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Fulltext Comparison of apoptotic responses in Blastocystis sp. upon treatment with Tongkat Ali and Metronidazole

Girish S, Kumar S, Aminudin N, Hashim NM

Sci Rep, 2021 04 09;11(1):7833.
PMID: 33837230 DOI: 10.1038/s41598-021-81418-x

Blastocystis sp. infection, although many remain asymptomatic, there is growing data in recent studies that suggests it is a frequent cause of gastrointestinal symptoms in children and adults. This proposes that treatment against this infection is necessary however metronidazole (MTZ), which is the current choice of treatment, has expressed non-uniformity in its efficacy in combating this infection which has led to the study of alternative treatment. In our previous study, it was established that Tongkat Ali fractions exhibited promising anti-protozoal properties which leads to the current aim of the study, to further narrow down the purification process in order to identify the specific active compound promoting the anti-protozoal effect through HPLC analysis. Based on the data analysis and in-vitro susceptibility assay, the collected Tongkat Ali fraction that demonstrated anti-blastocystis property was shown to contain eurycomanone. Previous studies have suggested that there is a mechanism in Blastocystis sp. that regulates the apoptotic process to produce higher number of viable cells when treated. In reference to this, our current study also aims to investigate the apoptotic response of Tongkat Ali extract and eurycomanone across different subtype groups with comparison to MTZ. Based on our investigation, both Tongkat Ali extract and eurycomanone induced the high apoptotic rate however exhibited a reduction in viable cell count (p
Omicron and Delta variant of SARS-CoV-2: A comparative computational study of spike protein

Kumar S, Thambiraja TS, Karuppanan K, Subramaniam G

J Med Virol, 2022 Apr;94(4):1641-1649.
PMID: 34914115 DOI: 10.1002/jmv.27526

Emerging severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) variants, especially those of concern, may have an impact on the virus's transmissibility and pathogenicity, as well as diagnostic equipment performance and vaccine effectiveness. Even though the SARS-CoV-2 Delta variant (B.1.617.2) emerged during India's second wave of infections, Delta variants have grown dominant internationally and are still evolving. On November 26, 2021, World Health Organization identified the variant B.1.1.529 as a variant of concern, naming it Omicron, based on evidence that Omicron contains numerous mutations that may influence its behavior. However, the mode of transmission and severity of the Omicron variant remains unknown. We used computational studies to examine the Delta and Omicron variants in this study and found that the Omicron variant had a higher affinity for human angiotensin-converting enzyme 2 (ACE2) than the Delta variant due to a significant number of mutations in the SARS-CoV-2 receptor-binding domain (RBD), indicating a higher potential for transmission. Based on docking studies, the Q493R, N501Y, S371L, S373P, S375F, Q498R, and T478K mutations contribute significantly to high binding affinity with human ACE2. In comparison to the Delta variant, both the entire spike protein and the RBD in Omicron include a high proportion of hydrophobic amino acids such as leucine and phenylalanine. These amino acids are located within the protein's core and are required for structural stability. We observed a disorder-order transition in the Omicron variant between spike protein RBD regions 468-473, and it may be significant in the influence of disordered residues/regions on spike protein stability and binding to ACE2. A future study might investigate the epidemiological and biological consequences of the Omicron variant.
Influence of Grafting on Pocket Depth and Dentin Hypersensitivity Around Third Molar Extraction Sites: A Split-Mouth Randomized Controlled Trial

