Taufiq Nur Budaya

Objective: Kidney stone disease is a growing global health problem, with increasing diagnostic challenges due to heterogeneous clinical presentations and imaging demands. This review aims to evaluate the role of artificial intelligence (AI) in imaging-based detection and assessment of urinary tract stones. Methods: A systematic review was conducted by searching PubMed/MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science from database inception to May 2025 for studies evaluating AI-based imaging in the diagnosis of urinary tract stones. The search followed Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S) guidance and used a Population, Intervention, Comparison, Outcomes and Study (PICOS) framework to identify eligible adult studies applying AI models to computed tomography (CT), ultrasound, or radiographic imaging, with expert interpretation as reference and diagnostic performance outcomes. Results: From 1142 records identified, 11 studies published between 2017 and 2025 met the inclusion criteria. Most studies used CT imaging and reported high diagnostic performance, with accuracies exceeding 90% in eight studies and reaching over 95% in several deep learning–based approaches, while ultrasound-based AI models also demonstrated strong performance with sensitivities and accuracies above 90%. Conclusion: AI–based imaging demonstrates high diagnostic accuracy for urinary tract stone detection, particularly with CT. AI-enhanced ultrasound represents a practical and cost-effective alternative for implementation in resource-limited and rural settings. Level of evidence: 2

Objective: This study aims to generate polyclonal antibodies against the 47 kDa protein using rabbits, and to evaluate both the diagnostic and prognostic potential of this biomarker in patients with bladder cancer. Methods: Rabbits were immunized intraperitoneally with epitope antigens of the 47 kDa protein over a period of four weeks. Serum was collected in the fifth week five for antibody isolation. The resulting polyclonal antibodies were employed to detect urinary biomarkers in patients with bladder cancer. Additionally, these antibodies were used to evaluate therapeutic response in patients undergoing trimodal therapy, based on the RECIST (Response Evaluation Criteria in Solid Tumors) criteria, using the dot blot technique. Results: The highest density value with the best dilution effectiveness of 18.27 was found at antibody dilution 1/105 and antigen 1/106. From the dot blot analysis, this study found that the sensitivity and specificity of this antibody are 98.7% and 100%, respectively. The 47 kDa protein showed a high significant difference between each cancer stage before and after chemotherapy (PD: 7.91±1.99; SD: -1.00±0.83, PR: -5.80±3.21 CR: -7.95±1.47; p= 0.000), with a negative correlation with RECIST Criteria (r: -0.833, p=0.000). Conclusion: The 47 kDa protein demonstrates strong diagnostic performance and may be utilized as a prognostic factor in bladder cancer patients who have undergone trimodal therapy.

Objective: This study aims to determine the effect of HIFEM on OABSS and pad usage through the Voiding Diary. Material & Methods: An experimental study with pre and post-test. Patients will be given a questionnaire before and after undergoing HIFEM therapy for six sessions, and be followed for one month. Data analysis was carried out using SPSS software. Paired T-test was used for data with normal distribution, while the Wilcoxon Non-parametric test was used for data which is not normally distributed. Data are considered statistically significant if the p-value <0.05. Results: Twenty-eight patients completed the study. After six HIFEM sessions, the mean OABSS significantly decreased from 12.89 ± 1.03 to 11.61 ± 1.59 (p < 0.001), and pad usage reduced from 8.39 ± 1.20 to 2.82 ± 1.56 (p < 0.001). Conclusion: Six sessions of HIFEM therapy were associated with a decrease in OABSS and pad use in patients with urinary incontinence. But OABSS did not significantly reduce in patient with DM and HT. Keywords: HIFEM, urinary incontinence, OABSS.

Wilms tumor is the most common pediatric renal malignancy, with two predominant management approaches creating clinical decision-making challenges. SIOP advocates preoperative chemotherapy to reduce tumor burden, while NWTS/COG prioritizes immediate surgery for histopathological analysis. Evidence-based comparison is essential, particularly in resource-limited settings. To systematically compare preoperative chemotherapy (SIOP) versus upfront nephrectomy (NWTS/COG) protocols in Wilms tumor management by analyzing diagnostic accuracy, treatment efficacy, and surgical outcomes through direct comparative studies. A PRISMA 2020-guided systematic review was conducted, searching PubMed, ScienceDirect, SpringerLink, and Google Scholar for comparative studies (2015-2024) that directly compared SIOP and NWTS/COG protocols in pediatric Wilms tumor patients. Quality assessment was performed using the ROBINS-I tool. Four comparative studies encompassing 226 patients from developing countries (India, Pakistan, Iraq, Vietnam) were included. Diagnostic accuracy varied significantly, with SIOP protocols showing misdiagnosis rates of 17.4-21.7% in resource-limited settings, while NWTS protocols achieved 100% accuracy in the single study reporting this outcome. Surgical outcomes were heterogeneously reported: one Indian study found no intraoperative spillage in SIOP patients (0/23) versus 22.2% in NWTS patients (2/9), though this finding cannot be generalized due to single-center limitations. Postoperative complications varied by setting, with one Pakistani study reporting higher rates in SIOP patients (21% vs. 9.5%). Survival outcomes ranged from 80.9-96.7% across protocols and countries, with no consistent pattern favoring either approach. Neither protocol demonstrates consistent superiority across all outcomes. Protocol selection should be individualized based on disease stage, diagnostic capabilities, and healthcare infrastructure. The limited number of comparative studies and heterogeneous reporting highlight the need for standardized outcome measures and larger multicenter trials.

