Browse publications by year: 2023

  1. Lim KC, Then AY, Loh KH
    PeerJ, 2023;11:e15849.
    PMID: 37637173 DOI: 10.7717/peerj.15849
    Small coastal demersal sharks form a major proportion of the sharks landed in Malaysia. However, little is known about their feeding ecology and reproduction. This study sought to elucidate the dietary patterns, role of ontogeny in prey consumption, and reproductive biology of four dominant small demersal shark species in Malaysian waters: the Hasselt's bamboo shark, Chiloscyllium hasseltii; brownbanded bamboo shark, C. punctatum; spadenose shark, Scoliodon laticaudus; and Pacific spadenose shark, S. macrorhynchos. Dietary analyses revealed a high overlap in prey taxa consumed; clear resource partitioning among co-occurring species based on the percentage Prey-specific Index of Relative Importance (%PSIRI), with higher fish %PSIRI for Chiloscyllium hasseltii, higher cephalopod %PSIRI for C. punctatum, and higher crustacean %PSIRI for both Scoliodon species; and an ontogenetic diet shift, seen through changes in prey size. Based on the examination of reproductive organs, the results showed larger sizes at maturity for males compared to females for all four species; no obvious reproductive cycles, based on hepatosomatic and gonadosomatic indices for all species; female bias in the sex ratio of the embryos of Scoliodon species; and increased reproductive output (number of eggs or embryos and size of eggs) with larger female size for C. hasseltii and Scoliodon species. The partitioning of food resources minimizes direct competition for food and supports coexistence within shared coastal habitats. The reproductive strategies of these small coastal sharks appear to be favorable for supporting short-term population productivity; although a reduction in fishing pressure, especially from bottom trawlers, is essential for the long-term sustainable use of these sharks.
    MeSH terms: Animals; Ecology*; Feeding Behavior*; Female; Malaysia; Male; Reproduction*; Cephalopoda
  2. Jawad MS, Dhawale C, Ramli AAB, Mahdin H
    MethodsX, 2023 Dec;11:102324.
    PMID: 37637288 DOI: 10.1016/j.mex.2023.102324
    [This corrects the article DOI: 10.1016/j.mex.2023.102124.].
  3. Hashim H
    PMID: 37637325 DOI: 10.1016/j.jctube.2023.100392
    Tuberculosis-associated immune reconstitution syndrome (TB-IRIS) is an increasingly recognized complication of children living with HIV who are receiving treatment for active tuberculosis (TB). The purpose of the study was to appraise available evidence of morbidity and mortality related to TB IRIS among the paediatric population. A non-systematic review of the literature was conducted by retrieving records from Scopus, PubMed and Google Scholar). Four specific research questions assessing the risk factors (age, undernutrition, extrapulmonary TB and degree of immunosuppression) for TB-IRIS were discussed. The search yielded 370 articles, subsequently screened for eligibility according to the inclusion criteria. The majority of the articles were adult studies. Six studies were identified: Three retrospective and three prospective studies. The majority of the studies were conducted in TB/HIV-endemic countries. Only one study addressed mortality due to TB-IRIS as an outcome. A total of 6 mortalities related to TB-IRIS were reported. Advanced immunosuppression is universally agreed as an established risk factor for mortality in TB-IRIS in children. The severe presentation was more common in children with extrapulmonary tuberculosis. There is a paucity of data available on mortality in HIV-infected children with TB-IRIS. Future research is needed to assess the predictive factors of morbidity and mortality in HIV-infected children with TB-IRIS especially in low resource and high endemic countries.
  4. Priyank H, Verma A, Zama Khan DU, Prakash Rai N, Kalburgi V, Singh S
    Cureus, 2023 Jul;15(7):e42414.
    PMID: 37637546 DOI: 10.7759/cureus.42414
    Dental caries is a common dental health problem affecting all age groups across the globe. Accurate detection and assessment of dental caries are crucial for effective treatment and preventive measures. Teledentistry, which involves remote dental assessment using digital technologies, has shown promise as a potential tool for caries screening. This systematic review and meta-analysis aims to compare the dental caries scores obtained from clinical examinations and teledentistry assessments. Literature searches were conducted across databases such as PubMed, Embase, the Cochrane Library, Scopus, the Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO by using predefined search terms and inclusion criteria. Two reviewers separately extracted the data. The study designs, evaluation techniques, dentition types, mean scores, and follow-up times of the included studies were examined. The New Castle-Ottawa Scale was used to assess the risk of bias. Review Manager (RevMan) (computer program) Version 5.4, The Cochrane Collaboration 2020, was used for the quantitative assessment of the data. Eight studies met