Displaying publications 81 - 100 of 238 in total

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  1. Kamis AB, Ahmad RA, Badrul-Munir MZ
    Parasitol Res, 1994;80(1):74-7.
    PMID: 8153130
    Gonadectomized male laboratory rats were given 0.06 mg/kg estradiol benzoate daily for 14 days before being inoculated with 50 third-stage larvae of Parastrongylus malaysiensis. Hormone treatment was continued until the rats were killed. The numbers of larvae in the brain and of adult worms in the pulmonary area of the rats were determined every 7 days after the inoculation. It was found that the rats treated daily with estradiol benzoate had significantly and consistently higher numbers of larvae and adult worms as compared with the controls. The number of total leukocytes increased significantly after the rats were infected. The results show that estradiol-treated rats become susceptible to P. malaysiensis infection, which may indicate that the immunosuppressive effects of testosterone observed in earlier studies may partly be caused by estradiol that was peripherally aromatized from testosterone.
  2. Sriwahyuni E, Sriwahyuni E, Fuad A, Ahmad RA, Ahmad RA, Rustamaji R, et al.
    Med J Malaysia, 2020 05;75(Suppl 1):41-47.
    PMID: 32483106
    INTRODUCTION: Rubella infection during early pregnancy may cause fatal consequences such as congenital rubella syndrome (CRS). The incidence rate (IR) of CRS confirmed cases in Yogyakarta, Indonesia between July 2008 and June 2013 was high at 0.05 per 1,000 live births. This study aimed to discover the spatiotemporal pattern of rubella and CRS and also identify whether the proximity of rubella cases was associated with the occurrence of CRS cases.

    METHODS: This observational research used a spatiotemporal approach. We obtained CRS and rubella surveillance data from Dr. Sardjito Hospital, Provincial, and District Health Offices in Yogyakarta, Indonesia during January-April 2019. The home addresses of rubella and CRS cases were geocoded using the Global Positioning System. Average of the nearest neighbour and space-time permutation analyses were conducted to discover the spatiotemporal patterns and clusters of rubella and CRS cases.

    RESULTS: The peak of rubella cases occurred in 2017 (IR: 22.3 per 100,000 population). Twelve confirmed cases of CRS were found in the 2016-2018 period (IR: 0.05 per 1,000 live births). The occurrence of CRS in Yogyakarta was detected 6-8 months after the increase and peak of rubella cases. The spatiotemporal analysis showed that rubella cases were mostly clustered, while CRS cases were distributed in a dispersed pattern. Rubella cases were found within a buffer zone of 2.5 km from any CRS case.

    CONCLUSIONS: Rubella cases were spatiotemporally associated with the occurrence of CRS in Yogyakarta. We recommend strengthening the surveillance system of CRS and rubella cases in order to contain any further spreading of the disease.

  3. Chelladurai G, Noor Azhar AM, Mohd Isa R, Bustam A, Ahmad R, Munisamy M
    Med J Malaysia, 2020 09;75(5):514-518.
    PMID: 32918419
    INTRODUCTION: Cardiopulmonary Resuscitation (CPR) remains the primary mechanism of resuscitation for cardiac arrest victims. However, the quality of delivery of CPR varies widely in different settings, possibly affecting patient outcomes. This study is aimed to determine the efficacy of an audio-visual (AV) CPR feedback device in improving the quality of CPR delivered by healthcare providers.

    METHODS: This pre-post, single-arm, quasi-experimental study randomly sampled 140 healthcare providers working in the Emergency Department of Hospital Ampang, Malaysia. Parameters of CPR quality, namely chest compression rate and depth were compared among participants when they performed CPR with and without an AV CPR feedback device. The efficacy of the AV CPR feedback device was assessed using the Chi-square test and Generalised Estimating Equations (GEE) models.

    RESULTS: The use of an AV CPR feedback device increased the proportion of healthcare providers achieving recommended depth of chest compressions from 38.6% (95% Confidence Interval, 95%CI: 30.5, 47.2) to 85.0% (95%CI: 78.0, 90.5). A similar significant improvement from 39.3% (95%CI: 31.1, 47.9) to 86.4% (95%CI: 79.6, 91.6) in the recommended rate of chest compressions was also observed. Use of the AV CPR device significantly increased the likelihood of a CPR provider achieving recommended depth of chest compressions (Odds Ratio, OR=13.01; 95%CI: 7.12, 24.01) and rate of chest compressions (OR=13.00; 95%CI: 7.21, 23.44).

