AIM: to estimate anatomical and functional outcomes of surgical treatment for rectocele combined with rectal intussusception.PATIENTS AND METHODS: the retrospective study included 96 patients with rectocele with internal rectal intussusception. The median age was 52 (21; 79) years. Laparoscopic rectocolposacropexy was performed in 59/96 (61%) patients with rectocele combined with high internal rectal intussusception, and Longo’s procedure was performed in 37/96 (39%) women with rectocele and low internal rectal intussusception.RESULTS: late outcomes were estimated in 71/96 (74%) patients. The median follow up was 16 (6; 72) months. No complications occurred after laparoscopic rectocolposacropexy. Two (5%) patients had bowel movements up to 8–10 times a day after Longo procedure right after the surgery. After 2 months, bowel movements decreased to 2–3 times a day. Normal residual volume of the rectum after the Longo procedure was detected in 16/37 patients, while laparoscopic rectocolposacropexy did not affect it (p = 0.01). The median rectocele size after surgery in both groups decreased from 5.0 cm to 2.7 cm (p < 0.0001). High rectal intussusception persisted in 20/59 (34%) patients after rectocolposacropexy, low intussusception — in 15/37 (40%) after Longo procedure. According to the original scale-questionnaire, a decrease in the manifestations of SOD was noted in 20/31 (65%) patients after Longo procedure and in 14/40 (35%) patients after rectocolposacropexy (p = 0.018). Improvement in the quality of life (PFDI questionnaire) after the surgery was registered in both groups without significant differences (p = 0.2). The severity of the effect was 22 (6-48) points (p < 0.0001).CONCLUSION: surgery for complex rectocele, regardless of the operation, does not always provide complete anatomical correction of the defects of the rectum. Laparoscopic rectocolposacropexy is inferior to the Longo procedure in functional outcomes.

AIM: to improve late results of pilonidal disease treatment.PATIENTS AND METHODS: a multicenter retrospective cohort study included patients with pilonidal disease using the original new method — the main group (n = 31) and patients with Karidakis method as controls (n = 70). The recurrence rate was estimated. Six months after surgery, ultrasound, the Vancouver Scale and the SF-36 questionnaire assessed the postoperative scar, cosmetic result and quality of life.RESULTS: the cosmetic effect of the postoperative scar was evaluated and significant differences between groups were obtained. According to the Vancouver Scale, 12 (41.4%) patients of the main group and 11 (16.9%) patients from the control group had a normal color of the postoperative scar (0 points) (p = 0.02). When assessing the pigmentation of the scar, it was found that normal pigmentation (0 points) was found in 8 (28.0%) patients of the main group, and in the control group this indicator was only 5 (8.0%) cases (p = 0.02). The pressure-resistant scar density (2 points) was 17 (59.0%) patients in the main group and 22 (34.0%) patients in the control group (p = 0.04). The scar width in the group using the new method was 1–2 mm (1 point) in 20 cases (69%), whereas in the control group, a similar scar width was recorded in 18 (28.0%) patients (p < 0.001). When evaluating the results of ultrasound of the soft tissue infiltration zone (p = 0.26) and the volume of infiltration (p = 0.36), as well as assessing the quality of life, no significant differences were found. There were no significant differences in the recurrence rate: in the main group it was 2 (6.45%), in the comparison group — 5 (7.14%) cases (p = 0.77).CONCLUSIONS: a new original method for pilonidal disease in comparison with the Karydakis method provides a better cosmetic result

Chronic spontaneous urticaria (CSU) is a condition characterized by the daily occurrence of wheals, with or without angioedema, persisting for more than six weeks, without any identifiable triggering factor. CSU is caused by the abnormal activation of mast cells and basophils and the release of histamine, resulting in itching and skin lesions that can significantly impact patients' quality of life. Diagnosis is primarily based on clinical observation and the exclusion of other conditions, while standard treatment involves the use of second-generation antihistamines, with the addition of omalizumab for more resistant cases.

Pulmonary adenocarcinoma is a common malignant tumor in clinical practice. Traditional Chinese medicine believes that this disease is often caused by deficiency, leading to excess due to deficiency. It belongs to the category of deficiency with excess as the basis, and positive deficiency as the basis. Phlegm turbidity, qi stagnation, blood stasis, and toxin accumulation accumulate in the lungs as the basis. This article provides a review of the research status of traditional Chinese medicine in the treatment of lung adenocarcinoma in recent years, including etiology and pathogenesis, traditional Chinese medicine prescriptions, empirical prescriptions, and new traditional Chinese medicine preparations. The results show that traditional Chinese medicine can enhance the clinical efficacy of radiotherapy, chemotherapy, or targeted drug treatment, reduce various side effects of Western medicine treatment, reduce drug resistance, and significantly improve the quality of life of patients and prolong their survival.

