challenges

Bean cultivation is vital to the global food and economy, especially in Brazil. Facing challenges from diseases that affect production, it is crucial to seek new strategies to maintain productivity and sustainability. Melaleuca alternifolia, known as the tea tree due to its medicinal properties, has little explored potential in controlling diseases in bean plants. The objective of this work was to evaluate the effectiveness of tea tree essential oil in controlling diseases in bean cultivation. In vitro tests were carried out to evaluate bacterial growth, at concentrations of (0.0%, 0.05%, 0.1%, 0.5%, 1% and 2%). And antibiogram with the bacteria Xanthomonas axonopodis pv. phaseoli, in different concentrations (0.0%, 0.05%, 0.1%, 0.5%, 1%, 2% and 3%). For the fungus Pseudocercospora griseola, sporulation tests were carried out, using direct and indirect methods, at concentrations of (0.0%, 0.05%, 0.1%, 0.5%, 1%, 2%, and 3%). Furthermore, for the fungus Colletotrichum lindemuthianum, mycelial growth tests were carried out with the same concentrations. The experiments took place in vivo, with a completely randomized statistical design, involving five replications per treatment and concentrations varying from (0.0%, 0.05%, 0.1%, 0.5%, 1% and 2%). Disease incidence was assessed using a diagrammatic scale, disease severity, Area under the Disease Progress Curve (AACPD) and Area under the Incidence Progress Curve (AACPI). Melaleuca Essential Oil (EO) inhibited the development of fungi and bacteria in in vitro tests starting at 0.5%. In vivo, Melaleuca Essential Oil (EO) showed a significant reduction in the incidence and severity of the disease from 0.5% in both fungi and bacteria. Melaleuca EO can be an effective alternative for disease control in bean cultivation. 

Background: Sinonasal myxomas are exceptionally rare benign tumors in pediatric patients. This report presents the case of a 4-year-old boy diagnosed with a sinonasal myxoma extending into the right orbit.Case presentation: The patient’s clinical presentation included moderate-angle esotropia and ocular torticollis. Advanced imaging revealed an expansile lesion in the right posterior ethmoid cavity with orbital involvement. The differential diagnosis considered included malignancies such as rhabdomyosarcoma and lymphoma, as well as benign neoplasms and inflammatory changes. A biopsy confirmed the diagnosis of sinonasal myxoma. The patient underwent a wide local resection performed by a multidisciplinary team, leading to a confirmed histopathological diagnosis of sinonasal myxoma.Conclusion: This case highlights the diagnostic challenges and the importance of thorough clinical and radiologic evaluation in pediatric patients with unusual ocular symptoms. The report underscores the need for a multidisciplinary approach in managing rare neoplasms such as sinonasal myxomas.

Evening and weekend imaging services at outpatient radiology centers offer extended access to diagnostic imaging, potentially increasing patient satisfaction and accessibility, especially for underserved populations. This review explores the benefits and challenges associated with these after-hours operations, focusing on health equity, patient satisfaction, economic considerations, energy and cost savings, and the impact on healthcare professionals. Findings indicate that while after-hours operations can enhance patient satisfaction and access, they also pose challenges such as increased operational costs and staff fatigue. Strategies for improvement include optimizing shift schedules, leveraging technology for better scheduling and communication, and enhancing patient-centered care. Collaborative efforts among imaging centers can further improve service delivery and efficiency.

The presence of heavy metals (HMs) on Earth is essential to all forms of life. These metals are essential for plant and animal development but can have numerous negative effects on the living environment. In this review, we looked at where HMs come from, why they are harmful, and how they affect plants. Articles indexed in Google Scholar, PubMed, Research Gate, Science Direct, and a few books on heavy metals were consulted for this study. Heavy metals are essential for plant development and growth. According to this analysis, the hazardous effects of HMs are on the rise all throughout the globe, and this trend may be attributed mostly to human activity. Because of its impact on agricultural productivity and environmental changes, soil pollution caused by HMs is among the most crucial elements. Plants have evolved very sophisticated defense systems to deal with these environmental challenges. The threat that HM stress poses to plants has attracted a lot of attention worldwide because it could stunt agriculture’s long-term expansion. In spite of their importance for plants, this study found that HMs pose a significant threat to plant life. The novelty of this review lies in its detailed examination of both the beneficial and detrimental roles of HMs, providing a balanced perspective often overlooked in current literature. The significance of this work is underscored by its potential to inform sustainable agricultural practices and environmental management strategies, as it highlights the delicate balance required to harness the benefits of HMs while mitigating their risks. Despite their necessity for plant development, this review underscores the significant risks HMs pose to plant health and ecosystems.Less than 10 cases have been reported in the literature of the association of germline BRCA1 and Squamous cell Carcinoma – the esophagus. The article focuses on the probable pathogenesis of BRCA1 mutation with non-classic malignancies and the response of Poly adenosine diphosphate ribose polymerase inhibitors (PARP) inhibitors in such a scenario. We report an unusual manifestation of the BRCA1 gene with second primary oesophageal squamous cell cancer occurring five years later to triple-negative breast cancer.