    CONCLUSION: The use of an AV CPR feedback device significantly improved the delivered rate and depth of chest compressions closer to American Heart Association (AHA) recommendations. Usage of such devices within real-life settings may help in improving the quality of CPR for patients receiving CPR.

  4. Ahmad R, Salina M, Mamat MH, Teh AA, Kara M, Rusop M, et al.
    J Nanosci Nanotechnol, 2012 Oct;12(10):8153-7.
    PMID: 23421193
    This paper addresses the growth of nano-structured MgZnO thin films by sol-gel spin coating method which will be used as a template layer to grow carbon nanotubes. The nano-structured MgZnO films were deposited on platinized (100) silicon substrates. In this work, we focused on the effect of aging and Mg content on the film structure and resistivity. Sols with Mg content of 10, 30 and 50 at.% were subjected to aging times of between 3 to 240 hours. Results from scanning (SEM) and field emission scanning electron (FESEM) microscopes and surface profiler (SP) showed that the sol aging increased the thickness, grain size and surface roughness for aging up to 240 hours. The energy dispersive analysis by X-ray (EDAX) confirmed the element of Mg in the ZnO films. The electrical resistivity also increased with aging time as confirmed by four point probe method. The results suggest that appropriate aging of the sol is important for improving physical quality and electrical performance of MgZnO thin films derived from sol-gel technique.
  5. Abu Zarin M, Tan JS, Murugan P, Ahmad R
    BMC Complement Med Ther, 2020 Oct 19;20(1):317.
    PMID: 33076892 DOI: 10.1186/s12906-020-03113-0
    BACKGROUND: The banana or scientifically referred to as Musa sp., is one of the most popular fruits all over the world. Almost all parts of a banana tree, including the fruits, stem juice, and flowers are commonly used as traditional medicine for treating diarrhoea (unripe), menorrhagia, diabetes, dysentery, and antiulcerogenic, hypoglycemic, antilithic, hypolipidemic conditions, plus antioxidant actions, inflammation, pains and even snakebites. The study carried out was to evaluate in vitro anti-urolithiatic activity from different types of Musa pseudo-stems.

    METHODS: Observing anti-urolithiathic activity via in vitro nucleation and aggregation assay using a spectrophotometer followed by microscopic observation. A total of 12 methanolic extracts were tested to determine the potential extracts in anti-urolithiasis activities. Cystone was used as a positive control.

    RESULTS: The results manifested an inhibition of nucleation activity (0.11 ± 2.32% to 55.39 ± 1.01%) and an aggregation activity (4.34 ± 0.68% to 58.78 ± 1.81%) at 360 min of incubation time. The highest inhibition percentage in nucleation assay was obtained by the Musa acuminate x balbiciana Colla cv "Awak Legor" methanolic pseudo-stem extract (2D) which was 55.39 ± 1.01%at 60 min of incubation time compared to the cystone at 30.87 ± 0.74%. On the other hand,the Musa acuminate x balbiciana Colla cv "Awak Legor" methanolic bagasse extract (3D) had the highest inhibition percentage in the aggregation assay incubated at 360 min which was obtained at 58.78 ± 1.8%; 5.53% higher than the cystone (53.25%).The microscopic image showed a great reduction in the calcium oxalate (CaOx) crystals formation and the size of crystals in 2D and 3D extracts, respectively, as compared to negative control.

    CONCLUSIONS: The results obtained from this study suggest that the extracts are potential sources of alternative medicine for kidney stones disease.

