Dexamethasone phosphate when administered undiluted by intravenous push in dosage reduced even up to 4 mg, produces paraesthesia ranging from mild hot flushes to severe burning and itching, strangely restricted to perineum in 40 to 60 percent of patients. In this study, apart from grading its severity, we have tried to emphasize its greater recognition among those engaged in its administration. In addition to recommend that always mention a note of it on patient's file, we propose a cheaper and easy approach for its use in different required dosages in a suitable dilutional form. This concept should help build a better compliance with the cancer chemotherapy and should improve comprehensive cancer care.

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Spontaneous and mutagen induced Sister Chromatid Exchange (SCE) frequencies were assessed among 16 Down syndrome (DS) patients and 15 healthy controls. The spontaneous SCE rates were comparable in both the groups. MMC-induced SCE frequencies were significantly lower in DS patients as compared to the controls. However, the number of cells with high frequency of spontaneous SCEs was three times higher in DS patients as compared to controls. Thus, the present study on MMC-induced SCE frequencies is not sufficient to evaluate the risk of neoplasia in DS patients. Further study with different mutagen as well as cytogenetic end point e.g. chromosome aberration frequency will be helpful in understanding the risk of malignancy among DS patients.

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Merkel cell carcinoma is a rare primary neuroendocrine tumour of skin thought to arise from merkel cell touch receptor. We present a case of merkel cell carcinoma of scalp. The patient was managed by surgery, radiotherapy and chemotherapy. She eventually developed wide spread metastases in bone and lungs.

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Familial clustering is known to occur in lymphoproliferative disorders. It is also observed in 8.8 percent of patients with chronic lymphocytic leukemia. Present case report describes a brother and a sister with chronic lymphocytic leukemia. There must be multiple factors like genetic as well as environmental factors which must be responsible for familial clustering. These factors and their contributions are discussed at length.

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