Achalasia is an uncommon primary esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter and esophageal body peristalsis, with a rising prevalence among the elderly due to global population aging. This review summarizes the current evidence on the clinical presentation, diagnostic algorithm, and management of achalasia in geriatric patients. A literature search was conducted focusing on age-related differences in symptoms, endoscopic and functional testing, and outcomes of available therapeutic modalities. Clinical presentation of achalasia differs among younger and geriatric patients, with the latter presenting less pronounced symptoms. Geriatric patients experience a higher risk of malnutrition and aspiration and exhibit more often advanced disease stages, including sigmoid esophagus. High-resolution manometry represents the gold standard for diagnosis, and upper gastrointestinal endoscopy should precede it in order to exclude causes of mechanical obstruction. The treatment remains non-causative and encompasses botulinum toxin injection, pneumatic dilation, peroral endoscopic myotomy, and laparoscopic Heller's myotomy with fundoplication. Considering the evolving potential of minimally invasive techniques, advanced age should not be regarded as a contraindication for the definitive treatment of achalasia, and evidence-based, age-specific recommendations should be developed for optimizing clinical outcomes.

Intracranial aneurysm affect 3-7% of the global population, with rupture causing > 80% of non-traumatic subarachnoid hemorrhage and approximately 50% mortality. Clinical management relies on precise measurement of aneurysm neck width and maximum length, where ≥ 1mm growth signals elevated rupture risk. computed tomography angiography enables non-invasive monitoring but manual measurements suffer from inter-observer variability. Commercial artificial intelligence platforms offer potential improvements, yet their consistency and accuracy versus digital subtraction angiography, the gold standard, are understudied. This retrospective study analyzed 148 patients with 163 Intracranial aneurysms via computed tomography angiography, including a subgroup of 86 with digital subtraction angiography within 1 week. Measurements were obtained using Shukun artificial intelligence, UIH artificial intelligence, manual computed tomography angiography (intra-observer repeated at 1 month), and digital subtraction angiography. Reproducibility was assessed by coefficient of variation; agreement by Bland-Altman analysis, with 95% limits of agreement within ± 1.0mm considered clinically acceptable. Results For aneurysm neck width, manual measurements had a mean difference of -1.62mm and 95% limits of agreement of -4.87 to 1.62mm vs. digital subtraction angiography, while UIH artificial intelligence and Shukun artificial intelligence had mean differences of + 0.80mm and - 1.01mm, and 95% limits of agreement of -3.68 to 2.08mm and - 3.06 to 1.04mm, respectively. For aneurysm maximum length, UIH artificial intelligence systematically overestimated (mean difference: +3.46mm) and Shukun artificial intelligence underestimated (mean difference: -2.20mm) vs. digital subtraction angiography. Both artificial intelligence platforms had narrower coefficients of variation (0.31-0.36 for aneurysm neck width, 0.23-0.26 for aneurysm maximum length) than manual measurements (0.36-0.42, 0.23-0.24). However, all methods exceeded the clinically acceptable ± 1.0mm threshold. Artificial intelligence platforms have better reproducibility than manual measurements but show systematic biases, not meeting the clinical ± 1.0mm precision vs. the digital subtraction angiography gold standard. Inter-platform variability exceeds the aneurysm growth threshold, requiring consistent use of the same artificial intelligence platform in serial surveillance to prevent misinterpreting changes.

Herbal medicines, derived from medicinal plants, are in high demand due to global population growth and the increasing prevalence of chronic diseases; however, the use of substitutes or adulterants can compromise the quality of these medicines. DNA barcoding and metabolite fingerprinting are used to identify plants and ensure the safety of drugs. The effectiveness of authentication methods depends on the availability and coverage of the reference library. However, reference DNA barcodes and metabolite fingerprint libraries for traditional Indian medicinal plants are lacking, which hinders the authentication of herbal drugs and the elucidation of the therapeutic effects of secondary metabolites. In the present study, we developed a user-friendly 'Comprehensive Database of Medicinal Plants, Molecular Markers, and Metabolite Fingerprinting (CDMMM)' that provides extensive details on traditional Indian medicinal plants used in drug formulations, DNA barcode sequences, metabolites, and their therapeutic targets associated with diseases. CDMMM is an expandable data resource comprising 89 experimentally obtained DNA barcode accessions from 67 plant species, 3033 annotated plant metabolites, and 1414 therapeutic targets associated with 441 diseases from 20 plant species. The ever-expanding CDMMM resource is available at https://slsdb.manipal.edu/cdmmm/. Overall, it is a powerful platform for taxonomy, systematics, species identification, and drug discovery, promoting knowledge and addressing taxonomic uncertainties.

