1.Hypertriglyceridemia in Type 2 Diabetes Is Associated With T Regulatory Cell Dysfunction
Karthik RAJ ; Seema GARG ; Mohit MEHNDIRATTA ; SV MADHU ; Rajarshi KAR ; Edelbert Anthonio ALMEIDA
Journal of Lipid and Atherosclerosis 2026;15(1):161-172
Objective:
Hypertriglyceridemia (HTG), often but not always coexists with type 2 diabetes mellitus (T2DM). Both independently increase the risk of vascular complications, with inflammation serving as the underlying pathology. T-regulatory (Treg) cells, identified as CD4+CD25+forkheadbox-P3(FoxP3)+ cells, mitigate inflammation through secretion of interleukin(IL) 10. We investigated markers of Treg cell function in patients of T2DM with and without HTG.
Methods:
Patients with T2DM were divided into 2 groups: T2DM with normal triglyceride (TG) levels (n=30), designated as (DNT) and T2DM with HTG (n=30) designated as (DHTg).Expression of the FOXP3 and IL-10 genes were evaluated using quantitative polymerase chain reaction. Serum soluble CD25 (sCD25) levels were measured by enzyme-linked immunosorbent assay.
Results:
FOXP3 and IL-10 expressions were reduced in DHTg group. Serum sCD25 levels were significantly higher in the DHTg group (p=0.04). FOXP3 and IL-10 expressions correlated positively in both groups. FOXP3 and IL-10 expression were reduced in both DHTg-normal body mass index (NW) and DHTg-overweight and obese (OwO) compared with respective DNT subgroups, although difference was smaller among OwO groups.
Conclusion
Reduced expression of FOXP3 and IL-10 indicates compromised Treg function in patients with T2DM and HTG. This impairment may contribute to inflammatory stress, thereby increasing the risk of atherosclerosis. Elevated serum sCD25 levels may represent an additional link between TG and immune imbalance. Obesity also appears to influence Treg function, though its precise role remains uncertain. Aggressive management of HTG in T2DM is warranted. Furthermore, Tregs may represent an attractive therapeutic target for mitigating risk of complications.
2.Metabolomic Profile in Children and Adolescents with Attention Deficit Hyperactivity Disorders
Brijesh Kumar YADAV ; Manendra Singh TOMAR ; Mohit ; Ankit PATERIYA ; Sujita Kumar KAR ; Amit ARYA ; Ashutosh SHRIVASTAVA ; Pawan Kumar GUPTA
Clinical Psychopharmacology and Neuroscience 2026;24(1):151-165
Objective:
Biological processes are the sum of metabolic reactions that result in intermediate and end metabolite products. These processes are the reflection of genetic regulation and are profoundly impacted by environmental influence and changes, including those associated with attention-deficit/hyperactivity disorder (ADHD). This study aimed to assess the untargeted plasma metabolomic profile of children and adolescents with ADHD and to compare them with healthy controls and to study associations of dysregulated metabolic parameters with the clinical and socio-demographic parameters of ADHD.
Methods:
This study involved 42 registered cases of ADHD among children aged 6 to 16 years, diagnosed based on DSM-5 criteria. Each case was matched by age and gender with 24 healthy controls. The severity of ADHD was evaluated using the ADHD Rating Scale, while behavioral issues were assessed through the Child Behavior Checklist. The gas chromatography-mass spectrometry technique was employed to examine changes in plasma metabolite content.
Results:
We identified a total of 45 metabolites in the ADHD subtypes, which exhibited altered levels compared to the control group. The content of these metabolites and associated metabolic pathways showed significant differences between ADHD subjects and controls. Furthermore, we analyzed biomarkers derived from the compounds with the greatest fold changes in accumulation levels.
Conclusion
The identification and analysis of these metabolites and metabolic pathways represent a promising new approach for tracking disease progression in ADHD. The findings of this study indicate that metabolite-based biomarkers may hold considerable potential for effective disease management.
