ABSTRACTIn selected palliative care patients with nasogastric tube syndrome but no signs of acute airway obstruction, conservative management with corticosteroids and proton pump inhibitors may allow safe retention of the tube. This approach balances essential nutritional support and symptom control against the risks of removal.

ABSTRACTThis study presents a case report with a literature review describing a rare manifestation of oral sarcoidosis involving the tongue in a 57‐year‐old woman with a prior diagnosis of cutaneous sarcoidosis. The lesion appeared as painless grayish‐white papules on the tip and dorsal surface of the tongue. A review of the reported cases of tongue sarcoidosis indicates lesions usually occur during the fifth and sixth decades of life, with a marked predominance in females. The most observed signs were swelling and nodules, which commonly affect the tip and dorsal surfaces, in contrast to the usual sites of oral squamous cell carcinoma. Various approaches have been described for managing oral sarcoidosis, ranging from observation without treatment to pharmacological (steroids/immunosuppressive) and surgical interventions. Since in many cases, oral lesions constitute the initial manifestation of sarcoidosis, as well as the wide variety of clinical symptoms and involvement of vital organs/systems (e.g., pulmonary, cardiac, lymph nodes) in the majority of sarcoidosis patients, dentists should regularly examine oral cavity, pay attention to the signs and symptoms of the disease, obtain biopsies of lesions if suspicious, and refer the patient to the relevant specialist.

ABSTRACTThough lipomas are the most common benign soft tissue tumors, giant lipomas are rarely reported in the literature. Giant lipomas should be properly evaluated for any evidence of malignant transformation such as symptomatic, progressive growth in size, heterogeneity, hypervascularity, and irregular septation. Surgical resection should be considered in asymptomatic giant lipomas due to the risk of malignant transformation. Lipomas are the most common benign soft tissue tumors of adipose tissue and are typically small, slow‐growing, and asymptomatic. Giant lipomas, defined as lesions measuring ≥ 10 cm in one dimension or weighing ≥ 1 kg, are rare and may mimic malignancy due to their size and deep location. We report a case of a 58‐year‐old woman who presented with a progressively enlarging, asymptomatic mass over the right thigh for 7 years. Clinical examination revealed a firm mass measuring approximately 20 × 8 cm. Magnetic resonance imaging demonstrated a well‐defined, lobulated intermuscular lipomatous lesion measuring 24 × 8.5 × 7 cm involving the vastus medialis muscle, without features suggestive of malignant transformation or neurovascular encasement. Given the progressive enlargement and giant size of the tumor with local mass effect, marginal en‐bloc resection was performed through an anteromedial approach. Histopathological examination confirmed a benign encapsulated lipoma composed of mature adipocytes without atypia or malignancy. The postoperative course was uneventful, and no recurrence was noted at the 6‐month follow‐up. Although most lipomas are managed conservatively, giant lipomas warrant surgical excision for definitive diagnosis, symptom prevention, and exclusion of malignancy. A careful surgical planning, meticulous surgical resection, and close postoperative follow‐up can ensure excellent functional outcomes and prevent surgical complications.

ABSTRACTTuberculous sacroiliitis is a rare form of osteoarticular tuberculosis and is particularly uncommon in the postpartum period. Its presentation is often nonspecific and can mimic more common postpartum musculoskeletal or infectious conditions, leading to delayed diagnosis, especially in high tuberculosis‐endemic regions. We report the case of a 24‐year‐old woman presenting 10 days postpartum with severe, debilitating right‐sided lower back pain and markedly elevated inflammatory markers. Initial evaluation revealed retained products of conception (RPOC), which were managed surgically and with broad‐spectrum antibiotics, resulting in biochemical improvement but no clinical relief. A comprehensive rheumatologic work‐up was negative. Magnetic resonance imaging of the sacroiliac joint demonstrated unilateral joint effusion, bone marrow edema, joint space widening, and adjacent soft tissue inflammation, features highly suggestive of infectious sacroiliitis. In the context of a tuberculosis‐endemic setting, lack of response to conventional antibiotics, negative blood cultures, and characteristic MRI findings, a diagnosis of presumed tuberculous sacroiliitis was made. The patient was started on empirical anti‐tuberculous therapy with a standard four‐drug regimen, followed by continuation therapy. She showed marked clinical improvement with resolution of pain and restoration of mobility. Follow‐up MRI at 7 months demonstrated significant regression of inflammatory changes, confirming an excellent treatment response and no evidence of ongoing infection. This case highlights the importance of maintaining a high index of suspicion for tuberculous sacroiliitis in postpartum women from tuberculosis‐endemic regions presenting with severe, refractory lower back pain. Early MRI plays a pivotal role in diagnosis when routine investigations are inconclusive. Prompt initiation of empirical anti‐tuberculous therapy, even in the absence of microbiological confirmation, can lead to excellent outcomes and prevent long‐term joint damage.

