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Management of bleeding irregularities among etonogestrel implant users: Is combined oral contraceptives pills or nonsteroidal anti-inflammatory drugs the better option?

Upawi SN, Ahmad MF, Abu MA, Ahmad S

J Obstet Gynaecol Res, 2020 Mar;46(3):479-484.
PMID: 31958877 DOI: 10.1111/jog.14195

AIM: This study is to evaluate whether unacceptable bleeding among the etonogestrel implant user could be better alleviated using combined oral contraceptive pills (COCP) or nonsteroidal anti-inflammation drugs (NSAID).
METHODS: This is a prospective randomized study for evaluation of 84 etonogestrel implant (Implanon) users with prolonged or frequent bleeding. They were assigned to either receiving a COCP containing 20 mcg ethinyl estradiol/150 mg desogestrel for two continuous cycle or NSAID; mefenamic acid 500 mg TDS for 5 days, 21 days apart for two cycles. Bleeding pattern during the treatment was recorded and analyzed.
RESULTS: A total of 32 women (76.2%) in COCP group and 15 women (35.7%) in NSAID group stop bleeding within 7 days after the initiation of treatment which was statistically significant (P
Fulltext Effect of physical activity intervention on physical activity, body mass index, blood pressure, blood lipid and fasting blood sugar among overweight and obese military personnel

Ahmad Fuad AF, Ismail S, Abdul Rahman H

Malaysian Journal of Medicine and Health Sciences, 2019;15(203):8-14.
MyJurnal

Introduction: About 18% of Malaysian Armed Forces (MAF) personnel are diagnosed with either hypertension, diabetes or coronary artery disease, while another 8% are obese. The rising prevalence necessitates intervention.
Methods: This is a single blinded randomized controlled trial among overweight and obese MAF personnel attending medical checkup in MAF hospital in Kuala Lumpur. An intervention module was developed to increase their physical activity level. Short version of International Physical Activity Questionnaire was used to assess physical activity in metabolic equivalent of task score (METs score), while blood pressure, body mass index (BMI), blood lipid profile and fasting blood sugar measurements were also obtained. These parameters were measured at baseline and again at 6 months. Generalized estimating equations (GEE) statistical test were applied to evaluate the effect of the intervention.
Results: Response rate was 100%. Most of participants were aged above 40 years, male, from Malay ethnic group, completed secondary education and had monthly income above RM 4000. Most of the respondents were obese and had moderate level of physical activity at baseline. All variables compared between groups at baseline showed no significant difference. At six months, after controlling for covariates, the significant difference was only in METs score. The odds of having high METs score in the intervention group after receiving intervention was nearly 3 times higher than those in the control group, after adjusting for interaction between time and group as well as other covari- ates (AOR = 2.908, 95% CI 1.323 – 6.391, P=0.008).
Conclusion: Intervention was effective in increasing physical activity among overweight and obese military personnel.
Study site: Malaysian Armed Forces Hospital, Kuala Lumpur, Malaysia
Fulltext Entropy in Education System: Transformation of an Individual Through Meaningful Interactions in a Community of Inquiry

Ahmad MI, Khan IA, Ahmad M, Husain A, Jamaludin R

Syst Pract Action Res, 2021 Nov 20.
PMID: 34840496 DOI: 10.1007/s11213-021-09585-6

Every individual is unique and may serve a unique purpose in this life. Education is widely accepted to be the means of transformation of individuals so that they may achieve their unique success or create their own lives. However, not every individual seems to be realizing their true potential. This paper explores the concept of entropy in education system as a force that is usually imagined to oppose realization of potential of an individual during life in this phenomenal world. Alternatively, the same may provide an impetus that is necessary to bring in organization in oneself to realize the hidden potential. A one group Pretest-Posttest quasi-experimental design was used to draw the conclusions on data obtained from participants of workshops in three different modes, viz. face-to-face Pre COVID-19, face-to-face in COVID-19 with SOPs, and online in COVID-19. Realization of an individual's potential was represented as a dependent variable, i.e. transformation in cognition, skills, and attitude while the independent variables taken into account were the meaningful interactions of an individual with peers and advanced learners in a designed environment. It was inferred from the results that transformation in learners' cognition (6-30 %), skills (0-20 %), and attitude (5-32 %) occurred through human discourse, in a community of inquiry.
Fulltext Conversion of Waste Polyethylene Terephthalate (PET) Polymer into Activated Carbon and Its Feasibility to Produce Green Fuel