3.Safety and Efficacy of Transcranial Random Noise Stimulation in Psychiatric Disorders: A Systematic Review
Adarsh TRIPATHI ; Pritanshi JESWANI ; Surobhi CHATTERJEE ; Rini JOSEPH ; Sujita Kumar KAR
Clinical Psychopharmacology and Neuroscience 2026;24(1):40-57
Background:
Transcranial random noise stimulation (tRNS) is a non-invasive brain stimulation technique that modulates cortical excitability through stochastic resonance. While promising, its safety and efficacy in psychiatric disorders remain underexplored.
Objective:
To systematically evaluate the efficacy and safety of tRNS in various psychiatric disorders.
Methods:
A systematic review was conducted per PRISMA guidelines and registered on PROSPERO (CRD420251040192).Databases searched included CENTRAL-Cochrane Central Register of Controlled Trials, PubMed, Scopus, and Web of Science. Studies were included from their inception to 30th April, 2025. Studies involving tRNS in psychiatric populations, regardless of study design, were included. The risk of bias was assessed using JBI tools.
Results:
22 studies were included (642 individuals), spanning ADHD, depression, schizophrenia, dyslexia, and other conditions. Most studies used 20-minute tRNS sessions over 1−4 weeks. ADHD and dyslexia showed consistent improvements in overall executive function and reading & phonological skills, respectively. Schizophrenia studies demonstrated significant reductions in negative symptoms and auditory hallucinations. Effects in depression were mixed, with some studies reporting substantial symptom relief, while others found no significant benefit. Across disorders, tRNS was generally well-tolerated with only mild, transient adverse effects.
Conclusion
tRNS appears to be a safe, well-tolerated, and potentially effective intervention for specific psychiatric symptoms, especially in ADHD, dyslexia, and schizophrenia. However, inconsistent protocols and mixed outcomes in mood disorders highlight the need for standardized protocols and further research.
6.Evaluation of the Functional and Radiological Outcomes of Fixed Angle versus Variable Angle Volar Locking Compression Plates in Managing Intra-articular Fractures of Distal End Radius
Garg DK ; Sakale H ; Agrawal AC ; Kar B ; Pandiyarajan E ; Yadav SK
Malaysian Orthopaedic Journal 2025;19(No. 2):9-17
Introduction: Distal end radius fractures are common upper
extremity fractures often requiring surgical intervention for
instability. This study compares the functional and
radiological outcomes of fixed angle versus variable angle
volar locking compression plates in managing these
fractures.
Materials and methods: A prospective randomized study
was conducted at AIIMS, Raipur, from July 2020 to
December 2022. Patients aged 18-60 years with complete
intra-articular distal end radius fractures (AO Type 23C1,
23C2, 23C3) were included. Sixty-four patients were
randomized into two groups: one receiving fixed angle plates
(Group 1) and the other variable angle plates (Group 2).
Functional outcomes were assessed using the Mayo wrist
score, and radiological outcomes were evaluated with the
Sarmiento modification of Lindstrom’s criteria. Statistical
analysis was performed using IBM SPSS 22.0, with p-values
<0.05 considered significant.
Results: At 3 months, the variable angle group had
significantly higher Mayo wrist scores (63.12 ± 11.81)
compared to the fixed angle group (48.75 ± 11.90, p=0.005).
This trend continued at 6 months (75.93 ± 9.16 vs. 64.37 ±
14.59, p=0.025) and 1 year (91.87 ± 7.27 vs. 81.25 ± 16.17,
p=0.044). Radiologically, the variable angle group
demonstrated better volar tilt restoration at all follow-up
points (p<0.001 at 3 months, p=0.001 at 6 months, p=0.004
at 1 year). Complication rates were similar between groups.
Conclusion: Variable angle volar locking compression
plates offer superior functional outcomes and better volar tilt
restoration compared to fixed angle plates for unstable distal
end radius fractures. Both types exhibited similar
complication rates.
