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Purpose To analyse the preference of end of life care place in paediatric oncology patients, and to understand the end of life care needs and regrets among the care givers. Method This was an observational qualitative study. Parents of incurable paediatric malignancy patients who died during the years 2016-2018 were interviewed using a pre-formed open-ended questionnaire. Fears during the last phase of child's life, most disturbing symptoms, choice of end of life care plan, regret of care givers and reasons for such choices were noted and analysed. Result Twenty six families were interviewed. A median of 3 months of discordance was noted between declaration of incurability and acceptance of the same by the family. During terminal months, pain (84.62%) was described as the most bothersome symptom followed by respiratory distress (73.08%). Eighteen families (69%) opted for home-based terminal care, 8 (31%) for hospital-based terminal care. Regret of choice was noted in 62.5% families of the hospital-based care group (separation from home environment being the main reason) and 38.89% of the home-based care group (lack of access to health care personnel and pain medication being the main reasons). Conclusion Home-based care is the preferred option for end of life care by the care givers. Lack of community-based terminal care support system and availability of analgesics are the main areas to work on in India.

The scope and application of hematopoietic stem cell transplantation are increasing. With advancement in science and close cooperation of health centers, HSCT units are coming up in new developing and underdeveloped countries. India hosts many HSCT units and often provides financially viable option for HSCT to foreign patients as well. Recently Indian Council of Medical Research (ICMR) issued a guideline about HSCT unit in India. This review article discusses establishment of new HSCT unit in resource limited setting. Subsequent implication of ICMR guideline has been done.

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A 12-year-old female patient presented to the Surgery Department with the complaint of gradually increasing painful swelling on the anterior chest wall for 1 month. There was presence of fever with chills but there was negative history of cough, dyspnea, anorexia, weight loss and trauma. Past medical history was negative for diabetes mellitus, steroid use, chest operation and recurrent systemic infections. The history of BCG vaccination was negative. General physical examination was normal. Local examination revealed a slightly erythematous, firm and severely tender swelling with local warmth over the manubrio-sternal area measuring approximately 6 × 3 cm. The laboratory examinations revealed normal white blood cell count of 7,400/mm 3 and raised ESR (65 mm in first hour). The mantoux test was positive. Anteroposterior radiograph of the chest was normal; however, the lateral radiograph of the chest revealed permeative destruction of manubrium sterni (Figure 1). On Ultrasound examination, a collection measuring approximately 20 ml was noted at expected location of manubrium and posterior to it, with bony destruction (Figure 2). Computed tomography of the chest was performed, which revealed evidence of osteolytic permeative destruction of manubrium sterni with formation of collection extending to