Pediatric Oncology, Palliative Care and Low- or Middle- Income Countries: A Call for Action.

Pediatric oncology, which includes cancer screening and therapy in children, poses significant challenges in low- and middle-income countries (LMICs). Palliative care improves children's and their families' quality of life. In LMICs, palliative care resources are scarce, resulting in poor symptom management, psychological support, and spiritual care. All relevant English-language articles on pediatric palliative oncology were searched in PubMed, Google Scholar, Scopus, and Medline databases using the following keywords: "Pediatric Oncology," "Pediatric Palliative Oncology," "Pediatric Palliative Care," "Palliative Care," "Child Cancer," and "Lower- and Middle-Income Countries." This study highlights the significance of incorporating palliative care early in therapy and the recommendations may improve the competence of information provided by medical professionals to patients and families. LMICs have the potential to improve overall treatment and outcomes for child cancer patients and their families by prioritizing the integration of palliative care, guaranteeing a compassionate and dignified attitude toward the disease.

Multisegment Extradural Tuberculoma Masquerading as a Spinal Tumor.

We report a case of a man who presented with features of spinal cord compression, and imaging showed an L3-S2 space-occupying lesion that mimicked a spinal tumor. The patient underwent L3 to S2 laminectomy and a fibrous, thick sheet-like, poorly vascular lesion was observed macroscopically. The histopathological examination of the lesion showed caseous necrosis and epithelioid giant cells. This raised suspicion of tuberculosis and which was later confirmed on a polymerase chain reaction. The present case illustrates that tuberculosis is a disease that should not be ignored, particularly considering its ability to resemble other types of mass lesions.

Giant Epidermoid Cyst of the Posterior Fossa.

Epidermoids are rare intracranial neoplasms that grow slowly and present in the third to fifth decade of life. Giant epidermoid cysts are infrequent, and their occurrence in the posterior fossa is rare. We describe a similar case, where a patient presented with a long-standing history of headache, imbalance, and progressive weakness in the arms. Imaging revealed a giant space-occupying lesion in the posterior fossa measuring 6.25 cm x 7.56 cm x 6.8 cm, which was confirmed on histopathology to be an epidermoid cyst. The patient underwent suboccipital craniotomy extending up to the rectosigmoid junction to remove the same and was on a follow-up to check for recurrences.

Multisegment Intradural Extramedullary Ependymoma.

Ependymomas are commonly reported at an intradural intramedullary location and more frequently at the conus medullaris or filum terminale. In comparison to this, the incidence of spinal tumors being reported at an intradural extramedullary site is less. We describe a young patient who presented with urinary retention and a long-standing history of back pain radiating to the right lower limb. Imaging revealed an intradural ependymoma extending from D11 to S1 and measuring 21 cm in length. The patient underwent D10 to S1 laminectomy. Although the tumor originated from the conus medullaris, the histological evaluation revealed a WHO grade II ependymoma, which is rare, as only 30% of tumors in this location are non-myxopapillary.

Fractional order automatic tuning of PIλD controller for stable processes.

This paper presents modified fractional order relay based automatic tuning of PIλD controller for stable processes with load disturbance. The modified relay comprises of PIλcontroller introduced with the ideal relay in series. The proportional gain of PIλ controller is assumed as unity and the integral time constant is chosen such that, the system attains minimum 0° phase margin. λ of PIλ controller helps in reducing the harmonics in the output which ultimately leads to improvement in the accuracy of the proposed scheme. The limit cycle, thus, obtained helps in extracting the critical frequency and peak amplitude which helps in controller design. The designing of PIλD controller is based on the measured parameters from modified relay. Subsequently, the derivative time constant is derived in the design of PIλD controller using phase margin criteria and Nyquist curve is used to obtain the proportional gain. The integral time constant for PIλD controller is same as that of PIλ controller for auto tuning test. The auto tuning method and PIλD controller design, thus proposed, is validated using typical examples through simulation.