the inclusion criteria and were included in the review. The findings revealed that teledentistry assessments (based on intraoral photographs captured using smartphones or intraoral cameras) demonstrated comparable accuracy to traditional clinical examinations in detecting and assessing dental caries. Among the four studies that were quantitatively analysed, no significant difference was noted at p = 0.09. A mean difference of 0.64 (95% confidence interval (CI): -0.10; 1.38) suggested that clinical examination and teledentistry-based checkup were on par with each other for the detection of dental caries. The New Castle-Ottawa scale (NOS) grading indicated that the studies were of good quality. Teledentistry may be an effective approach for identifying and evaluating dental caries. However, further research is required to substantiate the findings observed in the present review.
  5. Wong KH, Cheng TC, Md Pauzi SH, Wan Abdul Halim WH, Md Din N
    Cureus, 2023 Jul;15(7):e42497.
    PMID: 37637548 DOI: 10.7759/cureus.42497
    Convergence-retraction nystagmus alongside behavioral changes can be rare manifestations of a potentially life-threatening midbrain lesion. After experiencing headaches for three months, a 13-year-old boy was diagnosed with depression due to exhibiting reduced speech, hypersomnia, and psychomotor slowing for three weeks. It was preceded by headache for three months. Examination revealed visual acuity of 6/6 bilaterally, convergence-retraction nystagmus worst on upgaze, limited bilateral ocular motility in upgaze, and light-near dissociation on pupil examination, all of which point towards Parinaud's syndrome. However, there was no lid retraction to suggest Collier's sign. Fundus examination revealed papilledema. Magnetic resonance imaging showed a large pineal mass extending to both thalami, dilated ventricles due to obstructive hydrocephalus, and cerebral edema. An urgent external ventricular drain was inserted, and biopsy revealed pineal gland germinoma. Chemotherapy and radiotherapy resulted in adequate tumor shrinkage. This case report highlights that subacute behavioral changes may mask a potentially life-threatening intracranial tumor, especially when associated with abnormal eye movement.
  6. Tan JA, Khoo ET, Al-Chalabi MMM, Mohd Zainal H, Wan Sulaiman WA
    Cureus, 2023 Jul;15(7):e42572.
    PMID: 37637587 DOI: 10.7759/cureus.42572
    Conjunctival melanoma is a rare and potentially deadly tumor. Therefore, adequate oncological resection is essential, commonly leading to total orbital exenteration, which causes patients' extensive functional and cosmetic impairment. As a result, it is essential to reconstruct the orbital region post-exenteration to obliterate the cavity, provide adequate and pliable cutaneous covering, and restore a stable vascularized tissue that can withstand adjuvant radiotherapy. In recent years, the techniques used for orbital reconstruction have included the transorbital temporoparietal fascial flap, the anterolateral thigh flap, and local flaps, such as the paramedian forehead flap. A free radial forearm flap is currently not commonly used for orbital reconstruction due to potential donor site morbidity and cosmetic issues. In our case, we report a free radial forearm fasciocutaneous flap that has been utilized with promising surgical outcomes to reconstruct the orbital region following orbital exenteration.
  7. Teoh RJJ, Lai YP, Alias R
    Cureus, 2023 Jul;15(7):e42435.
    PMID: 37637668 DOI: 10.7759/cureus.42435
    Orbital cellulitis is a sight- and life-threatening condition. Prompt diagnosis and immediate intervention are required. We report a case of fatal odontogenic orbital cellulitis complicated with intracranial abscesses in a 55-year-old gentleman. The patient presented with painful swelling of the left eye associated with reduced eye movement, blurry vision, and a headache. There was generalized periodontitis. Initial imaging was suggestive of left eye orbital cellulitis with intracranial abscess, and intensive systemic antibiotic therapy was initiated. After six weeks of antibiotic therapy, there was an improvement in ocular signs and symptoms. However, the patient developed signs of meningism with a persistent fever. Serial brain imaging demonstrated worsening intracranial abscesses. The patient died eight weeks after the initial onset of presentation. This case emphasized that brain abscesses could be a fatal complication of odontogenic orbital cellulitis. A high index of suspicion is important in diagnosing orbital cellulitis and its complications. Early consideration of surgical intervention is necessary in cases not responding to antibiotic therapy.
  8. Wang X, Wang J, Pang F
    Int J Gen Med, 2023;16:3655-3663.
    PMID: 37637714 DOI: 10.2147/IJGM.S426168
    OBJECTIVE: Both Malaysian and Chinese populations have benefited from the utilization of Traditional Chinese Medicine (TCM) in the treatment of COVID-19. This study aims to analyze the herb selection in TCM COVID-19 treatment protocols employed by Malaysia and China.