ABSTRACT We estimate and assess the impact of a comprehensive social protection intervention on sanitation access and behaviour in rural Haiti. Evaluations of such interventions point to positive effects on lives and livelihoods, yet their impact on sanitation remains relatively unexplored. Despite rapid acceleration of efforts in the past decade, progress towards adequate and equitable sanitation has been limited. Using a mixed methods approach, we find that bundled interventions can be effective in improving access to sanitation facilities and promoting sanitation behaviour. Findings also point to the importance of contextual factors and the role of women in facilitating positive outcomes.

PurposeThis study examines the implementation and performance of Occupational Health and Safety (OHS) practices in the Pokhara Regional International Airport Project (PRIAP), a key public infrastructure initiative in Nepal. Given airports' significance to Nepal’s economy, particularly for tourism and trade, the research highlights the unique safety challenges in airport construction, addressing gaps in OHS management in developing countries.Design/methodology/approachA case study methodology focused on the PRIAP enabled a thorough analysis of safety practices. Data were gathered using structured questionnaires from various stakeholders. The Cronbach’s alpha and relative importance index (RII) were used to assess response reliability and ranked factors affecting safety performance.FindingsThe study identifies both strengths and weaknesses in the project’s OHS practices. While plant and equipment handling and financial aspects, such as budget allocation for safety measures and accident compensation, were deemed satisfactory, significant deficiencies were found in hazard identification and the investigation of near misses. These results suggest that improvements are needed in proactive safety management, particularly in worker-management communication.Research limitations/implicationsThis study provides valuable insights but is limited by its single-site focus and use of descriptive statistics. Future research should employ advanced statistical methods, like ANOVA, and include multiple construction sites to capture a broader range of OHS challenges. Evaluating the long-term effectiveness of proposed interventions is also essential. Addressing these limitations will enhance the development of comprehensive safety management strategies tailored to the specific needs of construction projects in developing countries.Practical implicationsThis study provides practical recommendations for improving OHS practices in airport construction and similar large-scale projects in developing countries. Enhanced hazard identification and improved communication among stakeholders can help reduce accidents and boost project efficiency.Social implicationsImproving safety regulations and culture can reduce workplace injuries, enhancing workers' well-being and quality of life. This research supports stronger public policies, helping lower economic burdens from accidents, promoting social stability and increasing public trust in regulatory bodies.Originality/valueThis research contributes to the limited literature on OHS in airport construction projects in developing countries, particularly in Nepal. The case study methodology provides a detailed examination of safety practices and offers a framework for improving OHS in similar projects.

ABSTRACT This research was designed as a pretest-posttest experimental study to evaluate the effect of a group intervention based on horticultural therapy on 20 older adults residing in different districts of Istanbul. Participants, aged between 58 and 65, were randomly assigned to either the experimental or control group. In addition to the Personal Information Form, the Older People’s Quality of Life-Brief (OPQOL-Brief) and the Depression, Anxiety, and Stress Scale (DASS-21) were administered to the participants as both pretests and posttests. The collected data were analyzed using the SPSS 22.0 software. At the conclusion of the group intervention, a significant improvement was observed in the total scores of the OPQOL-Brief and DASS-21 among the older adults in the experimental group. These findings suggest that incorporating horticultural therapy practices may be beneficial in enhancing the quality of life and mental well-being of older adults.

Autologous blood therapy has emerged as a promising modality in managing ocular surface disorders. This review provides a comprehensive overview of the current literature regarding the use of autologous blood in ocular surface disorders, encompassing its physiological basis, clinical applications, techniques, challenges, and future perspectives. The ocular surface, comprising the cornea, conjunctiva, and tear film, plays a critical role in maintaining visual function, and its disruption can lead to various pathological conditions. With its rich composition of growth factors, cytokines, and other bioactive molecules, autologous blood offers therapeutic potential in promoting corneal wound healing, reducing inflammation, and improving tear film stability. Clinical studies have demonstrated the efficacy and safety of autologous blood therapy in diverse ocular surface disorders, including persistent epithelial defects, neurotrophic keratopathy, and dry eye disease. However, challenges such as variability in treatment response, adverse effects, and optimal patient selection remain areas of concern. Further research is needed to elucidate the underlying mechanisms of action, refine treatment protocols, and explore synergistic approaches with other therapeutic modalities. Despite these challenges, autologous blood therapy holds promise as a valuable adjunctive treatment option for ocular surface disorders, offering new avenues for improving patient outcomes and quality of life. This review examines the mechanisms underlying ocular surface disorders while discussing existing autologous blood-based therapies for managing these disorders. Current clinical trials are also summarized, and a comparison between autologous blood therapy and conventional eyedrops is attempted. Finally, safe techniques and protocols for autologous blood medicine are elucidated, and adverse effects and future perspectives of this novel therapy are reviewed.