Chronic bacterial prostatitis is a commonly diagnosed genitourinary infection that presents significant challenges both in diagnosis and treatment. In an upcoming era of antibiotic resistance, and limited therapeutic options it becomes imperative to revise current guidelines and to provide more effective treatment strategies. At the Eliava Phage Therapy Center (Tbilisi, Georgia) we utilize bacteriophage therapy as an alternative approach against chronic bacterial infections. Bacteriophages, viruses that target and lyse specific bacterial cells, can be used as a stand-alone treatment or in conjunction with antibiotics. We present a case report of a patient with prostatitis caused by Escherichia coli infection, who prior to addressing our clinic, has been receiving antibiotic therapy without any positive effect. Our approach of combined use of antibiotics and phages was successful not only in complete clinical improvement but also in total bacterial eradication. This outcome shows the potential of bacteriophage therapy as a valuable adjunct to conventional antibacterials in the management of prostatitis.

The aging of stones in response to climate change and the carbon lifeform environment is a fascinating topic that highlights the resilience and adaptability of geological structures to the ever-changing conditions of our planet. Stones, as foundational components of the Earth's crust, undergo a complex process of weathering, erosion, and transformation in the face of environmental challenges such as climate change and the presence of carbon-based lifeforms. In this essay, we will explore the key characteristics of how stones age in response to these factors and the implications for climate resilience.

Dentistry is a challenging and demanding physical profession, and this impacts not only the quality of the task outcomes but also the professional’s quality of life. The nature of dentistry demands prolonged static and awkward seated postures, frequent motions, positioning struggles, and working distances to the oral cavity for strategic procedure management, which become cumulative challenges over the working days, prone to discomfort, pain, or injuries, and musculoskeletal disorders for the operator.The limitations of the naked eye in dentistry, particularly in terms of visual information and resolution, underscore the need for visual aids. These aids are crucial for achieving the precision required for accurate procedures. Also, visual aids, such as magnifying loupes and the operative microscope, have been in the market for a while, and their proper use has shown ergonomic benefits that promote a neutral working posture and changes in work practice-oriented to control unbalanced awkward posture and motions.In this study, the Rapid Upper Limb Assessment RULA compares the posture between naked-eye dentistry, conventional loupes, and operative microscope, and with the observational assessment, determine the risk of developing musculoskeletal disorders and the need for priority of change. The Rodgers muscle fatigue analysis RMFA is used to predict fatigue in the muscular regions of the body during specific dental tasks.

This article examines the relationship between Premenstrual Dysphoric Disorder (PMDD), neurovascular dynamics, and sensory sensitivities in autistic women during menstruation. The redirection of blood flow to the uterus during the menstrual cycle has been found to exacerbate cerebral perfusion deficits in neurodivergent individuals, particularly in the Prefrontal Cortex (PFC), which contributes to the mood dysregulation and emotional instability characteristic of PMDD. Autistic women, who often exhibit heightened sensory sensitivities, experience intensified discomfort during menstruation, as sensory overload and altered pain perception compound the emotional challenges of PMDD. These findings emphasize the need for neurodivergent-friendly menstrual products that mitigate both physical and emotional discomfort. Additionally, innovations using biodegradable materials, smart fabrics, and custom-fit menstrual solutions are discussed as potential breakthroughs to improve the quality of life for autistic women managing PMDD. This research highlights the importance of addressing both neurobiological and sensory aspects when designing interventions for PMDD in neurodivergent populations.

Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.

Flooding is a significant natural hazard impacting societies worldwide, with increasing severity in urbanized regions. This paper presents a case study of Lagos, Nigeria, examining flood risk management efforts in the city. The purpose is to evaluate the effectiveness of current strategies and suggest improvements for reducing the impacts of flooding. Findings highlight the roles of government and private stakeholders, as well as policy challenges. Recommendations for sustainable flood management practices are provided, with implications for other high-risk areas. 