    METHODS: Based on TCM theories, a comparative analysis was conducted on the treatment protocols of the two countries. This analysis encompassed syndrome differentiation and classification, therapeutic principles and formulas, as well as herb characteristics. The herbs within the protocols were subjected to frequency statistics and cluster analysis using SPSS 25, and network analysis was performed using SPSS Modeler 18.0 software.

    RESULTS: The properties (cold, warm, ping and bitter, pungent, sweet) and meridian (lung, stomach, spleen) associated with the herbs in both protocols exhibit fundamental similarities. Furthermore, the propensity for selecting pairs of herbs is also consistent. The herb pairs selected also have the same propensity. The clustering results reveal six categories, of which in the two protocols are good. The top three herb-pairs in Malaysian Protocols are Gan Cao - Yi Yi Ren, Ban Xia - Gan Cao, Chen Pi - Gan Cao, while the top three in Chinese Protocol are Huo Xiang - Ma Huang, Shi Gao - Gan Cao, Cang Zhu - Gan Cao.

    CONCLUSION: Characteristics of herbs in Both Malaysian and Chinese Protocols herb reflect the advantages and regional adaptation of TCM principles. These findings offer valuable guidance in the application of herbs or herb pairs for the treatment of COVID-19.

  9. Dashti M, Nizam R, Jacob S, Al-Kandari H, Al Ozairi E, Thanaraj TA, et al.
    Front Immunol, 2023;14:1238269.
    PMID: 37638053 DOI: 10.3389/fimmu.2023.1238269
    Type 1 diabetes (T1D) is a complex autoimmune disorder that is highly prevalent globally. The interactions between genetic and environmental factors may trigger T1D in susceptible individuals. HLA genes play a significant role in T1D pathogenesis, and specific haplotypes are associated with an increased risk of developing the disease. Identifying risk haplotypes can greatly improve the genetic scoring for early diagnosis of T1D in difficult to rank subgroups. This study employed next-generation sequencing to evaluate the association between HLA class II alleles, haplotypes, and amino acids and T1D, by recruiting 95 children with T1D and 150 controls in the Kuwaiti population. Significant associations were identified for alleles at the HLA-DRB1, HLA-DQA1, and HLA-DQB1 loci, including DRB1*03:01:01, DQA1*05:01:01, and DQB1*02:01:01, which conferred high risk, and DRB1*11:04:01, DQA1*05:05:01, and DQB1*03:01:01, which were protective. The DRB1*03:01:01~DQA1*05:01:01~DQB1*02:01:01 haplotype was most strongly associated with the risk of developing T1D, while DRB1*11:04-DQA1*05:05-DQB1*03:01 was the only haplotype that rendered protection against T1D. We also identified 66 amino acid positions across the HLA-DRB1, HLA-DQA1, and HLA-DQB1 genes that were significantly associated with T1D, including novel associations. These results validate and extend our knowledge on the associations between HLA genes and T1D in Kuwaiti children. The identified risk alleles, haplotypes, and amino acid variations may influence disease development through effects on HLA structure and function and may allow early intervention via population-based screening efforts.
    MeSH terms: Alleles; Amino Acids/genetics; Child; Genes, MHC Class II*; Haplotypes; Humans; Kuwait/epidemiology; HLA-DRB1 Chains
  10. Akyuz E, Lazarowski A, de Cabo C, Godlevsky LS, Shaikh MF, Doganyigit Z
    Front Neurol, 2023;14:1263539.
    PMID: 37638194 DOI: 10.3389/fneur.2023.1263539
  11. Parveen A, Anjum M, Mahmood S, Nawaz R, Khalid A
    Environ Monit Assess, 2023 Aug 26;195(9):1100.
    PMID: 37632590 DOI: 10.1007/s10661-023-11710-y
    Pakistan is the fourth largest yarn producer in the world heavily that relies on cotton crop which receives a substantial 62% of all pesticide applications. The present study was conducted to quantify the levels of pesticides such as bifenthrin, spirotetramat, pyriproxyfen, imidacloprid, and diafenthiuron in soil and plants residue at selected cotton fields of Multan District, Pakistan. In addition to pesticides, the assessment of heavy metal concentration was also conducted in order to determine the overall risks that these compounds to both plants and human population. For this analysis, 20 soil samples and 10 plant samples were collected from 10 selected cotton