Access to mifepristone, misoprostol, and contraceptive medicines in eight countries in the Eastern Mediterranean Region: descriptive analyses of country-level assessments.

BACKGROUND: Despite their importance in reducing maternal mortality, information on access to Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region is limited. METHODS: A standardized assessment tool measuring access to Mifepristone, Misoprostol, and contraceptive medicines included in the WHO essential medicines list (EML) was implemented in eight countries in the Eastern Mediterranean Region (Afghanistan, Iraq, Lebanon, Libya, Morocco, Palestine, Pakistan, and Somalia) between 2020-2021. The assessment focused on five access measures: 1) the inclusion of medicines in national family planning guidelines; 2) inclusion of medicines in comprehensive abortion care guidelines; 3) inclusion of medicines on national essential medicines lists; 4) medicines registration; and 5) procurement and forecasting of Mifepristone, Misoprostol, and contraceptive medicines. A descriptive analysis of findings from these eight national assessments was conducted. RESULTS: Only Lebanon and Pakistan included all 12 contraceptives that are enlisted in the WHO-EML within their national family planning guidelines. Only Afghanistan and Lebanon included mifepristone and mifepristone-misoprostol combination in post-abortion care guidelines, but these medicines were not included in their national EMLs. Libya and Somalia lacked a national regulatory authority for medicines registration. Most contraceptives included on the national EMLs for Lebanon, Morocco and Pakistan were registered. Misoprostol was included on the EMLs-and registered-in six countries (Afghanistan, Iraq, Lebanon, Morocco, Palestine, and Pakistan). However, only three countries procured misoprostol (Iraq, Morocco, and Somalia). CONCLUSION: These findings can guide efforts aimed at improving the availability of Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region. Opportunities include expanding national EMLs to include more options for Mifepristone, Misoprostol, and contraceptive medicines and strengthening the registration and procurement systems to ensure these medicines' availability were permitted under national law and where culturally acceptable.

Ensuring access to Mifepristone, Misoprostol, and contraceptive medicines is critical to improving women's health, and more specifically reducing maternal mortality and improving women's sexual and reproductive health in the Eastern Mediterranean Region.The aim of this study was to analyse findings from national assessments to capture information on the implementation of relevant policies and procedures. Those were the policies that ensure access to Mifepristone, Misoprostol, and contraceptive medicines in the public sector for the eight Eastern Mediterranean Region countries included in the study (Afghanistan, Iraq, Libya, Lebanon, Morocco, Palestine, Pakistan, and Somalia). The assessments were completed between 2020 and 2021.We found that most countries did not include all twelve contraceptives enlisted in the WHO essential medicines list (EML) in their national family planning guidelines. No country had developed a national abortion care guidelines nor included mifepristone (alone or in combination with misoprostol) on national EML. Libya and Somalia lacked a national regulatory authority for medicines registration. Most contraceptives included on the national EMLs for Lebanon, Morocco and Pakistan were registered. Misoprostol was included on the EMLs­and registered­in six countries (Afghanistan, Iraq, Lebanon, Morocco, Palestine, and Pakistan) yet, only three countries procured misoprostol (Iraq, Morocco, and Somalia).Our findings provide evidence on system-level barriers to availability of Mifepristone, Misoprostol, and contraceptive medicines (e.g., lack of guidelines or inclusion on EML, lack of registration and procurement) that can support policy and advocacy efforts to strengthen the pharmaceutical sector to better ensure availability of Mifepristone, Misoprostol, and contraceptive medicines to women in reproductive age at the country-level in accordance with the national law and prevailing culture.

Effect of Intermittent Fasting on Improve Body Composition and Anthropometric Measurements of Women with Polycystic Ovarian Syndrome / Efecto del ayuno intermitente para mejorar la composición corporal y las medidas antropométricas de mujeres con síndrome de ovario poliquístico