Pseudotumoral calcinosis (CPT) is a condition characterized by the deposition of calcium phosphate crystals in the periarticular tissues, forming large calcified masses. Although the pathophysiology of CPT is not fully understood, an increase in the calcium-phosphate product beyond the precipitation threshold and severe hyperparathyroidism appear to play a significant role. Treatment remains controversial, with surgical excision often recommended. We report a case of CPT in a 74-year-old diabetic patient undergoing chronic hemodialysis who experienced progressively worsening pain in the left hip for six months, along with mobility difficulties. A CT scan revealed a calcified mass on the posterior thigh, likely explaining the electric shock-like pain, as well as compression of the superficial femoral artery causing decubitus pain resembling critical limb ischemia. The biological assessment showed elevated calcium-phosphate levels and hyperparathyroidism. Surgical excision is not indicated due to the mass’s proximity to vascular and nerve structures. This case highlights the diagnostic and therapeutic challenges of CPT, emphasizing the need for iterative angioplasties, considering that this condition is rare in chronic hemodialysis patients with calcified periarticular masses.

Objective: Caesarean Scar Ectopic Pregnancies (CSEP) pose distinct diagnostic and management challenges. This study investigates the risk factors, treatment options, and outcomes for CSEP cases treated at Prince Sultan Medical Military City, Riyadh.Methods: Over a two-year period, medical records of 28 patients with CSEP were reviewed, collecting data on patient demographics, obstetric history, and treatment outcomes. This analysis aimed to identify influential risk factors and assess the effectiveness of various management strategies.Results: Treatment success was achieved in 85.7% of cases, with Methotrexate (MTX) proving effective in over half of the cases. The findings suggest significant risk factors and best practices for managing this rare condition.Conclusion: Early detection, risk factor awareness, and tailored treatment strategies are key to optimizing outcomes in patients with CSEP.

Fibrothecal tumors of the ovary are rare neoplasms, comprising less than 4% of all ovarian tumors and primarily affecting post-menopausal women. These benign tumors arise from the stromal tissue of the ovary and may produce hormones, particularly estrogen. Their diagnosis presents considerable challenges, frequently leading to misclassification as malignant ovarian tumors or uterine myomas. This report describes the case of a 59-year-old woman who presented with abdominal distension and pelvic pain. Clinical examination revealed a large, lobulated mass and imaging studies classified the right ovarian mass as ORADS 4. An exploratory laparotomy confirmed the absence of metastasis, resulting in total hysterectomy, bilateral adnexectomy, and omentectomy. The anatomopathological analysis identified the latero-ovarian mass as a fibrothecoma. Generally, fibrothecal tumors are benign with a favorable prognosis following surgical intervention. Common symptoms include pelvic pain and abdominal distension, and diagnosis typically relies on imaging techniques such as ultrasound and CT, with definitive confirmation achieved through histopathological examination. Given their potential to mimic malignant ovarian cancer, accurate diagnosis is critical and necessitates a multidisciplinary approach.

Children who experience Adverse Childhood Experiences (ACEs)—including trauma, family instability, or significant loss—are at increased risk for enduring mental, emotional, and physical challenges, including conditions such as depression, anxiety, and chronic health issues. Without effective support, these adverse experiences can have lasting effects on a child’s well-being, often persisting into adulthood and impacting mental, emotional, and physical health outcomes over the long term. Storytelling is a powerful method to support resilience in these children by enabling them to process emotions, make sense of complex experiences, and view themselves as active agents in their lives. By framing their experiences within personal narratives, children can create coherent stories that aid emotional regulation and support mental well-being. Through storytelling, children can frame their struggles as part of a larger, purposeful journey, fostering a sense of agency and self-worth. Techniques such as narrative therapy, story circles, and resilience-themed books-exemplified by The Adventures of Gabriel—help children explore their experiences, visualise positive outcomes, and strengthen social bonds. Moreover, storytelling is an accessible tool that aids in perspective—taking, allowing children to relate their challenges to those of characters, which reinforces their ability to overcome adversity and navigate life’s complexities with strength and optimism.

