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Preoperative therapy in locally advanced esophageal cancer

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World Journal of Gastroenterology 2016年第39期22卷 8750-8759页

作者： pankaj kumar garg Jyoti Sharma Ashish Jakhetiya Aakanksha Goel Manish kumar Gaur Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi Department of Surgical Oncology Sawai Man Singh Medical College Department of Surgical Oncology Dr BRA Institute Rotary Cancer Hospital All India Institute of Medical Sciences

Esophageal cancer is an aggressive malignancy associated with dismal treatment outcomes. Presence of two distinct histopathological types distinguishes it from other gastrointestinal tract malignancies. Surgery is the cornerstone of treatment in locally advanced esophageal cancer(T2 or greater or node positive); however, a high rate of disease recurrence(systemic and loco-regional) and poor survival justifies a continued search for optimal therapy. Various combinations of multimodality treatment(preoperative/perioperative, or postoperative; radiotherapy, chemotherapy, or chemoradiotherapy) are being explored to lower disease recurrence and improve survival. Preoperative therapy followed by surgery is presently considered the standard of care in resectable locally advanced esophageal cancer as postoperative treatment may not be feasible for all the patients due to the morbidity of esophagectomy and prolonged recovery time limiting the tolerance of patient. There are wide variations in the preoperative therapy practiced across the centres depending upon the institutional practices, availability of facilities and personal experiences. There is paucity of literature to standardize the preoperative therapy. Broadly, chemoradiotherapy is the preferred neo-adjuvant modality in western countries whereas chemotherapy alone is considered optimal in the far East. The present review highlights the significant studies to assist in opting for the best evidence based preoperative therapy(radiotherapy, chemotherapy or chemoradiotherapy) for locally advanced esophageal cancer.

关键词： Esophageal cancer Preoperative therapy Multimodality treatment Chemotherapy Radiotherapy Chemoradiotherapy

Mixed Saddle Point and Its Equivalence with an Efficient Solution under Generalized (V, <i>p</i>)-Invexity

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Applied Mathematics 2015年第9期6卷 1630-1637页

作者： Arvind kumar pankaj kumar garg Department of Mathematics University of Delhi Delhi India Department of Mathematics Rajdhani College University of Delhi Delhi India

The purpose of this paper is to define the concept of mixed saddle point for a vector-valued Lagrangian of the non-smooth multiobjective vector-valued constrained optimization problem and establish the equivalence of ... 详细信息

关键词： Nonsmooth Multiobjective Programs (V p)-Invexity Mixed Saddle Point Vector-Valued Mixed Lagrangian Function

Giant exophytic renal angiomyolipoma masquerading as a retroperitoneal liposarcoma: A case report and review of literature

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World Journal of Clinical Oncology 2018年第7期9卷 162-166页

作者： Gopal Sharma Ayush Jain Prerit Sharma Sonal Sharma Vinita Rathi pankaj kumar garg Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi Department of Pathology University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi Department of Radiology University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi

A 42-years-old lady, presented with a large retroperitoneal mass which was preoperatively diagnosed as a retroperitoneal liposarcoma following an image guided core biopsy. She underwent a margin-negative resection of the retroperitoneal mass(multi visceral resection-enbloc excision of the retroperitoneal mass with a left nephrectomy and a segmental descending colectomy). The final histopathological examination of the resected specimen confirmed an exophytic renal angiomyolipoma(AML) which was extending into the retroperitoneum. AML is a rare benign tumor arising most commonly from the kidney. It can sometimes present as a diagnostic challenge as it mimics a retroperitoneal liposarcoma or a fat-containing renal cell carcinomas closely. We present this case to share our experience of managing a case of giant exophytic AML which resembled retroperitoneal liposarcoma closely and resulted into an aggressive surgery.