Introduction: Polycystic ovary syndrome is a metabolicdisorder that affects women of reproductive age and is associated with insulin resistance.Objectives: The study aims to evaluate the effect of intermittent fasting and dietary intervention in improving anthropometric measures and body composition.Material and Methods: An interventional trial was carriedout on eighty-six women between the ages of 19 and 40 with a body mass index of more than 25 kg/m2 were assigned to two intervention groups: the first group (n = 57) followed intermittent fasting plus dietary restriction, and the second group (n = 29) followed dietary restriction without intermittent fasting.Results: The results show that the fasting polycystic ovarian syndrome women experienced a significant (P < 0.05) increase in muscle mass (2.2 ± 2.4) compared to the non-fasting group (0.01 ± 1.5). At the end of the intervention, fasting women with the polycystic ovarian syndrome had significantly (P < 0.05) lost weight (9.2 ± 4.5kg), fat mass % (4.6 ± 3.4), and visceral fat (2.3 ± 2.1 kg), while gaining muscle mass (2.2 ± 2.4 kg). However, non-fasting women with polycystic ovarian syndrome showed significantly reduced body weight (2.4 ± 0.4 kg), fat mass % (1.2 ± 1.1), and visceral fat (0.5 ± 0.7). The results of the linear regression model showed that the highest effect of intermittent fasting was seen in weight, fat-free mass, and muscle mass. Body fat mass changed by 93% under the effect of intermittent fasting.Conclusion: Intermittent fasting may improve health outcomes, reduce body fat, maintain muscle mass, and aidweight loss in women with polycystic ovarian syndrome.Large-scale randomized controlled trials can improve our understanding of intermittent fasting in polycystic ovarian syndrome.(AU)

Prevalence of diabetic retinopathy and associated risk factors in diabetic type II patients in Ajdabiya, Libya

Diabetic retinopathy (DR) is One of the most wellknown microvascular complications of diabetes mellitus (DM) and is a frequent side effect of untreated diabetes that can lead to blindness and visual impairment. This study was conducted to assess the prevalence of diabetic retinopathy and associated factors among type 2 diabetic patients. A cross sectional study was done at Ajdabiya diabetic center from November 2023 to January 2024. Subjects and Methods: 52 patients (104 eyes) with T2DM were included in this study, their fasting blood sugar and glycosylated hemoglobin level, lipid profile measured.in addition to fundus examination (done by noncontact +90-diopter lens), fundus photographs taken by Non-Mydriatic Fundus Camera TFC-1000. Around 61 eyes (58.7%) had diabetic retinopathy, 27 eyes (26%) had back ground DR, 6 eyes (5.8 %) had pre-proliferative DR, 4 eyes (3.8%) had proliferative DR, 2 eyes (1.9%) had advanced diabetic eye disease, 22 eyes (21.2%) had CSME. Their ages ranges between 36­74 years with mean (58.90) years, (26.9%) were males, (73.1%) were females. There was a significant association between the development of DR and duration of DM (p=0.003), The FBS levels were also determined to be a significant risk factor for DR (p = 0.031), also LDL with (p=0.039). No other factors were found to have a significant association with DR. In this study more than half of diabetic patients had diabetic retinopathy. There was a significant association between the development of DR and duration of DM, FBS, LDL levels, there was no significant relation between diabetic retinopathy and hypertension, HgA1c Serum cholesterol or triglyceride levels or previous cataract surgery.

Medical and Surgical Management of Symptomatic and Asymptomatic Carotid Artery Stenosis: A Comprehensive Literature Review.

Carotid artery stenosis is a condition where the carotid artery is blocked by fatty cholesterol deposits called plaque, increasing the risk of stroke. Elderly individuals with high cardiovascular risk are more susceptible, along with smokers, those with high cholesterol, males, and older individuals. Young females may also be affected by fibromuscular dysplasia. Carotid stenosis significantly raises stroke risk, and the severity is closely linked to stroke incidence and other cardiovascular events. Early detection and treatment are essential to prevent complications. Treatment options include medical and surgical interventions, such as carotid endarterectomy (CEA) and carotid artery stenting (CAS). The choice between surgery and medical management varies depending on patient characteristics and risk factors. This review explores carotid artery stenosis pathophysiology, risk factors, the importance of early detection and treatment, and the surgical approaches of CEA and CAS, addressing their roles and controversies. Healthcare professionals must understand these aspects to provide optimal care to patients with this condition.

Budd-Chiari Syndrome following COVID-19 infection: a case report.

Introduction and importance: Budd-Chiari Syndrome (BCS) is a rare disorder that affects the liver and is caused by blockage of the hepatic veins. Coronavirus disease 2019 (COVID-19) has been linked to an increased risk of developing BCS due to its ability to cause inflammation in the body, which can lead to clotting disorders. Case presentation: A 43-year-old female presented to the emergency department complaining of severe epigastric and right upper quadrant pain and progressive abdominal distention. Upon examination, investigation, and triphasic liver computed tomography with contrast, the patient was diagnosed with BCS. Clinical discussion: The patient was started on anticoagulant therapy with low-molecular-weight heparin and supportive treatment. She was hospitalized for 3 weeks and discharged on oral warfarin 5 mg/day after showing clinical improvement. Conclusion: Hepatosplenomegaly and abdominal distention after COVID-19 infection raise suspicion for BCS. Therefore, early detection of these signs is essential for immediate management.