Ahangar FA, Rashid U, Ahmad J, Tsubota T, Alsalme A

Polymers (Basel), 2021 Nov 16;13(22).
PMID: 34833251 DOI: 10.3390/polym13223952

In this study, a novel idea was proposed to convert the polyethylene terephthalate (PET) waste drinking-water bottles into activated carbon (AC) to use for waste cooking oil (WCO) and palm fatty acid distillate (PFAD) feasibility to convert into esters. The acidic and basic char were prepared by using the waste PET bottles. The physiochemical properties were determined by employing various analytical techniques, such as field emission scanning electron microscopy (FESEM), thermogravimetric analysis (TGA), Fourier transform infrared (FTIR), Brunauer-Emmett-Teller (BET) and temperature-programmed desorption - ammonia/carbon dioxide (TPD-NH3/CO2). The prepared PET H3PO4 and PET KOH showed the higher surface area, thus illustrating that the surface of both materials has enough space for impregnation of foreign precursors. The TPD-NH3 and TPD-CO2 results depicted that PET H3PO4 is found to have higher acidity, i.e., 18.17 mmolg-1, due to the attachment of phosponyl groups to it during pretreatment, whereas, in the case of PET KOH, the basicity increases to 13.49 mmolg-1. The conversion results show that prepared materials can be used as a support for an acidic and basic catalyst for the conversion of WCO and PFAD into green fuel.
Fulltext Mirror Therapy Rehabilitation in Stroke: A Scoping Review of Upper Limb Recovery and Brain Activities

Jaafar N, Che Daud AZ, Ahmad Roslan NF, Mansor W

Rehabil Res Pract, 2021;2021:9487319.
PMID: 35003808 DOI: 10.1155/2021/9487319

Background: Mirror therapy (MT) has been used as a treatment for various neurological disorders. Recent application of electroencephalogram (EEG) to the MT study allows researchers to gain insight into the changes in brain activity during the therapy.
Objective: This scoping review is aimed at mapping existing evidence and identifying knowledge gaps about the effects of MT on upper limb recovery and its application for individuals with chronic stroke.
Methods and Materials: A scoping review through a systematic literature search was conducted using PubMed, CINAHL, PsycINFO, and Scopus databases. Twenty articles published between 2010 and 2020 met the inclusion criteria. The efficacy of MT on upper limb recovery and brain activity during MT were discussed according to the International Classification of Functioning, Disability and Health (ICF).
Results: A majority of the studies indicated positive effects of MT on upper limb recovery from the body structure/functional domain. All studies used EEG to indicate brain activation during MT.
Conclusion: MT is a promising intervention for improving upper limb function for individuals with chronic stroke. This review also highlights the need to incorporate EEG into the MT study to capture brain activity and understand the mechanism underlying the therapy.
Amniotomy and early oxytocin infusion vs amniotomy and delayed oxytocin infusion for labour augmentation amongst nulliparous women at term: A randomised controlled trial

Upawi SN, Ahmad MF, Abu MA, Ahmad S

Midwifery, 2022 Feb;105:103238.
PMID: 34968819 DOI: 10.1016/j.midw.2021.103238

OBJECTIVE: to compare the effect of amniotomy with early vs delayed oxytocin infusion on successful vaginal delivery.
DESIGN: randomised controlled trial of nulliparous women with spontaneous labour at term.
SETTING: labour suite of a university teaching hospital in Kuala Lumpur, Malaysia.
PARTICIPANTS: 240 women were included (120 randomised into two arms).
INTERVENTIONS: the randomisation sequence was generated using a computer randomisation program in two blocks: oxytocin infused early following amniotomy; and oxytocin infused 2 h after amniotomy.
MEASUREMENTS AND FINDINGS: labour duration, mode of delivery, oxytocin dosage used, uterine hyperstimulation, postpartum haemorrhage, Apgar score and admission to the neonatal intensive care unit were recorded. No differences in vaginal delivery rate (62.9% vs 70.9%; p = 0.248) and second-stage labour were found between the early and delayed oxytocin infusion groups (21.2 ± 18.3 min vs 25.5 ± 19.9 min; p = 0.220). The mean interval from amniotomy to vaginal delivery was significantly shorter for the early group (5.8 ± 1.7 h vs 7.0 ± 1.9 h; p = 0.001), and more women in the early group delivered during/before the planned review at 4 h after amniotomy (53.6% vs 10.6%; p<0.001). Maximum oxytocin usage was lower in the early group (5.6 ± 4.4 mL/hour vs 6.8 ± 5.3 mL/hour; p = 0.104).
KEY CONCLUSIONS: early oxytocin augmentation following amniotomy could be employed in low-risk primigravida, given that it is associated with a shorter labour duration without jeopardising maternal or neonatal outcomes.
IMPLICATIONS FOR PRACTICE: low-risk primigravida benefit from early oxytocin infusion following amniotomy, and this can be offered as an additional practice in labour room care.
Fulltext Corrigendum to "A new innovative breakthrough in the production of salt from bittern using a spray dryer" [Heliyon 8 (10) (2022) e11060]

