Oral microflora in patients on hemodialysis and kidney transplant recipients

We aimed to determine oral microflora of patients on long-term hemodialysis and kidney transplant recipients, and to compare them with individuals without kidney disease. We studied on 3 groups including patients on at least 6 months of hemodialysis, kidney transplant recipients for more than 2 years, and controls with a normal kidney function. Staining and culture were applied for samples from the dorsum of the tongue and the oral floor in order to detect aerobic and anaerobic bacteria and Candida. The participants were 49 patients on hemodialysis, 50 kidney transplant recipients, and 50 volunteers in the control group. The abundance of Candida was significantly higher in the hemodialysis and transplant groups compared with the control group. The mean of various microorganisms was found to be significantly higher in the hemodialysis group than the control group [P = .03]; however, the frequency of these microorganisms in the transplant group was lower than that in the hemodialysis group. Adjusting for confounding factors, the odds of having Candida in the hemodialysis and transplant groups were 3.54 [95% CI, 1.21 to 10.41] and 3.49 [95% CI, 1.27 to 9.18] times higher compared to the control group, respectively. Hemodialysis and kidney transplantation could affect oral microflora. Candida was significantly more frequent in these patients compared to healthy adults. Streptococcus mutans, Lactobacilli, Porphyromonas, and Candida is seen slightly less frequently after kidney transplantation, which might be in favor of promising effects of kidney transplantation on oral microflora

Effect of Rowatinex on calculus clearance after extracorporeal shock wave lithotripsy

Our aim was to evaluate the effect of Rowatinex, an essential oil preparation of terpenic type, on kidney calculi clearance after extracorporeal shock wave lithotripsy [SWL]. A randomized controlled trial was performed at Hormozgan Hospital in Bandar Abbas, Iran, on 100 patients with 10-mm to 20-mm kidney calculi. They underwent SWL, and then, they were randomly assigned into 2 groups to receive Rowatinex, 100 mg, 3 times per day, or placebo after SWL. The patients were followed up with plain abdominal radiography, ultrasonography, and excretory urography [if required], 2 and 4 weeks postoperatively. Two weeks following SWL, 6 [12%] and 9 [18%] patients in the Rowatinex and control groups had fragmented calculi without clearance, 26 [52%] and 24 [48%] had less than 50% clearance, 9 [18%] and 15 [30%] had more than 50% but not total clearance, and 9 [18%] and 2 [4%] patients were stone free, respectively. Rowatinex had a significant effect on the stone-free rate [P=.02]. Four weeks post-SWL, 3 [7.3%] and 7 [14.6%] other patients in the Rowatinex and control groups became stone free, respectively. Overall, Rowatinex had no significant effect on the stone-free rate [P=.46]. No complications or differences between the two groups in symptoms and sign we reported. Rowatinex does not have a significant effect on clearance rate of kidney calculi after SWL. However, it can accelerate calculus passage after 2 weeks, and it does not have any significant adverse effects

Buccal mucosal graft in repeat urethroplasty

Our aim was to evaluate the efficacy of a tubed buccal mucosal graft in repeat urethroplasty for patients with urethral stricture and failed previous operations. Ten patients [aged 12 to 47 years] with urethral stricture were entered into the study. All had a history of failed previous urethroplasties, and 5 had failed internal urethrotomies, too. Repeat urethroplasties were performed by excising the fibrous tissue around the stricture; buccal mucosa was then harvested from the inner cheek, made into graft tubing, and interposed into the defect. The patients were followed at 1, 6, and 12 months. The procedure was technically successful in all the patients. The mean operative time was 150 minutes. The stricture sites were in the posterior urethra in 8 and the anterior urethra in 2 patients. The mean urethral defect length was 4.9 cm. The primary etiology was pelvic fracture in 7 patients. Strictures recurred postoperatively in 3 patients, all of whom had a urethral defect longer than 5 cm, and 2 of whom had more than 1 previous failed urethroplasties [compared with 1 out of 7 in the successful cases]. Urinary flow rate increased significantly [from 0 to 10.4 +/- 7.33 mL/s] postoperatively [P = .018]. Longer strictures produced signifcantly poorer graft urethroplasty outcomes [P = .001]. Urethroplasty with buccal mucosal grafts is tough, resilient, easy to harvest, and leaves no scar. It appears to be an optimal substitute for anterior and posterior urethral strictures longer than 3 cm