Majid H, Ramachandra SS, Kumar S, Wei M, Gundavarapu KC

Compend Contin Educ Dent, 2022 Jan;43(1):e5-e8.
PMID: 35019665

This study evaluated the effect of alloplastic bone grafts in osseous defects following surgical removal of horizontally impacted third molars by comparing the periodontal measures distal to the second molar in grafted and nongrafted third molar extraction sites. Materials and Methods: A double-blind, randomized, controlled clinical trial was designed on subjects with bilateral horizontally impacted mandibular third molars. Grafting consisting of alloplasts at the third molar extraction sites was compared with nongrafted sites. This study assessed 54 randomized sites in 27 patients who were selected using a split-mouth design. The predictor variable included the change in pocket depth distal to the mandibular second molar and associated dentin hypersensitivity around the second molar, assessed preoperatively and at 3 and 6 months after third molar surgery. The data regarding pocket depth reduction was statistically analyzed using paired t-test. The data concerning reduction in dentin hypersensitivity was statistically analyzed using chi-square test. Results: Six months after third molar surgery, mean pocket depth distal to mandibular second molar decreased significantly at the grafted sites compared to the nongrafted sites. The reduction in dentin hypersensitivity of mandibular second molar was statistically significant for the grafted sites at 6 months, compared to the nongrafted sites.
Fulltext Human CD3+ T-Cells with the Anti-ERBB2 Chimeric Antigen Receptor Exhibit Efficient Targeting and Induce Apoptosis in ERBB2 Overexpressing Breast Cancer Cells

Munisvaradass R, Kumar S, Govindasamy C, Alnumair KS, Mok PL

Int J Mol Sci, 2017 Sep 08;18(9).
PMID: 28885562 DOI: 10.3390/ijms18091797

Breast cancer is a common malignancy among women. The innate and adaptive immune responses failed to be activated owing to immune modulation in the tumour microenvironment. Decades of scientific study links the overexpression of human epidermal growth factor receptor 2 (ERBB2) antigen with aggressive tumours. The Chimeric Antigen Receptor (CAR) coding for specific tumour-associated antigens could initiate intrinsic T-cell signalling, inducing T-cell activation, and cytotoxic activity without the need for major histocompatibility complex recognition. This renders CAR as a potentially universal immunotherapeutic option. Herein, we aimed to establish CAR in CD3+ T-cells, isolated from human peripheral blood mononucleated cells that could subsequently target and induce apoptosis in the ERBB2 overexpressing human breast cancer cell line, SKBR3. Constructed CAR was inserted into a lentiviral plasmid containing a green fluorescent protein tag and produced as lentiviral particles that were used to transduce activated T-cells. Transduced CAR-T cells were then primed with SKBR3 cells to evaluate their functionality. Results showed increased apoptosis in SKBR3 cells co-cultured with CAR-T cells compared to the control (non-transduced T-cells). This study demonstrates that CAR introduction helps overcome the innate limitations of native T-cells leading to cancer cell apoptosis. We recommend future studies should focus on in vivo cytotoxicity of CAR-T cells against ERBB2 expressing tumours.
The contribution of ethnic groups to Malaysian scientific output, 1982-2014, and the effects of the new economic policy

Lewison G, Kumar S, Wong CY, Roe P, Webber R

Scientometrics, 2016 10 01;109(3):1877-1893.
PMID: 27942083

Malaysia has three main ethnic communities: Chinese, Indians and Malays. At independence in 1957, the Chinese dominated commercial life, and this led to ethnic tensions and finally riots. As a result in 1969 Malaysia introduced a "New Economic Policy" (NEP) to promote Malays in all areas of activity, and in particular to assist them to obtain basic and higher education. We examined the scientific outputs from Malaysia between 1982 and 2014 and classified the names of Malaysian researchers into one of these three groups and two others. There was a major increase in Malay participation in research, which has risen from 20 % of researchers in 1982-1984 to 65 % in 2012-2014, with corresponding declines in the percentages of Chinese and Indian authors, although their absolute numbers have increased because Malaysian scientific output has increased so rapidly in the last 10 years. The huge increase in Malay researchers contrasts with their presence in the Malaysian population which has remained stable at about 50 % since 1969.
Fulltext Vulnerability of financial markets in India: The contagious effect of COVID-19

