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Author Topic: Dr Ramanan in Pune  (Read 49923 times)
Andy Battaglia
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« on: July 04, 2013, 11:39:11 PM »

Is anyone familiar with Dr Vijay Ramanan in Pune, India? There is much conversation about the doctor these days and as always, I prefer facts. Can anyone tell me about him? Is anyone being treated under him or was previously? For how long has he practiced in Pune?

This is important because the doctor has received much publicity and some are skeptical about his claims. Again, I must reserve judgment until I have facts.
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« Reply #1 on: July 05, 2013, 05:16:59 AM »

Hi Andy,
It is the blog of Dr Vijay Ramanan.

http://haematology.blogspot.in/

The address of Website is

http://www.vijayramanan.com/

There are certificates of him on the blog , u can get the brief idea about his practice in Pune.
He is pioneer in combining the Hydrea with Wheatgrass tablets and Anti oxidants like L-Carnitine.

What's the difference is , he prescribe hydrea to Thal. Major.

Have you contacted him on mail ?
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Andy Battaglia
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« Reply #2 on: July 05, 2013, 09:15:22 AM »

Yes, I have contacted him and have seen his website. Because there is one statement on his site that is apparently not true (concerning collaboration with Dr Sodani), and because he has become a frequent topic of discussion, I would like to learn more about him, so as to be able to advise patients whether or not they should try his protocol.

If you have any direct experience with him or know about his clinic, please comment.
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Dharmesh
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« Reply #3 on: July 06, 2013, 01:33:46 AM »

Hi Andy,

I do not have direct experience with him and have not visited pune.

But those who are benefitted by the treatment of Dr Vijay Ramanan , mention him as God.
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Andy Battaglia
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« Reply #4 on: July 07, 2013, 07:20:29 PM »

I feel that I have now spoken to enough patients in Pune to feel that they are getting good treatment under Dr Ramanan. He is using a program of hydroxyurea and wheatgrass and has some successes, with some patients off transfusions for at least 10 months. I am certain that their phenotype is intermedia, but formerly transfusion dependent, so this is a significant improvement for them. The doctor has told me that he has had mixed results, as have other doctors working with the drug. I feel that with a blood supply that is not adequate or totally safe, that patients who do experience enough increase in Hb to be at least at 8 may find this is a good alternative to transfusions.

The doctor seems quite good at self promotion and I think that's great because he is using it to attract patients into a good treatment program. I think perhaps that has been mistaken by some as making it about him, but he is using basic marketing to get the attention of the thalassemia patient. I wish the doctor much success and will be asking him about his BMT program shortly.
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Aditi


« Reply #5 on: July 27, 2013, 08:52:49 AM »

Can anyone share Dr. Ramanan's email id or any other contact detail?

Regards,
Himanshu

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Regular transfusion, Keeping pre transfusion HB above 10 and Iron Chelation are the three mantras for thals to stay healthy.
Andy Battaglia
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« Reply #6 on: July 28, 2013, 10:09:45 AM »

bmtpune@gmail.com
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« Reply #7 on: July 29, 2013, 12:18:38 PM »


http://articles.timesofindia.indiatimes.com/2013-06-20/pune/40092346_1_bone-marrow-transplant-patients

This article appeared in Time of India on 20th June (leading newspaper in India)

PUNE: At 13, Ali HousseinMoayad is a regular teenager hooked to videogames. What sets him apart from other teens is that this is the first time in his young life when he can play without feeling unwell. For 11 years, Ali underwent blood transfusions every 21 days to treat his disorder of thalassemia major, which made it difficult for his body to synthesise its own haemoglobin.

But things changed for the Iraqi teenager last October, when he successfully underwent a bone-marrow transplant at a hospital in Pune, with only a partially-matched bone-marrow transfused from his own mother using the 'Haploidentical transplantation' protocol. Eight months on, Ali is free from the once binding need for blood transfusions and all medication related to transplants. His haemoglobin has touched a healthy 14.7gm/dl and he is now prescribed only simple drugs to keep off viral infections.


Ali is among a handful of patients who have been successfully treated in the city using the haploidentical transplantation method for disorders such as leukaemia and aplastic anaemia.

Ali's recovery has brought much relief to his parents. Ali's father, Houssien Moayad Houssien, who has brought him again to Pune for a routine check-up says their lives have changed following the transplant. "My daughter too was a thalassemia major, but she could be treated as her bone marrow matched with her elder brother's. Ali's bone-marrow, however, did not match with his siblings. Initially, I was very sceptical about coming to India for treatment, but I got a lot of confidence with the kind of treatment we received here. I am very happy because Ali has become healthier and now regularly attends school," he says.

Haematologist Vijay Ramanan, who treated Ali, says the treatment's success is significant because it expands the donor-base for thalassemics who don't find a perfect bone marrow match in their family. "Only 15-20% of the thalassemic patients are able to find a perfect-match donor in their siblings. The rest of them can get an unrelated donor from the bone-marrow registry or the cord blood bank, which can be a very expensive procedure. A haploidentical transplant makes it possible to treat the disorder with fewer complications, even with a 50% match of the bone-marrow, which is usually of the mother," he says.

Ramanan said in this treatment the bone marrow from the mother is transfused into the child using the normal transplant procedure. "While in a normal transplant, the immunity of the patient is suppressed for about 6-9 months, in this case, the backbone of the therapy is the post-transplant treatment with a drug called cyclophosphamide, coupled with the right amount of patient care before and a little after the transfusion," he says.

Vibha Bafna, paediatric haemato-oncologist with a city hospital says the therapy is good, but notes that it needs the correct conditioning for it to be successful. "Haploidentical transplants are definitely a great advancement for patients who require a bone marrow transplant, because identical matches are either not possible, or are very expensive. But the treatment needs to be done with a lot of care, and the right amount of pre- and post-conditioning of the patient to reduce risk of infection and rejection. Once patients have successfully crossed the one-year post-operative period, they can lead an absolutely normal life," she says.

