Background Neuropathy is one of most common complications in diabetic patients. Diagnosis of diabetic neuropathy is essential for decreasing the rate of the disability and death. Neuron-specific enolase (NSE) is released from damaged neuronal cells and enters the blood circulation through an injured blood brain barrier. Therefore, serum NSE can reflect the damage of neurons and brain tissue. Objective To evaluate peripheral polyneuropathy and cognitive function in Type 2 Diabetes Mellitus (T2DM) and correlate them with NSE level as a possible biomarker of diabetic neuropathy. Subjects and Methods Forty five T2DM patients with polyneuropathy were randomly recruited in this study compared to 45 healthy age and sex matched subjects as a control. Patients group were divided into two subgroups, 24 diabetic patients with painful peripheral neuropathy and 21 with painless peripheral neuropathy. All were subjected to clinical assessment by diabetic neuropathy symptom score, Dyck neuropathy grading, Mini-Mental State Examination (MMSE), assessment of HbA1c, NSE biomarker and neurophysiological assessment (nerve conduction study (NCS), event related potential (P300wave) and somatosensory evoked potential (SSEP) of the right median nerve). Results There were significant decrease in cognitive functions in diabetic patients compared to controls and a significant increase in NSE in diabetic patients. There were no significant difference between patients with painless and painful diabetic neuropathy as regard MMSE, HbA1c and NSE. There were significant correlation of P300 in diabetic patients with HbA1c and NSE. Conclusion Neurophysiological assessment of diabetic patients by NCS, SSEP and P300 have well evaluation of cognitive functions, painless, and painful diabetic polyneuropathy. NSE is a beneficial biomarker in diabetic patients to pick up neurological complications.
Background: hypertensive diseases represent a major disease burden in Egypt. The prevalence of hypertension in Egypt in 2008 among adults of age ≥ 25 was 17.6%. In 60% of patients, hypertension is usually associated with cardiovascular risk factors. This leads to increased cardiovascular morbidity and mortality. Management of hypertension in Egypt is not easy because of treatment costs and inefficient primary health care system. There is a need for developing national hypertension guidelines to improve the rates of awareness, treatment and control of hypertension with the final goal of preventing and decreasing mortality and morbidity. Aim of work: to assess the essential hypertension status among the Egyptian adult population of age≥ 25 and to study the modifiable social and environmental risk factors, health consequences, and assess the cardiovascular and non-cardiovascular complications to help disease prevention and limitation of complications. Patients and methods: this study was conducted on 312 patients of age ≥ 25 with essential hypertension. All patient were subjected to full medical history and physical examination that including measurement of blood pressure (BP) and fundus examination. Anthropometric measurements including height, weight, waist circumferences, and hip circumferences were also measured. Waist to hip ratio and body mass index (BMI) were calculated. Laboratory investigations were performed including complete blood count (CBC), fasting blood glucose, measurement of creatinine, uric acid and lipid profile. Microalbuminuria was also assessed. Other investigations including electrocardiogram and echocardiograph were done. Results: Male patients were 134(42.9%), while females were 178(57.1%). Their ages ranged from 30 to 85 years with a mean ±SD of 55.16±9.4years.Dyslipidemia was found in 152 (49%) patients. Left ventricular diastolic dysfunction (LVDD) was represented in160 (51%) patients. Uncontrolled BP was represented in (73%), (66%) and (55%) of non-educated, mild to moderate educated and high educated patients respectively. Retinopathy was found in 121 (38.8%) patients, 76 (60%) patients were hypertensive diabetic and 45 (24%) patients were hypertensive non-diabetic. Albumin in urine was present in 20%of patients. Conclusion: strategies that enhance public awareness of hypertension and increase access to affordable medications are urgently needed. Prevention of hypertension needs both a population strategy and an intensive strategy focused on individuals at high risk. The complications of hypertension can be prevented by adequate blood pressure control with screening programs to identify the population at risk
ObjectiveTo evaluate the influence of irisin on the experimental paradigm of non-alcoholic fatty liver (NAFL) as a part of MetS cluster.MethodsForty male albino rats were divided into four groups; normal control, standard diet + irisin, high carbohydrate and fat diet (HCHF), and HCHF + irisin. After the experimental period, levels of fasting blood sugar (FBS), insulin, lipid profile, kidney functions, salusin-alpha (Sal-α), adropin, and retinol-binding protein-4 (RBP-4) were evaluated. Peroxisome proliferator-activated receptor-gamma coactivator-1alpha (PGC-1α) expression in skeletal muscle was evaluated by quantitative real-time PCR. Aorta, liver, pancreas, and skeletal muscle tissue samples were prepared for histopathological examination.ResultsRats administrated HCHF showed elevated levels of FBS, lipid profile, kidney functions, RBP-4, and downregulation of PGC-1α expression along with a decline in levels of insulin, Sal-α, and adropin while administration of irisin significantly attenuated these levels.ConclusionsIrisin as based therapy could emerge as a new line of treatment against MetS and its related diseases.
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