Parsonage-Turner Syndrome (PTS) is a rare neurological disorder involving brachial plexus and periscapular muscles following viral infection, surgery, and vaccination. We hereby describe the first case of PTS from India following Covishield (AstraZeneca ChAdOx1 nCoV-19) COVID-19 vaccination.A 21-year-old healthy male presented to us with complaints of pain and weakness in the right shoulder five weeks after Covishield vaccination on the contralateral deltoid. There was no history of injury or constitutional symptoms. On examination, hyperalgesia over the area innervated by the axillary nerve and wasting of the deltoid, supra, and infraspinatus muscles were noted. An MRI scan of the shoulder, cervical spine, and brachial plexus neurogram were normal. Decreased motor amplitude in right axillary and musculocutaneous nerve was recorded in the nerve conduction study (NCS). High titers of SARS-COV-2 IgG neutralizing antibodies were noted after a single dose of vaccination and SARS CoV-2 IgM antibodies were negative. Having been diagnosed with post-vaccination PTS, the right shoulder was splinted and an intravenous injection of 1g methylprednisolone was administered for three days followed by oral steroids for three weeks. NCS and electromyography at 10 weeks showed insignificant differences between the two sides suggesting early neurological recovery.Currently, the patient is being followed up regularly for complete neurological recovery. PTS is a known side effect of vaccination. We report the index case of PTS following the administration of Covishield vaccination from India to aid in early diagnosis and management, further evaluation, and public health safety.

Osteitis condensans ilii (OCI) is a rare self-limiting low back pain syndrome. It is an incidental imaging discovery around sacroiliac joints with distinctive sclerotic lesions. We present three case reports as a series. In the first case, a 38-year-old female presented with unresolved chronic low back pain for eight years. She had bilateral triangular sclerosis of the ilium abutting sacroiliac joints and other causes of back pain were ruled out. Non-operative management was successful. In the second case, a 38-year-old female presented with acute exacerbation of low back pain for one year. She suffered low back pain during her pregnancy and postpartum period 16 years ago and intermittently after that. Bilateral radiodensity around sacroiliac joints was noted in the radiograph and she had successful remission with non-operative management. In the third case, a 45-year-old female presented with chronic low back for six years. On radiographs, she had bilateral sclerotic lesions around sacroiliac joints and responded well to non-operative management. OCI is a benign, idiopathic cause of axial low back pain. It is a diagnosis of exclusion and the pelvic radiographs classically show areas of sclerosis in the ilium adjacent to sacroiliac joints bilaterally. Treatment for OCI is essentially non-operative.

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BACKGROUND Wounds and their management are important in the practice of surgery. Super oxidised solution is a recent concept in wound management. It is an aqueous solution which is electrochemically processed which is non-toxic, non-irrigating and is having a neutral pH. Povidone iodine is the most common topical wound care product used in surgical practice. Both are affordable solutions for the patients. There are very few studies comparing the efficacy. In this study, we wanted to compare the efficacy of super oxidised solution and povidone iodine in the management of lower limb ulcers. METHODS A prospective study was conducted on 100 patients who were randomized into two groups. Group A was treated with super oxidized solution and Group B were treated with povidone iodine. Assessments of wounds were done on various days (1, 3, 5, 7, 9, 12, 15, 18, 21). Various outcomes of data were analysed using statistical analysis. RESULTS The average percentage reduction in wound size on day 21 was 47 % in Group A compared to 24 % in Group B. Early appearance of granulation tissue, disinfection, decrease in wound size, and less duration of hospital stay was achieved in Group A. CONCLUSIONS The results were more favourable towards super oxidised solution than povidone iodine. In this comparative study, super oxidized solution had faster efficacy and wound healing in patients than povidone iodine. KEY WORDS Super Oxidized Solution, Ulcer, Povidone Iodine.

Tubercular tenosynovitis of the wrist with carpal tunnel syndrome (CTS) is a rare occurrence. The authors present a case of tubercular flexor tenosynovitis of the wrist with CTS. A 60-year-old female presented with complaints of swelling in the volar aspect of the right wrist with numbness of the first three fingers for the past 6 months. Clinical and radiological diagnosis of chronic flexor tenosynovitis with median nerve compression neuropathy was made. The patient was operated with carpal tunnel release and total tenosynovectomy. Histopathology showed features suggestive of Koch’s etiology. The patient was started with antitubercular therapy (ATT) and followed up regularly. Carpal tunnel symptoms subsided immediately after surgery and there was no recurrence of swelling at the last follow-up. Carpal tunnel release and tenosynovectomy should be performed at the earliest possible and followed up with ATT for better outcomes in tubercular tenosynovitis of the wrist with CTS.