However, the literature emphasizes introducing anatomical variations in the clinical phase of medical curricula and postgraduate training of surgical and radiological programs. The current study suggests creating a registry of anatomical variations encountered during practice that may enhance best care and prevent any confusion about those variations. In addition, there is a need to conduct more educational studies to research the best learning strategies for teaching and assessing anatomical variations in the medical curricula.Symmetrical peripheral gangrene (SPG) is a rare disorder leading to ischemic necrosis of extremities. We present a rare case of idiopathic SPG in a 58-year-old male who did not seek any medical care, and history was elucidated only after he presented one year later for treatment of pneumonia. Extensive investigations revealed no etiology. SPG can result from a variety of conditions that cause disseminated intravascular coagulation and lead to distal hypoperfusion. The treatment is aimed at the control of the underlying disease and wound management.Glycogenic hepatopathy is a rare but reversible condition that includes acute liver dysfunction and hepatomegaly. This occurs due to excessive glycogen accumulation in the hepatocytes. It can occur in patients with poorly controlled type 1 diabetes mellitus. We are reporting a case of a 17-year-old girl who developed liver dysfunction following admission with diabetic ketoacidosis. Ultrasound abdomen confirmed hepatomegaly. However, with improvement in her metabolic control, her liver enzymes and hepatomegaly improved.Introduction The coronavirus disease 2019 (COVID-19) virus was declared a pandemic on March 10, 2020 by the World Health Organization (WHO) and has massively burdened healthcare systems with cases exponentially rising throughout the United States and the rest of the world. Since implementing precautions to reduce the spread of this disease, emergency departments have seen a decrease in the number of traumas. By evaluating the differences in the number of trauma admissions in different subgroups of patients, we can assess where to target messaging to increase compliance with these precautions. In this study, we aim to analyze the effect of the COVID-19 pandemic on trauma admissions. Methodology This was a retrospective review of the trauma database at our institution, a level 2 trauma center in Southern California, to assess the impact of COVID-19 on the number of traumas. The inclusion criteria were patients activated as traumas, regardless of age. Patients were excluded from the study if they did not have co observers of stay-at-home and social distancing measures, the 18-39 age group, became fatigued with the guidelines and ventured out into the warming weather and summer activities. This difference in trauma admission due to COVID-19 between subsequent years can highlight the behavioral changes in our patient population and can be further extrapolated to target additional messaging to help reduce the spread of COVID-19.The long-term use of topical corticosteroids can result in rosacea-like dermatitis or facial perioral dermatitis. The case of a 54-year-old man is described who developed topical corticosteroid-induced perioral dermatitis (TOP STRIPED), and the features of topical corticosteroid-induced rosacea-like dermatitis are reviewed. The man presented with a painful erythematous facial eruption. Additional history revealed that he had been applying a high-potency topical corticosteroid twice daily to the affected area. Correlation of the clinical history and cutaneous examination established a diagnosis of topical corticosteroid-induced rosacea-like dermatitis (TOP SIDE RED). Treatment of the patient’s TOP SIDE RED included not only discontinuing the high-potency corticosteroid but also initiating topical and oral antibiotics. In addition, a low-potency topical corticosteroid and metronidazole gel were also applied to the affected area. His facial rash resolved within three months and has not recurred. TOP STRIPED, also referred to as TOP SIDE RED, is an adverse side effect associated with the use of high-potency topical corticosteroids to the face. Management includes discontinuing the corticosteroid. Additional treatment may include a low-potency topical corticosteroid, antibiotics (systemic or topical or both), and/or topical calcineurin inhibitors, such as tacrolimus or pimecrolimus.Purpose To describe clinical characteristics and outcomes of ICU patients with COVID-19 and to investigate differences between survivors and non-survivors. Methods Demographics, symptoms, laboratory values, comorbidities and outcomes were extracted retrospectively from the medical records of ICU patients with confirmed COVID-19 pneumonia from the Elisabeth-TweeSteden Hospital in Tilburg, the Netherlands from March until June 2020. Primary outcome was 28-day mortality and secondary outcomes were differences between survivors and non-survivors. Results Between March 1 and June 4, 2020, 114 patients with COVID-19 were admitted to the ICU. There were 83 (72.8%) survivors and 31 (27.2%) non-survivors. Non-survivors were significantly older (72.0 years [interquartile range, IQR 67.0-76.0] versus 65.0 years [IQR 58.0-73.0], P = 0.002), had a significantly higher Acute Physiology And Chronic Health Evaluation (APACHE) score (54 [IQR 45-72] versus 43 [IQR 36-53], P less then 0.001) and Sequential Organ Failure Assessment (SOFA) score (7 [IQR 4-7] versus 5 [IQR 3-6], P = 004). cTnT values were significantly higher in non-survivors due to more myocarditis (83.9% versus 40.8%, P less then 0.001). Fumarate hydratase-IN-1 nmr A multivariate Cox regression model revealed SOFA score (hazard ratio, HR 1.337, 95% CI 1.131-1.582, P = 0.001) to be an independent predictor of 28-day mortality. Conclusion We demonstrated a 28-day mortality rate of 27.2% in our cohort. These patients were older and presented with a higher severity of illness and more organ failure.Cauda equina syndrome (CES) is one of the emergency conditions that can lead to devastating permanent functional disabilities, if misdiagnosed. Multiple studies have questioned the reliability of clinical assessment in diagnosing CES, whether some of the features should be considered to be potential red flags. Bladder dysfunction can reflect CE compromise. The post-void residual (PVR) volume bladder scan is useful in CES diagnosis, but to date there has been no single systematic review supporting its use. Furthermore, there is no clear cut-off point to consider PVR statistically significant. The aim of the study is to perform a systematic review of the current evidence behind the use of the PVR bladder scan as a diagnostic tool for CES diagnosis. This was a comprehensive search using Medline, PubMed and Embase. All articles included post-void bladder scans with the mentioned clear cut-off volume as a diagnostic parameter. A total of five study articles from 1955 fit with our inclusion and exclusion criteria. The total number of patients who had a bladder scan was 531.