asked me I don't understand what's written amma I said no there are there are few people who do not want girl children it shook her so hard even Now after 4 years she still talks to me about it. I think it's it's very very important that we all get together. Um the importance of PNDT law is very very crucial to prevent sex determination. I think as long as uh the society is changing the social norms is changing the law will never do anything else. I think as a society we all should come together make sure that girl children are safe they are in safe hands and they're taken forward. over to my chairperson Dr. Diva for her final concluding points. Thank you so much both of you wonderful debate. I'm very glad Oxy and team public awareness committee for giving me the opportunity.

[01:03:08]Thank you ma'am and thank you.

[01:03:10]>> Thank you Deepi for taking this uh conversation. You made a moderation into a beautiful conversation and thank you for that. I like that model. Now I call upon the chairperson Dr. Diva to share her words.

[01:03:22]>> Excellent webinar. Uh congratulations to both the speakers and the moderators. Uh I have few points. The act was conceived with a powerful as a powerful ethical safeguard. The intent is very important and its relevance still holds good even today. And most of the points were all around form F. Form F is nothing but patient identifiers and your professional signature. that should not have much of clerical errors when we are doing our prescription audits. We are having accounts to maintain our financials. So that should not be a problem. The intent should be clear. You have even even if it is the slightest opportunity for patient to understand that sex determination is wrong. I think we should give that opportunity and I think many of my patients uh coming from abroad they they get sensitized that this is a problem in India and something has to be done towards it. So the the act is not only about format. There are four stakeholders in this act. the providers, the government, the administrative authorities, the clinicians, the providers, the diagnostic centers, the public, the uh patient as well as the relatives as well as the society. Now with going uh rampantly uh improvement in social media and other things, I think public awareness webinars like these will help in bringing up a positive change and uh rather than debating about this topic, the law is there. we should have healthy dialogues with the administrators and make sure it becomes a more effective protocol in preventing uh gender bias in our country. So this is my humble opinion. Thank you speakers and thank you chairpersons for this wonderful opportunity.

[01:05:14]>> Thank you Dr. Diva for uh lending your beautiful uh thoughts. I now request Dr. Vijay Lakmi Kandas Swami to um express what she felt about this uh webinar and then followed up by the uh word of thanks.

[01:05:31]Thank you madam dri m madam and uh I think it was an exemplary uh webinar with both the young and energetic debatants uh debating on such a very important topic and as you as both of them uh quoted from very contemporary uh evidence that it is something that is happening on a day-to-day basis and uh very beautifully uh the moderator and chairperson have given their views and uh they have given that the bottom line is if they are able to fill the forms then we will not face any problems at all. So I think uh we should not leave any room for clerical errors that has been beautifully brought out by uh Dr. Diva. Thank you so much for that. And yes it has our team Oxy 2026 2027 has started off with a big bang with a very successful webinar. uh madam and I would like to it gives me great uh you know privilege to be proposing the vote of thanks today at the end of uh this uh webinar. Uh should be we we be giving some uh uh uh audience interaction or anything like that matter before uh the >> question there are no questions actually this is a faculty uh opened link so um if there are anything we can always uh take it in our forums later so I would request you to give the vote of thanks >> thank you thank you at the outset I would like to thank our oxy President uh Prussia madam for her very dynamic and inspiring leadership.

[01:07:13]She has taken over the team and we have started off with a big big bang and we look up to you madam for uh continuous support and uh also inspire inspiration from your uh you know act uh words that you give us at every webinar or any event that we organize and I also would like to thank our vibrant and multifaceted uh beautiful secretary Dr. Dr. Malar Raj uh thank you for coming and joining us in the midst of your busy schedule and uh giving us the uh oxy prayer and joining with us and I would like to thank my beloved senior chairperson of the public awareness committee uh Sumati Pmanand madam she has been guiding me right from the time that I have entered into a uh for this tenure and uh has beautifully conducted this event. Thank you so much madam and you have given a role model as to how each and every webinar has to be conducted and I would like to thank our chairpersons uh Dr. Dya and moderator Dr. Di Jami for their lovely points. Dr. Jami is a storehouse of information and her uh the way she made it as an interaction and she brought out both the debatants points of view with various case scenarios was beautiful moderation and coming to both our young debatants.

[01:08:37]Thank you so much Dr. Lakshman and Dr. Rahul Ran uh very energetic and very lively debate, exemplary slides. Both of you protect uh projected your points of view very beautifully and at the end of it both of you agreed that is very very important and uh and I also would like to thank uh Sahiti from Shield Connect for giving their technical support and their webinar platform. And last but not the least all the delegates who have logged in. Thank you to all the delegates for having registered and logged in here. We've had a very good number more than 58 60 and quite a few would have been watching it on the YouTube live as well. Thank you one and all. Thank you Jen.

[01:09:24]>> Thank you. Can we all take a group photo? Can we all switch on whoever is there? Sahiti.

[01:09:33]>> Sure ma'am.

[01:09:35]>> Yeah. Thank you. So uh whoever is um uh logged in I see nearly 40 people still there. So can we all switch on our um uh videos so that we get a lovely uh mugsh shot of our >> is in the dark. [laughter] [clears throat] >> Yeah.

[01:09:53]>> Yeah. Once you're done you just let us know >> requesting everyone to kindly uh open your cameras. Yeah.

[01:10:11]Is it done?

[01:10:16][laughter] >> Sahiti.

[01:10:18]>> Yes, ma'am. Done. Ma'am.

[01:10:19]>> Yeah.

[01:10:20]>> Thank you. Thank you.

[01:10:21]>> So thanks to every single person who has joined and we had a phenomenal turnover and Siti will tell us exactly how many people saw this and this is going to be uh this was uh live streamed on uh YouTube and there will be many more to uh watch and this is not a platform which is just watched by doctors or particular sub specialtities. There are doctors who are non- gynecologists who watch this. There are public who watch this and we take pride in uh telling that we are one of those uh widely watched uh uh forums and uh we always try to do justice by choosing the right topics with the right speakers and the right moderators. Thank you so much. I thank every single person here uh from the bottom of my heart for making this a wonderful place