A Comparative Study of Efficacy and Safety among Metformin, Sitagliptin, and Glimepiride Monotherapies in Patients with Type 2 Diabetes Mellitus

Effective management of type 2 diabetes mellitus (T2DM) requires lifestyle changes and suitable medications to enhance quality of life and prevent complications. Choosing the right treatment involves considering the patient's clinical profile, drug efficacy, side effects, and cost. This study compares the safety and efficacy of sitagliptin, glimepiride, and metformin in T2DM patients. A prospective cross-sectional study was conducted at the Diabetes Center of Layla Qasim, Erbil, Iraq, including 143 diabetic patients. They were divided into three groups: group A received glimepiride (N=50), group B metformin (N=48), and group C sitagliptin (N=45). Drug costs, therapeutic outcomes, and side effects were analyzed. Patients aged 30 to 78 participated, with a female-to-male ratio of 83:60. All groups showed significantly improved HbA1c levels (P=0.001). Total cholesterol (TC) and LDL levels were also significantly different (P=0.047 and P=0.010, respectively). Sitagliptin significantly increased triglycerides (TG) and HDL-C. Gastrointestinal side effects were prominent in the metformin group. When selecting medication for T2DM, factors like age, HbA1c, glucose levels, obesity, metabolic syndrome, insulin secretion, and hypoglycemia risk should be considered. Both sitagliptin and glimepiride were well tolerated, with minimal hypoglycemia risk and no significant weight differences between groups. Glimepiride is an effective, safe, and weight-neutral adjunct to metformin, offering extrapancreatic benefits and remains a viable second-line treatment option for T2DM patients

Ischemia-Reperfusion Injury and Pregnancy Initiate Time-Dependent and Robust Signs of Up-Regulation of Cardiac Progenitor Cells

To explore how cardiac regeneration and cell turnover adapts to disease, different forms of stress were studied for their effects on the cardiac progenitor cell markers c-Kit and Isl1, the early cardiomyocyte marker Nkx2.5, and mast cells. Adult female rats were examined during pregnancy, after myocardial infarction and ischemia-reperfusion injury with/out insulin like growth factor-1(IGF-1) and hepatocyte growth factor (HGF). Different cardiac sub-domains were analyzed at one and two weeks post-intervention, both at the mRNA and protein levels. While pregnancy and myocardial infarction up-regulated Nkx2.5 and c-Kit (adjusted for mast cell activation), ischemia-reperfusion injury induced the strongest up-regulation which occurred globally throughout the entire heart and not just around the site of injury. This response seems to be partly mediated by increased endogenous production of IGF-1 and HGF. Contrary to c-Kit, Isl1 was not up-regulated by pregnancy or myocardial infarction while ischemia-reperfusion injury induced not a global but a focal up-regulation in the outflow tract and also in the peri-ischemic region, correlating with the up-regulation of endogenous IGF-1. The addition of IGF-1 and HGF did boost the endogenous expression of IGF and HGF correlating to focal up-regulation of Isl1. c-Kit expression was not further influenced by the exogenous growth factors. This indicates that there is a spatial mismatch between on one hand c-Kit and Nkx2.5 expression and on the other hand Isl1 expression. In conclusion, ischemia-reperfusion injury was the strongest stimulus with both global and focal cardiomyocyte progenitor cell marker up-regulations, correlating to the endogenous up-regulation of the growth factors IGF-1 and HGF. Also pregnancy induced a general up-regulation of c-Kit and early Nkx2.5+ cardiomyocytes throughout the heart. Utilization of these pathways could provide new strategies for the treatment of cardiac disease

Updating the approaches to define susceptibility and resistance to anti-tuberculosis agents: implications for diagnosis and treatment

11 páginas, 2 figuras, 1 tablaInappropriately high breakpoints have resulted in systematic false-susceptible AST results to anti-TB drugs. MIC, PK/PD and clinical outcome data should be combined when setting breakpoints to minimise the emergence and spread of antimicrobial resistance.I. Comas was supported by PID2019-104477RB-I00 from the Spanish Science Ministry and by ERC (CoG 101001038)Peer reviewe

Wytrzymałość na ścieranie przędz krzyżujących się pod kątem prostym

This paper investigates yarn abrasion behaviour based on the yarn structure, twist factor and fibre alignment at the rubbing contact points (twist direction at contact points). First yarns arranged at right angle (utilized with a high resolution camera) were introduced on a yarn abrasion tester and then the abrasion behaviour of the ring (R) and open-end rotor (O.E.) spun yarns were compared and analysed. Comparison of the yarns indicates that the abrasion resistance thereof is affected by the twist factor in a way that as the twist increases, the yarn on yarn abrasion cycles to failure follows the same trend as the effect of twist on the yarn strength (first an increase and then a decrease); that is, yarn on yarn abrasion resistance increases up to a certain degree (a=140 in ring spun yarn and a=156 in open-end rotor spun yarn), and then as the twist increases, the yarn on yarn abrasion resistance decreases. It also shows that the yarn abrasion cycle to failure is lower when the fibre alignments of the contact yarns are in the same direction. Close observation of the yarn rubbing also indicates that as the fibres are removed from the outer layers, the rotor spun yarn shows higher yarn on yarn abrasion resistance; that is, moving from the outer side to the interlayer of the rotor spun yarn, the relative yarn on yarn abrasion resistance (abrasion cycles to failure/yarn count) increases. This phenomenon indicates the fact that in open-end rotor spun yarn the compactness of the interlayer fibres are higher than the compactness of the outer layer fibres.Analizowano różne właściwości mechaniczne przy zrywaniu lnianych przędz łączonych różnymi węzłami, stosując test na rozciąganie dla czterech węzłów o różnej strukturze - węzeł prosty, zwykły, tkacki i rybacki. Zastosowano cztery próbki: 50 tex (A - bielona, B - surowa) i 68 tex (C - bielona, D - surowa), każda wyprzędziona z lnu. W pracy przedstawiono wartości siły zrywającej, wytrzymałości przy zerwaniu, wydłużenia przy zerwaniu, pracy do zerwania oraz jednostkowej pracy do zerwania dla przędz łączonych węzłami. Ponadto, przeanalizowano współczynnik retencji dla siły zrywającej, wydłużenia przy zerwaniu i pracy przy zerwaniu. Stwierdzono, że wytrzymałość przędz łączonych węzłami zależy w dużym stopniu od struktury węzłów, podczas gdy przędze surowe i bielone wykazały podobne właściwości wytrzymałościowe