fields. Pesticides and heavy metals in soil and plant samples were analyzed using high-performance liquid chromatography (HPLC) and Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES), respectively. It was observed that all samples collected from selected fields contained pesticide residue in top soil (0-15 cm). However, no pesticides were detected in the lower soil layer (16-30 cm). In case of heavy metals, the highest concentration of Fe, Pb, and Mn was observed in both soil and plant residue samples. The heavy metals were found in the order of Fe > Mn > Pb > Zn > Cu > Cd in the soil. The total carcinogenic risk values for a few pesticides were found to range from 10-6 to 10-2, indicating that residents of the study area have low to higher chances of developing cancer. A positive correlation was observed among the pesticides (r = 0.18-0.95) as well as in metals related parameters (r = 0.49-0.96), where a weak negative correlation was found among metal to pesticide parameters except Pd where the maximum r value was 0.62. In general, the finding of this study encourages the development and adoption of sustainable agricultural practices that lower the dependence on toxic pesticides and endorse environmentally friendly alternatives.
    MeSH terms: Cellulose; Environmental Monitoring; Environmental Pollutants*; Humans; Lead; Neoplasms*; Pakistan/epidemiology; Pesticides*; Risk Assessment
  12. Aleid GM, Alshammari AS, Alomari AD, Ahmad A, Alaysuy O, Ibrahim MNM
    PMID: 37632620 DOI: 10.1007/s11356-023-29430-8
    The benthic microbial fuel cell (BMFC) is one of the most efficient types of bioelectrochemical fuel cell systems. Modern bioelectrochemical fuel cells have several drawbacks, including an unstable organic substrate and a microorganism-unfriendly atmosphere. The recent literature to encounter such issues is one of the emerging talks. Researchers are focusing on the utilization of biomass and waste to encounter such challenges and make the technique more feasible at the pilot scale. This study investigated the combination of local bakery waste as an organic substrate with lignocellulosic biomass material. The whole experiment was conducted for 45 days. At an external resistance of 1000 ῼ and an internal resistance of 677 ῼ, the power density was found to be 3.51 mW/m2. Similarly, for Pb2+, Cd2+, Cr3+, Ni2+, and Co2+, the degradation efficiency was 84.40%, 81.21%, 80%, 89.50%, and 86.0%, respectively. The bacterial identification results showed that Liquorilactobacillus nagelii, Proteus mirabilis, Pectobacterium punjabense, and Xenorhabdus thuongxuanensis are the most prominent species found on anode biofilm. The method of electron generation in this study, which includes the degradation of metal ions, is also well described. Lastly, optimising the parameters showed that pH 7 provides a feasible environment for operation. A few future suggestions for practical steps are enclosed for the research community.
  13. Long V, Choi EC, Chen Z, Kamil MAA, Rajagopalan M, McMeniman E, et al.
    JMIR Dermatol, 2023 Jan 31;6:e43910.
    PMID: 37632921 DOI: 10.2196/43910
    BACKGROUND: The field of teledermatology has expanded tremendously and has been used for conditions including hidradenitis suppurativa (HS). However, due to the sensitive location of lesions, HS may be considered less suitable for teledermatology.

    OBJECTIVE: We sought to assess dermatologists' experiences and perceptions toward using teledermatology for HS relative to atopic dermatitis (AD) as a comparison.

    METHODS: A survey was disseminated electronically to practicing dermatologists in the Asia-Pacific region between February and June 2022. Differences in attitudes and perceptions between HS and AD were compared using random-effects ordered logistic regression, controlling for demographics.

    RESULTS: A total of 100 responses were obtained comprising of 76 (81.7%) dermatologists and 17 (18.3%) dermatology trainees; 62.6% (62/98) of physicians were uncomfortable with using teledermatology for HS. Multivariable regression confirmed increased perceived challenges with managing HS using teledermatology compared to AD. These challenges include the need for photography of hard-to-reach or sensitive areas (odds ratio [OR] 4.71, 95% CI 2.44-9.07; P

