Short-term surgical outcomes of twin-site combined phaco-emulsification and mitomycin-C augmented trabeculectomy in pseudo-exfoliation glaucoma versus primary open-angle glaucoma.

Purpose: To compare the short-term outcomes of combined phaco-emulsification with posterior chamber intra-ocular lens and mitomycin augmented trabeculectomy in patients with pseudo-exfoliation glaucoma (PXFG) versus primary open-angle glaucoma (POAG). Methods: A total of 144 eyes of 144 patients were enrolled in this prospective interventional comparative study, 72 each of which had PXFG and POAG, respectively. All patients underwent twin-site combined phaco-trabeculectomy at a tertiary eye center in India between December 2017 and December 2018 and were followed up for a period of 12 months. The main outcome measures were intra-ocular pressure (IOP), best corrected visual acuity (BCVA), total surgical time, rate of intra-operative and post-operative complications, and the number of ocular hypotensive medications needed. Success rates were determined via Kaplan-Meier survival analysis. Results: The mean age was 63.9 ± 7.9 years in the POAG group and 66.4 ± 6.8 years in the PXFG group (P - 0.04). The baseline BCVA, IOP, and cup-disc ratio were comparable between two groups. Intra-operative complications and post-operative outcomes were comparable between the two groups. There was a significant drop in anti-glaucoma medications in both groups. Six patients, three (4.2%) in each group, were lost to follow-up after 6 months. Three patients (4.2%) in PXFG needed additional glaucoma intervention for controlling IOP, one patient needed a non-valved glaucoma drainage device, and two patients required diode cyclo-photocoagulation within the follow-up period. Conclusion: Patients with PXFG had a longer surgical time than POAG. Similar success and complication rates were observed following combined twin-site phaco-trabeculectomy in both POAG and PXFG at 1 year. Combined glaucoma surgery resulted in good IOP control, improvement in BCVA, and lower requirement of ocular hypotensives in both the groups.

Blockchain and IPFS Integrated Framework in Bilevel Fog-Cloud Network for Security and Privacy of IoMT Devices.

Internet of Medical Things (IoMT) has emerged as an integral part of the smart health monitoring system in the present world. The smart health monitoring deals with not only for emergency and hospital services but also for maintaining a healthy lifestyle. The industry 5.0 and 5/6G has allowed the development of cost-efficient sensors and devices which can collect a wide range of human biological data and transfer it through wireless network communication in real time. This led to real-time monitoring of patient data through multiple IoMT devices from remote locations. The IoMT network registers a large number of patients and devices every day, along with the generation of huge amount of big data or health data. This patient data should retain data privacy and data security on the IoMT network to avoid any misuse. To attain such data security and privacy of the patient and IoMT devices, a three-level/tier network integrated with blockchain and interplanetary file system (IPFS) has been proposed. The proposed network is making the best use of IPFS and blockchain technology for security and data exchange in a three-level healthcare network. The present framework has been evaluated for various network activities for validating the scalability of the network. The network was found to be efficient in handling complex data with the capability of scalability.