Impact of Industrially Affected Soil on Humans: A Soil-Human and Soil-Plant-Human Exposure Assessment.

Heavy metal (HM) contaminated soil can affect human health via ingestion of foodstuffs, inhalation of soil dust, and skin contact of soil. This study estimates the level of some heavy metals in soils of industrial areas, and their exposures to human body via dietary intake of vegetables and other pathways. Mean concentrations of Cr, Fe, Cu, Zn, As and Pb in the studied soil were found to be 61.27, 27,274, 42.36, 9.77, 28.08 and 13.69 mg/kg, respectively, while in vegetables the respective values were 0.53, 119.59, 9.76, 7.14, 1.34 and 2.69 mg/kg. Multivariate statistical analysis revealed that Fe, Cu, Zn, and Pb originated from lithogenic sources, while Cr and As are derived from anthropogenic sources. A moderate enrichment was noted by Cr, As, and Pb in the entire sampling site, indicating a progressive depletion of soil quality. The bioaccumulation factor (BCF) value for all the vegetables was recorded as BCF < 1; however, the metal pollution index (MPI) stipulates moderately high value of heavy metal accumulation in the vegetable samples. Hazard Index (HI) of >0.1 was estimated for adults but >1 for children by direct soil exposure, whereas HI < 1 for both children and adults via dietary intake of vegetables. Estimated Total carcinogenic risk (TCR) value due to soil exposure showed safe for adults but unsafe for children, while both the population groups were found to be safe via food consumption. Children are found more vulnerable receptors than adults, and health risks (carcinogenic and non-carcinogenic) via direct soil exposure proved unsafe. Overall, this study can be used as a reference for similar types of studies to evaluate heavy metal contaminated soil impact on the population of Bangladesh and other countries as well.

Inverted Internal Limiting Membrane Flap vs Complete Internal Limiting Membrane Peeling for Large Macular Holes in Nonposturing Surgery.

Purpose: This study compared anatomical and functional outcomes of the inverted internal limiting membrane flap (ILMF) technique with complete ILM peeling (ILMP) in nonposturing surgery for large, full-thickness macular holes (MHs). Methods: This was a retrospective, comparative, single-surgeon study. Eyes with idiopathic large full-thickness MHs (minimum diameter > 400 µm) were included. A total of 46 patients including 22 ILMF cases and 24 ILMP cases were analyzed. No positioning instructions were advised postoperatively. Results: Primary hole closure was achieved in all patients (100%) in both groups. Mean logMAR visual acuity (VA) improved significantly in both groups compared with the preoperative values (ILMF: 0.60 [SD, 0.26] postoperatively, vs 0.93 [SD, 0.3] preoperatively, P = .032; ILMP: 0.43 [SD, 0.22] postoperatively vs 0.83 [SD, 0.16] preoperatively, P < .01). However, ILMP showed a statistically significant improvement in VA compared with ILMF (P = .02). Conclusions: All MHs in both groups closed after surgery (100%). There was a statistically significant improvement of VA in the ILMP group compared with the ILMF group (P = .02). Not posturing after surgery did not compromise surgical success in both groups.

Sources of toxic elements in indoor dust sample at export processing zone (EPZ) area: Dhaka, Bangladesh; and their impact on human health.

In industrial areas, increased human activities generate high emissions of metals that contaminate the environment, and eventually affect human health. Therefore, this study aims to investigate the sources of toxic elements in indoor dust samples, and to evaluate possible health risks due to expose of human body through dermal contact, inhalation, and ingestion. A total 36 indoor dust samples were collected from the windows of twelve (12) industrial buildings, which are facing the main roads in the biggest export process zone (DEPZ) in Dhaka City, Bangladesh. The indoor dust samples were analyzed using X-ray fluorescence (XRF) technique for the determination of Cu, Zn, As, Pb, Fe, Cr, Co, Ni, K, Ca, Ti, Rb, and Sr. This investigation revealed that Cu, Zn, Pb, Fe, and Sr concentrations were slightly higher in various degree than that of the background value in soil recommended by the Chinese Environmental Protection Administration (CEPA). Subsequently, ANOVA (α = 0.05, p < 0.001) test and %RSD values (33% to 168%) showed that the concentrations of these metals were present non-homogeneously in different sampling points. However, statistical analysis and several geochemical indices have been proposed that these heavy metals might be come in indoor dust samples because of anthropogenic events. This investigation also showed that the most-extreme permissible hazard index (HIs) levels known as non-cancer risk for As, Mn, and Zn because of dust exposure in the study area were below than that of the safe limit (HI = 1) but with an exception of Pb (HI = 1.9E+00) for children. On the other hand, the degree of cancer-causing risk linked with exposure to arsenic in indoor dust (i.e., 0.502E-06 to 0.121E-05) falls within the range of threshold values (10-6 to 10-4). Therefore, following USEPA health risk models, it has been suggested that these metals present in indoor dust samples might not have significant impact on causing non-cancer and cancer risk to children and to adult at this moment in the DEPZ area, Bangladesh. However, a continuous monitoring should be needed to assess more accurately the non-cancer and cancer risk to children and adult.

