Lower midline syndrome is a rare congenital anomaly associated with omphalocele. Undescended testes is a congenital absence of one or both testes in the scrotum. Both of lower midline syndrome and undescended testes incidence have a positive correlation with exposure of cigarette and pesticide. Tobacco agricultural environment is a vulnerable area exposed by pesticides and cigarettes. This is the case report to associated tobacco agricultural environment’s exposure with lower midline syndrome and undescended testes. We describe a case of lower midline syndrome and undescended testes that occurs in the tobacco agricultural environment. In this case we found the exposures of paternal heavy smoker, second-hand smoker, pesticides from tobacco agricultural environment and daily use of bug spray in the house. As conclusion, the exposures from tobacco agricultural environment may take a contribution to lower midline syndrome and undescended testes incidence.

Introduction: Caspase-3 is a crucial mediator of the extrinsic apoptosis pathway. The role of caspase-3 for extrinsic apoptosis signalling is still a challenge and should be exploited in childhood ALL. This study aimed to compare the caspase-3 expression in the patient’s bone marrow before and after the induction phase of chemotherapy in childhood ALL. It will also to correlate the mean difference in caspase-3 expression between ALL standard-risk and ALL high-risk patients. Methods: Seventeen newly diagnosed ALL subjects were enrolled in this study. Caspase-3 expression in bone marrow was assessed using flow cytometry and monoclonal antibodies. A T-test and a paired T-test were used to compare between groups. The correlation coefficient between ALL groups was evaluated using Spearman’s test and linear regression with a significant p-value of 0.05. Results: The caspase-3 expression is higher after induction therapy. However, it showed an insignificant difference (16.56+12.91% vs 27.71+12.33%; p = 0.08, p > 0.05). The mean difference of caspase-3 in ALL high-risk groups was significantly higher than in ALL standard-risk groups with a positive correlation (p = 0.007, r = 0.756). Conclusion: The caspase-3 expression after induction phase chemotherapy was increased in all standard-risk and high-risk patients; other lymphoblast apoptosis markers need to be confirmed alongside caspase-3.