As the global elderly population grows, there is an increasing need for reliable and easy to use health monitoring tools that support independent living and reduce strain on healthcare system. This study presents the development of a wearable, Internet of Things (IoT) enabled device designed to monitor vital signs and environmental conditions in real time. The system integrated two low-cost sensors: the MAX30100 for tracking blood oxygen saturation (SpO₂) and heart rate, and the BME680 for measuring temperature, humidity, gas resistance (for VOCs), and air pressure. These sensors were connected to ESP8266 microcontroller that transmitted data through Wi-Fi to a mobile dashboard using the Blynk platform. To improve accuracy, especially during motion, signal processing techniques such as a moving average filter were implemented. The device was tested against commercial health monitoring tools and demonstrated strong performance, with an average error of ±2% for SpO₂ and ±5 BPM for heart rate. It also included threshold-based alerts to notify users or caregivers when readings exceed safe limits. This study contributes to the advancement of affordable, remote health monitoring systems by offering a practical solution that combines physiological and environmental sensing in a compact, user-friendly design. Its potential applications include elderly home care, telehealth services, and mobile health clinics.

This research note discusses one underexplored aspect of the study of polygyny, namely, the extent to which the practice remains viable from a purely demographic standpoint. Using data from the United Nations World Population Prospects 2022 covering 48 countries in sub-Saharan Africa (SSA), I evaluate a simple indicator-gamma-for capturing the "demographic potential" of polygyny, that is, the fraction of men who can have two wives with no other man pushed out of the marriage market. I estimate how this indicator has evolved between 1950 and 2021 across regions of SSA and show how the measure correlates with polygyny estimates from available men's and women's Demographic and Health Surveys. Gamma shows inverted U-curve patterns aligned with stages of the demographic transition, from modestly low levels to high levels during periods of rapid population growth and then declining again. Recent declines are starkest in South SSA, while potential remains moderate elsewhere. Gamma correlates positively with polygyny estimates from Demographic and Health Surveys-particularly in Central and South SSA-and can explain up to 50‒70% variation in polygyny, albeit not everywhere. Findings primarily hold within regions, suggesting this is one of manifold factors at play. I conclude by outlining fruitful directions for the study of polygyny.

Psoriasis is a chronic inflammatory disease that affects up to 3% of the global population. In recent years, monoclonal antibodies targeting key cytokines underlying skin lesions and joint involvement in the course of psoriasis, i.e., TNF-α, IL-17, and IL-23, have been increasingly used due to their high effectiveness and favorable safety profile. Numerous studies have been conducted analyzing the influence of cytokine inhibitors on non-specific inflammatory markers. However, only a limited number of studies on the effect of methotrexate (MTX) therapy on blood-count-derived inflammatory indices in patients with plaque psoriasis have been published so far. The study aims to analyze and compare the impact of methotrexate and biological drugs on the dynamics of selected blood-count-derived inflammatory indices in psoriatic patients. The analysis involved 182 patients receiving biological therapy, which resulted in a total of 219 treatment cycles (TCs) and 48 patients treated with therapeutic doses of MTX (48 TCs). In the biological subgroup, there were six TCs with an inhibitor of IL-12/23, 58 TCs with IL-17A inhibitors, 22 TCs with an inhibitor of IL-17AF, 113 TCs with IL-23 inhibitors, and 20 TCs with TNF-alfa inhibitors. A comparison between patients receiving biological treatment regardless of the drug and patients receiving MTX was conducted. Themajor factors determining the duration of MTX therapy were older age at the time of therapy initiation, a later onset of psoriasis, and a higher burden of comorbidities. Furthermore, the strongest impact on the average inflammatory state over time in patients treated with methotrexate was associated with comorbidities, male gender, and older age. Contrary to MTX therapy, patients receiving biological drugs were characterized by lower values of most assessed blood-count-derived inflammatory biomarkers at week 40 compared to baseline. It was confirmed that biologics and MTX treatment modify the dynamics of blood-count-derived inflammatory biomarkers in a different manner.

