Cotton-tipped Applicator Research Articles

Exploring the Microbiome of Mobile Devices: Implications for Public Health and Hygiene

This study, which examined the diversity of microorganisms found on mobile phones, took a novel approach by identifying pathogenic microbes on phone users within different age groups. The study also aimed to test the effectiveness of a simple disinfection method using 70% sterile alcohol pads. Samples were collected using sterile cotton tip applicators and transport broth media before and after disinfection. The samples were cultured and incubated on Muller Hinton agar petri plates at 32 degrees Celsius for 48 hours. The isolated microbes were identified based on their morphological characteristics, gram-stain test, and biochemical analysis. The survey, conducted to determine the frequency of mobile phone usage and factors contributing to microbial contamination, revealed significant findings. Participants from two villages were surveyed using a structured questionnaire. The sample size of participants was generated using a sample size calculator. Two participants from each age group per village were selected randomly for microbial sample collection from their mobile phones using R Studio software. The results showed that older adults' mobile phones were more contaminated than younger adults and adolescents, providing valuable insights. The frequency of usage and hygiene did not determine the total viable count of pathogenic microbes found, challenging existing assumptions. The study also found that disinfection using 70% sterile alcohol pads was 76% effective in reducing microbial contamination.

Treatment outcome of spontaneous chronic corneal epithelial defects in brachycephalic dogs comparing Boxers and non-Boxers: A retrospective multicenter study of 420 dogs.

To compare characteristics and treatment outcomes of spontaneous chronic corneal epithelial defects (SCCEDs) in brachycephalic non-Boxers and Boxers. We hypothesized that brachycephalic non-Boxers develop SCCEDs at a younger age and develop complications more frequently than Boxers. Retrospective review of medical records of brachycephalic dogs treated for SCCEDs between January 2018 and December 2022 in multiple ophthalmology referral centers in the UK. Data recorded included breed, age, time of onset, treatment prior to referral, treatment at referral, time to heal, need for further procedures, and complications. A total of 464 SCCEDs in 420 dogs were included composed of 173 Boxers with 200 SCCEDs and 247 brachycephalic non-Boxer dogs with 264 SCCEDs. Boxers were significantly older (median 8.2, range 4.5-12.7 years) than brachycephalic non-Boxers (median 7.2, range 1.6-15.9 years) (p < .001). The first treatment (cotton-tipped applicator [CTA] debridement, diamond burr debridement, superficial keratectomy, grid keratotomy, punctate keratotomy, or combinations of these) selected was significantly different between groups (p < .001). Healing, excluding cases addressed by CTA debridement, following the first procedure was significantly more successful in Boxers (p = .049). Excluding cases addressed by CTA debridement, 9.6% of SCCEDs in Boxers (20/200) and 13.4% (32/239) of non-Boxers required more than one procedure. In the non-Boxer group, 9.5% (25/264) developed complications, contrasting with 4% (8/200) in the Boxer group. Non-Boxers were more likely to develop complications after the first treatment (p = .006). Non-Boxer brachycephalic dogs develop SCCEDs younger than Boxers. This study suggests SCCEDs in brachycephalic non-Boxers may be less likely to heal following one mechanical treatment and are more likely to develop complications.

Intraoperative surgical planning with cotton tip applicator

Intraoperative surgical planning with cotton tip applicator

METHOD OF POVIDONE-IODINE APPLICATION AND ENDOPHTHALMITIS RISK.

To evaluate the proportion of patients developing endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents according to the mode of povidone-iodine (PI) antisepsis. A retrospective review of the anti-vascular endothelial growth factor injections given in a 7-year period at a community-based retinal practice. Endophthalmitis was diagnosed to have occurred if an eye developed intraocular inflammation and was given antibiotics with or without supportive culture identification of an organism. As part of their habitual clinical practice, component physicians used 5% PI as two drops, one drop, or just a dot of PI administered with a cotton-tipped applicator to the site before injection. There were 113,610 intravitreal injections administered and 23 cases were diagnosed with endophthalmitis over the 7-year period, for a rate of 1 case per 4,940 injections. The mode of PI antisepsis showed no significant relation to the rate of endophthalmitis ( P = 0.55, chi-square test). The proportion of endophthalmitis by physician demonstrated no significant difference ( P = 0.39, chi-square test). The use of PI has been associated with decreased incidence of endophthalmitis, but the mode of application has not been standardized. The results of this study suggest that "more is not better" in PI antisepsis in endophthalmitis. Moreover, the toxicity of PI on the ocular surface is known to be dose-related.

