Rationale: Triphalangeal thumb (TPT) is a rare congenital malformation where the thumb has three phalanges instead of two. Syndactyly is a condition in which children are born with fused or webbed fingers. The combination of TPT, Syndactyly, and thumb duplication is extremely rare, especially when these deformities are combined in one hand. Patient concerns: Hand abnormalities and polydactyl have been reported in a 1-year-old boy. Diagnosis: A clinical examination reveals two thumb duplications, finger fusion (Syndactyly), and a thumb with three phalanges (TPT). The diagnosis was based on clinical findings and an X-ray image of the hand. Interventions: The Z-plasty method was used to remove the adhesion between the thumb and forefinger, as well as the removal of the medial and distal phalanx of the thumb’s medial tip. Outcomes: The patient was followed for 2 months and found him in good health. To authors’ knowledge, we described an unusual case from Syria, considered the first in medical history. Lessons Learned: General and plastic surgeons should be aware about this unusual mix of the three abnormalities. The family history must also be carefully investigated to explore the occurrence of hereditary illnesses.

Dermoid cysts are a rare case of developmental abnormality that results in benign tumors, which are classified into three categories based on their cause and appearance. Dermoid cysts tend to present within the first year after birth and are most commonly diagnosed by the age of 5. A 15-year-old girl presented with a complaint of localized, paroxysmal pain and malodorous fluid oozing from the left shoulder for the last 2 weeks. A fistulogram showed an extension of the fistula behind the clavicle and above the scapula with a cystic formation measuring ~2 cm on the upper part of the fistula tract, which called for appropriate surgical intervention. Our case is the first reported dermoid cyst in the left shoulder area associated with a fistula at birth, which is a rare complication since the complications of dermoid cysts differ depending on their location and size.

Background: Healthcare workers have dealt with a range of psychological problems during the COVID 19 epidemic, including sadness, mental discomfort, anxiety, and poor sleep. Burnout is a state of prolonged work stress-related psychological, emotional, and physical stress brought on by emotional weariness, depersonalization, and decreasing professional success. The goal of this study was to find out how many healthcare workers burned out during the Omicron wave of the COVID-19 pandemic and to find out what factors put them at risk for this psychological effect.   Methods: This cross-sectional research was performed in Syria during the current Omicron wave of COVID-19 pandemic to evaluate the Burnout experienced by Syrian physicians who treat COVID-19 patients. The inclusion criteria were all Syrian healthcare workers who treated COVID-19 patients the current Omicron wave of COVID-19. The data was collected between April 3 and March 20, 2022. We investigated whether the questionnaire used was valid and understandable to the participants.   Results: A total of (729) healthcare providers inquired in our study; however, 30 participants were disqualified because their answers were not fully completed. The overall age of the participants was 31±9, and the ratio of males to females was almost equal. The majority (47.5%) of the sample study's participants are residents, and 72.8% of the participants carried for COVID19 patients. The prevalence of high level of burnout among the sample study was 41.6%. Compared to men (22.3%), women were much more likely (27.9%) to report experiencing a high degree of emotional exhaustion, also the participants who carried for COVID19 patients were much more likely (30.1%%) to report experiencing a high degree of emotional exhaustion compared to others, which individuals who carried for COVID19 patients were 1.76 times more likely than participants who did not carry for COVID19 patients to experience severe burnout (OR:1.766, 95%CI:1.2-2.4, P-value<0.001).   Conclusion: Our research found severe burnout among Syrian health care providers during the omicron wave of COVID19, with clinicians carrying COVID19 patients being considerably more likely to express high burnout than others. For this reason, it is imperative that we collaborate with international humanitarian organizations to provide a suitable psychiatric environment for Syrian physicians and provide practical recommendations to address this important concern.

Introduction Osteopoikilosis (OPK) is an extremely rare benign condition with sclerosing bony dysplasia and multiple benign enostoses. OPK is usually asymptomatic and is typically an incidental finding on imaging studies for unrelated conditions. Case presentation We presented a case of OPK in a 7-year-old female with hallux valgus, shortening and deformity of second and third metatarsals in the right foot. These abnormalities were observed on clinical findings with X-ray imaging, and osteopoikilosjs was confirmed by histopathology. The deformities were treated with surgical intervention, and the patient's condition was followed for 3 months until the patient walked and removed the gypsum. Discussion OP is a rare, benign disease that rarely causes bony deformities. It is diagnosed clinically and radiographically, so that the deformities are treated only surgically. Follow-up is necessary to assess the movement of the limb. Conclusion The distinctive thing that can be added to the medical literature is that it is possible for osteopoikilosis to cause bone deformities at an early age.