Introduction: Otomycosis which is caused by saprophytic fungi can be treated by topical antifungal agents. Sometimes eradication of the disease is difficult in patients with risk factors. Considering controversies about the anti-microbial effect of cerumen, this research was performed in Babul, was focused on revealing the antifungal effect of cerumen of healthy people on fungi causing otomycosis.Materials and Methods: This experimental study was carried out on the 60 samples of healthy peopleُs ear canal secretion. The average ages of the subjects were between 2-85 years. The antifungal activity of cerumen solution on 4 species of fungi including; Aspergillus fumigatus, Aspergillus niger, Candida albicans (clinical isolate) and standard Candida albicans were analyzed by paper disc diffusion and micro dilution methods. Results: 10% of cerumen showed antifungal activity in paper disc diffusion; whereas in the micro dilution method all of samples had antifungal activity. The most antifungal effect observed was on Aspergillus niger (27 samples) and the least effect on the species of Candida albicans (16 samples). Conclusion: According to the obtained results, cerumen has different effects on fungal growth, thus it is necessary to study more about components of cerumen for new approaches in future.

Introduction: cerumen is known as ear wax, produced regularly by cerumen and lipid secretary glands. Regarding the effect of Mazandaran province's humid weather on the prevalence of pathogenic microorganisms, this study was performed to determine the bacterial flora of the ear in patients with acute otitis externa and its comparison with healthy subjects.Materials and Methods: In this case-control study, cerumen was collected and cultured from 40 patients with clinically diagnosed acute otitis externa and 80 healthy controls.The data were finally analyzed using SPSS.Results: In the study group, Staphylococcus aureus (20.8%), Bacillus (18.9%) and Pseudomonas (11.3%) and in the control group Staphylococcus epidermidis (38.7%) and Diphtheroid (22.4%) were the most common bacteria, respectively.Conclusion: The isolated bacteria from cerumen of healthy subjects were totally different in comparison to those of acute otitis externa patients.

Introduction: The hepatitis B is a viral infection that causes a big problem globally. About 2 billion people worldwide are infected and there are now about 400 million HBV-DNA carriers around the world. HBV infection is the ninth cause of death worldwide and infects about 350 million new cases each year in the world. HBV-DNA can be spotted in different body secretions and fluids, including serum, saliva, tears, urine, amniotic fluid index, and cerumen isolated.Materials and Methods: This is a case - control study on the population of 140 participants (70 patients with chronic hepatitis B as cases and 70 healthy volunteers community as a control). The presence of HBV-DNA in their serum and ears cerumen using qualitative PCR and quantitative molecular detection Real-Time PCR (BioRad-CFX system) was determined.Results: Copy of serum HBV were detected in 98.5 % of case group and 7 % of healthy population (control group). In case group, 61 patients (87.2%) had HBV-DNA in their cerumens and 5control subjects (about 7 %)  were positive for HBV-DNA in their cerumens. All patients group and two subject (2.8%) of control group, were positive in HBsAg test.Average HB virus genome load in cerumen and serum of chronic HBV patients (group) were 8.98´106 and 3.60´108 copies per ml of the sample respectively.Conclusion: Like other body secretions, Ear cerumen is constantly produced and is subject to a pathogen such as HBV infection. The possiblity of disease transmission seems unlikely through cerumen, however considering the average copy of HBV genome in the cerumen, no doubt, it can be claimed that there is a potential transmission risk of HBV infection.

Background and Aim: Ear wax is the combination of different producing gland secretions. According to controversial ideas about the antifungal effects of ear cerumen and lack of any research around this matter in Iran, the present study performed on antifungal activity of cerumen from healthy people referred to Beheshti Hospital, Babol on some fungi.Materials and Methods: This experimental study was carried out on the 30 ear cerumen samples of healthy people referred to the Shahid Beheshti Hospital of Babol, Iran. The experiment was conducted on 4 type of fungi; Aspergillus fumigatus, Aspergillus niger, Candida albicans (clinical isolate) and standard Candida albicans (PTCC5027) by using of 10% cerumen solution in glycerol buffer, in sterile ELISA micro plate accompanying positive and negative controls (as duplicates); then the antifungal activities of cerumen as minimum fungicidal concentration and minimum inhibitory concentration 90% and 50% on fungi, were obtained.Results: The average ages of the subjects were between 2-85 years. Minimum inhibitory concentration (MIC50) observed in 70.83%. The most antifungal effect (MIC50) observed on Aspergillus fumigatus and Aspergillus niger (each 26 samples) and least effect observed on the species of Candida albicans (16 samples) (P=0.003). The Aspergillus niger was more sensitive to cerumen than others.Conclusion: Regarding to the results, cerumen has antifungal effect on tested fungi.

