Type 2 diabetes mellitus (T2DM) is a severe disease caused by metabolic disorders, particularly carbohydrate metabolism disorders. The disease is a fatal global trouble characterised by high prevalence rates, causing death, blindness, kidney failure, myocardial infarction, amputation of lower limps, and stroke. Biochemical metabolic pathways like glycolysis, gluconeogenesis, glycogenesis, and glycogenolysis are critical pathways that regulate blood glucose levels with the glucokinase (GK) enzyme playing a central role in glucose homeostasis. Any factor that perturbs the aforementioned biochemical pathways is detrimental. Endocrinological, neurophysiological, and molecular biological pathways that are linked to carbohydrate metabolism should be studied, grasped, and manipulated in order to alleviate T2DM global chaos. The challenge, howbeit, is that, since the body is an integration of systems that complement one another, studying one “isolated” system is not very useful. This paper serves to discuss endocrinology, neurophysiology, and molecular biology pathways that are involved in carbohydrate metabolism in relation to T2DM.

Rapid diagnostics, newer drugs, repurposed medications, and shorter regimens have radically altered the landscape for treating rifampicin-resistant TB (RR-TB) and multidrug-resistant TB (MDR-TB). There are multiple ongoing clinical trials aiming to build a robust evidence base to guide RR/MDR-TB treatment, and both observational studies and programmatic data have contributed to advancing the treatment field. In December 2019, the WHO issued their second ‘Rapid Communication´ related to RR-TB management. This reiterated their prior recommendation that a majority of people with RR/MDR-TB receive all-oral treatment regimens, and now allow for specific shorter duration regimens to be used programmatically as well. Many TB programs need clinical advice as they seek to roll out such regimens in their specific setting. In this Perspective, we highlight our early experiences and lessons learned from working with National TB Programs, adult and pediatric clinicians and civil society, in optimizing treatment of RR/MDR-TB, using shorter, highly-effective, oral regimens for the majority of people with RR/MDR-TB.

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Cellular microbiology, which is the interaction between harmful microbes and infected cells, is important in the determination of the bacterial infection processes and in the progression of data of different cellular mechanisms. The therapeutic role of bacteria has gained attention since the known methods such as radiation, chemotherapy, and immunotherapy have got drawbacks. Bacteria have demonstrated a favorable impact in treating cancer through eradication of tumors. Bacteria, in cancer treatment, have proven to be promising and have been shown in some of the previous work that it can successfully suppress the growth of tumors. In this paper, we analyzed the difficulties and settlement for using bacteria in cancer therapy as well the mechanisms in which bacteria works in order to achieve tumor eradication. Future works may focus on the use of bacteria along with other treatments in order to achieve effective tumor therapy.

Polypharmacy and the consequential risks of drug−drug interactions (DDIs) have been well documented [1] and have also been described in HIV infection [2,3]. As our patients become older with comorbidities, the number of coprescribed medications increases. So-called 'polypharmacy', usually defined as five or more medications, has been linked to decreased adherence, increased adverse drug reactions, more hospitalizations and an increase in mortality [4]. Evans et al. recently found that 27% of HIV-infected patients had a clinically significant drug interaction between their highly active antiretroviral therapy (HAART) and another agent [5].We performed an audit to quantify polypharmacy in our large UK HIV-infected cohort using an HIV clinical care database. Using our HIV clinic database for patients attending in the year prior to 4 October 2013, we extracted demographics, antiretroviral regimen and list of all other medications. We looked for evidence of potential DDIs, of which we present three here.Our cohort comprised 1415 patients, of whom 92 (6.5%) were aged over 60 years. Among 1395 patients with evaluable data, 1227 (88%) were on HAART and 988 (71%) reported taking other medications. The median number of coprescribed drugs was 2 [range 0 to 27; interquartile range (IQR) 4], with 21% of patients taking more than five drugs. A total of 574 different medicines were recorded (Table 1). The median number of antiretroviral formulations taken was 2 (range 0 − 5), with 303 (24% of treated) patients on a single tablet regimen. Thus, the total number of medications taken by our cohort was a median of 4 (range 0-28). In patients aged over 60 years, and in those with hepatitis C virus coinfection, the median number of coprescribed drugs rose to 4 [range 0-27 (IQR 1) and range 0-17 (IQR 2), respectively], and with the addition of their ARV regimen this rose to 6 total medications.In spite of this, we found little evidence of critical DDIs. No patients were found to be taking rilpivirine together with a proton pump inhibitor (PPI). One patient was recorded as taking a contra-indicated statin together with a protease inhibitor (PI); however, on case note review this interaction was found to have already been intercepted and a more appropriate statin prescribed. There were 78 patients identified who were coprescribed steroid preparations together with a PI. However, only seven of these were considered to be at risk of harm that had not been assessed and considered by the clinician.This audit highlights the ongoing potential for serious DDIs in HIV practice as a result of the degree of polypharmacy. Steroid coprescription is a concern, but two other concerning DDIs were not prevalent. Our findings rely on good data recording as well as a cooperation in good medicines reconciliation from both the clinician and the patient. We are introducing routine checking of our emergency care summary (ECS: an online record of prescriptions) in our out-patient clinical practice. In addition, we have asked primary care to add hospital-pres...