After more than a year of Coronavirus disease 2019 pandemic, in 2021 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination have been made possible and vaccine was distributed globally. Since then, there have been reports of symptoms following SARS-CoV-2 vaccination, including neurological symptoms of ascending paralysis known as Guillain-Barre syndrome. In this report, we describe the first case of Guillain-Barre syndrome following vaccination in Indonesia. Symptoms of ascending paralysis were of late onset after the first dose, however, were full blown after receiving the second dose followed by left-sided facial paralysis.

Background: Piriformis syndrome (PS) is a neuromuscular condition caused by the entrapment of the sciatic nerve at the level of the piriformis muscle (PM). Diagnosing PS remains challenging despite recent invasive and non-invasive diagnostic methods. Response to invasive nerve block is still one of the most reliable diagnostic modalities because there is no gold standard test for PS. As early diagnosis may prevent delayed diagnosis that results in chronic somatic dysfunction and muscle weakness, a screening test with high sensitivity could guide clinicians in performing the next appropriate step in diagnosing PS.Aim: The purpose of this study is to determine the sensitivity, specificity, and best cut-off point of ultrasound-guided PM thickness in PS.Method: This case-control study was conducted in a general hospital in Tangerang during a 3-month period. We recruited 58 patients clinically diagnosed with PS and 58 healthy patients (without a history of hip and buttock pain) during their visits to the outpatient clinic. All patients underwent ultrasound assessment to measure bilateral PM thickness. Sex, age, body mass index, history of micro-/macro-trauma, and prolonged sitting duration were recorded. Statistical analyses were performed using the Statistical Package for the Social Sciences version 25.Result: The PS and control groups predominantly comprised female subjects, with mean ages of 51.79 ± 14.10 and 50.09 ± 13.26 years on PS and healthy subjects, respectively. The mean ultrasound-guided PM thickness was higher in PS subjects compared to healthy subjects with mean thicknesses of 1.16 ± 0.13 and 0.85 ± 0.11 cm, respectively (p < 0.05). The area under the receiver operating characteristic curve of the PM was 0.970 (95% confidence interval 0.943–0.998, p < 0.05). The best cut-off point defined by Youden's J index was 0.9950 cm for all PS subjects.Conclusion: We propose 0.9950 cm as the cut-off point for diagnosing PS by ultrasound, which has the sensitivity and specificity of 94.8 and 87.9%, respectively.

Background: Piriformis syndrome is a neuromuscular condition characterized by hip and gluteal pain caused by abnormality of piriformis muscle. In clinical practice, this syndrome is usually misdiagnosed with other spinal disorders. There is no specific test in diagnosing piriformis syndrome, therefore by understanding the characteristics and predisposing factors, clinicians may be more aware in diagnosing this syndrome. Objective: To investigate the characteristics and predisposing factors of piriformis syndrome. Methods: A descriptive study was conducted on patients with gluteal pain in a referral hospital. Diagnosis was established by block injection on piriformis muscle and showed clinical improvement afterwards. Demographic characteristics, predisposing factors, and physical examination were analyzed. The data is collected and processed by SPSS 20.0. Results: The total of 65 patients were evaluated, with a male to female ratio 1:3. As much as 47.7% of patients were > 60 years old. Average weight was 60 kg and BMI (Body Mass Index) was within normal range (58.9%). Most subjects were housewives (55.4%) and the majority of subjects had history of microtrauma such as sitting on rigid surfaces (36.9%), walking or running long distances (18.5%), and cross-legged sitting (10.8%). Average sitting per day was approximately 5 hours. In 56.9% of subjects, exercises were conducted. There was no history of back pain in 81.5% of subjects. Conclusion: Our study showed age and housewives characteristics differ with other studies. The most predisposing factors were history of microtrauma, female, age, and normal BMI.

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