Insomnia is a common and complex disorder, rooted in the dysregulation of circadian rhythms, impaired neurotransmitter function, and disturbances in sleep–wake homeostasis. While conventional hypnotics such as benzodiazepines and Z-drugs are effective in the short term, their use is limited by a high potential for dependence, cognitive side effects, and withdrawal symptoms. In contrast, melatonergic receptor agonists—melatonin, ramelteon, tasimelteon, and agomelatine—represent a pharmacologically targeted alternative that modulates MT1 and MT2 receptors, which are pivotal to the regulation of circadian timing and sleep initiation. Clinical evidence supports the efficacy of these agents in reducing sleep onset latency, extending total sleep duration, and re-aligning disrupted circadian rhythms, particularly among older individuals and patients with non-24 h sleep–wake disorders. Notably, agomelatine offers additional antidepressant properties through selective antagonism of the 5-HT_2C receptor in micromolar concentrations. In contrast, its agonistic activity at melatonergic receptors is observed in the low sub-nanomolar range, which illustrates the complexity of this drug’s interactions with the human body. All compounds reviewed demonstrate a generally favorable safety and tolerability profile. Accumulating evidence highlights that selected medicinal plants, such as chamomilla, lemon balm, black cumin, valeriana, passionflower and lavender, may exert relevant hypnotic or anxiolytic effects, thus complementing melatonergic strategies in the management of insomnia. This structured narrative review presents a comprehensive analysis of the molecular pharmacology, receptor affinity, signaling pathways, and clinical outcomes associated with melatonergic agents. It also examines their functional interplay with serotonergic, GABAergic, dopaminergic, and orexinergic systems involved in arousal and sleep regulation. Through comparative synthesis of pharmacokinetics and neurochemical mechanisms, this work aims to inform the development of evidence-based strategies for the treatment of insomnia and circadian rhythm sleep–wake disorders.

Congenital nasolacrimal duct obstruction (CNLDO) is a prevalent condition in newborns, characterized by lacrimation excess due to anatomic occlusion of the nasolacrimal ducts (NLD). This narrative review provides a comprehensive overview of CNLDO, encompassing its etiology, epidemiology, clinical manifestations, diagnosis and current treatment options. Diagnosis comprises the fluorescein dye disappearance test (FDDT) and imaging studies. In most cases, CNLDO resolves spontaneously within the first year of life. However, if spontaneous resolution does not occur, or if complications arise during observation period, treatment with conservative methods such as massage is introduced earlier, depending on the severity and complexity of the case. If these methods prove unsuccessful, more invasive procedures, including probing, intubation or dacryocystorhinostomy, are employed. While early diagnosis is crucial, its direct impact on treatment outcomes is more related to the prompt identification of cases that may require escalation of care.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder generally associated with pediatric patients and in lesser extent with adults. Patients diagnosed with ADHD have a higher likelihood of developing addiction. Consequently, a disorder that frequently co-occurs with ADHD is Substance Use Disorder (SUD). The pharmaceuticals prescribed in the treatment of ADHD are predominantly stimulants, such as methylphenidate and amphetamines, which possess a high addiction potential. The objective of this study is to examine the risk of developing substance dependence during stimulant treatment in individuals with ADHD who have a natural predisposition to addiction, with particular emphasis on adult patients with a history of SUD. Our literature review was conducted using research papers from PubMed, Google Scholar, Embase, ProQuest and ScienceDirect. The main results from our review are as follows: (i) the majority of studies indicate that the administration of stimulants in the treatment of ADHD does not increase the risk of developing Substance Use Disorder; (ii) stimulants may also be used in the treatment of SUD; (iii) while pharmacotherapy is a crucial part of ADHD treatment, a holistic approach comprising pharmacological and non-pharmacological therapy is most effective; (iv) holistic management of ADHD is necessary to improve patients’ quality of life to the greatest extent possible.

