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Sleep Disorders and Sleep Studies Case Reports

Published on: 11th December, 2024

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.
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The Police Power of the National Health Surveillance Agency – ANVISA

Published on: 27th December, 2024

The National Health Surveillance Agency (ANVISA) is a public institution created by Law 9782/1999, which integrates the field of Collective Health and acts in the prevention, control, and inspection of sanitary conditions in various sectors, such as food, health, pharmacies, hospitals, and commercial establishments. Its main objective is to guarantee the protection of public health, ensuring that products, services, and environments comply with established standards, to promote health and preventing diseases. To exercise its inspection and control function, Sanitary Surveillance has the power of sanitary police, which gives it the authority to apply necessary measures and curb practices that pose risks to the health of the population.The performance of the Sanitary Surveillance is fundamental to prevent health risks in any part of society and to guarantee national programs for patient safety. It is also essential to prevent diseases, control risks, and monitor compliance with health standards and specific regulations. The police power of Sanitary Surveillance consists of establishing norms and technical regulations, carrying out inspections and inspections, issuing temporary or permanent interdiction orders in establishments that do not comply with the norms, as well as forwarding complaints to the Public Ministry in cases of crimes against public health. Arrests carried out by Sanitary Surveillance agents are extreme measures and applied in serious situations of risk to public health or when there is repeated disrespect for sanitary regulations. The prohibited establishments have the right of defense and may seek to regularize the situation to obtain the release of activities.The performance of the Sanitary Surveillance has significant impacts on the prevention of disease outbreaks and epidemics. Identifying and correcting inappropriate practices helps to prevent the spread of pathogenic agents and reduce the risk of contagion in collective environments. The institution’s preventive and supervisory activities contribute to reducing risks to the population’s health, preventing disease outbreaks, food poisoning, and the proliferation of pests, among other problems. Finally, the importance of exercising police power with transparency, impartiality, and respect for individual rights is emphasized, always aiming at the collective interest and the promotion of the common good. In summary, Health Surveillance plays an essential role in protecting public health, seeking to ensure that the population has access to safe products and services, contributing to the improvement of quality of life and disease prevention.
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Exploring the Potential of Medicinal Plants in Bone Marrow Regeneration and Hematopoietic Stem Cell Therapy

Published on: 31st January, 2025

Blood cell production through hematopoiesis within the bone marrow serves both to maintain blood equilibrium and to respond to tissue injury and infectious demands. Hematopoietic stem cell (HSC) therapy developments have revolutionized medical treatment approaches for anemia leukemia and bone marrow failure caused by chemotherapy or radiation exposure. The therapeutic compounds present in medicinal plants have traditionally supported blood health and researchers now understand these plants could help regenerate bone marrow tissue. The analysis investigates how phytochemicals affect HSC proliferation and differentiation while supporting HSC survival. The medicinal plants Panax ginseng, Astragalus membranaceus, and Curcuma longa receive special attention for their documented ability to enhance hematopoiesis in preclinical and clinical settings. This review examines the challenges that include standardization issues, toxicity concerns, and regulatory barriers alongside future perspectives about combining plant-based therapies with traditional treatments to improve bone marrow recovery and health results. 
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Hepatic Angiomyolipoma Mimicking Hepatocellular Carcinoma: Another Rare Case Report

Published on: 11th February, 2025

Epithelioid angiomyolipomas (AML) are uncommon mesenchymal neoplasms, belonging to the group of perivascular epithelioid cell neoplasms (PECOMA). Hepatic PECOMA is even rarer. It’s difficult to diagnose in preoperative by imaging, especially when the fatty component is scant or absent. The gold standard for the diagnosis is histologic examination coupled with an immunohistochemical study. Positive HMB45 immunostaining of the myoid cells is a major diagnostic feature. Herein, we report a particular case of hepatic angiomyolipoma in a middle-aged woman with no significant medical past history. The preoperative diagnosis was difficult given the absence of specific clinical manifestations, even the radiologists considered high suspicion of hepatocellular carcinoma. The final diagnosis has been made by post-operative histology coupled with an immunohistochemistry study.
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Comprehensive Acceptance Testing and Performance Evaluation of the Symbia Intevo Bold SPECT/CT System for Clinical Use

