Tadalafil oral disintegrating tablets: an approach to enhance tadalafil dissolution

Ahmed Refaat,Magda Sokar,Fatma Ismail,Nabila Boraei 한국약제학회 2015 Journal of Pharmaceutical Investigation Vol.45 No.5

Improvement of the dissolution behavior of poorly water soluble tadalafil using solid dispersion technique was investigated. Polyvinylpyrollidone (PVP) was used to prepare solid dispersions (SDs) based on different ratios; 1:1 (SD1,), 1:2 (SD2,), 1:3 (SD3), 1:4 (SD4,) respectively. Tadalafil/PVP/AvicelⓇ in a ratio of 1:2:2 respectively (SD5) was also prepared. SD5 was selected to formulate orally disintegrating tablets (ODTs). Five formulae were prepared (F1–F5) and characterized with respect to drug content uniformity, breaking strength, % friability, wetting behavior, oral disintegration time. Results revealed that SD2 exhibited the highest dissolution rate improvement, where mean dissolution time was 8.22 min compared to 60.12 min for free tadalafil. X-ray powder diffraction spectroscopy and differential scanning calorimetry showed partial drug amorphization in the tested SDs sample which was further confirmed by scanning electron microscope. Moreover, particle size analysis showed the presence of nanocrystals combined with microcrystals dispersed in the prepared SDs. Among the studied solid SDs, SD2 showed the most satisfactory results. In order to improve % yield of SD2 (70.14 %), avicel Ⓡ was added and the resulting tertiary combination (SD5) showed better flow and higher % yield value (94.22 %). % tadalfil released from SD2 & SD5 differ insignificantly (p ≥ 0.05). F3 (48 % mannitol, 16 % avicelⓇ, 16 % croscarmellose) showed superior wetting time (30.1 s), excellent oral disintegration time (20 s) with an accepted hardness (3.6 kg) & % friability (0.7). Additionally, F3 exhibited a significant improvement of tadalafil dissolution compared to that of pure drug and test commercial tablet brand (p B 0.05).

Novel Mutations in the Displacement Loop of Mitochondrial DNA are Associated with Acute Lymphoblastic Leukemia: A Genetic Sequencing Study

Yacoub, Haitham Ahmed,Mahmoud, Wael Mahmoud,El-Baz, Hatim Alaa El-Din,Eid, Ola Mohamed,ELfayoumi, Refaat Ibrahim,Elhamidy, Salem Mohamed,Mahmoud, Maged M. Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.21

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer diagnosed in children and represents approximately 25% of cancer diagnoses among those younger than 15 years of age. Materials and Methods: This study investigated alterations in the displacement loop (d-loop) region of mitochondrial DNA (mtDNA) as a risk factor and diagnostic biomarker for early detection and diagnosis of acute lymphoblastic leukemia. Using mtDNA from 23 subjects diagnosed with acute lymphoblastic leukemia, the first 450 bp of the d-loop region were amplified and successfully sequenced. Results: This revealed 132 mutations at 25 positions in this region, with a mean of 6 alterations per subject. The d-loop alterations in mtDNA in subjects were all identified as single nucleotide polymorphisms in a homoplasmic distribution pattern. Mutant alleles were observed in all subjects with individual frequency rates of up to 95%. Thirteen mutant alleles in the d-loop region of mtDNA occurred with a high frequency. Novel alleles and locations were also identified in the d-loop of mtDNA as follows: 89 G insertions (40%), 95 G insertions (13%), 182 C/T substitutions (5%), 308 C insertions (19%), and 311 C insertions (80%). The findings of this study need to be replicated to be confirmed. Conclusions: Further investigation of the relationship between mutations in mitochondrial d-loop genes and incidence of acute lymphoblastic leukemia is recommended.

