PurposeTo evaluate the effect of education and literacy status on completion of the Visual Prostate Symptom Score (VPSS) and the International Prostate Symptom Score (IPSS) in males aged over 40 years in a rural Indonesian area.MethodsWe enrolled 103 men who had visited Tc-Hillers Maumere Hospital. Four questions related to frequency, nocturia, weak stream, and quality of life (QoL) were presented by pictogram in the VPSS. Data on age, educational level, and literacy status were analyzed to determine associations with the capability to complete the IPSS and the VPSS questionnaires. Correlation test was used to identify correlation between the VPSS and the IPSS.ResultsThe median age of the 103 respondents was 60 years. A total of 69 patients (67.0%) were able to read, 99 patients (96.1%) understood the Indonesian language, and 52 patients (50.5%) had an education grade>9. The IPSS was completed without assistance by 55 patients (53.4%) and the VPSS by 82 patients (79.6%). None of the patients who could not read could complete the IPSS without assistance, whereas 15 patients (44.1%) who could not read could complete the VPSS without assistance (P<0.001). In the analysis of education level, 40 of 51 patients (78.4%) with an education grade≤9 required assistance to complete the IPSS compared with 8 of 52 patients (15.4%) with an education grade>9 (P>0.001). In the same groups, 19 of 51 patients (37.3%) compared with 2 of 52 patients (3.8%) required assistance to complete the VPSS (P<0.001). Total VPSS, VPSS obstructive symptoms, VPSS irritative symptoms, and VPSS QoL scores significantly correlated with the total IPSS, IPSS obstructive symptoms, IPSS irritative symptoms, and IPSS QoL, respectively (correlation coefficient, P-value: 0.675, <0.001; 0.503, <0.001; 0.731, <0.001; and 0.823, <0.001, respectively).ConclusionsThe VPSS correlated significantly with the IPSS and could be completed without assistance by a greater proportion of men with low levels of education. The VPSS might be useful in evaluating men with lower urinary tract symptoms in rural Indonesian areas with a high level of illiteracy and low level of education.

Introduction Delayed union is a problem that can occur after fracture healing. Many studies were conducted based on the diamond concept approach to solve the problem of delayed union. Granulocyte-colony stimulating factor (G-CSF) is one of the various substances known to have a positive role in healing skeletal tissue or adjuvant regeneration. This study was conducted to see the effect of G-CSF in affecting delayed union fracture healing. Materials and method The experimental study was conducted by randomized posttest only control group design on 24 experimental animals Sprague-Dawley white rats that had experienced delayed union models. The study compared the treatment group injected with subcutaneous G-CSF with a control group and was divided into four groups (n = 6). Harvest and follow-up histomorphometry and immunohistochemistry were performed in the second week and in the fourth week the histomorphometry analysis consisted of the percentage of immature bone area, cartilage, and fibrous area. The semiquantitative evaluation of immunohistochemistry with the expression of BMP-2 through the immunoreactive score (IRS). Result In the evaluation of histomorphometry and immunohistochemical parameters, there were significantly more woven bone area (p = 0,015), less fibrosis area (p = 0,002) and higher BMP 2 expression (p = 0,004) in treatment group week four compared to control. . Conclusion G-CSF was shown to increase the speed of healing in Sprague-Dawley rats on delayed union models evaluated from histomorphometry and immunohistochemical aspects.

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