  14. Song YH, Chung ES, Shahid S, Kim Y, Kim D
    Sci Data, 2023 Aug 26;10(1):568.
    PMID: 37633988 DOI: 10.1038/s41597-023-02475-7
    Reliable projection of evapotranspiration (ET) is important for planning sustainable water management for the agriculture field in the context of climate change. A global dataset of monthly climate variables was generated to estimate potential ET (PET) using 14 General Circulation Models (GCMs) for four main shared socioeconomic pathways (SSPs). The generated dataset has a spatial resolution of 0.5° × 0.5° and a period ranging from 1950 to 2100 and can estimate historical and future PET using the Penman-Monteith method. Furthermore, this dataset can be applied to various PET estimation methods based on climate variables. This paper presents that the dataset generated to estimate future PET could reflect the greenhouse gas concentration level of the SSP scenarios in latitude bands. Therefore, this dataset can provide vital information for users to select appropriate GCMs for estimating reasonable PETs and help determine bias correction methods to reduce between observation and model based on the scale of climate variables in each GCM.
  15. Harris JA, Beck NA, Niedziela CJ, Alvarez GA, Danquah SA, Afshar S
    Oral Maxillofac Surg, 2023 Sep;27(3):513-517.
    PMID: 35739365 DOI: 10.1007/s10006-022-01095-6
    PURPOSE: Social media use among oral and maxillofacial surgeons (OMSs) has grown in recent years, serving as an important resource for the dissemination of medical/surgical knowledge, research, education, diplomacy, and advocacy. However, no studies have attempted to characterize the global reach of social media in OMS.

    METHODS: This study examined the profile activity, content performance, and demographic characteristics of followers from a single OMS-related Instagram account. Variables assessed include the total number of followers since the account's inception, profile views over the selected time period, and unique media content posts, as well as likes, comments, saves, impressions, and reach for all media content posts. The top 45 countries, cities, and languages based on each follower's geolocation and user settings were also included.

    RESULTS: There were 9569 followers of which 6208 (64.9%) were listed as public accounts. Of the 6208 followers with public accounts, 2496 (40.2%) were female. The countries with the most followers included the United States (31.7%), India (12.5%), Malaysia (5.3%), Mexico (4.0%), and Pakistan (3.6%). The cities with the most followers included New York, New York (8.9%), Boston, Massachusetts (5.2%), Cairo, Egypt (4.3%), Santiago, Chile (3.7%), and Karachi, Pakistan (3.5%).

    CONCLUSION: OMS-related social media is uniquely positioned to facilitate global collaboration and augment the dissemination of surgical knowledge and expertise. This information is critical in understanding the distribution and demographics of the OMS workforce, trainees, and affiliates around the world.

    MeSH terms: Female; Humans; India; Male; Surgery, Oral*; United States; Social Media*
  16. Ting JSK, Tan YL, Veasuvalingam B, Yap AYM, Ghui SM, Yong JL, et al.
    Clin Exp Dermatol, 2023 Aug 25;48(9):998-1006.
    PMID: 37097177 DOI: 10.1093/ced/llad149
    BACKGROUND: To date, to our knowledge, there has not been a study on dermatological teaching in the preclinical years (usually the first 2 years of medical school), where the majority of learning takes place in the form of lectures and seminars. Near-peer teaching (NPT) involves students who are at least one academic year more senior imparting knowledge to junior students. The principles behind scaffolding are having a more experienced teacher to guide learning, breaking down learning into smaller tasks and helping to build interest in learning.

    OBJECTIVES: To investigate the feasibility and effectiveness of NPT in scaffolding dermatological learning among preclinical-year medical students.

    METHODS: Near-peer teachers who are content experts in dermatology taught alongside conventional teaching with lecturers. We employed five quiz questions before and after the case launch lecture, where students were first exposed to dermatology. We also invited students to provide feedback using a questionnaire on NPT in dermatology at the end of the case 8 teaching week.

    RESULTS: In total, 74 students participated in the pre- and post-lecture quiz questions, and 47 completed feedback. There was overwhelmingly positive feedback towards NPT, and various learning theories can help explain the success of this project.

    CONCLUSIONS: Preclinical students enjoy dermatological teaching with the involvement of suitable near-peers. With the professional barrier removed, students can better relate to near-peers (and vice versa). Helping students understand the relevance of dermatology in the clinical setting at an early stage and adopting learning tools such as mnemonics, summary tables, comparison tables and mapping teaching with the learning curriculum clearly helped students learn about dermatology.

