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Lower respiratory infections are often caused or precipitated by viruses and are a leading cause of global morbidity and mortality. Mutations in these viral genomes can produce highly infectious strains that transmit across species and have the potential to initiate epidemic, or pandemic, human viral respiratory disease. Transmission between humans primarily occurs via the airborne route and is accelerated by our increasingly interconnected and globalised society. To this date, there have been four major human viral respiratory outbreaks in the 21st century. Healthcare workers (HCWs) are at particular risk during respiratory epidemics or pandemics. This is due to crowded working environments where social distancing, or wearing respiratory personal protective equipment for prolonged periods, might prove difficult, or performing medical procedures that increase exposure to virus-laden aerosols, or bodily fluids. This review aims to summarise the evidence and approaches to occupational risk and protection of HCWs during epidemic or pandemic respiratory viral disease. [ABSTRACT FROM AUTHOR]

Purpose: To assess national endophthalmitis prophylaxis practice patterns during phacoemulsification surgery in Pakistan. Study Design: Cross sectional survey. Place and Duration of Study: Eye units registered with the British Pakistani Ophthalmic Society (BPOS) between September and November 2020. Methods: A survey-based cross sectional study was conducted in Pakistan between September and November 2020. A proforma was designed using a survey client (Survey Monkey) and distributed to the eye units registered with the British Pakistani Ophthalmic Society (BPOS). The survey explored demographic factors, current antibiotic prophylaxis practice during cataract surgery and audit practice in Pakistan. Results: A total of 339 respondents completed the survey. The survey was representative of ophthalmic surgeons working in the major provinces of Pakistan. A small majority of ophthalmic surgeons provided some form of routine antibiotic prophylaxis (n = 140, 53.8%). Povidone iodine 5% (PVP-I) solution on skin and in the conjunctival sac proved the most popular protocol (n = 163, 66.3%). This was followed by immediate postoperative topical antibiotics (n = 101, 41.1%). Intracameral antibiotic prophylaxis accounted for less than half of current antibiotic practice during cataract surgery in Pakistan (n=99, 40.3%). Most of the respondents did not conduct any audit regarding endophthalmitis (n = 119, 55.6%). Conclusion: Our survey provides an up-to-date view on the state of antibiotic prophylaxis during cataract surgery in Pakistan and highlights several areas for improvement. This includes policy changes to increase adherence to gold standard antibiotic prophylaxis guidelines, improvement in transparency of surgical outcomes and to audit current postoperative outcomes. [ABSTRACT FROM AUTHOR]

Background: Midface augmentation and orbital surgery carry an inherent risk of injury to the infraorbital vascular bundle, especially the infraorbital nerve where it exits the infraorbital foramen (IOF). This can result in significant morbidity for the patient, including paresthesia and neuralgia. Studies report significant heterogeneity in IOF position according to gender, ethnicity, and laterality. A knowledge of the relationship of the IOF to regional soft tissue, bony landmarks, and its variation among ethnicities is likely to reduce iatrogenic injuries., Methods: A single-center retrospective computed tomography (CT)-based study was conducted. Twenty Caucasians and 20 Black Africans patients were selected from an existing radiologic database at Moorfields Eye Hospital, London, UK. DICOM image viewing software (Syngo, Siemens Healthineers) was used to record the position of the IOF using standardized sagittal and axial views., Results: There was a statistically significant difference in the horizontal position of the IOF in the 2 races (P = 0.00). The combined measurements were used to derive a rectangular zone of variability measuring 14.30 mm by 10.60 mm. This zone was found to lie 3.50 mm below the infraorbital rim, 7.10 mm medial to the piriform aperture, and 11.60 mm from the lateral orbital rim., Conclusion: A sound knowledge of key facial landmarks is necessitated when performing midface augmentation and orbital surgery. An anatomical safe zone depicting the variation of the IOF will help reduce iatrogenic injury to the infraorbital nerve and prevent patient morbidity., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)