Analysis of Natural and Anthropogenic Radionuclide Content in Palm Date Fruit of the United Arab Emirates: A Baseline Study.

The purpose of this study is to contribute to a wider effort of establishing an environmental radiation baseline for the United Arab Emirates (UAE) before the startup of the country's first nuclear reactor in 2017. An investigation of gamma-emitting radionuclide concentrations in palm dates grown in the UAE was performed. Palm date samples of 10 varieties originating from several local commercial date palm farms of the UAE were collected and analyzed. The study targeted the naturally occurring radionuclides, such as U, Th, and K, in addition to any potential anthropogenic radionuclides, such as Cs and others. Gamma spectrometry revealed measured activity concentrations for U (Ra), Th (Ra), and K that ranged from 0.61 to 0.80 Bq kg, 0.10 to 0.23 Bq kg, and 191 to 362 Bq kg, respectively, on a dry-weight basis, and calculated activity concentrations on a wet basis ranged from 0.52 to 0.69 Bq kg, 0.09 to 0.22 Bq kg, and 168 to 297 Bq kg, respectively. No Cs or other anthropogenic radionuclides could be detected in this study. All measurements were performed using a coaxial HPGe detector with 40% relative efficiency quoted by the manufacturer. Efficiency calibration correction factors were calculated using Angle software.

Accuracy of user-adjusted axial length measurements with optical biometry in eyes having combined phacovitrectomy for macular-off rhegmatogenous retinal detachment.

PURPOSE: To evaluate the accuracy of user-adjusted axial length (AL) measured by optical biometry for intraocular lens (IOL) calculations in eyes having combined phacovitrectomy for macula-off rhegmatogenous retinal detachment (RRD). SETTING: Ophthalmology Department, Calderdale Royal Hospital, Halifax, United Kingdom. DESIGN: Retrospective case series. METHODS: Consecutive eyes having phacovitrectomy for macula-off RRD were evaluated. The ALs were measured using optical biometry with user adjustment to identify a posterior peak corresponding to the eye's AL and ultrasound (US). These were compared with each other and with the postoperative optical biometry and analyzed for accuracy as an indication of the eye's AL. RESULTS: The study comprised 22 eyes of 22 patients. There was no statistically significant difference between the mean AL measurements derived from user-adjusted optical biometry and US AL (P = .964). The user-adjusted optical biometry was not statistically significantly different from the postoperative optical biometry (P = .242). Compared with the postoperative optical biometry, the IOL power was within ±0.5 diopter in 12 (92%) of 13 cases (95% confidence interval [CI], 77.8 to 100.0) for user-adjusted optical biometry and in 10 (77%) of 13 cases (95% CI, 54.0 to 99.8) for US measurements. CONCLUSIONS: User-adjusted optical biometry could be used as an alternative method for measuring AL in macula-off RRD with combined phacovitrectomy. However, optical biometry would require assessment of agreement with US AL in cases in which a posterior peak is not easily identifiable. User-adjusted optical biometry might outperform US AL when calculating IOL power; however, a larger study should be performed to confirm this. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.

Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for rhegmatogenous retinal detachment.

