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Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges

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World Journal of Diabetes 2024年第5期15卷 828-852页

作者： Mahmoud emad-Eldin Gehan F Balata Eman A Elshorbagy Mona S hamed Mohamed S Attia Department of Pharmacy Practice Faculty of PharmacyZagazig UniversityZagazig HFQM+872Al-Sharqia GovernorateEgypt Department of Pharmacy Practice Faculty of PharmacyHeliopolis UniversityCairo 44519Egypt Department of Pharmaceutics Faculty of PharmacyZagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt Department of Internal Medicine Faculty of MedicineZagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt Department of Community at Faculty of Medicine Zagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt

Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease *** the past century,insulin formulations have undergone significant modifications and bioengineering,resulting in a diverse range of available insulin *** products show distinct pharmacokinetic and pharmacodynamic ***,various insulin regimens have em-erged for the management of type 2 diabetes,including premixed formulations and combinations of basal and bolus *** utilization of different insulin regimens yields disparate clinical outcomes,adverse events,and,notably,patient-reported outcomes(PROs).PROs provide valuable insights from the patient’s perspective,serving as a valuable mine of information for enhancing healthcare and informing clinical *** to insulin therapy,a critical patient-reported outcome,significantly affects clinical outcomes and is influenced by multiple *** review provides insights into the clinical effectiveness of various insulin preparations,PROs,and factors impacting insulin therapy adherence,with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.

关键词： Adherence Diabetes Insulin Patient-reported outcomes Pharmacokinetic Pharmacodynamic

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Ampelographic and Genetic Diversity Assessment of Some Local Grape Genotypes under Egyptian Conditions

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American Journal of Molecular Biology 2023年第3期13卷 183-196页

作者： Rania Ahmed Mahmoud Abeer Aly Dahab Gehan Ahmed Mahmoud Mohamed Abd El-Aziz Abd El-Wahab emad hamed El-Bassel Ehab Mawad Badr Mahdy Deciduous Fruits Research Department Biotechnology Central Laboratory Horticulture Research Institute (HRI) Agricultural Research Center (ARC) Giza Egypt Medicinal and Aromatic Plants Research Department Biotechnology Central Laboratory Horticulture Research Institute (HRI) Agricultural Research Center (ARC) Giza Egypt Fruit Crops Handling Research Department Chemical Analysis Central Laboratory Horticulture Research Institute (HRI) Agricultural Research Center (ARC) Giza Egypt Viticulture Research Department Horticulture Research Institute (HRI) Agricultural Research Center (ARC) Giza Egypt Fruit Breeding Department Horticulture Research Institute (HRI) Agricultural Research Center (ARC) Giza Egypt National Gene Bank (NGB) Agricultural Research Center (ARC) Giza Egypt

Grape (Vitis vinifera L.) is assumed as one of the most valuable and popular fruit crops all over the world. In this study, ten of local grape germplasm were characterized considering phenotypic diversity and genetic features under Egyptian conditions. Selected local grapes;Baltim Eswid, Edkawy, Matrouh Eswid, Bez El-Naka, Bez El-Anza, Romy Abiad, Romy Ahmer, Gharibi, Fayoumi and Banaty, were spread geographically among seven national governorates. A total of 58 attributes were characterized grape germplasm for the distinctness of vine parts. For molecular characterization, 9 nuclear SSR loci were analysed. Data revealed a broad sense of similarity at the level of studied morphological attributes, where the highest similarity (0.93) was between Romy Ahmer and Romy Abiad. A total of 24 alleles, ranging from 124 - 253 bp in size, were detected at the nine tested loci with an average of 2.67 alleles per locus. The amplification products in all of the 9 SSRs loci showed polymorphism among the 10 grapevine cultivars. The genetic relatedness among most of the cultivars was in accordance with their identification based on ampelographic properties. Data of phenotypic and molecular analysis revealed high variability of Vitis germplasm in Egypt and contributed substantially to our awareness of valuable local grape genetic resources which are on the verge of extinction.

关键词： Ampelographic Germplasm Grape Identification Molecular

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Frozen Section in Postmenopausal Women Presented with Suspicious Ovarian Masses, Does It Have a Role?

