SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.This study had been carried out on 90 subjects, they were divided into 3 groups.Group I- included 10 healthy subjects as a control group.Group IIa- it included 40 patients with diabetic peripheral neuropathy 20 0f them with type I diabetes mellitus and the other 20 with type II diabetes mellitus).Group II b- it included 40 patients with uraemic peripheral neuropathy, 20 of them under conservative treatment and the other 20 on regular dialysis (pertonial or haemodialysis)} .All subjects of this study subjected to the following investigations: liver function tests, kidney function tests ,complete blood picture, fasting and 2 hours postprandial blood glucose level , glycosylated haemoglobin (HBA1c), urine and stool analysis, E.S.R., lipid profils, serum nerve growth level and nerve conduction velocity measurment.The following results were obtained:? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in the whole groups compared to the control .? There was a significant decrease in the serum nerve growth factor levels and nerve conduction velocity in type 1diabetic patients as compared to type II.? A highly significant negative correlation was found between both of nerve growth factor (NGF) and nerve conuction velocity (NCV) to each of fasting blood glucose, glcosylated haemoglbulin, duration of diabetes, symptoms and examination scores in diabetic patients with peripheral neuropathy.? There was a significant positive correlation between neuropathy scores and each of fasting blood glucose,glcosylated haemoglbulin,and duration of diabetes ,while there was a highly significant negative correlation with nerve conduction velocity of four measured nerves in diabetic patients with P.N..? A significant decrease in the serum nerve growth factor and nerve conduction velocity was found in chronic renal failure patients on conservative treatment as compared to these on regular dialysis.? A highly significant negative correlation was found between both of nerve growth factor and nerve conuction velocity to each of serum urea, and serum creatinine and symptoms and examination scores . while there was non significant correlation between them and duration of dialysis in uraemic patients with peripheral neuropathy .? There was significant positive correlation between neuropathy scores and each of serum urea, and serum creatinine , while there was a highly significant negative correlation with duration of dialysis and nerve conduction velocity of four measured nerves ,in uraemic patients with peripheral neuropathy.CONCLUSION AND RECOMMENDATIONFrom the previous results, it is clear that serum nerve growth factor is decreased in patients with peripheral neuropathy and this reduction is closely related to control, duration, and type of diabetes in diabetic patients, and to the degree of renal affection , while there is no relation between this reduction and duration of dialysis in uraemic patients. Nerve growth factor deficiency may be responsible for the pathogenesis of neuropathy which occurs in such patients. Therefore modulation of nerve growth factor may offer hope for patients with peripheral neuropathy and will open new therapeutic era in mangment of peripheral neuropathy in new future.and also both good diabetic control and foot care are very important in improvment of diabetic peripheral neuropathy in diabetic subjects.-SUMMARYDiabetic neuropathy is probably the most common chronic complication of diabetes that encompass a wide range of abnormalities affecting the peripheral nervous system causing considerable morbidity and mortality. The prevelance of diabetic neuropathy approaches 50% in most diabetic populations, and its consequences in the form of foot ulceration and leg amputation may be mandatory as there is no curative therapy for diabetic neuropathies.Uramic Neuropathy develops during the course of chronic kidney disease and it is present in up to 65% of patients at the initiation of dialysis, and the severity of neuropathy is correlated strongly with the severity of the renal insufficiency.Nerve growth factor (NGF) is a neurotrophic polypeptide, belongs to a closely related family of neurotrophins composed of brain-derived neurotrophic factor, neurotrophin-3, and neurotrophin-4/5. it selectively promotes the differentiation and maintenance of small fibre sensory and sympathetic neurons in the peripheral nervous system. Later studies have suggested that decreased availability of NGF contributes to the pathogenesis of diabetic polyneuropathy.The present study was aimed to find out how much the changes in the level of nerve growth factor and nerve conduction velocity in some types of neuropathy (diabetic and uraemic) and to find out any relation between serum level of nerve growth factor and each of degree of glycemic control , duration and type of diabetes in diabetic subjects, to the degree of renal affection and sufficient dialysis in uraemic patients and to the degree of neuropathy and nerve conduction velocity in different types of neuropathy.Postoperative spherical equivalent within one diopter of emmetropia was achieved in 76.67%, 86.67%, 70% of cases in group A, B and C respectively. Postoperative defocus equivalent equal to or less than one diopter was achieved in 50%, 80% and 60% of cases group A, B and C respectively.The contrast sensitivity curves improved in the first postoperative month in all spatial frequencies in cases of group A and C without significant change in the subsequent visits. However; in cases of group B the contrast sensitivity curves decreased in the first postoperative month in all spatial frequencies, then improved at the third month visit to the preoperative level to exceed it in the sixth month without significant change in the subsequent ninth month visit.There was transient rise in IOP in cases of group A and C during the first postoperative week however; in group B IOP showed significant decline all through the follow up period.There was statistically significant loss of endothelial cells at one and nine months postoperatively however, the degree of loss varied in different groups. The loss in the mean endothelial cell count from preoperative level to the first month postoperatively was 6.29%, 1.56% and 9.78% and from the first month to the ninth month postoperatively was 0.99%, 1.28% and 0.92% in group A, B and C respectively.Regarding complications; in group (A), 6.67% of cases developed mild intraoperative hyphaema. Pupil ovalization occurred in 6.67% of cases, In 3.33% of cases rotation of the lens occurred due to too short haptics. In group (B), 3.33% of cases had decentered flap 3.33 % had decentered ablation. Interface deposits as well as bleeding to the interface were observed in 6.67%. The incidence of epithelial ingrowth, DLK and flap stria was 3.33% where as that of pseudoDLK was 6.67%. while in group (C), 3.33% of cases had intraoperative iris trauma while developed 6.67% posterior capsule opacification.CONCLUSIONSurgical correction of moderate to high myopia proved to be effective, safe and predictable. The choice of the procedure should be based on the patient’s condition, the surgeon’s expertise as well as the resources of the health care facility. The main procedures for correction of high myopia are Phakic IOLs, LASIK and clear lens extraction. Each of these procedures has its own indications, precautions as well as its most feared complications.Phakic IOLs despite the excellent initial outcome in terms of predictability and quality of vision imply certain risk for endothelial damage therefore should be followed up regularly. Phakic IOL should be removed as soon as serious decline in endothelial cell density occurs. As large proportion of high myopes will develop cataract, care should be taken to interfere before endothelial cell count decreases below safe limit for performing cataract extraction. The younger the patient at time of PIOL implantation, the higher the endothelial cell count required before PIOL implantation.LASIK is less invasive but irreversible procedure. Concerns about LASIK include degradation in quality of vision especially with marked flattening of the cornea which directly increases the higher order aberrations, the compromise between the optical zone and the possible correction respecting the minimal residual stromal bed. At any cost the risk of post LASIK keratectasia, the most devastating complication of LASIK nowadays, should be minimized. It should be kept in mind that theoretical calculations do not make up for the common error in the flap thickness.Clear lens extraction is more appealing in patients over forty five years especially if there is lens sclerosis as phakic IOL may enhance the cataract. LASIK also complicates IOL calculation should cataract progress necessitating removal. CLE should be performed through as small incision as possible to decrease the fluctuation in anterior chamber depth. Complete cortical clean up as well as capsular polishing must be performed to decrease the incidence of posterior capsular opacification and consequently YAG laser capsulotomy which is a very important added risk factor for retinal detachment in high myopes.Finally, due to the possible risks and elective nature of these procedures, they should only be offered to patients who refuse glasses and do not tolerate contact lenses. Clear explanation and proper informed consent is mandatory in every case.SUMMARYAs refractive surgery gets simpler, safer, more predictable and more effective, it becomes more popular. While cases of simple myopia are usually easy to handle and get satisfactory results when corrected with