PURPOSE: To evaluate the accuracy of intraocular lens power estimation in eyes having phacovitrectomy for rhegmatogenous retinal detachment. METHODS: Retrospective case review of 100 consecutive eyes that underwent phacovitrectomy for rhegmatogenous retinal detachment. Axial lengths were measured using optical biometry and/or ultrasound A-scan. Achieved and predicted refraction were compared to calculate the mean postoperative refractive prediction error and the mean absolute prediction error. Factorial analysis of variance models were developed to assess outcome on the whole and that between the subgroups. RESULTS: Ninety-five eyes had postoperative refraction: 41 macula-on (43%) and 54 macula-off (57%). The mean postoperative prediction error was -0.34 ± 0.89 diopters. There was no statistical significant difference in the refractive outcomes between macula-on and macula-off groups (P > 0.05). Overall, using mean absolute prediction error as the outcome measure, optical biometry was more accurate than ultrasound (P = 0.040). However, significantly more ultrasound-measured axial lengths were selected for intraocular lens power estimation in macula-off group compared with the macula-on group (P = 0.016). CONCLUSION: Combined phacovitrectomy in rhegmatogenous retinal detachment included a small biometric error that was within the tolerable range in most cases. Both optical biometry and ultrasound should be used to estimate axial lengths, for macula-off rhegmatogenous retinal detachment cases, to improve the accuracy of intraocular lens power calculation.

Persistent outer retinal fluid following non-posturing surgery for idiopathic macular hole.

AIM: To present the anatomical and visual outcomes of patients with hypo-reflective cystic defects in outer fovea (outer foveal defect; OFD) in macular holes repaired with non-posturing vitrectomy and short term gas tamponade. To identify the incidence and risk factors for developing OFD foveal defect. METHOD: A prospective consecutive case series of 58 patients undergoing macular hole surgery was undertaken. OFD detected on 2-week postoperative Optical coherence tomography (OCT) was measured. In these patients OCT was performed monthly until resolution of OCT. RESULTS: 27 eyes (46.6%) had an outer defect at 2 weeks, the presence of which was significantly associated with macular holes with larger base diameters preoperatively (p=0.006). All defects closed spontaneously without further intervention, and the final vision was not affected by the presence of an OFD. Visual recovery was only slightly (and not significantly) delayed by the presence of an outer defect. CONCLUSIONS: This is the first study of outcomes of OFDs following macular hole surgery in patients who did not posture postoperatively. OFDs are common but do not adversely affect visual outcomes.

Potential health risks from radioactive contamination of saltmarshes in NW England.

The present study focuses on the detection of Sellafield-derived (137)Cs and (241)Am in contaminated saltmarshes from North-West England, UK, with a view to assessing the radiological impacts from radioactivity stored within the sediment record. The surface activities from these radionuclides were found in the range between 73 and 851 Bq kg(-1) whereas peak activities ranging from 383 to 12690 Bq kg(-1) were found below the surface of the upper marsh at a depth of approximately 5-20 cm. Potential radioactive exposure to humans from these highly active radionuclides comes mainly from direct exposure and resuspended dust inhalation for different saltmarsh users, which may be exacerbated by the remobilisation of radionuclides resulting from saltmarsh erosion. The total annual minimum, maximum and 'best estimate' doses ranging from 11 to 972 µSv y(-1), fall below the ICRP-recommended annual dose limit, but the highest estimated total effective dose (972 µSv y(-1)) for a marsh user falls within 97% of the recommended dose limit and the highest 'best estimate' total annual doses of 110 and 307 µSv y(-1) for Dee estuary and Biggar marshes, respectively, are almost 3 and 4 times higher than the estimated doses that are based on existing surface activities.

Assessing CZT detector performance for environmental radioactivity investigations.

Cadmium zinc telluride (CdZnTe or CZT) is the leading semiconductor detector for gamma spectroscopy at room temperature. In the present study, a coplanar-grid CZT detector was used for gamma-ray measurements of environmental radioactivity on a contaminated saltmarsh sediment core in comparison with results from a coaxial high-purity germanium detector to assess their comparative performance. The findings reveal that the CZT performs well for both (241)Am and (137)Cs measurements over a broad range of activities, despite limited detector efficiency, and can be used to good effect in the study of environmental radioactivity in contaminated estuarine settings.

A comparison of several methods of macular hole measurement using optical coherence tomography, and their value in predicting anatomical and visual outcomes.

BACKGROUND/AIMS: To compare several methods of macular hole measurement using optical coherence tomography (OCT), and to assess their predictive capability against anatomical and visual outcomes in a single cohort of patients. METHODS: A retrospective study of 50 eyes undergoing standardised macular hole surgery. All patients underwent preoperative OCT scanning with measurement of macular hole inner opening diameter, minimum linear diameter, base diameter and macular hole height. Values were calculated for the macular hole index and the tractional hole index. RESULTS: Logistic regression analyses indicated that the preoperative base diameter, macular hole inner opening and minimum linear diameter were associated with both anatomical and visual success. Derived parameters as alternatives to these basic ophthalmic parameters add little to the modelling of either anatomical or visual success. CONCLUSION: Base diameter, macular hole inner opening and minimum linear diameter can each be used to predict anatomical and/or functional success in macular hole surgery. Preoperative base diameter is the most useful variable in this regard, as it holds the strongest association with anatomical and visual outcome and is easily measured on a OCT scan.