The biggest advantage of this line of treatment is the availability of the donor in the form of the mother or father, says paediatric haematologist Sandip Bartakke. "A complete match of the bone marrows of the patient and donor is the ideal treatment. But that does not usually happen and a haploidentical transplant can be considered in such cases. There is a greater risk of rejection, but with more research being done on the issue, it has the potential to become a widely accepted form of treatment in the coming years," he says.

Understanding haploidentical transplantation

* Doctors administer just enough chemotherapy to suppress the immune system, which keeps patients from rejecting the donated marrow without harming their organs. As a result, the side effects are much milder.

* Three days after the transplant, a patient is given a high dose of a drug called cyclophosphamide, which "re-boots" the immune system by sparing the donor's stem cells and allowing them to establish new blood cells and a new immune system. The budding immune system is re-trained to see the patient's body as friend, preventing the patient from rejecting the transplanted bone marrow.

* This procedure, which allows transplants with half-identical, or 'haploidentical' (related) donors has similar outcomes as seen in matched transplants.

* The technique, which has been developed by physician-scientists at the Johns Hopkins Kimmel Cancer Center in 2000, greatly expands the potential donor pool, making more patients eligible for the transplant.
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« Reply #8 on: July 29, 2013, 01:11:10 PM »

Surely a good option for those that don't have a complete HLA match
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« Reply #9 on: August 07, 2013, 09:13:26 AM »

Can anyone share Dr. Ramanan's email id or any other contact detail?

Regards,
Himanshu



mvijayr@gmail.com
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Poirot
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« Reply #10 on: August 30, 2013, 02:08:42 AM »

I feel that I have now spoken to enough patients in Pune to feel that they are getting good treatment under Dr Ramanan. He is using a program of hydroxyurea and wheatgrass and has some successes, with some patients off transfusions for at least 10 months. I am certain that their phenotype is intermedia, but formerly transfusion dependent, so this is a significant improvement for them. The doctor has told me that he has had mixed results, as have other doctors working with the drug. I feel that with a blood supply that is not adequate or totally safe, that patients who do experience enough increase in Hb to be at least at 8 may find this is a good alternative to transfusions.

The doctor seems quite good at self promotion and I think that's great because he is using it to attract patients into a good treatment program. I think perhaps that has been mistaken by some as making it about him, but he is using basic marketing to get the attention of the thalassemia patient. I wish the doctor much success and will be asking him about his BMT program shortly.

Personally, based upon interaction of two thals and their families with Dr Ramanan, I find that he is quite an aggressive doctor. Moreover, the treatment course he is proposing could be potentially life threatening or damaging to long term health of Thals.


It is quite a huge risk for any reasonably well-cared-for thal to take. I would strongly advise against it.


Poirot
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« Reply #11 on: September 07, 2013, 01:53:39 AM »

Hello Poirot,

Can u please explain what exactly u observed as life threatening or damaging to long term health with respect to treatment of these two thals by Dr Vijay Ramanan?
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« Reply #12 on: September 21, 2013, 02:38:48 AM »

Hello Poirot,

Can u please explain what exactly u observed as life threatening or damaging to long term health with respect to treatment of these two thals by Dr Vijay Ramanan?

Hi Dharmesh,

His course of treatment is the following:

1. Stop transfusions and do not transfuse unless HB falls to 6.0 gms
2. Stop chelation completely, stop all other vitamins and supplements completely
3. Start taking Hydroxy Urea tabs
4. Do this for 6 months, before you can judge whether the treatment is working or not.

Given the iron loading of many Thals in India, to suggest that chelation be stopped completely is hugely risky, if not a criminal piece of advice. And to suggest to young thals that HB be allowed to drop to 6.0gms is beyond my comprehension.

I strongly, strongly advised these parents not to follow this methodology. It is one thing, in the case of thal major, to take Hydroxy  Urea in addition to the rest of your treatment. It is another to suggest that one should rely on Hydroxy solely. There is no evidence whatsoever that Hydroxy works as a fetal haemoglobin inducer in Beta-zero thals.

Poirot
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« Reply #13 on: September 21, 2013, 08:33:15 AM »

Hi Dharmesh,

His course of treatment is the following:

1. Stop transfusions and do not transfuse unless HB falls to 6.0 gms
2. Stop chelation completely, stop all other vitamins and supplements completely
3. Start taking Hydroxy Urea tabs
4. Do this for 6 months, before you can judge whether the treatment is working or not.

Given the iron loading of many Thals in India, to suggest that chelation be stopped completely is hugely risky, if not a criminal piece of advice. And to suggest to young thals that HB be allowed to drop to 6.0gms is beyond my comprehension.

I strongly, strongly advised these parents not to follow this methodology. It is one thing, in the case of thal major, to take Hydroxy  Urea in addition to the rest of your treatment. It is another to suggest that one should rely on Hydroxy solely. There is no evidence whatsoever that Hydroxy works as a fetal haemoglobin inducer in Beta-zero thals.

Poirot
I'd completely agree with Poirot in this case here.

Stop supplements and chelators? No thanks, go away, I don't want any treatment then. I would in no way stop those two things ever in my life. And 6 hb? Seriously? I now get pains even if my hb falls around 9.5, I cannot even imagine what I'd be suffering in 6.0.

I'd better live as thal major rather than leaving a creepy transfusion free life.

Just my two cents.

-P.
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Andy Battaglia
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« Reply #14 on: September 21, 2013, 10:58:33 AM »

I have requested a response from Dr Ramanan. I feel it will be in his best interests to reply.
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