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  1. Darwis I, Hidayat H, Wisnu GNPP, Mentari S
    Malays J Med Sci, 2021 Oct;28(5):42-53.
    PMID: 35115886 DOI: 10.21315/mjms2021.28.5.4
    Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus and identification of the causative bacteria is an essential step in selecting the appropriate antibiotic therapy. This study aimed to evaluate the bacterial pattern and antibiotic susceptibility of the bacteria causing DFI in Lampung Province in Indonesia.

    Methods: This study is a retrospective study reviewing the medical records of DFI patients admitted to the Dr Hi Abdul Moeloek Regional General Hospital in 2017-2019. DFI patients with complete medical record data were included in this study. Demographic, clinical, laboratory, wound culture and antibiotic susceptibility data were collected from the medical records using a short structural chart. The data obtained then reviewed.

    Results: In this study, 131 DFI patients met the study criteria and were included. Based on the wound culture results, Gram-negative bacteria were obtained in 112 (85.5%) subjects with Enterobacter spp. as the predominant bacteria. Gram-positive bacteria were found in 19 (14.5%) subjects with Staphylococcus spp. as the predominant bacteria. Gram-negative bacteria found in this study showed high susceptibility to amikacin, meropenem and sulbactam/cefoperazone. Meanwhile, the Gram-positive bacteria showed high susceptibility to meropenem, sulbactam/cefoperazone and amikacin.

    Conclusion: The findings of the study revealed Enterobacter spp. as the most predominant bacteria causing DFI in the studied population. The highest antibiotic susceptibility was seen for amikacin, meropenem and sulbactam/cefoperazone.

  2. Hossain MS, Parvez A, Islam MT, Ahmmed S, Hasan MH, Indrayudha P, et al.
    Int J Mol Sci, 2026 Oct 20;27(20).
    PMID: 42942077 DOI: 10.3390/ijms27209308
    Zamzam water (ZW), a naturally occurring alkaline mineral water with a distinctive ionic and trace-element composition, has attracted growing scientific interest due to its reported pharmacological properties and emerging biological effects relevant to cancer research. This review provides a comprehensive mechanistic synthesis that links the physicochemical characteristics of ZW to molecular and cellular processes implicated in cancer biology. Integrating evidence from cancer biology, redox pharmacology, mitochondrial physiology, and cellular signaling, this review examines how the unique mineral composition and mildly alkaline pH of ZW may collectively influence pathways associated with the hallmarks of cancer. Preclinical studies demonstrate context-dependent modulation of cell proliferation, apoptosis, oxidative stress, mitochondrial function, cell-cycle progression, and signaling pathways, including mitogen-activated protein kinase (MAPK) and cyclic AMP (cAMP) networks, across multiple cancer models. Beyond its reported antiproliferative activity, ZW also exhibits antioxidant, anti-inflammatory, and organ-protective effects in non-malignant systems. Importantly, this review proposes a conceptual framework for investigating the relative contributions of mineral ions, ionic homeostasis, redox regulation, and physicochemical properties to the biological effects of ZW, and identifies key mechanistic and methodological gaps. ZW has exhibited cancer-associated biological effects in experimental animals; however, its therapeutic effectiveness has yet to be validated. Future studies integrating standardized physicochemical characterization, molecular validation, multi-omics approaches, and clinical investigations are required to establish its translational relevance in complementary oncology.
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