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Oligoasthenoteratozoospermia After Trial of Testicular Salvaging Surgery in Testicular Torsion: A Case Report Mahfuz, Muhammad Ainul; Suwanto; Krisna, Muhammad Sidharta
Green Medical Journal Vol 2 No 3 December (2020): Green Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/gmj.v2i3.64

Abstract

Testicular torsion (TT) is an emergency in urology that happens because of the spermatic cord’s rotation. Decreased of overall sperm parameters after TT often happens in which can endanger the patient’s fertility status. Approach on how to salvage the testicle and to prevent unwanted complications remains as the doctor’s greatest priority. We report a case of oligoasthenoteratozoospermia after surgical detorsion without orchidectomy in testicular torsion. A 19-year-old male, presenting with sudden, progressive, and continuous pain in the right testicle for 4 hours. The right testicle was larger in volume on physical examination, there were a negative phren sign and negative cremasteric reflex. Gray scale ultrasound without Doppler showed changes suggestive of testicular torsion. Emergency surgery revealed a dark-bluish right testicle with a 360o rotation of the spermatic cord. Detorsion without orchidectomy was performed with clinical judgment hoping for the restoration of testicular viability. Sperm analysis was done after one month and oligoasthenoteratozoospermia was found. Although some patients experience decreased overall sperm parameters after TT that perhaps making them infertile, interestingly there is no difference in pregnancy rates among couples with TT men when compared to the general population. The best testicular salvage surgery method to prevent testicular atrophy also has not been determined yet. Thus, the patient should be carefully counseled about the good outcome of pregnancy rate and the chance for testicular atrophy, regardless of what is the surgical choice.
COMPARISON OF PHARMACOLOGY AGENTS EFFECT IN TREATING URETERAL STENT RELATED SYMPTOMS: SYSTEMATIC REVIEW & META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL¬ Mubarak, Andi As'ad; Mahfuz, Muhammad Ainul; Aziz, Abdul; Dahlan, Muhammad Sopiyudin
Indonesian Journal of Urology Vol 31 No 1 (2024)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v31i1.840

Abstract

Objective: We wish to update existing meta-analyses to assess the effectiveness of pharmacological agents against ureteral stent-related symptoms with better design of RCTs, as well as more valid and reliable measurement methods. Material & Methods: Relevant published articles up to February 2022 were obtained from PubMed, CENTRAL, Google Scholar, Science Direct, and DOAJ. All single-blind or double-blind RCTs with various comparisons using pharmacological agents and/or placebo in patients with ureteral stent-related symptoms, with outcome assessment using USSQ at week 1 and week 4 during stent placement was included in the study. Statistical parameter Mean Difference (MD) with 95% CI was used to measure effect size. The p value less than 0.05 indicates statistical significance. Results: Alpha blockers (2 studies, 85 samples) significantly reduced fourth week UIS compared to placebo (MD: – 5.46, 95% CI: – 7.47 to -3.46, I2 = 0%, P = < 0.001), and alpha blockers (2 studies, 42 samples) significantly reduced first week SIS compared to combination therapy (MD: – 0.82, 95% CI: – 1.56 to – 0.08, I2 = 0%, P = 0.03). The results of the meta-analysis of USSQ scores in other domains have no significant differences. Conclusion: Alpha blockers were better than placebo in reducing UIS due to ureteral stent in the fourth week of stent placement, and better than combination therapy in reducing SIS due to ureteral stent in the first-week post stenting. However, more RCTs are needed with larger samples and better designs to reach valid conclusions. Keywords: Stents, Randomized Controlled Trials as Topic, Single-Blind Method.
Oxygen Saturation Diagnostic Accuracy Against COVID-19 in Rural Areas of Indonesia Mahfuz, Muhammad Ainul; Dahlan, Muhammad Sopiyudin; Ibrahim, Juliani; Sastinawati, Ayu
Majalah Kedokteran Bandung Vol 55, No 3 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n3.2990

Abstract

As a country with a high proportion of rural areas, Indonesia continues to struggle with a rapid and accurate diagnosis of COVID-19, necessitating the development of a diagnostic tool or parameter that is less expensive, easier to obtain, and produces rapid results. This retrospective study aimed to explore the diagnostic accuracy of oxygen saturation in detecting COVID-19 in rural areas of Indonesia. Data were collected consecutively  from medical records of adult patient (30 – 90 years old) suspected of having COVID-19 based on the WHO criteria and  underwent RT-PCR swab test in three (3) hospitals in one of the regions of Indonesia during the timeframe of May 1, 2020 to September 31, 2021. Analysis was conducted using the cross-table analysis with sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) as the variables with their respective confidence interval. Results indicated that 548 of 700 patients included in the analysis were confirmed positive for COVID-19 based on the RT-PCR test results. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) value of oxygen saturation for detecting COVID-19 were 33% (CI 95% 29 – 37%), 78% (CI 95% 72 – 85) %), 84% (CI 95% 80 – 89%), 24% (CI 95% 21 – 28%), and 56% (CI 95% 51– 61%), respectively.  Thus,  the oxygen saturation level alone does not have adequate diagnostic accuracy for the diagnosis of COVID-19 and, therefore, is not recommended to be used for diagnosing COVID-19.