Ansar, Ahmad Yahaya AN, Kamil AA, Sabani R, Murad, Aisyah S

Heliyon, 2022 Dec;8(12):e12455.
PMID: 36619405 DOI: 10.1016/j.heliyon.2022.e12455

[This corrects the article DOI: 10.1016/j.heliyon.2022.e11060.].
Fulltext Microstructural Characterization of Fibric Peat Stabilized with Portland Cement and Silica Fume

Ahmad A, Sutanto MH, Ahmad NR, Mohamad ME, Bujang M

Materials (Basel), 2022 Dec 20;16(1).
PMID: 36614356 DOI: 10.3390/ma16010018

Peat is a renowned problematic soil and needs stabilization to enhance its engineering properties. Silica fume (SF) and Ordinary Portland Cement (OPC) were extensively adopted to increase the mechanical properties of peat; however, their microstructural analysis is lacking. Investigated herein is the microstructural evolution caused by the OPC and SF implementation in peat soil stabilization. Initially, the compositional analysis (elements and oxides) of peat and binders was carried out via energy-dispersive X-ray (EDX) and X-ray fluorescence (XRF). Subsequently, the microstructural changes that occurred in the stabilized peat were examined through a series of microstructural analyses. The analysis includes scanning electron microscope (SEM), X-ray diffraction (XRD), Fourier-Transform Infrared Spectroscopy (FTIR), and thermogravimetric analysis (TGA) for morphological, mineralogical, functional group analysis, and bond thermal analysis, respectively. The SEM micrographs evidence the transformation of loosely packed with large micropores of untreated peat into a compact dense peat matrix. This transformation is due to the formation of newly developed minerals, i.e., calcium hydrates (CH), calcium silicate hydrates (C-S-H), calcium aluminate hydrate (CAH), ettringite (Aft) caused by the pozzolanic reaction of binders as recorded by the XRD. Similarly, different molecular functional groups were found in the FTIR analysis with the incorporation of SF and OPC. Finally, the percentage of mass loss was assessed through TGA analysis revealing the decomposition of stabilized in the second and third stages.
Roles of social media and counselling support in reducing anxiety among Malaysian during Covid-19 pandemic

Ahmad NS, Hussain Z, Abd Hamid HS, Khairani AZ

Int J Disaster Risk Reduct, 2021 Sep;63:102456.
PMID: 36567870 DOI: 10.1016/j.ijdrr.2021.102456

Covid-19 pandemic has created crises among some Malaysians. The crises have both opportunity and threat impacts. Without proper intervention, some people will develop stress, anxiety, and depression. This study aims to explore the emotional anxiety that exists in the society due to Covid-19 pandemic and the roles of social media and counselling support in reducing anxiety among Malaysians. This quantitative research involved online survey throughout the country. The online survey is administered during the First Phase and the Second Phase of Movement Control Order (MCO). The survey contains 13 items which cover three domain: i) anxiety, ii) roles of social media, and iii) roles of counselling support in reducing anxiety among members of the society. There were 8375 respondents from various age groups, locations, as well as economic and educational statuses involved in the study. Data were analysed using descriptive and inferential analysis. Majority of 7233 (86.6%) respondents felt anxious due to Covid-19 pandemic. A total of 7871 respondents (94%) followed the latest updates on Covid-19 to reduce their anxiety. They used social media such as Facebook, Instagram and Twitter to gather information and follow the updates through television and press conference. A total of 5251 respondents (62.7%) were aware of the counselling support provided during the MCO, and 4603 respondents (55%) felt comfortable to have counselling support by phone. The findings will contribute to knowledge on the society's emotional anxiety in facing Covid-19. It reflects the actual situation happened in Malaysia during Covid-19 and MCO.
Fulltext A secure and dependable trust assessment (SDTS) scheme for industrial communication networks