Introduction: It is estimated that more than 150 million men worldwide have erectile dysfunction (ED) and this number will reach more than 300 million by 2025. There is strong evidence that ED increases the risk of future cardiovascular events. ED and CAD share common risk factors. High sensitivity C-Reactive Protein (hs-CRP) is an important inflammatory biomarker in subclinical atherosclerosis. Albuminuria is also a marker of widespread endothelial dysfunction and is thought to be associated with ED. This study was conducted to analyze the prevalence of ED and the relationship between hs-CRP, albuminuria, and cardiovascular risk factors with the occurrence of ED in CAD patients.Materials and methods: From July 2024 to October 2024, 288 CAD cases from Saiful Anwar general hospital heart clinic met the inclusion criteria. Data on hs-CRP, albuminuria, and cardiovascular risk factors such as age, hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking were observed in relation to incidence of erectile dysfunction in CAD patients. Then logistic regression analysis was performed.Results: There were 255 CAD patients (88.5%) who experienced ED. There was no significant relationship between hs-CRP and albuminuria with ED in CAD patients (p>0.05). Significant risk factors for ED in CAD patients were age (OR = 15.92; 95% CI = 4.67-54.22; p=0.000), triglycerides (OR = 2.52; 95% CI = 1.12-5.66; p=0.024), and smoking (OR = 0.29; 95% CI = 0.09-0.89; p=0.031). Conclusions: The prevalence of erectile dysfunction was 88.5% in patients with coronary artery disease. Hs-CRP and albuminuria did not have a significant relationship with the incidence of ED in patients with CAD. Risk factors that independently affect incidence of ED in patients with CAD are age, smoking, and hypertriglyceridemia.

Introduction & Objectives: Renal cell carcinoma (RCC) represents the majority of kidney malignancies and is characterized by variable outcomes, even with current systemic therapies. Interleukin-6 (IL-6), a proinflammatory cytokine implicated in tumor progression and immune suppression, has been proposed as a prognostic biomarker in RCC. However, the evidence remains inconsistent due to methodological heterogeneity across studies. Therefore, our study aims to evaluate the prognostic significance of IL-6 in RCC by synthesizing data from published studies, specifically overall survival (OS) and progression-free survival (PFS). Methods: A systematic meta-analysis was conducted to evaluate the prognostic significance of IL-6 in RCC. Eligible studies were identified through PubMed, ScienceDirect, and ProQuest up to March 2025. Inclusion criteria encompassed original articles measuring pre-treatment serum IL-6 levels in RCC patients and reporting associations with overall survival (OS) or progression-free survival (PFS). Random-effects models were used to compute pooled hazard ratios (HRs) and survival differences. Results: Nine studies comprising 702 RCC patients were included. Patients with low IL-6 levels had significantly longer OS (difference: 5.36 months; 95% CI: 2.2-8.53; p<0.001; I² = 0%) and PFS (difference: 6.41 months; 95% CI: 1.3-11.53; p=0.01; I² = 48.5%) compared to those with high IL-6. The pooled HR for survival associated with elevated IL-6 was 2.06 (95% CI: -0.23-4.36), with considerable heterogeneity (I² = 89.19%) and borderline statistical significance (p=0.08). Despite variations in study design, sample size, and IL-6 detection methods, elevated IL-6 consistently predicted worse clinical outcomes. Conclusions: IL-6 is a promising prognostic biomarker in RCC, with elevated levels associated with significantly poorer OS and PFS.

Background: Orchidectomy is a surgical androgen deprivation therapy (ADT) for prostate cancer patients to achieve castrate testosterone levels. Selective androgen receptor modulators (SARMs) are used to mitigate the adverse effects of ADT, including elevated risk of osteoporosis, and reduced skeletal muscle mass. Rad140 is a novel SARMs that has high affinity for the androgen receptors. This study was conducted to determine the effects of SARM Rad140 on the number of osteoblasts, osteoclasts, muscle fiber cross-sectional area (CSA), muscle size, and number of myonuclei in rats underwent orchidectomy.Materials and Methods: An experimental study was conducted using a randomized post-test only control group design. Following orchidectomy, SARM Rad140 was administered orally for six weeks at various doses. Osteoblasts, osteoclasts, muscle fiber CSA, muscle size, and number of myonuclei were measured. Quantitative analysis was performed using one-way ANOVA.Results: There were significant differences in the effects of SARM Rad140 at different doses on osteoblast and osteoclast cells. At higher doses, the osteoblast cell counts in rats tended to increase, while the osteoclast counts tended to decline. The treatment group also showed significant results in the CSA of the gastrocnemius muscle fibers, as well as in the number of myonuclei of the gastrocnemius muscle.Conclusion: SARM Rad140 significantly increased the number of osteoblasts, muscle fiber CSA, and gastrocnemius muscle myonuclei, while decreasing osteoclasts. SARM Rad140 is a promising therapy for osteoporosis and muscle weakening due to ADT.Keywords: SARM Rad140, orchidectomy, osteoblasts, osteoclasts, muscle fiber cross sectional area, myonuclei

