Background: Chronic leg ulcers (CLU) are difficult to heal. Along with history and clinical examination, the ankle brachial index (ABI) is a simple, noninvasive tool used to screen peripheral arterial disease (PAD).Objective: This study sought to evaluate the association between abnormal ABI and clinical outcomes in patients with lower limb ulcers. Material and Methods:It was a prospective study involving 50 patients with mean age of 47 years having chronic ulcer/ulcers in lower limb. ABI was calculated for bilateral lower limbs.Results and Conclusions: CLU with vascular etiology accounted for 84% of all chronic ulcers. Maximum ulcers (52%) were due to arterial insufficiency. Mean value of ABI of diseased (limb with ulcer) limb was 0.96 (max=1.2 and min=0.45) and ABI of normal (limb without ulcer) limb was 0.94 (max=1.2 and min=0.8). It was statistically insignificant. ABI value of 0.9 indicates possible borderline PAD. Mean ABI value of diseased limb was 0.94 and it was significantly associated with smoking; (P-value<0.05). Out of 50 patients, 42 patients (84%) had ABI value >0.90 and 7 patients (14%) had ABI value <0.90. ABI value less than 0.9 was associated with poor wound healing and recurrence of ulcers. Hence, ABI is a safe and reliable method of screening of PAD. All patients with an ABI of less than 0.8 should be referred for specialist assessment.

Congenital midline dorsal nasal sinus is a rare clinical presentation in our day today clinical practice. Complete surgical excision can cure the patient. We must be careful while taking decision regarding its surgical management as it may have an intracranial extension and neurosurgical consultation and craniotomy may be required. Here we are discussing our case with the comprehensive approach and review of available literature.

It is really very difficult to live with a painful finger. Here, we are discussing a case who presented with a complaint of severe lancinating pain in her left index finger for about 7 years. This pain was so distressing to her that she was requesting for the amputation of her finger. Being a reconstructive surgeon, it was really very difficult to fulfill her wish. In the past 7 years, she consulted to several practitioners but did not get relief of her pain. Clinical suspicion of Glomus tumor was made and magnetic resonance imaging was done to confirm the diagnosis. Surgical excision of the swelling was done, and the patient was completely relieved of her pain.

Retained foreign bodies most commonly result in pain, delayed wound healing, localized and systemic infection, and further trauma during attempts at removal.

Introduction: Schwannomas are benign, encapsulated, silent, and usually solitary tumors originating from Schwann cells of the peripheral nerve sheath. Tibial nerve Schwannomas are very rare hence we are reporting this case for the better understanding of this unusual clinical entity. Case Presentation: A 53-year-old male patient, truck- driver by occupation, arrived to our Plastic Surgery Department complaining of swelling, pain and paresthesia in the upper part of his right leg. These symptoms were present for about 8 months and were more apparent at the end of the day. There was no evidence of any other medical comorbidity like peripheral vascular disease. There was no history of prior traumatic events related to right lower limb. Thorough clinical examination and MRI supported the diagnosis of a benign peripheral nerve tumor and patient was treated by microsurgical excision of the lesion which completely relieved the patient’s symptoms. Discussion: Mechanical compression caused by the space occupying lesion resulted in aggravation of symptoms. Classical burning/shooting pain and paresthesia often manifested by nerve sheath tumors. An increase in intracompartmental pressure resulted in pressure over nerve which consequently led to episodic pattern of neurological symptoms (diurnal variation in pain and paresthesia). Microsurgical excision of the tumor cured the symptoms completely and again patient was able to resume his regular day- to- day activities without any discomfort. Conclusion: We describe a rare case of a patient with an unusual tibial nerve Schwannoma clinical presentation. Microsurgical excision of the space occupying lesion preserving the nerve fascicles play an important role in achieving the good post- surgical outcome. Medical literature on this topic is scarce hence this case report intends to add further data about such pathological conditions