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Byline: Khaleel. Ahmed, H. Govardhan, Manisha. Roy, T. Naveen, P. Siddanna, P. Sridhar, M. Suma, Noopur. Nelson BACKGROUND: Owing to the aggressive nature of high-grade gliomas (HGGs), its early diagnosis [...]

Background: In India, the burden of delay in early diagnosis of childhood cancer and treatment is higher than previously suggested. Government policies in collaboration with all sections of society are required to improve care for children with cancer. This proposal outlines an early diagnosis and shared care model integrating palliative care into paediatric oncology with civil society participation in Karnataka, thereby the implementation of a National Policy. Objectives: 1. To identify the incidence, pattern, region and district-wide distribution of childhood cancers in Karnataka 2. To formulate a draft state childhood cancer comprehensive management policy 3. To Identify a National Health Programme/s formulate a pathway to implement the policy. The Methodology of Preparing this Proposal: Hospital Based Cancer Registry was analyzed, World Health Organization's (WHO) resources were searched, and communication with Government authorities for policy implementation followed by focused group discussion with concerned faculty and representatives. Results: 3305 childhood malignancies (0-18 years) were registered between the Year 2010-2015. 85.26% hailed from Karnataka. 60.9% were Boys and 42.2% were 7-14 Years. Focused group discussion resulted in the formulation of the referral pathway, shared care model integrating palliative care services and creation of a platform for civil society organizations' participation. Conclusion: A comprehensive childhood cancer policy ensuring early diagnosis through a shared care model and integrating palliative care into paediatric oncology practice in the form of well-structured and collective studies conducted are required to evolve a national collaborative policy aiming at reduction in the geographical gaps in treatment facilities. the same model may be incorporated into the management of other Childhood conditions. [ABSTRACT FROM AUTHOR]

Introduction: Children subjected to either radiation therapy or chemotherapy for brain tumors; suffer from short term and long term effects leading to notable restriction in physical activity and mobility due to fatigue. The above factors result in an overall depletion in quality of life. Efforts to localize an intervention within the hospital premises to provide a child-friendly supportive therapy to address the issue of QOL have to be undertaken. Yoga can be implemented as a low-intensity physical activity. The objective of this study is to establish the feasibility and therapeutic effect of yoga in pediatric brain tumor and to provide a foundation for the development of an RCT. Materials and Methodology: 20 potential participants, aged between 6-18 years, planned for either radiation or chemotherapy for brain tumors were screened during the commencement of their treatment from the in-patient department. 18 consented to the program with a written consent signed by the parent/guardian. A basic yoga module consisting of a set of loosening, breathing, postures, relaxation, and meditation was administered for 1 hour over 4 weeks. The primary outcome, feasibility, was defined as the ability to deliver a minimum of three sessions weekly (total - 5). Percentile of attendance will be calculated. A parent proxyreported feedback form, administered at baseline and at the end of 4 weeks with an open-ended question to assess willingness to continue the practice at home post-discharge. Items are rated on a 4 point Likert scale from 0 (never) to 4 (a lot). The simple paired sample t-test was used with Graph Pad online software for analysis. Results: The mean age of the group was found to be 9.8 yrs All participants achieved minimum required attendance. The median number of sessions attended was 16 with a range of 12. Good acceptability of the program has been established. An extremely significant difference was seen with respect to reduction in appreciation of Pain (0.0001), Relief in headache (0.0005), increase in appetite (0.0005), better sleep (0.0003), reduced fatigue (0.007). Increase in overall daily activity was also significant with p=0.0018. The above result shows sufficient evidence to establish the positive effects of yoga. No other adverse event which can be attributed to the practice of yoga occurred. Conclusion: Individualized yoga is feasible for children with cancer receiving intensive chemo and radiotherapy thereby supporting its therapeutic benefit. An RCT to confirm the findings with a larger sample size will help establish the outcome results. [ABSTRACT FROM AUTHOR]