Trans-cranial duplex and Visfatin as markers for cerebrovascular complications in type 2 DM / Samaa Ayman Anwar Saiid ; Supervised Sahar Abdelrahman Nassef , Nagwa Ramadan Ahmed , Dina Sabry

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Samaa Ayman Anwar Saiid

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TextLanguage: English Publication details: Cairo : Samaa Ayman Anwar Saiid , 2020Description: 205 P. : charts , facimiles ; 25cmOther title:

تقييم دور الدوبلكس عبر الجمجمة والفسفاتن كدلالات على مضاعفات الأوعية الدماغيه فى مرضى السكرى من النوع الثانى [Added title page title]

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Dissertation note: Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine Summary: Background Type 2 diabetes mellitus (T2DM) is a chronic, multisystem disease; chronic exposure to hyperglycaemia affects the microvasculature and macrovasculature as well. In the brain, T2DM is associated with white matter hyperintensities often presumed to be of vascular origin.Transcranial Doppler (TCD) is a modern and sophisticated diagnostic procedure that enables recording the changes in cerebral perfusion in various states. Visfatin is a newly cytokine that is discovered to have a direct relationship to (T2DM).Methods This observational prospective study includes 80 diabetic subjects divided into subjects with microvascular complications, subjects with macrovascular complications and subjects with no complications. All patients were examined clinically, kidney functions, lipid profile, glycated hemoglobin (HBA1c), albumin/ creatinine ratio (A/Cratio), triglyceride (TG) and visfatin level were done Ankle Brachial Index (ABI), carotid Intima Media Thickness (cIMT) and transcranial duplex (TCD) were also done to evaluate vascular complications Results There were statistically significant difference in A/C ratio,TG and HBA1c among the studied groups. Visfatin level was higher among diabetic patients with Macro and Micro-vascular complications than those with No complications but don't reach statistically significant difference.There was statistically significant difference in pulsatile index (PI) of right (RT), left (LT) middle cerebral (MC) and Basilar arteries between the studied groups. PI RT and LT MCA show high sensitivity (69.2% and 64.1%) and high specificity (75% and 95%) respectively in prediction of micro-vascular complications, with cut off value (1.005 and 1.035) respectively. Conclusion -DM may not affect the cerebral circulation with affecting large vessels only, it may also complicate with cerebral microangiopathy and even white matter affection. -TCD can be used in detecting large vessel stenosis reflected by MFV and also arteriolar and white matter affection reflected by PI

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Holdings
Item type	Current library	Home library	Call number	Copy number	Status	Date due	Barcode
Thesis	قاعة الرسائل الجامعية - الدور الاول	المكتبة المركزبة الجديدة - جامعة القاهرة	Cai01.11.18.Ph.D.2020.Sa.T (Browse shelf(Opens below))		Not for loan		01010110082305000
CD - Rom	مخـــزن الرســائل الجـــامعية - البدروم	المكتبة المركزبة الجديدة - جامعة القاهرة	Cai01.11.18.Ph.D.2020.Sa.T (Browse shelf(Opens below))	82305.CD	Not for loan		01020110082305000

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background Type 2 diabetes mellitus (T2DM) is a chronic, multisystem disease; chronic exposure to hyperglycaemia affects the microvasculature and macrovasculature as well. In the brain, T2DM is associated with white matter hyperintensities often presumed to be of vascular origin.Transcranial Doppler (TCD) is a modern and sophisticated diagnostic procedure that enables recording the changes in cerebral perfusion in various states. Visfatin is a newly cytokine that is discovered to have a direct relationship to (T2DM).Methods This observational prospective study includes 80 diabetic subjects divided into subjects with microvascular complications, subjects with macrovascular complications and subjects with no complications. All patients were examined clinically, kidney functions, lipid profile, glycated hemoglobin (HBA1c), albumin/ creatinine ratio (A/Cratio), triglyceride (TG) and visfatin level were done Ankle Brachial Index (ABI), carotid Intima Media Thickness (cIMT) and transcranial duplex (TCD) were also done to evaluate vascular complications Results There were statistically significant difference in A/C ratio,TG and HBA1c among the studied groups. Visfatin level was higher among diabetic patients with Macro and Micro-vascular complications than those with No complications but don't reach statistically significant difference.There was statistically significant difference in pulsatile index (PI) of right (RT), left (LT) middle cerebral (MC) and Basilar arteries between the studied groups. PI RT and LT MCA show high sensitivity (69.2% and 64.1%) and high specificity (75% and 95%) respectively in prediction of micro-vascular complications, with cut off value (1.005 and 1.035) respectively. Conclusion -DM may not affect the cerebral circulation with affecting large vessels only, it may also complicate with cerebral microangiopathy and even white matter affection. -TCD can be used in detecting large vessel stenosis reflected by MFV and also arteriolar and white matter affection reflected by PI

Issued also as CD

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