  6. Daud MNH, Fatanah DN, Abdullah N, Ahmad R
    Food Chem, 2017 Oct 01;232:621-632.
    PMID: 28490120 DOI: 10.1016/j.foodchem.2017.04.018
    Artocarpus heterophyllus J33 (AhJ33) fruit is a popular and valuable jackfruit variety in Malaysia. For export, the pulp has to be separated from the skin which is usually discarded. Hence, the conversion of the fruit waste to food products with economic value needs to be explored utilizing the waste to wealth concept. This paper reports the evaluation of antioxidant potential of AhJ33 fruit waste (rind and rachis) extracts from three different extraction methods (maceration, percolation and Soxhlet). The antioxidant potential was assessed by DPPH radical scavenging, FRAP and β-carotene bleaching assays. The total phenolic and total flavonoid contents were estimated by TPC and the TFC assays. For both rind and rachis, the maceration technique yielded extracts with the strongest antioxidant activities which correlated with the highest TPC and TFC values. TOF LCMS analyses identified two phenolic acids as the major constituents responsible for the antioxidant activity of the active extracts.
  7. Daud MNH, Wibowo A, Abdullah N, Ahmad R
    Food Chem, 2018 Nov 15;266:200-214.
    PMID: 30381177 DOI: 10.1016/j.foodchem.2018.05.120
    We have previously reported on the antioxidant potential of Artocarpus heterophyllus J33 (AhJ33) variety fruit waste from different extraction methods. In the study, the rind maceration extract (RDM) exhibited the highest phenolic and polyphenolic contents and strongest antioxidant potential measured by the DPPH assay (R2 = 0.99). In this paper, we now report on the bioassay-guided fractionation of the active ethyl acetate (EtOAC) fraction of RDM and its TOF-LCMS analysis. Seven sub-fractions resulting from the chromatographic separation of the EtOAC fraction showed radical scavenging activities between 80 and 94% inhibition. Subsequent LCMS analysis led to the identification of fifteen compounds comprising 5 phenolics and 10 non-phenolic compounds, 11 of which are reported for the first time from AhJ33 variety. Most of the identified compounds have been reported to possess antioxidant activity in many previous studies. This indicates that AhJ33 is a promising source of antioxidants for the development of food and nutraceutical products.
  8. Ahmad R, Rahman NA, Hasan R, Yaacob NS, Ali SH
    Spec Care Dentist, 2020 Jan;40(1):62-70.
    PMID: 31774579 DOI: 10.1111/scd.12436
    AIMS: To investigate the oral health and nutritional status of children with cerebral palsy (CP).

    METHODS AND RESULTS: Oral health assessment included dental caries and dental plaque maturity scores (DPMS) while the nutritional assessment included children's height-for-age Z-score (HAZ), body mass index-for-age Z-score (BAZ), mid-upper-arm circumference (MUAC), nutrient intake, cariogenic food frequency (CFF) and daily sugar exposure (DSE). Ninety-three CP children were recruited. The prevalence of caries was 81.7% (95% CI: 72.7%-88.3%). The median (IQR) of the DMFT and dft scores were 0.5(4.0) and 3.0(8.0), respectively. Most of the participants had acid-producing plaque (90.3%), severely stunted (81.4%), and 45% were severely thin with acute malnutrition. Intakes of calcium, iron, zinc, vitamin A, vitamin D and total fat were below 77% of the Recommended Nutrient Intakes for Malaysian children (RNI 2017). Nine types of cariogenic foods/drinks were consumed moderately, and DSE indicated that 45% of the children were at moderate risk of dental caries.

    CONCLUSION: Untreated dental caries, severe stunting and thinness were prevalent, and cariogenic foods/drinks were consumed moderately suggesting a moderate risk of caries. Therefore, controlling cariogenic food intake is crucial, but monitoring daily nutrient intake is needed for the optimum growth of children with CP.

