Search

Background: Continuous-wave transscleral cyclophotocoagulation (CW-TSCP) is usually reserved for advanced/refractory glaucoma. Micropulse transscleral laser therapy (MPTLT) utilises short energy pulses separated by 'off'-periods. MPTLT is postulated to have fewer complications, but its relative efficacy is not known. The National Institute for Health and Care Excellence (NICE) has deemed the evidence supporting MPTLT use of inadequate quality, limiting its use to research. This study aims to evaluate MPTLT efficacy and safety compared to CW-TSCP., Methods: This 24-month follow-up retrospective audit included 85 CW-TSCP and 173 MPTLT eyes at a London tertiary referral centre. Primary outcome was success rate at the last follow-up; defined as at least 20% intraocular pressure (IOP) reduction with the same/fewer medications, and IOP between 6 and 18 mmHg. Secondary outcomes were acetazolamide use and success rates per glaucoma type. Safety outcomes were reported as complication rates., Results: By 24-months, mean IOP reduced from 34.6[±1.4]mmHg to 19.0[ ± 3.0]mmHg post-CW-TSCP (p < 0.0001); and from 26.1[±0.8]mmHg to 19.1[±2.2]mmHg post-MPTLT (p < 0.0001). Average IOP decreased by 45.1% post-CW-TSCP, and 26.8% post-MPTLT. Both interventions reduced medication requirements (p ≤ 0.05). More CW-TSCP patients discontinued acetazolamide (p = 0.047). Overall success rate was 26.6% for CW-TSCP and 30.6% for MPTLT (p = 0.83). Only primary closed-angle glaucoma saw a significantly higher success rate following CW-TSCP (p = 0.014). CW-TSCP complication rate was significantly higher than MPTLT (p = 0.0048)., Conclusion: Both treatments significantly reduced IOP and medication load. CW-TSCP had a greater absolute/proportionate IOP-lowering effect, but it carried a significantly greater risk of sight-threatening complications. Further prospective studies are required to evaluate MPTLT compared to CW-TSCP., (© 2024. The Author(s).)