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Journal of Cancer Therapy 2015年第14期6卷 1192-1195页

作者： Basel Refky Anas Gamal emad hamed Adel Fathi Mohammad Arafa Sameh Roshdy Khaled Gaballa Essam Attia Mohamed Abdelkhalek Mohamed T. Hafez Fayz Shahatto Shadi Awny Doaa Shokry Gehad Tawfik Surgical Oncology Unit Oncology Center Mansoura University Mansoura Egypt Gynecology Department Mansoura University Hospitals Mansoura Egypt Pathology Department Mansoura University Mansoura Egypt Public Health Department Mansoura Faculty of Medicine Mansoura Egypt Medical Intern Mansoura University Hospitals Mansoura Egypt

Background: Frozen section (FS) has a valuable role in the diagnosis of ovarian tumors. It is considered a pivotal point in guiding the surgical therapy, particularly in premenopausal women. In postmenopausal women, it may be required as well to avoid unnecessary surgical staging in benign ovarian tumors. Aim: This study aims to evaluate the accuracy of intraoperative frozen section in ovarian neoplasms in postmenopausal women. Materials and Methods: A retrospective analysis was done for intraoperative FS for suspected ovarian neoplasms. The study was conducted in Oncology Center, Mansoura University from March 2008 to December 2014. The frozen and paraffin section reports were compared, and overall accuracy, sensitivity, specificity, positive and negative predictive values were determined. Results: The study included 105 patients and the overall accuracy of FS in determining malignancy was 81.7%. The sensitivity for malignant tumors was 75.32% with specificity of 100%. For benign tumors, the sensitivity and specificity were 100% and 93%, respectively. Borderline tumors had the lowest sensitivity of 100% with specificity of 95.19%. Conclusion: The present study concurs that frozen section is an accurate test for diagnosis of benign and malignant tumors in postmenopausal women thus determining the extent of surgery done for them. On the other hand, accuracy rates for borderline tumors are low.

关键词： Frozen Section Ovarian Cancer Surgical Staging

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Planning Target Volume Margin in Linac-Based Stereotactic Radiosurgery for Brain Metastases

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Journal of Cancer Therapy 2024年第7期15卷 265-272页

作者： Hany S. Attallah Radwa M. hamed Khaled M. EL-Shahat Aliaa Mahmoud Mahmoud Abdallah Ibraheem Haggag emad Moustafa Adel Yassin Department of Radiation Oncology International Medical Center (IMC) Cairo Egypt Department of Radiation Oncology Armed Forces Medical Collogue (AFCM) Cairo Egypt Department of Medical Physics Al Azhar University Cairo Egypt Department of Medical Physics International Medical Center (IMC) Cairo Egypt Department of Medical Physics Department of Clinical Oncology Faculty of Medicine Zagazig University Zagazig Egypt

Background: The treatment of brain metastases with radiotherapy has shifted to the use of Stereotactic Radio-surgery (SRS). The technical issue of expanding the treatment volume around the Gross Tumor Volume (GTV) is a current debate. Radiotherapy centers use variable GTV-PTV margins, ranging from one to 2 mm. Material and Methods: We performed a dosimetric comparison in plans of twenty patients using three margins: PTV zero, PTV1, and PTV2. We also developed imaginary Peel volumes. These volumes are described as follows: Peel1 = PTV1 − GTV, Peel2 = PTV2 − GTV. Results: Our results showed that the mean PTV volume differed significantly across the different margins (p = 0.000). The V12 of the brain significantly varied as a function of PTV margin (p = 0.000). The target coverage and plan quality indices were not significantly different. The Peel volume dosimetric analysis showed that the mean dose was significantly higher in the nearby normal brain tissue: Peel1 (p = 0.022) and Peel 2 (p = 0.013). Conclusion: According to our dosimetric analysis, expanding the GTV into a PTV by 1 mm margin is more convenient than 2 mm.