Global population aging is reshaping social structures and health demands at an unprecedented pace. Existing research indicates that decision-making power is significantly associated with health outcomes in later life. However, the underlying pathways linking household financial decision-making power to mental health remain underexplored in population-based studies. Elucidating multi-pathway effects will provide pathway-based evidence for identifying vulnerable populations and developing clinical interventions. We analyzed five waves (2005-2014) of the Chinese Longitudinal Healthy Longevity Survey(CLHLS), comprising 23,994 observations from 9,055 adults aged 65 years or older. Financial decision-making power was self-reported on a four-point ordinal scale. Mental health was assessed via five indicators: psychological resilience, subjective well-being, life satisfaction, self-rated health, and loneliness. Fixed-effects models were applied to control for time-invariant confounders, and inverse probability weighting was used to address attrition bias. Mediation pathways were tested using a bootstrapping approach (500 repetitions). A graded dose-response relationship was observed: lower financial decision-making power was associated with poorer mental health across all outcomes. Compared to those with full autonomy, older adults without decision-making power showed significantly lower psychological resilience (β = - 0.31, p < 0.001) and subjective well-being (β = - 0.51, p < 0.001). Mediation analyses revealed that activities of daily living (ADL) accounted for 13.0% to 31.8% of the total effect and leisure activities for 10.0% to 34.2%, with the strongest mediation observed for loneliness. Among the participants who were functionally independent at baseline, functional capacity exhibited dual mediating roles: a positive pathway for self-rated health and a suppression effect for loneliness. Heterogeneity analyses revealed more pronounced benefits among economically disadvantaged, financially dependent, female, and younger-old adults, with protective effects partially offsetting vulnerabilities in these populations. Financial decision-making power is a significant and potentially modifiable factor associated with mental health among older adults, representing an underexplored pathway for promoting healthy aging, with effects partially mediated through ADL and leisure engagement. Mental health promotion strategies should seek to preserve older adults' household financial decision-making power while supporting functional independence and social engagement.

Rice is a widely cultivated staple crop that serves as the primary source of carbohydrates for more than half of the global population. Elite parents with superior agronomic traits play a crucial role in rice breeding systems. In this study, we performed whole-genome resequencing of the rice cultivar GuiHeFeng and its nine derivative lines, identifying a total of 6,633,507 high-quality single-nucleotide polymorphisms (SNPs). The percentage of GuiHeFeng traceable blocks (GTBs) in the nine derivatives ranged from 48.94% to 63.2%. Based on the SNP analysis, we found 1310 key GuiHeFeng traceable blocks (kGTBs), which were derived from GuiHeFeng and present in all nine derivatives. Moreover, 375 selective sweeps (SSWs) were identified, of which 20 were also located within the kGTBs. These 20 SSWs were regarded as key genomic regions (kGRs) for rice breeding. After the association test, 20 alleles including 17 genes were identified on the kGTBs, and 38 significant genes were found within the key genomic regions. This research identifies the genomic segments and agronomically important genes/QTLs that will serve as essential targets for genomic selection in rice breeding.

Abstract Rice ( Oryza sativa ), a staple food for more than half of the world's population, is increasingly threatened by multiple abiotic and biotic stresses that interact to reduce productivity. Among these, salinity stress and insect and pest infestation are two of the most serious constraints in rice cultivation, particularly in coastal and irrigated ecosystems. Salinity impairs rice growth through osmotic stress, ionic toxicity, nutrient imbalance, and oxidative damage. Meanwhile, insect pests such as the brown planthopper, stem borer, and leaf folder further aggravate crop losses by disrupting photosynthesis, sucking plant sap, and destroying reproductive structures. Although these stresses have been studied independently, evidence suggests that their co-occurrence creates compounded damage that is greater than the sum of individual events, leading to severe instability. This dual stress interaction poses a critical challenge for global food security, especially in South and South-east Asia, where millions of smallholder farmers depend on rice for subsistence and income. Economic losses from combined salinity and pest pressure not only reduce farm profitability but also undermine resilience in already vulnerable farming communities. Addressing this issue requires integrating climate-smart and sustainable agricultural practices, including salt-tolerant and pest-resistant rice varieties, Judicious water and nutrient management, biological contents, and precision agriculture technologies. The novelty of this review lies in its focus on the combined impact of salinity stress and insect pests, an area where field-based evidence and mechanistic insights remain evident.

