The Contribution of Sex Difference on Different Liver Histopathology Between Male and Female Mice After Oral Administration of Caffeine

Background : There are several studies reporting the effect of caffeine on liver histopathology, but it remains controversy. The laboratory animal used in those studies were predominantly male, whereas there is contribution of sex difference on different liver reaction to xenobiotic between male and female subject. Objective : It is necessary to conduct a study to explore the differences between the liver histopathology of male and female mice after oral administration of caffeine. Methods : This study used 36 mice (Mus musculus) that were divided into 4 groups: male & female untreated groups and male & female treated groups which were orally administered with caffeine 0.4 mg / 20 gramBW daily for 30 days. At the end of treatment, mice were euthanized and dissected. Histopathological examination was done to determine the percentage of liver cell death of each group. Results: The percentage of liver cell deathin female treated group was higher than male treated group (p = 0.0001). But there was no significant difference of liver cells death between male control and treated group and between female control and treated group. Conclusion : There was significant difference in liver histopathology between male and female mice after oral administration of caffeine.

Adult Male’s Penile Size Measurement and Its Affecting Factors

Background: In the general population, it is estimated that 91% of adult males perceive their penile size to be smaller than average. Concern about penile size can affect one’s self-esteem, which then affects its sexual function, satisfaction, as well as physical and mental health. Therefore, accurate penile measurements are needed for clinical and academic purposes. Reviews: Measurement of penile size can be performed in an erect, stretched, even flaccid condition. However, from various researches, there is no standardization of such a measurement method. Various researches have carried out average penile measurement but many factors can affect these results such as race, genital conditions, systemic diseases, surgical procedures, and aging. Summary: There is no internationally agreed way of measuring an adult male's penis and many other factors can make the results of penile measurements vary. Proper measurement and finding out the right average of penile size in adult male with regard to other affecting factors, will be indispensable for both clinical and academic purposes.

Relations of Knowledge with Perceptions of Eligible Men About Vasectomy in Angsau Primary Health Care, Tanah Laut, South Kalimantan

Background: Indonesia’s Maternal Mortality Rate (MMR) in 2015 was still high around 305 over 100.000 population. South Kalimantan MMR’s in 2018 increase to 108 over 100.000 population. If not handled properly the increasing of MMR, it will not achieve the SDG's by 2030. The high MMR is caused by the large number of pregnancies and deliveries in Indonesia. One of the ways to prevent it, is by reducing the number of pregnancies and one of the most effective way is through the Family Planning (FP) program. Vasectomy is a method of operative contraception in men. Public perception of vasectomy is a complicated operation, so vasectomy is not an option. Aim: Knowing the relations between knowledge and perceptions of eligible men on vasectomy Method: This research is an analytical survey with a cross sectional approach. The number of subjects used as many as 80 respondents who meet the feasibility of being included in this study. The chi-square test with a significance level of p<0.05 was used for statistical analysis. Knowledge is considered good if it has a total score of more than 76 percent, and it is considered poor if it is less than equal to 76 percent. Positive perception if the respondent's mean score is less than the T score, and to be negative perception if the respondent's mean score is more than the T score. Results: A total of 108 respondents were included in this study. There are 89 respondents or 82% who have good knowledge and 19 respondents or 18% who have bad knowledge about vasectomy. Negative perceptions were owned by 81 respondents or 75% while positive perceptions were only found in 27 respondents or 25%. Chi-square analysis showed that there was a significant relation between poor knowledge and negative perceptions with p<0.05. Conclusion: Poor knowledge of vasectomy is associated with negative perceptions. This study shows lack of public knowledge about vasectomy, causing a negative stigma about vasectomy.

Technology Updates in Male Infertility Management

Background: Technologies are replacing manpower many fields including medical field. Several devices have been marketed for replacing/reducing manpower in the medical field including male infertility. Here we reviewed several technologies that developed in male infertility. Review: Computer assisted sperm analysis (CASA), Automatic assessment of biochemical marker of seminal plasma, B-mode ultrasound, and automatic sperm cryopreservation can be applied routinely. Several updates i.e. automatic histopathology assessment, ultrasound strain elastography, magnetic resonance imaging (MRI) stronger than 3.0 T, Artificial intelligence for predicting the presence of sperm in azoospermia cases, automatic sperm selection, and automatic intracytoplasmic sperm injection (ICSI) need more studies before their application. Summary: Prudent choice based on valid studies is needed in order to give a comprehensive management to patient with male infertility without using useless technology.

