Background: Phosphodiesterase type-5 (PDE5) inhibitors was the first choice for the oral treatment of erectile dysfunction because of its ability to prevent endothelial dysfunction and restored erectile function properly. However, the inflammatory parameter such as hs-CRP can be used to assess the performance of PDE5 inhibitors as well as clinical questionnaires, IIEF-5, and EHS. So that, this study aims to determine the effect of PDE5 inhibitors administration such as sildenafil citrate 50 mg per day can decrease the value of hs-CRP, as well as increased the IIEF-5 and EHS at Dr. Soetomo General Hospital. Methods: A true clinical experimental studies used pretest and posttest control group design were carried out among 20 patients during 4 weeks. In the next 2 weeks, the crossover was conducted among respondents for the washout period whereas divided into 2 groups, control (K1 and K2) and treatment (P1 and P2). Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 software for Windows. Results: The average age of group K1 and P2 was 51 ± 12.07 years old whereas 48.60 ± 15.40 years old in group P1 and K2. The research was conducted in Andrology Clinic of Doctor Soetomo Hospital in Surabaya during June to November 2017. The research data were not normally distributed, then analyzed by two-tail T-group tests and Wilcoxon test at significance level α=0.05. The results showed that PDE5 inhibitors did not decrease the hs-CRP significantly (p>0.05), but increased EHS (p<0.05) and increased IIEF-5 (p<0.05) significantly. Conclusion: This study concluded that the administration of sildenafil citrate per day by oral increased the EHS and IIEF-5, but not able to reduced hs-CRP in patients with erectile dysfunction significantly.

Freeze-drying technique is an alternative method on sperm preservation. However, this process can results in DNA damage. Adding antioxidants before freezing can reduce the detrimental effects of ROS on spermatozoa. Alpha lipoic acid (ALA) is one of the potent antioxidant that can be used to protect the sperm DNA. This study was aimed to determine the effect of ALA supplementation before freeze-drying on the DNA fragmentation index (DFI) of human spermatozoa. Nine semen samples were collected and evaluated for DFI (O1) then divided into 3 groups; freeze-drying without ALA (O2), freeze-drying with ALA 1,25 mg (O3) and freeze-drying with ALA 2,5 mg (O4).All three groups were stored at 4oC for 1 week. Sperm DFI were evaluated before and after freeze-drying. The result of this study showed a significant increase in sperm DFI in all three groups after freeze-drying (p<0,05) when compared to DFI before freeze-drying (14,67 ±3,295). However there was no significant difference between O2 (26,90 ±9,180) and O4 (29,29 ±5,524) group where the supplementation of 2,5 mg ALA did not have significant effect on protecting the DNA of freeze-dried human spermatozoa. The highest DFI was in the O3 group (44,64 ±11,717). Therefore, ALA supplementation before freeze-drying does not have a significant effect on protecting the DNA of freeze-dried human spermatozoa.

Sindrom Klinfelter merupakan kelainan kromosom seks yang banyak ditemukan pada laki-laki. Sindrom Klinefelter umumnya muncul pada masa pubertas dan dewasa dengan ciri khasnya: infertilitas, testis kecil, ginekomastia dan mikropenis. Anak-anak dengan Sindrom Klinefelter dapat memiliki manifestasi klinis mikropenis, hipospadia, kriptorkismus atau keterlambatan perkembangan. Namun, hipospadia merupakan manifestasi klinis yang jarang ditemukan pada sindrom ini. Pada laporan kasus ini, kami melaporkan  satu kasus seorang anak laki-laki yang memiliki hipospadia dan disertai kelainan kromosom 47, XXY. Laporan kasus ini menggambarkan Sindrom Klinefelter pada anak-anak dengan manifestasi klinis hipospadia, skrotum bifidum, kriptorkismus dan DSD di mana hal ini merupakan manifestasi klinis yang jarang ditemui pada kelainan ini.