Worldwide, harmful emissions from coal power plants cause many illnesses contribute to premature deaths burden. Despite its high impact on human health and being a major source of toxic pollutants, coal has been considered a component of global energy for decades. Hence, this work was envisaged to understand the rising environmental and multiple health issues from coal power plants. Studies on the adverse impacts of coal power plants on the environment, including soil, surface water, groundwater and air, were critically evaluated. The health risk from exposure to different pollutants and toxic metals released from the power plant was also demonstrated. The study also highlighted the government initiatives and policies regarding coal power operation and generation. Lastly, the study focused on guiding coal power plant owners and policymakers in identifying the essential cues for the risk assessment and management. The current study found an association between environmental and human health risks due to power generation, which needs intervention from the scientific and medical fields to jointly address public concerns. It is also suggested that future research should concentrate on exposure assessment techniques by integrating source-identification and geographic information systems to assess the health effects of different contaminants from power plants and to mitigate their adverse impact., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The seasonal quality of groundwater and its appropriateness for drinking and irrigation were assessed using a multiple indexing approach in this study. Physicochemical and ionic parameters were examined in groundwater samples near the industrial zone of Rupnagar, Punjab. To assess groundwater quality, water quality index (WQI) and pollution index were used. The Durov's, piper, wilcox and stiff diagrams were plotted to understand the hydro-chemistry. Similarly, the irrigation indices, i.e., salinity hazard, sodium adsorption ratio, soluble sodium percentage (Na%), magnesium adsorption ratio, residual sodium carbonate, permeability index and Kelley's ratio were applied to ascertain the water quality for agricultural purposes. As a result, total hardness, calcium (Ca 2+ ), magnesium (Mg 2+ ) and fluoride (F - ) were found above the standard permissible limits. WQI analysis showed 12% samples of pre-monsoon (PRE-M) and 28% samples of post-monsoon (POS-M) were of poor quality, which may pose health risks. Hydrochemistry revealed the predominance of Ca 2+ , Na + , Mg 2+ and HCO 3 - ions in the groundwater attributed to natural and anthropogenic sources. Piper diagram revealed Ca 2+ -Mg 2+ -Cl - , Na + -Cl - , Ca 2+ -Na + - HCO 3 - , Ca 2+ - HCO 3 - and Ca 2+ -Cl, Ca 2+ -HCO 3 - water types exist in the study area. USSL diagram showed that the samples from both seasons come under the low salinity hazard. In addition, total dissolved solids and electrical conductivity showed a strong positive association, indicating the saline nature of groundwater. Furthermore, hierarchical clustering classified groundwater into three groups (I, II and III), revealing that groundwater quality varies due to natural and anthropogenic effects. Based on the findings, the groundwater was found marginally suitable for drinking and irrigation purposes. It is therefore recommended that the groundwater is examined on a regular basis in order to maintain its quality., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Autologous costal cartilage for rhinoplasty is an excellent graft material providing both volume and quality of cartilage required for nasal reconstruction. Commonly, the 5th, 6th, 7th, and 8th rib costal cartilages have been harvested but other ribs such as the 10th rib are often overlooked and yet offer an excellent graft option for columellar, alar rim, nasal tip, and dorsal augmentation grafts. The use of the 10th rib costal cartilage in patients with complex secondary cleft nasal deformity has scant reference in the literature. We demonstrate our simple and quick 10th rib cartilage harvesting technique and elicit its use in secondary rhinoplasty and cleft lip nasal deformities. The advantages of harvesting the 10th rib cartilage and our long-term results demonstrating ease of harvest, stability, and predicable outcomes are with several clinical cases. The senior author has used the 10th rib graft successfully in a variety of challenging secondary cleft rhinoplasty procedures with excellent and consistent outcomes. We advocate the use of the 10th rib graft in such procedures as it is easy to harvest, is a dynamic cartilage graft, and offers predictable results with low levels of complications., Competing Interests: None declared., (Thieme. All rights reserved.)

Coal-powered thermal plants are the primary source of energy production around the globe. More than half (56.89%) of the Indian power plants use coal for power production. Coal burning in power plants results in coal combustion residuals, which contain coal fly ash (CFA) that is recognized as principle by-product. CFA is difficult to characterize due to its broad compositional variation. Hence, the present article summarizes the various physical, chemical, mineralogical, and petrological characterizations of CFA to its use in different applications. Indian coal thermal power plants are found to release two types of CFA: F (fine) and C (coarse). CFA particles are identified as unburned carbon particles with a large fraction of silica oxides, alumina oxides, and iron oxides with a small fraction of calcium oxide (CaO). Morphologically, CFA particles are spherical, with large carbon molecules and a smooth texture surface. In terms of mineralogy; quartz, mullite, magnetite, and hematite are the dominant mineral phases of CFA and tend to be non-plastic, with permeability levels ranging from 8 × 10 -6 to 1.87 × 10 -4 cms -1 . Petrographically, CFA is enriched in inertinite and liptinites as well as collotelinite, collodetrinite, and vitrodetrinite particles. Moreover, CFA is found to be composed of various organic and inorganic particles. By virtue of multiple characterizations, it has been utilized in several applications for decades, which is still quite limited. Therefore, current study aim to provide helpful insights into the potential use of CFA-derived products in different ways to increase sustainability., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