关键词： Angiomyolipoma Retroperitoneum Liposarcoma Diagnosis Biopsy

Lymphadenectomy in gastric cancer: Contentious issues

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World Journal of Gastrointestinal Surgery 2016年第4期8卷 294-300页

作者： pankaj kumar garg Ashish Jakhetiya Jyoti Sharma Mukur Dipi Ray Durgatosh Pandey Department of Surgical Oncology Dr BRA Institute Rotary Cancer Hospital All India Institute of Medical Sciences Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital

The stomach is the sixth most common cause of cancer worldwide. Surgery is an important component of the multi-modality treatment of the gastric cancer. The extent of lymphadenectomy has been a controversial issue in the surgical management of gastric cancer. The East-Asian surgeons believe that quality-controlled extended lymphadenectomy resulting in better locoregional control leads to survival benefit in the gastric cancer; contrary to that, many western surgeons believe that extended lymphadenectomy adds to only postoperative morbidity and mortality without significantly enhancing the overall survival. We present a comprehensive review of the lymphadenectomy in the gastric cancer based on the previously published randomized controlled trials.

关键词： Gastric neoplasms Lymphadenectomy Gastrectomy Survival Disease recurrence

Spontaneous rupture of the renal pelvis presenting as an urinoma in locally advanced rectal cancer

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World Journal of Clinical Cases 2014年第4期2卷 108-110页

作者： pankaj kumar garg Debajyoti Mohanty Vinita Rathi Bhupendra kumar Jain Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital Department of Surgical Oncology All India Institute of Medical Sciences Department of Radiology University College of Medical Sciences and Guru Teg Bahadur Hospital

A 29-year-old gentleman underwent a transverse colostomy for intestinal obstruction caused by advanced rectal carcinoma. On the 5th postoperative day, the patient developed a painful swelling on the right side of the abdomen. The contrast enhanced computed tomography of the abdomen revealed a right sided hydronephrosis, a large rent in the renal pelvis, and a large retroperitoneal fluid collection on the right side. Percutaneous nephrostomy and pigtail catheter drainage of the urinoma led to resolution of abdominal swelling. Development of a urinoma as a consequence of rectal carcinoma is highly unusual. Prompt imaging for confirmation of diagnosis, decompression of the renal pelvicalyceal system, and drainage of the urinoma limits morbidity.

关键词： Colorectal cancer Urinoma Spontaneous rupture of the renal pelvis Percutaneous nephrostomy Pigtail catheter drainage

garg incontinence scores: New scoring system on the horizon to evaluate fecal incontinence. Will it make a difference?

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World Journal of Gastroenterology 2024年第3期30卷 204-210页

作者： Petr Tsarkov Inna Tulina Parvez Sheikh Darya D Shlyk pankaj garg Department of Colorectal Surgery Sechenov First Moscow State Medical UniversityMoscow 119991Russia Department of Oncologic Colorectal Surgery Sechenov First Moscow State Medical UniversityMoscow 119991Russia Department of Colorectal Surgery Saifee HospitalMumbai 400004MaharashtraIndia Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia

The main aim of this opinion review is to comment on the recent article published by garg et al in the World Journal of Gastroenterology 2023;29:4593–*** authors in the published article developed a new scoring system,garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the *** IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a *** associated social stigmatization often leads to significant under-reporting of the condition,which further impairs *** important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their *** to this,the management becomes even more *** issue is resolved up to a considerable extent by a scoring *** were several scoring systems in use for the last three *** prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,*** Hospital or Vaizey’s scores,and the FI severity ***,there were several shortcomings in these scoring *** the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring *** main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into *** GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring *** to this,GIS in

关键词： Fecal incontinence Scoring system Urge Stress Flatus

Appraisal of pollution and health risks associated with coal mine contaminated soil using multimodal statistical and Fuzzy-TOPSIS approaches

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Frontiers of Environmental Science & Engineering 2024年第5期18卷 101-115页