7.Longitudinal Association of Changes in Metabolic Syndrome with Cognitive Function: 12-Year Follow-up of the Guangzhou Biobank Cohort Study
Yu Meng TIAN ; Wei Sen ZHANG ; Chao Qiang JIANG ; Feng ZHU ; Ya Li JIN ; Shiu Lun Au YEUNG ; Jiao WANG ; Kar Keung CHENG ; Tai Hing LAM ; Lin XU
Diabetes & Metabolism Journal 2025;49(1):60-79
Background:
The association of changes in metabolic syndrome (MetS) with cognitive function remains unclear. We explored this association using prospective and Mendelian randomization (MR) studies.
Methods:
MetS components including high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), waist circumference (WC), fasting plasma glucose (FPG), and triglycerides were measured at baseline and two follow-ups, constructing a MetS index. Immediate, delayed memory recall, and cognitive function along with its dimensions were assessed by immediate 10- word recall test (IWRT) and delayed 10-word recall test (DWRT), and mini-mental state examination (MMSE), respectively, at baseline and follow-ups. Linear mixed-effect model was used. Additionally, the genome-wide association study (GWAS) of MetS was conducted and one-sample MR was performed to assess the causality between MetS and cognitive function.
Results:
Elevated MetS index was associated with decreasing annual change rates (decrease) in DWRT and MMSE scores, and with decreases in attention, calculation and recall dimensions. HDL-C was positively associated with an increase in DWRT scores, while SBP and FPG were negatively associated. HDL-C showed a positive association, whereas WC was negatively associated with increases in MMSE scores, including attention, calculation and recall dimensions. Interaction analysis indicated that the association of MetS index on cognitive decline was predominantly observed in low family income group. The GWAS of MetS identified some genetic variants. MR results showed a non-significant causality between MetS and decrease in DWRT, IWRT, nor MMSE scores.
Conclusion
Our study indicated a significant association of MetS and its components with declines in memory and cognitive function, especially in delayed memory recall.
8.Longitudinal Association of Changes in Metabolic Syndrome with Cognitive Function: 12-Year Follow-up of the Guangzhou Biobank Cohort Study
Yu Meng TIAN ; Wei Sen ZHANG ; Chao Qiang JIANG ; Feng ZHU ; Ya Li JIN ; Shiu Lun Au YEUNG ; Jiao WANG ; Kar Keung CHENG ; Tai Hing LAM ; Lin XU
Diabetes & Metabolism Journal 2025;49(1):60-79
Background:
The association of changes in metabolic syndrome (MetS) with cognitive function remains unclear. We explored this association using prospective and Mendelian randomization (MR) studies.
Methods:
MetS components including high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), waist circumference (WC), fasting plasma glucose (FPG), and triglycerides were measured at baseline and two follow-ups, constructing a MetS index. Immediate, delayed memory recall, and cognitive function along with its dimensions were assessed by immediate 10- word recall test (IWRT) and delayed 10-word recall test (DWRT), and mini-mental state examination (MMSE), respectively, at baseline and follow-ups. Linear mixed-effect model was used. Additionally, the genome-wide association study (GWAS) of MetS was conducted and one-sample MR was performed to assess the causality between MetS and cognitive function.
Results:
Elevated MetS index was associated with decreasing annual change rates (decrease) in DWRT and MMSE scores, and with decreases in attention, calculation and recall dimensions. HDL-C was positively associated with an increase in DWRT scores, while SBP and FPG were negatively associated. HDL-C showed a positive association, whereas WC was negatively associated with increases in MMSE scores, including attention, calculation and recall dimensions. Interaction analysis indicated that the association of MetS index on cognitive decline was predominantly observed in low family income group. The GWAS of MetS identified some genetic variants. MR results showed a non-significant causality between MetS and decrease in DWRT, IWRT, nor MMSE scores.
Conclusion
Our study indicated a significant association of MetS and its components with declines in memory and cognitive function, especially in delayed memory recall.