Sphenopalatine Ganglion Block With Lidocaine Drops Relieves Lower Extremity Complex Regional Pain Syndrome: A Case Report

BACKGROUND: Lower extremity complex regional pain syndrome (CRPS) is a debilitating, neuropathic pain disorder that may develop into a refractory, chronic condition, which currently has no gold-standard treatment. We would like to share the first report of a transnasal sphenopalatine ganglion block with lidocaine that effectively relieved the pain of a patient suffering from lower extremity CRPS. CASE REPORT: A 48-year-old man with CRPS suffered from pain that was resistant to analgesic medications, spinal blocks, and a spinal cord stimulator. A sphenopalatine ganglion block was administered to the patient via long, hollow cotton-tip applicators with lidocaine drops. After just one block, for the first time in 10 years, he was 100% pain free for 5 days. CONCLUSIONS: This case report demonstrates that the lidocaine sphenopalatine ganglion block could be a simple, safe, inexpensive, and noninvasive treatment option for those affected by lower extremity CRPS. KEY WORDS: Sphenopalatine ganglion block, lidocaine, chronic pain, complex regional pain syndrome

The versatility of the transnasal sphenopalatine ganglion block.

Dear Editor, We read with great interest the article by Ferjani et al.1 on how a patient’s headache from a postoperative spinal dural tear was successfully relieved with a bilateral transnasal sphenopalatine ganglion block. This is a simple and valuable technique that was discovered in 1908, but few anesthesiology or pain physicians are familiar with the block and its versatility. Intranasal devices for the administration of the transnasal sphenopalatine ganglion block are available but are expensive and might not be readily available at all institutions. To safely and inexpensively perform the transnasal sphenopalatine ganglion block to treat headaches and also extend the treatment to other types of pain, we have created our own device from supplies that are readily accessible in most medical facilities. For our transnasal sphenopalatine ganglion block applicator, we attached a 3-mL syringe (filled with 4% lidocaine hydrochloride solution) to one side of intravenous extension tubing with a stopcock, and we attached a hollow cotton swab dipped into 5% lidocaine ointment to the other side of the tubing. The patients position themselves supine with neck extension and hemodynamic monitoring. The applicator is gently advanced perpendicular to the patient’s nostril until the tip reaches the back of the nasal pharynx and gentle resistance is met. Lidocaine 4% is administered slowly under low pressure through the cotton-tipped applicator until the medication is felt in the back of the throat. A second applicator is then inserted into the opposite nostril, and the medication is administered as before. Symptoms are evaluated 15 minutes after insertion. If the symptoms are not sufficiently relieved, this procedure is repeated up to 2 more times. In our experience, this transnasal sphenopalatine ganglion block has successfully relieved the pain amenable to sphenopalatine ganglion blockade; importantly, this approach has not had a technical failure.

Effects of bilateral transmucosal sphenopalatine ganglion block on intraoperative anesthetic requirements and recovery profile in children undergoing palatoplasty under general anesthesia.