  9. Islam R, Ahmad R, Ghailan K, Hoque KE
    J Relig Health, 2020 Jun;59(3):1327-1343.
    PMID: 31134517 DOI: 10.1007/s10943-019-00832-8
    People with HIV/AIDS (PLWHA) commonly pose problems to their family as well as to society because of their vulnerable health and economic conditions. Contrarily, PLWHA encounter social discrimination and adverse realities while finding it difficult to continue in their jobs. These complex phenomena interact to push them into a low economic status. A microfinance program can hopefully assist poor patients to cope with the negative economic consequences of this disease. But the conventional market-oriented microfinance institutions show reluctance to serve this group of people due to the possibilities of having credit risk. In this paper, we propose an alternative microfinancing technique that can provide a better economic life of the PLWHA while absorbing the credit risks. A comprehensive model is designed using specific Islamic financial instruments in conjugation with household economic portfolio theory. Critical realism method was adopted to construct this model. We concluded that the application of Islamic microfinance can enhance income of HIV patients while reducing the productivity-loss. This model can be useful to the microfinance practitioners and policymakers for addressing a different market segment, diversifying products, and formulating policy.
  10. Ishak R, Ahmad R, Gudum HR, Hassan K, Ang ES
    Malays J Reprod Health, 1992 Jun;10(1):7-11.
    PMID: 12345026
    PIP: Long term use of low doses of combination oral contraceptives appears to increase plasminogen level, thereby increasing fibrinolytic activity and reducing the risk of thromboembolism. Blood levels of plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI), were measured before and after stress (5 minutes of stair climbing) in a group of 30 women, 23-40 years old, who had taken 30 mcg of ethinyl estradiol with 150 mcg of desogestrel or levonorgestrel for at least 1 year. Similar measurements were taken from a control group of 30 women matched for age, height, and weight. Plasminogen and tPA levels in both groups increased significantly after exercise. The level of PAI did not change significantly with stress in either group. The level of plasminogen was significantly higher in the group taking contraceptives, whether before or after exercise, when compared to the control group. Levels of tPA and PAI, although slightly increased in the oral contraceptive group, were not significantly different between the two groups. The increase in plasminogen may be due to the estrogen component of the contraceptives. Stress seems to increase fibrinolytic response.
  11. Khan A, Hamdan AR, Ahmad R, Mustaffa MS, Mahalle S
    Community Ment Health J, 2016 Feb;52(2):245-50.
    PMID: 26499062
    This study examined whether productive coping styles and social support were significant mediators of the relationship between academic stress and suicidal ideation. The survey was performed on a sample of 300 Malaysian and 300 Indian college students. The participants completed psychological assessments of productive coping styles, social support, academic stress, and suicidal ideation. Significant cultural and demographic differences emerged. Indian students reported higher suicidal ideation and academic stress than did Malaysian students, and Malaysian students received more social support and had better problem-solving coping styles than did Indian students. Overall, students who were male, non-religious, and from low-income families reported more academic stress and more suicidal ideation. Productive coping styles and overall social support strongly affected the relationship between academic stress and suicidal ideation among both countries' participants.
  12. Adzitey F, Ali GR, Huda N, Ahmad R
    3 Biotech, 2013 Dec;3(6):521-527.
    PMID: 28324423 DOI: 10.1007/s13205-013-0115-7
    Salmonella species are important foodborne pathogens that can cause illness and death in humans. The objective of this study was to determine the genetic relatedness of 115 Salmonella strains isolated from ducks and their environment using random amplified polymorphic deoxyribonucleic acid (RAPD). The analysis of Salmonella strains by RAPD produced DNA fingerprints of different sizes for differentiation purposes, and cluster analysis at a coefficient of 0.85 grouped the Salmonella strains into various clusters and singletons. S. Typhimurium were grouped into nine clusters and ten singletons, S. Hadar were grouped into seven clusters and nine singletons, S. Enteritidis were grouped into four clusters and five singletons, S. Braenderup were grouped into five clusters and four singletons, S. Albany were grouped into two clusters and seven singletons, and S. Derby were grouped into two clusters and four singletons at a coefficient of 0.85 with discriminatory index (D) ranging from 0.879 to 0.957. With the exception of S. Typhimurium strains which were grouped into three major groups (genotypes) by RAPD analysis, the rest were grouped into two major genotypes. RAPD was a useful genotyping tool for determining the genetic relatedness of the duck Salmonella strains. Comparison of the genetic relatedness among foodborne pathogens and their sources of isolation are important to trace their source and possibly the source of human infection.
  13. Waheed M, Ahmad R, Ahmed W, Drieberg M, Alam MM
    Sensors (Basel), 2018 Feb 13;18(2).
    PMID: 29438278 DOI: 10.3390/s18020565
    The fabrication of lightweight, ultra-thin, low power and intelligent body-borne sensors leads to novel advances in wireless body area networks (WBANs). Depending on the placement of the nodes, it is characterized as in/on body WBAN; thus, the channel is largely affected by body posture, clothing, muscle movement, body temperature and climatic conditions. The energy resources are limited and it is not feasible to replace the sensor's battery frequently. In order to keep the sensor in working condition, the channel resources should be reserved. The lifetime of the sensor is very crucial and it highly depends on transmission among sensor nodes and energy consumption. The reliability and energy efficiency in WBAN applications play a vital role. In this paper, the analytical expressions for energy efficiency (EE) and packet error rate (PER) are formulated for two-way relay cooperative communication. The results depict better reliability and efficiency compared to direct and one-way relay communication. The effective performance range of direct vs. cooperative communication is separated by a threshold distance. Based on EE calculations, an optimal packet size is observed that provides maximum efficiency over a certain link length. A smart and energy efficient system is articulated that utilizes all three communication modes, namely direct, one-way relay and two-way relay, as the direct link performs better for a certain range, but the cooperative communication gives better results for increased distance in terms of EE. The efficacy of the proposed hybrid scheme is also demonstrated over a practical quasi-static channel. Furthermore, link length extension and diversity is achieved by joint network-channel (JNC) coding the cooperative link.
  14. Mohammad N, Ahmad R, Kurniawan A, Mohd Yusof MYP
    Front Artif Intell, 2022;5:1049584.
    PMID: 36561660 DOI: 10.3389/frai.2022.1049584
    BACKGROUND: Forensic odontology may require a visual or clinical method during identification. Sometimes it may require forensic experts to refer to the existing technique to identify individuals, for example, by using the atlas to estimate the dental age. However, the existing technology can be a complicated procedure for a large-scale incident requiring a more significant number of forensic identifications, particularly during mass disasters. This has driven many experts to perform automation in their current practice to improve efficiency.