excimer laser, those with high myopia still represent some challenges.To get the best possible outcome, the surgical plan should be tailored individually to suit each particular case with its peculiar characteristics regarding patients age, activities, visual needs, expectations and of course not the least his own eye parameters.In an attempt to better understand this issue, this study was conducted including ninety eyes of 48 patients, 22 males (45.8 %) and 26 (54.2%) females with a mean age of 40.66±12.03 (range 20 to 63) years and mean spherical equivalent of -12.67±4.64 (range -24 to -7.5) diopters. They were divided into three equal groups.The first group (A) underwent phakic intraocular lens implantation namely Kelman duet lens which is an angle supported anterior chamber phakic lens with rigid tripod haptic and foldable optic that can be injected through a self sealed clear corneal incision of as small size as two mm to be assembled to the previously implanted haptic.The second group (B) under went LASIK after doing the necessary investigations to exclude keratoconus suspects and to make sure that the cornea has enough thickness to allow complete correction of the refractive error in an ablation diameter that matches the scotopic pupil size.The third group (C) underwent clear lens extraction using micro-incision cataract surgery followed by implantation of acrylic foldable posterior chamber IOLs.The mean efficacy index three months postoperatively was 0.99, 0.874 and 0.916 in group A, B and C respectively. UCVA of 0.5 (6/12) or better was achieved in 80%, 93.33%, 63.3% of cases of group A, B and C respectively, while UCVA of 1.0 (6/6) was achieved in 16.67% and 33.3% of cases of group A and B.The mean postoperative safety index was 1.268, 1.03 and 1.249 in group A, B and C respectively. BCVA of 0.5 (6/12) or better was achieved in all cases however, 50%, 60% and 26.67% of cases in group A, B and C respectively achieved postoperative BCVA of 1.0 (6/6)Postoperative spherical equivalent within one diopter of emmetropia was achieved in 76.67%, 86.67%, 70% of cases in group A, B and C respectively. Postoperative defocus equivalent equal to or less than one diopter was achieved in 50%, 80% and 60% of cases group A, B and C respectively.The contrast sensitivity curves improved in the first postoperative month in all spatial frequencies in cases of group A and C without significant change in the subsequent visits. However; in cases of group B the contrast sensitivity curves decreased in the first postoperative month in all spatial frequencies, then improved at the third month visit to the preoperative level to exceed it in the sixth month without significant change in the subsequent ninth month visit.There was transient rise in IOP in cases of group A and C during the first postoperative week however; in group B IOP showed significant decline all through the follow up period.There was statistically significant loss of endothelial cells at one and nine months postoperatively however, the degree of loss varied in different groups. The loss in the mean endothelial cell count from preoperative level to the first month postoperatively was 6.29%, 1.56% and 9.78% and from the first month to the ninth month postoperatively was 0.99%, 1.28% and 0.92% in group A, B and C respectively.Regarding complications; in group (A), 6.67% of cases developed mild intraoperative hyphaema. Pupil ovalization occurred in 6.67% of cases, In 3.33% of cases rotation of the lens occurred due to too short haptics. In group (B), 3.33% of cases had decentered flap 3.33 % had decentered ablation. Interface deposits as well as bleeding to the interface were observed in 6.67%. The incidence of epithelial ingrowth, DLK and flap stria was 3.33% where as that of pseudoDLK was 6.67%. while in group (C), 3.33% of cases had intraoperative iris trauma while developed 6.67% posterior capsule opacification.CONCLUSIONSurgical correction of moderate to high myopia proved to be effective, safe and predictable. The choice of the procedure should be based on the patient’s condition, the surgeon’s expertise as well as the resources of the health care facility. The main procedures for correction of high myopia are Phakic IOLs, LASIK and clear lens extraction. Each of these procedures has its own indications, precautions as well as its most feared complications.Phakic IOLs despite the excellent initial outcome in terms of predictability and quality of vision imply certain risk for endothelial damage therefore should be followed up regularly. Phakic IOL should be removed as soon as serious decline in endothelial cell density occurs. As large proportion of high myopes will develop cataract, care should be taken to interfere before endothelial cell count decreases below safe limit for performing cataract extraction. The younger