Introduction: Since percutaneous nephrolithotomy (PCNL) was introduced in 1976, it has been the standard procedure for large renal stones. Over time, the PCNL technique changed and developed into various techniques. We introduce single site multipuncture supine (SMS) PCNL to give cosmetic advantage due to less tissue injury in complex renal stone. This study aimed to determine the outcome SMS PCNL procedure in patients with complex renal stones diseases. Materials and methods: This study was a retrospective study including all patients with kidney stones who had undergone SMS PCNL at the Urology Department of Saiful Anwar General Hospital from March 2019 until December 2022. All SMS PCNL procedures were performed by a single operator. The patients were divided into three groups that included that were treated with 2, 3, and 4 punctures. The data were collected using SPSS ver. 25. Results: Ninety-three patients were included in this study. The characteristics of the patient such as gender, age, BMI were not significantly different among the groups. The outcome of SMS PCNL procedure showed low complication rate during operation in 2-,3-,and 4-puncture groups (3.2%, 7.4%, 0%, respectively). The Stone Free Rate (SFR) showed no significant difference between the 3 groups (p = 0.496). The SFR was 85.7% in 2-puncture, 77.8% in 3-puncture, 66.7% in 4-puncture group. The AUC of Guy’s Stone Score with cut off value was 3.5 (AUC = 0.549, p-value = 0.541, CI 95%). Conclusions: Single Site Multi Puncture PCNL is safe and efficient approach to complex renal stones. Single Site Multipunctures Supine PCNL is comparable with other techniques of PCNL and gives minimal tissue injury that would benefit for cosmetic.

Introduction and Objectives: Premature ejaculation (PE) occurs in 31% of productive men aged 18-59 years, leading to disappointment and avoidance of sexual relations. The current guideline of treatment for PE is Dapoxetine, which possesses several adverse effects causing the limitation of long-term use. Silodosin, an alpha-1 blocker, has been proposed as a new option for treating PE due to its minimal side effects. Therefore, our study aims to assess the efficacy of silodosin in treating PE.Materials and Methods: This systematic review and meta-analysis was in accordance with Cochrane Handbook guidelines. Comprehensive literature search was conducted in several databases including PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials. The studies were included if they met the following criteria: (1) Involving premature ejaculation patients; (2) Intervention using silodosin; (3) Comparing placebo or other therapies for PE (4) Outcome includes the Intravaginal Ejaculation Latency Time (IELT) and reported adverse events related to the therapy. Study quality was assessed using Cochrane risk-of-bias criteria. Statistical analysis in this study was performed using Review Manager 5.4 Results: A total of four studies were included in this meta-analysis. Our study showed that patients who received silodosin had a significantly longer IELT compared to control (MD: 132.54, 95% CI 51.51-213.57, p<0.001). However, patient treated with silodosin also possessed significantly higher risk of adverse event for developing reduced semen ejaculation (OR 10.79, 95% CI 3.46 – 33.67, p<0.0001).Conclusion: Silodosin significantly increased IELT. However, it also reduced semen ejaculation as its drug adverse effect. This result supports the clinical use of silodosin as an alternative treatment for premature ejaculation.

Objective: This study was conducted to analyze the prognostic factors for orchidectomy in testicular torsion patients. Material & Methods: From January 2001 to December 2021, 100 cases of testicular torsion cases were retrospectively collected. Data were described and analyzed based on clinical factors (age, duration of symptoms, scrotal swelling, high-riding testis, Prehn test, cremasteric reflex, leukocytosis, degree of twisting) and non-clinical factors (distance from hospital, duration of travel to hospital, education level and employment status) for each surgical procedure. Then logistic regression analysis was performed. Results: There were 88 testicular torsion patients (88%) underwent orchidectomy and 12 patients (12%) underwent orchidopexy. There was no significant relationship between age, duration of symptoms, scrotal swelling, Prehn test, cremasteric reflex, leukocytosis, distance from hospital, duration of travel to hospital, education level and employment status with orchidectomy (p>0.05). Significant prognostic factors for orchidectomy in testicular torsion patients were high-riding testis (OR = 0.06; 95% CI = 0.01-0.37; p = 0.002) and degree of twisting (OR = 0.04; 95% CI = 0.006-0.24; p = 0.000). Conclusion: High-riding testis and degree of twisting are prognostic factors for orchidectomy in testicular torsion patients. Keywords: Orchidectomy, prognostic factors, testicular torsion.