000			03382cam a2200325 a 4500
003			EG-GiCUC
008			201212s2020 ua dh f m 000 0 eng d
040			_aEG-GiCUC _beng _cEG-GiCUC
041	0		_aeng
049			_aDeposite
097			_aPh.D
099			_aCai01.11.18.Ph.D.2020.Sa.T
100	0		_aSamaa Ayman Anwar Saiid
245	1	0	_aTrans-cranial duplex and Visfatin as markers for cerebrovascular complications in type 2 DM / _cSamaa Ayman Anwar Saiid ; Supervised Sahar Abdelrahman Nassef , Nagwa Ramadan Ahmed , Dina Sabry
246	1	5	_aتقييم دور الدوبلكس عبر الجمجمة والفسفاتن كدلالات على مضاعفات الأوعية الدماغيه فى مرضى السكرى من النوع الثانى
260			_aCairo : _bSamaa Ayman Anwar Saiid , _c2020
300			_a205 P. : _bcharts , facimiles ; _c25cm
502			_aThesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine
520			_aBackground 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
530			_aIssued also as CD
653		4	_aTranscranial duplex (TCD)
653		4	_aType II (DM)
653		4	_aVisfatin
700	0		_aDina Sabry , _eSupervisor
700	0		_aNagwa Ramadan Ahmed , _eSupervisor
700	0		_aSahar Abdelrahman Nassef , _eSupervisor
905			_aNazla _eRevisor
905			_aShimaa _eCataloger
942			_2ddc _cTH
999			_c79194 _d79194