Objective: Diabetic Polyneuropathy (DPN) represents a major health problem as it increases morbidity affecting patients' quality of life. Vitamin B frequently is used for treating DPN. ALPHA Lipoic Acid (ALA) seems to delay or reverse DPN. The present study compared the effect of Vitamin B complex combined with ALA versus Vitamin B in treatment of DPN in Egyptian type 2 diabetic patients. Methods:Forty type 2 diabetic patients with DPN of whom twenty received once-daily oral doses of ALA (600 mg) in combination with Vitamin B complex and the other twenty only received vitamin B complex for 12 weeks. Patients were evaluated by Michigan Neuropathy Screening Instrument (MNSI) questionnaire and Nerve Conduction Studies (NCS). Blood samples were collected for determination of Insulin Resistance and lipid abnormalities. All the previous assessments were performed at baseline and at week 12.Results: There was a significant reduction after 12 weeks of supplementation in vitamin B complex plus Alpha Lipoic Acid (ALA) group using MNSI questionnaire (p=0.001) and not in vitamin B complex group. NCS demonstrated that 12 out of 16 patients in vitamin B complex plus ALA group showed improvement in at least one property measured compared with only 6 out of 16 in vitamin B complex group (p=0.0732). The influence of the combination on the progression of diabetes with regards to insulin resistance and lipid profile showed no advantage over Vitamin B complex alone. Conclusion:Combined therapy of DPN with ALA and Vitamin B complex, orally for 12 weeks improves the symptoms of neuropathy (MNSI) with a similar trend in NCS.

Background Type 2 diabetes mellitus (T2DM) has reached global epidemic proportions, with more than 382 million people affected according to 2013 estimate. By 2035, its prevalence is expected to reach 471 million, meaning that 10% of the world’s population will have diabetes. Patients with diabetes often suffer from metabolic abnormalities, poor glycemic control, oxidative stress, insulin resistance, and low-grade inflammation. These conditions trigger vascular dysfunction, which predisposes them to atherothrombosis Objective The present study aimed to study the mean platelet volume (MPV) as a potential risk factor for ischemic heart disease and cerebrovascular stroke in type 2 diabetes. Methods The study was conducted on 150 subjects there ages ranged from 40 to 60 years old. They were divided into 4 groups: Group 1: included30 type 2 diabetic overweight or obese patients without previous history of myocardial infarction or cerebrovascular stroke. Then, they were subdivided into 2 subgroups: 1a) 15 diabetic non hypertensive patients. 1b) 15 diabetic hypertensive patients. Group 2: included A) 30 type 2 diabetic overweight or obese patients with recent cerebrovascular stroke. Then, they were subdivided into 2 subgroups: 2Aa) 15 diabetic non hypertensive patients. 2Ab) 15 diabetic hypertensive patients. B) 30 type 2 diabetic overweight or obese patients with acute myocardial infarction. Then, they were subdivided into 2 subgroups: 2Ba) 15 diabetic non hypertensive patients. 2Bb) 15 diabetic hypertensive patients. Group 3: 30 overweight or obese non-diabetic patients with acute myocardial infarction or recent cerebrovascular stroke. Then, they were subdivided into 3a) 15 patients with acute myocardial infarction. 3b) 15 patients with recent cerebrovascular stroke. Group 4: 30 Healthy control with matching age and sex and were subdivided into 2 subgroups: Control a) 15 lean subjects. Control b) 15 overweight or obese subjects. All subjects in this study were subjected to Full medical history taking. Thorough clinical examination (including weight, height, BMI, blood pressure). The following laboratory investigations were done: Fasting blood glucose, Two hour post prandial, HbA1c, Fasting insulin (for HOMA IR), Lipid profile (Total cholesterol-LDL-HDL-Triglycerides), Mean platelet volume and Liver and kidney function test. The following radiological investigation were done: Carotid ultrasonography for estimation of intima-media thickness and abdominal ultrasonography. Results As regards MPV, there was a high statistical significant difference between the studied groups (p-value<0.01), being the highest in group II (mean 11.93 ± 0.37 fl) followed by group III (10.77±1.69 fl), group I (10.67±1.98 fl) and group IV (8.83±0.98 fl). On comparing between every other groups there was a high statistical significant difference between group (I) & (II) being higher in group II, (I) & (IV) being higher in group I, (II) & (III) being higher in group II, (II) & (IV) being higher in group II and (III) & (IV) being higher in group III (P value<0.01). However, there was a non-statistical significant difference between group (I) & (III) regarding the MPV (P value>0.05). On comparing between hypertensive and non-hypertensive patients in each group as regard MPV, there were non-significant statistical difference. Conclusion MPV was higher in type 2 diabetic patients than healthy control. Moreover, MPV was significantly higher in type 2 diabetic patients with macrovascular complications. There was no significant difference between hypertensive and non hypertensive patients as regard MPV. There was no significant difference between obese and lean subjects as regard MPV. There was a positive significant correlation between MPV and markers of glycemic control in T2DM.

Background: Hashimoto's thyroiditis (HT), one of the most common autoimmune thyroid diseases (AITDs), is the major cause of hypothyroidism in the world's iodine-sufficient regions. The Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) causes COVID-19 illness, belong to the family of beta-coronaviruses which rapidly spread leading to COVID-19 pandemic on March 11, 2020. Since follicular thyroid cells express the angiotensin converting enzyme 2 (ACE2), the virus's receptor for cellular entry, they may serve as a direct target for SARS-CoV-2 infection. Objective: The aim of the current work was to evaluate the thyroid function consequences following either (COVID-19) infection or vaccination in group of Hashimoto thyroiditis and normal subjects in relation to their clinical features, biochemical, immunological, and inflammatory markers. Patients and Methods: This study was conducted on 80 subjects attending the COVID Vaccination Center and Emergency Isolation at Ain Shams University Hospital during the period from August to October 2022, 14 males, and 66 females, their age ranged from 18 to 70 years. They were divided according to thyroid Abs into Hashimoto's thyroiditis group and normal group, each of them divided into 2 subgroups (exposed to COVID 19 infection & got COVID 19 vaccine). Results: This study showed significant increase in the level of TSH and decrease in the level of free T3, Free T4 in Hashimoto's patients who exposed to COVID19 infection (P-value <0,01). Significant decrease in the level of TSH and increase in the level of free T3, Free T4 in Hashimoto's subjects' group after their exposure to COVID19 vaccine (AstraZeneca) (P-value <0,01), normal subjects group after exposure to COVID19 infection (P-value .02 and <0,01) and normal subjects group after being exposed to COVID19 vaccine (AstraZeneca) (P-value .02 and .04). Conclusion: COVID19 infection and vaccination against COVID might be followed by an attack of thyroiditis in Hashimoto patients and even in normal persons.

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