the patient at time of PIOL implantation, the higher the endothelial cell count required before PIOL implantation.LASIK is less invasive but irreversible procedure. Concerns about LASIK include degradation in quality of vision especially with marked flattening of the cornea which directly increases the higher order aberrations, the compromise between the optical zone and the possible correction respecting the minimal residual stromal bed. At any cost the risk of post LASIK keratectasia, the most devastating complication of LASIK nowadays, should be minimized. It should be kept in mind that theoretical calculations do not make up for the common error in the flap thickness.Clear lens extraction is more appealing in patients over forty five years especially if there is lens sclerosis as phakic IOL may enhance the cataract. LASIK also complicates IOL calculation should cataract progress necessitating removal. CLE should be performed through as small incision as possible to decrease the fluctuation in anterior chamber depth. Complete cortical clean up as well as capsular polishing must be performed to decrease the incidence of posterior capsular opacification and consequently YAG laser capsulotomy which is a very important added risk factor for retinal detachment in high myopes.Finally, due to the possible risks and elective nature of these procedures, they should only be offered to patients who refuse glasses and do not tolerate contact lenses. Clear explanation and proper informed consent is mandatory in every case.SUMMARYAs refractive surgery gets simpler, safer, more predictable and more effective, it becomes more popular. While cases of simple myopia are usually easy to handle and get satisfactory results when corrected with excimer laser, those with high myopia still represent some challenges.To get the best possible outcome, the surgical plan should be tailored individually to suit each particular case with its peculiar characteristics regarding patients age, activities, visual needs, expectations and of course not the least his own eye parameters.In an attempt to better understand this issue, this study was conducted including ninety eyes of 48 patients, 22 males (45.8 %) and 26 (54.2%) females with a mean age of 40.66±12.03 (range 20 to 63) years and mean spherical equivalent of -12.67±4.64 (range -24 to -7.5) diopters. They were divided into three equal groups.The first group (A) underwent phakic intraocular lens implantation namely Kelman duet lens which is an angle supported anterior chamber phakic lens with rigid tripod haptic and foldable optic that can be injected through a self sealed clear corneal incision of as small size as two mm to be assembled to the previously implanted haptic.The second group (B) under went LASIK after doing the necessary investigations to exclude keratoconus suspects and to make sure that the cornea has enough thickness to allow complete correction of the refractive error in an ablation diameter that matches the scotopic pupil size.The third group (C) underwent clear lens extraction using micro-incision cataract surgery followed by implantation of acrylic foldable posterior chamber IOLs.The mean efficacy index three months postoperatively was 0.99, 0.874 and 0.916 in group A, B and C respectively. UCVA of 0.5 (6/12) or better was achieved in 80%, 93.33%, 63.3% of cases of group A, B and C respectively, while UCVA of 1.0 (6/6) was achieved in 16.67% and 33.3% of cases of group A and B.The mean postoperative safety index was 1.268, 1.03 and 1.249 in group A, B and C respectively. BCVA of 0.5 (6/12) or better was achieved in all cases however, 50%, 60% and 26.67% of cases in group A, B and C respectively achieved postoperative BCVA of 1.0 (6/6)Postoperative spherical equivalent within one diopter of emmetropia was achieved in 76.67%, 86.67%, 70% of cases in group A, B and C respectively. Postoperative defocus equivalent equal to or less than one diopter was achieved in 50%, 80% and 60% of cases group A, B and C respectively.The contrast sensitivity curves improved in the first postoperative month in all spatial frequencies in cases of group A and C without significant change in the subsequent visits. However; in cases of group B the contrast sensitivity curves decreased in the first postoperative month in all spatial frequencies, then improved at the third month visit to the preoperative level to exceed it in the sixth month without significant change in the subsequent ninth month visit.There was transient rise in IOP in cases of group A and C during the first postoperative week however; in group B IOP showed significant decline all through the follow up period.There was statistically significant loss of endothelial cells at one and nine months postoperatively however, the degree of loss varied in different groups. The loss in the mean