Sphenopalatine ganglion block (SPGB) given as injection provides excellent perioperative analgesia during palatoplasty. Our objectives were to assess the effect of transmucosal SPGB on anesthetic requirements, intraoperative hemodynamics, recovery time, and emergence delirium in children undergoing palatoplasty. This prospective, randomized study was conducted in 30 children with cleft palate undergoing palatoplasty, divided into two equal groups. After induction and intubation, patients in Group B received bilateral SPGB using cotton-tipped applicators soaked in 2% lignocaine, which were passed through both the nares, and the distal tip was positioned just superior to middle turbinate and anterior to pterygopalatine fossa and sphenopalatine ganglion. In Group C, saline-soaked cotton applicators were used. All patients received general anesthesia as per a standardized protocol. Intraoperative heart rate, mean arterial pressure, the requirement of anesthetics, extubation time, and emergence delirium were compared. Compared with Group C, patients in Group B had significantly lower sevoflurane consumption (17.2 ± 2.6 vs. 27.5 ± 5.0mL, P < 0.001) and fentanyl consumption (2.2 ± 0.5 vs. 3.2 ± 0.6 μ/kg, P < 0.001).The extubation time was significantly shorter in Group B (3.9 ± 0.7 vs. 9.5 ± 1.6 minutes, P < 0.001). PAED (Pediatric Anesthesia Emergence Delirium Scale) scores at 5and 10 minutes were significantly higher in Group C (P < 0.001). Intraoperative heart rate was significantly higher in Group C. Group C had significantly higher mean arterial pressure at 15, 60, and 75 minutes. Preoperative, SPGB administered by mucosal application of local anesthetic significantly reduced sevoflurane and fentanyl requirements, with stable hemodynamics, quicker recovery, and less emergence delirium in children undergoing palatoplasty.

Facial masculinization surgery

Facial masculinization surgery

Conjunctival Lymphangiectasia Simulating Loa Loa.

A 46-year-old woman presented with complaints of irritation in the OS for 1 year. Her ocular examination revealed normal vision and anterior segment except for an incidental finding of a worm-like lesion in the temporal conjunctiva. The lesion was transparent, linear in shape forming a complete loop, extending from the superotemporal conjunctiva to the inferior conjunctiva (Panel A). The plane of the lesion was conjunctival. The lesion showed no mobility with exposure to light or when touched with a cotton-tip applicator. Differential diagnosis of dead loa loa versus lymphangiectasia was made. Her peripheral blood smear did not reveal any microfilariae and had a normal cell count. Surgical excision revealed the lesion to be embedded within the conjunctiva and no worm came out. Only a segment of the lesion was sent for biopsy as there was no worm. Histopathology revealed hyperplastic conjunctival epithelium (Panel B; ×200) showing diffuse and intense expression with pan-cytokeratin antibody (Panel C; ×200). Subepithelial stroma showed thickened, dilated, and ectatic vessels (Panel D; ×400). The endothelial lining of vessels showed strong and intense expression with CD34 and podoplanin antibodies (Panels E and F; ×400) indicating lymphatic origin. The final diagnosis of conjunctival lymphangiectasia was made. Isolated conjunctival lymphangiectasia can be an incidental finding or associated with chemosis or persistent irritation. A trial of topical steroids can be given in symptomatic patients. Surgical excision with or without amniotic membrane graft or conjunctival autograft can be performed in nonresponsive cases. Anterior segment optical coherence tomography of conjunctival lymphangiectasia shows multiple subepithelial cystic spaces within the conjunctiva.

Comparison of Effectiveness of Platelet Rich Plasma (PRP) versus 30% Trichloroacetic Acid (TCA) in the Treatment of Acne Scars

Objective: To compare the effectiveness of intradermal platelet-rich plasma with 30% Trichloroacetic acid in treating atrophic acne scars.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of Study: Tertiary Care Hospital of Multan Pakistan, from Aug 2019 to Sep 2020.&#x0D; Methodology: A total of 76 patients (38 in each group), were enrolled in the study. Platelet-rich plasma treatment was given to Group-A, and 30% Trichloroacetic acid treatment was given to Group-B patients. Platelet-rich plasma was injected in the dermis with an insulin syringe while 30%Trichloracetic acid was applied with a cotton tip applicator. The effectiveness of treatment was measured by Goodman and Baron quantitative acne scar scale.&#x0D; Results: A total of 76 patients with atrophic acne scars were included in the study. The mean age of patients in Plate rich plasma Group was 29.63±5.08 years and 29.92±5.85 years in the 30% Trichloroacetic acid Group. Platelet Rich Plasma was an effective treatment of atrophic acne scar (p= 0.030) with post-procedure improvement in the Goodman and Baron quantitative acne scar scale.&#x0D; Conclusion: Atrophic acne scar treatment with intradermal Plate-rich plasma is more effective than 30% Trichloroacetic acid.