Rao P, Goyal N, Kumar S, Hassan MK, Shahimi S

Res Int Bus Finance, 2021 Dec;58:101462.
PMID: 36540343 DOI: 10.1016/j.ribaf.2021.101462

This study aims to examine the impact of COVID-19 on financial markets, using emerging market data. Specifically, panel data regression is applied on 3200 observations for daily market returns during lockdown in India. The event study methodology is adopted to show abnormal returns registered in the lockdown period. A contrasting breakdown effect of COVID-19 on various Indian industries has been observed through sectoral analysis. The study also provides empirical evidence for lockdown measures taken by the government on stock market returns and post lockdown impact of COVID-19 on daily market returns for over 6550 observations.
Fulltext On Comparison of Heat Treated and Non-Heat-Treated LOM Manufactured Sample for Poly(lactic)acid: Mechanical and Morphological View Point

Singh I, Kumar S, R Koloor SS, Kumar D, Yahya MY, Mago J

Polymers (Basel), 2022 Nov 24;14(23).
PMID: 36501501 DOI: 10.3390/polym14235098

This work reports the comparison of heat-treated and non-heat-treated laminated object-manufactured (LOM) 3D-printed specimens from mechanical and morphological viewpoints. The study suggests that heat treatment of the FDM-printed specimen may have a significant impact on the material characteristics of the polymer. The work has been performed at two stages for the characterization of (a) non-heat-treated samples and (b) heat-treated samples. The results for stage 1 (non-heat-treated samples) suggest that the infill density: 70%, infill pattern: honeycomb, and six number of discs in a single LOM-manufactured sample is the optimized condition with a compression strength of 42.47 MPa. The heat treatment analysis at stage 2 suggests that a high temperature: 65 °C, low time interval: 10 min, works equally well as the low temperature: 55 °C, high time interval: 30 min. The post-heat treatment near Tg (65 °C) for a time interval of 10 min improved the compressive strength by 105.42%.
Fulltext COVID-19 and finance scholarship: A systematic and bibliometric analysis

Boubaker S, Goodell JW, Kumar S, Sureka R

Int Rev Financ Anal, 2023 Jan;85:102458.
PMID: 36439331 DOI: 10.1016/j.irfa.2022.102458

COVID-19 has posed unprecedented challenges to global finances because of its unparalleled global scope, with both concomitant shocks as well as the likely altering of risk assessments and forecasts for the foreseeable future. As the effects of COVID-19 on financial markets and institutions have been widely addressed by various literature, we systematically synthesize this literature. Through a comprehensive search process, we extract and review 818 articles. Appling bibliometric methods, we explore the trends among various research constituents involved in the field. Using multi-dimensional scaling, we identify the intellectual structure of research in the domain and outline four distinct themes. We also identify the evolution and shifts in research within the short span of three years since the inception of COVID-19. Through detailed content analysis, various future research directions are proposed.
Fulltext Relationship of salivary CD14 concentration with dental caries in young children

Kumar S, Tandon S, Nayak R, Saran R, Pentapati KC

J Clin Exp Dent, 2017 Aug;9(8):e958-e961.
PMID: 28936284 DOI: 10.4317/jced.53796

BACKGROUND: Dental caries is a chronic disease among children and there is need for studies assessing the caries risk factors using saliva. This study aimed to evaluate the association of salivary soluble CD14 and dental caries in young children.
MATERIAL AND METHODS: A cross-sectional study was done among 300, 3-6 year old school children of Udupi district. A total of 40 children who were caries free, with no past systemic illness or craniofacial anomalies and 40 children with dental caries with no history of dental treatment for caries, with no past systemic illness or craniofacial anomalies were included in control and test groups respectively. Salivary CD14 was evaluated using ELISA test.
RESULTS: The mean salivary soluble CD14 concentration was significantly higher in caries free (1.34±0.35 µg/ml) children than caries experienced (0.54±0.36 µg/ml) (p<0.001). There was significant strong negative correlation between number of decayed teeth and soluble salivary CD14 (r = -0.868, P< 0.001) among all the children. Similarly, sub-group analysis of caries experienced children also showed significant strong negative correlation between number of decayed teeth and soluble salivary CD14 (r = -0.774, P<0.001).
CONCLUSIONS: Results obtained in our study suggested that salivary CD14 can be a indicator of dental caries in young children. Key words:Caries, CD14, Children, Saliva.
Fulltext A Bibliometric Analysis of the Journal of Religion and Health: Sixty Years of Publication (1961-2021)