Background: The study of new neuron formation in the adult brain has sparked controversy and ignited interest among scientists in recent times, these include its occurrence and location in the adult human brain, functional significance, variation in study methods, translation from animal model to human, and ethical challenges involving neural stem cell research. Aim: To provide a comprehensive understanding of adult neurogenesis, functional significance, and challenges and explore the latest advances in the study of adult neurogenesis. Methodology: An extensive and systematic search of electronic databases (Medline, Scopus, Web of Science) was conducted using keywords related to adult neurogenesis and techniques involved in its study. Results: The mechanism of adult neurogenesis was found to occur in specific brain regions such as the subgranular zone of the dentate gyrus and subventricular zone of the lateral ventricle. Adult neurogenesis is vital neural plasticity, providing a potential mechanism for the brain to adapt and reorganize in response to environmental cues and experiences. Cutting-edge research and sophisticated imaging techniques, such as two-photon microscopy, MRI, optogenetic, and stem-cell-based therapies have provided deeper insight into the study of adult neurogenesis. Conclusion: The study of neurogenesis is important for understanding nervous system development, physiology, pathology, and exploring neuroplasticity. Its advancement is challenged by some ethical concerns regarding embryonic, pluripotent stem cells, and the need for safe, and noninvasive study methods. Although recent breakthroughs in neuroimaging, microscopic techniques, and genetic tools are aiding real-time study of adult neurogenesis.

Sleep disorders represent a significant public health concern due to their widespread prevalence, impact on overall health, and the economic burden they impose. These disorders encompass a broad spectrum of conditions, ranging from insomnia and obstructive sleep apnea (OSA) to narcolepsy, restless legs syndrome (RLS), and parasomnias. They are often associated with comorbidities such as cardiovascular diseases, metabolic dysfunctions, and mental health disorders, making their identification and management critical.The publication of this work is of high interest as it contributes to the expanding body of literature focused on understanding the complex interplay between sleep disorders and health outcomes. By presenting detailed case reports, this study provides valuable insights into the diagnostic challenges, treatment modalities, and potential avenues for personalized interventions in sleep medicine. Case reports are particularly important in this field as they shed light on unique presentations and rare conditions that might otherwise go unnoticed in large-scale epidemiological studies. From an epidemiological perspective, sleep disorders are highly prevalent globally. According to the World Health Organization (WHO), approximately 30% - 45% of the global population experiences sleep disturbances. Obstructive sleep apnea, for instance, affects nearly 1 billion individuals worldwide, with varying prevalence across age, gender, and geographic regions. Insomnia affects roughly 10% - 30% of adults, with rates as high as 50% - 60% in older populations.Meanwhile, narcolepsy, though rare, is estimated to affect 1 in 2,000 people in the general population. These statistics underscore the pressing need for enhanced diagnostic methods, improved treatment strategies, and comprehensive patient management. By detailing real-world cases, this publication aims to bridge the gap between clinical observations and broader scientific understanding. The insights gained from these case studies have the potential to inform future research directions, improve clinical practices, and ultimately enhance patient outcomes in sleep medicine.Sleep disorders affect millions of individuals globally, disrupting physical, mental, and emotional well-being. Conditions such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) are among the most studied. This paper examines the etiology, diagnosis, and management of sleep disorders, presenting detailed case reports and integrating relevant sleep study findings. Figures such as polysomnography (PSG) outputs and statistical trends provide visual insights into diagnostic and therapeutic interventions. Sleep disorders encompass a wide range of conditions that significantly disrupt sleep quality and overall well-being. Common disorders such as insomnia, obstructive sleep apnea (OSA), narcolepsy, and restless legs syndrome (RLS) affect millions globally, posing risks to physical health, mental stability, and cognitive performance. This study explores the clinical presentation, diagnostic approaches, and management of sleep disorders through the lens of detailed case reports and sleep study data.Polysomnography (PSG), the gold standard for sleep disorder diagnosis, plays a pivotal role in identifying abnormal sleep patterns, respiratory irregularities, and neural disruptions. Multiple sleep latency tests (MSLT) and actigraphy complement PSG, offering insights into disorders like narcolepsy and circadian rhythm abnormalities. This paper presents three representative case reports: chronic insomnia, severe OSA, and narcolepsy with cataplexy. Each case is analyzed in-depth, highlighting patient history, PSG findings, treatment interventions, and outcomes. For chronic insomnia, cognitive-behavioral therapy for insomnia (CBT-I) and pharmacological intervention resulted in marked improvements in sleep latency and efficiency. In the OSA case, continuous positive airway pressure (CPAP) therapy significantly reduced the apnea-hypopnea index (AHI) and alleviated daytime symptoms. The narcolepsy case demonstrates the efficacy of modafinil and sodium oxybate in managing excessive daytime sleepiness and cataplexy.Despite advancements, challenges persist in the field, including patient adherence to therapy, accessibility to specialized sleep studies, and the ethical implications of AI-driven diagnostic tools. Future research should focus on scalable, patient-centric approaches and the role of emerging technologies in enhancing diagnostic accuracy and treatment efficacy. This paper aims to contribute to the evolving understanding of sleep disorders, bridging clinical case insights with the broader implications for sleep health and research.