Floral Differences of Conjunctiva in Patients with Renal Diseases

Objectives: This study aimed to evaluate whether conjunctival flora is different in patients with chronic renal disease (CR) among its subgroups and healthy subjects.&#x0D; Methods: A total of 105 adult CR patients; 35 hemodialysis (HD), 35 diabetic hemodialysis (DHD), 35 renal transplantation (RT), and 40 healthy subjects were enrolled. After ophthalmologic examination, a swab was taken from the lower fornix of the right eye using a cotton-tipped applicator and directly sub-cultured on 5% sheep’s blood agar, chocolate agar, and eosin methylene blue agar. Differences in both bacterial growth and flora diversity of the groups were compared. &#x0D; Results: The order of bacterial growth rates in the groups are RT 65%), DHD (57%), HD (56%), and control (48%). The RT group had a statistically significant difference from the control group (p

Post Penile Inversion Vaginoplasty Clinical Examination: Considerations and Techniques.

Post Penile Inversion Vaginoplasty Clinical Examination: Considerations and Techniques.

Refill-Exchange Procedure of the Port Delivery System With Ranibizumab: Overview and Clinical Trial Experience.

To describe the Port Delivery System with ranibizumab refill-exchange procedure. Procedure based on the clinical trial program in patients with retinal diseases. The refill-exchange procedure is performed under topical anesthesia and strict aseptic conditions. Supplemental task lighting and magnification are recommended throughout the procedure. Ranibizumab is aseptically transferred from the vial with the filter needle and air is removed from the syringe. The filter needle is then replaced with the refill needle; any remaining air is removed from the syringe and the plunger is advanced to the 0.1-mL mark. Targeting the implant septum center, the refill needle is inserted perpendicularly to the globe until the soft stop contacts the conjunctiva (perpendicular orientation and conjunctival contact are maintained throughout the procedure); a cotton-tipped applicator is recommended for globe stabilization. The entire syringe contents are slowly injected over 5-10 seconds while existing solution fills the fluid collection reservoir. Once completed, the needle is carefully withdrawn while maintaining perpendicularity. The procedure can be successfully performed in rare, specific cases, including subconjunctival thickening or fibrous capsule formation, fluid-filled bleb formation, and corneal patch grafts. The procedure is straightforward but distinct from intravitreal injections and requires adherence to standardized techniques. With appropriate preparation, the procedure can be performed in specific cases. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:257-265.].

Demonstrating the cotton-tipped applicator method to standardize dermatologic surgery suture tail length

Suture end length is an important indicator of knot integrity. Knots with an end length between 3 and 10 mm are less likely to come unraveled than knots with an end length of <3 mm.1 It is important, however, to cut the sutures short enough to prevent the ends from entangling. This can be achieved by cutting the sutures to a length that is less than the distance between sutures.2 For new learners and surgical assistants, measuring each knot end length before cutting is time consuming and laborious.

Feasibility, Gross Postmortem Results and Participant Perception of Oblique Prefemoral Ovariectomy in Red Eared Sliders (Trachemys scripta elegans) During a Teaching Workshop

The purpose of the present report is to describe feasibility and gross postmortem results of oblique prefemoral ovariectomy in red-eared sliders (Trachemys scripta elegans) performed by veterinarians in a teaching environment. Sixteen red-eared sliders were included in a teaching workshop. The turtles were anesthetized and placed in dorsolateral recumbency at an oblique 45-degree angle by use of folded towels. After prefemoral access to the celom and placement of a retractor with elastic bands, the ipsilateral follicles were exteriorized via gentle maneuvering with cotton tip applicators and excised after application of titanium clips and cautery with bipolar radiosurgery. On 14 of the 16 chelonians (87.5%) surgery was successfully completed. Of the two chelonians that did not have the surgical procedure completed, one had marked celomitis with adhesion of the ovaries to the liver and one had immature ovaries. At the end of the surgical procedures all chelonians were euthanized and postmortem was performed. The 14 chelonians that had surgery completed had no evident remaining ovarian tissue on gross postmortem. A survey completed by the attendants nine months after the workshop showed that a minority of the respondents (1/17) found the procedure difficult, and that one of the seven respondents that performed the surgery after the workshop was not able to complete the procedure. This report indicated that oblique prefemoral ovariectomy in mature red-eared sliders can be effectively taught to veterinarians during a workshop, and that if the procedure is completed the chances of leaving ovarian remnants are low.