New Haplotypes of the ATP Synthase Subunit 6 Gene of Mitochondrial DNA are Associated with Acute Lymphoblastic Leukemia in Saudi Arabia

Yacoub, Haitham Ahmed,Mahmoud, Wael Mahmoud,El-Baz, Hatim Alaa-Eldeen El-Din,Eid, Ola Mohamed,El-Fayoumi, Refaat Ibrahim,Mahmoud, Maged Mostafa,Harakeh, Steve,Abuzinadah, Osama H.A. Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.23

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer diagnosed in children and represents approximately 25% of cancer diagnoses among those younger than 15 years of age. Aim and Objectives: This study investigated substitutions in the ATP synthase subunit 6 gene of mitochondrial DNA (mtDNA) as a potential diagnostic biomarker for early detection and diagnosis of acute lymphoblastic leukemia. Based on mtDNA from 23 subjects diagnosed with acute lymphoblastic leukemia, approximately 465 bp of the ATP synthase subunit 6 gene were amplified and sequenced. Results: The sequencing revealed thirty-one mutations at 14 locations in ATP synthase subunit 6 of mtDNA in the ALL subjects. All were identified as single nucleotide polymorphisms (SNPs) with a homoplasmic pattern. The mutations were distributed between males and females. Novel haplotypes were identified in this investigation: haplotype (G) was recorded in 34% in diagnosed subjects; the second haplotype was (C) with frequency of 13% in ALL subjects. Neither of these were observed in control samples. Conclusions: These haplotypes were identified for the first time in acute lymphoblastic leukemia patients. Five mutations able to change amino acid synthesis for the ATP synthase subunit 6 were associated with acute lymphoblastic leukemia. This investigation could be used to provide an overview of incidence frequency of acute lyphoblastic leukemia (ALL) in Saudi patients based on molecular events.

Developing Strategy: A Guide For Nurse Managers to Manage Nursing Staff's Work-related Problems

Gab Allah Amal Refaat,Elshrief Hayam Ahmed,Ageiz Marwa Hassan 한국간호과학회 2020 Asian Nursing Research Vol.14 No.3

Purpose: The purpose of this study was to assess nursing staff's work-related problems as perceived by their managers and thereafter develop strategies that would serve as a guide for nurse managers to manage these problems. Methods: A descriptive research design was used. The participants included in the study consisted of the following two groups: Group 1da convenience sample of 150 first-line managers working at three different hospitals; and Group 2da panel of experts for the Delphi technique, selected using the Snowball sampling technique. Tools for data collection included the following: Tool 1dquestionnaire about nursing staff's problems; Tool 2dDelphi technique to develop strategies for managing nursing staff's problems; and Tool 3dopinionnaire format. Results: The recruited first nurse managers were of the opinion that job stress, work overload, conflict, workplace violence, poor performance, staff turnover, demotivation, lack of empowerment, and staff absenteeism were among the common problems faced by staff nurses at work. Conclusion: From the expert panelists’ perspectives, the newly developed strategy in this study was considered valid; the researchers recommend the strategy developed in this study to be universalized in different health care settings and used as a guide for nurse managers.

Resistin and Insulin Resistance: A Link Between Inflammation and Hepatocarcinogenesis

Elsayed, Engy Yousry,Mosalam, Nesreen Ahmed,Mohamed, Noha Refaat Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.16

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin > 12 ng/ml and HOMA > 4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.

Quality of life among patients with supraventricular tachycardia post radiofrequency cardiac ablation in Jordan

Al- Betar Mohammad Tayseer,Masa'deh Rami,Hamaideh Shaher H.,Ahmed Fatma Refaat,Bakkali Hajar,AbuRuz Mohannad Eid 대한중환자의학회 2023 Acute and Critical Care Vol.38 No.3

Background: Supraventricular tachycardia (SVT) is a common arrhythmia with associated symptoms such as palpitation, dizziness, and fatigue. It significantly affects patients’ quality of life (QoL). Radiofrequency cardiac ablation (RFCA) is a highly effective treatment to eliminate arrhythmia and improve patients’ QoL. The purpose of this study was to assess the level of QoL among patients with SVT and examine the difference in QoL before and after RFCA. Methods: One group pre-posttest design with a convenience sample of 112 patients was used. QoL was assessed by 36-Item Short Form (SF-36). Data were collected at admission through face-to-face interviews and 1-month post-discharge through phone interviews. Results: There was a significant difference between QoL before (33.7±17.0) and one month after (62.5±18.5) the RFCA. Post-RFCA patients diagnosed with atrioventricular re-entry tachycardia had higher QoL than other types of SVT. Moreover, there were significant negative relationships between QoL and the number and duration of episodes pre- and post-RFCA. There were no significant differences in QoL based on: age, sex, working status, marital status, smoking, coronary artery disease, diabetes mellitus, and hypertension. Conclusions: After RFCA, the QoL of patients with ST improved for both physical and mental component subscales.