Verification of posterior hyaloid status during pars plana vitrectomy, after preoperative evaluation on optical coherence tomography.

BACKGROUND: The purpose of the study is to establish the accuracy of optical coherence tomography (OCT) in visualizing the presence or absence of vitreopapillary adhesion. METHODS: This is a prospective, interventional case series based at Calderdale Royal Hospital and Huddersfield Royal Infirmary, both district general hospitals in the United Kingdom. Fifty consecutive eyes of 50 patients listed for vitrectomy surgery that showed media clear enough to enable adequate visualization of the fundus were included. All patients underwent assessment of posterior hyaloid status by OCT imaging of the optic disk. All OCT images were assessed by two observers, and preoperative OCT data were compared with intraoperative observations. Statistical analysis was performed using the Cohen κ coefficient to measure the interrater agreement. RESULTS: There was 100% agreement between Observer 1 and 2. Cohen κ was 0.95 and (95% confidence interval, 0.84-1.05) for agreement between preoperative OCT and intraoperative findings. CONCLUSION: Optical coherence tomography imaging can accurately visualize the vitreopapillary interface. Our results show a strong correlation between OCT and intraoperative findings. The presence of a posterior vitreous detachment would be useful knowledge to the vitreoretinal surgeon in planning surgery and weighing up the risk of developing certain conditions.

Outcomes of sulfur hexafluoride (SF6) versus perfluoroethane (C2F6) gas tamponade for non-posturing macular-hole surgery.

AIM: To compare the outcomes of non-posturing macular-hole surgery using sulfur hexafluoride (SF(6)) gas versus perfluoroethane (C(2)F(6)) for idiopathic macular hole repair. Design Interventional, comparative cohort study. METHODS: 39 eyes of 38 patients undergoing macular-hole surgery with SF(6) were compared with another consecutive group of 39 eyes (39 patients) in whom C(2)F(6) was used. All patients were operated on by a single surgeon and underwent 23G transconjunctival phakovitrectomy with no prone posturing in the postoperative period. The best-corrected Snellen's visual acuity (VA) was converted to the logarithm of minimal angle of resolution (logmar) visual acuity for analysis. Optical coherence tomography documentation of anatomical closure and complications of surgery were recorded. RESULTS: Primary hole closure was achieved in 89.75% in the C(2)F(6) group and 87.2% in the SF(6) group. Secondary closure after non-posturing redo surgery with heavy oil (Oxane-HD) was 100% in both groups. The mean preoperative VA in the C(2)F(6) group and SF(6) group was 0.81 logMAR and 0.78 respectively. 2 weeks after surgey, SF(6) was completely absorbed in all cases, and the mean VA improved to 0.5 logMAR; however, it remained 1.9 logMAR in the C(2)F(6) group. The final mean VA at 6 months was 0.44 (range 0-0.78) and 0.38 (range 0-1) in the C(2)F(6) and SF(6) group respectively. There were no instances of pupillary capture in the SF(6) group, whereas there were four in the C(2)F(6) group. CONCLUSION: Macular-hole surgery with SF(6) gas achieves similar results to C(2)F(6) and is absorbed faster, allowing quicker visual rehabilitation for the patient.

Factors contributing to posterior capsule opacification following 23-gauge transconjunctival phacovitrectomy.

BACKGROUND AND OBJECTIVE: To determine posterior capsule opacification (PCO) rate and identify contributory factors in a series of patients undergoing combined 23-gauge transconjunctival phacovitrectomy. PATIENTS AND METHODS: Retrospective data on 221 consecutive patients operated on by a single senior surgeon using a standard technique were collected and subjected to univariate analysis with chi-square tests and multivariate analysis with logistic regression. RESULTS: PCO developed in 46 of 221 cases (20.8%). Major risk factors were: rhegmatogenous retinal detachment (relative risk = 3.3, P = .002), axial length greater than 24.5 mm (relative risk = 2.0, P = .093), intraoperative/postoperative complications (relative risk = 3.3, P = .04), C2F6 tamponade (versus SF6/air) (relative risk = 2.8, P = .01), and postoperative posturing (relative risk = 4.1, P < .001). Multiple logistic regression analysis showed the latter two to be most important. CONCLUSION: PCO rate following 23-gauge phacovitrectomy is lower than most rates reported for 20-gauge phacovitrectomy. Using shorter-acting gas tamponade and avoiding postoperative posturing may help lower PCO rates.