This review aims to emphasize the scientific focus on platelet therapies by presenting the results already obtained in mares susceptible to Persistent Breeding-Induced Endometritis (PBIE), as well as highlighting opportunities for further improvement. The recent publication demonstrating the absence of bacterial growth in susceptible mares treated with PRP underscores the potential of regenerative therapies to control infections without promoting the emergence of multidrug-resistant bacteria. Alternative therapies have gained prominence in the current public health context, with the World Health Organization listing antimicrobial resistance among the ten most significant global threats. Endometritis is the leading cause of subfertility in mares, and empirical antibiotic therapies are commonly used in the field due to market pressures related to the high financial value of embryos, along with logistical challenges in obtaining laboratory-dependent diagnostic results. Platelet-Rich Plasma (PRP) is an alternative therapy derived from whole blood plasma with a high concentration of platelets. Its anti-inflammatory, regenerative, and antimicrobial properties are particularly tested when traditional therapies fail to achieve the desired effect. In recent years, research on the use of PRP in equine reproduction has primarily focused on endometritis, with a particular emphasis on persistent breeding-induced endometritis (PBIE). However, there is a growing interest in other platelet derivatives, such as lyophilized platelet-rich plasma and platelet lysate, which offer practical field applications.

Africa is one of the continent’s most vulnerable to the effects of climate change despite contributing the least to global greenhouse gas emissions. The continent has faced many environmental challenges recently, including rising temperatures, altered precipitation patterns, frequent droughts, and extreme weather events. These changes exacerbate existing vulnerabilities in agriculture, water resources, human health, and infrastructure, which are vital for the livelihoods of millions of people. Africa’s population is 60% occupied by agriculture and is threatened by shifting rainfall patterns and extended droughts. Crop yields are increasingly variable, leading to food insecurity and exacerbating poverty. Water scarcity is another pressing concern, as reduced rainfall and more frequent droughts strain already limited water resources, affecting agriculture and access to clean drinking water. Coastal regions are also at risk, with rising sea levels threatening millions living in low-lying areas. In effect, the impacts of climate change extremely affect Africa’s low-level income populations, deepening social and economic inequalities. Africa’s limited financial resources and infrastructure hinder its ability to adapt to these challenges. Nonetheless, Africa also has the potential for resilience through nature-based solutions, renewable energy investments, and regional cooperation. Efforts to enhance climate adaptation, such as sustainable farming practices, improved water management, and climate-smart policies, are critical in building the resilience of communities in combating climate change.

Aim and objective: This study aimed to determine the prevalence and characteristics of drug dependency among patients in various rehabilitation centers in the Shimla district. Introduction: Drug abuse is a multifaceted and significant issue impacting individuals worldwide, and the city of Shimla in Himachal Pradesh is no exception. Despite its reputation as a picturesque hill station known for its natural beauty and rich cultural heritage, Shimla faces challenges related to substance abuse. Materials and methods: A cross-sectional survey was conducted, gathering demographic data, drug history, and indicators of dependency from the participants.Results: The findings revealed that 60% of the patients were drug-dependent, with 44% addicted to heroin and 11% to alcohol. Additionally, 60% of the patients reported a family history of chemical dependency. The study also identified associated psychological disorders such as depression and anxiety, as well as interpersonal and environmental factors like peer pressure and coping mechanisms such as avoidance and denial. Conclusion: These findings underscore the complexity of drug dependency, highlighting the need for comprehensive, multidimensional approaches to address the medical, emotional, and social aspects of addiction.

Extrahepatic biliary neuroendocrine tumors (EBNETs) are a rare group of neoplasms with varying characteristics, with 223 cases documented since their discovery. In this case report, an EBNET is described as a result of vague abdominal pain and significantly elevated liver function tests in a 41-year-old woman who presented with vague abdominal pain and elevated liver function tests. Despite the challenges faced in preoperative diagnosis, including the need to differentiate from cholangiocarcinoma, surgical intervention was successful. Due to the tumor’s complex nature, meticulous dissection and reconstruction were required, leading to crucial insights into surgical management. In addition to highlighting the rarity of EBNETs, this case emphasizes the importance of early detection and customized surgical approaches.