Khan T, Singh K, Ahmad K, Ahmad KAB

Sci Rep, 2023 Feb 02;13(1):1910.
PMID: 36732583 DOI: 10.1038/s41598-023-28721-x

Due to tamper-resistant sensor nodes and wireless media, Industrial Wireless Sensor Networks (WSNs) are susceptible to various security threats that severely affect industrial/business applications. The survival of sensor networks is highly dependent on the flourishing collaboration of sensor nodes. Trust management schemes seem to be realistic and promising techniques to improve security as well as cooperation (dependability) among sensor nodes by estimating the trust level (score) of individual sensor nodes. This research paper presents a well-organized and motivating secure, dependable trust assessment (SDTS) scheme for industrial WSNs to cope with unexpected behavior such as an on-off attack, bad-mouthing attack, garnished attack, etc., by employing robust trust evaluation components based on success ratio and node misbehaviour. SDTS incorporates an interesting trust evaluation function in which the trust range can be adjusted in accordance with the application requirement. SDTS include direct communication trust, indirect communication trust, data trust, and misbehavior-based trust to defend the multiple internal attacks. SDTS works according to the behavior of nodes, i.e., whether the sensor nodes are interacting frequently or not. Moreover, abnormal attenuation and dynamic slide lengths are incorporated in the proposed model (SDTS) to deal with various natural calamities and internal attacks. SDTS is compared against three recent state-of-the-art methods and found efficient in terms of ease of trust assessment, false-positive rate (2.5%), false-negative rate (2%), attack detection rate (90%), detection accuracy (91%), average energy consumption (0.40 J), and throughput (108 Kbps) under the load of 500 sensor nodes with 50% malicious nodes. Investigational results exhibit the potency of the proposed scheme.
Air pollution, governance quality, and health outcomes: evidence from developing countries

Ahmad NA, Ismail NW, Sidique SFA, Mazlan NS

Environ Sci Pollut Res Int, 2023 Mar;30(14):41060-41072.
PMID: 36630041 DOI: 10.1007/s11356-023-25183-6

While studies have demonstrated that air pollution can be catastrophic to the population's health, few empirical studies are found in the economic literature because a considerable proportion of the evidence comes from epidemiological studies. Because of the crucial role of governance in the health community, good governance has been a contentious issue in public sector management in recent years. Therefore, the aim of this study is to examine the effects of air pollution and the role of governance on health outcomes. This study employed the generalized method of moment (GMM) estimation techniques to analyse panel data for 72 developing countries from 2010 to 2017. The empirical results confirm that higher PM2.5 and CO2 levels have a detrimental influence on life expectancy and healthy life expectancy, whereas the role of governance has a positive impact on life expectancy and healthy life expectancy. Furthermore, the findings show governance quality plays a role in moderating the negative effect of PM2.5 on health outcomes. The ongoing rise in air pollution has had a significant impact on the health of developing countries. It appears that governance quality has improved health outcomes. The findings have important policy implications, such that strengthening governance can reduce air pollution emissions in developing countries. However, to reduce the health effects of air pollution, developing countries must implement effective environmental development policies and track the implementation and enforcement of such policies.
The Association Between Economic Status and Religious Identity With Oral Health Disparities and Inequalities Around the World

