Papers by Dr Pardeep Garg
IP International journal of medical paediatrics and oncology/IP international journal of medical paediatrics and oncology, Feb 15, 2024
Malignant epithelial ovarian tumor is a rare entity in children. Especially, mucinous ovarian cys... more Malignant epithelial ovarian tumor is a rare entity in children. Especially, mucinous ovarian cystadenocarcinoma is exceedingly rare in pediatric age group, only a limited number of cases are reported in this age group till date with less than 5 cases reported in adolescence age in the literature. We describe a case of mucinous cystadenocarcinoma in a sixteen-year old postmenarchal girl presenting with complaints of abdominal distension and irregular periods from last three months. Management of such cases is tricky as conservative approach involving sparing fertility of the patient is adopted. This case is presented for its rarity and unique presentation.
IP International journal of medical paediatrics and oncology/IP international journal of medical paediatrics and oncology, Feb 15, 2024
Cutaneous metastasis from head and neck cancers are uncommon, accounting for less than 1% for dis... more Cutaneous metastasis from head and neck cancers are uncommon, accounting for less than 1% for distant metastasis in head and neck cancers. It can be single and discrete or it may present as multiple lesions at different anatomic sites. There is a correlation between the frequency of cutaneous metastasis and the type and prevalence of primary cancer. Head and neck squamous cell carcinomas are aggressive tumors with metastasis occurring in up to 15-20% cases. However, they rarely metastasize to skin and the reported incidence is about 0.8-1.3%. Very few cases of distant cutaneous head and neck SCC (HNSCC) metastases have been described and are usually multiple. Underreporting is likely in cases of simultaneous occurrence with lung, bone and brain metastases. Cutaneous distant metastases signify a poor prognosis and 1-year survival is 0%.
IP International journal of medical paediatrics and oncology/IP international journal of medical paediatrics and oncology, Feb 15, 2024
Background: The incidence of cutaneous metastasis in head and neck cancers is less than 1%. Carci... more Background: The incidence of cutaneous metastasis in head and neck cancers is less than 1%. Carcinoma of the oral cavity is one of the most common cancers of the head neck region with frequent metastasis to internal organs, especially the lungs, liver, and bone.We present a case of Carcinoma of floor of mouth with cutaneous metastasis. Case Presentation: A 55 year old lady presented to our department with complaints of non-healing ulcer in the oral cavity and ulcerated nodules over neck and chest. On examination, mouth opening tongue mobility was restricted with grade 2 trismus. An ulcer in left gb sulcus, bilateral lymphadenopathy and multiple ulcerated skin nodules on neck and chest wall were noted. CECT Face and Neck showed heterogenously ehancing mass at the floor of mouth involving left buccal mucosa and erosion of mandible, lymph node mets and skin nodules. ECOGPS was 1.She was treated with palliative systemic chemotherapy and thereafter Palliative radiation. Now she is having stable disease and is on metronomic chemotherapy with regular follow up. Conclusion: Our case has highlighted that cutaneous metastasis can be seen in the cancers of floor of mouth. Palliative chemotherapy and radiotherapy can significantly increase Progression free survival and hence the Quality of life of patients with such presentation.
Carcinoma vulva: Ten years experience in a teaching institution of North India
Journal of family medicine and primary care, 2023
Factors infleuecing the oral mucositis in the patients undergoing radiotherapy for head and neck cancer-an institutional based study
International Journal of Medical and Health Research, Apr 1, 2017
Indian journal of nursing sciences, 2023
Every part of life, whether physical, physiological, social, or spiritual, is profoundly impacted... more Every part of life, whether physical, physiological, social, or spiritual, is profoundly impacted by cancer. By the year 2020, it is predicted that there would be 18.1 million new cancer cases worldwide (excluding skin cancers) and more than 9.9 million cancer-related deaths (excluding non-melanoma skin cancer). In developing countries, up to 25% of tumors are associated with chronic infections such as Hepatitis B, Human Papillomaviruses, and other factors such as tobacco use, environmental exposure, certain infections as well as genetic pre-disposition play a vital role in carcinogenesis. Cancer produces serious health problems, especially when it causes pressure, obstruction, hemorrhage, and infection in vital tissues organ. Depending on the type and stage of the disease, cancer can be treated. Surgery, radiation, chemotherapy, hormone
International Journal of Case Reports and Images, Nov 10, 2016
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, mont... more International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties. Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor.