作者： Sumit kumar Sonali Banerjee Saibal Ghosh Santanu Majumder Jajati Mandal pankaj kumar Roy Pradip Bhattacharyya Agricultural and Ecological Research Unit Indian Statistical InstituteGiridih815301India Department of Life and Environmental Sciences Bournemouth University(Talbot Campus)Fern BarrowPooleBH12 5BBUK School of Sciences Engineering & EnvironmentUniversity of SalfordSalfordM5 4QJUK School of Water Resource Engineering Jadavpur UniversityKolkata700032India School of Environmental Studies Jadavpur UniversityKolkata700032India

The present study assesses the concentration,probabilistic risk,source classification,and dietary risk arising from heavy metal(HMs)pollution in agricultural soils affected by coal mining in eastern part of *** of soil and rice plant indicated significantly elevated levels of HMs beyond the permissible limit in the contaminated zones(zone 1:PbSoil:108.24±72.97,CuSoil:57.26±23.91,CdSoil:8.44±2.76,CrSoil:180.05±46.90,NiSoil:70.79±25.06 mg/kg;PbGrain:0.96±0.8,CuGrain:8.6±5.1,CdGrain:0.65±0.42,CrGrain:4.78±1.89,NiGrain:11.74±4.38 mg/*** 2:PbSoil:139.56±69.46,CuSoil:69.89±19.86,CdSoil:8.95±2.57,CrSoil:245.46±70.66,NiSoil:95.46±22.89 mg/kg;PbGrain:1.27±0.84,CuGrain:7.9±4.57,CdGrain:0.76±0.43,CrGrain:8.6±1.58,NiGrain:11.50±2.46 mg/kg)compared to the uncontaminated zone(zone 3).Carcinogenic and non-carcinogenic health risks were computed based on the HMs concentration in the soil and rice grain,with Pb,Cr,and Ni identified as posing a high risk to human *** Carlo simulation,the solubility-free ion activity model(FIAM),and severity adjusted margin of exposure(SAMOE)were employed to predict health *** hazard quotient(HQ)values for Ni,Cr,Cd,and Pb were>1,indicating a significant non-carcinogenic ***(risk thermometer)results for contaminated zones ranged from low to moderate risk(CrSAMOE:0.05,and NiSAMOE:0.03).Fuzzy-TOPSIS and variable importance plots(from random forest)showed that Ni and Cr were mostly responsible for the toxicity in the rice plant,respectively.A self-organizing map for source classification revealed common origin for the studied HMs with zone 2 exhibiting the highest *** positive matrix factorization model for the source apportionment identified coal mining and transportation as the predominant sources of *** distribution analysis indicated higher contamination near mining sites as compared to distant sampling ***,this study will aid environmental scientists and policymakers controllin

关键词： Coal mine Free ion activity model Monto Carlo Simulation Pollution and Health risk Fuzzy-TOPSIS

Hydro-uvarovite from Mantle Peridotites of Naga Hills Ophiolite: A Mineral Tracer for Neo-Tethyan Mantle Wedge Metasomatism

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Acta Geologica Sinica(English Edition) 2024年第4期98卷 867-877页

作者： Anisha VERENCAR Abhishek SAHA Nilanjana SORCAR Sohini GANGULY pankaj kumar Atul kumar SINGH CSIR-National Institute of Oceanography Dona PaulaGoa 403004India School of Earth Ocean and Atmospheric SciencesGoa UniversityTaleigao PlateauGoa 403206India National Centre for Earth Science Studies ThiruvananthapuramKeralaIndia Inter University Accelerator Centre(IUAC) New Delhi 110067India North-Eastern Hill University ShillongMeghalaya 793022India