Chaudhary FA, Ahmad B, Arjumand B, Alharkan HM

Cureus, 2024 Jan;16(1):e51917.
PMID: 38333499 DOI: 10.7759/cureus.51917

INTRODUCTION: The inequalities in oral health remain one of the current issues in the global public health agenda. The number of studies investigating health disparity by religious identity is limited and there is currently no such report relating to oral health. Similarly, there is compelling evidence for oral health disparities between socioeconomic statuses, education levels, and ethnic groups. This ecological study aimed to explore the disparity in oral health-related outcomes between Muslim and non-Muslim countries and country income status.
METHODS: Publicly available data related to oral health measures, country income status, and membership in the Organization of Islamic countries were used. Five oral health-related measures were examined: caries experience (decayed, missing, and filled teeth (DMFT)), percentage of the population with no periodontal disease, and disability-adjusted life years (DALY) attributed to oral conditions, and mouth and oropharynx cancer. One-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare the oral health parameters by country income status and simple linear regression was used to compare the parameters between the non-member countries (n-MC) and member countries (MC). For the significant parameters, adjusted coefficients were obtained using multiple linear regression.
RESULTS: From 170 countries included, 53 (31%) were MC and 117 (69%) were n-MC. Analysis showed that the mean DMFT in adults aged 35-44 years was significantly higher in the n-MC compared to MC after adjusting for country income status (p<0.05) but the latter was the stronger explanatory predictor of the outcome. The strength of the effect of country membership classification (standardized coefficient β: DMFT35-44-year-old = -0.16) was smaller than country income status (β = -0.60) in the multiple regression.
CONCLUSION: There is significant but weak evidence from the available data to support the claim that economic status and religion contribute to oral health disparity.
Current Trends of Analytical Techniques for Total Alkalinity Measurement in Water Samples: A Review

Ahmad M, Ahmad A, Omar TFT, Mohammad R

Crit Rev Anal Chem, 2024;54(8):2734-2744.
PMID: 37052389 DOI: 10.1080/10408347.2023.2199432

Increasing acidity of seawater caused by increasing anthropogenic carbon dioxide absorbed into the seawater attracted the interest of researchers due to increased concern on the deterioration of marine systems and food supply to humans. Total alkalinity (TA) is one of the important parameters in determining carbonate chemistry and is described as the capacity of the sample to neutralize acids. Over the last two decades, many analytical techniques have been developed to determine TA. This article presents a review of different analytical techniques including titration, colorimetric, spectrophotometric, and potentiometric analyses in measuring TA. Among these analytical techniques, potentiometry analysis, which utilizes electrode systems such as glass electrode and ion-selective electrode used as indicator electrodes, is the most used technique. Important features such as principle, limitations, and challenges of the involved technique are discussed in detail.
Fulltext Biopsychosocial factors of depression among community-dwelling geriatric population with low perceived social support; a population-based study

Balqis-Ali NZ, Ahmad N, Minhat HS, Fattah Azman AZ

BMC Geriatr, 2024 Aug 14;24(1):685.
PMID: 39143517 DOI: 10.1186/s12877-024-05211-x

BACKGROUND: Although significant and disabling consequences are presented due to geriatric population-related depression, an insufficient comprehension of various biological, psychological, and social factors affecting this issue has been observed. Notably, these factors can contribute to geriatric population-related depression with low social support. This study aimed to identify factors associated with depression among the community-dwelling geriatric population with low social support in Malaysia.
METHODS: This study used secondary data from a population-based health survey in Malaysia, namely the National Health Morbidity Survey (NHMS) 2018: Elderly Health. The analysis included 926 community-dwelling geriatric population aged 60 and above with low social support. The primary data collection was from August to October 2018, using face-to-face interviews. This paper reported the analysis of depression as the dependent variable, while various biological, psychological and social factors, guided by established biopsychosocial models, were the independent variables. Multiple logistic regression was applied to identify the factors. Analysis was performed using the complex sampling module in the IBM SPSS version 29.
RESULTS: The weighted prevalence of depression among the community-dwelling geriatric population aged 60 and above with low social support was 22.5% (95% CI: 17.3-28.7). This was significantly higher than depression among the general geriatric Malaysian population. The factors associated with depression were being single, as compared to those married (aOR 2.010, 95% CI: 1.063-3.803, p: 0.031), having dementia, as opposed to the absence of the disease (aOR 3.717, 95% CI: 1.544-8.888, p: 0.003), and having a visual disability, as compared to regular visions (aOR 3.462, 95% CI: 1.504-7.972, p: 0.004). The analysis also revealed that a one-unit increase in control in life and self-realisation scores were associated with a 32.6% (aOR: 0.674, 95% CI: 0.599-0.759, p
Fulltext Probiotic potentials of Lactobacillus plantarum isolated from fermented durian (Tempoyak), a Malaysian traditional condiment