Cureus
Introduction: Anticancer agents are responsible for a majority of adverse drug reactions (ADRs) i... more Introduction: Anticancer agents are responsible for a majority of adverse drug reactions (ADRs) in cancer patients. ADR reporting with anticancer drugs is very rare in India due to the lack of awareness and knowledge about the Pharmacovigilance Programme of India. Hence, this study was done to assess the pattern of ADRs with anticancer agents in cancer patients and to increase awareness about ADR monitoring among healthcare professionals. Materials and methods: This is an observational, retrospective and non-interventional study conducted in an ADR monitoring centre (AMC) in Govt. Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, North India. Voluntarily reported ADR forms with anticancer drugs as suspected drugs over a period of seven years from January 2016 to December 2022 were analyzed. Various parameters were analyzed, which include demographic details of the patients, type of ADR, department reporting ADR and suspected drug. Causality assessment, severity assessment and preventability assessment were done according to the World Health Organization Uppsala Monitoring Centre (WHO-UMC) scale, modified Hartwig and Siegel scale and modified Schumock and Thornton scale, respectively. Results: The maximum numbers of ADRs were reported in the age group of 41-60 years (68.29%) and in females (59.75%). The maximum number of ADRs was reported with the use of taxanes (docetaxel and paclitaxel) (24.39%), targeted drugs (geftinib, imatinib, bortezomib, bevacizumab, rituximab and pazopanib) (24.39%) and platinum co-ordination complexes (cisplatin, oxaliplatin and carboplatin) (17.07%). Majority of the ADRs reported were shivering and ADRs on the skin. Majority of the ADRs were probable (64.70%), mild in nature (85.29%), definitely preventable (45.58%) and probably preventable (45.58%). Conclusion: ADR monitoring is needed to increase the outcome of anticancer drug treatment in cancer patients. The quality of treatment in cancer patients can be improved through the timely management of these ADRs. It is a need of the present era to inform healthcare professionals about the Pharmacovigilance Programme to increase the reporting of ADRs due to anticancer drugs. Categories: Dermatology, Internal Medicine, Oncology Keywords: modified hartwig and siegel scale, modified schumock and thornton scale, molecular targeted drugs, taxanes, chemotherapy adverse effects, dermatological side effects, drug-related adverse reactions, anticancer agents, who-umc causality assessment scale 1 1 2 1 3 4 5
Cureus
The study aims to determine the role of intratympanic dexamethasone (ITD) on the hearing profile ... more The study aims to determine the role of intratympanic dexamethasone (ITD) on the hearing profile of patients with head and neck cancer post-chemoradiotherapy. This study employs a prospective case-control design. In total 834 patients were evaluated for eligibility. Seven hundred and eleven were excluded because they didn't meet the inclusion criteria. A hundred cases out of 123 were diagnosed with head and neck cancer for which the treatment protocol included cisplatin concurrent to radiotherapy recruited. Before each cisplatin treatment session, ITD was injected into one ear (experimental ear) while the other ear of the same patient served as the control. Pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) test results of the baseline and follow-up examinations in the sixth and 12th weeks were compared within and between the study and control ears. For pure tone thresholds, significant hearing threshold change was noticed at 8 kHz in the experimental group at six weeks and at ≥ 6 kHz in the control group. At 12 weeks, high frequencies were significantly affected at ≥ 4 kHz in the control group. When the baseline was compared across the groups in the 12th week, for otoacoustic emissions, high frequencies showed a loss in the control group more compared to the experimental side (Wilcoxon signed-rank test). ITD functions less effectively at higher frequencies because the basal turn of the cochlea is more susceptible to cisplatin ototoxicity. ITD might have potential in the reduction of cisplatin-induced hearing loss.
Indian Journal of Nursing Sciences
Background: People undergoing chemotherapy will have side effects, usually occurring such as naus... more Background: People undergoing chemotherapy will have side effects, usually occurring such as nausea and vomiting, alopecia, pain, fatigue, neutropenia, mouth sores, and thrombocytopenia. Some side effects can be serious enough to create delays in treatment. These may include febrile neutropenia, anemia, thrombocytopenia, etc. The objectives were formulated to carry out the study to assess the knowledge of staff nurses on immediate physiological problems occurring due to chemotherapy. Methods: The study opted to use a descriptive approach to its methodology. The research was conducted at the Patel Multispecialty Hospital in Jalandhar, which is located in the state of Punjab in India. The information was gathered from eighty staff nurses using the convenient sample technique and a self-structured questionnaire, and it was then analyzed to determine the level of knowledge possessed by the staff nurses. When doing the analysis of the data, both descriptive and inferential statistics wer...