endothelial cell count from preoperative level to the first month postoperatively was 6.29%, 1.56% and 9.78% and from the first month to the ninth month postoperatively was 0.99%, 1.28% and 0.92% in group A, B and C respectively.Regarding complications; in group (A), 6.67% of cases developed mild intraoperative hyphaema. Pupil ovalization occurred in 6.67% of cases, In 3.33% of cases rotation of the lens occurred due to too short haptics. In group (B), 3.33% of cases had decentered flap 3.33 % had decentered ablation. Interface deposits as well as bleeding to the interface were observed in 6.67%. The incidence of epithelial ingrowth, DLK and flap stria was 3.33% where as that of pseudoDLK was 6.67%. while in group (C), 3.33% of cases had intraoperative iris trauma while developed 6.67% posterior capsule opacification.CONCLUSIONSurgical correction of moderate to high myopia proved to be effective, safe and predictable. The choice of the procedure should be based on the patient’s condition, the surgeon’s expertise as well as the resources of the health care facility. The main procedures for correction of high myopia are Phakic IOLs, LASIK and clear lens extraction. Each of these procedures has its own indications, precautions as well as its most feared complications.Phakic IOLs despite the excellent initial outcome in terms of predictability and quality of vision imply certain risk for endothelial damage therefore should be followed up regularly. Phakic IOL should be removed as soon as serious decline in endothelial cell density occurs. As large proportion of high myopes will develop cataract, care should be taken to interfere before endothelial cell count decreases below safe limit for performing cataract extraction. The younger the patient at time of PIOL implantation, the higher the endothelial cell count required before PIOL implantation.LASIK is less invasive but irreversible procedure. Concerns about LASIK include degradation in quality of vision especially with marked flattening of the cornea which directly increases the higher order aberrations, the compromise between the optical zone and the possible correction respecting the minimal residual stromal bed. At any cost the risk of post LASIK keratectasia, the most devastating complication of LASIK nowadays, should be minimized. It should be kept in mind that theoretical calculations do not make up for the common error in the flap thickness.Clear lens extraction is more appealing in patients over forty five years especially if there is lens sclerosis as phakic IOL may enhance the cataract. LASIK also complicates IOL calculation should cataract progress necessitating removal. CLE should be performed through as small incision as possible to decrease the fluctuation in anterior chamber depth. Complete cortical clean up as well as capsular polishing must be performed to decrease the incidence of posterior capsular opacification and consequently YAG laser capsulotomy which is a very important added risk factor for retinal detachment in high myopes.Finally, due to the possible risks and elective nature of these procedures, they should only be offered to patients who refuse glasses and do not tolerate contact lenses. Clear explanation and proper informed consent is mandatory in every case.SUMMARYAs refractive surgery gets simpler, safer, more predictable and more effective, it becomes more popular. While cases of simple myopia are usually easy to handle and get satisfactory results when corrected with excimer laser, those with high myopia still represent some challenges.To get the best possible outcome, the surgical plan should be tailored individually to suit each particular case with its peculiar characteristics regarding patients age, activities, visual needs, expectations and of course not the least his own eye parameters.In an attempt to better understand this issue, this study was conducted including ninety eyes of 48 patients, 22 males (45.8 %) and 26 (54.2%) females with a mean age of 40.66±12.03 (range 20 to 63) years and mean spherical equivalent of -12.67±4.64 (range -24 to -7.5) diopters. They were divided into three equal groups.The first group (A) underwent phakic intraocular lens implantation namely Kelman duet lens which is an angle supported anterior chamber phakic lens with rigid tripod haptic and foldable optic that can be injected through a self sealed clear corneal incision of as small size as two mm to be assembled to the previously implanted haptic.The second group (B) under went LASIK after doing the necessary investigations to exclude keratoconus suspects and to make sure that the cornea has enough thickness to allow complete correction of the refractive error in an ablation diameter that matches the scotopic pupil size.The third group (C) underwent clear lens extraction using micro-incision