SummaryThirty patients with exudative pleural effusions were 17 males and 13 females. Their age ranged from 18-77 years, according to Light’s criteria, were fit for pleural biopsy and didn’t have any of the following; bleeding disorders, positive culture of pleural fluid, frank pus, chylothorax, recent history of chest trauma, recent abdominal operation or recent coronary artery bypass, were selected from Patients with pleural effusions, who were admitted at Chest and Internal Medicine Departments, Zagazig University Hospitals, in the period from July 2004 to August 2005, and subjected to the following:1) Thorough medical history2) Full clinical examination.3) Plain Chest X- ray (postero-anterior and lateral views).4) Hematological investigations including:a) Complete blood picture.b) Liver function tests (total proteins, albumin, SGOT, SGPT, and total and direct bilirubin).c) Kidney function tests (blood urea and serum creatinine).d) Prothrombin time and partial thromboplastin time.e) Erythrocyte sedimentation rate (ESR).f) Fasting blood sugar; simultaneous with measurement of pleural fluid glucose level.g) Serum LDH simultaneous with measurement of pleural fluid value of LDH.h) Bone marrow biopsy from the sternum, under local anesthesia, was done in one case which diagnosed as chronic lymphocytic leukemia.5) Sputum analysis: was done for 5 patients with expectoration• Z.N. staining.• Cytological examination for malignant cells.6) Tuberculin skin test. (Mantoux method)7) Serological studies including some selected tests:a) Serum rheumatoid factor (RF).b) Serum antinuclear antibody (ANA)8) Pelvi-abdominal ultrasound.9) Ultrasound guided thoracocentesis.10) Pleural fluid analysis:(pH, protein, glucose, LDH, total and differential leukocytic count, gram stain, culture and sensitivity for aerobic, anaerobic organisms and AFB, ZN staining and cytological examination for malignant cells)11) Blind pleural biopsy by Abrams’ needle: biopsy taken was sent for culture for AFB and histopathological examination.12) Contrast enhanced CT chest.13) CT guided pleural biopsy: from the maximum area of parietal pleural thickening detected in CT chest and sent for histopathological examination.14) Fiberoptic bronchoscope: was done for 8 patients with parenchymal lesions detected in radiological examination and one patient with hemoptysis. The biopsy was sent for histopathological examination and BAL was sent for both ZN staining and cytological examination.15) Medical thoracoscope: with biopsy taken using the ”Storz” rigid thoracoscope 9 mm diameter was performed. The procedure of thoracoscopy was done under local anaesthesia and through a single puncture, that was made before for Abrams’ needle, at the posterior axillary line in the 6th-8th intercostal space while the patient lying in the lateral decubitus position with affected hemithorax up.The results of current study were as follow:1) The final diagnosis as established by different diagnostic tools was reached in 30 cases (100%) and distributed as follow; 8 patients (26.7%) with tuberculosis, one patient (3.3%) with rheumatoid arthritis, 4 patients (13.3%) with primary lung cancer (3 adenocarcinoma and 1 small cell carcinoma), 10 patients (33.3%) with metastatic carcinoma, 2 patients (6.7%) with hematological malignancies (one lymphoma and the other leukemia), and 5 patients (16.7%) with mesothelioma.2) Pleural fluid cytology achieved the diagnosis in 8 /21cases with sensitivity (38 %) of malignant pleural effusion, among them 2 cases (50%) with primary lung cancer, 5 cases (50%) with metastatic carcinoma and one case (20%) with mesothelioma.3) Abrams’ pleural biopsy yielded an overall sensitinity in 21 patients (70%) was obtained. It was positive (pathology and culture for AFB) in 7 patients of tuberculous pleural effusion (87.5%), while the corresponding result for malignancy was 14 patients (66.7%) which distributed as follow; 3 patients (75%) with primary lung cancer, 8 patients (80%) with metastatic carcinoma and 3 patients (60%) with malignant pleural mesothelioma.(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.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.-