Prevalence of multi-antimicrobial resistant non-typhoidal Salmonella isolated from filth flies at wet markets in Klang, Malaysia, and their survival in the simulated gastric fluid.

Filth flies at wet markets can be a vector harbouring multiple antimicrobial-resistant (MAR) nontyphoidal Salmonella (NTS), and such strains are a significant threat to public health as they may cause severe infections in humans. This study aims to investigate the prevalence of antimicrobial-resistant NTS, especially Salmonella Enteritidis and S. Typhimurium harboured by filth flies at wet markets, and investigate their survival in the simulated gastric fluid (SGF). Filth flies (n = 90) were captured from wet markets in Klang, Malaysia, and processed to isolate Salmonella spp. The isolates (n = 16) were identified using the multiplex-touchdown PCR and assessed their antimicrobial susceptibility against 11 antimicrobial agents. Finally, three isolates with the highest MAR index were subjected to SGF survival tests. It was observed that 17.8 % of flies (n = 16/90) harbouring Salmonella, out of which 10 % (n = 9/90) was S. Enteritidis, 2.2 % (n = 2/90) was S. Typhimurium, and 5.6 % was unidentified serotypes of Salmonella enterica subsp. I. 43.8 % (n = 7/16) were confirmed as MAR, and they were observed to be resistant against ampicillin, chloramphenicol, kanamycin, streptomycin, and nalidixic acid. Three strains, F35, F75, and F85 demonstrated the highest MAR index and were able to survive (>6-log10) in the SGF (180 min), indicating their potential virulence and invasiveness. This study provides significant insights into the prevalence and severity of MAR nontyphoidal Salmonella harboured by filth flies in wet markets, which may help inform strategies for controlling the spread and outbreak of foodborne disease.

The Use of Herbs, Dietary Products, and Different Types of Diet for Weight Loss Purposes.

Background: Obesity is a global pandemic health problem. Attempting weight reduction, excess weight people commonly seek herbal products in addition to claim diets. We aimed to assess the prevalence of consuming herbal and dietary products for weight loss purposes and to assess weight reduction attitudes and beliefs among a group of excess-weight adults in Jordan. Methods: A cross-sectional study was conducted on a sample of 477 Jordanian adults (81.6% females), between Feb-Apr/2021. The study data collection was completed by using a validated online structured questionnaire. Results: 28.9% of the male participants reported that the most common source of diets they followed was by themselves (43.2%) and by dietitians (25%). Whereas female participants followed the weight reduction diets prescribed by dietitians, by themselves, and on the internet (31.1%; 26.5%, and 23.7; respectively, P=0.011). The majority of participants from both genders do not believe in using weight reduction herbs alone for losing weight; it must be done along with diet and exercise (P=0.018). Females who use herbs for weight reduction were more than males. In addition, green tea was the most used herb by all participants (8%). The main advisor for using weight reduction herbs and dietary products in females was the internet (30.1%) followed by their own (24.2%). However, in males, it was by their own (21.6%), then by a dietitian (12.6%), and by the internet (12.5%) (P=0.001). Moreover, a quarter of male participants and 21.6% of females did not feel that using herbs to lose weight was efficient. Conclusion: The excess weight adults in Jordan seek to use diet, herbs, and dietary products for weight reduction, advised by unreliable sources. Although the majority are convinced that it is not effective alone, further studies are needed to assess the side effects and safety of such consumption among the population.

Poly(ADP-ribose) polymerase inhibitors in the treatment landscape of triple-negative breast cancer (TNBC).