Introduction: According to the World Atlas of Obesity, overweight and obesity will affect nearly 3 billion adults (approximately 50% of the global adult population) by 2030. Melatonin therapy (MEL) and its pharmacological analogues are notable therapeutic agents for treating various pathologies, including obesity, metabolic diseases, and diabetes. Objective: A meta-analysis of melatonin therapy in the treatment of patients with obesity and meta-inflammation was conducted. Methods: The PRISMA systematic review guidelines were followed. Randomized clinical trials, prospective studies, and retrospective studies were included in the analysis. The literature search was conducted from July to August 2025 and was based on Web of Science, Scopus, Embase, PubMed, Lilacs, Ebsco, Scielo, and Google Scholar, covering scientific articles from various periods to the present. Results and Conclusion: Eighteen clinical studies with 4,678 participants were selected for this meta-analysis. According to the GRADE instrument, most studies presented homogeneous results, with X2=96.8%&gt;50%. Considering the Cochrane risk of bias tool, the overall assessment resulted in 20 studies with a high risk of bias and 24 studies that did not meet the GRADE and AMSTAR-2 criteria. It was concluded that melatonin supplementation with an average of 5.0 mg significantly reduced body weight and reduced comorbidities in patients with obesity and meta-inflammation. Melatonin also regulates food intake, regulating the production and secretion of insulin, glucagon, and cortisol, and plays an important role in insulin signaling, with its deficiency having diabetogenic effects.

Sorghum, often referred to as the “camel crop,” is one of the most important nutri-cereals for the global population. Though rabi sorghum is better in quality as compared to kharif crop, the yield level of rabi hybrids is lesser, which necessitates development of high yielding rabi hybrids. Additionally, to overcome cytoplasmic uniformity, it is essential to develop hybrids based on alternate cytoplasmic sources other than milo (A1 cytoplasm). In this context, a study was conducted using an F­4 population derived from the cross PKV Kranti × DSMR 8, where DSMR 8 is a reported restorer for the A4 cytoplasm, while PKV Kranti is known for its quality and is a ruling rabi variety. The population was subjected to Canonical Correlation Analysis (CCA) to identify the relationships between fertility restoration traits and yield-related traits. A mutualistic association was observed between the two groups of variables, indicating that improvement in one could positively influence the other. Among the ten F4 families evaluated, the families 75R, 69R, and 54R exhibited strong restoration ability along with desirable yield traits, as confirmed through integrated multivariate analyses. These promising families can be further advanced in cascade breeding programs to develop superior restorers with enhanced agronomic performance for the maldandi cytoplasmic background in sorghum.

Neuroimmune Dysregulation in Alzheimer's Disease: Mechanisms and Therapeutic Strategies.

Estimating the proportion of individuals currently infected with Mycobacterium tuberculosis (Mtb) is key for informing global health policies. Although a substantial portion of the global population exhibit tuberculous immunoreactivity, not all have a viable Mtb infection. Moreover, individuals with recent infections are at a higher risk of developing tuberculosis (TB). Here, we present estimates of the global burden of viable Mtb infection, using new insights into the natural history of TB. We constructed country-specific trends in annual risk of infection considering estimates of TB burden, immunoreactivity reversion, and age-specific mixing. We applied these trends to a deterministic mathematical model incorporating reinfection and self-clearance to estimate recent (within 2 years) and total viable Mtb infections. Empirical data on self-clearance are limited, so rates were informed by modelling estimates. In 2022, we estimated that 133.7 million people (95% uncertainty interval [UI]: 104.0, 171.1) had a recent Mtb infection, representing 1.7% (95% UI: 1.3, 2.2) of the global population. In total, 288.9 million people (95% UI: 242.2, 342.7)-or 3.7% (95% UI: 3.1, 4.3) globally-were estimated to harbour a viable Mtb infection. Among those recently infected, 12.0% (95% UI: 11.4, 12.7) were children under 15 years of age. Most recent infections were found in the World Health Organization regions of South-East Asia (49.0%; 95% UI: 37.2, 62.4), the Western Pacific (19.7%; 95% UI: 12.6, 30.5), and Africa (17.9%; 95% UI: 12.9, 24.1). India, Indonesia, and China had the highest burden, with 39.1 million (95% UI: 18.0, 73.6), 12.0 million (95% UI: 5.8, 22.9), and 11.2 million (95% UI: 5.0, 25.5) people, respectively, recently infected with Mtb. Sensitivity analyses of varying self-clearance scenarios showed significant changes in global estimates of viable Mtb infection, particularly in total burden, with lower self-clearance rates. Overall uncertainty in the estimates was considerable, reflecting limitations in the underlying data informing key model parameters. Our findings offer global burden estimates of viable Mtb infection and reveal a sizable population recently infected with Mtb and at high risk of progression to disease. New diagnostic tools that can detect individuals with viable Mtb-particularly those who would benefit from TB preventive therapy-are urgently needed.

