Macroglossia is a common feature in patients with Beckwith-Wiedemann syndrome (BWS). The underlying cause of macroglossia in BWS remains unknown, and further histological studies are required to uncover its etiology. We present the case of a 5-year-old girl who was diagnosed with BWS and underwent partial tongue resection for difficulties in articulation and aesthetics. click here The keyhole-shaped partial resection revealed a harder posterior side than the anterior. Microscopically, the posterior side consisted of dense subepithelial eosinophilic areas composed of an abundance of tightly packed skeletal muscle fibers that were arranged in a fascicular or storiform pattern. BWS-associated macroglossia results from skeletal muscle hyperplasia, consistent with true macroglossia. Therefore, tongue resection may be beneficial for such patients. Further studies are required to develop personalized surgical interventions for each patient with BWS.The facial injection of liquid silicone is performed for cosmetic purposes. The use of injectable fillers in facial procedures has become extremely popular over the past decade. Most procedures are performed in the perioral, periocular, and cheek areas of middle-aged women. Even though silicone is biologically inert, its injection can result in the formation of granulomas. Silicone granulomas can result from an inflammatory or autoimmune tissue response. However, the development of silicone granulomas secondary to dental infection has not yet been reported. We report a case of a 73-year-old woman with a right buccal silicone granuloma that developed following a dental infection. Ultimately, this case healed completely after the surgical removal of all lesions. Silicone in the facial region may become infected by a dental infection, and infective silicone develops granulomas and cellulitis. In the context of cosmetic facial silicone injections, it is necessary to improve oral hygiene prior to dental treatment and to maintain a healthy oral environment after surgery. In some cases, surgical treatment using an intraoral approach is effective.Decompression sickness (DCS) is a well-recognized complication of diving but rarely results in shock or respiratory failure. We report a case of severe DCS in a diver associated with shock and respiratory failure requiring mechanical ventilation. A healthy 50-year-old male diver dove to a depth of 218 feet for 43 minutes while breathing air but omitted 6.5 hours of air decompression due to diver error. The clinical presentation was remarkable for loss of consciousness, hypotension, cutis marmorata, peripheral edema, and severe hypoxia requiring mechanical ventilation with diffuse lung opacities on chest radiograph. Laboratories were significant for polycythemia and hypoalbuminemia. A single hyperbaric oxygen treatment was provided on the day of admission during which shock worsened requiring aggressive volume resuscitation and three vasopressors. In the first 37 hours of hospitalization, 22 liters of crystalloid and multiple albumin boluses were administered for refractory hypotension by which time all vasopressors had been discontinued and blood pressure had normalized. He required 10 days of mechanical ventilation and was discharged on day 21 with mild DCS-related neurologic deficits. This clinical course is characteristic of DCS-related shock wherein bubble-endothelial interactions cause a transient capillary leak syndrome associated with plasma extravasation, hemoconcentration, and hypovolemia. The pathophysiology and typical clinical course of DCS-related shock suggest the need for aggressive but time-limited administration of crystalloid and albumin. Because hyperbaric oxygen is the primary treatment for DCS, treatment with hyperbaric oxygen should be strongly considered even in the face of extreme critical illness.Sodium-glucose cotransporter-2 SGLT2 inhibitors are antihyperglycemic drugs that are currently being recommended as second-line therapy for patients with diabetes mellitus. They have grown increasingly popular over recent years, as they have been shown to have some protective effects on the heart and kidneys, both organ systems that diabetes mellitus has shown to have deleterious effect on over time. Despite their growing popularity, they have been found to increase the risk of euglycemic diabetic ketoacidosis (DKA). There is an increasing body of literature detailing cases of euglycemic DKA after bariatric surgery. We present a case series of three cases of euglycemic DKA postbariatric surgery in patients with an underlying history of type 2 diabetes mellitus, who were being treated with SGLT2 inhibitors prior to the surgery. All three patients reported to the emergency room with signs, symptoms, and clinical findings of euglycemic DKA. The AACE recommends SGLT2 inhibitors to be discontinued at least 24 hours prior to surgery and resumed when a patient resumes a normal diet. Our patients presented with euglycemic DKA after bariatric surgery, and we recommend more research should be done targeted at the prolonged postoperative course of patients on SGLT-2 inhibitors and into creating specific guidelines for their use after bariatric surgery.Chronic Chagas cardiomyopathy (CCC) is the most common cause of nonischemic cardiomyopathy in endemic Latin American countries. Immigrants to the United States suffer from this disease, but it is underrecognized. We describe the three hallmark clinical presentations stroke, ventricular arrhythmias, and heart failure, which should prompt suspicion for CCC.Coronary artery aneurysm (CAA) is a rare cardiac anomaly with a reported incidence of 0.3-4.9% of patients who undergo coronary angiography. The term is used when the coronary artery diameter exceeds more than 50% or 1.5 times the reference diameter. It can be congenital or acquired. The commonest acquired cause in an adult is atherosclerosis and in a child is Kawasaki’s disease. The commonest culprit vessel is the Right Coronary Artery (RCA), followed by Left Circumflex (LCx) and Left Anterior Descending (LAD). Left main coronary aneurysms are extremely rare in clinical practice. Coronary angiography is the gold standard procedure, both for diagnosis and treatment. We report a 49-year-old male who presented with anterior wall ST-Elevation Myocardial Infarction (STEMI). The initial angiography showed LAD stent thrombosis, but when the second angiography was done, there was spontaneous recanalization of the LAD. Coronary angiography was performed at our hospital, which revealed a long left main coronary artery aneurysm measuring 9.