Ahmad A, Yap WB, Kofli NT, Ghazali AR

Food Sci Nutr, 2018 Sep;6(6):1370-1377.
PMID: 30258578 DOI: 10.1002/fsn3.672

Lactic acid bacterium isolated from fermented durian (tempoyak) was investigated for its potentials as a probiotic strain. Bacterial tolerance toward gastrointestinal environment, adhesion, and cytotoxic activity in human colon adenocarcinoma cell line HT-29 was evaluated. 16S rRNA sequencing identified the lactic acid bacterium as Lactobacillus plantarum. The bacterium demonstrated good tolerance toward gastrointestinal pH 2.0 and 0.3% bile salts. It showed strong adhesive capacity in human intestinal cell line, HT-29, with an adhesion index of 159 ± 10. Cytotoxicity of L. plantarum was investigated using both live bacterial cells (BC) and cell-free supernatant (CFS). Findings showed that both BC and CFS of L. plantarum reduced proliferation of HT-29 colon adenocarcinoma cells using MTT assay. The results imply potential probiotic properties of L. plantarum isolated from tempoyak.
Fulltext Antibacterial potential of silver nanoparticles (SP-AgNPs) synthesized from Syzygium polyanthum (Wight) Walp. against selected foodborne pathogens

Khan S, Rukayadi Y, Jaafar AH, Ahmad NH

Heliyon, 2023 Dec;9(12):e22771.
PMID: 38125456 DOI: 10.1016/j.heliyon.2023.e22771

Foodborne diseases continue to pose a significant global health concern, causing a considerable number of deaths worldwide. In response to concerns surrounding bacterial resistance and the limitations of traditional antibiotics, there is a growing interest in exploring natural antibacterial agents as potential alternatives for addressing foodborne pathogens. Nowadays efforts are being made on exploring the potential of natural antibacterial agents against foodborne pathogens. In this study, the antibacterial efficacy of silver nanoparticles synthesized using S. polyanthum leaves extract (SP-AgNPs) against selected Gram-negative and Gram-positive foodborne pathogens was investigated by using multiple assays, including the well diffusion assay (WDA), minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill assay. The well diffusion assay demonstrated the inhibitory potential of SP-AgNPs against all tested foodborne pathogens, with inhibition zones ranging from 10.16 + 1.25 to 13.16 + 1.52 mm. Furthermore, the MIC values ranged from 0.008 to 0.125 mg/mL, indicating the potent antibacterial activity of SP-AgNPs across a broad spectrum of foodborne pathogens. The MBC values, ranging from 0.008 to 0.250 mg/mL, further confirming the bactericidal ability of SP-AgNPs against these pathogens. In the time-kill experiment, most foodborne pathogens were entirely killed after 4 h of incubation at 4 × MIC concentration. However, only E. coli, K. pneumoniae, and S. Typhimurium showed a reduction in population to 3 Log10 CFU/mL, indicating a strong bactericidal effect of SP-AgNPs on most tested pathogens. In conclusion, this study provides compelling evidence that SP-AgNPs exhibit potent antibacterial activity against selected foodborne pathogens. The findings suggest that SP-AgNPs synthesized using S. polyanthum leaves extract hold great promise as a novel antibacterial agent for effectively controlling foodborne pathogens. These findings contribute to continuing efforts in developing alternative strategies to prevent foodborne diseases and enhance food safety.
Green finance and environmental sustainability: a systematic review and future research avenues

Khan HHA, Ahmad N, Yusof NM, Chowdhury MAM

Environ Sci Pollut Res Int, 2024 Feb;31(6):9784-9794.
PMID: 38194178 DOI: 10.1007/s11356-023-31809-6