Published on: 19th February, 2025

Aim: This prospective study reports the acceptance testing of the Symbia Intevo Bold SPECT/CT scanner (Siemens Healthineers), recently installed at SQCCCRC, University Medical City, Muscat, Oman, before its clinical implementation.Materials and methods: The acceptance tests were performed using a Low Energy High Resolution (LEHR) collimator and Technetium-99m (Tc-99m) as the radioactive source, following the manufacturer’s protocols. The tests included physical inspection, peaking and tuning, intrinsic and extrinsic uniformity calibration, intrinsic energy resolution, and planar spatial resolution without scatter. Key performance parameters such as full-width at half-maximum (FWHM), system sensitivity, and count rate performance were evaluated.Results: All critical acceptance tests, including intrinsic energy resolution, energy calibration (symmetric curve), and extrinsic uniformity with the LEHR collimator, were completed and met the required specifications. System sensitivity and count rate performance were within the expected ranges, confirming the system’s readiness for clinical use.Conclusion: The Symbia Intevo Bold SPECT/CT system passed all performance tests successfully. The acceptance testing validated the system’s optimal performance following international standards, ensuring its suitability for clinical operations.
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Maximizing the Potential of Ketogenic Dieting as a Potent, Safe, Easy-to-Apply and Cost-Effective Anti-Cancer Therapy

Published on: 3rd March, 2025

The global menace of cancer requires supplementary treatments beyond standard medical approaches for effective medical intervention. The Ketogenic Diet (KD) composed of high fats combined with moderate proteins and low carbohydrates has become popular as a metabolic therapy for cancer. The anti-cancer mechanism of KD works through metabolic stress induction in cancer cells, reduced insulin and IGF-1 signaling pathways, improved mitochondrial function, inflammation, and immune regulation. Standard cancer treatments receive enhanced outcomes through KD synergistic action which simultaneously decreases treatment-related side effects. To achieve optimized treatment outcomes in cancer, ketogenic diet practitioners need to use personalized nutritional planning in combination with metabolic tracking and exogenous ketone supplements. It is essential to find solutions for diet adherence issues and nutrient deficiencies because they determine KD’s effectiveness as a cancer treatment. The fight against cancer needs sustained and multipronged clinical research and validation to establish the proper implementation of this method.
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A Comparative Study of Metoprolol and Amlodipine on Mortality, Disability and Complication in Acute Stroke

Published on: 4th April, 2025

Stress in acute stroke may increase mortality and complications, but there is a paucity of information on the efficacy of beta blockers  over other anti-hypertensive. To report efficacy of metoprolol over amlodipine in reducing mortality, disability and infections in acute stroke. CT/MRI confirmed stroke patients within 3 days of onset were included whose age was 18 to 75 years. Patients with secondary intracerebral hemorrhage, organ failure, pregnancy, malignancy, and immunosuppressant or on beta-blocker/amlodipine were excluded. Stroke risk factors, Glasgow Coma Scale (GCS) score, National Institute of Health Stroke Scale (NIHSS) score and CT/MRI findings were noted. Patients with a blood pressure of > 160/90 mm of Hg were randomized using 1:1 randomization to metoprolol (25 mg on day 1, 50 mg if BP is not controlled) or amlodipine (2.5 mg on day 1, then 5 mg then 10 mg on, subsequent days if BP is not controlled). Other standard treatment was continued. The primary outcome was mortality at 1 month; secondary outcomes included  were in-hospital gastrointestinal hemorrhage, pneumonia, sepsis and 3 months functional outcome based on modified Rankin Scale (mRS). Side effects were noted. 18 (14.4%) patients died; 6 (9.7%) in metoprolol and 12 (19%) in amlodipine (p = 0.20) group. At 3-months, 66 patients had good outcome; 45 (80.4%) in metoprolol and 21 (43.3%) in amlodipine group (p < 0.001). The other secondary outcomes were comparable between the two groups. Metoprolol was withdrawn in 6 patients due to bradycardia, and amlodipine in 5 due to hypotension and in 1 due to allergic reaction. Metoprolol is associated with improved functional outcomes in acute stroke  compared to amlodipine.
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Success Rate and Complications of Endoscopic Deacryocystorhinostomy without Stenting: A Retrospective Study

Published on: 16th April, 2025

Endoscopic dacryocystorhinostomy (EDCR) is a well accepted surgical treatment for patients with nasolacrimal duct obstruction (NLDO). Previously, external dacryocystorhino-stomy was considered as the gold standard treatment for NLDO, however, EDCR has gained momentum due to its several advantages. The EDCR has been sounding more aesthetic and as functional compared to the traditional external dacryocystorhinostomy in the surgical treatment of nasolacrimal duct obstruction with comparable outcomes. Purpose: to determine the success rate and complications of endoscopic dacryocystorhinostomy without stenting.Materials and methods: it was a retrospective study performed in the department of Otorhinolaryngology and Head and Neck Surgery (ORL-HNS), Universal College of Medical Sciences-Teaching Hospital (UCMS-TH) from June 2019 to September 2024. A total of 19 patients charts were reviewed. All the cases were performed under general anesthesia. All the cases had undergone without silicon stenting and were regularly followed up for a period of 3 months. Post operative stomal patency and complications were noted based on subjective and endoscopic evaluation.Results: Out of 19 patients, 12 were female and 7 were male with the age range of 12 to 70 years. Transnasal synechiae was seen in 2 female and 1 male patients. Stomal patency was 100% with no recurrence of epiphora in 17 patients (89.4%) during 3 months of follow up. 2 female patients with released synechiae didn’t come for 3 months follow up.Conclusion: It is a safe and minimally invasive procedure and has a comparable success rate to external DCR with an additional advantage of more aesthetic value.
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Touch DNA Recovery from Non-porous Surfaces

