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Discussion Snakebites are considered critical health issues with considerable morbidity and mortality if not properly managed (Fatani 2015

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doi: 10.1136/bmjopen-2020-039358 168

This metabolic switching is regulated by sirtuins, namely SIRT3 and SIRT2 repress the Warburg effect 342,343,344,345 , while SIRT5 maintains glycolysis 346

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These are managed by metabolic geneticists, and carnitine supplementation is part of the standard protocol