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Background: Tailored adjuvant treatment is key to managing endometrial cancer effectively. Understanding prognostic factors of loco-regional failure and the impact of adjuvant treatment can help in treatment de-escalation without compromising survival outcomes.The aim of this study was to assess the pattern of failure in endometrial cancer patients and to determine predicting Loco-Regional Recurrence (LRR) factors.Patients and methods: Data were collected from 214 patients treated for endometrial cancer between 2005 and 2012 in Salah Azaiez Institute in Tunisia. All patients underwent upfront surgery followed by adjuvant brachytherapy with or without external beam radiation. The median follow-up period was 44 months. Univariate and multivariate analyses were performed to identify prognostic factors for LRR.Results: The 5-year overall survival rate was 78.1%, and the 5-year progression-free survival rate was 80.1%. LRR occurred in 25 patients (11.6%), with a median recurrence time of 29 months (range 4 months - 46 months). Pelvic relapse was the most common site, occurring in 10 patients. Vaginal relapses were observed in 9 patients, and retro-peritoneal relapses were observed in 6 cases. FIGO stage, tumor grade, histologic type, Lympho-Vascular Space Invasion (LVSI), and delays in adjuvant treatment were significant predictors of LRR.Conclusion: Identifying prognostic factors for LRR in endometrial cancer is crucial for optimizing adjuvant treatment strategies. Higher FIGO stages and the presence of LVSI were independent predictive factors for LRR. Tailored adjuvant treatment, taking these prognostic factors into account, is essential to improve patient outcomes and minimize unnecessary treatment-related toxicity.

Background: The establishment of eye clinics in the form of rural outreach centers as a means of educating and providing eye care to rural residents was made necessary by the lack of eye care services in rural areas within Nigeria and the need to increase the cataract surgical rate among ophthalmologists in training. Understanding patterns of eye diseases in rural areas and eye health-seeking behaviors is crucial to achieving the goals of Vision 2020 especially for aspiring ophthalmologists.Aim and objectives: To examine the types of eye conditions observed at Nenwe, a rural outreach post of a tertiary hospital, and to evaluate their distribution.Methodology: A retrospective analysis of all patients who were seen at the community eye clinic during seven years was carried out. Records of patients at the Nenwe outreach eye clinic dating from November 2016 to August 2023 were examined, yielding information on patients examined during the period of study.Results: Glaucoma was the most common eye condition to be diagnosed. Cataracts were the second most common eye condition accounting for 20.8%. Other common eye illnesses were refractive error (9%), pterygium (7%), and allergic eye disease (6%) with 129, 101, and 95 cases, respectively. Retinal detachment (51 cases), prebyopia (47 cases), corneal lesion (58 cases), and dry eye condition (47 cases) were less common.Conclusion: The results show the burden of eye disorders in the Nenwe rural community and the importance of community-based eye care services.

Bloodstain Pattern Analysis (BPA) is a crucial forensic technique in crime scene investigation, employing the interpretation of blood spatter patterns to reconstruct event sequences and determine spatial relationships between victims and surfaces. This study explores BPA’s application in forensic science, emphasizing its role in establishing links between crimes and culprits, as posited by Edmond Locard’s exchange principle. The research examines how bloodstain shape, size, and distribution reveal critical information about impact angles, areas of convergence, and points of origin, while also providing insights into blood flow direction, force applied, suspect positioning, and weapons used. The investigation delves into various bloodstain types, including void patterns, spikes, and satellite stains, and their formation on different surfaces. To enhance understanding of blood behaviour from various sources, the study compares blood samples from three species: human (Homo sapiens), obtained from a professional doctor from discarded piles with precaution from a government hospital in Laxmangarh, Rajasthan and goat (Capra aegagrus hircus), and chicken (Gallus gallus domesticus), obtained from butcher shops in Laxmangarh, Rajasthan. The experimental setup involves dropping blood from a height of 50 centimetre’s and measuring the resulting stain dimensions. This comprehensive approach to BPA research aims to refine crime scene analysis techniques, ultimately contributing to more accurate event reconstructions and enhanced forensic investigations. The study underscores the importance of BPA in modern forensic science while acknowledging the need for its integration with other investigative methods to ensure robust and reliable crime scene interpretations.

This editorial explores the crucial yet often overlooked role of sleep in enhancing student-athlete performance and well-being. It highlights sleep’s impact on physical recovery, cognitive function, and emotional stability, emphasizing the unique benefits for athletes. The editorial examines the detrimental effects of early school start times on adolescent sleep patterns and their subsequent impact on academic and athletic performance. By advocating for policy changes that prioritize sleep, such as delaying school start times, this editorial presents a novel approach to optimizing student-athlete success. Through a synthesis of current research and practical insights, it urges stakeholders in education and sports to recognize and act upon the foundational importance of sleep, positioning it as a key component of athletic and academic excellence.