Phacoemulsification and foldable intraocular lens implantation combined with 23-gauge transconjunctival sutureless vitrectomy.

PURPOSE: To evaluate the effectiveness, technical feasibility, outcomes, and complications of phacoemulsification and intraocular lens (IOL) implantation combined with 23-gauge transconjunctival sutureless vitrectomy. SETTING: Ophthalmology Department, Calderdale Royal Hospital, Halifax, United Kingdom. METHOD: This retrospective noncomparative interventional case series evaluated the results of 23-gauge transconjunctival sutureless vitrectomy combined with phacoemulsification and IOL implantation. Primary outcome measures included suture, complication, and hypotony rates; logMAR visual acuity; and intraocular inflammation. RESULTS: Sixty consecutive patients (60 eyes) were included. The mean visual acuity was 0.87 logMAR +/- 0.68 (SD) preoperatively and 0.46 +/- 0.34 logMAR 6 weeks postoperatively; the improvement was statistically significant (P<.0001). The 23-gauge ports were self-sealing in all eyes but 4 (6.7%), in which a single pars plana port was sutured. The mean intraocular pressure was 24.0 +/- 15.6 mm Hg 1 day postoperatively. Eight eyes (13.0%) had postoperative hypotony (<10 mm Hg); all recovered spontaneously within 24 hours. Of the eyes in which long-term tamponade was not necessary (n =12), all 3 with no endotamponade and 3 of 9 with air tamponade had postoperative hypotony; the difference was not statistically significant (P = .09). CONCLUSIONS: Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in managing simultaneous cataract and vitreoretinal pathology. The self-sealing incisions did not adversely affect the overall surgical or visual outcomes, led to faster visual rehabilitation, and reduced ocular inflammation. The use of air tamponade when no long-term endotamponade was necessary appeared to reduce the risk for hypotony.

Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for macular holes.

PURPOSE: To report the accuracy of intraocular lens (IOL) power estimation in eyes having combined phacoemulsification and vitrectomy for macular holes and to compare the axial length (AL) in those eyes with that in the fellow eyes. SETTING: Calderdale Royal Hospital, Halifax, West Yorkshire, United Kingdom. METHOD: The mean and standard deviation of the refractive aim, achieved refraction, and postoperative prediction error (calculated as difference between achieved refraction and refractive aim) were determined in 40 patients who had phacovitrectomy with gas tamponade for the treatment of idiopathic macular holes. The percentage of patients with an achieved refraction within +/-0.50 diopter (D), +/-1.00 D, and more than 2.00 D of the refractive aim was recorded. The mean absolute error (MAE) of the postoperative prediction error was calculated. In addition, the AL in eyes with macular holes was compared with that in fellow eyes. Axial lengths were measured using applanation A-scan ultrasound. RESULTS: Of eyes having phacovitrectomy, 45.0%, 67.5%, and 90.0% achieved a postoperative refraction within +/-0.50 D, +/-1.00 D, and +/-2.00 D, respectively, of the refractive aim; 10.0% of eyes were more than -2.00 D from the refractive aim. The overall postoperative prediction error ranged from +1.64 D to -2.51 D. The mean refractive aim was +0.30 +/- 0.72 D and the mean achieved refraction, -0.09 +/-1.25 D. There was no clinically significant difference between the means. The mean postoperative prediction error was -0.39 +/- 1.01 D, suggesting a myopic overcorrection occurred postoperatively. The MAE of the postoperative prediction error was 0.83 D. The mean AL was 23.40 mm in operated eyes and 23.46 mm in fellow eyes. CONCLUSIONS: The achieved refraction after phacovitrectomy for macular holes was comparable to results after phacoemulsification alone. The myopic overcorrection after phacovitrectomy might be a result of the gas bubble causing forward displacement of the capsular bag and IOL or inaccuracies in AL and keratometry measurements. Aiming for residual hyperopia may counteract the overcorrection. There was no difference in AL between eyes with macular holes and fellow eyes.