Introduction: The combined modality treatment (chemotherapy and radiation therapy using both conv... more Introduction: The combined modality treatment (chemotherapy and radiation therapy using both conventional and altered fractionation) have produced increases in both disease-free and overall survival rates, although these approaches have produced higher rates of mucosal toxicity, with grade 3 rates ranging from 32% to 84% and grade 4 rates ranging from 0% to 30%. When compared with other toxic effects, these studies have established mucositis as the dose-limiting toxicity. Material and methods: Patients receiving chemo-radiation in the form of Cis-platinum, Gemcitabine or Paclitaxel alternating with Gemcitabine were enrolled in this study. Patients particulars were noted, a thorough history of the disease was taken. A complete physical examination with assessment of ECOG performance score, oral assessment, Mucositis was determined weekly while the patient was on chemo-radiation or radiation. Results were displayed as mean ± standard deviation or percentage. The independent sample &qu...
Introduction: Head and neck cancer is a major health problem in Asia, especially in the Indian su... more Introduction: Head and neck cancer is a major health problem in Asia, especially in the Indian subcontinent. Study aimed to assess the response of concomitant boost radiotherapy against the concurrent chemoradiotherapy in locally advanced oral cavity and oropharyngeal cancers and to compare the toxicity in terms of oral mucositis in both treatment groups. Material and methods: Total 60 patients were enrolled and randomly allotted to arm A (n=30) that received concurrent chemoradiotherapy and arm B (n=30) that received concomitant boost radiotherapy without any concurrent chemotherapy. The response at 6 weeks in both treatment arms was comparable (p value-0.721), the toxicity in terms of mucositis (p value-0.133) also came out to be comparable in both arms. The observations made in our study helped us arrive at a conclusion that concomitant boost radiotherapy without concomitant cisplatin has a response comparable to the conventional chemoradiotherapy regimen with not significantly higher cases of oral mucositis
INTRODUCTION Carcinoma cervix is the 4th most commonly diagnosed cancer in women and 10th overall... more INTRODUCTION Carcinoma cervix is the 4th most commonly diagnosed cancer in women and 10th overall worldwide. There were 569,847 new cases and 311,365 deaths from cervical cancer worldwide which accounts for 7.5% of total number of cancer deaths in women. 1 Cervical cancer is the 2nd most common cancer among Indian women aged 15-44 years with an estimate of 1,23,000 incident cases and 67,000 deaths in 2013 . 2 The choice of treatment depends on staging. Treatment planning i.e. Radiotherapy for cervical cancer consists of EBRT (external beam radiotherapy) along with concurrent chemotherapy followed by Intracavitary irradiation (ICRT) . 3 External beam radiotherapy can be provided in the form of conventional (2 D), 3 dimensional conformal and intensity modulated techniques. In late 1990s, the technique of 3D-CRT emerged as a preferred treatment for gynaecological malignancies. It uses information obtained from computed tomography scanning to identify visible tumour and organs at risk (...
