Our report describes a sudden flare-up of a skin rash (Grade 3) after the 5th cycle of cetuximab following use of OTC skin care remedies, which was unusual for this patient, suggesting a possible relation to the therapy. Skin crucially depends on EGFR for its normal function and becomes extremely sensitive during cetuximab therapy. Topical OTC acne and dry skin remedies can suddenly change the mild acneiform rash into severe skin toxicity associated with marked desquamation and exfoliation. Avoidance of further skin damage caused by topical applications and the use of doxycycline and diphenhydramine show a significant success in the management of skin toxicity.

Objectives: To provide awareness to the pathologists and technologists all about the red cells parameters in cold antibodies concerned cases. Case Report Findings: A sixty seven-years-old male admitted in emergency department of our hospital, having clinical history of swelling and pain in both the lower limb and feet, on physical examination, provisionally diagnosed as a case of Cellulitis and deep vein thrombosis(DVT). Blood specimen was obtained for general hematological investigations. Full blood count (FBC) was performed on sysmex XP-100 hematological analyzer which showed invalid findings especially red cells indices which were not corresponding to the hemoglobin (Hb) concentration of the patient. Blood sample was repeated, to confirm invalid red cells indices which showed values as in the 1st blood specimen. Blood smears revealed aggregation of red cells. By warming the ethylenediamine tetra-acetic acid (EDTA) tube containing the blood specimen, in water bath at 37⁰C for one hour and repeated the FBC on hematological analyzer and found the corrected red cells indices. Conclusion: Basic knowledge of cold antibodies and warming the blood sample at 37⁰c for one hour helps the correct diagnosis.

The objective of our study was to evaluate the efficacy of Master Lithoclast, also known as trilogy lithoclast, in simultaneous bilateral Percutaneous Nephrolithotomy (PCNL). The study was a prospective case series, involving 40 patients undergoing bilateral simultaneous PCNL, with 20 (50%) males and 20 (50%) females. The mean age of subjects was 32.9 ± 7.9 years. In Guy’s stone scoring 7(17.5%) patients classified in Group I, 28 (70%) in group II and the remaining 5(12.5%) patients were placed in group III. Total operative time observed was 74.8 ± 17.9 minutes. Complete stone clearance was observed in 30 (75%) patients. In conclusion, study data confirmed that Master Lithoclast provides faster stone clearance and is unaffected by the composition of stones, ease of usability, and improved tissue safety with reduced chances of fragments blocking are key factors. Keywords: Master lithoclast, Simultaneous bilateral PCNL, Trilogy lithoclast, Renal stone.