Bacteriological Assessment of Stethoscope Used by Health Care Personnel in Attat Hospital, Snnp, Gurage Zone, Ethiopia

The stethoscope has always been an important element of a physician's toolkit when it comes to examining patients. The widespread use of stethoscopes by health-care workers for patient examinations makes them a potential source of nosocomial infection transmission. The goal of this study was to see if stethoscopes used by different health-care professionals in Attat Hospital may transmit bacteria. From April to June 2018, a cross-sectional study was done in the molecular laboratory of Wolkite University's department of biotechnology and biology. A total of 26 stethoscopes from health workers who had direct contact with patients were gathered during the study period. The sample was obtained using a sterile cotton-tipped applicator saturated in a sterile solution of physiologic saline (0.85% sodium chloride) to swab the whole surface of the stethoscope's diaphragm and then inoculated into macconkey agar, tryptone soya agar, and blood agar medium. 18 (69.2%) stethoscopes out of total collected stethoscopes had bacterial growth, and 12 bacterial isolates were selected and characterized to genus level. Isolates include staphylococcus aureus (37.5%), coagulase negative staphylococci (28.12%), Streptococcus sp. (21.88%), and Bacillus sp. (12.5%). All isolates were susceptible to the co-trimoxazole and ciprofloxacine, while resistant to cifoxitine. They showed intermediate growth against vancomycine. All except streptococcus were found resistant against penicillin. Both S. aureus and CoNS were sensitive to the chloramphenicol; Streptococcus was intermediate while bacillus was resistant to the chloramphenicol. All stethoscopes (42.2%) that had never been cleaned and were last cleaned a week ago were severely contaminated, while those washed multiple times a day and cleansed between each patient before the examination of the patient had lower levels of contamination (27%).

EFFICACY OF 5% POTASSIUM HYDROXIDE VERSUS 10% POTASSIUM HYDROXIDE SOLUTION FOR THE TREATMENT OF MOLLUSCUM CONTAGIOSUM AT A TERTIARY CARE HOSPITAL

Objective: To compare the efficacy of 5% potassium hydroxide (KOH) and 10% potassium hydroxide (KOH) solution for the treatment of molluscum contagiosum at a tertiary care Hospital.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of Study: Dermatology Department, Tertiary Care Hospital Karachi, from Oct 2019 to Apr 2021.&#x0D; Methodology: Sixty patients with molluscum contagiosum who fulfilled the inclusion and exclusion criteria were enrolled in the outpatient department of tertiary care hospital in Karachi. Patients were divided into two groups, A (5% KOH) and B (10% KOH) of 30 patients each. Potassium Hydroxide (KOH) solution was applied at home using the cotton-tipped applicator twice daily. Follow-up of patients was done at 2-weekly intervals for 12 weeks. Efficacy was measured based on the resolution of lesions or improvement from baseline.&#x0D; Results: Complete response occurred in 23 (76.7%) cases in 10% KOH Group while 6 (20%) in 5% KOH Group, Partial response occurred in 6 (20%) in 10% KOH group while 15 (50%) in 5% KOH group, No response occurred in 1 (3.33%) in 10% KOH group and 9 (30%) in 5% KOH group (p&lt;0.001).&#x0D; Conclusion: 10% Potassium Hydroxide (KOH) is an efficient modality for the treatment of molluscum contagiosum compared to 5% Potassium Hydroxide (KOH).

The Ocular Microbiome Is Altered by Sampling Modality and Age.