Published on: 1st May, 2025

Touch DNA, the minute quantities of DNA deposited through skin contact, has become a valuable tool in forensic investigations. However, the recovery of touch DNA from non-porous surfaces remains a challenging task, requiring optimized collection and extraction techniques to maximize DNA yield, because non-porous surfaces have smooth, non-absorbing material properties. This review explores various non-porous surfaces such as glass, plastic, and metal, analyzing their impact on DNA recovery efficiency. Different collection methods, including swabbing, tape lifting, scrubbing, and vacuum collection methods, are evaluated to determine their effectiveness in retrieving minute amounts of DNA from these surfaces. Through a comparative analysis of existing studies, this paper identifies which collection methods work best for different non-porous surfaces and why choosing the right technique matters. Factors such as surface type, environmental conditions, and collection technique performed, time duration, and so on can affect DNA recovery, making it crucial to use the most effective approach. This review also emphasizes the need for standardized protocols to ensure consistent and reliable results in forensic investigations. Having clear guidelines can reduce errors, improve DNA analysis, and make touch DNA analysis more reliable in forensic investigations. By focusing on these aspects, this study aims to contribute to the ongoing efforts in refining touch DNA recovery strategies.
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A Systematic Review of Advancement in Gait Analysis Techniques

Published on: 16th May, 2025

The examination and the survey of how a person moves, particularly the way of life of walking and running. It entails studying and quantifying a person's gait in terms of their stride length, cadence, foot position, and movement of various body joints. Wearable technology makes it possible to monitor the gait pattern continually while moving about freely. The direction line, gait line, foot line, foot angle, principle line, step length, step breadth, and displacement value obtained from the gyro and accelerated sensors coupled to the shank and thigh are all used to analyze the gait pattern. There has been a lot of research on this method of recognizing people by the way they walk.The two most crucial facts are that OpenPose, a 2D multi-person posture estimation library, can detect 135 critical body locations without the requirement for fiducial markers, and that smartphone cameras can detect the gait pattern without the use of physical markers. In addition, lower extremity sagittal joint angles, spatiotemporal gait parameters, and timings of gait events were independently determined for motion capture. Gait analysis systems use portable, readily available cameras to measure gait characteristics. The pace of gait, length of steps, time of steps, cadence of steps, and the period of stance are the most crucial factors. Recently, the top standard for the examination of gait was used to evaluate the schemes based on two camera usage to evaluate the framework of different gait patterns.The precision of the examination of SCA is being increased by data scientists through the development of AI-based computer algorithms. To increase individualization, Bertillon measured the body and faces of several convicts in 1883.
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Detection of Transferrin Oxidative Modification In vitro and In vivo by Mass Spectrometry. Hereditary Hemochromatosis is a Model

Published on: 27th May, 2025

Hereditary Hemochromatosis (HH) is an inherited recessive autosomal disorder characterized by the accumulation of excess iron. When iron-binding proteins become saturated, concentrations of free or Non-transferrin-bound iron (NTBI) rise, a condition thought to be responsible for the adverse effects associated with HH. To investigate whether disturbing iron homeostasis plays a role in free radical injury in HH, protein carbonyls were found to be 1-7 times higher in patients with HH than in controls, with the greatest increases observed in untreated HH patients with high ferritin and > 90% transferrin saturation with iron. An unpaired t-test revealed a p value of 0.0278 (p < 0.05), which is considered statistically significant.In vitro oxidation of transferrin standards with hydrogen peroxide and excess iron, followed by immobilized trypsin digestion (Poroszyme), high-resolution LC-MS/MS analysis (Q-TOF Ultima, Waters), and MS/MS data processing (PEAKS, Bioinformatics Solution), identified several tryptic peptides containing oxidized Methionine (Met), Tryptophan (Trp), and Histidine (His) residues. Using the same methodology, oxidized residues were subsequently detected in transferrin isolated from plasma samples of patients severely affected by HH. Comparison of MS/MS spectra of in vitro oxidized samples with the most fragment ion peaks in common with oxidized peptide MS/MS spectra from patient samples revealed a strong correlation between the two. These data show that elevated NTBI may be involved in the oxidative modification of transferrin and that such modifications may play a significant role in the pathophysiology of HH.
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Microscopic Diagnostics and Mapping of Cytophysiological Effects of Reactive Oxygen Species during Microwave Exposure of Living Tissues