Relationship Between Smoker Male Partner and Intrauterine Insemination Success in Kasih Ibu General Hospital Denpasar

Background : Assisted reproductive technology, one of which is intrauterine insemination (IUI) allows infertile couples to get pregnant. The pregnancy success of IUI procedure varies among individuals. Objective: The study aim is to determine whether there is a relationship between smoker male partners and IUI success. Methods: This research is an analytic study with cross-sectional approach conducted at Kasih Ibu General Hospital Denpasar with purposive sampling technique. There are 35 male couples aged 25-50 years who underwent the IUI procedure selected as samples. The research data was gathered from patient's medical records and statistically analyzed using the Chi-Square test. Results: The study found that of the 35 samples, 13 (37.1%) were smokers, whereas 22 (62.9%) male partners were non-smokers. There were 6 (17.1%) samples’ partners who were pregnant after undergoing the IUI procedure, and 29 (82.9%) samples’ partners were not pregnant. It was found that there was no significant relationship between male partner smokers and the success of IUI at Kasih Ibu General Hospital Denpasar (p=0.832). However, in descriptive analysis and relative risk calculation, smoker male partner is less likely to achieve pregnancy than non-smoker’s male partner (RR=0.85). Conclusion: Smoker male partners may not contribute to IUI success. Further studies should be done with a higher number of samples, multicenter, and more controlled risk factors to make it more accurate in determining the relationship.

Relationship of Type 2 Diabetes Mellitus Duration with The Occurrence of Erectile Dysfunction at Puskesmas Denpasar Barat I

Background: Type 2 diabetes mellitus is a metabolic disease that characterized by high blood sugar levels. This condition is often not noticed immediately and usually patient starting to realize it when complications have been occurred. A long-term complication of type 2 DM that occurred in men is erectile dysfunction (ED). ED is a condition when a person is unable to achieve or maintain an erection for sexual intercourse. One factor that influence the occurrence of ED and its severity in type 2 DM patients is the duration of the disease. Objective: The aim of this study was to determine the relationship of type 2 DM duration and the occurrence of ED. Methods: This study is an observational analytic cross-sectional study conducted at the Puskesmas (Public Health Center) Denpasar Barat I. The research data was obtained through medical record data and fill the International Index of Erectile Function (IIEF-5) questionnaire on 36 type 2 DM patients aged around 40-60 years. The statistical analysis used was Fisher's exact test. Results: The results showed that of the 36 samples, 19 (52.8%) samples had type 2 DM <24 months and 17 (47.2%) samples had type 2 DM >24 months. It was found that 5 (13.9%) samples did not experience ED while the rest experienced ED with different severity. There was a significant relationship between the type 2 DM duration and the occurrence of erectile dysfunction at Puskesmas Denpasar Barat I (p = 0.022). Conclusion: Study has found that type 2 DM patients with the longer duration (>24 months) have a higher occurrence of ED and tended to be more severe compared to those with shorter duration (<24 months). Further studies should be performed with higher number of patients and more controlled risk factor so it will be more accurate in determining the relationship between the duration of type 2 DM and ED.

The Effectiveness of Depigmentation, Interleukin-1B, and Transforming Growth Factor-B Antibodies in Activating and Increasing Collagenase in Keloid as Adjuvant Therapy After Scar Excision

Background: Keloid is an abnormal scar in previously traumatic skin after going through the wound healing process. One hundred million cases have been found in developing countries with the main complaint of scar appearances. To overcome this problem, 24 literatures from various journals and textbooks are reviewed. Reviews: Keloid formation is based on high melanin amount which inhibits the collagenase enzyme. Moreover, the high melanin amount would block interleukin (IL)-1B work resulting in collagen synthesis and collagenase reduction. Depigmentation effort with 4% hydroquinone is implemented to reduce the amount of melanin presented in the skin. With melanin reduction, IL-1B can work optimally by inhibiting fibroblast growth in keloid tissue without affecting on normal skin. It also induces Matrix Metalloproteinase (MMP)-1 which is an interstitial collagenase. IL-1B has an opposing effect compared to Transforming Growth Factor (TGF)-B, thus TGF-B antibody is needed to potentiate IL-1B therapeutic effect. TGF-B antibody can neutralize TGF-B ligand and avB6 integrin resulting in blocking of COL1A1 gene expression which is responsible for MMP-1 production and type-I collagen synthesis. These three components are combined in cream with liposome as a drug carrier. This combination is applicated for adjuvant therapy after scar excision. Liposomes are chosen because of their high biocompatibility, low toxicity, and low biodegradability. Liposomes also can release slowly in the extravascular area such as skin. This advantage may carry drug components effectively to the target location. Summary: The combination of depigmentation, IL-1B, and TGF-B antibodies has a potency to be developed as a future adjuvant therapy of keloid.

