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.Comparison of lung aeration loss in open abdominal oncologic surgeries after ventilation with electrical impedance tomography-guided PEEP versus conventional PEEP: a pilot feasibility study
A. R. KARTHIK ; Nishkarsh GUPTA ; Rakesh GARG ; Sachidanand Jee BHARATI ; M. D. RAY ; Vijay HADDA ; Sourabh PAHUJA ; Seema MISHRA ; Sushma BHATNAGAR ; Vinod KUMAR
Korean Journal of Anesthesiology 2024;77(3):353-363
Background:
Existing literature lacks high-quality evidence regarding the ideal intraoperative positive end-expiratory pressure (PEEP) to minimize postoperative pulmonary complications (PPCs). We hypothesized that applying individualized PEEP derived from electrical impedance tomography would reduce the severity of postoperative lung aeration loss, deterioration in oxygenation, and PPC incidence.
Methods:
A pilot feasibility study was conducted on 36 patients who underwent open abdominal oncologic surgery. The patients were randomized to receive individualized PEEP or conventional PEEP at 4 cmH2O. The primary outcome was the impact of individualized PEEP on changes in the modified lung ultrasound score (MLUS) derived from preoperative and postoperative lung ultrasonography. A higher MLUS indicated greater lung aeration loss. The secondary outcomes were the PaO2/FiO2 ratio and PPC incidence.
Results:
A significant increase in the postoperative MLUS (12.0 ± 3.6 vs 7.9 ± 2.1, P < 0.001) and a significant difference between the postoperative and preoperative MLUS values (7.0 ± 3.3 vs 3.0 ± 1.6, P < 0.001) were found in the conventional PEEP group, indicating increased lung aeration loss. In the conventional PEEP group, the intraoperative PaO2/FiO2 ratios were significantly lower but not the postoperative ratios. The PPC incidence was not significantly different between the groups. Post-hoc analysis showed the increase in lung aeration loss and deterioration of intraoperative oxygenation correlated with the deviation from the individualized PEEP.
Conclusions
Individualized PEEP appears to protect against lung aeration loss and intraoperative oxygenation deterioration. The advantage was greater in patients whose individualized PEEP deviated more from the conventional PEEP.
3.A determination of occlusal plane comparing different levels of the tragus to form ala-tragal line or Camper's line: A photographic study.
Sandeep KUMAR ; Sandeep GARG ; Seema GUPTA
The Journal of Advanced Prosthodontics 2013;5(1):9-15
PURPOSE: The purpose of this study was to determine accurately the part of the tragus to be used to form the Ala-Tragal line or Camper's line in orthognathic profile patients. MATERIALS AND METHODS: 150 dentate subjects with age of 18-40 years with orthognathic profile were sampled. Life-size lateral digital photographs of the face with fox plane were taken in natural head position. Different angles between Eye-Ear plane and occlusal plane (OT1-OP), Eye-Ear plane and ala-superior border of tragus (OT1-AT1), Eye-Ear plane and ala-middle border of tragus (OT1-AT2) and Eye-Ear plane and ala-inferior border of tragus (OT1-AT3) were calculated using computer software package, AutoCAD 2004. From the three angles formed by the Eye-ear plane (OT1 or FH plane) and the ala-tragal lines, the one closest to the angle formed between Eye-Ear plane (OT1) and occlusal plane (OP) was used to determine the occlusal plane of orientation. The obtained results were subjected to ANOVA F test, Tukey's Honestly significant difference test, followed by Karl Pearson coefficient of correlation test. P values of less than 0.05 were taken as statistically significant. RESULTS: The mean of base line angle i.e. OT1-OP angle (11.96 +/- 4.36) was found to be close to OT1-AT2 angle (13.67 +/- 1.93) and OT1-AT3 angle (10.31 +/- 2.03), but OT1-OP angle was found to be more closer to OT1-AT3 angle. Comparison of mean angles showed that OT1-OP angle in both males (11.68) and females (12.51) is close to OT1-AT3 angle (males- 11.01, females- 11.95). CONCLUSION: The line joining from ala to the lower border of the tragus was parallel to the occlusal plane in 53.3% of the subjects. There was no influence of the sex on the level of occlusal plane.
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Orientation
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