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Abstrak :
Varikokel telah terbukti mempengaruhi kualitas sperma. Namun, efek operasi varikokel terhadap tingkat keberhasilan pengambilan sperma melalui pembedahan dan pola histopatologi testis pada pria dengan azoospermia nonobstruktif belum banyak dilaporkan. Penelitian retrospektif ini bertujuan untuk menginvestigasi tingkat keberhasilan pengambilan sperma dengan teknik operasi dan pola histopatologi testis pada pria dengan azoospermia nonobstruktif yang dirujuk ke Klinik Urologi di Rumah Sakit Dr. Cipto Mangunkusumo (Jakarta, Indonesia) dan Rumah Sakit Umum Bunda (Jakarta, Indonesia) pada periode Januari 2009 hingga Desember 2019. Subjek yang dibandingkan adalah pasien yang menjalani prosedur pengambilan sperma melalui pembedahan tidak lebih awal dari tiga bulan setelah operasi varikokel dan pasien yang tidak menjalani operasi varikokel melainkan langsung menjalani prosedur pengambilan sperma melalui pembedahan. Penelitian ini melibatkan 104 subjek dengan rentang usia 26-54 tahun, 42 di antaranya telah menjalani operasi varikokel sebelum prosedur pengambilan sperma. Spermatozoa motil ditemukan pada 29 (69,1%) pasien yang menjalani operasi varikokel dan 17 (27,4%) pasien yang langsung menjalani prosedur pengambilan sperma melalui pembedahan (risiko relatif: 2,51; interval kepercayaan 95%: 1,60±3,96; P < 0,001). Grafik probabilitas yang diprediksi menunjukkan tingkat keberhasilan prosedur pengambilan sperma yang lebih tinggi secara konsisten untuk subjek yang menjalani operasi varikokel terlebih dahulu. Pasien yang menjalani operasi varikokel menunjukkan pola histopatologi testis yang lebih baik (P = 0,001). Kesimpulan penelitian ini adalah pria dengan azoospermia nonobstruktif dan varikokel klinis yang menjalani operasi varikokel memiliki tingkat keberhasilan pengambilan sperma yang lebih tinggi dibandingkan dengan mereka yang tidak menjalani operasi varikokel. ......Varicocele adversely affects semen parameters. However, the effect of varicocele repair on the sperm retrieval rate and testicular histopathological patterns in men with nonobstructive azoospermia has not been widely reported. We retrospectively assessed the sperm retrieval rates and testicular histopathological patterns in men with nonobstructive azoospermia who were referred to the Urology Clinic in Dr. Cipto Mangunkusumo Hospital (Jakarta, Indonesia) and Bunda General Hospital (Jakarta, Indonesia) between January 2009 and December 2019. We compared patients who had undergone a surgical sperm retrieval procedure for assisted reproductive technology no earlier than three months after varicocele repair and those who had not undergone varicocele repair. The study included 104 patients (age range: 26±54 years), 42 of whom had undergone varicocele repair before the sperm retrieval procedure and 62 who had not. Motile spermatozoa were found in 29 (69.1%) and 17 (27.4%) patients who had undergone varicocele repair before the sperm retrieval procedure and those who had not undergone the repair, respectively (relative risk: 2.51; 95% confidence interval: 1.60± 3.96; P < 0.001). A predicted probabilities graph showed consistently higher sperm retrieval rates for patients with varicocele repair, regardless of their follicle-stimulating hormone levels. Patients who underwent varicocele repair showed higher testicular histopathological patterns (P = 0.001). In conclusion, men with nonobstructive azoospermia and clinical varicocele who underwent varicocele repair before the sperm retrieval procedure had higher sperm retrieval rates compared to those who did not undergo varicocele repair

