Browsing by Author "Jog, Pramod"
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Item Umbilical Cord Blood Banking: Consensus Statement of the Indian Academy of Pediatrics(Indian Academy of Pediatrics, 2018-06) Sachdeva, Anupam; Gunasekaran, Vinod; Malhotra, Payal; Bhurani, Dinesh; Yadav, Satya Prakash; Radhakrishnan, Nita; Kalra, Manas; Bhat, Sunil; Misra, Ruchira; Jog, PramodJustification: Practitioners and people need information about the therapeutic potential of umbilical cord blood stem cells and pros andcons of storing cord blood in public versus private banks.Process: Indian Academy of Pediatrics conducted a consultative meeting on umbilical cord blood banking on 25th June 2016 in Pune,attended by experts in the field of hematopoietic stem cell transplantation working across India. Review of scientific literature was alsoperformed. All expert committee members reviewed the final manuscript.Objective: To bring out consensus guidelines for umbilical cord banking in India.Recommendations: Umbilical cord blood stem cell transplantation has been used to cure many malignant disorders, hematologicalconditions, immune deficiency disorders and inherited metabolic disorders, even when it’s partially HLA mismatched. Collectionprocedure is safe for mother and baby in an otherwise uncomplicated delivery. Public cord blood banking should be promoted over privatebanking. Private cord blood banking is highly recommended when an existing family member (sibling or biological parent) is sufferingfrom diseases approved to be cured by allogenic stem cell transplantation. Otherwise, private cord blood banking is not a ‘biologicalinsurance’, and should be discouraged. At present, autologous cord stem cells cannot be used for treating diseases of genetic origin,metabolic disorders and hematological cancers. Advertisements for private banking are often misleading. Legislative measures arerequired to regularize the marketing strategies of cord blood banking.Item The world of synbiotics: a review of literature and clinical evidence in diarrhoea from the lens of a paediatrician(Medip Academy, 2019-01) Jog, PramodThe use of synbiotics in the management of acute diarrhoea in children is becoming a common practice in India. However, since this is an upcoming modality of treatment, it is essential to review the scientific rationale and evidence on clinical efficacy and safety in the context of paediatric diarrhoea. In addition, most synbiotics contain a combination of multiple probiotics along with a prebiotic. Thus arises, a parallel need to understand whether a combination of probiotics performs better than single probiotics, hence justifying the rationale for such combinations. A review of available evidence suggests that synbiotics are indeed safe and superior in efficacy to single probiotics (like Bacillus clausii, Lactobacillus rhamnosus GG etc) and that there is a good body of evidence to support the efficacy and tolerability of synbiotics in the management of paediatric acute gastroenteritis. There is also evidence to suggest that combination probiotics have superior benefits compared to single probiotics, thus justifying their use as part of synbiotics. The overall benefits of synbiotics reported in various clinical trials on paediatric diarrhoea include, a rapid normalization of the gastrointestinal flora, a reduction in the duration of diarrhoea, quicker improvement in stool consistency, lesser administration of additional medications like antibiotics, antiemetics and antipyretics, higher physician reported treatment satisfaction scores and enhanced overall efficacy against gastrointestinal pathogens, including diarrhoea of rota virus origin. Hence, synbiotics put up a strong case to look beyond probiotics and single probiotic formulations in paediatric diarrhoea.