cataract surgery followed by implantation of acrylic foldable posterior chamber IOLs.The mean efficacy index three months postoperatively was 0.99, 0.874 and 0.916 in group A, B and C respectively. UCVA of 0.5 (6/12) or better was achieved in 80%, 93.33%, 63.3% of cases of group A, B and C respectively, while UCVA of 1.0 (6/6) was achieved in 16.67% and 33.3% of cases of group A and B.The mean postoperative safety index was 1.268, 1.03 and 1.249 in group A, B and C respectively. BCVA of 0.5 (6/12) or better was achieved in all cases however, 50%, 60% and 26.67% of cases in group A, B and C respectively achieved postoperative BCVA of 1.0 (6/6)Postoperative spherical equivalent within one diopter of emmetropia was achieved in 76.67%, 86.67%, 70% of cases in group A, B and C respectively. Postoperative defocus equivalent equal to or less than one diopter was achieved in 50%, 80% and 60% of cases group A, B and C respectively.The contrast sensitivity curves improved in the first postoperative month in all spatial frequencies in cases of group A and C without significant change in the subsequent visits. However; in cases of group B the contrast sensitivity curves decreased in the first postoperative month in all spatial frequencies, then improved at the third month visit to the preoperative level to exceed it in the sixth month without significant change in the subsequent ninth month visit.There was transient rise in IOP in cases of group A and C during the first postoperative week however; in group B IOP showed significant decline all through the follow up period.There was statistically significant loss of endothelial cells at one and nine months postoperatively however, the degree of loss varied in different groups. The loss in the mean endothelial cell count from preoperative level to the first month postoperatively was 6.29%, 1.56% and 9.78% and from the first month to the ninth month postoperatively was 0.99%, 1.28% and 0.92% in group A, B and C respectively.Regarding complications; in group (A), 6.67% of cases developed mild intraoperative hyphaema. Pupil ovalization occurred in 6.67% of cases, In 3.33% of cases rotation of the lens occurred due to too short haptics. In group (B), 3.33% of cases had decentered flap 3.33 % had decentered ablation. Interface deposits as well as bleeding to the interface were observed in 6.67%. The incidence of epithelial ingrowth, DLK and flap stria was 3.33% where as that of pseudoDLK was 6.67%. while in group (C), 3.33% of cases had intraoperative iris trauma while developed 6.67% posterior capsule opacification.CONCLUSIONSurgical correction of moderate to high myopia proved to be effective, safe and predictable. The choice of the procedure should be based on the patient’s condition, the surgeon’s expertise as well as the resources of the health care facility. The main procedures for correction of high myopia are Phakic IOLs, LASIK and clear lens extraction. Each of these procedures has its own indications, precautions as well as its most feared complications.Phakic IOLs despite the excellent initial outcome in terms of predictability and quality of vision imply certain risk for endothelial damage therefore should be followed up regularly. Phakic IOL should be removed as soon as serious decline in endothelial cell density occurs. As large proportion of high myopes will develop cataract, care should be taken to interfere before endothelial cell count decreases below safe limit for performing cataract extraction. The younger the patient at time of PIOL implantation, the higher the endothelial cell count required before PIOL implantation.LASIK is less invasive but irreversible procedure. Concerns about LASIK include degradation in quality of vision especially with marked flattening of the cornea which directly increases the higher order aberrations, the compromise between the optical zone and the possible correction respecting the minimal residual stromal bed. At any cost the risk of post LASIK keratectasia, the most devastating complication of LASIK nowadays, should be minimized. It should be kept in mind that theoretical calculations do not make up for the common error in the flap thickness.Clear lens extraction is more appealing in patients over forty five years especially if there is lens sclerosis as phakic IOL may enhance the cataract. LASIK also complicates IOL calculation should cataract progress necessitating removal. CLE should be performed through as small incision as possible to decrease the fluctuation in anterior chamber depth. Complete cortical clean up as well as capsular polishing must be performed to decrease the incidence of posterior capsular opacification and consequently YAG laser capsulotomy which is a very important added risk factor for retinal detachment in high myopes.Finally, due to the possible risks and elective