ABSTRACT
Introduction and Objectives: Hypospadias is a congenital disorder in boys in which the urethral meatus is located on the ventral penis. The incidence rate of hypospadias is increasing, however, there is still no literature regarding how significant is the role of maternal and environmental factors to the risk of hypospadias, especially in Indonesia. This study aims to analyze the maternal and environmental factors during pregnancy to the risk of hypospadias. Materials and Methods: This study was an analytical observational study with a case control design. The subjects were mothers who gave birth to children with hypospadias, compared to normal, who visited the urology, pediatric-surgery, plastic-surgery, and pediatric clinic at Hasan Sadikin General Hospital. Results: A total of 120 samples (60 cases and 60 control) were included in this study. There were 14 maternal factors, which 5 of them found significantly correlated with hypospadias, including maternal occupation as an industrial worker (P = .003; OR:4.789), pregnancy-enhancing drugs usage (P = .004; OR: 5.783), smoking consumption (P = .034; OR: 2.294), mosquito-repellant usage (P = .0001; OR: 82.600), and preterm birth (P = .013; OR: 2.895). There were 2 environmental factors, and one of them was significant, which was the distance from home to industrial/rice fields/waste areas, approximately 780 m (P = .0001; OR: 6.102). Based on multivariate analysis, we found that maternal occupation, mosquito repellent usage, and the distance from home to industrial area had a strong relationship in predicting hypospadias occurrence. Conclusion: Several maternal and environmental factors were found significantly correlated to hypospadias occurrence. Among these, mosquito-repellant usage was found to be the most significant factor.
ABSTRACT
Herlyn-Werner-Wunderlich (HWW) syndrome is difficult to diagnose. We report our first experience of fistula repair in HWW syndrome in Hasan Sadikin General Hospital Indonesia. A 12 years old girl presented with urinary retention, and was consulted to urology because the urethral meatus could not be found. MRI showed two separate uteri, cervices, and vaginas. Complete separation of vagina and urethra was done. After 2 years follow up, the patient had no complaint. HWW syndrome should be suspected in cases with pelvic pain or urinary retention during menarche period among teenagers and neonatal cases with any renal malformation.
ABSTRACT
Application of supercritical carbon dioxide for processing of food products has an impact on microbial inactivation and food quality. This technique is used to preserve tempeh due to no heat involved. The quality of tempeh is highly influenced by mold growth because of its role in forming a compact texture, white color, and functional properties as well as consumer acceptance. This study aims to observe viability of molds and bacteria in tempeh after processed with supercritical CO2 and to determine the best processing conditions which can maintain mold growth and reduce the number of bacteria in tempeh. For that purpose, tempeh was treated using high pressure CO2 at 7.6 MPa (supercritical CO2) and at 6.3 MPa (sub/near supercritical CO2) with incubation period of 5, 10, 15, and 20 min. The best treatment obtained was used to process tempeh for storage study. The results showed that there was a significant interaction between pressure and incubation period for bacterial and mold viability at ρ>0.05. Reduction of bacteria and molds increased with longer incubation period. Molds were undetectable after treatment for 20 min with either supercritical CO2 or sub-supercritical, and bacteria significantly reduced up to 2.40 log CFU/g. On the other hand, sub-supercritical CO2 for 10 min was the best processing method because molds survived 4.3x104 CFU/gram after treatment and were able to grow during storage at 30°C, producing white mycelium as indicated by increasing the Lâ color value and tempeh acceptability. The inactivation of mold was reversible causing it to grow back during storage under suitable conditions. Tempeh matrix composition can provide protection against the destructive effects of supercritical CO2. Gram-positive bacteria were more resistant than Gram-negative. In conclusion, sub-supercritical CO2 can act as a method of cold pasteurization of tempeh and can be used as an alternative method to preserve tempeh.
