endothelial dysfunction; ischemic stroke; endothelin-1; nitric oxide.well as the second leading cause of mortality worldwide. The role of endothelial dysfunction in stroke is critical. Nitric oxide (NO) and endothelin-1 (ET-1) which are produced in endothelial cells are leading molecules regulating vascular function. Aim of the work: the aim of our study was to estimate serum nitric oxide and endothelin-1 levels as biomarkers of endothelial function in ischemic cerebrovascular stroke with or without type 2 diabetes mellitus (T2DM). Methods: A cross-section study included 100 patients with ischemic stroke who were stratified into two groups according to their fasting blood glucose into non-diabetic group (n=45) and diabetic group (n=55). The levels of serum NO were determined calorimetrically. Serum ET-1 concentrations were also estimated by enzyme immunoassay technique. Results: Our results showed that non diabetic patients with ischemic stroke had significantly higher values of serum NO compared to diabetic group .On the contrary; there was highly significant elevated serum ET-1 levels in diabetic group compared to non-diabetic group. After adjusted for the traditional risk factors, logistic regression analysis test demonstrated that both serum NO and ET-1 levels were statistically significant predictors of insulin resistance among patients with ischemic stroke. Linear regression analysis test showed that serum NO levels were independently correlated with high density cholesterol (HDL.C) values and systolic blood pressure. Regarding serum ET-1 levels, they were independently correlated with homeostasis model assessment of insulin resistance index (HOMA-IR) and waist/hip ratio (WHR) in patients with ischemic stroke. Conclusions: Both serum endothelin-1 and nitric oxide levels could be useful diagnostic biomarkers predicting insulin resistance among patients with ischemic stroke.

Background: The prevalence of sub clinical hypothyroidism (SCH) is relatively high and ranges from 4% to 20% in the adult population with more common in elderly. Elderly with SCH had higher risk of incident heart failure. Few studies reported the prevalence of thyroid dysfunction in elderly Egyptians especially coronary heart disease (CHD). The aim of our study was to estimate the prevalence of Subclinical hypothyroidism in elderly cardiac patients and to assess the relation between thyroid function, cardiovascular risk and severity of CHD in elderly. Methods: cross sectional study included 45 elderly Egyptian patients with cardiovascular disease and 45 healthy elderly subjects as controls. Cardiac patients were subdivided to ischemic (n=23) and hypertensive groups (n=22), ischemic group subdivided according to number of coronary artery occlusions. Serum level of FT 4 , FT 3 , TSH, lipid profile, fasting blood glucose were measured. Results: our results shows that, there were statistically significant higher levels of thyroid stimulating hormone (TSH), lipid profile, systolic and diastolic blood pressure in case group compared to control group. Additionally, There were statistically significant higher levels of TSH in ischemic cardiac group compared to hypertensive cardiac group (p <0.05), on the contrary there were no significant different as regard free T3 and T4 levels among studied groups. The prevalence of coronary artery occlusion in ischemic cardiac group was; normal (62.2%), single vessel disease (24.4%), two vessel disease (11.2%) and three vessel disease (2.2%). There was significant positive correlation between TSH levels and the number of coronary artery occlusion .In ischemic cardiac patients, linear regression analysis showed that TSH levels were independently correlated with TC, TG, LDL and HDL (P < 0.05). Conclusion: the prevalence of subclinical hypothyroidism in all cardiac group was (22%); in ischemic group (26%) and in hypertensive group (18%). Also, there was positive association between Subclinical Hypothyroidism, Hypertension, Dyslipidemia and CHD in elderly Patients.

Background:End-stage renal disease has become a public health concern worldwide. Type 2 diabetes is associated with significantly accelerated rates of diabetic nephropathy. There are controversies about the role of intact parathyroid hormone (iPTH) in the pathogenesis of osteodystrophy among diabetic patients on regular hemodialysis. We aimed to estimate serum levels of iPTH, 25-hydroxyvitamin D and to clarify the possible relationships between iPTH and HbA1c ;which reflect the glycemic control as well as other clinical and biochemical parameters in end-stage renal disease patients on regular hemodialysis. Subjects and methods: A case-control study of 84end-stage renal disease patients on maintenance hemodialysis thrice weekly.Patients were stratified into three groups;group1:28 diabetic patients with good glycemic control(HbA1c < 7), group 2:28 diabetic patients with poor glycemic control(HbA1c >7), and group3:28non diabetic patients, In all studied participants,blood urea, serum creatinine , calcium, phosphorus, albumin, alkaline phosphatase, lipid profile, HbA1c, fasting blood glucose (FBG),post prandial blood glucose (PPBG) and25-hydroxyvitamin Dwere measured.Also, we estimate serum iPTHlevels by ADVIA CENTAUR instrument using Chemiluminescence principle. Results:Non diabetic patienton chronic hemodialysis had significantly higher values of serum 25-hydroxyvitamin D,serum iPTHmore than diabetic group, moreover diabetic patients with poor glycemic control had significantly lower values of serum 25-hydroxyvitamin D and serum iPTH, compared to good glycemic control.In diabetic patients with poor glycemic control,iPTHlevel was negatively correlated with Alkaline phosphatase,post prandial blood glucose, fasting blood glucose, as well as HbA1c. In patients with good glycemic control serum iPTHlevel was positively correlated with25-hydroxyvitamin D., there were significant negative correlations betweeniPTH level and creatinine, alkaline phosphatase, phosphorous, albumin, post prandial blood glucose, fasting blood glucose, as well as HbA1c.Stepwise linear regression analysis showed that, serum iPTH levels were independently correlated with 25-hydroxyvitamin D with diastolic blood pressure,

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