Coronary artery aneurysm is an uncommon condition defined as abnormal dilatation of the coronary artery.We report the case of a man admitted to the Emergency Department for suspected intestinal obstruction. At abdominal/thoracic Computed Tomography (CT) it was reported a suspected pericardial cyst. Contrast echocardiography showed a clear pattern of blood flow inside the mass with a probable origin at a very limited region where it was also possible to sample an ECG-synchronized system-diastolic Pulse-Wave (PW)-Doppler pattern, typical for a coronary artery flow. Our suspicion of a giant coronary artery aneurysm was then confirmed by coronary CT and coronary angiography. The patient was transferred to a Cardiac Surgery center where he underwent surgical treatment for the aneurysm.Most coronary aneurysms are clinically silent and are often incidentally detected. Coronary angiography is the ‘‘gold standard’’ for diagnosis and evaluation of coronary artery aneurysms. Among non-invasive diagnostic techniques, Computed Tomography Coronary Angiography is the best method for coronary artery anatomy and coronary abnormalities. However, echocardiography with the use of a contrast agent, a cost-effective non-radiation nature, and a widespread use method, maybe a reliable method to detect and characterize the masses, allowing a differential diagnosis.Learning objective1.    Recognition and evaluation of cardiac masses require first-line imaging methods such as echocardiography.2.    The use of additional non-invasive (cardiac CT or MRI) and/or invasive imaging methods are often required. 3.    Contrast echocardiography may be helpful, as second-line imaging methods, to better characterize the mass and approach the correct diagnosis.

This research focused on assessing the levels of selected metal contamination in seven different rice brands (Jasmine, Basmati, Mapembe, Morogoro, Shinyanga, Mbeya, and Cheju). Cheju rice was obtained from local producers from the Cheju area in Zanzibar, while the remaining rice brands namely, Jasmine, Basmati, Mapembe, Morogoro, Shinyanga, and Mbeya were randomly taken from local markets at Darajani and Mwanakwerekwe in Zanzibar. Samples were prepared in accordance with applicable Safe Operating Procedures (SOPs) and laboratory SOPs using information provided by field sample preparation. The samples were ground to fineness and an aliquot of about 10.0 g was measured on the beam balance and mounted on the sample holders for laboratory analysis. An Energy Dispersive X-Ray Fluorescence (EDXRF) technique with a Rigaku NEX CG EDXRF model spectrometer was used for metal analysis. The study revealed that the percentage of metal contamination varied considerably from one rice brand to another, with Basmati and Jasmine rice each exhibiting a contamination level of 50%, while Shinyanga, Mbeya, Mapembe, and Cheju rice showed a level of 25% each. Notably, Morogoro rice had no observable heavy metal contamination. Additionally, a significant positive correlation was observed between several metal pairs: Au and Cr (r² = 1.00), Au and Ti (r² = 0.613), Cr and Ti (r² = 0.613), Ni and Pb (r² = 0.748), Ni and Hf (r² = 0.660), Pb and Hf (r² = 0.656), and Ti and Sn (r² = 0.671). The individual occurrence (percentage) for metals across all rice brands were as follows: 71.42% for Sn, and 28.57% for Hf, Ni, Pb, and Ti, while traces of Au, Cr, and Y each had an occurrence level of 14.28%. While Morogoro rice showed no metal discernible analyzed heavy metal contamination, the other rice brands were observed to have a considerable heavy metal contamination trend. The patterns of metal occurrence in each rice brand were observed as follows: Basmati: Sn > Ti > Au > Cr; Jasmine: Sn > Hf > Ni > Pb; Shinyanga: Sn > Pb; Mbeya: Sn > Hf; Mapembe: Sn > Ti; Cheju: Ni > Y. The patterns, then yield the ranking of metal contamination across all seven rice brands from lowest to highest is as follows: Morogoro < (Mapembe, Cheju, Mbeya, Shinyanga) < (Jasmine, Basmati). Furthermore, the data analysis indicated that the concentrations of Cr (1.08 mg/Kg), Ni (4.65 mg/Kg), and Pb (3.05 mg/Kg) detected in the samples surpassed the maximum permissible limits established by WHO/FAO which were 1.0 mg/Kg, 0.10 mg/Kg and 0.20 mg/Kg respectively. Consequently, the study concludes that Morogoro rice is the most superior and considered the safest choice for consumption, while Jasmine and Basmati rice are associated with higher levels of metal contamination. Thus, it is highly recommended that Tanzania intensify its rice cultivation efforts to reduce reliance on rice imports from other nations.

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.

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.

This case study is based on a crime scene examination murder of a young person. This case was reported in the police station located in the north-northeast district of Delhi, India. An unknown dead body was found lying on the roadside with a head injury, suspected to be a road accident. A team of forensic experts was called for a crime scene examination. After examination, it was observed that the body had multiple injuries. There was a blood pattern seen behind the hand and the head of the dead body. This was a suspicion of a murder case, instead road accident. After body identification by the family members and the last location of the victim, the place of murder i.e. house has been identified and examined by the expert team and found a lot of incriminating evidence from the scene of the crime. A two-wheeler was recovered suspected to be used to dump the dead body on the roadside. After examination of the vehicle, clue material found it was found. After a complete examination of the spot and vehicle, sufficient forensic evidence was collected and preserved to establish the crime was murder, not a road accident. This case study involved the application of scientific tools, interpretation of the sequence of evidence at the scene, systematic study of case-related information, and the logical formulation of a theory to give the proper information to the investigating agency. It has been concluded that the boy was murdered in the room and dumped roadside by using the bike.