    OBJECTIVE: This article aims to evaluate current artificial intelligence applications and discuss their performance concerning the algorithm architecture used in forensic odontology.

    METHODS: This study summarizes the findings of 28 research papers published between 2010 and June 2022 using the Arksey and O'Malley framework, updated by the Joanna Briggs Institute Framework for Scoping Reviews methodology, highlighting the research trend of artificial intelligence technology in forensic odontology. In addition, a literature search was conducted on Web of Science (WoS), Scopus, Google Scholar, and PubMed, and the results were evaluated based on their content and significance.

    RESULTS: The potential application of artificial intelligence technology in forensic odontology can be categorized into four: (1) human bite marks, (2) sex determination, (3) age estimation, and (4) dental comparison. This powerful tool can solve humanity's problems by giving an adequate number of datasets, the appropriate implementation of algorithm architecture, and the proper assignment of hyperparameters that enable the model to perform the prediction at a very high level of performance.

    CONCLUSION: The reviewed articles demonstrate that machine learning techniques are reliable for studies involving continuous features such as morphometric parameters. However, machine learning models do not strictly require large training datasets to produce promising results. In contrast, deep learning enables the processing of unstructured data, such as medical images, which require large volumes of data. Occasionally, transfer learning was used to overcome the limitation of data. In the meantime, this method's capacity to automatically learn task-specific feature representations has made it a significant success in forensic odontology.

  15. Chowdhury K, Ahmad R, Sinha S, Dutta S, Haque M
    Cureus, 2023 Feb;15(2):e35154.
    PMID: 36819973 DOI: 10.7759/cureus.35154
    Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.
  16. Mohd Sidik S, Arroll B, Goodyear-Smith F, Ahmad R
    Singapore Med J, 2012 Jul;53(7):468-73.
    PMID: 22815016
    Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.
  17. Salim F, Ismail NH, Awang K, Ahmad R
    Molecules, 2011 Aug 04;16(8):6541-8.
    PMID: 21818057 DOI: 10.3390/molecules16086541
    Two new heteroyohimbine-type oxindole alkaloids, rauniticine-allo-oxindole B and rauniticinic-allo acid B, have been successfully isolated from the stems extract of Malaysian Uncaria longiflora var. pteropoda. The structures of the two new alkaloids were determined by spectroscopic analysis.
  18. Dagli N, Kumar S, Ahmad R, Narwaria M, Haque M
    Cureus, 2023 Oct;15(10):e46510.
    PMID: 37808605 DOI: 10.7759/cureus.46510
    This study analyzes the most relevant authors, sources, cooccurrence of keywords, thematic map, and trend topics of the most recent and most cited research papers on semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA). Also, the content of the 25 most cited papers is summarized. A total of 2995 results appeared in an online electronic search performed on 14 August 2023 in the Scopus database using the term semaglutide. The most recently published 500 articles and most cited 200 documents were selected for bibliometric analysis. Network analysis visualization was conducted with the help of the VOSviewer software (version 1.6.18) (Centre for Science and Technology Studies, Leiden, the Netherlands) and Biblioshiny (it is a shiny application providing a web interface for bibliometrix) (Department of Economics and Statistics, University of Naples Federico II, Naples, Italy). After excluding duplicates and editorials, the data analysis found that 495 most recent documents were published in 279 journals by 2461 authors, and 200 most cited papers were published in 103 sources by 1241 authors. There is an increasing trend in the number of research papers from 2014 to 2022, with a peak in 2022. The most relevant authors in the most recent semaglutide research papers are Chen and Zhang. The pertinent authors of the most cited research papers on semaglutide are Lingvay and Khunti. The most common keywords used in the most recent and most cited research papers are semaglutide, obesity, diabetes mellitus type 2, glucagon-like peptide-1, glucagon-like peptide-1 receptor agonist, antidiabetic agent, liraglutide, and cardiovascular disease (CVD). The most relevant source is "Diabetes, Obesity and Metabolism" for the research papers on semaglutide. Trend topic analysis suggests that most of the research between 2020 and 2022 on semaglutide was done on non-insulin-dependent diabetes mellitus. The most cited papers provide essential insights into using semaglutide in managing type 2 diabetes mellitus (T2DM), obesity, and related conditions, along with their potential benefits, side effects, and possible mechanisms of action. This analysis highlights that the pharmacological effects of semaglutide extend beyond its role as a glycemic regulator.
  19. Ahmad R, Narwaria M, Singh A, Kumar S, Haque M
    Diagnostics (Basel), 2023 Jul 21;13(14).
    PMID: 37510185 DOI: 10.3390/diagnostics13142441
    BACKGROUND: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus and can lead to patient demise if not immediately treated. From the recent literature, the diabetic ketoacidosis mortality rate, depending on age, is 2-5%. Insulin discontinuation and infection remain the two most common triggers for diabetic ketoacidosis. About 50% of cases of ketoacidosis result from bacterial infections like urinary tract infections and pneumonia. It is also important to diagnose the presence of infection in diabetic ketoacidosis patients to prevent the excessive use of antibiotics, which may lead to antibiotic resistance. Although performing bacterial culture is confirmatory for the presence or absence of bacterial infection, the time required to obtain the result is long. At the same time, emergency treatment needs to be started as early as possible.