Carey LB, Kumar S, Goyal K, Ali F

J Relig Health, 2023 Feb;62(1):8-38.
PMID: 36622579 DOI: 10.1007/s10943-022-01704-4

In 1961, the Journal of Religion and Health (JORH) commenced publishing articles that examined modern religious and spiritual philosophy in relation to psychology and health. The year 2021 marked the 60th anniversary of the founding of JORH. This research paper retrospectively analyses the journal's content. It provides insight into JORH's publication trends, citation records, prominent themes, authors' collaboration and its aggregate contribution to the field of religion and health. Over time, the number of publications, citations and downloads of JORH articles have substantially increased, as has the journals prominence and diverse contributions to the study of religion, spirituality and health.
Fulltext Artificial Intelligence and Blockchain Integration in Business: Trends from a Bibliometric-Content Analysis

Kumar S, Lim WM, Sivarajah U, Kaur J

Inf Syst Front, 2023;25(2):871-896.
PMID: 35431617 DOI: 10.1007/s10796-022-10279-0

Artificial intelligence (AI) and blockchain are the two disruptive technologies emerging from the Fourth Industrial Revolution (IR4.0) that have introduced radical shifts in the industry. The amalgamation of AI and blockchain holds tremendous potential to create new business models enabled through digitalization. Although research on the application and convergence of AI and blockchain exists, our understanding of the utility of its integration for business remains fragmented. To address this gap, this study aims to characterize the applications and benefits of integrated AI and blockchain platforms across different verticals of business. Using bibliometric analysis, this study reveals the most influential articles on the subject based on their publications, citations, and importance in the intellectual network. Using content analysis, this study sheds light on the subject's intellectual structure, which is underpinned by four major thematic clusters focusing on supply chains, healthcare, secure transactions, and finance and accounting. The study concludes with 10 application areas in business that can benefit from these technologies.
Fulltext Iron and Virulence in Stenotrophomonas Maltophilia: All We Know So Far

Kalidasan V, Joseph N, Kumar S, Awang Hamat R, Neela VK

Front Cell Infect Microbiol, 2018;8:401.
PMID: 30483485 DOI: 10.3389/fcimb.2018.00401

Stenotrophomonas maltophilia is a multi-drug-resistant global opportunistic nosocomial pathogen, which possesses a huge number of virulence factors and antibiotics resistance characteristics. Iron has a crucial contribution toward growth and development, cell growth and proliferation, and pathogenicity. The bacterium found to acquire iron for its cellular process through the expression of two iron acquisition systems. Two distinct pathways for iron acquisition are encoded by the S. maltophilia genome-a siderophore-and heme-mediated iron uptake system. The entAFDBEC operon directs the production of the enterobactin siderophore of catecholate in nature, while heme uptake relies on hgbBC and potentially hmuRSTUV operon. Fur and sigma factors are regulators of S. maltophilia under iron-limited condition. Iron potentially act as a signal which plays an important role in biofilm formation, extracellular polymeric substances (EPS), extracellular enzymes production, oxidative stress response, diffusible signal factor (DSF) and siderophore production in S. maltophilia. This review summarizes the current knowledge of iron acquisition in S. maltophilia and the critical role of iron in relation to its pathogenicity.
Fulltext An Update on Semaglutide Research: A Bibliometric Analysis and a Literature Review