OBJECTIVE: Chemotherapy is the mainstay for triple-negative breast cancer (TNBC) patients. Over the years, the use of chemotherapy for these patients has demonstrated many adversities, including toxicity and resistance, which suggested the need to develop novel alternative therapeutic options, such as poly(ADP-ribose) polymerase inhibitors (PARPi). Herein, we provide an overview on PARPi, mechanisms of action and the role of biomarkers in PARPi sensitivity trials, clinical advances in PARPi therapy for TNBC patients based on the most recent studies and findings of clinical trials, and challenges that prevent PARP inhibitors from achieving high efficacy such as resistance and overlapping toxicities with other chemotherapies. DATA SOURCES: Searching for relevant articles was done using PubMed and Cochrane Library databases by using the keywords including TNBC; chemotherapy; PARPi; BRCA; homologous recombination repair (HRR). Studies had to be published in full-text in English in order to be considered. DATA SUMMARY: Although PARPi have been used in the treatment of local/metastatic breast malignancies that are HER2 negative and has a germline BRCA mutation, several questions are still to be answered in order to maximize the clinical benefit of PARP inhibitors in TNBC treatment, such as questions related to the optimal use in the neoadjuvant and metastatic settings as well as the best combinations with various chemotherapies. CONCLUSIONS: PARPi are emerging treatment options for patients with gBRCA1/2 mutations. Determining patients that are most likely to benefit from PARPi and identifying the optimal treatment combinations with high efficacy and fewer side effects are currently ongoing.

Characterization, molecular identification, and antimicrobial activity of lactic acid bacteria isolated from selected fermented foods and beverages in Malaysia.

The present work investigated the profile and biodiversity of lactic acid bacteria (LAB) isolated from selected manufactured and homemade fermented foods in Malaysia. A total of 55 LAB were isolated from 20 samples, and identified based on the sequencing of 16S rRNA gene. The LAB isolates were identified as Lacticaseibacillus rhamnosus (34.5%), Lactiplantibacillus plantarum (20%), Limosilactobacillus fermentum (20%), Lacticaseibacillus paracasei (12.7%), Lacticaseibacillus casei (3.6%), Lactobacillus sp. (1.8%), Enterococcus faecalis (3.6%), Enterococcus faecium (1.8%), and Enterococcus durans (1.8%). Majority (94%) of the LAB isolates exhibited broad-spectrum antimicrobial activity against selected foodborne pathogens, and four isolates (L. fermentum SC1001, L. paracasei K2003, and L. rhamnosus KF1002 and MK2003) could produce bacteriocin-like inhibitory substance (BLIS). Lacticaseibacillus paracasei M1001 (homemade mozzarella) exhibited high-temperature tolerance and acid resistance, was homofermentative, and generated good antimicrobial activity, which strongly implied its potential for industrial applications. The present work results would potentially widen our knowledge of LAB diversity in Malaysian fermented foods and provide a potential for their applications in the food industry or other purposes.

Effects of Individual and Combined Fermentation Factors on Antimicrobial Activity of Nisin by Lactococcus lactis ATCC 11454.

There is an increasing demand for natural food preservatives due to consumers' concern on the negative effects of chemical preservatives in food products. Nisin (bacteriocin) is an effective food biopreservative that has been approved globally. However, its low yield proves to be a limiting factor and must be addressed to meet the increasingly high demand from the food industry. The present work thus investigated the effects of individual and combined fermentation factors on Lactococcus lactis ATCC 11454 growth and nisin activity using the one-factor-at-a-time (OFAT) method. The level of each factor that gave the highest nisin production was then selected and combined to further improve its activity. The best combined conditions for highest cell growth and nisin activity were 30 °C, pH 6.0, and mild agitation with the addition of 1.0% w/v glucose, 1.0% w/v skim milk, and 0.5% v/v Tween 20. This increased nisin production by 22.7% as compared to control (basic condition). The present work provided critical information on the relationship between fermentation conditions, growth, and nisin activity of L. lactis ATCC 11454 that could be explored to understand the potential and limitation of the strain. This fermentation strategy can also serve as a benchmark to further enhance the production of bacteriocin or other biopreservative compounds.

The Prevalence of Bacterial and Fungal Coinfections among Critically Ill COVID-19 Patients in the ICU in Jordan.

Background: Secondary bacterial and fungal coinfections have been reported among critically ill coronavirus disease-19 (COVID-19) patients and are associated with increased disease severity and mortality incidence (MI) rates. Aims: This study aimed to track bacterial and fungal coinfections among COVID-19 patients in the intensive care unit (ICU) and to assess the impact of these infections on disease prognosis and patient outcomes in Jordan. Materials and Methods: This was a single-center study that enrolled 46 ICU patients diagnosed with COVID-19. Microbiological and antimicrobial susceptibility results and inflammatory biomarker data were retrospectively analyzed. Results: The MI rate attributed to bacterial and fungal coinfections was 84.8%, and the highest rate was reported among patients older than 70 years (66.7%). The MI rate related to bacterial coinfections was 95.2%, whereas that of fungal coinfections was 4.8%. The most commonly isolated bacterium in the blood was a coagulase-negative staphylococcus (41%), followed by Klebsiella pneumoniae in nasopharyngeal swabs (34%) and Acinetobacter baumannii in sputum samples (31%). Candida species were the sole cause of fungal coinfections in the studied population. In particular, Candida albicans was isolated from 3% of patients with bacteremia, whereas Candida glabrata was isolated from 8% of nasopharyngeal swabs. Klebsiella pneumoniae was considered the major cause of upper respiratory tract infections (34%). Multifactorial infection was significantly associated with increased MI (p value <0.001). Conclusion: COVID-19 MI is associated with respiratory bacterial/fungal coinfections. The ability to predict bacterial and fungal coinfections in ICU patients may be crucial to their survival and prognosis.