关键词： SRS Brain Metastases PTV

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The Effectiveness of Intraoperative Frozen Section Analysis of Safety Margins in Breast Conserving Surgery and the Role of Surgeon in Decreasing the Rate of Positive Margins

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Surgical Science 2017年第12期8卷 499-509页

作者： Omar Farouk Ahmed Senbel Mosab Shetiwy Essam Attia Ahmed Abdallah Osama El-Damshety Ashraf Khater Sameh Roshdy Amr Abouzid Amr Hossam Islam H. Metwally Omar Hamdy Amir M. Zaid Mahmoud Abdelaziz Mohamed Elmetwally Adel Fathi emad-Eldeen hamed Khaled Abdel Wahab Wagdi El-Kashef Mohamed Hafez Khaled Zalata Mohamed Hegazy Adel Denewer Surgical Oncology Department Oncology Center Faculty of Medicine Mansoura University Mansoura Egypt Pathology Department Faculty of Medicine Mansoura University Mansoura Egypt

Introduction: Nowadays the more accepted surgical option for treating early breast cancer is breast conserving surgery. The main challenge in this type of surgery is to get free safety margins without need of second surgical operation, so many breast surgeons have started to depend on intraoperative frozen sections to ensure free safety margins. Aim of work: To assess our policy that we prefer to depend on intraoperative frozen section analysis to get free safety margin in breast conserving surgery from the 1st surgery, and its oncologic outcome. Patients and Methods: This is a retrospective study conducted in Oncology Center—Mansoura University (OCMU), where the data of 219 patients with breast cancer, who were managed by breast conserving surgery with intraoperative frozen section analysis of the safety margins, was analyzed. Results: The intraoperative frozen section analysis of safety margin was negative from the start in 183 (83.6%) patients, while it was positive in 36 patients (16.4%). Intraoperative decision of margin re-excision was applied for 29 patients (13.2%) in order to reach negative margin, modified radical mastectomy was offered for 4 patients (1.8%), while nipple sparing mastectomy with immediate breast reconstruction using latissimus dorsi flap was offered for 3 patients (1.4%). The postoperative paraffin results were typical with intraoperative frozen section analysis results in 216 patients (98.6%) and different results were obtained in only 3 patients (1.4%) who were managed by modified radical mastectomy in a second operation. Only 4 patients had local recurrence (1.8%) during the period of follow-up duration which was ranged from 1 to 86 months with mean ± SD (22.3 ± 14.1). Conclusion: The intraoperative frozen section analysis of safety margins in breast conserving surgery has very high-rate typical results with the paraffin section analysis and it is very helpful in decreasing the rate of second surgical operation in cases of infiltrated m

关键词： Breast Conserving Surgery Intraoperative Frozen Section Analysis Safety Margins Breast

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Post-endoscopic retrograde cholangiopancreatography pancreatitis: Risk factors and predictors of severity

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World Journal of Gastrointestinal Endoscopy 2016年第19期8卷 709-715页

作者： Ayman El Nakeeb Ehab El Hanafy Tarek Salah Ehab Atef Hosam hamed Ahmad M Sultan emad Hamdy Mohamed Said Ahmed A El Geidie Tharwat Kandil Mohamed El Shobari Gamal El Ebidy Gastroenterology Surgical Center Mansoura University

AIMTo detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity. METHODSThis is a prospective cohort study of all patients who underwent ERCP. Pre-ERCP data, intraoperative data, and post-ERCP data were collected. RESULTSThe study population consisted of 996 patients. Their mean age at presentation was 58.42 (± 14.72) years, and there were 454 male and 442 female patients. Overall, PEP occurred in 102 (10.2%) patients of the study population; eighty (78.4%) cases were of mild to moderate degree, while severe pancreatitis occurred in 22 (21.6%) patients. No hospital mortality was reported for any of PEP patients during the study duration. Age less than 35 years (P = 0.001, OR = 0.035), narrower common bile duct (CBD) diameter (P = 0.0001) and increased number of pancreatic cannulations (P = 0.0001) were independent risk factors for the occurrence of PEP. CONCLUSIONPEP is the most frequent and devastating complication after ERCP. Age less than 35 years, narrower median CBD diameter and increased number of pancreatic cannulations are independent risk factors for the occurrence of PEP. Patients with these risk factors are candidates for prophylactic and preventive measures against PEP.

关键词： Pancreatitis Obstructive jaundice Endoscopic retrograde cholangiopancreatography

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