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.
Risks of stillbirth, neonatal mortality, and severe neonatal morbidity by birthweight centiles associated with expectant management at term

Hong J, Crawford K, Odibo AO, Kumar S

Am J Obstet Gynecol, 2023 Oct;229(4):451.e1-451.e15.
PMID: 37150282 DOI: 10.1016/j.ajog.2023.04.044

BACKGROUND: Determining the optimal time of birth at term is challenging given the ongoing risks of stillbirth with increasing gestation vs the risks of significant neonatal morbidity at early-term gestations. These risks are more pronounced in small infants.
OBJECTIVE: This study aimed to evaluate the risks of stillbirth, neonatal mortality, and severe neonatal morbidity by comparing expectant management with delivery from 37+0 weeks of gestation.
STUDY DESIGN: This was a retrospective cohort study evaluating women with singleton, nonanomalous pregnancies at 37+0 to 40+6 weeks' gestation in Queensland, Australia, delivered from 2000 to 2018. Rates of stillbirth, neonatal death, and severe neonatal morbidity were calculated for <3rd, 3rd to <10th, 10th to <25th, 25th to <90th, and ≥90th birthweight centiles. The composite risk of mortality with expectant management for an additional week in utero was compared with rates of neonatal mortality and severe neonatal morbidity.
RESULTS: Of 948,895 singleton, term nonanomalous births, 813,077 occurred at 37+0 to 40+6 weeks' gestation. Rates of stillbirth increased with gestational age, with the highest rate observed in infants with birthweight below the third centile: 10.0 per 10,000 (95% confidence interval, 6.2-15.3) at 37+0 to 37+6 weeks, rising to 106.4 per 10,000 (95% confidence interval, 74.6-146.9) at 40+0 to 40+6 weeks' gestation. The rate of neonatal mortality was highest at 37+0 to 37+6 weeks for all birthweight centiles. The composite risk of expectant management rose sharply after 39+0 to 39+6 weeks, and was highest in infants with birthweight below the third centile (125.2/10,000; 95% confidence interval, 118.4-132.3) at 40+0 to 40+6 weeks' gestation. Balancing the risk of expectant management and delivery (neonatal mortality), the optimal timing of delivery for each birthweight centile was evaluated on the basis of relative risk differences. The rate of severe neonatal morbidity sharply decreased in the period between 37+0 to 37+6 and 38+0 to 38+6 weeks, particularly for infants with birthweight below the third centile.
CONCLUSION: Our data suggest that the optimal time of birth is 37+0 to 37+6 weeks for infants with birthweight <3rd centile and 38+0 to 38+6 weeks' gestation for those with birthweight between the 3rd and 10th centile and >90th centile. For all other birthweight centiles, birth from 39+0 weeks is associated with the best outcomes. However, large numbers of planned births are required to prevent a single excess death. The healthcare costs and acceptability to women of potential universal policies of planned birth need to be carefully considered.
Clinicopathological features in 102 cases of Hirschsprung disease

Ziad F, Katchy KC, Al Ramadan S, Alexander S, Kumar S

Ann Saudi Med, 2006;26(3):200-4.
PMID: 16861859

BACKGROUND: Hirschsprung disease [HD] is a predominantly childhood disorder of intestinal motility with a multifactorial and polygenic etiology. The objective of this study was to document the clinical and pathological features of HD in Kuwait, which has an estimated consanguinity rate of 54%.
METHODS: We analyzed all rectal and colonic biopsies (n=268) for suspected HD identified from the records in the Pathology Department of Al-Sabah Hospital for the period between 1994 and 2004.
RESULTS: One hundred and two patients (87 males and 15 females) had histologically confirmed HD. Fifty-eight (57%) were neonates (<1 month of age), while 21% were more than 4 months old. The diagnosis was based on open biopsy in 11 cases and rectal biopsies in 91 cases. Nine patients with open biopsies presented as intestinal obstruction, necrotizing enterocolitis, or perforation. The extent of the disease was unknown in 13 patients. There were 67 males and 3 females with short segment HD. Nine had long segment, two ultra-short segment and eight total colonic aganglionosis (TCA). Five TCA cases involved the small intestine. A skip area was observed in two cases. Six patients had other anomalies. A positive family history for HD was established in three patients. Two of these were male siblings from a consanguineous marriage and had Waardenburg syndrome.
CONCLUSION: This study has highlighted an exceptionally strong male predominance of short segment and a relatively high frequency (5.6%) of small intestinal involvement in HD in Kuwait. These data call for a more detailed epidemiological study with special emphasis on genetics.
Fulltext The relationship between sleep quality, inappropriate medication use and frailty among older adults in aged care homes in Malaysia

