Zainal, Ahmad Taufik Fadillah
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MICROSURGICAL VARICOCELECTOMY IN PRE-PUBERTAL CHILDREN: SAFETY, EFFICACY, AND REPRODUCTIVE IMPLICATIONS - A CASE REPORT AND LITERATURE REVIEW Bakri, Syarif; Azis, Abdul; Zainal, Ahmad Taufik Fadillah; Rahmat A., Saidah; Makkaraka, Moh Anfasa Giffari
Indonesian Journal of Urology Vol 32 No 3 (2025)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v32i3.1038

Abstract

Objective: In this report, we aim to present a case of a prepubertal child with left varicocele who underwent successful microsurgical ligation. Case(s) Presentation: A 9-year-old boy was admitted to urology clinic due to his parents complaint about a mass in his left scrotum. We diagnosed this patient with grade III varicocele (Dubin-Amelar classification). The patient underwent microsurgical ligation surgery. After surgery, the mass such as "bag of worms" disappeared and the testicular volume increased by 53% from preoperative volume (1.8 to 2.3 cc). Discussion: The results of this case report indicate that microsurgical ligation of varicocele in children is a safe and effective therapeutic option. Conclusion: Microsurgical ligation of varicocele in pre-pubertal children represents a safe and effective therapeutic option, offering symptom relief and potential preservation of future fertility. Further studies are warranted to elucidate the long-term outcomes and reproductive implications of microsurgical varicocelectomy in this population. Keywords: Microsurgical ligation, varicocele, children.
Probiotik sebagai Pengatur Komposisi Gut microbiota dalam Menghambat Progresivitas Parkinson’s Disease Zainal, Ahmad Taufik Fadillah; Gunawan, Andi Muh. Aunul Khaliq; A. Fitri Febrianty Fariadi
SCRIPTA SCORE Scientific Medical Journal Vol. 3 No. 1 (2021): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v3i1.4410

Abstract

Background: Parkinson's Disease (PD) is one of the most common neurodegenerative diseases at the age of 40-70 years. Disorders of the Gut-Microbiota-Brain Axis have been linked to bacterial metabolite products that play a role in the occurrence of neuroinflammation. Understanding precisely the role of the neuroinflammatory process in PD can lead to an understanding of how PD occurs and its relation to gut microbiota (GM). Objectives: To determine the effectiveness of probiotics as a therapeutic target to inhibit the progression of PD. Methods: Literature study method by collecting valid references regarding GM and PD and the relationship between them. Discussion: Evidence from in vivo trials using Alpha-Synuclease-Overexpressing (αSyn) mice reported that Dysbiosis GM can cause inflammation by activating microglia cells and increasing proinflammatory cytokines modulated by metabolite products of Short Chain Fatty Acids (SCFAs)  which lead to the occurrence of alpha-Synuclein aggregation and leads to the progression of PD. One of the microbes that have decreased the number of Dysbiosis GM is Lactobacillus rhamnous GG, which has a neuroprotective role in inhibiting the progression of PD. Microbiota-targeted interventions using the probiotic L-GG method have shown a positive effect on inhibiting PD progression. Conclusion: GM dysbiosis caused by PD has a pathway that can increase the progression of PD. This can be used as a therapeutic target, microbial composition engineering with the method of giving L-GG probiotics to be a solution in inhibiting the progression of PD by restoring the neuroprotective effect of L-GG. Keywords: alpha-Synuclein (αSyn), Gut Microbiota (GM), Lactobacillus rhamnous GG (L-GG), Parkinson's Disease (PD), Short Chain Fatty Acids (SCFAs)   Latar Belakang: Penyakit Parkinson (Parkinson’s Disease/PD) adalah salah satu penyakit neurodegeneratif yang paling banyak terjadi pada usia 40-70 tahun. Dewasa kini, gangguan pada Gut-Microbiota-Brain Axis telah dihubungkan dengan produk metabolit bakteri yang berperan pada terjadinya neuroinflamasi. Memahami secara tepat peranan dari proses neuroinflamasi pada Parkinson Disease (PD) dapat membawa pemahaman terhadap bagaimana PD timbul dan kaitannya dengan mikroba usus (Gut Microbiota/GM). Tujuan: Untuk mengetahui efektivitas probiotik sebagai target terapi untuk menghambat progresivitas PD. Metode: Literature reviewini disusun menggunakan metode studi pustaka dengan mengumpulkan referensi yang valid mengenai GM dan PD serta hubungan antar keduanya. Pembahasan: Bukti uji coba in vivo menggunakan tikus Alpha-Synuclease-Overexpressing (ASO) dilaporkan bahwa Dysbiosis Gut Microbiota dapat menyebabkan terjadinya inflamasi dengan mekanisme pengaktifan sel mikroglia dan peningkatan sitokin proinflamasi yang dimodulasi oleh produk metabolit Short Chain Fatty Acids (SCFAs) yang mengarahkan pada terjadinya agregasi alpha-Synuclein (αSyn) dan berujung pada progresivitas PD. Salah satu mikroba yang mengalami penurunan jumlah pada Dysbiosis Gut Microbiota adalah Lactobacillus rhamnous GG (L-GG), yang memiliki peran neuroprotektif dalam menghambat progresivitas PD. Intervensi berbasis Microbiota-targeted dengan metode penggunaan probiotik L-GG telah menunjukkan efek positif pada penghambatan progresivitas PD. Kesimpulan: Dysbiosis GM memiliki jalur yang mampu meningkatkan progresivitas dari penyakit parkinson. Hal ini mampu dimanfaatkan sebagai target terapi, rekayasa komposisi mikroba dengan metode pemberian probiotik L-GG menjadi solusi dalam menghambat progresivitas PD dengan mengembalikan efek neuroprotektif dari L-GG. Kata Kunci: alpha-Synuclein (αSyn), Gut Microbiota(GM), Lactobacillus rhamnous GG (L-GG), Parkinson Disease (PD), Short Chain Fatty Acids (SCFAs)