ABSTRACTSpontaneous coronary artery dissection (SCAD) is an uncommon cause of non‐atherosclerotic acute coronary syndrome (ACS) resulting in myocardial ischemia and ventricular wall motion abnormalities (WMA). SCAD and Takotsubo Cardiomyopathy (TC) share a common risk factor profile and clinical characteristics. We report a 55‐year‐old female patient who presented with chest pain and elevated troponin level. Coronary angiography (CA) showed tortuosity in the first diagonal (D1) artery suspicious of SCAD. Left ventriculogram showed typical apical ballooning of TC. Because of ongoing chest pain during the procedure, we proceeded to percutaneous coronary intervention (PCI) to D1. Intracoronary optical frequency domain imaging (OFDI) of D1 showed intramural hematoma extending to proximal LAD and treated with a 2.25 × 12 mm Promus Element drug‐eluting stent (DES). Transthoracic Echocardiography (TTE) showed mid anterolateral, inferolateral, and all apical hypokinesia of LV with preserved basal segments and mildly impaired systolic function. TTE after 3 months showed fully recovered LV systolic function with resolution of WMA. Repeat CA 6 months later demonstrated healing of SCAD and OFDI showed resolution of the intramural hematoma, and cardiac MRI showed normal LV systolic and full‐thickness delayed enhancement in only the lateral wall.

ABSTRACTCyanotic heart disease is a known risk factor for brain abscess. Anesthesia for burr‐hole drainage in these patients can be challenging due to complications like an increase in right‐to‐left shunt, arrhythmias, heart failure, and paradoxical air embolism. The risk of these complications can be decreased by choosing a scalp block with conscious sedation.

ABSTRACTSacrococcygeal masses in neonates that appear benign, such as presumed lipomas, may conceal germ cell tumors. Careful clinical evaluation, functional anorectal assessment, and magnetic resonance imaging are essential to differentiate benign lesions from sacrococcygeal teratomas and guide appropriate surgical management and follow‐up.

ABSTRACTIntravascular large B‐cell lymphoma (IVLBCL) can present with neurological symptoms such as urinary and fecal incontinence. A failure to recognize this association may delay the diagnosis, especially as imaging does not always reveal lesions. Clinicians must maintain a high index of suspicion for IVLBCL in patients with unexplained neurological symptoms, persistent fever, and elevated interleukin‐10, even when imaging is non‐specific. Early biopsy and multidisciplinary evaluation are essential for timely diagnosis and management.

ABSTRACTAlveolar ridge preservation and regeneration remain critical challenges in implant dentistry and periodontics. This article presents a minimally invasive surgical approach for the management of complex buccal bone deficiencies using a novel biodegradable magnesium membrane. The Magnesium Membrane Shield Technique is designed to provide mechanical stability while gradually resorbing, thereby avoiding the need for secondary surgery and the additional morbidity associated with it. Its degradation involves the release of Mg2+ ions, which have been reported to modulate biological processes relevant to bone healing. The present study describes the biological rationale, clinical application, and radiographic observations associated with the treatment of a severe buccal plate loss case. Within the limitations of the presented case, this approach resulted in uneventful healing and satisfactory functional aesthetic outcomes, contributing to the existing clinical experience with magnesium‐based biomaterials in GBR compared with conventional resorbable and non‐resorbable approaches.

ABSTRACTGranulomatosis with polyangiitis, formerly Wegener's granulomatosis, is a rare antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis primarily affecting the respiratory tract and kidneys. Cardiovascular involvement, particularly valvular disease, is rare, especially in pediatric patients. We report a case of a 12‐year‐old boy newly diagnosed with granulomatosis with polyangiitis, who developed an aortic valve perforation. The patient presented with systemic inflammatory symptoms and was found to have aortic regurgitation secondary to aortic valve perforation. Laboratory findings confirmed markedly elevated c‐ANCA titers. Imaging revealed pulmonary involvement, and echocardiography confirmed a perforation in the noncoronary cusp of the aortic valve. Immunosuppressive therapy led to clinical improvement and stabilization of cardiac function, without the need for immediate surgical intervention. This case highlights the importance of considering vasculitis in pediatric patients with systemic inflammation and unexplained cardiac murmurs. Early recognition and prompt immunosuppressive treatment can prevent severe complications.