INTRODUCTION: Aging is a vital period of life that people often think about in their retirement years. The global population of this age group has grown significantly. In addition, older persons in low- and medium-income countries (LMICs) confront a number of challenges, including poverty, a scarcity of skilled geriatric experts, food insecurity, disability and health issues, and insufficient long-term care. This study aimed to understand the challenges and needs of implementing Rwanda’s national policy for older persons. METHODS: This study employed a qualitative design, involving ten participants recruited through snowball non-probability sampling methods. Face-to-face semi-structured in-depth interviews were conducted till theme saturation. Inductive thematic analysis was used to analyze data. RESULTS: This study emerged with two themes with their sub-themes: (1) Challenges hindering the implementation of the policy (awareness and dissemination Issues, financial constraints, lack of coordination and leadership, inadequate legal and structural framework, social and cultural barriers, and healthcare access issues); and (2) needs to facilitate policy implementation (enhanced awareness and education, increased financial and resource allocation, stronger leadership and coordination mechanisms, legal and structural reforms, and social and cultural integration). CONCLUSION: The efficacy of the national policy for older individuals is constrained by insufficient awareness and distribution efforts, as well as financial constraints. To tackle these difficulties, the study emphasized the necessity for financial budget allocation, awareness initiatives, and coordinated, effective leadership.

Allergic diseases persist as a significant global health concern, profoundly diminishing the quality of life for millions of people across the globe. Allergic diseases exert a growing economic toll worldwide, with prevalence rates rising sharply – now affecting between 10% and 30% of the global population. This upward trend underscores the urgent need for more effective prevention, diagnosis, and management strategies. Rapid urbanization and shifting environmental conditions – particularly those driven by global warming – are increasingly recognized as key contributors to the rising prevalence of allergic diseases worldwide. We examine the current challenges in addressing these complex disorders, from diagnostic limitations to the heterogeneity of clinical presentations. We explore the role of statistical computational tools in predicting allergenicity, offering new avenues for precision medicine in this evolving field.

Abstract Introduction Phacoemulsification is a widely used cataract surgery technique, particularly in older adults, offering significant improvements in vision and quality of life. As the global population ages, understanding the outcomes and risks of this procedure in elderly individuals becomes increasingly important. This review aims to assess the safety, efficacy, and potential complications of phacoemulsification in older adults. Method A search was conducted across three databases—PubMed, Scopus, and Cochrane—for studies published between 2020 and 2025. Inclusion criteria were studies focusing on phacoemulsification in older adults, reporting on clinical outcomes, safety, and efficacy. Only peer-reviewed, full-text, and English-language articles were considered. From an initial pool of 376 papers, 41 were selected for review based on relevance and quality of evidence. Results The findings demonstrated a significant enhancement in best-corrected visual acuity (BCVA) following surgery, with a majority of patients achieving 20/40 or better within weeks of the procedure. Functional vision improvements were observed across various daily activities, including reading, mobility, and overall quality of life. Complication rates remained relatively low, with posterior capsular opacification (PCO) being the most common long-term issue, requiring subsequent Nd:YAG laser capsulotomy. Other complications, such as transient intraocular pressure elevation and corneal edema, were typically mild and self-limiting. Patients with pre-existing conditions such as diabetes, glaucoma, and age-related macular degeneration exhibited slightly higher complication rates but still benefited significantly from the procedure. Although recovery times were generally similar to those in younger populations, some studies indicated delayed neuroadaptation in older adults, particularly in those receiving multifocal IOLs. Despite this, patient satisfaction remained high, with most individuals reporting increased independence and an improved quality of life. Conclusion Phacoemulsification in older adults shows promising results, with minimal complications and high satisfaction. The procedure enhances independence, with advancements in techniques further improving outcomes and reducing risks.