Purpose The function of banking development in reducing income inequality is critical because financial institutions can grant loans, stimulating prospective productive investments. Based on this promise, the aim of this study is to fill the vacuum by particularly evaluating the influence of banking development, as proxied by bank cost efficiency estimated using a parametric approach, on income inequality. Design/methodology/approach To evaluate the impact of banking development on income inequality, the authors use data from 20 Italian regions from 2004 to 2017. Particular attention will be made to the consequences that the varied composition of the Italian banking structure, namely, the presence of cooperative and non-cooperative banks, may have on income inequality. To do this, the authors use a generalized method of moments (GMM) regression on panel data to address the endogeneity problem that exists between banking development and income inequality. Findings Evidence reveals that increasing bank development plays an important impact in reducing income inequality, with cooperative banks faring best. A set of robustness tests generally validates our empirical findings and brings relevant policy implications. Originality/value A “qualitative” measure, such as cost efficiency, which is computed using a parametric technique, has been used as a proxy for banking development to analyse the relationship between banking development and income inequality. The contribution, in particular, focuses on how bank diversity influences the nexus between banking development and income inequality in a homogenous context.

Limited studies have assessed the long-term benefit/risk of gene therapy for Leber hereditary optic neuropathy (LHON). To determine the safety and efficacy of lenadogene nolparvovec in patients with LHON due to the MT-ND4 gene variant for up to 5 years after administration. The RESCUE and REVERSE Long-Term Follow-up Study (RESTORE), conducted from 2018 to 2022, is the 5-year follow-up study of the 2 phase 3 clinical studies RESCUE (Efficacy Study of Lenadogene Nolparvovec for the Treatment of Vision Loss Up to 6 Months From Onset in LHON Due to the MT-ND4 Mutation) and REVERSE (Efficacy Study of Lenadogene Nolparvovec for the Treatment of Vision Loss From 7 Months to 1 Year From Onset in LHON Due to the MT-ND4 Mutation). At the end of each study, ie, 2 years after gene therapy administration, patients were offered enrollment in the RESTORE trial, a multinational, multicenter, prospective study, for an additional 3 years of follow-up. Patients with LHON due to the MT-ND4 gene variant received lenadogene nolparvovec in 1 eye and a sham injection in the other eye. Lenadogene nolparvovec was administered as a single intravitreal injection in the RESCUE/REVERSE studies. Measures included best-corrected visual acuity (BCVA), quality of life using the National Eye Institute visual functioning questionnaire 25 (NEI VFQ-25), and adverse events. Among the 76 patients who received gene therapy in the RESCUE (n = 39) and REVERSE (n = 37) studies, 72 (94.7%) completed these studies; 62 patients (81.6%) participated in the RESTORE trial, and 55 patients (72.4%) completed the 5-year follow-up. Participants were mostly male (49 [79.0%]) with a mean (SD) age of 35.9 (15.3) years at treatment. At baseline, the mean (SD) BCVA was 1.5 (0.5) logMAR (20/600 Snellen) in eyes to be treated with lenadogene nolparvovec and 1.4 (0.5) logMAR (20/500) in sham eyes. At the end of the RESCUE/REVERSE trials, ie, 2 years after treatment, eyes treated with lenadogene nolparvovec and eyes treated with sham reached a mean BCVA value of 1.4 (0.6) logMAR (20/500). The mean (SD) change from baseline to year 2 was -0.05 (0.6) logMAR (+1 line) and 0.01 (0.6) logMAR (-0 line) in gene therapy-treated and sham eyes, respectively (difference, -0.03; 95% CI, -0.16 to 0.09; P = .60). Five years after treatment, the bilateral improvement from nadir was similar to that observed at 2 years, with a mean (SD) change in BCVA of -0.4 (0.5) logMAR (more than +4 lines) for eyes treated with lenadogene nolparvovec and -0.4 (0.4) logMAR (+4 lines) for eyes treated with sham (difference, -0.05; 95% CI, -0.15 to 0.04; P = .27). An improvement of at least -0.3 logMAR (+3 lines) from the nadir in at least 1 eye was observed in 66.1% of participants (41 of 62). Between 2 and 5 years, intraocular inflammation was noted in 4 participants with 8 events in eyes treated with lenadogene nolparvovec and 1 event in an eye treated with sham. In this analysis of the RESTORE trial, follow-up of patients with LHON due to the MT-ND4 gene variant unilaterally treated with lenadogene nolparvovec demonstrated a sustained bilateral improvement in BCVA and a good safety profile up to 5 years after treatment. This evidence of persistent benefit over time is promising for the use of gene therapy in these patients. ClinicalTrials.gov Identifier: NCT03406104.