Cannabis is one of the most studied psychoactive substances due to its increasing prevalence and evolving legal status. Of particular concern is the rising consumption among young individuals, where excessive use may disrupt reproductive processes and pose long-term health risks to offspring. This narrative review examines the effects of cannabis use on male and female reproductive health, including its impact on male fertility, the female reproductive system, placental function, and prenatal and postnatal outcomes, as well as fetal development. A nonsystematic review was conducted using PubMed, Scopus, Web of Science, and Google Scholar databases in November 2024. After screening titles and abstracts and the full-text analysis, 64 studies were included in this narrative review. In men, cannabinoids can interfere with spermatogenesis, reduce sperm motility and quality, and lower testosterone levels, as demonstrated in clinical and experimental studies. In women, cannabinoid-induced disorders include negative effects on ovarian follicle maturation, ovulation, placental function, and prenatal development. Prenatal exposure to cannabis is associated with the risk of reduced birth weight, birth defects, sudden infant death syndrome (SIDS) or lactation problems due to the penetration of cannabis metabolites into breast milk. The findings highlight the potential negative effects of cannabis on reproductive health and fetal development. Given these risks, individuals attempting to conceive, and pregnant women should be advised against cannabis use. Greater awareness is needed among healthcare professionals and the public regarding the reproductive risks associated with cannabis consumption. While the evidence on teratogenic effects is not always conclusive, caution should be exercised, and further research is essential to deepen the understanding of these effects.

This narrative review provides a comprehensive overview of current evidence on the use of the Amsler grid as a simple and cost-effective tool for detecting central visual field defects, particularly in macular disorders such as age-related macular degeneration (AMD). Despite the availability of advanced imaging techniques like optical coherence tomography (OCT), the grid remains valuable in primary care and home monitoring due to its accessibility and ease of use. This review includes studies evaluating its diagnostic performance, clinical applications, and recent digital adaptations, with a focus on early detection and patient self-monitoring. It facilitates early detection of visual disturbances, enabling timely diagnosis and intervention. The test is applicable in various retinal conditions, including AMD, diabetic macular edema, central serous chorioretinopathy, and epiretinal membrane. Although its diagnostic accuracy varies depending on the condition and stage, clinical studies support its reliability as an adjunctive tool in everyday practice. Recent developments include mobile and web-based platforms, as well as integration with artificial intelligence, which may enhance diagnostic accuracy, enable longitudinal monitoring, and improve patient adherence. Early detection is crucial for preserving vision and reducing the global burden of visual impairment.

Aim: This article aims to comprehensively analyse the available literature on synovial sarcoma (SS), focusing on its pathogenesis, epidemiology, clinical presentation, diagnostic strategies, treatment approaches, and emerging therapeutic research. Methods: A systematic literature search was conducted in PubMed, ClinicalKey and Google Scholar using the keywords synovial sarcoma and soft tissue sarcoma. A total of 104 peer-reviewed articles published within 1914-2025 were selected based on relevance, methodological quality and contribution to the field. Results: SS is a rare soft tissue sarcoma (STS), accounting for 2–4.2% of all STS cases. It predominantly affects adults aged 20–44 years, with 10% of cases occurring among children. The tumor most commonly arises in the extremities, particularly the lower limbs, and typically presents as a painless mass. Diagnosis relies on magnetic resonance imaging (MRI) followed by biopsy, histopathological analysis, and molecular testing for SYT-SSX fusion genes. The mainstay of treatment is en bloc surgical resection, with radiotherapy and chemotherapy (e.g., doxorubicin + ifosfamide) serving as adjunct therapies in select cases. Conclusions: SS presents a significant clinical challenge due to its rarity, nonspecific symptoms, and aggressive nature. Early detection of tumors, particularly those <5 cm, is crucial for improving outcomes. Multidisciplinary management in specialized sarcoma centers is essential for optimizing treatment strategies. Further research is needed to explore targeted therapies, immunotherapy, and molecular-driven treatment approaches to improve long-term prognosis.