Cancer is one of the leading causes of death worldwide. Several treatments are available for cancer treatment, but many treatment methods are ineffective against multidrug-resistant cancer. Multidrug resistance (MDR) represents a major obstacle to effective therapeutic interventions against cancer. This review describes the known MDR mechanisms in cancer cells and discusses ongoing laboratory approaches and novel therapeutic strategies that aim to inhibit, circumvent, or reverse MDR development in various cancer types. In this review, we discuss both intrinsic and acquired drug resistance, in addition to highlighting hypoxia- and autophagy-mediated drug resistance mechanisms. Several factors, including individual genetic differences, such as mutations, altered epigenetics, enhanced drug efflux, cell death inhibition, and various other molecular and cellular mechanisms, are responsible for the development of resistance against anticancer agents. Drug resistance can also depend on cellular autophagic and hypoxic status. The expression of drug-resistant genes and the regulatory mechanisms that determine drug resistance are also discussed. Methods to circumvent MDR, including immunoprevention, the use of microparticles and nanomedicine might result in better strategies for fighting cancer.

Marburg virus (MARV) has been a major concern since 1967, with two major outbreaks occurring in 1998 and 2004. Infection from MARV results in severe hemorrhagic fever, causing organ dysfunction and death. Exposure to fruit bats in caves and mines, and human-to-human transmission had major roles in the amplification of MARV outbreaks in African countries. The high fatality rate of up to 90% demands the broad study of MARV diseases (MVD) that correspond with MARV infection. Since large outbreaks are rare for MARV, clinical investigations are often inadequate for providing the substantial data necessary to determine the treatment of MARV disease. Therefore, an overall review may contribute to minimizing the limitations associated with future medical research and improve the clinical management of MVD. In this review, we sought to analyze and amalgamate significant information regarding MARV disease epidemics, pathophysiology, and management approaches to provide a better understanding of this deadly virus and the associated infection.

Introduction: According to the vascular theory arterial overflow in the superior haemorrhoidal arteries would lead to dilatation of the haemorrhoidal venous plexus. The technique helps to promote the obliteration of the terminals of the superior rectal artery. The objective of this study is to describe the results of 100 patients with hemorrhoidal disease treated by the Hemorrhoidal LASER Procedure technique. Method: Under SAB anesthesia terminal arteriole of the upper rectal arteries were fulgurated by fiber laser diode, causing interruption of hemorrhoidal flow. This procedure is repeated circumferentially, following the clockwise positions.This procedure can be performed as a day care surgery. Results: Between January 2018 to January 2019, 100 patients underwent the Hemorrhoidal LASER Procedure technique for hemorrhoidal disease grades I, II and III. Total 100 patients were treated with HeLP procedure. Among them number of men was 81 and female was 19.The procedure proved to be successful at 3 month follow up of 92% patient. No major adverse effects or complications were reported. Post operative minor pain that required medication was 5 cases (5% patient). Postoperative minor bleeding was observed in 3 cases that were managed conservatively. At 3 month after procedure resolution of symptoms were observed in 88% cases with overall satisfaction rate was 89%. Significantly higher quality of life was observed in laser haemorrhoidal procedure. Conclusion: Hemorrhoidal LASER Procedure is a painless outpatient technique .It is a safe, effective, improve symptoms & chance of cure is high compared to other conventional surgery. Similar benefits are seen for patient with severe anal spasm, external thrombosis, fissure and sentinel tags & fistula. J Bangladesh Coll Phys Surg 2020; 38(1): 18-22

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