    MeSH terms: Curriculum; Education, Medical, Undergraduate*; Feedback; Humans; Learning; Peer Group; Students, Medical*
  17. Korada HY, Arora E, Maiya GA, Rao S, Hande M, Shetty S, et al.
    Curr Diabetes Rev, 2023;19(9):e290422204244.
    PMID: 37622461 DOI: 10.2174/1573399818666220429085256
    BACKGROUND: Diabetic peripheral neuropathy is a severe complication of type 2 diabetes mellitus. The most common symptoms are neuropathic pain and altered sensorium due to damage to small nerve fibers. Altered plantar pressure distribution is also a major risk factor in diabetic peripheral neuropathy, leading to diabetic foot ulcers.

    OBJECTIVE: The objective of this systematic review was to analyze the various studies involving photobiomodulation therapy on neuropathic pain and plantar pressure distribution in diabetic peripheral neuropathy.

    METHODS: We conducted a systematic review (PubMed, Web of Science, CINAHL, and Cochrane) to summarise the evidence on photobiomodulation therapy for Diabetic Peripheral Neuropathy with type 2 diabetes mellitus. Randomized and non-randomized studies were included in the review.

    RESULTS: This systematic review included eight studies in which photobiomodulation therapy showed improvement in neuropathic pain and nerve conduction velocity. It also reduces plantar pressure distribution, which is a high risk for developing foot ulcers.

    CONCLUSION: We conclude that photobiomodulation therapy is an effective, non-invasive, and costefficient means to improve neuropathic pain and altered plantar pressure distribution in diabetic peripheral neuropathy.

    MeSH terms: Humans; Neural Conduction; Low-Level Light Therapy*
  18. Dasgupta S, Hong J, Morris R, Iqbal J, Lennox-Bowley A, Saniasiaya J
    Audiol Res, 2023 Aug 04;13(4):600-614.
    PMID: 37622928 DOI: 10.3390/audiolres13040052
    Conductive hearing losses are typically present in disorders of the external/middle ear. However, there is a rare group of inner ear conditions called third windows that can also generate a conductive hearing loss. This is due to an abnormal connection between the middle and the inner ear or between the inner ear and the cranial cavity. X-linked gusher disorder is an extremely rare congenital inner ear dysplastic syndrome with an abnormal connection due to a characteristic incomplete cochlear partition type III and an incomplete internal auditory meatus fundus. The disorder is inherited in an X-linked fashion due to the mutation of the POU3F4 gene. We present two siblings diagnosed with the condition and their long-term follow-ups. They both presented audiovestibular symptoms and showed progressive mixed losses and bilateral vestibular weakness. They were treated with cochlear implant, digital amplification and with vestibular rehabilitation. Significant others around them were involved in their journey with the medical team, and in both, a very favourable outcome was achieved. This is the first time that we have reported evolving audiovestibular function with vestibular quantification in X-linked gusher disorder and emphasize on the multidisciplinary holistic approach to manage these children effectively.
  19. Al-Saffar FY, Wong LS, Paul SC
    Gels, 2023 Jul 28;9(8).
    PMID: 37623068 DOI: 10.3390/gels9080613
    Concrete as a building material is susceptible to degradation by environmental threats such as thermal diffusion, acid and sulphate infiltration, and chloride penetration. Hence, the inclusion of nanomaterials in concrete has a positive effect in terms of promoting its mechanical strength and durability performance, as well as resulting in energy savings due to reduced cement consumption in concrete production. This review article discussed the novel advances in research regarding C-S-H gel promotion and concrete durability improvement using nanomaterials. Basically, this review deals with topics relevant to the influence of nanomaterials on concrete's resistance to heat, acid, sulphate, chlorides, and wear deterioration, as well as the impact on concrete microstructure and chemical bonding. The significance of this review is a critical discussion on the cementation mechanism of nanoparticles in enhancing durability properties owing to their nanofiller effect, pozzolanic reactivity, and nucleation effect. The utilization of nanoparticles enhanced the hydrolysis of cement, leading to a rise in the production of C-S-H gel. Consequently, this improvement in concrete microstructure led to a reduction in the number of capillary pores and pore connectivity, thereby improving the concrete's water resistance. Microstructural and chemical evidence obtained using SEM and XRD indicated that nanomaterials facilitated the formation of cement gel either by reacting pozzolanically with portlandite to generate more C-S-H gel or by functioning as nucleation sites. Due to an increased rate of C-S-H gel formation, concrete enhanced with nanoparticles exhibited greater durability against heat damage, external attack by acids and sulphates, chloride diffusion, and surface abrasion. The durability improvement following nanomaterial incorporation into concrete can be summarised as enhanced residual mechanical strength, reduced concrete mass loss, reduced diffusion coefficients for thermal and chloride, improved performance against sulphates and acid attack, and increased surface resistance to abrasion.
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