This study critically examines the dynamic interplay between green finance and environmental sustainability using a systematic review and bibliometric analysis. The analysis is centered on 507 scholarly articles published between 2013 and 2023 in the Scopus database and leverages Microsoft Excel, Harzing Publish or Perish, and VOSviewer to identify publication trends, key contributors, research impact, and emergent themes in this rapidly evolving field. The findings reveal that research on green finance and environmental sustainability has increased exponentially over the past decade, with China and institutions in Asia emerging as prominent contributors compared to other regions. This study also identified the Environmental Science and Pollution Research journal as the most active source title, demonstrating its commitment to publishing current findings on the topic. Through keyword analysis, several research avenues have been proposed to guide future research on enhancing the strategic role of green finance in promoting environmental sustainability. These avenues include broadening the geographical scope of research, exploring the synergies between green finance and emerging fintech innovations, developing robust metrics to quantify the socioeconomic impacts of green finance, establishing a risk and resilience framework to protect green finance against uncertainties, and creating a Green Finance Performance Index to evaluate the dual returns of environmental and financial performance.
Fulltext Meek Micrografting Technique for Reconstruction of Extensive Necrotizing Fasciitis of the Anterior Abdomen and Bilateral Femoral Region: A Case Report

Ng JC, Ahmad Zaidi AI, Lee J, Jabar MF

Arch Plast Surg, 2023 Nov;50(6):610-614.
PMID: 38143843 DOI: 10.1055/a-2077-5745

Necrotizing fasciitis is an uncommon yet fatal soft tissue infection. Current recommended treatment includes antibiotics with repeat surgical exploration and wound debridement followed by reconstruction. In burn patients, the Meek micrograft has demonstrated a higher true expansion ratio, faster reepithelialization rate, more resilient toward infection, and reduced risk of graft failure as compared with meshed graft. To our best knowledge, the use of Meek micrografting technique in reconstruction of postdebridement wounds of necrotizing fasciitis has not been reported. Hereby, we present a case of a 57-year-old gentleman who was referred to us for wound reconstruction after surgical debridement of Fournier's gangrene and extensive necrotizing fasciitis involving the anterior abdomen and bilateral femoral region. Meek micrografting technique was used to reconstruct the anterior abdomen as the wound bed was large. Although the graft was complicated with a small area of localized infection, it did not spread across the entire graft and was successfully treated with topical antibiotics and regular wound dressing. In our case, wound reconstruction using Meek micrografting technique in a patient with extensive necrotizing fasciitis was successful and showed positive outcome. Therefore, we suggest further studies to be conducted to investigate the applications and outcomes of the Meek micrografting technique, especially in patients with extensive wound bed and limited donor site availability.
Fulltext Bilateral vocal cord palsy as the sole presentation of acquired syphilis

Asha'ari ZA, Razali MS, Ahmad RA

Malays J Med Sci, 2010 Apr;17(2):56-60.
PMID: 22135539

Bilateral vocal cord palsy is almost always caused by neck surgery, particularly surgery of the thyroid. We report a case of bilateral vocal cord palsy requiring emergency surgery to relieve the airway obstruction as the sole presentation of acquired syphilis. As the incidence of syphilis worldwide is rising, this unusual presentation may give clinicians a different perspective on the disease.
Fulltext Profound swim stress-induced analgesia with ketamine

Ahmad AH, Ismail Z, Than M, Ahmad A

Malays J Med Sci, 2008 Jan;15(1):13-22.
PMID: 22589610 MyJurnal

The potential of ketamine, an N-methyl D-aspartate (NMDA) receptor antagonist, in preventing central sensitization has led to numerous studies. Ketamine is increasingly used in the clinical setting to provide analgesia and prevent the development of central sensitization at subanaesthetic doses. However, few studies have looked into the potential of ketamine in combination with stress-induced analgesia. This study looks at the effects of swim stress, which is mediated by opioid receptor, on ketamine analgesia using formalin test. Morphine is used as the standard analgesic for comparison. Adult male Sprague-Dawley rats were assigned to 6 groups: 3 groups (stressed groups) were given saline 1ml/kg intraperitoneally (ip), morphine 10mg/kg ip or ketamine 5mg/kg ip and subjected to swim stress; 3 more groups (non-stressed groups) were given the same drugs without swim stress. Formalin test, which involved formalin injection as the pain stimulus and the pain score recorded over time, was performed on all rats ten minutes after cessation of swimming or 30 minutes after injection of drugs. Combination of swim stress and ketamine resulted in complete analgesia in the formalin test which was significantly different from ketamine alone (p<0.05) and saline with stress (p<0.01). There is no significant difference between ketamine stressed and morphine stressed. These results indicate that ketamine and swim stress act synergistically to produce profound analgesia in the formalin test. This suggests that in the clinical setting, under stressful situations such as operative stress, ketamine is capable of producing profound analgesia at a subanaesthetic dose.

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