Comprehensive literature review of monkeypox.

The current outbreak of monkeypox (MPX) infection has emerged as a global matter of concern in the last few months. MPX is a zoonosis caused by the MPX virus (MPXV), which is one of the Orthopoxvirus species. Thus, it is similar to smallpox caused by the variola virus, and smallpox vaccines and drugs have been shown to be protective against MPX. Although MPX is not a new disease and is rarely fatal, the current multi-country MPX outbreak is unusual because it is occurring in countries that are not endemic for MPXV. In this work, we reviewed the extensive literature available on MPXV to summarize the available data on the major biological, clinical and epidemiological aspects of the virus and the important scientific findings. This review may be helpful in raising awareness of MPXV transmission, symptoms and signs, prevention and protective measures. It may also be of interest as a basis for performance of studies to further understand MPXV, with the goal of combating the current outbreak and boosting healthcare services and hygiene practices.Trial registration: ClinicalTrials.gov identifier: NCT02977715..Trial registration: ClinicalTrials.gov identifier: NCT03745131..Trial registration: ClinicalTrials.gov identifier: NCT00728689..Trial registration: ClinicalTrials.gov identifier: NCT02080767..

Jordanian women's (studying or working in medical fields) awareness in terms of the use of dental imaging during pregnancy.

BACKGROUND: The anxiety among pregnant women about the imaging of teeth during pregnancy may have an adverse effect on the oral health of both the mother and the fetus too. This research study was conducted to evaluate women's knowledge of the utilization of dental imaging during pregnancy. METHODS: In this research, structured questionnaires were distributed electronically through social media. The questionnaires contained questions focused on the women's (studying or working in medical fields) awareness regarding the ionizing radiation protection that takes place during dental imaging, the safest period for dental imaging, the sort of radiographs that can be required, and the chance of radiation-induced malignant tumor and malformation of the fetal as a result of dental imaging. RESULTS: Overall, 984 participants completed questionnaires that were analyzed after being received. Most of the participants (n = 637; 64.7%) were < 30 years of age. The greater number of the participants (66.8%) had fair knowledge of dental imaging. 25.4% mentioned that pregnant women are able to do dental imaging during the first trimester. And approximately half of the participants thought that cone-beam computed tomography and panoramic images must not be carried out during pregnancy. Moreover, nearly the same percentage of them also believed that the risk of inborn malformation is high due to dental imaging. CONCLUSIONS: The results refer to a low awareness among people who have medical knowledge regarding dental radiograph protection during pregnancy. This needs to be paid attention to among students, graduates, and workers in medical fields by focusing on the courses and lectures related to dental imaging protection during pregnancy.

Remodeling Immune Response in A Celiac Disease Patient Using Herbal Supplementation: A Clinical Case-Study.

Background: Celiac disease (CD) is an autoimmune disorder characterized by abnormal serological response (autoimmune anti-tissue-Transglutaminase antibodies) triggered by gluten ingestion in genetically predisposed individuals. The only available effective management for those patients is a strict gluten-free diet. Aim: To investigate the improvement of CD after completing a traditional herbal supplementation and alternative medicine treatment. Case description, treatment, and results: A 23-year-old female presented with a confirmed CD diagnosis (positive anti-tissue Transglutaminase IgA with infiltration of mixed inflammatory cell detected in small bowel biopsy). After 9 months of alternative treatment with traditional herbal supplementation (Taraxaf®, Ferrolina®, and Indomirol®), the clinical, laboratory, and endoscopy profile tests have shown an overall improvement with negative results for anti-tissue Transglutaminase IgA, and normal small bowel mucosal appearance. She was returned to an ordinary diet containing gluten. Conclusion: A traditional herbal supplementation with specific doses followed by a physician's instruction led to obvious improvement in this CD patient.