Abstract Background The global population of people aged 65 years and over is expected to rise from 761 million in 2021 to 1.6 billion by 2050. Many of these older adults have multiple comorbidities and functional impairments that make them particularly vulnerable during acute hospitalisation. Engagement in meaningful activities can be vital to older people’s care, particularly in acute hospitals. Evidence suggests that such engagement can have a positive impact on the patients’ hospital journeys. To ensure individualised support, it is important to understand the purpose of meaningful activities for older adults in acute hospital settings, including their definitions, implementation methods, and impact on patients. Objectives The aims and objectives of this scoping review were to: Methods The review stages identified in the Arksey and O’Malley framework were used. The electronic databases MEDLINE, CINAHL and PsycINFO were searched to discover relevant articles on meaningful activities/older adults in acute hospital care. The results are reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) extension for scoping reviews. A total of 3466 titles were identified in an initial search that used the term ‘meaningful activity.’ Screening these articles using the keywords ‘older adults’ and ‘acute care setting’ cut this figure to 34. Some of these were duplicates or the studies had not been carried out in the UK; after excluding these, 24 articles related to the research interests remained. These 24 articles were screened and six were found to apply to adults 65 years and older. These six were analysed in the review. Findings and Conclusion The findings regarding the meaningful activity experiences of older adults in acute hospitals indicate that comprehensive models of care that embrace physical, psychological, social and spiritual frameworks are required. Summarisation of the data led to the identification of three themes: ‘physical, social and art activities,’ ‘the benefits of meaningful activities,’ and ‘the desire for meaningful activity.’ Regarding the latter, patients in the studies highlighted the importance of taking part in meaningful activities during their acute hospital journeys. Regarding the first two themes, the reported observations and reviews of the evidence indicate that interventions that include physical exercise, music and art therapy improve mental health and well-being and alleviate anxiety and depression in older adults. Loneliness and isolation among some older patients may be eradicated through social interaction. However, implementation of such models in acute hospital settings poses a challenge, given the shortage of staff, particularly those trained in meaningful activity.

INTRODUCTION: Aging is a vital period of life that people often think about in their retirement years. The global population of this age group has grown significantly. In addition, older persons in low- and medium-income countries (LMICs) confront a number of challenges, including poverty, a scarcity of skilled geriatric experts, food insecurity, disability and health issues, and insufficient long-term care. This study aimed to understand the challenges and needs of implementing Rwanda’s national policy for older persons. METHODS: This study employed a qualitative design, involving ten participants recruited through snowball non-probability sampling methods. Face-to-face semi-structured in-depth interviews were conducted till theme saturation. Inductive thematic analysis was used to analyze data. RESULTS: This study emerged with two themes with their sub-themes: (1) Challenges hindering the implementation of the policy (awareness and dissemination Issues, financial constraints, lack of coordination and leadership, inadequate legal and structural framework, social and cultural barriers, and healthcare access issues); and (2) needs to facilitate policy implementation (enhanced awareness and education, increased financial and resource allocation, stronger leadership and coordination mechanisms, legal and structural reforms, and social and cultural integration). CONCLUSION: The efficacy of the national policy for older individuals is constrained by insufficient awareness and distribution efforts, as well as financial constraints. To tackle these difficulties, the study emphasized the necessity for financial budget allocation, awareness initiatives, and coordinated, effective leadership.

As the global population ages, innovative strategies for cancer management in older adults are urgently needed. Liquid biopsy, a non-invasive tool, offers great promise for this demographic by enabling early detection, real-time monitoring, and therapeutic target identification. This review highlights the clinical utility, feasibility, and safety of liquid biopsies in geriatric oncology, emphasizing their potential integration into routine care to improve treatment outcomes and quality of life for older patients.

Background/Objectives: Alopecia areata is an autoimmune disorder affecting approximately 2% of the global population and is associated with a substantial impairment in quality of life. Owing to the limited number of approved therapeutic options, off-label pharmacotherapy is frequently employed in clinical practice when managing this disease. Methods: This retrospective study analyzed electronic medical records of patients treated for alopecia areata at the University Clinical Centre in Gdańsk between 2014 and 2024 to characterize the epidemiological profile and real-world treatment patterns. Results: A total of 334 affected patients were identified, including 199 diagnosed exclusively with alopecia areata and others presenting with immune-mediated comorbidities, most commonly atopic dermatitis and psoriasis. Among patients with isolated disease, women were more frequently affected and were older at diagnosis than men. Most individuals were managed in the outpatient setting, and demographic characteristics remained stable throughout the study period. Off-label pharmacotherapy was used in 77.9% of all patients and in 99.4% of those receiving drug treatment, with no significant associations observed between off-label use and age, sex, place of residence, or calendar year. Glucocorticosteroids, administered both topically and systemically, were the most commonly prescribed off-label agents (65.3%), and monotherapy was the predominant treatment strategy. Conclusions: These findings highlight the extensive reliance on off-label therapies in routine management of alopecia areata in a real-world European clinical setting.