BackgroundStudies of the ocular microbiome have used a variety of sampling techniques, but no study has directly compared different sampling methods applied to the same eyes to one another or to a reference standard of corneal epithelial biopsy. We addressed this lack by comparing the microbiome from three conjunctival swabs with those of corneal epithelial biopsy.MethodsTwelve eyes (11 patients) were swabbed by calcium alginate swab, cotton-tipped applicator, and Weck-Cel cellulose sponge before a corneal epithelial biopsy (48 samples). We then performed 16S rRNA gene sequencing and universal 16S rRNA gene real-time polymerase chain reaction. Negative/blank controls were used to eliminate contaminants. An analysis was performed to examine the concordance of the three swab types to corneal epithelial biopsy. The effect of patient age on the ocular microbiome as determined by epithelial biopsy was also examined.ResultsThe ocular microbiome from corneal epithelial biopsies consisted of 31 genera with a relative abundance of 1% or more, including Weisella, Corynebacterium, and Pseudomonas. Of the three swab types, Weck-Cel differed the most from corneal biopsies based on beta-diversity analysis. Cotton swabs were unable to capture the Bacteroides population seen on epithelial biopsy. Therefore, calcium alginate swabs seemed to be the closest to epithelial biopsies. Older patients (≥65 years old) had higher alpha diversity (P < 0.05) than younger patients. Differential abundance testing showed that there were 18 genera that were differentially abundant between the two age groups, including Streptococcus and eight members of the Proteobacteria phylum.ConclusionsWe demonstrate that ocular sampling method and patient age can greatly affect the outcome of sequencing-based analysis of the ocular microbiome.Translational RelevanceBy understanding the impact of different sampling methods on the results obtained from the ocular surface microbiome, future research on the topic will be more reproducible, leading to a better understanding of ocular surface microbiome in health and disease.

Simple lung retraction method for uniportal video-assisted thoracoscopic surgery.

In conventional multiportal video-assisted thoracoscopic surgery, devices such as cotton-tipped applicators are used instead of graspers to avoid injuring the fragile lung tissue while stabilizing the lung and securing the surgical visual field. However, in uniportal video-assisted thoracoscopic surgery, which requires the simultaneous use of multiple instruments, the instruments tend to interfere with each other during the procedure because they share a single incisional port. Here, we describe a simple, easy and cost-effective lung retraction technique using cotton swabs to solve the problem. We present this technique and comment on its advantages, including decreased cost and improved surgical visualization.

Bacteriological assessment of stethoscope used by health care personnel in attat hospital, SNNP, Gurage Zone, Ethiopia

Abstract Stethoscope has always been a part of the physicians’ basic tool for examining patients. Universal use of stethoscope for examination of patients by health care personnel makes it a potential source for spread of nosocomial infection. This study was designed to assess the potential for bacterial transmission by stethoscopes used by different health-care workers in Attat hospital. A cross sectional study was conducted from April to June 2018 in university of Wolkite, department of biotechnology and biology in molecular laboratory. During the study period there were a total of 26 stethoscopes from health professionals who had direct contact with patients are collected. Sample was collected by sterile cotton-tipped applicator moistened in a sterile solution of physiologic saline (0.85% sodium chloride) that was used to swab the entire surface of the diaphragm of the stethoscope and then inoculated into macconkey agar, tryptone soya agar and blood agar media. 18(69.2%) stethoscopes out of total collected stethoscopes had bacterial growth and 12 bacterial isolates were selected and characterized to genus level. Isolates include staphylococcus aureus(37.5%), coagulase negative staphylococci (28.12%), Streptococcussp. (21.88%), and Bacillus sp.(12.5%). All isolates were susceptible to the co-trimoxazole and ciprofloxacine, while resistant to cifoxitine. They showed intermediate growth against vancomycine. All except streptococcus were found resistant against penicillin. Both S. aureus and CoNS were sensitive to the chloramphenicol; Streptococcus was intermediate while bacillus was resistant to the chloramphenicol All stethoscopes (42.2%) that had never cleaned and last cleaned a week agowere highly contaminated while lower levels of contamination (27%) were found on those cleaned several times a day and cleaned between each patient before the examination of the patients.