nature of these procedures, they should only be offered to patients who refuse glasses and do not tolerate contact lenses. Clear explanation and proper informed consent is mandatory in every case.SUMMARYAs refractive surgery gets simpler, safer, more predictable and more effective, it becomes more popular. While cases of simple myopia are usually easy to handle and get satisfactory results when corrected with excimer laser, those with high myopia still represent some challenges.To get the best possible outcome, the surgical plan should be tailored individually to suit each particular case with its peculiar characteristics regarding patients age, activities, visual needs, expectations and of course not the least his own eye parameters.In an attempt to better understand this issue, this study was conducted including ninety eyes of 48 patients, 22 males (45.8 %) and 26 (54.2%) females with a mean age of 40.66±12.03 (range 20 to 63) years and mean spherical equivalent of -12.67±4.64 (range -24 to -7.5) diopters. They were divided into three equal groups.The first group (A) underwent phakic intraocular lens implantation namely Kelman duet lens which is an angle supported anterior chamber phakic lens with rigid tripod haptic and foldable optic that can be injected through a self sealed clear corneal incision of as small size as two mm to be assembled to the previously implanted haptic.The second group (B) under went LASIK after doing the necessary investigations to exclude keratoconus suspects and to make sure that the cornea has enough thickness to allow complete correction of the refractive error in an ablation diameter that matches the scotopic pupil size.The third group (C) underwent clear lens extraction using micro-incision cataract surgery followed by implantation of acrylic foldable posterior chamber IOLs.The mean efficacy index three months postoperatively was 0.99, 0.874 and 0.916 in group A, B and C respectively. UCVA of 0.5 (6/12) or better was achieved in 80%, 93.33%, 63.3% of cases of group A, B and C respectively, while UCVA of 1.0 (6/6) was achieved in 16.67% and 33.3% of cases of group A and B.The mean postoperative safety index was 1.268, 1.03 and 1.249 in group A, B and C respectively. BCVA of 0.5 (6/12) or better was achieved in all cases however, 50%, 60% and 26.67% of cases in group A, B and C respectively achieved postoperative BCVA of 1.0 (6/6)Postoperative spherical equivalent within one diopter of emmetropia was achieved in 76.67%, 86.67%, 70% of cases in group A, B and C respectively. Postoperative defocus equivalent equal to or less than one diopter was achieved in 50%, 80% and 60% of cases group A, B and C respectively.The contrast sensitivity curves improved in the first postoperative month in all spatial frequencies in cases of group A and C without significant change in the subsequent visits. However; in cases of group B the contrast sensitivity curves decreased in the first postoperative month in all spatial frequencies, then improved at the third month visit to the preoperative level to exceed it in the sixth month without significant change in the subsequent ninth month visit.There was transient rise in IOP in cases of group A and C during the first postoperative week however; in group B IOP showed significant decline all through the follow up period.There was statistically significant loss of endothelial cells at one and nine months postoperatively however, the degree of loss varied in different groups. The loss in the mean endothelial cell count from preoperative level to the first month postoperatively was 6.29%, 1.56% and 9.78% and from the first month to the ninth month postoperatively was 0.99%, 1.28% and 0.92% in group A, B and C respectively.Regarding complications; in group (A), 6.67% of cases developed mild intraoperative hyphaema. Pupil ovalization occurred in 6.67% of cases, In 3.33% of cases rotation of the lens occurred due to too short haptics. In group (B), 3.33% of cases had decentered flap 3.33 % had decentered ablation. Interface deposits as well as bleeding to the interface were observed in 6.67%. The incidence of epithelial ingrowth, DLK and flap stria was 3.33% where as that of pseudoDLK was 6.67%. while in group (C), 3.33% of cases had intraoperative iris trauma while developed 6.67% posterior capsule opacification.CONCLUSIONSurgical correction of moderate to high myopia proved to be effective, safe and predictable. The choice of the procedure should be based on the patient’s condition, the surgeon’s expertise as well as the resources of the health care facility. The main procedures for correction of high myopia are Phakic IOLs, LASIK and clear lens extraction. Each of these procedures has its own indications, precautions as well as its most feared complications.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.