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Objective: To study the clinical effect of lens cleaning paper patching on traumatic eardrum perforations., Methods: A total of 122 patients were divided into 2 groups, of which 56 patients were treated with lens cleaning paper patching and 66 acted as controls. The closure rate and healing time were compared between the two groups., Results: The healing rate of small perforations was 96.4 per cent (27 out of 28) in the patching group and 90 per cent (27 out of 30) in the control group. The difference was not statistically significant (p > 0.05). The healing rate of large perforations was 89.3 per cent (25 out of 28) and 80.6 per cent (29 out of 36) in the two groups, respectively. The difference was statistically significant (p < 0.05). The healing time of large perforations was shorter in the patching group than in the control group (p < 0.01)., Conclusion: Patching with lens cleaning paper under an endoscope can accelerate the closure of large traumatic eardrum perforations.

Background: Application of one or several paper patches on the tympanic membrane can improve autophony and other symptoms in some patients with a patulous eustachian tube., Method: The charts of 21 patients treated for patulous eustachian tube syndrome between 2006 and 2011 were studied for subjective improvement of symptoms following the application of paper patches., Results: Paper patching of the tympanic membrane provided symptomatic relief in 76.2 per cent of patients; relief was permanent in 50 per cent of these patients., Conclusion: Paper patching of the tympanic membrane is a simple and effective means of temporarily or permanently alleviating patulous eustachian tube syndrome symptoms. It is postulated that the patches decrease the admittance of low- to mid-frequency acoustic input at the tympanic membrane by increasing the stiffness of the tympanic membrane, thereby counteracting the middle-ear cushion effect caused by the open eustachian tube.

Objective: To evaluate warm air and paper towel drying for removing bacteria from washed hands., Methods: After hands were washed with non-antibacterial soap, they were dried using warm air with and without ultraviolet light, while being rubbed or held stationary, or paper towels. Each method was performed as a randomized trial using 30 hands., Results: Log colony-forming units (CFU) on palms and fingers increased significantly when hands were dried with warm air while being rubbed for 15 seconds (P < .001), and many bacteria remained at 30 seconds without ultraviolet light (P < .001) Holding hands stationary while drying significantly decreased log CFU on palms, fingers, and fingertips (P < .01 or < .001). Few CFU were detected on palms and fingers dried with ultraviolet light. Although log CFU of palms and fingers did not decrease after drying with three sheets of paper towel, those of fingertips decreased significantly (P < .001). For palms and fingers, log reductions were greater with warm air drying while holding hands stationary, paper towels, and warm air drying while rubbing hands. For fingertips, the log reduction was often greater with paper towels than with warm air., Conclusions: Holding hands stationary and not rubbing them was desirable for removing bacteria. Ultraviolet light reinforced the removal of bacteria during warm air drying. Paper towels were useful for removing bacteria from fingertips but not palms and fingers.

Objectives: To develop a microbial test method to ascertain the passage of airborne bacteria through the medical device packaging system after sterilization, and to apply this test method to flexible packages under mechanical pressure changes., Methods: Petri dishes filled with nutrient agar were integrated into the packaging unit prior to sterilization. We examined paper packaging consisting of 1 (single-paper packaging [P]), 2 (double-paper packaging [PP] and textile and paper double packaging [TP]), and 3 (double packaging with transport packaging [TPP]) layers. After sterilization, the test packages were pressed five times per minute for 1 or 3 hours by a mechanical device weighing 1 kg. This exposure took place in rooms with an average airborne bacterial count of 35 (room 1) or 440 (room 2) CFU/m3. The packaging was opened following culture at 37 degrees C for 48 hours to determine the number of colonies formed., Results: The proportion of contaminated packages rose with the duration of mechanical stress and increased airborne bacteria concentration. Thus, mechanical pressure change for 3 hours resulted in the contamination of 60% (P), 15% (PP), 0% (TP), and 0% (TPP) of the packages in room 1, whereas 100% (P), 65% (PP), 73% (TP), and 0% (TPP) of the packages in room 2 were contaminated., Conclusions: This test method allows sterile packaging systems to be tested for contamination under practical conditions without extensive laboratory preparation. Contamination as a result of laboratory errors can be ruled out almost certainly.