Dr Sonali Karnwal, Dr Raja Paramjeet Singh Benipal, Dr Jai Lal, Dr Pardeep Garg, Dr Manraj Singh ... more Dr Sonali Karnwal, Dr Raja Paramjeet Singh Benipal, Dr Jai Lal, Dr Pardeep Garg, Dr Manraj Singh Kang, Dr Romi Kant Grover Affiliations: Senior Resident, Professor, Professor, Associate Professor, Assistant Professor, Assistant Professor 1 Department of Radiotherapy, Guru Gobind Singh Medical College & Hospital, Faridkot 2 Department of Radiotherapy, Government Medical College & Hospital, Patiala 3 Department of ENT, Guru Gobind Singh Medical College & Hospital, Faridkot Corresponding Author:Dr.Romi Kant Grover, Assistant Professor, Department of Radiotherapy, Guru Gobind Singh Medical College & Hospital, Faridkot
Role of palliative radiotherapy in painful bone metastases: A prospective study
MedPulse International Journal of Medicine, 2019
Carcinoma vulva: Ten years experience in a teaching institution of North India
Journal of Family Medicine and Primary Care
Identifying barriers to early diagnosis of breast cancer and perception of women in Malwa region of Punjab, India
Global Health Journal
Functional and biochemical changes in the thyroid gland following exposure to therapeutic doses of external beam radiotherapy in the head-and-neck cancer patients
Journal of Cancer Research and Therapeutics
Context: Majority of the head-and-neck cancers are locoregionally advanced at the time of diagnos... more Context: Majority of the head-and-neck cancers are locoregionally advanced at the time of diagnosis. Hence, radiotherapy (RT) portals will invariably cover the whole neck and thus, the thyroid gland which may lead to its dysfunction. Aims: The purpose of this study is to identify the functional and biochemical changes in the thyroid gland following RT to the neck using single-photon emission computed tomography-computed tomography (SPECT-CT) and thyroid function tests (TFTs). Subjects and Methods: In this prospective study, 45 patients of the head-and-neck cancer, receiving RT with or without chemotherapy were investigated. Baseline TFTs and thyroid scans (on SPECT-CT) were done, and the same were repeated at the completion of RT, at 3 and 6 months. Results: All patients received a minimum of 30 Gy to the whole neck. Baseline TFTs and thyroid scans were normal. None of them developed hypothyroidism clinical or subclinical (C/S) at the completion of RT. Six patients developed hypothyroidism (four subclinical, two clinical) at 3 months of the completion of treatment. At 6 months of follow-up 14 patients (31.1%) developed hypothyroidism (ten subclinical, four clinical) with P≤ 0.01. All patients having clinical or subclinical hypothyroidism had decreased uptake on thyroid scan. Patients having decreased uptake on thyroid scan only, with normal TFTs and no symptoms of hypothyroidism were zero at the completion of RT, 1 at 3 months follow-up, and seven at 6 months follow-up. Conclusions: Hypothyroidism (C/S) is an under-recognized but significant complication of therapeutic doses of RT to the neck. In our study, we recognized hypothyroidism as early as 3 months following the completion of RT. Hence, tests to evaluate functional and biochemical changes in the thyroid gland should be instituted as early as 3 months following RT.
SRMS JOURNAL OF MEDICAL SCIENCE, 2017
Introduction: Colorectal lymphoma is an extremely rare disease. The disease is usually diagnosed ... more Introduction: Colorectal lymphoma is an extremely rare disease. The disease is usually diagnosed in the advanced stages because of its primary nonspecific symptoms. Treatment modality of primary lymphoma of the rectum remains uncertain. Case History: A 45-year-old male presented with rectal bleeding, pain in perianal region and alteration in bowel habits along with fungating and circumferential mass in the rectum. The histopathology and immunohistochemistry confirmed the diagnosis of Plasmablastic Lymphoma. He was planned six cycles of CHOP regime. On follow up the residual disease was managed with second line of chemotherapy (DHAP regimen). The patient was started on Metronomic chemotherapy (Chlorambucil & Etoposide) in view of persistent residual disease. Conclusion: Optimal treatment for rectal lymphoma needs to be established.
Radiotherapy treatment plan quality metrics for breast cancer patients using conformal planning techniques
Iranian Journal of Medical Physics, 2021
Background: The purpose of this study is to evaluate and compare treatment plan quality metrics f... more Background: The purpose of this study is to evaluate and compare treatment plan quality metrics for postmastectomy breast cancer patients using 3Dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) planning techniques. Materials and Methods: The current study included 50 postmastectomy breast cancer patients out of which 24 were planned with 3DCRT and 26 with IMRT technique. Treatment plan quality metrics namely homogeneity index (HI), conformity index (CI), conformation number (CN), uniformity index (UI) and spillage index (R50), volume receiving 110% and 95% of prescribed dose (V110% and V95%) were calculated and compared for the two planning techniques. Results: IMRT plans have better conformity, homogeneity indices and low V110% than 3DCRT plans with almost similar R50% and V95%. Conclusions: Quantitative values of radiotherapy treatment plan quality metrics for the target are found in favour of IMRT technique than 3DCRT. Implementation of these...
Uploads
Papers by Dr Pardeep Garg