9.Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement?Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group
Daniele CASTELLANI ; Bhaskar Kumar SOMANI ; Khi Yung FONG ; Steffi Kar Kei YUEN ; Chin Tiong HENG ; Mohamed ELSHAZLY ; Karl TAN ; Thomas R. W. HERRMANN ; Olivier TRAXER ; Vineet GAUHAR
Investigative and Clinical Urology 2025;66(3):236-244
Purpose:
To evaluate whether using flexible and navigable suction ureteral access sheath can obviate insertion of double J stent and establish the safety of overnight ureteric catheter placement as alternative following flexible ureteroscopy for kidney stones.
Materials and Methods:
Five hundred forty adults were prospectively enrolled across 25 centers (from April 2023 to January 2024). Patients were divided into group 1 (overnight ureteric catheter), and group 2 (double J stent). Surgeons could choose either modality as per their discretion. One-to-one propensity score-matching for age, sex, pre-stenting, Hounsfield units, stone volume and location was performed. Thirty-day computed tomography scan was done to estimate stone-free status.
Results:
After matching, 120 patients were included in each group. Group 1 had significantly shorter lasing, ureteroscopy, surgical time. Median day 1 loin pain score was similar (1 [1, 2] in both groups). Median postoperative stay was shorter in group 1 (0 days [0, 1] vs. 1 day [0, 2], p<0.001). One patient in group 2 required a blood transfusion. Incidence of fever was similar (5.0% vs. 0.8%).Loin/abdominal pain requiring medication occurred in one patient in group 2. Stent-related symptoms occurred in 2 patients in group 1. Three patients (2.5%) in group 1 and 2 patients (1.7%) in group 2 required readmission. Thirty-day stone-free status was higher in group 1 patients (79.2% vs. 56.7%).
Conclusions
In selected patients after thorough inspection to ensure no injury or residual fragments remain, placing an overnight ureteric catheter can be a safe alternative to a double J stent.
10.Longitudinal Association of Changes in Metabolic Syndrome with Cognitive Function: 12-Year Follow-up of the Guangzhou Biobank Cohort Study
Yu Meng TIAN ; Wei Sen ZHANG ; Chao Qiang JIANG ; Feng ZHU ; Ya Li JIN ; Shiu Lun Au YEUNG ; Jiao WANG ; Kar Keung CHENG ; Tai Hing LAM ; Lin XU
Diabetes & Metabolism Journal 2025;49(1):60-79
Background:
The association of changes in metabolic syndrome (MetS) with cognitive function remains unclear. We explored this association using prospective and Mendelian randomization (MR) studies.
Methods:
MetS components including high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), waist circumference (WC), fasting plasma glucose (FPG), and triglycerides were measured at baseline and two follow-ups, constructing a MetS index. Immediate, delayed memory recall, and cognitive function along with its dimensions were assessed by immediate 10- word recall test (IWRT) and delayed 10-word recall test (DWRT), and mini-mental state examination (MMSE), respectively, at baseline and follow-ups. Linear mixed-effect model was used. Additionally, the genome-wide association study (GWAS) of MetS was conducted and one-sample MR was performed to assess the causality between MetS and cognitive function.
Results:
Elevated MetS index was associated with decreasing annual change rates (decrease) in DWRT and MMSE scores, and with decreases in attention, calculation and recall dimensions. HDL-C was positively associated with an increase in DWRT scores, while SBP and FPG were negatively associated. HDL-C showed a positive association, whereas WC was negatively associated with increases in MMSE scores, including attention, calculation and recall dimensions. Interaction analysis indicated that the association of MetS index on cognitive decline was predominantly observed in low family income group. The GWAS of MetS identified some genetic variants. MR results showed a non-significant causality between MetS and decrease in DWRT, IWRT, nor MMSE scores.
Conclusion
Our study indicated a significant association of MetS and its components with declines in memory and cognitive function, especially in delayed memory recall.


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