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Takayasu Arteritis (TA) is a chronic inflammatory disease affecting large blood vessels, particularly the aorta and its branches, making it a type of vasculitis. It is reported to be highly prevalent in Southeast Asian countries. Clinical presentations may vary, including headache, weight loss, malaise, fever, hypertension, visual disturbances, and musculoskeletal symptoms. Gangrene is a rare manifestation of TA, with relatively few cases reported globally. If gangrene is present, it is commonly noted in the lower limbs. Inflammation of the blood vessels caused by TA might lead to stenosis of the affected vessels. The underlying pathophysiology of gangrene development in TA is poorly understood but is mainly attributed to the occlusion of blood vessels. It is associated with inflammatory markers produced by lymphocytes and macrophages. Immunosuppressive drugs are recommended for symptomatic relief. Early diagnosis and intervention can be useful in managing TA, preventing adverse outcomes, and reducing its financial, social, and psychological consequences. This is a case report of a 32-year-old female, presented with gangrene and a history of rheumatoid arthritis. Further examination revealed a presentation of TA. The patient was managed by below-knee amputation for gangrene of the left leg and medical management for TA. Therefore, authors aim to draw attention to the diagnosis of TA and the rare associated morbidity, ‘gangrene,’ and the importance of timely intervention.

Abdominal cocoon syndrome is a rare clinical presentation that has been associated with abdominal tuberculosis in rural India. It is also known as sclerosing encapsulating peritonitis, where the small bowel becomes encapsulated by a fibrous membrane due to unclear causes, leading to obstipation. Common symptoms include vomiting, nausea, and constipation. Due to these general clinical symptoms, it can be mistaken for other gastrointestinal disorders, resulting in delayed diagnosis, which may lead to adverse outcomes or even mortality. Surgery is often used to free the entrapped bowel and remove the fibrous tissue, while supportive care and problem management are crucial. The present case involves a 55-year-old male who presented with a distended abdomen and obstipation, leading to intestinal perforation and sclerosing encapsulating peritonitis, which was managed through resection and anastomosis of the small intestine. The patient was followed-up after three months with no new complaints. The present case helps in understanding the sequelae of acute intestinal perforation that can result in abdominal cocoon syndrome.

Mucocele of the appendix is a rare condition caused by mucus accumulation due to a blocked appendix resulting from inflammation, infection, or faecal matter blockage. It presents as lower abdominal pain, vomiting, nausea, abdominal mass, and distension. It is more common in individuals over 50 years old and is more prevalent in the elderly. Mucocele can be differentiated into mucinous cystadenocarcinoma, mucosal hyperplasia, and mucinous cystadenoma. It is often diagnosed incidentally during radiological, laparoscopic, or surgical interventions. Ultrasound and computed tomography imaging techniques are useful in screening and diagnosing appendiceal mucocele, as they can detect a cystic mass or soft tissue mass and differentiate between a mucocele and other neoplasms. Most cases are reported in older individuals, with few in young adults. In the present case report, the authors present a case of a 34-year-old female with a history of occasional abdominal pain. On investigation, it was found to be an inflamed appendix with a mass in the right iliac fossa for which the patient underwent appendectomy. Due to the involvement of the right adnexa with tubo-ovarian complex and omentum, the present case presents a unique manifestation of an appendix mucocele.

Leiomyomas are common benign tumours of smooth muscles, often occurring in the uterine muscle wall. These growths usually appear during a woman’s reproductive years and are not malignant. Leiomyomas are quite common and impact a large percentage of women worldwide. Occasionally, leiomyomas can be located in the extremities and cause pain due to compression effects. Typically, foot leiomyomas appear as a lump or mass in the soft tissue of the foot that grows slowly. They are normally painless, but pain or discomfort occurs when the growth affects or compresses the surrounding tissues or nerves. Although the precise cause of leiomyomas is unknown, it is thought that hormone changes, genetics, and other unidentified factors play a role in their incidence. Cutaneous leiomyomas are most often benign, and surgical removal can benefit patients in terms of pain management or symptom relief. Leiomyomas of the foot are uncommon. The present case report illustrates the clinical, radiographic, and pathological findings of a rare subcutaneous leiomyoma in the foot. The authors present the case of a 50-year-old woman who visited the Outpatient Department (OPD) complaining of swelling over the back of her left heel. Magnetic Resonance Imaging (MRI) of the ankle depicted the characteristics of the swelling, which was confirmed as leiomyoma through Immunohistochemical (IHC) tumour markers {Haematoxylin and Eosin (H&E)}. The lesion was surgically excised, and histopathology of the excised sample revealed leiomyoma.

Topical administration of drugs into the vagina can provide local therapy of vaginal infections, preventing the possible systemic side effects of the drugs. The natural polysaccharide chitosan is known for its excellent mucoadhesive properties, safety profile, and antibacterial effects, and thus it can be utilized in improving localized vaginal therapy by prolonging the residence time of a drug at the vaginal site while acting as an antimicrobial in synergy. Therefore, we aimed to explore the potential of chitosan, namely chitosan-coated liposomes and chitosan hydrogel, as an excipient with intrinsic antimicrobial properties. Liposomes were prepared by the thin-film hydration method followed by vesicle size reduction by sonication to the desired size, approximately 200 nm, and coated with chitosan (0.01, 0.03, 0.1, and 0.3%, w/v, respectively). The mucoadhesive properties of chitosan-coated liposomes were determined through their binding efficiency to mucin compared to non-coated liposomes. Non-coated liposomal suspensions were incorporated in chitosan hydrogels forming the liposomes-in-hydrogel formulations, which were further assessed for their texture properties in the presence of biological fluid simulants. The antibacterial effect of chitosan-coated liposomes (0.03%, 0.1% and 0.3%, w/v) and chitosan hydrogels (0.1% and 0.3%, w/w) on Staphylococcus epidermidis and Staphylococcus aureus was successfully confirmed.