An Uncommon Diagnosis of Necrotizing Mastoiditis Presenting as Bell's Palsy: A Case Report.

Introduction: The benign nature of Bell's palsy has led to a lack of a standardized work-up, and dangerous underlying mimics are at risk of being missed. Case Report: An 84-year-old female with a history of vertigo presented to the emergency department with a left-sided facial droop consistent with Bell's palsy. After further work-up, the patient was diagnosed with bilateral necrotizing mastoiditis. Conclusion: Unilateral facial weakness involving the forehead and palpebral fissures is often diagnosed as idiopathic Bell's palsy. Various pathologies can present with unilateral facial weakness, and the differential needs to remain broad.

Efficacy of Peer-to-Peer Education for Emergency Medicine Resident Financial Literacy: Curriculum Development Study.

BACKGROUND: Early career physicians are under enormous stress from rigorous academic demands and financial insecurity due to increasingly large loan burdens and stagnant income. There are no institutionally required training programs to educate professionals on financial pitfalls or strategies for overcoming these burdens. Fiscal ignorance leaves them in a vulnerable position to be taken advantage of often, at great personal cost. METHODS: Using a cross-sectional, convenience sample of emergency medicine residents at a single center, we evaluated the benefit of a six-month curriculum on financial education. Focusing on topics that were most pertinent early in medical careers, we assessed the utility of a six-lecture series totaling three hours of education on fundamental financial literacy. Lectures were given by a single educator with no formal financial background in the following areas: general principles, student loans, retirement accounts, basic taxes, real estate, and insurance. RESULTS: Using pre-test and post-test information on 55 residents, financial literacy, as assessed by a 24-question multiple-choice survey, increased from 50% to 62% (p=<.001). Subgroup analysis was also performed within each financial category as well as by postgraduate year (PGY) of training. Raw data of individual percentages achieving specific financial milestones demonstrated an objective increase in the number of residents contributing to retirement accounts, creating an emergency fund, and establishing student loan repayment plans after the curriculum. CONCLUSIONS: Programs can institute sufficient financial literacy education for trainees that covers financial foundations. These programs can be taught without financial professional expertise or long hours of didactics.