The mean platelet volume (MPV) is a laboratory marker associated with platelet function and activity. Increased MPV in thromboembolic disease is reflected as an important risk factor. The aim of this study was to compare the MPV and mean platelet volume/platelet count (MPV/PC) ratio between ischemic cerebrovascular stroke and control subjects and furthermore, to find out their diagnostic value in an acute setting to help risk stratification in patients with ischemic stroke. Methods: The cross-sectional study was conducted in Kuwait city Medical Hospitals, the state of Kuwait from April 2015 to October 2015. It comprised 50 consecutive patients with acute ischemic stroke, and 20 healthy volunteers. Blood samples were taken to measure MPV and MPV/PC ratio. The Severity of ischemic stroke was assessed by the Modified Rankin scale. Result: The ischemic stroke patients had significantly higher MPV and MPV/PC ratio compared to the control group (p = 0.001 and p = 0.017) respectively. The MPV value was higher and more significant (p = 0.011) in patients group with high Rankin scale (P3) in comparison with those with lower scores. Receiver operator characteristic analysis revealed that an MPV cutoff value of >8.1 femtoliters provided 68.0% sensitivity and 80.0% specificity. An MPV/PC cutoff value of >0.031 fl10 À4 lL À1 showed 70% sensitivity and 75% specificity. The area under the ROC curve for MPV and MPV/PC ratio was 0.789 and 0.701 respectively, which indicates the high discriminative value of MPV and MPV/PC ratio for predicting severe ischemic stroke based on Rankin score P3 from a mild stroke. Conclusion: MPV and MPV/PC ratio could be considered meaningful laboratory markers for the risk of acute ischemic stroke.

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The incidence of thyroid dysfunction in diabetic patients is higher than that of the general population. Undiagnosed thyroid dysfunction may affect the metabolic control and enhance cardiovascular, and other chronic complication risks in diabetic patients. Few studies have examined the relationship between subclinical hypothyroidism (SCH) and vascular complications of type 2 diabetes. Objectives: To find out the relationship between SCH and vascular complications in patients with Type 2 diabetes. Subjects and Methods: Our cross sectional study included 110 patients with type 2 DM (45 males and 65 females) who were followed at the Diabetes outpatient Clinics in the state of Kuwait during 6 months period. All patients subjected to complete clinical and laboratory data, including thyroid function tests, total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, urinary albumin, fundus examination, ECG, and Glycosylated hemoglobin. Results: Among 110 patients, 21 (19.1%) Patients had SCH. Patients with SCH were more significantly older, with longer duration of diabetes, higher HbA1c, total cholesterol and LDL-C than euthyroid group. However, gender (p = 0.076), BMI (p = 0.092), and smoking (P = 0.715) were not significantly different between the SCH and euthyroid groups. The SCH group had a higher prevalence of dyslipidemia (p = 0.017), diabetic nephropathy (p = 0.003) diabetic retinopathy (p = 0.004) and IHD (p = 0.011) than the euthyroid group while no significant difference in the prevalence of diabetic neuropathy (p = 0.420). Conclusions: SCH is a common endocrine disorder in patients with Type 2 diabetes. It could be associated with a higher prevalence of vascular complications in type 2 diabetes. We could not prove a relation between SCH and diabetic neuropathy.

Introduction: Alpha lipoic acid (ALA) is an antioxidant used in the treatment of neuroinflammation, diabetes and diabetic nephropathy. The current study aiming to gauge the effect of oral ALA on diabetic peripheral neuropathy, glycemic control, LDL-C, and HDL-C. Methods: This is a prospective, interventional study carried out on patients with type 2 diabetes mellitus (DM) who were following at the outpatient internal medicine & diabetes clinics at Benha University Hospital. Treatment with ALA for 3 months was given to patient with diabetic peripheral neuropathy. Data in the form of age, sex, body mass index (BMI), duration & treatment of DM, manifestations of peripheral neuropathy were collected. LDL-C, HDL-C, HbA1c, TSH, ALT, AST were measured before and after intervention. Peripheral neuropathy symptoms, nerve conduction velocities, cardiovascular (CV) tests of autonomic neuropathy, and cross-section area of the posterior tibial nerve were performed before and after treatment intervention. Results: 90 adult diabetic patients were recruited in the study, 42.2% were females and 57.8% were males with a median age of 50-60.3 years (IQR = 52). A statistically significant improvements of neuropathic symptoms, nerve conduction velocity, and cardiovascular autonomic neuropathy were noted after 3 months of administration of ALA (p ˂0.001). However, the cross-section area of the posterior tibial nerve at baseline and after treatment did not change significantly (p value of 0.84). There was a significant improvement in the BMI, HDL-C, LDL-C, HbA1c (p ˂ 0.001). Conclusion: Oral treatment with ALA might cause ameliorations of peripheral neuropathy, HbA1c, and LDL-C & HDL-C levels in diabetic patients. Our result failed to proof effect of ALA on nerve cross-section area. The global data encourage further studies with this medication as an ancillary treatment of DM2.Clinical trial registration: It was registered in clinical trial website; ClinicalTrials.gov Identifier (NCT number): NCT04322240.

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