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: To study various etiologies of traumatic tympanic membrane perforation; evaluate the factors involved in healing of traumatic tympanic membrane perforation; and identify patients with perforations unlikely to benefit from conservative management.
METHODS:
Design: Prospective observational study
Setting: Tertiary Government Medical College and Hospital
Participants: 64 consecutive cases of traumatic tympanic membrane perforation seen over one year were followed for 3 months. Perforations were assessed in terms of size, etiology, condition of edge and other associated factors or combinations of factors with regards to spontaneous healing using descriptive statistics and chi-square tests.
RESULTS: Of the 64 cases, 51 perforations healed while 13 did not. There were significant associations between tympanic membrane condition after 3 months and explosive mode of injury (?2 = 23.30; p=.00001) as well as with size of perforation ((?2 = 25.75; p=.00001). The risk of persistence of a tympanic membrane perforation was 34.57 times more among patients with a perforation size >50% compared to those with perforation size ?50% [OR-34.57 (6.28, 190.14); p= .00001]. Combined, explosive etiology and perforation size >50% were significantly associated with non-healing ((?2 = 37.60; p = .00001). There were no significant associations with the condition of the edge of the perforation and upper respiratory tract infection.
CONCLUSIONS: An explosive etiology and tympanic membrane perforation size >50% may be significant risk factors predicting non-healing of the perforation. Risk stratification of patients having one or both of these risk factors with early intervention for those with both, and close monitoring for those with any one of these may lessen unnecessary morbidity. Bigger multicenter future studies are necessary to confirm these initial findings.

Human ; Male ; Female ; Adult ; Adolescent ; Tympanic Membrane Perforation ; Tympanic Membrane ; Early Intervention (education) ; Conservative Treatment ; Wound Healing ; Morbidity ; Craniocerebral Trauma ; Respiratory Tract Infections