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Hypertensive disorders of pregnancy (HDP) are one of the commonest maladies, affecting 5%–10% of pregnancies worldwide. The American College of Obstetricians and Gynecologists (ACOG) identifies four categories of HDP, namely gestational hypertension (GH), Preeclampsia (PE), chronic hypertension (CH), and CH with superimposed PE. PE is a multisystem, heterogeneous disorder that encompasses 2%–8% of all pregnancy‐related complications, contributing to about 9% to 26% of maternal deaths in low‐income countries and 16% in high‐income countries. These translate to 50 000 maternal deaths and over 500 000 fetal deaths worldwide, therefore demanding high priority in understanding clinical presentation, screening, diagnostic criteria, and effective management. PE is accompanied by uteroplacental insufficiency leading to vascular and metabolic changes, vasoconstriction, and end‐organ ischemia. PE is diagnosed after 20 weeks of pregnancy in women who were previously normotensive or hypertensive. Besides shallow trophoblast invasion and inadequate remodeling of uterine arteries, dysregulation of the nonimmune system has been the focal point in PE. This results from aberrant immune system activation and imbalanced differentiation of T cells. Further, a failure of tolerance toward the semi‐allogenic fetus results due to altered distribution of Tregs such as CD4+FoxP3+ or CD4+CD25+CD127(low) FoxP3+ cells, thereby creating a cytotoxic environment by suboptimal production of immunosuppressive cytokines like IL‐10, IL‐4, and IL‐13. Also, intracellular production of complement protein C5a may result in decreased FoxP3+ regulatory T cells. With immune system dysfunction as a major driver in PE pathogenesis, it is logical that therapeutic targeting of components of the immune system with pharmacologic agents like anti‐inflammatory and immune‐modulating molecules are either being used or under clinical trial. Cholesterol synthesis inhibitors like Pravastatin may improve placental perfusion in PE, while Eculizumab (monoclonal antibody inhibiting C5) and small molecular inhibitor of C5a, Zilucoplan are under investigation. Monoclonal antibody against IL‐17(Secukinumab) has been proposed to alter the Th imbalance in PE. Autologous Treg therapy and immune checkpoint inhibitors like anti‐CTLA‐4 are emerging as new candidates in immune horizons for PE management in the future. [ABSTRACT FROM AUTHOR]

Undue heat production in surgical bone drilling leads to osteonecrosis and can be an important cause of failure of osteosynthesis, impaired healing, and loosening of implants following orthopedic surgery. The present work aims to minimize heat production below the critical temperature for thermal osteonecrosis (i.e., 47°C) and obviate thermal bone damage due to drilling. A total of 20 samples from the shaft of the human femur were obtained at autopsies and drilling was performed at room temperature by an operation theater (OT) compatible rotary ultrasonic bone drilling (RUBD) machine. K‐type thermocouples were used to measure the temperature rise during drilling and the physical changes of the bone samples were observed by infrared gama camera. Light microscopic and transmission electron microscopic studies were performed to evaluate the bone cell damage. The maximum temperature recorded in RUBD (40.6 ± 1.3°C) was much below the critical temperature for thermal osteonecrosis (p <.05) at the rotational speed of 2000 rpm. Light microscopic and ultrastructural studies also revealed that there was no appreciable damage to the bone cells. Conventional bone drilling (CD) on the other hand recorded much higher temperature (66.6 ± 3.2°C), tissue burn and bone cell necrosis. Hence, RUBD machine has a potentiality for its use in orthopedic surgery and may provide better results. [ABSTRACT FROM AUTHOR]

Misdiagnosed PAS confirmed at medicolegal autopsy Pulmonary artery sarcoma (PAS) is a rare disease and usually indistinguishable from acute or chronic thromboembolic disease of the pulmonary arteries. We present a case of pulmonary artery sarcoma in a 54‐year‐old male, who was clinically misdiagnosed as pulmonary thromboembolism. The patient died of disease; however, the actual diagnosis of PAS was made after a medicolegal autopsy. PAS can be a diagnostic challenge for both clinicians and pathologists. In an autopsy case with a clinical suspicion of pulmonary thromboembolism, if there is an abnormal gross appearance in the pulmonary artery, the forensic pathologist should have a high index of suspicion of PAS, which should be ruled out by a histopathologic examination. [ABSTRACT FROM AUTHOR]

Maffucci syndrome is characterized by multiple benign vascular anomalies and enchondromas present on the distal extremities. Effective treatment options are currently not available for Maffucci syndrome‐associated vascular lesions. Sirolimus is a mTOR pathway inhibitor, and has been tried successfully in the treatment of various vascular anomalies. We treated a 23‐year‐old female with Maffucci syndrome‐associated spindle cell hemangiomas with oral sirolimus (2mg/day, 0.04mg/kg/day). There was improvement in pain, but no change in colour or size of the vascular nodules. In view of unsatisfactory response and treatment‐related adverse effects (oral aphthae, mild transaminitis), sirolimus was stopped after 6 months. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 14-year-old boy was presented for evaluation of multiple erythematous papules on his back. It mentions that on examination it revealed numerous erythematous dome-shaped papules, on which excision biopsy was performed. It states that the patient was diagnosed with recurrent pyogenic granulomas with satellitosis. It mentions the several treatment modalities include surgical excision, curettage, and electrocautery.