This study investigates the impact of socio-political disruptions on air quality in Khartoum, Sudan, focusing on key pollutants: Aerosol Optical Depth (AOD), Carbon Monoxide (CO), Nitrogen Dioxide (NO₂), and Sulfur Dioxide (SO₂). Using Sentinel-5P satellite data (2020–2024) processed in Google Earth Engine (GEE), spatial and temporal variations in pollutant levels were analyzed before and after a significant war event in April 2023. The methodology included data acquisition, preprocessing (e.g., cloud masking, spatial filtering), monthly averages computation, visualization, and statistical analysis using Google Earth Engine (GEE), ArcGIS Pro, and Microsoft Excel. Results showed a marked post-war increase in AOD levels, attributed to infrastructure destruction, fires, and diminished industrial oversight, alongside spatially consistent pollution patterns in some regions. CO concentrations exhibited an overall decline due to reduced industrial activities and transportation, though localized anomalies were linked to concentrated emissions. Similarly, NO₂ levels dropped significantly, reflecting reduced vehicular and industrial activities, while sporadic increases suggested localized emissions like generator use. SO₂ demonstrated mixed trends, with reduced mean levels but increased variability, indicating sporadic high-emission events linked to emergency fuel use or conflict-related disruptions. This study uniquely combines high-resolution satellite data with advanced spatial and temporal analysis techniques to reveal the nuanced and multi-pollutant impact of socio-political conflicts on air quality in Khartoum, providing novel insights into the environmental repercussions of armed conflicts. These findings highlight the profound impact of socio-political events on atmospheric pollution dynamics, underscoring the need for robust urban planning, targeted environmental monitoring, and policies to mitigate air quality deterioration and address public health concerns in conflict-prone regions. The study emphasizes the importance of satellite-based monitoring to provide critical insights into the environmental repercussions of socio-political upheavals.

Background: Studies explored the therapeutic role of agents inhibiting RAS in epilepsy. Fewer studies addressed the electrophysiological changes associated with angiotensin converting enzyme inhibitors (ACEIs) in terms of sustained seizures (status epilepticus). Sodium valproate (SVPA), a broad-spectrum anticonvulsant, has been associated with adverse cardiac events upon long-term use, in contrast to the beneficial role of ACEIs in cardiovascular disorders.  This work explored the potential effects of ramipril, an ACEI, compared to SVPA, on the behavior, and electrophysiology of the brain and heart in a rat model of status epilepticus. The dose dependent pattern of the presumed ramipril activities was investigated. Methods: Adult male rats were assigned into seven groups, controls, IP pyridostigmine (36 mg/kg)-induced status epilepticus (PISE), oral SVPA (5 mg/kg), and three groups receiving oral ramipril at respective doses of 5 (R5), 10 (R10), and 20 mg/kg (R20). Rat behavior was assessed using Racine’s motor convulsion scoring for 10 minutes.  Blood pressure was recorded, and electroencephalography (EEG) and electrocardiography (ECG) were performed on the sedated rats 24 hours after recovery. Results: Despite the partial behavioral improvement of motor convulsions with R5 and R10 exhibited epileptogenic activity, as indicated by the increased relative power of fast and slow gamma waves and total EEG power. R10 triggered arrhythmia and cardiac ischemia as indicated by absence of P wave, along with ST elevation and tall T wave, slowed heart rate and prolonged QRS, QTc, and RR intervals. Conclusion: PISE was resistant to sodium valproate and ramipril. Ramipril at low and moderate doses induced epileptogenic activity and, especially at moderate dose, precipitated cardiac ischemia and arrhythmia. SummaryThe debatable role of ramipril in epilepsy was studied in a rat model of pyridostigmine-induced status epilepticus, compared to sodium valproate. Increasing ramipril doses did not resolve status epilepticus in rats. Instead, low and moderate doses exhibited epileptogenic activity, opposite to high dose ramipril and sodium valproate. Blood pressure was dose-dependently reduced with ramipril. Electrocardiography showed evidence of cardiac arrythmia and ischemia, especially with the moderate ramipril dose. The behavioral and EEG indices correlated with systolic blood pressure and ECG changes.

Meningiomas, classical extra-axial dural-based tumors of the meninges, have well-documented classical imaging features and signs on CT and MRI. Most meningiomas are classical lesions with prompt diagnosis on imaging and generally exhibit benign outcomes with slow growth patterns. The latest WHO classification of tumors in 2021 has classified 15 subtypes of meningiomas, and while classical meningiomas are WHO Grade 1 tumors, grading between varying subtypes varies between WHO Grades 1 and 3. The microcystic meningioma is a rare and atypical subtype of meningioma that has been sparsely documented in literature. In this case report, we revisit this rare subtype of meningioma with a brief review of literature.