Effect of Acute Exposure of Cigarette Smoke on Endometrium Thickness and Number of Ovarian Follicles in Rats

Background: Cigarrete smoke has been ascociated with many health-related problems especially in long time use. One of many health problems that are affected is the reproductive system that give negative impact in fertility. However, there are limited studies about this in acute exposure of cigarette smoke. Objective: The aim of this study is to investigate the effect of acute exposure of cigarette smoke on endometrial thickness and number of ovarian follicles in rats. Methods: Thirty adult female rats were randomly divided into 3 groups: P0, P1 and P2. The P1 and P2 groups were exposed to cigarette smoke for 15 days with dose of 2 and 4 cigarettes daily, respectively. Vaginal swab was done twice, before and after the last treatment, to determine the proestrus phase of the animals. Histological slide of uterus and ovarium using Haematoxylin Eosin staining were observed under light microscop. Number of ovarian follicles were measured, and the thickness of endometrium was meassured using CellSens software version 2.3 (Olympus Life Science). Statistical analysis of data was performed using MANOVA in SPSS software version 23 for Windows. Results: There were no significant differences in both endometrial thickness and number of ovarian follicles between 3 groups (p>0.05). However, we found that there were a downward trend of some variables (endometrial thickness, number of primary follicles, de Graff follicles, and corpus luteum) from P0 to P2. Conclusion: We concluded that acute exposure of cigarette smoke not yet influenced the female reproductive organ, based on histological appearance of endemotrium and ovarium.

Relationship Between Waist Circumference and The Event of Andropause in Male Employees in Government Institutions of Badung Regency

Background: Andropause occurs with slow development and is a physiological process in males. Andropause symptoms arise vary in individuals. One of the factors that influence these symptoms is obesity, especially central obesity with a waist circumference of >90 cm. Objective: The purpose of this study is to show the relationship between waist circumference and the event of andropause. Methods: This research is an analytical study with a cross-sectional study approach conducted in one of the government institutions of Badung Regency, Bali Province. The sampling technique used was purposive sampling. The subjects consisted of 40 male employees at aged around 35-60 years. The research data were obtained from filling out the Androgen Deficiency in Aging Male (ADAM) score questionnaire and direct measurement of waist circumference. The statistical analysis used was the Chi-Square test. Results: The results showed that from 40 subjects, 23 (57.5%) subjects had a waist circumference of >90 cm, and a normal waist circumference of <90 cm in 17 (42.5%) subjects. There were 22 subjects (55.0%) who experienced andropause and 18 (45.0%) subjects who did not experience andropause. It was found that there was a significant relationship between waist circumference and the event of andropause among male employees in government institutions of Badung Regency (p = 0.001, OR = 11.7). Conclusion: The study has found that higher in waist circumference may contribute in the event of andropause. For further studies should takes a higher number of subjects to make it more accurate in wider population.

Effect of Kembang Bulan Leaf (Tithonia diversifolia) Ethanolic Extract to SGOT and SGPT Levels in Diabetic Rats (Rattus norvegicus)

Introduction: Kembang Bulan (Tithonia diversifolia) is one of Indonesian traditional medicine that contains saponins, flavonoids, and, tannins and is predicted has a lowering effect on blood-glucose. Diabetes mellitus (DM) is a disease caused by insufficient insulin secretory by the pancreas or ineffective usage of insulin that produced by the body thus cause a hyperglycemia condition. Hyperglycemia can cause an increase in Reactive Oxygen Species which can cause free radicals. Free radicals can cause damage to liver cells. Method: This was an experiment with posttest control group design. Samples were 40 rats, divided into five different groups (P1, P2, P3, P4 and P5). Each group were induced by multiple low doses STZ. P1 (give the extract of Tithonia diversifolia at a dose 50 mg/100 gr BB), P2 (give the extract of Tithonia diversifolia at a dose 150 mg/100 gr BB), and P3 (give the extract of Tithonia diversifolia at a dose 450 mg/100 gr BB), P4 was treated with metformin, P5 was not treated. After STZ induction and give the extract to diabetic rat model, the resulting liver cell damage will be measured using the SGOT and SGPT measurement methods. Result: On the average results of SGOT levels in the five treatments, using the ANOVA test p value was 0.877 (p> 0.05) which means there were no significant differences. Furthermore, on the average results of SGPT levels in all five treatments, using the ANOVA test p value was 0.822 (p> 0.05) which means there were no significant differences. But from all results obtained P4 (given metformin) with the results closest to normal levels (SGOT: 197.5 ± 37.25; SGPT: 90.33 ± 29.36). From the treatment given Tithonia diversifolia extract obtained P1 (with a dose of 50 mg / 200gr BB) with the results closest to normal levels compared to P2 and P3. Conclusion: The Extract of kembang Bulan Leaf (Tithonia diversifolia) obtained less significant results compared to the untreated group. However, there is no significant difference. And giving ethanol extract of the leaves of kembang Bulan (Tithonia diversifolia) at a dose of 50 mg / 100gr BB is the most effective way to reduce levels of SGOT and SGPT.