Immunomodulatory Properties of Human Breast Milk: MicroRNA Contents and Potential Epigenetic Effects.

Infants who are exclusively breastfed in the first six months of age receive adequate nutrients, achieving optimal immune protection and growth. In addition to the known nutritional components of human breast milk (HBM), i.e., water, carbohydrates, fats and proteins, it is also a rich source of microRNAs, which impact epigenetic mechanisms. This comprehensive work presents an up-to-date overview of the immunomodulatory constituents of HBM, highlighting its content of circulating microRNAs. The epigenetic effects of HBM are discussed, especially those regulated by miRNAs. HBM contains more than 1400 microRNAs. The majority of these microRNAs originate from the lactating gland and are based on the remodeling of cells in the gland during breastfeeding. These miRNAs can affect epigenetic patterns by several mechanisms, including DNA methylation, histone modifications and RNA regulation, which could ultimately result in alterations in gene expressions. Therefore, the unique microRNA profile of HBM, including exosomal microRNAs, is implicated in the regulation of the genes responsible for a variety of immunological and physiological functions, such as FTO, INS, IGF1, NRF2, GLUT1 and FOXP3 genes. Hence, studying the HBM miRNA composition is important for improving the nutritional approaches for pregnancy and infant's early life and preventing diseases that could occur in the future. Interestingly, the composition of miRNAs in HBM is affected by multiple factors, including diet, environmental and genetic factors.

Benefit-risk analysis of maintaining essential Reproductive, Maternal, Newborn, and Child Health (RMNCH) services against risk of COVID-19 infection.

With the COVID-19 pandemic spreading across the world, its disruptive effect on the provision and utilization of non- COVID related health services have become well-documented. As countries developed mitigation strategies to help continue the delivery of essential health services through the pandemic, they needed to carefully weigh the benefits and risks of pursuing these strategies. In an attempt to assist countries in their mitigation efforts, a Benefit-Risk model was designed to provide guidance on how to compare the health benefits of sustained essential reproductive, maternal, newborn and child (RMNCH) services against the risk of SARS-CoV-2 infections incurred by the countries' populations when accessing these services. This article describes how two existing models were combined to create this model, the field-testing process carried out from November 2020 through March 2021 in six countries and the findings. The overall Benefit-Risk Ratio in the 6 countries analyzed was found to be between 13.7 and 79.2, which means that for every 13.7 to 79.2 lives gained due to increased RMNCH service coverage, there was one loss of a life related to COVID-19. In all cases and for all services, the benefit of maintaining essential health services far exceeded the risks associated with additional COVID-19 infections and deaths. This modelling process illustrated how essential health services can continue to operate during a pandemic and how mitigation measures can reduce COVID-19 infections and restore or increase coverage of essential health services. Overall, this Benefit-Risk analysis underscored the importance and value of maintaining coverage of essential health services even during public health emergencies, including the recent COVID-19 pandemic.

Increasing Lovastatin Production by Re-routing the Precursors Flow of Aspergillus terreus via Metabolic Engineering.

Lovastatin is an anti-cholesterol medicine that is commonly prescribed to manage cholesterol levels, and minimise the risk of suffering from heart-related diseases. Aspergillus terreus (ATCC 20542) supplied with carbohydrates or sugar alcohols can produce lovastatin. The present work explored the application of metabolic engineering in A. terreus to re-route the precursor flow towards the lovastatin biosynthetic pathway by simultaneously overexpressing the gene for acetyl-CoA carboxylase (acc) to increase the precursor flux, and eliminate ( +)-geodin biosynthesis (a competing secondary metabolite) by removing the gene for emodin anthrone polyketide synthase (gedC). Alterations to metabolic flux in the double mutant (gedCΔ*accox) strain and the effects of using two different substrate formulations were examined. The gedCΔ*accox strain, when cultivated with a mixture of glycerol and lactose, significantly (p < 0.05) increased the levels of metabolic precursors malonyl-CoA (48%) and acetyl-CoA (420%), completely inhibited the (+)-geodin biosynthesis, and increased the level of lovastatin [152 mg/L; 143% higher than the wild-type (WT) strain]. The present work demonstrated how the manipulation of A. terreus metabolic pathways could increase the efficiency of carbon flux towards lovastatin, thus elevating its overall production and enabling the use of glycerol as a substrate source. As such, the present work also provides a framework model for other medically or industrially important fungi to synthesise valuable compounds using sustainable carbon sources.