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.

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.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

PURPOSE: Hoffa fracture is a femoral condyle fracture in the coronal plane. The lateral condyle is more commonly involved. The diagnosis is often difficult to detect with routine radiographs. Conservative management in this type of fracture resulted in nonunion, malunion, and other complications, such as stiff knee. Therefore, surgical management is mandatory in displaced fractures. Previous studies suggest only application of cancellous screw fixation, but these are not enough to counter vertical shear stress. Therefore, this study will evaluate the clinical outcomes of open reduction and internal fixation of Letenneur type I Hoffa fracture using cancellous screws with posterior buttressing plate. METHOD: This was a prospective cohort study conducted from March 2017 to July 2022 in orthopaedics department of tertiary care center after approval of institutional ethical committee. The study included 36 patients with Letenneur type I fractures treated by open reduction and internal fixation using posterior buttress plate and cancellous screws. Radiographs and clinical outcomes, range of movement (ROM), bone union, and knee society score (KSS) of patients were assessed at the end of 4 and 12 months in the follow-ups. All statistical analysis was done using Epi info version 7.2.1.0. RESULTS: In the 36 patients with Letenneur type I fracture, the majority belong to younger age group between 25 and 54 years with 22 males and 14 females. The modes of injury were road traffic accidents in 25 patients and fall from height in 11 patients. The right knee was involved in 21 cases and left was involved in 15 cases. Lateral condyle involvement was seen in 27 cases and medial condyle in 9 cases. All 36 patients with Letenneur type I Hoffa fracture were evaluated 4 months after surgical intervention. The notable improvements were observed in terms of ROM 120.4° ± 5.0° and KSS 85.0 ± 4.2. At the 12-month follow-up, considerably better outcomes were maintained regarding ROM 128.1° ± 5.2° and KSS 89.3 ± 4.8 with p < 0.05 which was statistically significant. At the final follow-up, all patients had routine fracture healing with a union time of (3.2 ± 3.4) months. CONCLUSIONS Fixation of Letenneur type I Hoffa fracture with cancellous screws and posterior buttress plate is effective, reliable and capable of providing adequate stability. Buttress plate assisted fixation is a valuable enhancement of the conventional technique of lag screw fixation of Hoffa fractures.
Humans ; Bone Plates ; Male ; Female ; Fracture Fixation, Internal/instrumentation* ; Adult ; Prospective Studies ; Middle Aged ; Femoral Fractures/surgery* ; Bone Screws ; Range of Motion, Articular ; Young Adult ; Aged ; Hoffa Fracture

PURPOSE: Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury. METHOD: A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries. Hemodynamically unstable patients or those on ventilators were excluded, as well as patients who suffered significant head, spinal cord, and/or bladder injuries. The study predominantly included males (83.9%) with a mean age of 32.5 years. IAP was monitored continuously and the relation of IAP with various parameters, interventions, and outcomes were measured. Data were summarized as frequency (percentage) or mean ± SD or median (Q₁, Q₃) as indicated. χ² or Fisher's exact test was used for categorical variables, while for continuous variables parametric (independent t-test) or nonparametric tests (Wilcoxon rank sum test) were used as appropriate. Clinical and laboratory correlates of IAP < 12 with p < 0.200 in the univariable logistic regression analysis were included in the multivariable analysis. A p < 0.05 was used to indicate statistical significance. RESULTS: Intra-abdominal hypertension (IAH) was seen in 19.0% of the study population. IAH was strongly associated with a high injury severity score (p < 0.001), and other physiological parameters like respiratory rate (p < 0.001), change in abdominal girth (AG) (p < 0.001), and serum creatinine (p < 0.001). IAH along with the number of solid organs involved, respiratory rate, change in AG, and serum creatinine was associated with the intervention, either operative or non-operative (p = 0.001, p = 0.002, p < 0.001, p < 0.001, p = 0.013, respectively). On multivariable analysis, IAP (p = 0.006) and the mean change of AG (p = 0.004) were significantly associated with the need for intervention. CONCLUSION As a part of NOM, IAP should be monitored as a continuous vital. However, the decision for any intervention, either operative or non-operative cannot be guided by IAP values alone.
Humans ; Male ; Adult ; Female ; Wounds, Nonpenetrating/physiopathology* ; Spleen/injuries* ; Prospective Studies ; Cross-Sectional Studies ; Liver/injuries* ; Middle Aged ; Monitoring, Physiologic/methods* ; Pressure ; Abdominal Injuries/physiopathology* ; Intra-Abdominal Hypertension ; Young Adult