Kumar S, Wong PS, Hasan SS, Kairuz T

PLoS One, 2019;14(10):e0224122.
PMID: 31622445 DOI: 10.1371/journal.pone.0224122

Poor sleep quality is prevalent among older adults and is compounded by frailty and polypharmacy. This descriptive, cross-sectional study examines the associations between sleep quality, inappropriate medication use and frailty. The study was conducted among 151 residents of 11 aged care homes in three states in Malaysia; convenience sampling was used. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and Groningen Frailty Indicator (GFI) was used to assess frailty. Medication appropriateness was assessed using Drug burden Index (DBI), Potentially Inappropriate Medications (PIMs) and Potentially Inappropriate Prescriptions (PIPs). Most of the subjects (approximately 95%) reported poor sleep quality, as measured by a cut-off of global PSQI score of ≥ 5. With a second cut-off at 10, just over half (56%) reported moderately poor sleep quality followed by 39% who had very poor sleep quality. Most (90%) denied taking medication to improve their sleep during the previous month. There was no statistically significant association between medication inappropriateness (PIMs, PIPs, DBI) and global PSQI score. However, the average number of PIM was associated significantly with sleep efficiency (a measure of the actual 'sleep to total time spent in bed) (p = 0.037). The average number of PIP was associated with subjective sleep quality (p = 0.045) and the use of sleep medications (p = 0.001), and inversely associated with sleep disturbance (0.049). Furthermore, frailty correlated significantly with poor overall sleep quality (p = 0.032). Findings support the need for medication review to identify and reduce PIMs and optimise prescriptions to improve sleep quality and hence, related health outcomes among residents of aged care homes.
Fulltext Cisplatin-Loaded Graphene Oxide/Chitosan/Hydroxyapatite Composite as a Promising Tool for Osteosarcoma-Affected Bone Regeneration

Sumathra M, Sadasivuni KK, Kumar SS, Rajan M

ACS Omega, 2018 Nov 30;3(11):14620-14633.
PMID: 30555982 DOI: 10.1021/acsomega.8b02090

Presently, tissue engineering approaches have been focused toward finding new potential scaffolds with osteoconductivity on bone-disease-affected cells. This work focused on the cisplatin (CDDP)-loaded graphene oxide (GO)/hydroxyapatite (HAP)/chitosan (CS) composite for enhancing the growth of osteoblast cells and prevent the development of osteosarcoma cells. The prepared composites were characterized for the confirmation of composite formation using Fourier transform infrared spectroscopy, scanning electron microscopy, transmission electron microscopy, and X-ray diffraction techniques. A flowerlike morphology was observed for the GO/HAP/CS-3/CDDP composite. UV-vis spectroscopy was used to observe the controlled release of CDDP from the GO/HAP/CS-3/CDDP composite, and 67.34% of CDDP was released from the composite over a time period of 10 days. The GO/HAP/CS-3/CDDP nanocomposites showed higher viability in comparison with GO/HAP/CS-3 on MG63 osteoblast-like cells and higher cytotoxicity against cancer cells (A549). The synthesized composite was found to show enhanced proliferative, adhesive, and osteoinductive effects on the alkaline phosphatase activity of osteoblast-like cells. Our results suggested that the CDDP-loaded GO/HAP/CS-3 nanocomposite has an immense prospective as a bone tissue replacement in the bone-cancer-affected tissues.
Characteristics of antibiotic resistance mechanisms and genes of Klebsiella pneumoniae