Published on: 30th May, 2025

A specialized installation has been developed for microscopic study of the Reactive Oxygen Species (ROS) formation during microwave irradiation of biological samples with automated control / mechanized tube and real-time data acquisition. The above installation can be used in biomedical practice for: standardization or certification of the microwave sources; testing of the potential antioxidants that protect tissues from ROS-induced effects; testing fluorescent sensors for ROS; analysis of ROS localization and distribution in various tissues in order to establish specific pharmaco-physiotherapeutic and toxicological localizations of ROS in different topographic-anatomical zones. The paper pays special attention to the singlet oxygen produced by the samples upon microwave treatment, as a physiologically active and highly reactive agent.
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Forensic Psychology and Criminal Profiling

Published on: 3rd June, 2025

Introduction: Forensic psychology plays a critical role in the criminal justice system, bridging the gap between psychology and law enforcement. One of its most significant applications is in criminal profiling, which involves the analysis of crime scene evidence, behavioral patterns, and psychological indicators to construct a profile of potential offenders. This study explores the intersection of forensic psychology and criminal profiling, focusing on how psychological principles aid in understanding and predicting criminal behavior.Aim: The study aimed to evaluate the effectiveness and limitations of criminal profiling as a tool in criminal investigations, and to examine the methodologies that underpin profiling practices as a vital tool in the field of forensic sciences.Methodology: Qualitative content analysis of documented criminal cases from reputable journals were reviewed for this study. Related articles were searched for from Google Scholar and Research Gate using the Keywords. A selection of high-profile cases where profiling significantly contributed to suspect identification were analyzed to assess the practical utility of psychological profiling.Results: The results indicate that while criminal profiling is not a standalone solution, it offers valuable insights when integrated with traditional investigative techniques. Psychological constructs such as personality disorders, cognitive distortions, and behavioral consistency were found to be instrumental in building accurate profiles. However, the findings also highlight challenges including subjectivity, bias, and the risk of stereotyping, potentially compromising investigative objectivity.Conclusion: Forensic psychology, through the application of criminal profiling, provides a powerful adjunct to investigative procedures. When used responsibly and in conjunction with empirical data and forensic evidence, profiling can enhance the efficiency and direction of criminal investigations. Continued research and standardization of profiling methodologies are essential to maximize its reliability and effectiveness in modern forensic practice. This study contributes to a deeper understanding of the practical roles and limitations of forensic psychology’s role in the pursuit of justice.
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Cannabinoids, Oxidative Stress and Female Reproduction: Where do we stand?

Published on: 6th June, 2025

Cannabis sativum has long been used globally for hallucination. However, detrimental effects on female reproduction have never been studied. The aim of the present paper is to evaluate cannabinoid-induced oxidative stress and reproductive containment in female mice. Fifteen adult female Parkes strain mice were randomly chosen from institutional animal houses (n = 5/group) with ad libitum access to water and food. Animals were grouped into control (vehicle-treated), treated with 6mg of cannabis/100 g of body weight, and 12 mg of cannabis/100 g of body weight. After 15 days all animals were sacrificed and tissues were collected for histology, immunohistochemistry, and estimations of different parameters. Histology and immunohistochemistry (of Cannabinoid Receptor 1; CB1) were performed following standardized protocols. All parameters were estimated either by standard biochemical protocols or by kit following the manufacturer’s protocol. Stress parameters (Super Oxide Dismutase; SOD, Catalase, CAT; Malonaldehyde, MDA and Glutathione Peroxidase; GPx), apoptotic parameters of thecal cells (by Caspase-3 assay), serum level of Estrogen (E2), steroidogenic parameters (3β Hydroxy-steroid dehydrogenase; 3β HSD and 17β Hydroxy-steroid dehydrogenase; 17β HSD) and expression of CB1 were noted in ovary. Data were analyzed by One-way Analysis of Variance (One-way ANOVA) followed by Duncan’s Multiple Range post hoc Test. We found a significant (p < 0.05) decrease in steroidogenic parameters and a significant increase (p < 0.05)in free radical and apoptotic parameters and CB1 receptor expressions upon dose-dependent cannabis treatment. We may conclude that chronic treatment of cannabis causes reproductive containment in females which has never been addressed previously.
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