This case-control study aims to compare the efficacy, safety, and postoperative burden of MicroShunt versus trabeculectomy. The first consecutive cohort of MicroShunt procedures (n = 101) was matched to recent historical trabeculectomy procedures (n = 101) at two London hospital trusts. Primary endpoints included changes in intraocular pressure (IOP) and glaucoma medications. Secondary outcome measures included changes in retinal nerve fibre layer (RNFL) thickness, rates of complications, further theatre interventions, and the number of postoperative visits. From the baseline to Month-18, the median [interquartile range] IOP decreased from 22 [17-29] mmHg (on 4 [3-4] medications) to 15 [10-17] mmHg (on 0 [0-2] medications) and from 20 [16-28] mmHg (on 4 [3-4] medications) to 11 [10-13] mmHg (on 0 [0-0] medications) in the MicroShunt and trabeculectomy groups, respectively. IOP from Month-3 was significantly higher in the MicroShunt group ( p = 0.006), with an increased number of medications from Month-12 ( p = 0.024). There were greater RNFL thicknesses from Month-6 in the MicroShunt group ( p = 0.005). The rates of complications were similar ( p = 0.060) but with fewer interventions ( p = 0.031) and postoperative visits ( p = 0.001) in the MicroShunt group. Therefore, MicroShunt has inferior efficacy to trabeculectomy in lowering IOP and medications but provides a better safety profile and postoperative burden and may delay RNFL loss.

Background: Tackling the spread of COVID-19 remains a crucial part of ending the pandemic. Its highly contagious nature and constant evolution coupled with a relative lack of immunity make the virus difficult to control. For this, various strategies have been proposed and adopted including limiting contact, social isolation, vaccination, contact tracing, etc. However, given the heterogeneity in the enforcement of these strategies and constant fluctuations in the strictness levels of these strategies, it becomes challenging to assess the true impact of these strategies in controlling the spread of COVID-19., Methods: In the present study, we evaluated various transmission control measures that were imposed in 10 global urban cities and provinces in 2021- Bangkok, Gauteng, Ho Chi Minh City, Jakarta, London, Manila City, New Delhi, New York City, Singapore, and Tokyo., Findings: Based on our analysis, we herein propose the population-level Swiss cheese model for the failures and pitfalls in various strategies that each of these cities and provinces had. Furthermore, whilst all the evaluated cities and provinces took a different personalized approach to managing the pandemic, what remained common was dynamic enforcement and monitoring of breaches of each barrier of protection. The measures taken to reinforce the barriers were adjusted continuously based on the evolving epidemiological situation., Interpretation: How an individual city or province handled the pandemic profoundly affected and determined how the entire country handled the pandemic since the chain of transmission needs to be broken at the very grassroot level to achieve nationwide control., Funding: The present study did not receive any external funding., Competing Interests: The authors declare no conflicts of interests with regards to the present study. Authors did not receive any external funding for the study., (© 2022 The Author(s).)

Coal thermal power plants are the dominant factor in producing various hazardous elements in surrounding surface soil, resulting in a significant human health hazard. In the current study, the seasonal (pre- and post-monsoon) concentration of As, Cd, Co, Cr, Cu, Fe, Li, Mg, Mn, Ni, Pb, and Zn in surface soil around coal power production unit was analyzed using inductively coupled plasma-mass spectrometry (ICP-MS). The possible health risks throughout multiple exposure routes, i.e., ingestion, dermal, and inhalation were estimated for adult and children. Furthermore, geo-accumulation index (Igeo), enrichment factor (EF), pollution factor (CF), ecological risk index, and pollution load index (PLI) were applied to interpret the environmental pollution in the study area. The geospatial distribution pattern was computed to understand the trace and hazardous element distribution in the surface soil. As a result, the concentration of Fe (mg/kg) in pre-monsoon (15,620) and post-monsoon (27,180), Ni (mg/kg) in pre-monsoon (19.8), and post-monsoon (81.7) was found above the standard limits of soil prescribed by the WHO and FAO. Enrichment factor was observed between 0.95-6948 (pre-monsoon) and 0.53-116.09 (post-monsoon). The ecological risk index was found moderate to considerable for As and Cd metals during both seasons. In addition, the average PLI value was observed high for both seasons indicating the contamination of the study area with heavy metals. Moreover, Igeo values for Fe, Mg, and As were found relatively high. Conversely, health risks to the human population were found within the USEPA acceptable limits., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)