    METHODS: This narrative review examines various septic markers to identify the appropriate tools for diagnosis and to distinguish between diabetic ketoacidosis with and without infection. Electronic databases were searched using the Google engine with the keywords "Diabetes Mellitus", "Diabetic Ketoacidosis", "Infection with Diabetic Ketoacidosis", "biomarkers for infection in Diabetic Ketoacidosis", "Procalcitonin", "Inflammatory cytokines in DKA", "Lactic acidosis in DKA", and "White blood cell in infection in DKA".

    RESULTS: This narrative review article presents the options for diagnosis and also aims to create awareness regarding the gravity of diabetic ketoacidosis with infection and emphasizes the importance of early diagnosis for appropriate management. Diabetes mellitus is a clinical condition that may lead to several acute and chronic complications. Acute diabetic ketoacidosis is a life-threatening condition in which an excess production of ketone bodies results in acidosis and hypovolemia. Infection is one of the most common triggers of diabetic ketoacidosis. When bacterial infection is present along with diabetic ketoacidosis, the mortality rate is even higher than for patients with diabetic ketoacidosis without infection. The symptoms and biomarkers of diabetic ketoacidosis are similar to that of infection, like fever, C reactive protein, and white blood cell count, since both create an environment of systemic inflammation. It is also essential to distinguish between the presence and absence of bacterial infection to ensure the appropriate use of antibiotics and prevent antimicrobial resistance. A bacterial culture report is confirmatory for the existence of bacterial infection, but this may take up to 24 h. Diagnosis needs to be performed approximately in the emergency room upon admission since there is a need for immediate management. Therefore, researching the possible diagnostic tools for the presence of infection in diabetic ketoacidosis patients is of great importance. Several of such biomarkers have been discussed in this research work.

  20. Chowdhury K, Sinha S, Kumar S, Haque M, Ahmad R
    Cureus, 2024 Jan;16(1):e52551.
    PMID: 38249647 DOI: 10.7759/cureus.52551
    Constipation suffered by children is a global public health problem. Functional constipation (FC) brings about deteriorating effects in the children's lives who suffer from it. The risk factors for the development of constipation include the consumption of a diet low in fiber and high in calories (such as the consumption of fast food), a sedentary lifestyle with a lack of exercise, a family history of constipation, and emotional and psychological stress endured by children in their families. It is one of the most common causes of stomachaches in children. FC may lead to fecal incontinence (FI), anal fissures, recurrent urinary tract infections (RUTI), and enuresis in children. Severe constipation may result in stool becoming rock-hard and inflexible in the rectum, which is clinically identified as fecal impaction. It is imperative to perform clinical evaluation and treatment, including pharmacological (the use of stimulant and osmotic laxatives) and non-pharmacological (education, changes in diet, intervention to promote positive behavior and address any emotional issues, toilet training, and physiotherapy for the pelvic floor) interventions. In the case of refractory patients, neuromodulation, the irrigation of the anal canal, and surgical management may be needed. It is essential to lead a healthy, stress-free lifestyle with plenty of exercise and a balanced diet rich in fiber (such as fruits and vegetables) so children can have regular bowel habits and thrive.
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