Abstract Introduction: Children in pre-schools are at high risk of getting infections due to overcrowding, minimal awareness of basic hygiene and lack of immunity against microorganisms. Hand hygiene practice should be started at home where parents set good example, followed by formal education in pre- schools, primary and secondary school. This study aimed to develop a comprehensive program on hand hygiene practice in pre-schools. This paper presents the developmental aspects of the program material and the results of its evaluation process in a selected pre-school. Methods: Stage of development involved preparation of song, lyric, video clip, infographic and tablet application. The module was introduced during an intervention day called ‘Healthy Hands’ day. The acceptance of the module was evaluated before and after the intervention day. Evaluation was done by assessing pre-school children by faceto-face interview about knowledge on hand hygiene techniques and routine, such as before or after certain activities. Results: We managed to compose a song in three languages (Malay, English & Arabic), produced a video clip, an infographic and tablet application. A total of 227 children participated. Post intervention evaluation showed significant (p<0.001) increase of knowledge for eight out of eleven handwashing steps. The knowledge on hand hygiene routine i.e. after toilet, after playing outdoor, after sneezing and after playing with pet was also increased significantly. Conclusion: This comprehensive knowledge transfer program significantly improved the children’s hand hygiene techniques and routine and is recommended to be integrated into pre-school curriculum.

Varicocele adversely affects semen parameters. However, the effect of varicocele repair on the sperm retrieval rate and testicular histopathological patterns in men with nonobstructive azoospermia has not been widely reported. We retrospectively assessed the sperm retrieval rates and testicular histopathological patterns in men with nonobstructive azoospermia who were referred to the Urology Clinic in Dr. Cipto Mangunkusumo Hospital (Jakarta, Indonesia) and Bunda General Hospital (Jakarta, Indonesia) between January 2009 and December 2019. We compared patients who had undergone a surgical sperm retrieval procedure for assisted reproductive technology no earlier than three months after varicocele repair and those who had not undergone varicocele repair. The study included 104 patients (age range: 26-54 years), 42 of whom had undergone varicocele repair before the sperm retrieval procedure and 62 who had not. Motile spermatozoa were found in 29 (69.1%) and 17 (27.4%) patients who had undergone varicocele repair before the sperm retrieval procedure and those who had not undergone the repair, respectively (relative risk: 2.51; 95% confidence interval: 1.60-3.96; P < 0.001). A predicted probabilities graph showed consistently higher sperm retrieval rates for patients with varicocele repair, regardless of their follicle-stimulating hormone levels. Patients who underwent varicocele repair showed higher testicular histopathological patterns (P = 0.001). In conclusion, men with nonobstructive azoospermia and clinical varicocele who underwent varicocele repair before the sperm retrieval procedure had higher sperm retrieval rates compared to those who did not undergo varicocele repair.
Adult ; Azoospermia ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sperm Retrieval ; Testis ; Varicocele/surgery*

This article aimed to review the available anthropometry measurements used in the assessment of nutritional status among Cerebral Palsy (CP) children. Searched journals were from Medline, PubMed and Ovid published from 2015 to 2018. The search identified 443 articles, and eight studies met the criteria. Anthropometric measurements included weight, height, recumbent length, knee height, tibia length, Dual-energy X-ray absorptiometry (DXA), Bioelectrical impedance (BIA), Mid arm circumference (MUAC) subscapular skinfold (SFT), Triceps skinfold (TSF) and prediction equations. Body fat composition can be obtained by DXA, BIA, skinfold measurement, and also prediction equation. The predictive equation is the most reported method to determine nutritional status among CP. This review found that TSF and SFT are more accurate to determine body fat percentage when using together with the predictive equation. Besides, predictive equations using segmental length are reliable in estimating the height and can be used to evaluate the nutritional status using the specific CP growth chart.