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Evolution of pediatric gastroenterology - Dr Anupam Sibal
- 1. Prof Anupam Sibal MD, FIAP, FIMSA, FRCP(Lon), FRCP(Glas), FRCPCH, FAAP Group Medical Director, Apollo Hospitals Group Clinical Professor Faculty 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 Hepatologists Apollo Centre for Advanced Pediatrics Indraprastha Apollo Hospital Evolution of Pediatric Gastroenterology
- 2. 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
- 3. Lancet 1957 : first report of intestinal biopsy of a child of celiac disease
- 4. 1895 German Gastroenterological Society 1897 American Gastroenterological Association 1902 Japanese Society 1932 American Society of Gastroenterology 1937 British Society of Gastroenterology
- 5. 1949 AASLD 1958 First World Congress of Gastroenterology and World Gastroenterology Organization 1958 IASL 1966 EASL
- 6. 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)
- 7. 1984 Commonwealth Association of Pediatric Gastroenterology and Nutrition (CAPGAN) London 1993 The Asian Pan Pacific Society of Pediatric Gastroenterology (APPSPGHAN) Tokyo
- 8. 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
- 9. 1970s AIIMS and PGIMER CMC Vellore and Madras Medical College 1980s Osmania Medical College and Trivandrum Medical College SGPGI, Lucknow
- 10. Events leading to the emergence of pediatric gastroenterology Small intestinal biopsy Ileocolonoscopy Percutaneous liver biopsy Gut immunology and food allergy Oral rehydration Parenteral nutrition Metabolic liver disease Portoenterostomy (Kasai) procedure for biliary atresia Organ transplantation Liver Small bowel
- 12. 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
- 13. 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
- 14. 2013 DM in Pediatric Hepatology ILBS, Delhi 2014 FNB in Pediatric Gastroenterology Apollo Hospital, Delhi 2015 DM in Pediatric Gastroenterology, PGI
- 15. IBD Early onset IBD Celiac disease CMPA Multiple food allergies
- 17. Biochemical studies available TMS and GCMS for: Carbohydrate metabolism Urea cycle disorders Amino acid metabolism FAOD Organic acidemias Succinyl acetone urine and blood for tyrosinemia
- 18. Genetic studies Alfa-1 antitrypsin deficiency: SERPINA-1 gene CF: CFTR Galactosemia: GALT, GALE (epimerase) and GALK1 (kinase) GSD 1A and 1B: G6PC and G6PT1 GSD 3: AGL GSD 4: GBE1 GSD 6: PYGL Hemochromatosis: HFE
- 19. MSUD: BCKDHA NPC: NPC 1 and 2 Cirtrin deficiency Alagille: JAG1 and NOTCH2 Tyrosinemia: FAH PFIC 1 – 3
- 21. 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)
- 26. 95 248 40 219 16 194 88 2310 0 500 1000 1500 2000 2500 1997-2006 2007 till date Fit for LT Willing for LT Underwent LT Adult LT The watershed
- 27. 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
- 28. 2608 210 Liver transplants at Apollo