Evolution of pediatric gastroenterology - Dr Anupam Sibal
-
Upload
apollogleaneagls -
Category
Health & Medicine
-
view
46 -
download
1
Transcript of Evolution of pediatric gastroenterology - Dr Anupam Sibal
Prof Anupam SibalMD, FIAP, FIMSA, FRCP(Lon), FRCP(Glas), FRCPCH, FAAP
Group Medical Director, Apollo Hospitals Group
Clinical ProfessorFaculty of Medicine and Health Sciences Macquarie University, Sydney, Australia
Dr Vidyut Bhatia, Dr Akshay Kapoor, Dr Smita Malhotra,
Dr Karunesh, Dr Ishaq, Dr Ravi, Dr Aditi
Pediatric Gastroenterologists and HepatologistsApollo Centre for Advanced Pediatrics
Indraprastha Apollo Hospital
Evolution of Pediatric Gastroenterology
1833 William Beaumont published experiments and observations
on gastric juice and the physiology of digestion
1875 Victor Charles Hanot described cirrhotic jaundice and
other diseases of liver
Lancet 1957 : first report of intestinal biopsy of a child of celiac disease
1895 German Gastroenterological Society
1897 American Gastroenterological Association
1902Japanese Society
1932 American Society of Gastroenterology
1937 British Society of Gastroenterology
1949 AASLD
1958 First World Congress of Gastroenterology and World Gastroenterology Organization
1958 IASL
1966 EASL
1968
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)
1973
Pediatric gut club morphed into North American Society for Pediatric Gastroenterology (NASPGHAN)
1974
The Latin American Society for Pediatric Gastroenterology and Nutrition (LASPGAN)
1984 Commonwealth Association of Pediatric Gastroenterology
and Nutrition (CAPGAN)London
1993 The Asian Pan Pacific Society of Pediatric
Gastroenterology (APPSPGHAN)Tokyo
2000
First World Congress was held in Boston
ESPGHAN, NASPGHAN, APPSPGHAN and LASPGHAN
Federation of the International Societies of Paediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN) was created
1970s AIIMS and PGIMER CMC Vellore and Madras Medical College
1980s Osmania Medical College and Trivandrum Medical CollegeSGPGI, Lucknow
Events leading to the emergence of pediatric gastroenterology
Small intestinal biopsyIleocolonoscopyPercutaneous liver biopsyGut immunology and food allergyOral rehydrationParenteral nutritionMetabolic liver diseasePortoenterostomy (Kasai) procedure for biliary atresiaOrgan transplantation Liver Small bowel
1980s
PGI
MAMC
ICH, Chennai
1990s
Pediatric Gastroenterology SGPGI, Lucknow
Diarrheal disease research center at AIIMS, Delhi
Clinical and research services in pediatric liver diseases at AIIMS, Delhi
Apollo Centre for Advanced Pediatrics, New Delhi
2002
One year post-doctoral certificate course (PDCC) in Pediatric Gastroenterology at SGPGI, Lucknow
2009 DM in Pediatric Gastroenterology, SGPGI, Lucknow
2012 IAP Fellowship Apollo Hospital, Delhi Medanta, Gurgaon
2013 DM in Pediatric Hepatology
ILBS, Delhi
2014 FNB in Pediatric Gastroenterology
Apollo Hospital, Delhi
2015 DM in Pediatric Gastroenterology, PGI
IBD
Early onset IBD
Celiac disease
CMPA
Multiple food allergies
ICC
NCS
PFIC
PHT
MLD
Biochemical studies available TMS and GCMS for: Carbohydrate metabolism Urea cycle disorders Amino acid metabolism FAOD Organic acidemiasSuccinyl acetone urine and blood for tyrosinemia
Genetic studiesAlfa-1 antitrypsin deficiency: SERPINA-1 geneCF: CFTRGalactosemia: GALT, GALE (epimerase) and
GALK1 (kinase)GSD 1A and 1B: G6PC and G6PT1GSD 3: AGLGSD 4: GBE1GSD 6: PYGLHemochromatosis: HFE
MSUD: BCKDHANPC: NPC 1 and 2Cirtrin deficiencyAlagille: JAG1 and NOTCH2Tyrosinemia: FAHPFIC 1 – 3
Enzyme studies
GalactosemiaFructosemia Gaucher’sNPCFAODUrea cycle disorders
Specialized formulae available in India (on demand)
Galactosemia – lactose free/soy formula (Zerolac, Isomil, Galactomin 17)
MSUD – leucine, iso-leucine and valine free (MSUD diet powder, MSUD analogue)
Tyrosinemia – low tyrosine and phenylalanine powder (Tyrex, XPHEN TYR)
Fatty acid oxidation defects: modified fat and carbohydrate (ProViMin, Monogen)
Urea cycle disorders: non-essential aminoacid free (Cyclinex)
The watershed
No internet
1 TV channel
3 + 3 Airlines
$6 billion foreign reserves
1991 2016
350 million internet users
1790 TV channels
22 Airlines
$367 billion foreign reserves
2608
210
Liver transplants at Apollo