SUMMARY AND CONCLUSIONThis study was carried out on fifty allergic asthmatic children from Allergy and Clinical Immunology unit, Zagazig University Hospital, 29 of them were of moderate asthma and 21 were of severe asthma.The diagnosis of asthma was achieved by:1- Through history and clinical diagnosis by presence of recurrent wheezes, cough, chest tightness and dyspnea.2- Plain x-ray chest to rule out other pulmonary pathology.The clinical types of asthma were diagnosed by:1- Skin test by intradermal method for the common allergens: house dust, house dust mite, cotton dust, mixed pollens, straw, hay dust and wool.2- Total serum IgE level.3- Medication that were used to control symptoms.? 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.(1) Theory of acoustic impedance.(2) Theory of cavitation.(3) Theory of revascularization.(4) Theory of microtrauma.(5) Theory of hyperstimulation analgesia.Indications are:(1) Delayed unions and non-unions.(2) Lateral epicondylitis of the elbow (tennis elbow).(3) Calcifying tendonitis of the shoulder.(4) Painful heel and chronic plantar fasciitis.(5) Femoral head necrosis in adults.Approximately ? of patients have some discomfort at the treatment site. Others adverse effects of ESWT are very rare, including swelling, ecchymosis, local reddening, and hematoma that resolve spontaneously after 48 hours.Unsuitable patients are:(1) Local arthrosis, arthritis, or rheumatoid arthritis.(2) Pathological neurological findings.(3) Pregnancy.(4) Patients less than 18 years of age.(5) Coagulopathy or anticoagulant therapy.(6) Thyrotoxicosis.(7) Tumours.Most, or nearly all, clinical work and scientific papers reported that success rates for ESWT are good to excellent. ESWT is considered to be an alternative or even superior, to surgery because of safety, noninvasiveness, and high success rates.