الفهرس 
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Abstract
Sepsis is one of the main causes of death in intensive care units and other hospital ward, the early diagnosis and therapy of sepsis still remain a major challenge, where time plays a crucial role. Endocan is a proteoglycan secreted by vascular endothelium. In contrast to the larger PG molecules of ECM, endocan has essentially distinct biological functions. Both the protein core and GAG of endocan have been implicated in interactions with ECM components, cell surface proteins, intracellular molecules, as well as soluble mediators which in turn regulates cell differentiation, migration, and adhesion. Current research suggests that endocan might have the key role in inflammation, healing, and tumor genesis. This thesis aimed to evaluate endocan as a good marker of endothelial dysfunction and multiorgan failure in sepsis, and if it can be accepted as a good prognostic marker for survival in sepsis. Methods Patients were subjected to the following: PRISM score in first 24 hours of developing sepsis , endocan serum level in first 24 hours of developing sepsis, endocan serum level after 48 hours from first endocan serum level and relating it to developing multiple organ dysfunction , aPTT, PT, CRP and investigation were done to detect the presence of MODS. In the current study, Endocan was found to be useful tool to differentiate between patient with sepsis and patient with MODS, on comparing between level of Endocan among survivors and non survivors, Endocan showed statistically significant increase in non-survivors than survivors. As for validity of Endocan as predictor of severity and mortality, our study reached that Endocan is important predictor of severity as regard sepsis syndrome on the other hand it can be considered as a sensitive predictor of mortality. Second end point in our study is evaluation of PRISM score as predictor of severity of sepsis and mortality, which resulted in being sensitive predictor for MODS and mortality.