Background Herpes zoster (HZ) also known as shingles is a common dermatological pathology seen in the emergency department. Multidermatomal involvement is an uncommon presentation and usually is linked to immunocompromised individuals. However, it is rarely reported in the immunocompetent population. Case presentation We report a 30-year-old Emirati male complaining of low-grade fever for 3 days, sore throat and an uncomfortable pruritic erythematous rash over his chest and back for 2 days. He was treated the day preceding his presentation in another facility for a presumed allergic reaction after taking ibuprofen. On physical examination, he was found to have exudative tonsillitis and influenza and was treated for both and discharged. He returned to the emergency department reporting increasing pain and was referred to be seen in the dermatology clinic where a biopsy was obtained, and he was discharged with a steroid topical cream. Fourteen days later, he returned to the clinic reporting crusting of the rash; the biopsy results were positive for herpes zoster. The diagnosis of multidermatomal herpes zoster was made, and he was then treated with antivirals. Conclusions Herpes zoster can present with atypical manifestations. Multidermatomal HZ is a rare dermatological manifestation in the immunocompetent adult. It is characterised by a rash spread over two or more adjacent dermatomes. This case highlights the challenging diagnosis of this dermatological presentation.

Point of care ultrasound (POCUS) performed at bedsides is an invaluable tool and is used to evaluate clinical manifestations, to facilitate accurate diagnosis, and to assist procedures in emergency and critical care. This study aimed to characterize the current practice of emergency physician-performed POCUS in UAE Emergency Departments. An online survey of all government emergency departments in the UAE was conducted from January 2016 to August 2016 in order to determine how POCUS was used. A 20-question survey, including Emergency department demographics, ownership of ultrasound (US) equipment, and frequency of POCUS performance in general and by examination type, credentialing patterns, quality assurance methods, and billing patterns was conducted. Overall, 70% of respondents reported lack of training as the greatest barrier for the use of POCUS. Other shortcomings included not owning equipment, concerns regarding liability, not beneficial financially, and adequate coverage by other specialists. In conclusion, the study identified an underutilization of POCUS in UAE government Emergency Departments, with only a quarter of them performing POCUS regularly. Most of the respondents stated that attending a training course is the minimal requirement for the physicians to perform POCUS. Recent educational and training advancements might help to overcome this barrier.

Introduction CTKUB use in patients presenting to Emergency Department (ED) with suspected renal colic has increased by 10-fold over last few years. However, its impact on the urological intervention is not fully known.Methods We performed a retrospective study of adult patients, presenting consecutively to ED with suspected renal colic who underwent CTKUB from January to June 2014. We calculated descriptive summary statistics for analysis to determine the association of predefined radiological and patients’ characteristics on the urological intervention.Results Of the 282 patients enrolled in the study, 38% had stones. Commonest locations of stone were ureter (15%), uretero-vesical junction (12.4%). Of the study participants, 2% of the patients underwent urological intervention. Chi Square analysis did not find any significant associations between radiological or patients related characteristics and urological interventionConclusion There was no significant correlation between CTKUB findings or patients’ characteristics and urological intervention in this study cohort.

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Background: Herpes Zoster (HZ) also known as shingles is common dermatological pathology seen in in the emergency department. Multidermatomal involvement is an uncommon presentation and usually is linked to individuals with compromised immune systems. However it is rarely reported in the immunocompetent population. Case presentation: We report a 30-year-old Emirati male complaining of low-grade fever for 3 days, sore throat and discomfortable pruritic erythematous rash over his chest and back for 2 days. He was treated the day preceding his presentation in another facility for a presumed allergic reaction after taking ibuprofen. On physical examination, he was found to have exudative tonsillitis and Influenza and was treated for both and discharged. He returned again reporting increasing pain and was referred to be seen in the dermatology clinic where a biopsy was obtained and he was discharged with a steroid topical cream. 14 days later, he returned to the clinic reporting crusting of the rash, the biopsy results were positive for Herpes Zoster. The diagnosis of multidermatomal herpes Zoster was made and he was then treated with antivirals. Conclusions: Herpes Zoster can present with atypical manifestations. Multidermatomal HZ is a rare dermatological manifestation in the immunocompetent adult. It is characterised by a rash spread over two or more adjacent dermatomes. This case highlights the challenging diagnosis of this dermatological presentation.