We report an unusual case of a subjective hearing improvement, confirmed by audiometry, in a patient using a paper towel prosthesis.

Objective: To evaluate the efficacy of the AbTox Plazlyte Sterilization System against selected microbial species using inoculated carriers and surgical instruments., Setting: The microbiology laboratory of a 700-bed adult tertiary-care hospital., Design: The study was conducted in two phases. In phase 1, microorganisms were inoculated to various metal, paper, plastic, and glass carriers, as well as surgical equipment, and processed in cycle II of the AbTox sterilizer. Phase 2 compared AbTox cycle III with ethylene oxide sterilization using stainless steel washers, penicylinders, and surgical equipment. In both phases, cultures of equipment and carriers were obtained after processing. The phenotypic profiles and antibiograms of positive cultures were compared to the original inoculate to rule out the possibility of contamination., Results: Of a total of 350 paper carriers, 375 metal washers, and 234 pieces of equipment processed in cycle II and using trypticase soy broth as the inoculating medium, 123 metal washers (32%) and 8 instruments (3%) failed to be sterilized. Similar failures were noted with cycle III. The presence of either salt or protein adversely affected the system's ability to sterilize in either cycle., Conclusion: Further studies are needed to evaluate the extent to which salt or organic material compromise low-temperature gas-plasma sterilization. Meanwhile, users should exercise caution and use care in the cleaning of instruments that will be processed in the plasma-based sterilization technologies.

Thirty consecutive patients with permanent perforations of their tympanic membranes (TM) present from 2.5 to 50 years (mean 18.7 years) were admitted to a prospective study using two alternative methods of dressings for closure of the perforations. An adhesive-coated hydrocolloid material was compared with a conventional dressing of vaseline impregnated rice paper patch after de-epithelialization of the perforation border. Nine of the permanent TM perforations (30 per cent), five with the hydrocolloidal dressing and four with the rice paper patch had healed when followed-up after one year. The size of eight of the central perforations that had healed was equal to or less than 25 per cent of the TM. Also one perforation with a size of 65 per cent had healed. Seven perforations were located in the posterior part of the TM: four in the posterior-superior quadrant, one in the inferior quadrant, one had engulfed the posterior half of the TM and one included the anterior-inferior quadrant. Only two perforations out of 14, with a size of 25 per cent or less, located in the anterior-inferior quadrant, healed. No significant difference was demonstrated between the two types of dressings. Both groups noted an immediate improvement in hearing of 10.8 and 9.3 dB, respectively, after application of the dressing. The study demonstrates that application of an occlusive dressing or paper patch in 30 per cent of patients can promote the healing of long-standing perforations. The chances for healing are better if the perforation is located in the posterior part of the TM. This simple technique immediately improved hearing and should be tried before a patient is referred for myringoplasty surgery.

A new material, the wax paper enveloping the Fucidin gauze which is routinely used to pack the nose post-operatively, was utilized in 120 cases considered as 'high-risk' for the formation of post-operative nasal adhesions. This proved to be an inexpensive, simple and effective method when the prevention of the formation of nasal adhesions was the primary goal.

To assess the potential of fomites and environmental surfaces as vehicles in the transmission of rotaviral diarrhoea, disks (1 cm diameter) of various porous and non-porous materials were contaminated with about 10(5) plaque-forming units of the Wa strain of human rotavirus (HRV) suspended in faecal matter. The contaminated disks were then held for 10 days at either room temperature (22 +/- 2 degrees C) or 4 degrees C with the relative humidity (RH) at the high (85 +/- 5%), medium (50 +/- 5%) or low (25 +/- 5%) level. Survival was longer on non-porous surfaces at the lower temperature and at lower humidity. In contrast, survival on porous surfaces was very variable; better on cotton-polyester than on poster card or paper currency on which HRV survived very poorly. These results suggest that under the right environmental conditions, HRV-contaminated objects could play a role in the transmission of rotavirus infections in hospitals, nursing homes and day-care centres.