Li Y, Kumar S, Zhang L, Wu H, Wu H

Open Med (Wars), 2023;18(1):20230707.
PMID: 37197355 DOI: 10.1515/med-2023-0707

Klebsiella pneumoniae is an important multidrug-resistant (MDR) pathogen that can cause a range of infections in hospitalized patients. With the growing use of antibiotics, MDR K. pneumoniae is more prevalent, posing additional difficulties and obstacles in clinical therapy. To provide a valuable reference to deeply understand K. pneumoniae, and also to provide the theoretical basis for clinical prevention of such bacteria infections, the antibiotic resistance and mechanism of K. pneumoniae are discussed in this article. We conducted a literature review on antibiotic resistance of K. pneumoniae. We ran a thorough literature search of PubMed, Web of Science, and Scopus, among other databases. We also thoroughly searched the literature listed in the papers. We searched all antibiotic resistance mechanisms and genes of seven important antibiotics used to treat K. pneumoniae infections. Antibiotics such as β-lactams, aminoglycosides, and quinolones are used in the treatment of K. pneumoniae infection. With both chromosomal and plasmid-encoded ARGs, this pathogen has diverse resistance genes. Carbapenem resistance genes, enlarged-spectrum β-lactamase genes, and AmpC genes are the most often β-lactamase resistance genes. K. pneumoniae is a major contributor to antibiotic resistance worldwide. Understanding K. pneumoniae antibiotic resistance mechanisms and molecular characteristics will be important for the design of targeted prevention and novel control strategies against this pathogen.
Current advances in the development of meniscus tissue engineering: narrative review

Tong JB, Sanjiv R, Elderdery A, Wu X, Rajesh R, Suresh Kumar S, et al.

Med J Malaysia, 2023 Jul;78(4):534-540.
PMID: 37518929

INTRODUCTION: The meniscus plays an important role in maintaining homeostasis to facilitate the normal function of the knee joint. It is one of the most commonly injured areas of the knee joint. Meniscal-related injuries can lead to significantly decreased athletic ability, and their incidence has increased yearly. It has been found that most meniscal injuries are irreparable, and meniscectomy can increase the predisposition to knee osteoarthritis. Tissue engineering technology on meniscus repairing and transplantation has received widespread attention recently. This review aimed to analyse the scientific literature regarding the potential applications of tissue engineering on meniscus repairing and transplantation procedures.
METHOD AND MATERIALS: The electronic search was carried out using PubMed/MEDLINEⓇdatabases with the keywords "tissue engineering AND meniscus" spanning the period of publications from Jan 1980 until Dec 2022.
RESULTS: The literature search identified 405 references in PubMed/MEDLINE, and 179 were selected following the eligibility requirements. The research analysis showed that the existing meniscal tissue engineering studies used a wide variety of seed cells, cytokines, bioactive materials and 3D structures. Each showed distinct advantages and disadvantages in terms of biocompatibility, degradability, mechanical strength, porosity, and etc. It was noted that 3D printing technology is promising for tissue engineering meniscus research. In addition, the optimal use of compression and hydrostatic pressure to markedly improve the functional properties of tissue-engineering meniscal can serve as an useful strategy.
CONCLUSION: This review analysed the different approaches employed for meniscus tissue engineering and regeneration. Meniscal tissue engineering still faces several major challenges in terms of seed cells, choice of materials and 3D printing strategies, which should be effectively overcome to harness the full potential of this technology.
Fulltext Detecting Diabetic Ketoacidosis with Infection: Combating a Life-Threatening Emergency with Practical Diagnostic Tools

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.

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