Abstrak :
Anemia adalah masalah kesehatan yang umum terjadi di masyarakat. Anemia normositik-normokromik adalah salah satu jenis anemia yang umum terjadi pada penderita penyakit kronis. Anemia jenis ini ditandai dengan penurunan nilai hemoglobin (Hb) di bawah batas normal tetapi nilai mean cell volume (MCV) dan mean cell hemoglobin (MCH) dalam batas normal. Hingga saat ini, tidak banyak riset yang mempelajari mengenai anemia normositk-normokromik. Sebagian besar dari riset tersebut tidak langsung meneliti mengenai anemia normositik-normokromik melainkan pada penyakit-penyakit yang mendasarinya. Penelitian ini memiliki desain cross-sectional dan bertujuan untuk mencari proporsi anemia normositik-normokromik pada pasien anemia yang menjalani pengobatan rawat jalan di RSUPN Dr. Cipto Mangunkusumo dan hubungannya dengan usia dan jenis kelamin. Data sekunder tentang profil hematologi pasien rawat jalan bulan Maret 2011 diambil dari Laboratory Information System di RSUPN Dr. Cipto Mangunkusumo. Statistik deskriptif digunakan untuk menentukan prevalensi. Signifikansi perbedaan proporsi pada kategori umur yang berbeda pada pasien anemia normostik-normokromik dibandingkan dan diuji dengan uji chi-square, begitu pula dengan perbedaan proporsi pada wanita dan laki-laki juga diuji dengan uji chi-square. Studi ini menemukan bahwa proporsi pasien anemia normositik-normokromik dibandingkan dengan anemia jenis lain adalah sebesar 48.1%. Kategori umur II (15 - 59 tahun) merupakan kategori umur dengan presentase penderita anemia normositik-normokromik tertinggi (71.8%) dan wanita memiliki persentase lebih tinggi dibandingkan pria (62.8%) sebagai penderita anemia normositik-normokromik.

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Anemia is a serious public health problem. One of the types of anemia based on its morphology is normocytic-normochromic anemia. This anemia usually occurs in individuals with chronic diseases. To date, there are limited studies investigating the prevalence of normocytic-normochromic anemia. Most of these studies investigated the underlying conditions of normocytic-normochromic anemia. This study is a cross-sectional study that aims to investigate the proportion of normocytic-normochromic anemia among anemic outpatients at RSUPN Dr. Cipto Mangunkusumo and its association with age and gender by using data from laboratory results of outpatients who had their blood checked at RSUPN Dr. Cipto Mangunkusumo in March 2011. Descriptive statistical analysis was performed to determine prevalence. Then, statistical significance was tested with Chi-Square Test for gender and age. Our result showed that normocytic-normochromic anemia accounts for 48.1% among all anemic outpatients. Age group II had the highest percentage for normocytic-normochromic anemia (71.8%) and female seemed to be more prevalent than male (62.8%).

Abstrak :
ABSTRACT
Background: Tadalafil is a PDE5I which has been licensed for the treatment of erectile dysfunction (ED) since 2003, is effective from 30 minutes after administration and its efficacy is maintained for up to 36 hours. More recently, it is also given OAD in a lower dose to allow spontaneous sexual activities. However, whether OAD administration is more effective than PRN administration in improving the EF is yet to be established. This study aimed to evaluate whether OAD administration of tadalafil leads to a better improvement of erectile function (EF) in patients with erectile dysfunction (ED) compared to PRN administration. Methods: literature search of electronic database was performed through Medline, Scopus, Cochrane Library, and CINAHL databases. Cochrane Risk of Bias Tool was then employed to assess the risk of bias in each study. Results: initial literature search resulted in 231 hits, but only four studies were included in final selection. Based on our judgements, the study by Kang et al. was the most applicable in our clinical setting. This study showed that subjects who received tadalafil OAD had statistically significant higher increases of mean IIEF-EF (6,5 (SD 4,5) vs 4,9 (SD 4,2), p=0,032), proportion of yes responses to SEP-2 (81,8% vs 64,7%, p=0,025), and proportion of yes responses to SEP-3 (77,3% vs 60,3%, p= 0,034). Conclusion: administration of tadalafil OAD leads to a better improvement of EF compared to PRN administration.