2Background: Otalgia is defined as pain localizing in the ear that can be primary or referred. By careful history and physical examination, all causes in this extensive differential diagnosis can be excluded. Given that otalgia is one of the most common causes for patients to visit the clinic and has a wide variety of differential diagnosis, the purpose of this study is to investigate the frequency of different etiologies of ear pain in patients referred to referral clinic. Methods: This cross-sectional study was performed on patients presenting with otalgia. After entering the study, the patient underwent a thorough examination of the ear, nose, throat, head and neck, teeth and salivary glands by a resident under the supervision of a senior otologist, and based on the findings, relevant para clinical procedures such as x-ray, CT scan or stroboscopy were performed. Data collection was done based on a data log check list. Samples were collected during six months. SPSS software version 20 was used for analyses. Results: The most common causes of otalgia were acute otitis media 29%, external otitis 17% and chronic otitis media 15%. cerumen and referral ear pain were next in line (13. 5%). There was significant relationship between otalgia with age groups (The age between 13 and 30 years were the most referred due to otalgia). There was no significant relationship between otalgia and gender, underlying disease, economic status, smoking and opium use. Conclusion: Given that otalgia is a common complaint in patients referred to the clinic, knowing its causes and origin is useful in diagnosing, proper treating it and avoiding unnecessary para clinical procedures and empirical treatment. The most common causes of otalgia in this study were acute otitis media, otitis externa and chronic otitis media, respectively. Referral otalgia and cerumen impaction were the next causes. Among the age groups, the age between 13 and 30 years were the most referred due to otalgia, but there was no significant relationship with any of the variables of gender, economic status and smoking and opium use

Background: Hepatitis B is a disease that is prevalent worldwide and is responsible for 10% of the deaths that occur every year. The virus persists in 5% of infected adults and 90% of infected children and can cause chronic hepatitis. In addition to blood, the virus may also be present in other secretions. Transmission through saliva, sexual fluids, and urine has also been confirmed.Objectives: The main aim of this study was to compare viral DNA copies in the serum, cerumen, and saliva of patients with HBeAg levels in their sera.Patients and Methods: This was a cross-sectional study and subjects were selected by non-randomized methods. Serum, cerumen, and saliva samples were collected from 50 patients who were diagnosed with chronic hepatitis B about a year prior to the study. Enzyme-linked immunosorbent assay (ELISA) was performed to determine the presence of HBsAg and HBeAg in the gathered specimens. Viral DNA was extracted from specimens by using a Qiagen kit. The number of viral DNA copies was determined using a real-time polymerase chain reaction (PCR) assay. The study was performed in Ilam province in western Iran.Results: Twenty-eight percent of the patients were HBeAg positive. The average number of viral copies in serum, cerumen, and saliva was higher in women than in men, and a significant correlation was observed between the gender and average viral copies. However, no significant correlation was observed between viral copies present in the serum and cerumen with the age and gender of patients. In addition, no correlation was observed between serum HBeAg and viral copies present in serum, cerumen, and saliva. The correlation analysis confirmed a direct and definite correlation between viral DNA loads in the patients’ serum and cerumen.Conclusions: A significant direct correlation was observed between the viral DNA copies present in patients’ cerumen and serum. However, the correlation between saliva viral load with serum and cerumen viral load was very low and inverse. These findings suggest that the presence of the hepatitis B virus (HBV) in non-invasive specimens (such as cerumen and saliva) should also be evaluated when monitoring patients to determine the course of infection and disease.

Background: Sensorineural hearing loss is the most sensory deficit in children. Auditory function in these affected children is poor and their potential hearing may be influenced by some factors such as otitis media and cerumen. In this paper, our interest was to seek the effects of overlooked otitis media and cerumen on potential hearing of these children.Methods: This was a quasi experimental, pretest post-test study that was conducted in 48 bilateral sensorineural hearing impaired children, between 2010-2013. Their age ranged 5-20 years, suffering from the mentioned ear diseases in the better ear, without serious ear symptoms. Modes of interventions were: cerumen removal, medical treatment of otitis media, and both of modes. Two indices including auditory threshold shift by means of (SRT) changes and hearing ability improvement through self- reporting were used before and after medical intervention. SRT examined through pure tone audiometer, and scored by dB (HL). The data was analyzed using the nonparametric Fisher’s Exact Test and Kruskal-Wallise. Findings: Potential hearing improved in about 80% of the cases. Auditory threshold decreased in 50% of them and in all three types of intervention, but with different frequency and different degree. It showed statistically significant relation between frequency, and degree of SRT changes as well as mode of intervention. Hearing ability improved in most of the cases after intervention, but the relation between these improvement and mode of intervention was not statistically significant.Conclusion: This study showed that potential hearing improved in most of the cases after medical intervention. Although the effect of otitis media treatment on threshold shift was more prominent than cerumen removal, but cerumen had a considerable effect on hearing ability or potential hearing of hearing impaired children.