Hydrous Cr-bearing uvarovite garnets are rare in natural occurrences and belong to the ugrandite series and exist in binary solid solutions with grossular and andradite garnets. Here, we report the occurrence of hydrous uvarovite garnet having Cr_(2)O_(3) upto 19.66 wt% and CaO of 32.12–35.14 wt% in the serpentinized mantle peridotites of Naga Hills Ophiolite(NHO), India. They occur in association with low-Cr diopsides. They are enriched in LILE(Ba, Sr), LREEs, with fractionating LREE-MREE [avg.(La/Sm)_(N) = 2.16] with flat MREE/HREE patterns [avg.(Sm/Yb)_(N) = 0.95]. Raman spectra indicate the presence of hydroxyl(OH^(–)) peaks from 3500 to 3700 cm^(-1). Relative abundances in fluid mobile elements and their close association with clinopyroxenes are suggestive of the formation of uvarovite garnets through low temperature metasomatic alteration of low-Cr diopsides by hydrothermal slab fluids. The high LREE concentration and absence of Eu anomaly in the garnet further attest to alkaline nature of the transporting slab dehydrated fluid rather the involvement of low-p H solution. The chemical characteristics of the hydroxyl bearing uvarovite hosted by the mantle peridotite of NHO deviate from the classical features of uvarovite garnet, and their origin is attributed to the fluid-induced metasomatism of the sub arc mantle wedge in a suprasubduction zone regime.

关键词： uvarovite hydroxyl metasomatic alteration low-Cr diopsides serpentinization mantle peridotite

Assessment of albendazole efficacy against Ascaris lumbricoides at three sites of Andhra Pradesh,Odisha,and Kerala in India

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Asian Pacific Journal of Tropical Medicine 2024年第7期17卷 310-316页

作者： Vinay garg Ankur garg Shubha garg Sudhir kumar Jain Tanzin Dikid Saurabh Jain Jitendra Manjhi Antonio Montresor Atul Goel Division of Parasitic Diseases National Centre for Disease ControlMinistry of Health and Family WelfareGovernment of India22-Sham Nath MargCivil LinesNew Delhi-110054India National Centre for Disease Control Ministry of Health and Family WelfareGovernment of India22-Sham Nath MargCivil LinesNew Delhi-110054India Epidemiology Division National Centre for Disease ControlMinistry of Health and Family WelfareGovernment of India22-Sham Nath MargCivil LinesNew Delhi-110054India Department of Control of Neglected Tropical Diseases(NTD) World Health Organization(WHO)Av Appia 20 CH-1211Geneva 27Switzerland Department of Community&Family Medicine AIIMS KalyaniIndia Community and Primary Care-based Intervention Department of Control of Neglected Tropical Diseases(NTD)World Health Organization(WHO)Av Appia 20 CH-1211Geneva 27Switzerland Director General of Health Sciences(DGHS)&Director National Centre for Disease ControlMinistry of Health and Family WelfareGovernment of India22-Sham Nath MargCivil LinesNew Delhi-110054India

Objective:To assess efficacy of albendazole against Ascaris(A.)lumbricoides among school-children at three sites of Rajahmundry,Sundergarh and ***:Sites were selected based on soil-transmitted helminths prevalence,different sociocultural-geographical characteristics and operational feasibility.9-12 Years old children from 14 schools were *** study was conducted in two rounds:baseline&follow up *** eligible children found positive for *** at baseline were administered supervised single tablet albendazole 400 mg under the National Deworming Day *** post-treatment follow-up survey,eligible children who provided second stool sample were included in the final *** samples were examined using WHO recommended Kato-Katz *** was estimated based on cure rate(CR)and Fecal Egg Count Reduction Rate(FECRR)among children found positive in baseline and follow-up ***:328 Out of 625(52.5%)were found positive for *** in the baseline survey and 85 out of 178 samples(47.8%)during post-treatment follow-up ***,the estimated CR was 52.2%.FECRR(95%CI)for albendazole was 72.6%(79.2%-66.0%).The FECRR was highest in East Godaveri[89.7%(96.8%-82.6%)],followed by Sundergarh[86.4%(95.3%-77.5%)]and Wayanad[69%(81.7%-56.4%)].Conclusions:Our study confirmed overall reduction in FEC although with varying albendazole efficacy for *** infection at three different locations in ***,these finding may be assessed in context of ongoing MDA under Filaria control program and further studies by in vivo as well as in vitro methods are required to reach to a conclusion on possible resistance if any.

关键词： Soil transmitted helminths Ascaris lumbricoides Albendazole Efficacy